Risk and Recurrence of Serious Adverse Outcomes in the First and Second Pregnancies of Women With Preexisting Diabetes

OBJECTIVE: Women with preexisting (type 1 or type 2) diabetes experience an increased risk of serious adverse pregnancy outcomes. It is not known, however, how these risks change between the first and second pregnancy andwhether there is an increased risk of recurrence. This study describes the absolute risks and recurrence of serious adverse pregnancy outcomes in 220 women with preexisting diabetes. RESEARCH DESIGN AND METHODS: A total of 440 pregnancies occurring in 220 women with preexisting diabetes who delivered successive singleton pregnancies in the North of England during 1996-2008 were identified fromtheNorthern Diabetes in Pregnancy Survey (NorDIP). Predictors of serious adverse outcome were estimated by competing-risks regression. RESULTS: Sixty-seven first pregnancies (30.5%) ended in serious adverse outcome, including 14 (6.4%) with congenital anomalies and 53 (24.1%) additional fetal or infant deaths. Thirty-seven second pregnancies (16.8%) ended in serious adverse outcomedhalf the rate among first pregnancies (P = 0.0004)dincluding 21 (9.5%) with congenital anomalies and 16 (7.3%) additional fetal or infant deaths. Serious adverse outcomes in the second pregnancy occurred twice as frequently in women who experienced a previous adverse outcome than in those who did not (26.9% vs. 12.4%, P = 0.004), but previous adverse outcome was not associated with preparation for the following pregnancy. CONCLUSIONS: Serious adverse outcomes are less common in the second pregnancies of women with preexisting diabetes, although the risk is comparable in those whose first pregnancy ends in adverse outcome. Reducing the risk of recurrence may require more support in the immediate period after an adverse pregnancy outcome

Pre-existing diabetes, maternal glycated haemoglobin, and the risks of fetal and infant death: A population-based study

Aims/hypothesis: Pre-existing diabetes is associated with an increased risk of stillbirth, but few studies have excluded the effect of congenital anomalies. This study used data from a long-standing population-based survey of women with pre-existing diabetes to investigate the risks of fetal and infant death and quantify the contribution of glycaemic control. Methods: All normally formed singleton offspring of women with pre-existing diabetes (1,206 with type 1 diabetes and 342 with type 2 diabetes) in the North of England during 1996-2008 were identified from the Northern Diabetes in Pregnancy Survey. RRs of fetal death (≥20 weeks of gestation) and infant death were estimated by comparison with population data from the Northern Perinatal Morbidity and Mortality Survey. Predictors of fetal and infant death in women with pre-existing diabetes were examined by logistic regression. Results: The prevalence of fetal death in women with diabetes was over four times greater than in those without (RR 4.56 [95% CI 3.42, 6.07], p < 0.0001), and for infant death it was nearly doubled (RR 1.86 [95% CI 1.00, 3.46], p = 0.046). There was no difference in the prevalence of fetal death (p = 0.51) or infant death (p = 0.70) between women with type 1 diabetes and women with type 2 diabetes. There was no evidence that the RR of fetal and infant death had changed over time (p = 0.95). Increasing periconception HbA1c concentration above 49 mmol/mol (6.6%) (adjusted odds ratio [aOR] 1.02 [95% CI 1.00, 1.04], p = 0.01), prepregnancy retinopathy (aOR 2.05 [95% CI 1.04, 4.05], p = 0.04) and lack of prepregnancy folic acid consumption (aOR 2.52 [95% CI 1.12, 5.65], p = 0.03) were all independently associated with increased odds of fetal and infant death. Conclusions/interpretation: Pre-existing diabetes is associated with a substantially increased risk of fetal and infant death in normally formed offspring, the effect of which is largely moderated by glycaemic control

Pulsar Science with the Green Bank 43m Telescope

The 43m telescope at the NRAO site in Green Bank, WV has recently been outfitted with a clone of the Green Bank Ultimate Pulsar Processing Instrument (GUPPI \cite{Ransom:2009}) backend, making it very useful for a number of pulsar related studies in frequency ranges 800-1600 MHz and 220-440 MHz. Some of the recent science being done with it include: monitoring of the Crab pulsar, a blind search for transient sources, pulsar searches of targets of opportunity, and an all-sky mapping project. For the Crab monitoring project, regular observations are searched for giant pulses (GPs), which are then correlated with $\gamma$-ray photons from the \emph{Fermi} spacecraft. Data from the all-sky mapping project are first run through a pipeline that does a blind transient search, looking for single pulses over a DM range of 0-500 pc~cm$^{-3}$. These projects are made possible by MIT Lincoln Labs.Comment: 2 pages, 1 figure, to appear in AIP Conference Proceedings of Pulsar Conference 2010 "Radio Pulsars: a key to unlock the secrets of the Universe", Sardinia, October 201

A Giant Sample of Giant Pulses from the Crab Pulsar

We observed the Crab pulsar with the 43-m telescope in Green Bank, WV over a timespan of 15 months. In total we obtained 100 hours of data at 1.2 GHz and seven hours at 330 MHz, resulting in a sample of about 95000 giant pulses (GPs). This is the largest sample, to date, of GPs from the Crab pulsar taken with the same telescope and backend and analyzed as one data set. We calculated power-law fits to amplitude distributions for main pulse (MP) and interpulse (IP) GPs, resulting in indices in the range of 2.1-3.1 for MP GPs at 1.2 GHz and in the range of 2.5-3.0 and 2.4-3.1 for MP and IP GPs at 330 MHz. We also correlated the GPs at 1.2 GHz with GPs from the Robert C. Byrd Green Bank Telescope (GBT), which were obtained simultaneously at a higher frequency (8.9 GHz) over a span of 26 hours. In total, 7933 GPs from the 43-m telescope at 1.2 GHz and 39900 GPs from the GBT were recorded during these contemporaneous observations. At 1.2 GHz, 236 (3%) MP GPs and 23 (5%) IP GPs were detected at 8.9 GHz, both with zero chance probability. Another 15 (4%) low-frequency IP GPs were detected within one spin period of high-frequency IP GPs, with a chance probability of 9%. This indicates that the emission processes at high and low radio frequencies are related, despite significant pulse profile shape differences. The 43-m GPs were also correlated with Fermi gamma-ray photons to see if increased pair production in the magnetosphere is the mechanism responsible for GP emission. A total of 92022 GPs and 393 gamma-ray photons were used in this correlation analysis. No significant correlations were found between GPs and gamma-ray photons. This indicates that increased pair production in the magnetosphere is likely not the dominant cause of GPs. Possible methods of GP production may be increased coherence of synchrotron emission or changes in beaming direction.Comment: 33 pages, 10 figures, 6 tables, accepted for publication in Ap

MONITORING AND PRESERVATION OF THE KYIV PECHERSK LAVRA CAVES

The Kyiv Pechersk Lavra is a unique monastery complex included in the UNESCO World Heritage List. The first mentions of the caves in the chronicles date back to the year 1051. The idea of creating a 3D model of Lavra’s caves was suggested by the Kiev Pechersk Lavra coenobites with the aim to attract public attention to the problem of preserving the Lavra Caves for future generations. It consists of an above-ground part (a complex of religious buildings) and an underground part (caves). The caves form a system of underground corridors subdivided into several parts – the Near Caves, the Far Caves, and the Varangian Caves. Today the caves are in an emergency state and need urgent restoration. Results presented in the paper comprise all steps of the 3D model of the Kyiv Pechersk Lavra caves creation. At the first step, a spatial underground geodetic network for scans georeferencing was created. Totally over 60 stations with quite short distances from 2&thinsp;m up to 15&thinsp;m, with many open traverses were measured. Terrestrial laser scanning for over than 450&thinsp;m tunnels and entrance structures has been performed. At the last step, data processing and modelling have been done with a result in the form of plans, cross-sections and TIN model of the whole complex. The paper devoted to features of those works and prospective applications of the results

СУЧАСНІ ПІДХОДИ ДО ЗАСТОСУВАННЯ ЕМУЛЬГАТОРІВ ТА КОНСЕРВАНТІВ У СКЛАДІ ДЕРМАТОЛОГІЧНИХ ЛІКАРСЬКИХ ЗАСОБІВ

The aim of the work.&nbsp; Study the nomenclature of emulsifiers and antimicrobial preservatives, used in modern semi-solid drugs, data analysis of scientific literature on the development of new drugs emulsion type.&nbsp; Materials and Methods.&nbsp; Methods of information retrieval and analysis of literature data are used.&nbsp; Results and Discussion.&nbsp; To date, a large number of dermatological preparations are medicines of emulsion type with a high content of the water phase – these are semi-solid preparations for the skin and medicinal cosmetic creams. In the manufacture of emulsion preparation, it is important to select the auxiliary substances, in particular emulsifiers and antimicrobial preservatives, which are mainly surfactants by their structure, and often cause side reactions.&nbsp; Practically all synthetic surface-active substances can remove all fatty products from the body surface, in particular a thin protective film that forms sebaceous and sweat glands of the skin.&nbsp; Therefore, it is promising to use biogenic surfactants as emulsifiers and preservatives.&nbsp; The study of the range of emulsifiers and antimicrobial preservatives used in semi-solid emulsion registered in the State Register of Medicinal Products of Ukraine was conducted.&nbsp; As a result of the study, it was found that polysorbates are mainly used as emulsifiers of the 1st kind and cetostearyl alcohol and lanolin as emulsifiers of the 2nd kind in emulsion medicines. &nbsp;Conclusions.&nbsp; Considering that synthetic surfactants can cause significant adverse reactions and are strong allergens, it is relevant to study biogenic surfactants as promising emulsifiers and antimicrobial preservatives, to establish their emulsion and preservation ability, which will facilitate the expansion of the range of excipients for emulsion medicines and cosmetics.Мета роботи. Дослідити номенклатуру емульгаторів і консервантів, які найчастіше застосовуються у складі сучасних м’яких лікарських засобів, проаналізувати дані наукової літератури щодо розробки нових лікарських засобів емульсійного типу. Матеріали і методи. Використано методи інформаційного пошуку та аналізу даних літератури. Результати й обговорення. На сьогодні значну кількість дерматологічних лікарських засобів становлять лікарські засоби емульсійного типу з високим вмістом водної фази – це м’які лікарські засоби для нашкірного застосування та лікарські косметичні креми. При виготовленні емульсійних засобів важливим є вибір допоміжних речовин, зокрема емульгаторів та консервантів, які за структурою, здебільшого є поверхнево-активними речовинами та часто зумовлюють побічні реакції. Практично всі синтетичні поверхнево-активні речовини здатні видаляти з поверхні тіла жироподібні речовини, зокрема тонку захисну плівку, яку утворюють сальні та потові залози шкіри. Тому перспективним є використання біогенних поверхнево-активних речовин як емульгаторів та консервантів. Проведено вивчення номенклатури емульгаторів і консервантів, які застосовуються у складі м’яких емульсійних лікарських засобів, зареєстрованих у Державному реєстрі лікарських засобів України. В результаті проведеного дослідження встановлено, що як емульгатори 1-го роду у складі емульсійних лікарських засобів в основному використовують полісорбати, як емульгатори 2-го роду – цетостеариловий спирт та ланолін. Висновки. Враховуючи, що синтетичні поверхнево-активні речовини можуть спричиняти значні побічні реакції та є сильними алергенами, актуальним є дослідження біогенних ПАР як перспективних емульгаторів та консервантів, зокрема вивчення їх емульсійної та консервуючої здатності, що буде сприяти розширенню номенклатури допоміжних речовин для емульсійних лікарських та косметичних засобів

Effects of Intermittent Emission: Noise Inventory for Scintillating Pulsar B0834+06

We compare signal and noise for observations of the scintillating pulsar B0834+06, using very-long baseline interferometry and a single-dish spectrometer. Comparisons between instruments and with models suggest that amplitude variations of the pulsar strongly affect the amount and distribution of self-noise. We show that noise follows a quadratic polynomial with flux density, in spectral observations. Constant coefficients, indicative of background noise, agree well with expectation; whereas second-order coefficients, indicative of self-noise, are about 3 times values expected for a pulsar with constant on-pulse flux density. We show that variations in flux density during the 10-sec integration account for the discrepancy. In the secondary spectrum, about 97% of spectral power lies within the pulsar's typical scintillation bandwidth and timescale; an extended scintillation arc contains about 3%. For a pulsar with constant on-pulse flux density, noise in the dynamic spectrum will appear as a uniformly-distributed background in the secondary spectrum. We find that this uniform noise background contains 95% of noise in the dynamic spectrum for interferometric observations; but only 35% of noise in the dynamic spectrum for single-dish observations. Receiver and sky dominate noise for our interferometric observations, whereas self-noise dominates for single-dish. We suggest that intermittent emission by the pulsar, on timescales < 300 microseconds, concentrates self-noise near the origin in the secondary spectrum, by correlating noise over the dynamic spectrum. We suggest that intermittency sets fundamental limits on pulsar astrometry or timing. Accounting of noise may provide means for detection of intermittent sources, when effects of propagation are unknown or impractical to invert.Comment: 38 pages, 10 figure

Diatoms from the Spring Ecosystems Selected for the Long-Term Monitoring of Climate-Change Effects in the Berchtesgaden National Park (Germany)

We studied diatoms from the fifteen springs selected in the Berchtesgaden National Park on behalf of the Bavarian State Ministry for the Environment to be sentinel environments of climate-change effects. For three of these springs, diatom data based on samples taken in 1997 were also available. A total of 162 species belonging to 49 genera were found sampling three microhabitat types (lithic materials, bryophytes, surface sediments). The cumulative percentage of all species included in a threat category including endangered species was 43%, confirming previous findings for comparable environments of the Alps. We could find a statistically significant positive association between the Meinzer variability index for discharge and the cumulative relative abundance of aerial diatom species. This study thus highlighted once again the relevance of discharge (and associated water-level) variability as an environmental determinant of diatom assemblages in spring ecosystems. Increased nitrate concentrations in some springs, likely due to diffuse airborne pollution and, locally, to impacts such as forest management, game, and cattle, led to a relevant occurrence of eutraphentic diatom species. Our results show a segregation of the older data in non-parametric diatom-based ordinations, suggesting a strong potential for the use of spring diatoms in studies aiming at tracking the effects of climate and environmental change