Πέμπτη, 22 Φεβρουαρίου 2018

The glucose-lowering effects of exogenous ketones: is there therapeutic potential?

Abstract

The ketone bodies acetoacetate, β-hydroxybutyrate (βHB) and acetone are small, lipid-derived molecules that are generated during ketogenesis, a process that is amplified during fasting, starvation, ketogenic diets, and prolonged glycogen-depleting exercise.

This article is protected by copyright. All rights reserved



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Systematic Complex Haploinsufficiency-Based Genetic Analysis of Candida albicans Transcription Factors: Tools and Applications to Virulence-Associated Phenotypes

Genetic interaction analysis is a powerful approach to the study of complex biological processes that are dependent on multiple genes. Because of the largely diploid nature of the human fungal pathogen Candida albicans, genetic interaction analysis has been limited to a small number of large-scale screens and a handful for gene-by-gene studies. Complex haploinsufficiency, which occurs when a strain containing two heterozygous mutations at distinct loci shows a phenotype that is distinct from either of the corresponding single heterozygous mutants, is an expedient approach to genetic interactions analysis in diploid organisms. Here, we describe the construction of a barcoded-library of 133 heterozygous TF deletion mutants and deletion cassettes for designed to facilitate complex haploinsufficiency-based genetic interaction studies of the TF networks in C. albicans. We have characterized the phenotypes of these heterozygous mutants under a broad range of in vitro conditions using both agar-plate and pooled signature tag-based assays. Consistent with previous studies, haploinsufficiency is relative uncommon. In contrast, a set of 12 TFs enriched in mutants with a role in adhesion were found to have altered competitive fitness at early time points in a murine model of disseminated candidiasis. Finally, we characterized the genetic interactions of a set of biofilm related TFs in the first two steps of biofilm formation, adherence and filamentation of adherent cells. The genetic interaction networks at each stage of biofilm formation are significantly different indicating that the network is not static but dynamic.



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Photosensitive Alternative Splicing of the Circadian Clock Gene timeless Is Population Specific in a Cold-Adapted Fly, Drosophila montana

To function properly, organisms must adjust their physiology, behavior and metabolism in response to a suite of varying environmental conditions. One of the central regulators of these changes is organisms' internal circadian clock, and recent evidence has suggested that the clock genes are also important in the regulation of seasonal adjustments. In particular, thermosensitive splicing of the core clock gene timeless in a cosmopolitan fly, Drosophila melanogaster, has implicated this gene to be involved in thermal adaptation. To further investigate this link we examined the splicing of timeless in a northern malt fly species, Drosophila montana, which can withstand much colder climatic conditions than its southern relative. We studied northern and southern populations from two different continents (North America and Europe) to find out whether and how the splicing of this gene varies in response to different temperatures and day lengths. Interestingly, we found that the expression of timeless splice variants was sensitive to differences in light conditions, and while the flies of all study populations showed a change in the usage of splice variants in constant light compared to LD 22:2, the direction of the shift varied between populations. Overall, our findings suggest that the splicing of timeless in northern Drosophila montana flies is photosensitive, rather than thermosensitive and highlights the value of studying multiple species and populations in order to gain perspective on the generality of gene function changes in different kinds of environmental conditions.



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A Genome-Wide Association Study for Host Resistance to Ostreid Herpesvirus in Pacific Oysters (Crassostrea gigas)

Ostreid herpesvirus (OsHV) can cause mass mortality events in Pacific oyster aquaculture. While various factors impact on the severity of outbreaks, it is clear that genetic resistance of the host is an important determinant of mortality levels. This raises the possibility of selective breeding strategies to improve the genetic resistance of farmed oyster stocks, thereby contributing to disease control. Traditional selective breeding can be augmented by use of genetic markers, either via marker-assisted or genomic selection. The aim of the current study was to investigate the genetic architecture of resistance to OsHV in Pacific oyster, to identify genomic regions containing putative resistance genes, and to inform the use of genomics to enhance efforts to breed for resistance. To achieve this, a population of ~1,000 juvenile oysters were experimentally challenged with a virulent form of OsHV, with samples taken from mortalities and survivors for genotyping and qPCR measurement of viral load. The samples were genotyped using a recently-developed SNP array, and the genotype data were used to reconstruct the pedigree. Using these pedigree and genotype data, the first high density linkage map was constructed for Pacific oyster, containing 20,353 SNPs mapped to the ten pairs of chromosomes. Genetic parameters for resistance to OsHV were estimated, indicating a significant but low heritability for the binary trait of survival and also for viral load measures (h2 0.12 - 0.25). A genome-wide association study highlighted a region of linkage group 6 containing a significant QTL affecting host resistance. These results are an important step towards identification of genes underlying resistance to OsHV in oyster, and a step towards applying genomic data to enhance selective breeding for disease resistance in oyster aquaculture.



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Progression of corticospinal tract dysfunction in pre-ataxic spinocerebellar ataxia type 2: a two-years follow-up TMS study

Spinocerebellar ataxia type 2 (SCA2) is a severe and progressive autosomal dominant cerebellar ataxia caused by a dynamic mutation in the ATXN2 gene, consisting of an abnormal expansion of cytosine-adenine-guanine (CAG) triplets in the first codon of the gene, and leading to expression of long polyglutamine (PolyQ) stretches in the ataxin-2 protein (Auburger, 2012; Pulst et al., 1996). This protein seems to have global effects on mRNA metabolism, as well as on endocytosis, calcium signaling and control of metabolism and energy balance.

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Value of ictal and interictal epileptiform discharges and high frequency oscillations for delineating the epileptogenic zone in patients with focal cortical dysplasia

Focal Cortical Dysplasia (FCD) is one of the most common etiology of medically intractable seizures in adults (Kabat and Król, 2012). Patients with this type of lesion often have drug-resistant epilepsy and become candidate for a surgical treatment. The area responsible to generate seizure, or the Epileptogenic Zone (EZ), however may be difficult to define, even in patients with identifiable lesions on MRI. Non-congruent semiology, scalp EEG and imaging findings often indicate poor localization of the EZ, and invasive EEG studies may help to define the EZ in patients with FCDs (Chassoux et al., 2000).

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Introduction to the TSJ special issue on interdisciplinary spine

"The Lion was so tickled at the idea of the Mouse being able to help him, that he lifted up his paw and let him go." ~ Aesop

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Orientation and property of fibers of the myodural bridge in human

Studies over the last 20 years have revealed that there are fibrous connective tissues between the suboccipital muscles, nuchal ligament and cervical spinal dura mater(SDM). This fibrous connection with the SDM is through the posterior atlanto-occipital and/or atlanto-axial interspaces and is called the Myodural Bridge(MDB). Researches have inferred that the MDB might have important functions. It was speculated that the function of MDB might be related to proprioception transmission, keeping the subarachnoid space and the cerebellomedullary cistern unobstructed, and affecting the dynamic circulation of the cerebrospinal fluid (CSF).

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Factors that Influence Parental Misperception of Their Child’s Actual Weight Status in South Carolina

Abstract

Objectives Studies suggest that parents tend to misperceive their child's actual weight status and typically underestimate their child's weight. Since few studies examine the factors that influence parental misperception, this study aims to assess the influence of parent and child factors with parental misperception of their child's actual weight status who were either at their recommended weight or overweight/obese in South Carolina in 2013 and 2014. Methods Secondary data were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) and the Children's Health Assessment Survey (CHAS) in 2013 and 2014 in SC. Parental misperception of child's actual weight status was measured by comparing parental perception to their child's actual weightstatus measured via BMI. Logistic regression was conducted to assess the association between parental and child factors with parental misperception of child's weight status. Results In the adjusted multivariate analysis, only child's age was significantly and positively associated with parental misperception of their child's actual weight status. Conclusions for Practice This cross sectional analysis showed an association between child's age and parental misperception of child's actual weight status. It is essential to educate parents about their children's weight status, especially among young children.



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Safety, Tolerability, and Effectiveness of Dextromethorphan/Quinidine for Pseudobulbar Affect Among Study Participants With Traumatic Brain Injury: Results From the PRISM-II Open Label Study

Dextromethorphan 20mg /quinidine 10mg (DM/Q) was approved to treat pseudobulbar affect (PBA) based upon phase 3 trials conducted in participants with amyotrophic lateral sclerosis or multiple sclerosis. PRISM II evaluated DM/Q effectiveness, safety and tolerability for PBA following stroke, dementia or traumatic brain injury (TBI). Objective. To report results from the TBI cohort of PRISM II, including a TBI-specific functional scale. Design. Open-label trial evaluating twice daily DM/Q over 90 days.

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Effect of Rear Wheel Suspension on Tilt-in-Space Wheelchair Shock and Vibration Attenuation

Suspension systems are designed to reduce shock and vibration exposure. An aftermarket rear-wheel suspension system is now available for manual tilt-in-space wheelchairs.

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Editorial Board

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Publication date: March 2018
Source:Journal of Human Evolution, Volume 116





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Craniomandibular form and body size variation of first generation mouse hybrids: A model for hominin hybridization

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Publication date: March 2018
Source:Journal of Human Evolution, Volume 116
Author(s): Kerryn A. Warren, Terrence B. Ritzman, Robyn A. Humphreys, Christopher J. Percival, Benedikt Hallgrímsson, Rebecca Rogers Ackermann
Hybridization occurs in a number of mammalian lineages, including among primate taxa. Analyses of ancient genomes have shown that hybridization between our lineage and other archaic hominins in Eurasia occurred numerous times in the past. However, we still have limited empirical data on what a hybrid skeleton looks like, or how to spot patterns of hybridization among fossils for which there are no genetic data. Here we use experimental mouse models to supplement previous studies of primates. We characterize size and shape variation in the cranium and mandible of three wild-derived inbred mouse strains and their first generation (F1) hybrids. The three parent taxa in our analysis represent lineages that diverged over approximately the same period as the human/Neanderthal/Denisovan lineages and their hybrids are variably successful in the wild. Comparisons of body size, as quantified by long bone measurements, are also presented to determine whether the identified phenotypic effects of hybridization are localized to the cranium or represent overall body size changes. The results indicate that hybrid cranial and mandibular sizes, as well as limb length, exceed that of the parent taxa in all cases. All three F1 hybrid crosses display similar patterns of size and form variation. These results are generally consistent with earlier studies on primates and other mammals, suggesting that the effects of hybridization may be similar across very different scenarios of hybridization, including different levels of hybrid fitness. This paper serves to supplement previous studies aimed at identifying F1 hybrids in the fossil record and to introduce further research that will explore hybrid morphologies using mice as a proxy for better understanding hybridization in the hominin fossil record.



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Editorial Board

Publication date: February 2018
Source:Journal of Human Evolution, Volume 115





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Best Core Stabilization for Anticipatory Postural Adjustment and Falls in Hemiparetic Stroke

Publication date: Available online 21 February 2018
Source:Archives of Physical Medicine and Rehabilitation
Author(s): Nam G. Lee, H. You Joshua Sung, Chung H. Yi, Hye S. Jeon, Bong S. Choi, Dong R. Lee, Jae M. Park, Tae H. Lee, In T. Ryu, Hyun S. Yoon
ObjectivesTo compare the effects of conventional core stabilization (CCS) and dynamic neuromuscular stabilization (DNS) on anticipatory postural adjustment (APA) time, balance performance, and fear of falls in chronic hemiparetic stroke.DesignTwo-group randomized controlled trial with pretest-posttest designSettingHospital's rehabilitation center.ParticipantsTwenty-eight adults with chronic hemiparetic strokeInterventionParticipants were randomly divided into either CCS (n=14) or DNS (n=14) groups. Both groups received a total of 20 sessions of CCS or DNS training for 30 minutes per session 5 times a week during the 4-week period.Main Outcome MeasuresElectromyography was used to measure the APA time for bilateral external oblique (EO), transverse abdominis/internal oblique (TrA/IO), and erector spinae (ES) activation during rapid shoulder flexion. Trunk Impairment Scale (TIS), Berg Balance Scale (BBS), and Falls Efficacy Scale (FES) were used to measure trunk movement control, balance performance, and fear of falling.ResultsBaseline APA times were delayed and fear of falling was moderately high in both the CCS and DNS groups. After the interventions, the APA times for EO, TrA/IO, and ES were shorter in the DNS group than in the CCS group (P<0.008). The BBS and TIS scores (P<0.008) as well as FES score (P<0.003) were improved compared to baseline in both groups, but FES remained stable through the two-year follow-up period only in the DNS group (P<0.003).ConclusionsThis is the first clinical evidence highlighting the importance of core stabilization exercises for improving APA control, balance, and fear of falls in individuals with hemiparetic stroke.



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Exploring the switching of the focus of attention within working memory: A combined event-related potential and behavioral study

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Publication date: Available online 21 February 2018
Source:International Journal of Psychophysiology
Author(s): Marius Frenken, Stefan Berti
Working memory enables humans to maintain selected information for cognitive processes and ensures instant access to the memorized contents. Theories suggest that switching the focus of attention between items within working memory realizes the access. This is reflected in object-switching costs in response times when the item for the task processing is to be changed. Another correlate of attentional allocation in working memory is the P3a-component of the human event-related potential. The aim of this study was to demonstrate that switching of attention within working memory is a separable processing step. Participants completed a cued memory-updating task in which they were instructed to update one memory item at a time out of a memory list of four digits by applying a mathematical operation indicated by a target sign. The hypotheses predicted (1) prolonged updating times in switch (different item compared to previous trial) versus repetition trials (same item), (2) an influence of cues (valid/neutral) presented before the mathematical target on switching costs, and (3) that the P3a-component is more pronounced in the cue-target interval in the valid cue condition and more pronounced in the post-target interval in the neutral cue condition. A student's t-test verified the first hypothesis, repeated-measurement analyses of variance demonstrated that hypotheses 2 and 3 should be rejected. Results suggest that switching of attention within working memory could not be separated from further processing steps and retro-cue benefits are not due to a head start of retrieval as well as that switch costs represent internal processes.



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Effect of exercise intensity on circulating microparticles in men and women

Abstract

Circulating microparticles (MPs) are biological vectors of information within the cardiovascular system, eliciting both deleterious and beneficial effects on the vasculature. Acute exercise has been shown to alter MP concentrations, likely through a shear stress-dependent mechanism, however evidence is limited. Therefore, we investigated the effect of exercise intensity on plasma levels of CD34+ and CD62E+ MPs in young, healthy men and women. Blood samples were collected before, during, and after two energy-matched bouts of acute treadmill exercise: interval exercise (10 × 1-minute intervals at ∼95% VO2max) and continuous exercise (65% VO2max). Continuous exercise, but not interval, reduced CD62E+ MP concentrations in men and women by 18% immediately after exercise (from 914.5 ± 589.6 MPs μL−1 to 754.4 ± 390.5 MPs μL−1, P < 0.05), suggesting that mechanisms underlying exercise-induced CD62E+ MP dynamics are intensity dependent. Furthermore, continuous exercise reduced CD62E+ MPs in women by 19% (from 1030.6 ± 688.1 MPs μL−1 to 829.9 ± 435.4 MPs μL−1, P < 0.05), but not men. While interval exercise did not alter CD62E+ MPs per se, the concentrations after interval exercise were higher than that observed after continuous exercise (p < 0.05). Conversely, CD34+ MPs did not fluctuate in response to short-duration acute continuous or interval exercise in men or women. Our results suggest that exercise-induced MP alterations are intensity dependent, sex-specific, and differentially impact MP populations.

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Blood transfusion management in the severely bleeding military patient

Purpose of review Hemorrhage remains the primary cause of preventable death on the battlefield and in civilian trauma. Hemorrhage control is multifactorial and starts with point-of-injury care. Surgical hemorrhage control and time from injury to surgery is paramount; however, interventions in the prehospital environment and perioperative period affect outcomes. The purpose of this review is to understand concepts and strategies for successful management of the bleeding military patient. Understanding the life-threatening nature of coagulopathy of trauma and implementing strategies aimed at full spectrum hemorrhage management from point of injury to postoperative care will result in improved outcomes in patients with life-threatening bleeding. Recent findings Timely and appropriate therapies impact survival. Blood product resuscitation for life-threatening hemorrhage should either be with whole blood or a component therapy strategy that recapitulates the functionality of whole blood. The US military has transfused over 10 000 units of whole blood since the beginning of the wars in Iraq and Afghanistan. The well recognized therapeutic benefits of whole blood have pushed this therapy far forward into prehospital care in both US and international military forces. Multiple hemostatic adjuncts are available that are likely beneficial to the bleeding military patient; and other products and techniques are under active investigation. Summary Lessons learned in the treatment of combat casualties will likely continue to have positive impact and influence and the management of hemorrhage in the civilian trauma setting. Correspondence to Philip C. Spinella, MD, FCCM, Director, Pediatric Critical Care Translational Research Program, Professor, Department of Pediatrics, Washington University in St Louis School of Medicine, Campus Box 8116, One Children's Place, Northwest Tower 10th Floor, St Louis, MO 63110, USA. Tel: +1 314 286 0858; fax: +1 210 8963462; e-mail: spinella_p@kids.wustl.edu Copyright © 2018 YEAR Wolters Kluwer Health, Inc. All rights reserved.

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The Effects of Leukocyte Filtration on Cell Salvaged Autologous Blood Transfusion on Lung Function and Lung Inflammatory and Oxidative Stress Reactions in Elderly Patients Undergoing Lumbar Spinal Surgery

Background: This study was designed to investigate the effects of leukocyte filtration of autologous salvaged blood on lung function, lung inflammatory reaction, and oxidative stress reaction in elderly patients undergoing lumbar spinal surgery. Materials and Methods: Sixty elderly patients undergoing lumbar spinal surgery were randomly divided into 2 groups: Leukocyte Filter group and Control group. Serum levels of inflammatory markers including white blood cell and polymorphonuclear count, neutrophil elastase, serum surfactant protein A, methane dicarboxylic aldehyde, superoxide dismutase, interleukin (IL)-6, IL-8, tumor necrosis factor-α, and respiratory function markers including dynamic respiratory system compliance, oxygenation index, and respiratory index were measured immediately before induction of anesthesia (T0), immediately before blood transfusion (T1), and 1 (T2), 6 (T3), and 12 hours (T4) after end of blood transfusion. Results: The Leukocyte Filter group had higher dynamic respiratory system compliance at T2, oxygenation index at T2 and T3, respiratory index and superoxide dismutase at T2, T3, and T4 than those in the Control group (P

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Protecting the Brain With Xenon Anesthesia for Neurosurgical Procedures

Xenon possesses some, but not all, of the clinical features of an ideal anesthetic agent. Besides well-known advantages of rapid awakening, stable hemodynamics and lack of biotransformation, preclinical data lead to the expectation of xenon's advantageous use for settings of acute ongoing brain injury; a single randomized clinical trial using an imaging biomarker for assessing brain injury corroborated xenon's preclinical efficacy in protecting the brain from further injury. In this review, we discuss the mechanisms and hence the putative applications of xenon for brain protection in neurosurgery. Although the expense of this rare monoatomic gas will likely prevent its widespread penetration into routine clinical neurosurgical practice, we draw attention to the theoretical benefits of xenon anesthesia over other anesthetic regimens for awake craniotomy and for neurosurgery in older, high-risk, and sicker patients. M.M. is a cofounder and Board Member of NeuroproteXeon, a spinout company formed by Imperial College, London on the basis of patents that were filed when he was employed at that institution. NeuroproteXeon's mission is to develop xenon for clinical use to prevent acute ongoing neurological injury. M.M. has an equity stake in NeuroproteXeon through (i) founder status, (ii) exercised stock options, and (iii) personal investment. M.M is neither an employee of NeuroproteXeon nor does he have an executive role in the company. A.R. declares no funding or conflict of interest to disclose. Address correspondence to: Mervyn Maze, MB, ChB, Department of Anesthesia and Perioperative Care University of California San Francisco, 1001 Potrero Avenue, P.O. Box 1363, San Francisco, CA 94143 (e-mail: mervyn.maze@ucsf.edu). Received June 2, 2017 Accepted December 31, 2017 Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved

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Acid–base balance during muscular exercise: response to Dr. Böning and Dr. Maassen



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Continuing Professional Development in Maternal Health Care: Barriers to Applying New Knowledge and Skills in the Hospitals of Rwanda

Abstract

Objectives Training healthcare professionals in emergency maternal healthcare is a critical component of improving overall maternal health in developing countries like Rwanda. This paper explored the challenges that healthcare professionals who participated in a Continuing Professional Development (CPD) program on Advanced Life Support in Obstetrics® (ALSO) face in putting the learned knowledge and skills into practice in hospitals of Rwanda. Methods This study used a mixed methods approach to understand the challenges/barriers to applying new knowledge and skills in the hospitals of Rwanda. We conducted thirteen purposive in-depth interviews with ALSO® trainees (nurses, midwives and physicians) complemented with a cross-sectional survey on staff turnover in eight of the nine hospitals in the Eastern province of Rwanda. Results Our study found that trainees do not get enough opportunity to apply the new knowledge and skills in their hospitals and expand to health centers. In part because they are frequently rotating to different departments of the hospital and are not getting the opportunity to train their colleagues to share the learned knowledge and skills. The lack of refresher trainings/mentorship and the high personnel turnover were also reported as a barrier to applying new knowledge and skills. Reasons for staff turnover included pursuing further studies, a better opportunity (job/remuneration), low morale, and family related motives including joining a spouse or better schools for children. Conclusions for Practice Expanding and formalizing CPD training to all the healthcare professionals involved in providing maternal care services would improve the provision of emergency maternal healthcare in Rwanda.



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Structural and Socio-cultural Barriers to Prenatal Care in a US Marshallese Community

Abstract

Objectives Pacific Islanders are disproportionately burdened by poorer perinatal health outcomes with higher rates of pre-term births, low birth weight babies, infant mortality, and inadequate or no prenatal care. The aim of this study is to examine Marshallese mothers' beliefs, perceptions, and experiences of prenatal care and to identify potential barriers. Methods Three focus groups were conducted with Marshallese mothers, who were 18 years or older, and living in Arkansas. Focus groups focused on mothers' beliefs, perceptions, and experiences of prenatal care. A thematic qualitative analysis was conducted to identify salient themes within the data. Results The results demonstrated that negotiating health insurance, transportation, and language barriers were all major structural barriers that constrain prenatal care. The social–cultural barriers that emerged included a lack of understanding of the importance of seeking early and consistent prenatal care, as well as how to navigate the healthcare process. The more complicated challenges that emerged were the feelings of shame and embarrassment due to the perception of their age or being unmarried during pregnancy not being acceptable in American culture. Furthermore, the participants described perceived discrimination from prenatal care providers. Lastly, the participants described fear as a barrier to seeking out prenatal care. Conclusions for Practice This study identified both structural and socio-cultural barriers that can be incorporated into suggestions for policy makers to aid in alleviating maternal health disparities among Pacific Islander women. Further research is needed to address the Marshallese mothers' perceived discrimination from maternal health care providers.



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Molecular and clinical studies in eight patients with Temple syndrome

Temple syndrome (TS14, #616222) is a rare imprinting disorder characterised by phenotypic features including pre- and postnatal growth retardation, muscular hypotonia and feeding difficulties in infancy, early puberty and short stature with small hands and feet and often truncal obesity. It is caused by maternal uniparental disomies, paternal deletions and primary imprinting defects that affect the chromosomal region 14q32 and lead to a disturbed expression of imprinted genes in this region.

Here we present detailed clinical data of eight patients with Temple syndrome, four with an imprinting defect, two with an imprinting defect in a mosaic state as well as one complete and one segmental maternal uniparental disomy of chromosome 14.

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Temple syndrome is a rare imprinting disorder caused by genetic and epigenetic disturbances of the imprinted region on chromosome 14q32. Detailed clinical description of eight patients with Temple syndrome due to different molecular causes (imprinting defects, mosaic imprint defects, maternal uniparental disomy of chromosome 14) and first description of a segmental maternal uniparental disomy of chromosome14q32 causing Temple syndrome.



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