Midwives Safeguarding Abortion Access: Establishing Medication Abortion Services.

The abortion access landscape for patients has changed dramatically in the wake of the US Supreme Court Dobbs v. Jackson Women's Health Organization decision in June of 2022. In response, the Division of Midwifery at Baystate Medical Center in Springfield, Massachusetts, began a medication abortion service for both established patients and those who may seek care from out of state. This service increases access to abortion care now while also providing the clinical experience needed for student nurse-midwives to become future abortion providers. This article outlines the steps taken to implement a medication abortion service and ways it can be adopted by other midwifery practices. Strategies to address possible clinical, administrative, and logistical challenges are addressed. Finally, this article is a call to action because midwives are well qualified to provide high quality, safe, and comprehensive medication abortion within the midwifery model of care.

An fMRI study of loneliness in younger and older adults.

Loneliness, the subjective experience of social isolation, may reflect, in part, underlying neural processing of social signals. Aging may exacerbate loneliness due to decreased social networks and increased social isolation, or it may reduce loneliness due to preferential attentional processing of positive information and increased interactions with emotionally close partners. Here, we conducted a functional magnetic resonance imaging (fMRI) study of loneliness in younger (N = 50, 26 female, Mage = 20.4) and older (N = 49, 30 female, Mage = 62.9) adults. Compared to younger adults, older adults were less lonely and dwelled longer on faces, regardless of valence. Previous studies in younger adults found that loneliness was negatively correlated with ventral striatal (VS) activation to pleasant social pictures of strangers yet positively correlated with VS activation to faces of close others. In the present study, we observed no association between loneliness and VS activation to social pictures of strangers in either age group. Further, unlike previous studies, we observed no association between social network size and amygdala activation to social stimuli. Additional research is needed to examine the effect of loneliness and social network size on neural processing of different dimensions of social stimuli.

Norepinephrine-mediated emotional arousal facilitates subsequent pattern separation.

Pattern separation, the process by which similar experiences can be stored as distinct memories, has been ascribed to the dentate gyrus (DG) of the hippocampus. The DG is the target of noradrenergic modulation directly and indirectly via the basolateral amygdala. We tested the hypothesis that noradrenergic activation (tested using salivary alpha-amylase) potentiates DG function, enhancing pattern separation, by showing participants fearful stimuli in a pre-training task and then testing their capacity for pattern separation in a later test. Consistent with our hypothesis, we found that increased levels of salivary alpha-amylase were positively correlated with enhanced pattern separation performance even after accounting for general enhancements in recognition.

Characteristics of stem cells from human neuroblastoma cell lines and in tumors.

Cellular heterogeneity is a hallmark of human neuroblastoma tumors and cell lines. Within a single neuroblastoma are cells from distinct neural crest lineages whose relative abundance is significant for prognosis. We postulate that a self-renewing multipotent tumor stem cell, which gives rise to diverse cell lineages, is the malignant progenitor of this cancer. To test this hypothesis, we have established 22 cloned, phenotypically homogeneous populations of the three major cell types from 17 neuroblastoma cell lines. In vitro, malignant neuroblastoma stem cells, termed I-type (intermediate type), have distinct morphologic, biochemical, differentiative, and tumorigenic properties. I-type cells express features of both neuroblastic (N) cells (scant cytoplasm, neuritic processes, neurofilaments, pseudoganglia, and granin and neurotransmitter enzyme expression) and substrate-adherent (S) cells (extensive cytoplasm and vimentin and CD44 expression). Moreover, they show bidirectional differentiation to either N or S cells when induced by specific agents. I-type cells are significantly more malignant than N- or S-type cells, with four- to five-fold greater plating efficiencies in soft agar and six-fold higher tumorigenicity in athymic mice. Differences in malignant potential are unrelated to N-myc amplification/overexpression or the ability to digest and migrate through the extracellular matrix. Immunocytochemical analyses of a small series of tumors reveal that frequency of cells coexpressing N and S cell markers correlates with poor prognosis. Thus, I-type stem cells may be instrumental in the genesis and growth of tumors in the patient. Their unique biology deserves attention and further investigation.