COVID-19 Illness: Mother–Baby Separation, Viruses, and Breastfeeding

Objectives

Some hospitals have instituted separation of mothers and their newborn(s) when SARS-CoV-2 is suspected or confirmed in the mother. Limited data are available for SARS-CoV-2 vertical transmission, including studies on breast milk. This article looks at SARS CoV-2 case studies and data to date as well as prior pertinent research.

Methods

Informal searches of PUBMED, CINAHL and Ovid Emcare were used to identify early reports of vertical transmissions of the novel Coronavirus, case reports, and population based reports of early evolving protocols and their outcomes. As this is a novel virus the authors used previously identified anti-infectivity and antiviral mechanisms of human milk on other similar viruses to guide analysis. Further this article reviewed the well established literature regarding the risks of undue infant separation which negatively affect nearly every aspect of infant and maternal health.

Results

Informal searches conducted in the spring and early summer of 2020 identified 14 early reports attempting to analyze the initial and evolving global response to SARS-CoV-2 and the effects of the virus on the maternal-infant dyad.

Conclusion

The feasibility of single-family rooms and support for breastfeeding as an alternative approach that addresses many of the risks favorably and reduces economic cost, both in lifetime disease burden and direct care are discussed. Initial reports seem to indicate that immediate separation of the mother from her newborn is likely to increase the risk to both mother and infant.

Novel Concordance Between Geographic, Environmental, and Genetic Structure in the Ecological Generalist Prickly Sculpin (Cottus asper) in California

Ecological generalists may contain a wealth of information concerning diversity, ecology, and geographic connectivity throughout their range. We explored these ideas in prickly sculpin (Cottus asper), a small generalist freshwater fish species where coastal forms have potentially undergone radiations into inland lacustrine and riverine environments. Using a 962bp cytochrome b mtDNA marker and 11 microsatellites, we estimated diversity, divergence times, gene flow, and structure among populations at 43 locations throughout California. We then incorporated genetic and GIS data into ecological niche models to assess ecological conditions within identified groups. Though not reciprocally monophyletic, unique mtDNA haplotypes, microsatellite clustering, and measures of isolation by distance (Coastal: r = 0.960, P < 0.001; Inland: r = 0.277, P = 0.148) suggest 2 novel taxonomic groups, Coastal and Inland (constrained to Great Central Valley). Divergence estimates of 41-191 kya combined with the regional biogeographic history suggest geographic barriers are absent between groups since divergence, but ecological niche modeling revealed significant environmental differences (t = 10.84, P < 0.001). Introgressed individuals were also discovered between groups in an ecologically and geographically intermediate region. Population structure was limited, predominately found in tributaries of the San Joaquin basin in the Inland group. Overall, C. asper exhibited substantial genetic diversity, despite its ecological generality, reflecting California's historically unique and complex hydrology. More broadly, this study illustrates variable environments within the range of a generalist species may mask genetic divergences and should not be overlooked in biodiversity assessments.

Ameliorative effect of chronic moderate exercise in smoke exposed or nicotine applied rats from acute stress

INTRODUCTION

Physical activity has been found to be related with many health benefits. Our aim was to investigate the effect of chronic moderate exercise from acute stress on nicotine and cigarette smoke exposed rats.

METHODS

Male Sprague Dawley rats (200-250g, n = 48) were divided into 6 groups as non-exercised, exercised, smoke exposed, smoke exposed and exercised, nicotine applied, and nicotine applied and exercised. Nicotine bitartarate was applied intraperitoneally (0.1mg/kg/day) for 5 weeks, and cigarette smoke was exposed in a ventilated chamber. After 1 week of nicotine application or smoke exposure, moderate exercise training protocol was applied to exercise groups. At the end of the experiments, acute stress induction was made to all groups by electric foot shock. Holeboard tests were performed before and after the experiments. Biochemical and histological analyses were performed in lung, liver, colon, stomach, and gastrocnemius tissues.

RESULTS

Malondialdehyde levels were increased in all tissues of smoke exposed group (p < .05-.01) except gastrocnemius tissue compared to non-exercised group and were decreased with exercise (p < .05-.001). Myeloperoxidase levels were increased in lung, liver and colon tissues of smoke exposed group (p < .05-.001) and liver and colon tissues of nicotine applied rats (p < .01-.001) and decrease with exercise in liver and colon tissues of both smoke exposed or nicotine applied groups (p < .05-.01). In all tissue samples, increased histological injury scores (p < .05-.001) decreased significantly with exercise (p < .01-.001).

CONCLUSION

Biochemical parameters and histological scoring indicated increased tissue injury due to nicotine application and cigarette smoke exposure and exercise training ameliorated these effects in most of the tissues of acute stress induced rats.

Measures of physiological stress: a transparent or opaque window into the status, management and conservation of species?

Conservation physiology proposes that measures of physiological stress (glucocorticoid levels) can be used to assess the status and future fate of natural populations. Increases in glucocorticoids may reflect a more challenging environment, suggesting that the influence of human activities on free-living animals could be quantified by measuring glucocorticoids. Biomedical studies suggest that chronic increases in glucocorticoids can have detrimental effects on survival and reproduction, which could influence the viability of populations. Here, we discuss the use of measurements of glucocorticoids in conservation physiology. We first provide an overview of the different methods to quantify glucocorticoids and their utility in conservation physiology. We then discuss five questions we think are essential for conservation physiologists to address. We highlight how intrinsic (e.g. sex, reproductive status, age, recent experiences) and ecological factors (e.g. predation, food availability, snowfall) can, by themselves or through their interactions with anthropogenic disturbances, affect the physiological stress response and mask any general patterns about the effects of anthropogenic disturbances on glucocorticoids. Using a meta-analysis, we show that anthropogenic disturbances are consistently associated with increased glucocorticoids regardless of the type of human disturbance. We also show that males may be more sensitive to anthropogenic disturbances than females and that faecal glucocorticoids, but not baseline plasma glucocorticoids, consistently increase in response to anthropogenic disturbances. Finally, we discuss how increases in glucocorticoids in free-living animals can sometimes enhance survival and reproduction. Unfortunately, our literature analysis indicates that this observation has not yet gained traction, and very few studies have shown that increases in glucocorticoid levels resulting from anthropogenic disturbances decrease survival or reproduction. We think that the use of measures of glucocorticoids in conservation physiology has tremendous potential, but there are still a number of methodological concerns, in addition to several crucial questions that should be addressed.

Deep genetic divergence between disjunct Refugia in the Arctic-Alpine King's Crown, Rhodiola integrifolia (Crassulaceae)

Despite the strength of climatic variability at high latitudes and upper elevations, we still do not fully understand how plants in North America that are distributed between Arctic and alpine areas responded to the environmental changes of the Quaternary. To address this question, we set out to resolve the evolutionary history of the King's Crown, Rhodiola integrifolia using multi-locus population genetic and phylogenetic analyses in combination with ecological niche modeling. Our population genetic analyses of multiple anonymous nuclear loci revealed two major clades within R. integrifolia that diverged from each other ~ 700 kya: one occurring in Beringia to the north (including members of subspecies leedyi and part of subspecies integrifolia), and the other restricted to the Southern Rocky Mountain refugium in the south (including individuals of subspecies neomexicana and part of subspecies integrifolia). Ecological niche models corroborate our hypothesized locations of refugial areas inferred from our phylogeographic analyses and revealed some environmental differences between the regions inhabited by its two subclades. Our study underscores the role of geographic isolation in promoting genetic divergence and the evolution of endemic subspecies in R. integrifolia. Furthermore, our phylogenetic analyses of the plastid spacer region trnL-F demonstrate that among the native North American species, R. integrifolia and R. rhodantha are more closely related to one another than either is to R. rosea. An understanding of these historic processes lies at the heart of making informed management decisions regarding this and other Arctic-alpine species of concern in this increasingly threatened biome.

Glucocorticoid stress responses of lions in relationship to group composition, human land use, and proximity to people

Large carnivore populations are in global decline, and conflicts between large carnivores and humans or their livestock contribute to low tolerance of large carnivores outside of protected areas. African lions (Panthera leo) are a conflict-prone species, and their continental range has declined by 75% in the face of human pressures. Nonetheless, large carnivore populations persist (or even grow) in some areas that are occupied by humans. Lions attain locally high density in the Olkiramatian and Shompole Group Ranches of Kenya's South Rift region, despite residence by pastoralist Maasai people and their sheep, goats, and cattle. We have previously found that these lions respond to seasonal movements of people by moving away from occupied settlements, shifting into denser habitats when people are nearby, and moving into a protected conservation area when people move into the adjacent buffer zone. Here, we examined lion stress responses to anthropogenic activities, using enzyme-linked immunoassay to measure the concentration of faecal glucocorticoid metabolites in 136 samples collected from five lion groups over 2 years. Faecal glucocorticoid metabolite concentrations were significantly lower for lions in the conservation area than for lions in the human-settled buffer zone, and decreased significantly with increasing distance to the nearest occupied human settlement. Faecal glucocorticoid metabolite concentrations were not detectably related to fine-scaled variation in prey or livestock density, and surprisingly, faecal glucocorticoid metabolite concentrations were higher in the wet season, when regional prey abundance was high. Lions coexist with people and livestock on this landscape by adjusting their movements, but they nonetheless mount an appreciable stress response when conditions do not allow them to maintain adequate separation. Thus, physiological data confirm inferences from prior data on lion movements and habitat use, showing that access to undisturbed and protected areas facilitates human-lion coexistence in a broader landscape that is used by people and livestock.

HPA axis changes during the initial phase of psychosocial stressor exposure in male mice

Chronic subordinate colony (CSC) housing for 19 days results in unaffected basal morning corticosterone (CORT) levels despite a pronounced increase in adrenal mass, likely mediated by an attenuation of adrenal corticotropin (ACTH) responsiveness. Given that the pronounced increase in basal morning plasma CORT levels returns to baseline as early as 48 h after the start of CSC, it is likely that the attenuated ACTH responsiveness develops already during this initial phase. This was tested in the present study. In line with previous findings, basal morning plasma CORT levels were elevated following 10 h, but not 48 h, of CSC exposure. Basal morning plasma ACTH concentrations and relative in vivo adrenal CORT content were increased following 10 h and to a lesser extent following 48 h of CSC exposure, positively correlating. Relative in vitro adrenal CORT secretion in response to ACTH (100 nM) and kidney protein expression of 11β-hydroxysteroid dehydrogenase type 2 (HSD11B2) were unaffected following both time points. Adrenal mRNA expression of key steroidogenic enzymes was unaffected/decreased following 10 h and unaffected/increased following 48 h of CSC exposure. Together, our findings suggest that basal plasma hypercorticism during the initial CSC phase is mainly prevented by an attenuation of pituitary ACTH release. An increased absolute adrenal weight following 10 h, but not 48 h, of CSC exposure indicates that restoration of normal adrenal mass also adds to a lesser extent to prevent basal hypercorticism. A contributing role of alterations in enzymatic CORT degradation and steroidogenic enzyme availability is likely, but has to be further addressed in future studies.

Indicators of job strain at midlife and cognitive functioning in advanced old age

OBJECTIVES

We used data from SWEOLD, a Swedish nationally representative study of individuals aged 77 years or older, to examine midlife indicators of job strain in relation to cognitive performance and impairment.

METHODS

In all, 827 participants completed an abridged 11-point version of the Mini-Mental State Examination in-person in 1992 and/or 2002 and had self-reported and/or occupation-based scores for job control and demands from data collected in 1968. Seventeen percent scored below the cutoff for cognitive impairment.

RESULTS

Controlling for age, sex, education, self-rated health, and year of cognitive screening, low self-reported and occupation-based job control at midlife was associated with poorer cognitive performance later (ps < .001). For the occupation-based measure, low job control was also associated with greater likelihood of impairment, whereas having an active job (high job control/high job demands) was associated with better cognitive performance and lower likelihood of impairment (ps < .01). Childhood environment, midlife depressive symptoms, and social activity had limited influence, whereas the influence of both adulthood socioeconomic position and work complexity on these results was more pronounced.

DISCUSSION

Job control at midlife, by itself and in combination with job demands, may influence cognitive functioning later above and beyond demographic variables and other occupational characteristics.

Frontiers in the use of biomarkers of health in research on stress and aging

Assessment of biomarkers that reflect objective indicators of physiological processes has become increasingly popular in psychological research on stress and aging. The current article reviews biomarkers of the neuroendocrine and immune systems, including issues related to measurement and normative age-related changes. We also discuss how exposure to stressors can provoke changes in these biomarkers and propose that stressful experiences may accelerate age-related declines in these systems. We recommend that future research examining physical health and aging incorporate dynamic and multivariate methods for assessing links between stressors and biomarkers.

Midlife psychological stress and risk of dementia: a 35-year longitudinal population study

The number of people with dementia has increased dramatically with global ageing. Nevertheless, the pathogeneses of these diseases are not sufficiently understood. The present study aims to analyse the relationship between psychological stress in midlife and the development of dementia in late-life. A representative sample of females (n = 1462) aged 38-60 years were examined in 1968-69 and re-examined in 1974-75, 1980-81, 1992-93 and 2000-03. Psychological stress was rated according to a standardized question in 1968, 1974 and 1980. Dementia was diagnosed according to Diagnostic and Statistical Manual of Mental Disorders criteria based on information from neuropsychiatric examinations, informant interviews, hospital records and registry data. During the 35-year follow-up, 161 females developed dementia (105 Alzheimer's disease, 40 vascular dementia and 16 other dementias). We found that the risk of dementia (hazard ratios, 95% confidence intervals) was increased in females reporting frequent/constant stress in 1968 (1.60, 1.10-2.34), in 1974 (1.65, 1.12-2.41) and in 1980 (1.60, 1.01-2.52). Frequent/constant stress reported in 1968 and 1974 was associated with Alzheimer's disease. Reporting stress at one, two or three examinations was related to a sequentially higher dementia risk. Compared to females reporting no stress, hazard ratios (95% confidence intervals) for incident dementia were 1.10 (0.71-1.71) for females reporting frequent/constant stress at one examination, 1.73 (1.01-2.95) for those reporting stress at two examinations and 2.51 (1.33-4.77) at three examinations. To conclude, we found an association between psychological stress in middle-aged women and development of dementia, especially Alzheimer's disease. More studies are needed to confirm our findings and to study potential neurobiological mechanisms of these associations.

Neuroticism in adolescence and cognitive function in midlife in the British 1946 birth cohort: The HALCyon program

We examined whether higher levels of neuroticism in adolescence were associated with poorer cognitive function in midlife in 2,071 members of the British 1946 birth cohort. Higher neuroticism at age 13 was associated with poorer performance on tests of verbal ability, verbal fluency, and verbal memory at age 53 in sex-adjusted analyses. However, higher neuroticism was also associated with poorer cognitive performance at age 8. After adjustment for childhood cognition or educational attainment, the associations between neuroticism at age 13 and midlife cognition ceased to be statistically significant. The link between neuroticism and subsequent cognitive ability may be a reflection of a long-standing correlation between the stable aspects of these traits since childhood, but further measurements of both traits are needed to confirm this.

Childhood living conditions, socioeconomic position in adulthood, and cognition in later life: exploring the associations

OBJECTIVES

This study examined the association between childhood living conditions, socioeconomic position in adulthood, and cognition in later life. Two questions were addressed: Is there an association between childhood living conditions and late-life cognition, and if so, is the association modified or mediated by adult socioeconomic position?

METHODS

Nationally representative data of the Swedish population aged 77 years and older were obtained from the 1992 and 2002 Swedish Panel Study of Living Conditions of the Oldest Old (SWEOLD). Cognition was assessed with an abbreviated version of the Mini-Mental State Examination scale. Childhood living conditions were assessed by self-reports of childhood living conditions.

RESULTS

The results showed independent associations between conflicts in the household during childhood, father's social class, education, own social class in adulthood, and cognition in later life. Exposure to conflicts during childhood, having a father classified as a manual worker, low education, and/or being classified as a manual worker in adulthood was associated with lower levels of cognition in old age. There seemed to be no modifying effect of adult socioeconomic position on the association between childhood conditions and cognition in later life.

DISCUSSION

This suggests the importance of childhood living conditions in maintaining cognitive function even in late life.

Near-synchronous interhemispheric termination of the last glacial maximum in mid-latitudes

Isotopic records from polar ice cores imply globally asynchronous warming at the end of the last glaciation. However, 10Be exposure dates show that large-scale retreat of mid-latitude Last Glacial Maximum glaciers commenced at about the same time in both hemispheres. The timing of retreat is consistent with the onset of temperature and atmospheric CO2 increases in Antarctic ice cores. We suggest that a global trend of rising summer temperatures at the end of the Last Glacial Maximum was obscured in North Atlantic regions by hypercold winters associated with unusually extensive winter sea ice.

Postnatal touch stimulation acutely alters corticosterone levels and glucocorticoid receptor gene expression in the neonatal rat

Environmental manipulation early in life can alter the development of the hypothalamic-pituitary-adrenal (HPA) axis by mechanisms that are still unclear. The aim of the present work was to study the acute effects of postnatal touch stimulation, in an attempt to understand the mechanism by which touch stimulation early in life alters the HPA response to stress in adult animals. Rat pups were gently brushed for 15 min daily during the 1st postnatal week. Serum corticosterone levels were determined by radioimmunoassays, while glucocorticoid receptor (GR) gene expression was assayed by semiquantitative reverse transcriptase-polymerase chain reaction. Touch stimulation induced a significant decrease (30-36%) in serum corticosteroid secretion during the 1st and 2nd postnatal day as compared to the unstimulated group. In contrast, GR gene expression in the touch stimulation group was significantly increased in several brain areas such as the hippocampus (19-21%), frontal cortex (26-34%) and midbrain (15-24%). The results thus indicate that neonatal touch stimulation causes acute hormone- secretion and gene-expression changes within the period of stimulation. These changes may be the underlying cause for the permanent changes that have been observed in adult animals touch-stimulated as neonates.

Intra-oral administration of sweet-tasting substances and infants' crying response to immunization: a randomized, placebo-controlled trial

The analgesic effects of four solutions administered intra-orally (25 and 50% sucrose solutions, hydrogenated glucose, and a sterile water placebo) were tested in groups of babies receiving routine DTP (diphtheria, tetanus, and pertussis) and HIB (Haemophilus influenzae type B) injections at the first, second, or third immunization. The duration of the baby's cry during 3 min following DTP and HIB injections was measured as main outcome. For all three immunization groups, the babies receiving the placebo generally spent most time crying. For both the DTP and HIB injections, the difference between 50% sucrose and placebo was most evident in the group receiving the 3rd immunization. Intra-oral administration of the 50% sucrose solution, compared to placebo, appeared to reduce the cry response to painful experiences in babies beyond the neonatal period.

Maternal risk factors for fetal and neonatal brain damage

Prematurity is probably the major factor associated with brain damage in newborns. Our growing knowledge of the biochemical mechanisms leading to the onset of labour at term allows the biochemical correlates of the epidemiological risk factors for prematurity to be understood. Infection is the major cause of early preterm labour and is now recognised to be a major cause of fetal cerebral damage leading to cerebral palsy. Only some 5% of cerebral palsy is due to intrapartum asphyxia at term. This may occur due to an obstetric catastrophe or through inadequate placental function leading to chronic intrapartum asphyxia.

Steroid hormones, dendritic remodeling and neuronal death: insights from insect metamorphosis

Steroid hormones influence neuronal structure and function throughout the animal kingdom, via highly conserved receptor proteins. Insights into steroid effects on neurons and behavior have come from a range of vertebrate species including reptiles, amphibians, fish, birds, rodents and primates. In many instances, steroid hormones regulate the volume of particular regions of the nervous system by affecting both the number of constituent neurons and their size. A major determinant of neuronal number is the process of programmed cell death (PCD), which involves molecular machinery that is conserved across species. This article reviews steroid-mediated PCD and dendritic remodeling during metamorphosis of the hawkmoth, Manduca sexta. Metamorphosis is driven by a class of steroid hormones, the ecdysteroids. During the transformation from larva to pupa to adult moth, accessory planta retractor (APR) motoneurons of Manduca undergo dendritic regression and regrowth, and segment-specific PCD, in response to specific ecdysteroid cues. Experiments utilizing APRs in primary cell culture show that PCD is a direct response to ecdysteroids, regulated by the intrinsic segmental identity of individual APRs. As in other systems, activation of caspases (cysteine proteases) is involved in the execution phase of PCD. Other experiments demonstrate that the ecdysteroid-mediated regression of APRs' dendrites at pupation causes weakening of monosynaptic excitatory inputs from sensory neurons that trigger a larval withdrawal reflex. Thus, the steroid-mediated reduction in dendritic extent is linked to a specific electrophysiological and behavioral change during metamorphosis. The comparative approach, taking advantage of a variety of vertebrate and invertebrate species, holds the most promise for elucidating the full spectrum of steroid effects on neurons and behavior.

Is depression a risk factor for dementia or cognitive decline? A review

BACKGROUND

It is generally accepted that depression can be associated with significant cognitive deficits and that depression can be comorbid with dementia.

OBJECTIVE

This review seeks to go further and ask whether depression earlier in life can be a risk factor for subsequent dementia or for cognitive decline.

METHODS

A review was made of the epidemiological evidence from case-control and prospective studies that depression is a risk factor. The literature was also reviewed in relation to six hypotheses that might explain an association: (1) depression treatments are a risk factor for dementia, (2) dementia and depression share common risk factors, (3) depression is a prodrome of dementia, (4) depression is an early reaction to cognitive decline, (5) depression affects the threshold for manifesting dementia, and (6) depression is a causal factor in dementia.

RESULTS

A meta-analysis found that depression was associated with an increased risk of subsequent dementia in both case-control studies (95% CI for relative risk: 1.16-3.50) and prospective studies (95% CI: 1.08-3.20). There was little support for hypotheses 1 and 2. The other hypotheses have limited support, but warrant further research.

CONCLUSION

There is sufficient evidence to take seriously the possibility that depression is a risk factor for dementia and cognitive decline. Further work is needed to examine depression as a prodrome of vascular dementia, depression as an early reaction to perceived cognitive decline, the effects of depression on the threshold for manifesting dementia, and depression as a source of hippocampal damage through a glucocorticoid cascade.

As climate changes, so do glaciers

Understanding abrupt climate changes requires detailed spatial/temporal records of such changes, and to make these records, we need rapidly responding, geographically widespread climate trackers. Glacial systems are such trackers, and recent additions to the stratigraphic record show overall synchronous response of glacial systems to climate change reflecting global atmosphere conditions.

Measurements of Past Ice Sheet Elevations in Interior West Antarctica

A lateral moraine band on Mount Waesche, a volcanic nunatak in Marie Byrd Land, provides estimates of past ice sheet surface elevations in West Antarctica. Helium-3 and chlorine-36 surface exposure ages indicate that the proximal part of the moraine, up to 45 meters above the present ice surface, was deposited about 10,000 years ago, substantially later than the maximum ice extent in the Ross Embayment. The upper distal part of the moraine may record multiple earlier ice sheet high stands. A nonequilibrium ice sheet model predicts a delay of several thousand years in maximum ice levels at Mount Waesche relative to the maximum ice extent in the Ross Sea. The glacial geologic evidence, coupled with the ice sheet model, indicates that the contribution of the Ross Sea sector of the West Antarctic Ice Sheet to Holocene sea level rise was only about 3 meters. These results eliminate West Antarctic ice as the principle source of the large meltwater pulse during the early Holocene.