PeerJ Preprints: Gynecology and Obstetricshttps://peerj.com/preprints/index.atom?journal=peerj&subject=4900Gynecology and Obstetrics articles published in PeerJ PreprintsBone morphogenetic protein 15 induces differentiation of mesenchymal stem cell derived from human follicular fluid to oocyte like cellhttps://peerj.com/preprints/280062019-10-072019-10-07Mahin Taheri MoghadamAli Reza Eftekhari MoghadamGhasem SakiRoshan Nikbakht
Background. To study the effect of Bone morphogenetic protein 15 on differentiation potential of mesenchymal stem cell derived from human follicular fluid to oocyte like cell. Methods. Human FF derived cells were collected from 78 women in assisted fertilization program, and cultured in differentiation medium containing human recombinant BMP15 for 21 days. Mesenchymal stem cells and OLCs were characterized by real-time PCR and immunocytochemistry (ICC) staining. Results. MSCs expressed germ line stem cell markers, such as OCT4 and NANOG. After 15 days, OLCs formed and expressed zona pellucida markers (ZP2, ZP3), and reached 20 – 30 µm in diameters. Ten days after induction with BMP15, round cells remarkably developed, and the maximum size of OLCs reached 115 µm. Finally, a decrease ranging from 0.04 to 4.5 in the expression of pluripotency and oocyte specific markers was observed in the cells cultured in BMP15 supplemented medium. Our work demonstrates, FF derived MSCs have an innate potency to differentiate into OLCs, and BMP15 is effective in stimulating the differentiation of these cells, which may give an in vitro model to examine human germ cell development.
Background. To study the effect of Bone morphogenetic protein 15 on differentiation potential of mesenchymal stem cell derived from human follicular fluid to oocyte like cell. Methods. Human FF derived cells were collected from 78 women in assisted fertilization program, and cultured in differentiation medium containing human recombinant BMP15 for 21 days. Mesenchymal stem cells and OLCs were characterized by real-time PCR and immunocytochemistry (ICC) staining. Results. MSCs expressed germ line stem cell markers, such as OCT4 and NANOG. After 15 days, OLCs formed and expressed zona pellucida markers (ZP2, ZP3), and reached 20 – 30 µm in diameters. Ten days after induction with BMP15, round cells remarkably developed, and the maximum size of OLCs reached 115 µm. Finally, a decrease ranging from 0.04 to 4.5 in the expression of pluripotency and oocyte specific markers was observed in the cells cultured in BMP15 supplemented medium. Our work demonstrates, FF derived MSCs have an innate potency to differentiate into OLCs, and BMP15 is effective in stimulating the differentiation of these cells, which may give an in vitro model to examine human germ cell development.Synthesis, characterization, and biological evaluation of new spebrutinib analogues: potential candidates with enhanced activity and reduced toxicity profileshttps://peerj.com/preprints/277552019-05-242019-05-24Zaid M Jaber Al-ObaidiOmar F Abdul-RasheedMonther F MahdiAyad M R Raauf
Background: Cancer is regarded as an undoubtable major concern for both researchers and the general public because of its high mortality rates. While breast cancer has the highest incidence of malignancy globally, colon cancer also has high morbidity and mortality rates. Currently, researchers are working on designing, synthesizing, and biologically investigating the effects of some potential anticancer candidates.
Methods: The authors successfully synthesized and characterized two potential spebrutinib analogues. These analogues were evaluated with the employment of MCF-7, HCT116, and MDCK cell lines.
Results: With respect to the spebrutinib standard, one of these analogues had superior activity against the MCF-7 cell line (IC50; 10.744 µg/mL against 13.566 µg/mL for spebrutinib) and an enhanced toxicity profile on the MDCK cell line (IC50; 8.653 mg/mL against 4.011 mg/mL for spebrutinib).
Background: Cancer is regarded as an undoubtable major concern for both researchers and the general public because of its high mortality rates. While breast cancer has the highest incidence of malignancy globally, colon cancer also has high morbidity and mortality rates. Currently, researchers are working on designing, synthesizing, and biologically investigating the effects of some potential anticancer candidates.Methods: The authors successfully synthesized and characterized two potential spebrutinib analogues. These analogues were evaluated with the employment of MCF-7, HCT116, and MDCK cell lines.Results: With respect to the spebrutinib standard, one of these analogues had superior activity against the MCF-7 cell line (IC50; 10.744 µg/mL against 13.566 µg/mL for spebrutinib) and an enhanced toxicity profile on the MDCK cell line (IC50; 8.653 mg/mL against 4.011 mg/mL for spebrutinib).Evolutionary-rooted models for denial of pregnancy, concealment of pregnancy and pseudocyesishttps://peerj.com/preprints/269792018-06-062018-06-06Patrick SandozJens Wessel
Women in denial of pregnancy remain unaware of their gravid state. Typically women in labor present to emergency units while attributing their pain to unrelated causes. In higher risk cases, women experience unassisted delivery in a non-hospital setting. In concealment of pregnancy, the woman knows about her pregnancy but keeps it secret for diverse reasons. This induces also a lack of prenatal care and increased perinatal risks for mother and child. Such cases are very challenging to clinicians because of increased medical risk and psychological needs. Better understanding of these psychosomatic disorders is necessary to address the public-health issues raised.
In regard to denial and concealment of pregnancy, in which a pregnant woman thinks or says she is not pregnant, pseudocyesis corresponds to the opposite configuration in which a non-pregnant woman believes, claims and presents objective signs to be pregnant. Pseudocyesis takes therefore place in the same psychosomatic issue to be addressed. This paper aims to explain satisfactorily these psychosomatic disorders of gravida status.
We consider human reproduction in regard to evolution with emphasis on the various forms of parenting existing among sexually reproducing species. This evolutionary study highlights that for some pregnant women, the forthcoming maternal status may be internally appraised as psychologically-unacceptable because of diverse personalized causes. The ongoing pregnancy enters then into conflict with the intense fears triggered by the promise of motherhood. From this perspective, denial and concealment of pregnancy are satisfactorily explained as transitory means to cope with such an internal conflict by pursuing pregnancy while containing associated fears. In the absence of conflict resolution, the avoidance means is protracted over time, sometimes until an unexpected delivery.
Conversely, pseudocyesis is explained as an attempt to obtain a psychologically-indispensable maternal status in the absence of actual pregnancy. Specific conflict formulations are elucidated for each type of psychosomatic disorder of gravida status considered. These formulations, related to subjective internal appraisals, comply with the huge diversity of causative events reported in literature and specific to each woman concerned.
These explanations will help clinicians in caring those high-demanding patients and in exploring individualized causative events of such challenging experiences.
Women in denial of pregnancy remain unaware of their gravid state. Typically women in labor present to emergency units while attributing their pain to unrelated causes. In higher risk cases, women experience unassisted delivery in a non-hospital setting. In concealment of pregnancy, the woman knows about her pregnancy but keeps it secret for diverse reasons. This induces also a lack of prenatal care and increased perinatal risks for mother and child. Such cases are very challenging to clinicians because of increased medical risk and psychological needs. Better understanding of these psychosomatic disorders is necessary to address the public-health issues raised.In regard to denial and concealment of pregnancy, in which a pregnant woman thinks or says she is not pregnant, pseudocyesis corresponds to the opposite configuration in which a non-pregnant woman believes, claims and presents objective signs to be pregnant. Pseudocyesis takes therefore place in the same psychosomatic issue to be addressed. This paper aims to explain satisfactorily these psychosomatic disorders of gravida status.We consider human reproduction in regard to evolution with emphasis on the various forms of parenting existing among sexually reproducing species. This evolutionary study highlights that for some pregnant women, the forthcoming maternal status may be internally appraised as psychologically-unacceptable because of diverse personalized causes. The ongoing pregnancy enters then into conflict with the intense fears triggered by the promise of motherhood. From this perspective, denial and concealment of pregnancy are satisfactorily explained as transitory means to cope with such an internal conflict by pursuing pregnancy while containing associated fears. In the absence of conflict resolution, the avoidance means is protracted over time, sometimes until an unexpected delivery.Conversely, pseudocyesis is explained as an attempt to obtain a psychologically-indispensable maternal status in the absence of actual pregnancy. Specific conflict formulations are elucidated for each type of psychosomatic disorder of gravida status considered. These formulations, related to subjective internal appraisals, comply with the huge diversity of causative events reported in literature and specific to each woman concerned.These explanations will help clinicians in caring those high-demanding patients and in exploring individualized causative events of such challenging experiences.Robotic Olympics: A novel robotic surgical training experience for residents in an obstetrics and gynecology residency programhttps://peerj.com/preprints/35102018-01-072018-01-07Malte RenzEric LibermanBrian DanielsSara IsaniDennis Y KuoNicole Nevadunsky
Background: Resident experience and opinions regarding robotic surgical training as part of the formal obstetrics and gynecology curriculum has not been reported.
Objective: To evaluate residents’ experience with the newly introduced Robotic Olympics and a robotic surgical trainings curriculum in general, especially in correlation with future career goals.
Methods: All residents of the Obstetrics and Gynecology Residency Program at the Montefiore Medical Center, who participated in the Robotic Olympics 2014, a team-based simulation competition, completed a de-identified pre- and post-Olympics survey.
Results: For the participating 31 residents, the mean number of bedside-assistant robotic and console cases was 8 (0-50) and 4 (0-30), respectively. Both were positively associated with postgraduate level. The majority of residents (89%) reported that they were best trained in open surgery. Only 52% anticipated using robotic surgery in their future practice. Anticipated use of the robot and interest in robotic training were correlated with surgical subspecialty career goals. 100% of residents aspiring a career in gynecologic oncology and none interested in maternofetal medicine anticipated future use of robotic surgery. However, all residents desired the Robotic Olympics to be integral part of resident education.
Conclusions: The majority of residents welcomed the addition of the Robotic Olympics to the robotic-surgical curriculum. However, the residents’ interest in robotic surgical training in general was disparate and correlated with the anticipated use of the robot in the residents’ future career. This data suggests the need for directed robotic surgical training for residents interested in surgical sub-specialties to focus resources early on.
Background: Resident experience and opinions regarding robotic surgical training as part of the formal obstetrics and gynecology curriculum has not been reported.Objective: To evaluate residents’ experience with the newly introduced Robotic Olympics and a robotic surgical trainings curriculum in general, especially in correlation with future career goals.Methods: All residents of the Obstetrics and Gynecology Residency Program at the Montefiore Medical Center, who participated in the Robotic Olympics 2014, a team-based simulation competition, completed a de-identified pre- and post-Olympics survey.Results: For the participating 31 residents, the mean number of bedside-assistant robotic and console cases was 8 (0-50) and 4 (0-30), respectively. Both were positively associated with postgraduate level. The majority of residents (89%) reported that they were best trained in open surgery. Only 52% anticipated using robotic surgery in their future practice. Anticipated use of the robot and interest in robotic training were correlated with surgical subspecialty career goals. 100% of residents aspiring a career in gynecologic oncology and none interested in maternofetal medicine anticipated future use of robotic surgery. However, all residents desired the Robotic Olympics to be integral part of resident education.Conclusions: The majority of residents welcomed the addition of the Robotic Olympics to the robotic-surgical curriculum. However, the residents’ interest in robotic surgical training in general was disparate and correlated with the anticipated use of the robot in the residents’ future career. This data suggests the need for directed robotic surgical training for residents interested in surgical sub-specialties to focus resources early on.What are the possible determinants of urinary incontinence during pregnancy? Results of a pilot studyhttps://peerj.com/preprints/18982016-03-252016-03-25Nejat DemircanÜlkü ÖzmenFürüzan KöktürkHamdi KüçükŞevket AtaMüge Harmaİnan İlker Arıkan
Objectives: This study was conducted to determine the frequency, predisposing factors and impact of urinary incontinence (UI)during pregnancyon quality of life (QOL). Materials and Method: A preliminary cross-sectional survey was carried out among pregnant women from January to June of 2014. A total of 132 pregnant women were enrolled. We used a questionnaire form for sociodemographic features, ICIQ-SF-Turkish version to determine the occurrence and characteristics of UI and Wagner’s Quality of Life scale to assess impact on QOL. Results: Urinary incontinence was present in 56 out of 132 pregnant women (42.4%); these women were referred to as the UI-present group. The remaining 76 women comprised the UI-absent group. The overall mean age was 27.5 ± 5.1 y (p=0.780), median height in UI-present group was 160 cm (min-max: 153-176, p=0.037 <0.05) and median BMI was 28.7 kg/m2(min-max: 22.4-50.0, p=0.881).For women in the UI-present group, urine leakage occurred once a week (n=18, 32.1%) to twice or thrice a week (n=8, 14.3%), few times a day (n=14, 25%), once a day (n=5, 8.9%) and always (n=8, 14.3%). The pregnant women in the UI-present group mainly reported a small amount of urine leakage (n=33, 58.9%) or a moderate amount of leakage (n=4, 7.1%). There were statistically significant relationships between QOL scores and frequency of UI (p=0.002 <0.05) as well as the amount of leakage (p=0.002 <0.05). Impact on QOL scores ranged from mild (n=33, 58.9%) or moderate (n=4, 7.1%) to severe (n=4, 7.1%) levels. QOL has ‘mildly deteriorated’. The following features were found to favour the onset of UI: age of pregnant woman (OR= 0.845, 95% CI 0.268-2.669), occupational status (OR=1.800, 95% CI 0.850-3.810), anaemia (OR=0.939, 95% CI 0.464-1.901), parity (OR=0.519, 95% CI 0.325-0.829), miscarriage in previous pregnancies (OR=1.219, 95% CI 0.588-2.825) and living in rural vs urban settlement (OR=1.800, 95% CI 0.887-3.653).Heigt (p= 0,037<0.05), educational status (p=0.016 <0.05), miscarriage, parity and place of living (p=0.002, p=0.006, p=0.020 <0.05 respectively)were significant in favour of UI-present. Conclusions: Urinary incontinence was frequently encountered among pregnant women (42.1%). Urinary incontinence distorted the QOL in pregnant women at a mild level and caused life style changes. Frequency and amount of UI were the significant factors in deterioration. Age, parity, miscarriage, being housewife, place of living (rural) and anaemia were the factors in favour of onset of UI during pregnancy. Among them, height, educational status (primary-intermediate school graduate), place of living (rural), miscarriage and parity were statistically significant predictors. It is necessary to pay attention to UI and its impact on women’s health during pregnancy.
Objectives: This study was conducted to determine the frequency, predisposing factors and impact of urinary incontinence (UI)during pregnancyon quality of life (QOL). Materials and Method: A preliminary cross-sectional survey was carried out among pregnant women from January to June of 2014. A total of 132 pregnant women were enrolled. We used a questionnaire form for sociodemographic features, ICIQ-SF-Turkish version to determine the occurrence and characteristics of UI and Wagner’s Quality of Life scale to assess impact on QOL. Results: Urinary incontinence was present in 56 out of 132 pregnant women (42.4%); these women were referred to as the UI-present group. The remaining 76 women comprised the UI-absent group. The overall mean age was 27.5 ± 5.1 y (p=0.780), median height in UI-present group was 160 cm (min-max: 153-176, p=0.037 <0.05) and median BMI was 28.7 kg/m2(min-max: 22.4-50.0, p=0.881).For women in the UI-present group, urine leakage occurred once a week (n=18, 32.1%) to twice or thrice a week (n=8, 14.3%), few times a day (n=14, 25%), once a day (n=5, 8.9%) and always (n=8, 14.3%). The pregnant women in the UI-present group mainly reported a small amount of urine leakage (n=33, 58.9%) or a moderate amount of leakage (n=4, 7.1%). There were statistically significant relationships between QOL scores and frequency of UI (p=0.002 <0.05) as well as the amount of leakage (p=0.002 <0.05). Impact on QOL scores ranged from mild (n=33, 58.9%) or moderate (n=4, 7.1%) to severe (n=4, 7.1%) levels. QOL has ‘mildly deteriorated’. The following features were found to favour the onset of UI: age of pregnant woman (OR= 0.845, 95% CI 0.268-2.669), occupational status (OR=1.800, 95% CI 0.850-3.810), anaemia (OR=0.939, 95% CI 0.464-1.901), parity (OR=0.519, 95% CI 0.325-0.829), miscarriage in previous pregnancies (OR=1.219, 95% CI 0.588-2.825) and living in rural vs urban settlement (OR=1.800, 95% CI 0.887-3.653).Heigt (p= 0,037<0.05), educational status (p=0.016 <0.05), miscarriage, parity and place of living (p=0.002, p=0.006, p=0.020 <0.05 respectively)were significant in favour of UI-present. Conclusions: Urinary incontinence was frequently encountered among pregnant women (42.1%). Urinary incontinence distorted the QOL in pregnant women at a mild level and caused life style changes. Frequency and amount of UI were the significant factors in deterioration. Age, parity, miscarriage, being housewife, place of living (rural) and anaemia were the factors in favour of onset of UI during pregnancy. Among them, height, educational status (primary-intermediate school graduate), place of living (rural), miscarriage and parity were statistically significant predictors. It is necessary to pay attention to UI and its impact on women’s health during pregnancy.Behavior of biomarkers during pregnancy and lactation through a biological multi-paradigm model. BECOME study protocolhttps://peerj.com/preprints/18782016-03-202016-03-20María José Aguilar-CorderoLaura Baena-GarcíaRaquel Rodríguez-BlanqueJuan Carlos Sánchez-GarcíaManuel Isidoro Capel-TuñónAntonio Manuel Sánchez-López
Background Despite of advances in research, at the moment, various points related to the physiology of gestation and the etiology of severe diseases that can be developed in the course of it remain unknown. One of those aspects is the behavior of biomarkers (triglycerides, prolactin, glucose and cholesterol) during pregnancy, which experience a gradual increase in their levels until they reach the peak of hypertriglyceridemia, a few days before delivery. Several studies have reported that biomarkers experience a higher elevation in diabetic and obese pregnant women and in those women who suffer preeclampsia. The description of their behavior in different population of pregnant women (healthy women and women at risk) would identify the relation of these with some of the alterations that occurs more frequently during pregnancy. Objective The aim of this study is to develop a multi-paradigm biological model of systems to determine triglyceride, prolactin, glucose and cholesterol levels during pregnancy and its relation with lactogenesis in healthy and risk pregnant women. Methods A prospective cohort study will take place with women during pregnancy and lactation. Participating women will be divided into two groups. One group will be integrated by healthy women and the other group by pregnant women with a risk medical history. The personal, family and a detailed medical history will be collected in each group. A study of all the variables which influence the level of the mentioned biomarkers (triglycerides, cholesterol, glucose and prolactin) will be done. The universe consists in 4,300 women, who constitute the historical average deliveries during the semester in the city of Granada (Spain). The sample collection will be made in medical office’s pregnancy control in Granada’s hospitals, in their respective health centers and during the second half of 2015. The sample will be stratified and probabilistic. Peculiarities of pregnant women will be taken into account when calculating the size of the study sample. This sample will be made up of 224 women who comply with the inclusion criteria and that have signed the informed consent. To achieve the project objectives an organization comprising six theoretical and practical phases enabling the scientific development of the project. During the first phase, the technical and administrative preparation of the project is constructed. Thereafter, the work is divided into two action areas which encompass the collection and data modeling. The creation of a biological multi-paradigm computer simulation model of the levels of biomarkers in different months of pregnancy and in the various pathologies of pregnant women can be very effective to know the risks that involve high levels of lipids for the mother and for the baby.
Background Despite of advances in research, at the moment, various points related to the physiology of gestation and the etiology of severe diseases that can be developed in the course of it remain unknown. One of those aspects is the behavior of biomarkers (triglycerides, prolactin, glucose and cholesterol) during pregnancy, which experience a gradual increase in their levels until they reach the peak of hypertriglyceridemia, a few days before delivery. Several studies have reported that biomarkers experience a higher elevation in diabetic and obese pregnant women and in those women who suffer preeclampsia. The description of their behavior in different population of pregnant women (healthy women and women at risk) would identify the relation of these with some of the alterations that occurs more frequently during pregnancy. Objective The aim of this study is to develop a multi-paradigm biological model of systems to determine triglyceride, prolactin, glucose and cholesterol levels during pregnancy and its relation with lactogenesis in healthy and risk pregnant women. Methods A prospective cohort study will take place with women during pregnancy and lactation. Participating women will be divided into two groups. One group will be integrated by healthy women and the other group by pregnant women with a risk medical history. The personal, family and a detailed medical history will be collected in each group. A study of all the variables which influence the level of the mentioned biomarkers (triglycerides, cholesterol, glucose and prolactin) will be done. The universe consists in 4,300 women, who constitute the historical average deliveries during the semester in the city of Granada (Spain). The sample collection will be made in medical office’s pregnancy control in Granada’s hospitals, in their respective health centers and during the second half of 2015. The sample will be stratified and probabilistic. Peculiarities of pregnant women will be taken into account when calculating the size of the study sample. This sample will be made up of 224 women who comply with the inclusion criteria and that have signed the informed consent. To achieve the project objectives an organization comprising six theoretical and practical phases enabling the scientific development of the project. During the first phase, the technical and administrative preparation of the project is constructed. Thereafter, the work is divided into two action areas which encompass the collection and data modeling. The creation of a biological multi-paradigm computer simulation model of the levels of biomarkers in different months of pregnancy and in the various pathologies of pregnant women can be very effective to know the risks that involve high levels of lipids for the mother and for the baby.To transmit genes without becoming mother: An evolutionary conflict behind denial of pregnancyhttps://peerj.com/preprints/18532016-03-122016-03-12Patrick Sandoz
Aim: The etiology of pregnancy denial remains poorly understood. Neither necessary nor sufficient conditions can be synthesized from the risk factors identified from psychological analyses. In accordance with clinical observations, we aim to explain denial of pregnancy from an evolutionary conflict perspective.
Methods: Authors investigate evolutionary biology aspects and emphasize on the transition from solitary animal species to social species. The possibility of conflicts between primitive species-perpetuation forces and subjective social-identity forces are explored.
Results: As members of a social species, human beings have a dual, contradictory character of independent organisms but interdependent people. This results in evolutionary inherited conflicts that, with respect to women's reproduction, distinguish between primitive and social-identity issues: i) to transmit genes by giving birth and ii) to become mother. Authors explain denial of pregnancy as a standby-in-tension response to a conflicting attempt to transmit genes without becoming mother. It may thus be considered as temporarily adaptive response by postponing conflict resolution. This model, based on subjective internal appraisals, is compatible with a huge diversity of causative events as expected from the specificity of each woman's life course.
Conclusions: The proposed etiology is consistent with clinical observations and brings prior models into agreement. From a clinical practice perspective, the ability to explain denial of pregnancy rationally may favor understanding and acceptation by concerned women. Health professionals' information may also be facilitated and psychotherapeutic follow up may gain in efficiency with reduced recidivism.
More generally, this evolutionary conflict approach provides a supplementary perspective to explore psychosomatic dysfunctions.
Aim: The etiology of pregnancy denial remains poorly understood. Neither necessary nor sufficient conditions can be synthesized from the risk factors identified from psychological analyses. In accordance with clinical observations, we aim to explain denial of pregnancy from an evolutionary conflict perspective.Methods: Authors investigate evolutionary biology aspects and emphasize on the transition from solitary animal species to social species. The possibility of conflicts between primitive species-perpetuation forces and subjective social-identity forces are explored.Results: As members of a social species, human beings have a dual, contradictory character of independent organisms but interdependent people. This results in evolutionary inherited conflicts that, with respect to women's reproduction, distinguish between primitive and social-identity issues: i) to transmit genes by giving birth and ii) to become mother. Authors explain denial of pregnancy as a standby-in-tension response to a conflicting attempt to transmit genes without becoming mother. It may thus be considered as temporarily adaptive response by postponing conflict resolution. This model, based on subjective internal appraisals, is compatible with a huge diversity of causative events as expected from the specificity of each woman's life course.Conclusions: The proposed etiology is consistent with clinical observations and brings prior models into agreement. From a clinical practice perspective, the ability to explain denial of pregnancy rationally may favor understanding and acceptation by concerned women. Health professionals' information may also be facilitated and psychotherapeutic follow up may gain in efficiency with reduced recidivism.More generally, this evolutionary conflict approach provides a supplementary perspective to explore psychosomatic dysfunctions.Denied and false pregnancies: Opposite settings of a single evolutionary conflicthttps://peerj.com/preprints/17612016-02-202016-02-20Patrick Sandoz
Aim: A woman in denial of pregnancy is pregnant but remains unaware of her gravid state. In the case of a false pregnancy; the woman is not pregnant but believes she is and presents signs and symptoms of pregnancy. These syndromes correspond to opposite contradictions that were mainly explored separately. Our aim is to explain them by a common and consistent etiology.
Method: We explore internal conflicts inherited from the evolutionary transition from solitary animals to social species.
Results: The solitary and social characters are contradictory. They induce internal conflicts intrinsic to the human condition. At the reproduction level, those conflicts oppose primitive interests (genes transmission) to social identity ones (to become a parent). Both syndromes are described by powerful identity interests in contradiction with the actual physiological state: i) actual pregnancy but unacceptable motherhood (denial), and ii) imperative motherhood in a non-pregnant woman (false pregnancy). The physiological symptoms results from a temporarily adaptive artifice hiding the internal tension and fulfilling simultaneously (but superficially) the incompatible demands.
Conclusion: The proposed model explains clinical observations satisfactorily. It complies with a huge diversity of causative events for the identity tensions involved as reported in literature. The model also elucidates the temporary adaptive character of those psychosomatic dysfunctions. To explain those syndromes in a rational and understandable way will facilitate health professional information, thus favoring the detection and follow-up of cases. The acceptation of their condition by concerned women will also be made easier.
Aim: A woman in denial of pregnancy is pregnant but remains unaware of her gravid state. In the case of a false pregnancy; the woman is not pregnant but believes she is and presents signs and symptoms of pregnancy. These syndromes correspond to opposite contradictions that were mainly explored separately. Our aim is to explain them by a common and consistent etiology.Method: We explore internal conflicts inherited from the evolutionary transition from solitary animals to social species.Results: The solitary and social characters are contradictory. They induce internal conflicts intrinsic to the human condition. At the reproduction level, those conflicts oppose primitive interests (genes transmission) to social identity ones (to become a parent). Both syndromes are described by powerful identity interests in contradiction with the actual physiological state: i) actual pregnancy but unacceptable motherhood (denial), and ii) imperative motherhood in a non-pregnant woman (false pregnancy). The physiological symptoms results from a temporarily adaptive artifice hiding the internal tension and fulfilling simultaneously (but superficially) the incompatible demands.Conclusion: The proposed model explains clinical observations satisfactorily. It complies with a huge diversity of causative events for the identity tensions involved as reported in literature. The model also elucidates the temporary adaptive character of those psychosomatic dysfunctions. To explain those syndromes in a rational and understandable way will facilitate health professional information, thus favoring the detection and follow-up of cases. The acceptation of their condition by concerned women will also be made easier.Characterisation of the human uterine microbiome in non-pregnant women through deep sequencing of the V1-2 region of the 16S rRNA genehttps://peerj.com/preprints/12692015-12-032015-12-03Hans VerstraelenRamiro Vilchez-VargasFabian DesimpelRuy JaureguiNele VankeirsbilckSteven WeyersRita VerhelstPetra De SutterDietmar H PieperTom Van De Wiele
Background. It is widely assumed that the uterine cavity in non-pregnant women is physiologically sterile, also as a premise to the long-held view that human infants develop in a sterile uterine environment, though likely reflecting under-appraisal of the extent of the human bacterial metacommunity. In an exploratory study, we aimed to investigate the putative presence of a uterine microbiome in a selected series of non-pregnant women through deep sequencing of the V1-2 hypervariable region of the 16S ribosomal RNA (rRNA) gene. Methods. Nineteen women with various reproductive conditions, including subfertility, scheduled for hysteroscopy and not showing uterine anomalies were recruited. Subjects were highly diverse with regard to demographic and medical history and included nulliparous and parous women. Endometrial tissue and mucus harvesting was performed by use of a transcervical device designed to obtain endometrial biopsy, while avoiding cervicovaginal contamination. Bacteria were targeted by use of a barcoded Illumina MiSeq paired-end sequencing method targeting the 16S rRNA gene V1-2 region, yielding an average of 41,194 reads per sample after quality filtering. Taxonomic annotation was pursued by comparison with sequences available through the Ribosomal Database Project and the NCBI database. Results. Out of 183 unique 16S rRNA gene amplicon sequences, 15 phylotypes were present in all samples. In some 90% of the women included, community architecture was fairly similar in as much B. xylanisolvens, B. thetaiotaomicron, B. fragilis and an undetermined Pelomonas taxon constituted over one third of the endometrial bacterial community. On the singular phylotype level, six women showed predominance of L. crispatus or L. iners in the presence of the Bacteroides core. Two endometrial communities were highly dissimilar, largely lacking the Bacteroides core, one dominated by L. crispatus and another consisting of a highly diverse community, including Prevotella spp., Atopobium vaginae, and Mobiluncus curtisii. Discussion. Our findings are, albeit not necessarily generalizable, consistent with the presence of a unique microbiota dominated by Bacteroides residing on the endometrium of the human non-pregnant uterus. The transcervical sampling approach may be influenced to an unknown extent by endocervical microbiota, which remain uncharacterised, and therefore warrants further validation. Nonetheless, consistent with our understanding of the human microbiome, the uterine microbiota are likely to have a previously unrecognized role in uterine physiology and human reproduction. Further study is therefore warranted to document community ecology and dynamics of the uterine microbiota, as well as the role of the uterine microbiome in health and disease.
Background. It is widely assumed that the uterine cavity in non-pregnant women is physiologically sterile, also as a premise to the long-held view that human infants develop in a sterile uterine environment, though likely reflecting under-appraisal of the extent of the human bacterial metacommunity. In an exploratory study, we aimed to investigate the putative presence of a uterine microbiome in a selected series of non-pregnant women through deep sequencing of the V1-2 hypervariable region of the 16S ribosomal RNA (rRNA) gene. Methods. Nineteen women with various reproductive conditions, including subfertility, scheduled for hysteroscopy and not showing uterine anomalies were recruited. Subjects were highly diverse with regard to demographic and medical history and included nulliparous and parous women. Endometrial tissue and mucus harvesting was performed by use of a transcervical device designed to obtain endometrial biopsy, while avoiding cervicovaginal contamination. Bacteria were targeted by use of a barcoded Illumina MiSeq paired-end sequencing method targeting the 16S rRNA gene V1-2 region, yielding an average of 41,194 reads per sample after quality filtering. Taxonomic annotation was pursued by comparison with sequences available through the Ribosomal Database Project and the NCBI database. Results. Out of 183 unique 16S rRNA gene amplicon sequences, 15 phylotypes were present in all samples. In some 90% of the women included, community architecture was fairly similar in as much B. xylanisolvens, B. thetaiotaomicron, B. fragilis and an undetermined Pelomonas taxon constituted over one third of the endometrial bacterial community. On the singular phylotype level, six women showed predominance of L. crispatus or L. iners in the presence of the Bacteroides core. Two endometrial communities were highly dissimilar, largely lacking the Bacteroides core, one dominated by L. crispatus and another consisting of a highly diverse community, including Prevotella spp., Atopobium vaginae, and Mobiluncus curtisii. Discussion. Our findings are, albeit not necessarily generalizable, consistent with the presence of a unique microbiota dominated by Bacteroides residing on the endometrium of the human non-pregnant uterus. The transcervical sampling approach may be influenced to an unknown extent by endocervical microbiota, which remain uncharacterised, and therefore warrants further validation. Nonetheless, consistent with our understanding of the human microbiome, the uterine microbiota are likely to have a previously unrecognized role in uterine physiology and human reproduction. Further study is therefore warranted to document community ecology and dynamics of the uterine microbiota, as well as the role of the uterine microbiome in health and disease.A systemic explanation of denial of pregnancy fitting clinical observations and previous modelshttps://peerj.com/preprints/11142015-05-222015-05-22Patrick Sandoz
Introduction: The etiology of denial of pregnancy remains poorly understood. Neither necessary nor sufficient conditions can be synthesized from the risk factors identified from psychological analyses. Furthermore, the involvement of mother-fetus interactions cannot result only from psychology causes in the mother. Although instructive, the few available evolutionary and systemic explanations proposed remain insufficient. This article synthesizes and extends previous knowledge within a systemic model which is fully compatible with clinical observations.
Methods: A systemic intrapersonal conflict theory opposing primitive, evolutionary-inherited forces to psycho-sociological forces embodied across individual’s childhood is developed.
Results: As members of a social species, human beings have a dual character of independent organisms and of social group members that is a source of customized intrapersonal conflicts. Authors explain denial of pregnancy as a standby-in-tension response to such an unresolved intrapersonal conflict between forand against-pregnancy forces. As long as the woman’s brain is unable to renounce one option in favor of the other, denial of pregnancy offers a standby-in-tension means to postpone conflict resolution. It may thus be considered as temporarily adaptive response.
Conclusions: The proposed systemic psycho-evolutionary explanation of denial of pregnancy is fully consistent with clinical observations. It brings into agreement the previously reported models with the advantage of being more synthetic. It is thus compatible with a large diversity of causative events in accordance with the actual life story of each woman concerned.
The systemic intrapersonal conflict approach developed herein provides a new means of investigating body-mind problems, especially pseudocyesis.
Introduction: The etiology of denial of pregnancy remains poorly understood. Neither necessary nor sufficient conditions can be synthesized from the risk factors identified from psychological analyses. Furthermore, the involvement of mother-fetus interactions cannot result only from psychology causes in the mother. Although instructive, the few available evolutionary and systemic explanations proposed remain insufficient. This article synthesizes and extends previous knowledge within a systemic model which is fully compatible with clinical observations.Methods: A systemic intrapersonal conflict theory opposing primitive, evolutionary-inherited forces to psycho-sociological forces embodied across individual’s childhood is developed.Results: As members of a social species, human beings have a dual character of independent organisms and of social group members that is a source of customized intrapersonal conflicts. Authors explain denial of pregnancy as a standby-in-tension response to such an unresolved intrapersonal conflict between forand against-pregnancy forces. As long as the woman’s brain is unable to renounce one option in favor of the other, denial of pregnancy offers a standby-in-tension means to postpone conflict resolution. It may thus be considered as temporarily adaptive response.Conclusions: The proposed systemic psycho-evolutionary explanation of denial of pregnancy is fully consistent with clinical observations. It brings into agreement the previously reported models with the advantage of being more synthetic. It is thus compatible with a large diversity of causative events in accordance with the actual life story of each woman concerned.The systemic intrapersonal conflict approach developed herein provides a new means of investigating body-mind problems, especially pseudocyesis.