Experiences of maternity care in New South Wales among women with mental health conditions.

BACKGROUND: High quality maternity care is increasingly understood to represent a continuum of care. As well as ensuring a positive experience for mothers and families, integrated maternity care is responsive to mental health needs of mothers. The aim of this paper is to summarize differences in women's experiences of maternity care between women with and without a self-reported mental health condition. METHODS: Secondary analyses of a randomized, stratified sample patient experience survey of 4787 women who gave birth in a New South Wales public hospital in 2017. We focused on 64 measures of experiences of antenatal care, hospital care during and following birth and follow up at home. Experiences covered eight dimensions: overall impressions, emotional support, respect for preferences, information, involvement, physical comfort and continuity. Multivariable logistic regression was used to compare experiences of women with and without a self-reported longstanding mental health condition. RESULTS: Compared to women without a condition, women with a longstanding mental health condition (n = 353) reported significantly less positive experiences by eight percentage points on average, with significant differences on 41 out of 64 measures after adjusting for age, education, language, parity, type of birth and region. Disparities were pronounced for key measures of emotional support (discussion of worries and fears, trust in providers), physical comfort (assistance, pain management) and overall impressions of care. Most women with mental health conditions (75% or more) reported positive experiences for measures related to guidelines for maternity care for women with mental illness (discussion of emotional health, healthy behaviours, weight gain). Their experiences were not significantly different from those of women with no reported conditions. CONCLUSIONS: Women with a mental health condition had significantly less positive experiences of maternity care across all stages of care compared to women with no condition. However, for some measures, including those related to guidelines for maternity care for women with mental illness, there were highly positive ratings and no significant differences between groups. This suggests disparities in experiences of care for women with mental health conditions are not inevitable. More can be done to improve experiences of maternity care for women with mental health conditions.

Highly selective hydrolysis of kinins by recombinant prolylcarboxypeptidase.

We have previously cloned a cDNA encoding human prolylcarboxypeptidase (PRCP) and expressed the cDNA in the Schneider 2 (S2) drosophila cell line. Here, we further characterized this recombinant enzyme. Investigations were performed to determine whether recombinant PRCP (rPRCP) metabolizes kinins (BK 1-9 and BK 1-8). The metabolites of these kinins were identified by LC/MS. rPRCP metabolized BK 1-8 to BK 1-7, whereas rPRCP was ineffective in metabolizing BK 1-9. The hydrolysis of BK 1-8 by rPRCP was dose- and time-dependent. A homology model of PRCP was developed based upon the sequence of dipeptidyl-peptidase 7 (DPP7, PDB ID: 3JYH), and providentially, the structure of PRCP (PDB ID: 3N2Z) was characterized during the course of our investigation. Docking studies of bradykinin oligopeptides were performed both from the homology model, and from the crystal structure of PRCP. These docking studies may provide a better understanding of the contribution of specific residues involved in substrate selectivity of human PRCP.

LacI mutation spectra following benzo[a]pyrene treatment of Big Blue mice.

The mutation spectrum of the lacI gene from the liver of C57Bl6 Big Blue transgenic mice treated with benzo[a]pyrene (B[a]P) has been compared with the spectrum of spontaneous mutations observed in the liver of untreated Big Blue mice. Mice were treated with B[a]P for 3 days followed by a partial hepatectomy one day after the last injection. Liver tissue was removed for analysis at hepatectomy and, again, 3 days later at the time of sacrifice. Earlier, we reported that the lacI mutant frequency in these B[a]P-treated mice was elevated in the liver both at the time of hepatectomy and at sacrifice; however, a statistically significant increase in the mutant frequency was observed only at sacrifice. In this study, the DNA sequence spectra of lacI mutations observed in the liver of B[a]P-treated Big Blue mice at hepatectomy and at time of sacrifice were compared with each other and with the spectrum of spontaneous liver mutations. No differences were observed between the two B[a]P-treatment spectra. However, mutation frequencies of both GC-->TA and GC-->CG at the time of hepatectomy and at sacrifice were significantly elevated compared with the spontaneous frequency of these same transversions. Also, the frequency of AT-->TA transversions was significantly higher than the spontaneous frequency at the time of hepatectomy but not at sacrifice. The frequency of all other classes of mutations scored was not significantly different from the frequency of these same events in the spontaneous spectra. These data support the view that B[a]P treatment results in the induction of GC-->TA and GC-->CG transversions within 1 day of the last injection and they provide insights regarding the relative roles of benzo[a]pyrene-7,8-diol-9, 10-epoxide and radical cations of B[a]P in B[a]P-induced mutagenesis in vivo. Finally, these data provide evidence for B[a]P-induced mutagenesis under conditions where no statistical increase in mutant frequency could be shown.

Characterization of new transgenic Big Blue(R) mouse and rat primary fibroblast cell strains for use in molecular toxicology studies.

We have established and characterized primary mouse and rat cell strains for studies designed to complement in vivo gene mutation assays using the Big Blue(R) mouse or rat. Primary fibroblast cell strains, designated BBM1 and BBR1, were derived from a transgenic male Big Blue(R) B6C3F1 mouse and from a male Big Blue(R) Fischer-344 rat, respectively. Both BBM1 and BBR1 are genetically stable and mostly diploid. Both cell strains have low spontaneous frequencies of mutation at the lacI and cII loci as well as low frequencies of sister chromatid exchange and micronuclei formation. In addition, N-ethyl-N-nitrosourea (ENU) induces mutations at the cII locus in both BBM1 and BBR1 cells. These new primary Big Blue(R) mouse (BBM1) and rat (BBR1) fibroblast cell strains represent useful new models for molecular toxicology studies. Environ. Mol. Mutagen. 34:90-96, 1999 Published 1999 Wiley-Liss, Inc.

Regulation of the sol locus genes for butanol and acetone formation in Clostridium acetobutylicum ATCC 824 by a putative transcriptional repressor.

A gene (orf1, now designated solR) previously identified upstream of the aldehyde/alcohol dehydrogenase gene aad (R. V. Nair, G. N. Bennett, and E. T. Papoutsakis, J. Bacteriol. 176:871-885, 1994) was found to encode a repressor of the sol locus (aad, ctfA, ctfB and adc) genes for butanol and acetone formation in Clostridium acetobutylicum ATCC 824. Primer extension analysis identified a transcriptional start site 35 bp upstream of the solR start codon. Amino acid comparisons of SolR identified a potential helix-turn-helix DNA-binding motif in the C-terminal half towards the center of the protein, suggesting a regulatory role. Overexpression of SolR in strain ATCC 824(pCO1) resulted in a solvent-negative phenotype owing to its deleterious effect on the transcription of the sol locus genes. Inactivation of solR in C. acetobutylicum via homologous recombination yielded mutants B and H (ATCC 824 solR::pO1X) which exhibited deregulated solvent production characterized by increased flux towards butanol and acetone formation, earlier induction of aad, lower overall acid production, markedly improved yields of solvents on glucose, a prolonged solvent production phase, and increased biomass accumulation compared to those of the wild-type strain.

Spontaneous and ENU-induced mutation spectra at the cII locus in Big Blue Rat2 embryonic fibroblasts.

Big Blue Rat2 embryonic fibroblasts carry the lambda-Liz shuttle vector which is also present in the Big Blue mouse and rat. Mutations in the Big Blue systems have most often been measured at the lacI locus. However, a method for positive selection of mutations at the lambda cII locus was recently described. This assay appears to have many advantages over the use of lacI as a mutational target, but it has yet to be well characterized in mammalian mutagenesis studies. The objective of these studies was to determine the spontaneous and ethylnitrosourea (ENU)-induced mutant frequencies (MFs) and mutational spectra at cII using Big Blue Rat2 embryonic fibroblasts. The average spontaneous MF was 13 +/- 1.4 x 10(-5). The average induced MF was 60 +/- 10 x 10(-5) 10 days following a 30 min treatment with 0.1 mg/ml ENU. Eighty four independent spontaneous mutants were sequenced: 23 (27.4%) were frameshift mutations and 61 (72.6%) were base substitutions. Two spontaneous frameshift hotspots were detected, both in mononucleotide runs. G:C-->A:T transitions were the most common type of base substitution in cII; of these 71% occurred at CpG sites. The ENU-induced mutational spectrum at cII (44 mutants) consisted of 42 base substitutions (95.5%) and two -1 frameshift mutations (4.5%). Compared with the spontaneous spectrum, the ENU-induced spectrum had significantly fewer frameshift mutations (4.5 versus 27%) and base substitutions occurred predominantly at A:T base pairs (71 versus 34%). Overall, the spontaneous cII mutational spectrum reported here differs slightly from spontaneous spectra reported at the Big Blue lacI locus, but the mutational spectra and base substitution MFs following treatment with ENU were comparable at both loci. These data support the continued use of cII as a selectable marker in mutagenesis studies involving cells or tissues that carry a lambda transgene.

Induction of hepatic CYP1A in channel catfish increases binding of 2-aminoanthracene to DNA in vitro and in vivo.

Data are presented from in vitro and in vivo studies that indicate cytochrome P4501A (CYP1A) in channel catfish (Ictalurus punctatus) hepatic tissue activates 2-amino-anthracene (AA) to a reactive metabolite that binds to DNA. Channel catfish were injected i.p. with vehicle or 10 mg/kg beta-naphthoflavone (betaNF) on two consecutive days. Two days after the final injection of vehicle or betaNF, vehicle or [3H]AA was injected i.p. at 10 mg/kg, creating four different treatments: vehicle only, betaNF only, [3H]AA only, and betaNF/[3H]AA. Hepatic tissue was examined for CYP1A-associated ethoxyresorufin-O-de-ethylase (EROD) activity, and for DNA adducts at 1, 2, 4 and 7 days following administration of vehicle or [3H]AA. Hepatic EROD activity in betaNF-treated fish was 17-fold higher at day 0 and remained significantly greater than untreated animals for the 7-day experiment. Hepatic DNA adducts, as measured by tritium-associated DNA, ranged from 4.8 to 8.6 pmol/mg DNA in vehicle-pretreated fish injected with [3H]AA, but ranged from 12.6 to 22.7 pmol/mg DNA in betaNF-pretreated fish injected with [3H]AA. Thus, pretreatment with betaNF significantly increased binding of [3H]AA to hepatic DNA in vivo at all four times. Analysis by 32P-post-labeling and thin layer chromatography of hepatic DNA from channel catfish treated with AA revealed two major and several minor spots, which are indicative of DNA adduct formation. Hepatic microsomes from betaNF-pretreated fish were more effective at catalysing the binding of [3H]AA to DNA in vitro than were microsomes from non-treated fish. In addition, binding was decreased by the CYP1A inhibitor 3,3',4,4'-tetrachlorobiphenyl. Collectively, these data demonstrate that CYP1A is involved in the activation of AA in channel catfish.

Cloning, sequence, and expression of the phosphofructokinase gene of Clostridium acetobutylicum ATCC 824 in Escherichia coli.

The pfk gene encoding phosphofructokinase (Pfk) from the anaerobic bacterium Clostridium acetobutylicum ATCC 824 was cloned and sequenced. The gene was identified in a plasmid library by complementation of an E. coli pfk mutant and by the ability to amplify a fragment by PCR using primers based on homologous regions of Pfk from other microorganisms. Nucleotide sequence analysis revealed a coding region for a 319-aa protein homologous to Pfks from other organisms. Enzyme assay and ability to complement the growth defects of E. coli pfk mutants confirmed the expression of the clostridial pfk gene. The pyruvate kinase (pyk) gene was identified adjacent to pfk. Such an arrangement for the genes encoding key regulators of glycolytic flux had not yet been described in a strict anaerobe. This gene arrangement has been found in other Gram-positive organisms, but not in Gram-negative organisms.

Cloning and assembly of PCR products using modified primers and DNA repair enzymes.

We present a method for the creation of ligatable 3' overhangs by the incorporation of a modified base, uracil, at a specific position in the PCR primer and subsequent treatment with the DNA-modifying enzyme uracil DNA glycosylase and then either T4 endonuclease V or human apurinic/apyrimidinic endonuclease 1. In this study, we describe the cloning of a fragment specifying the chloramphenicol-resistance gene into a SacI vector site. To further test this method, three segments of the lacZ gene were amplified by PCR, and after treatment with the DNA-modifying enzymes, the properly oriented segments were ligated into a SacI-cleaved plasmid. Using the methods described, we were able to assemble PCR products into appropriate structures.

Aminoanthracene is a mechanism-based inactivator of CYP1A in channel catfish hepatic tissue.

In beta NF-induced channel catfish, hepatic ethoxyresorufin-O-deethylase (EROD) activity decreased 66.5% 24 hr after injection of 2-aminoanthracene (AA, 10 mg/kg) compared with non-AA-injected animals (p < 0.05). This difference in hepatic EROD activity was also significant 48 hr after treatment (p < 0.05), but no significant difference was observed after 4 or 7 days. Immunoblot analysis of hepatic microsomal protein from fish 24 hr after treatment with AA revealed two bands cross-reacting with CYP1A-specific monoclonal antibody 1-12-3: an apparently native CYP1A protein (52 kDa) and a 30-kDa protein. Furthermore, these two proteins were preferentially bound by [3H]AA compared with other microsomal proteins. Interestingly, the 30-kDa protein was observed only in fish exposed to AA and was immunoprecipitable with 1-12-3. In a separate in vivo experiment, hepatic EROD activity decreased and the 30-kDa protein increased with increased dose of AA. The 30-kDa protein is thought to be a CYP1A degradation product. In vitro experiments helped elucidate the mechanisms of interaction between AA and CYP1A. Incubation of microsomes with AA, prior to analysis of these microsomes for EROD activity, resulted in a NADPH- and time-dependent inhibition of EROD activity. Additionally, the P450 inhibitors 1-phenylimidazole and 3,3',4,4'-tetrachlorobiphenyl were used to decrease the binding of AA to CYP1A, suggesting that the binding of AA to CYP1A requires the enzymatic activity of CYP1A. It is proposed that mechanism-based inactivation of CYP1A by AA accounts for the observed AA-dependent decrease in hepatic EROD activity in vitro and in vivo in channel catfish.

Mandibular refracture as treatment method for jaw alignment. Case report.

A case of malocclusion of the lower jaw following trauma and healing which was subsequently corrected by mandibular refracture is described.

Condylar replacement with a metatarsal bone implant. Case report.

A case is reported where a metatarsal bone has been used to replace a mandibular condyle which was surgically removed because of a cystic condition in the meniscus.

Thermochemical remanent magnetization and thermal remanent magnetization: comparison in a basalt.

Recent studies have shown that the remanent magnetization carried by an extrusive igneous rock may not be entirely thermal remanent magnetization (TRM). Some may be thermochemical remanent magnetization (TCRM) acquired by the rock at temperatures at least as low as 300 degrees C during oxidation of the contained titanomagnetite grains. Results from a study of a set of basaltic samples from one locality indicate that the intensity of TCRM acquired by a sample in a known magnetic field is equal to that of TRM subsequently produced in the same sample in the same field. On the assumption that the samples we studied are not magnetically unique, we tentatively conclude that paleointensity studies are valid in spite of the presence of TCRM, as long as the rock acquired the magnetization during the initial cooling.

Potamotrygon spp.: elasmobranchs with low urea content.

All previously reported species of Chondrichthyes, from both marine and fresh water, have contained urea at concentrations ranging from about 300 to 1300 milligrams of urea nitrogen per 100 milliliters of fluid. Body fluids from two species of Potamotrygon, permanent residents of the Amazon basin, contained only 2 to 3 milligrams of urea nitrogen per 100 milliliters. Although they have abandoned the retention of urea exhibited by other chondrichthyans, the extent to which they have lost the mechanisms of retaining and tolerating urea in a hypertonic medium has not been determined.