823 research outputs found

    Ability of the e-TellTale sensor to detect flow features over wind turbine blades: flow separation/reattachment dynamics

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    Monitoring the flow features over wind turbine blades is a challenging task that has become more and more crucial. This paper is devoted to demonstrate the ability of the e-TellTale sensor to detect the flow separation/reattachment dynamics over wind turbine blades. This sensor is made of a strip with a strain gauge sensor at its base. The velocity field was acquired using TR- PIV measurements over an oscillating thick blade section equipped with an e-TellTale sensor. PIV images were post-processed to detect movements of the strip, which was compared to movements of flow. Results show good agreement between the measured velocity field and movements of the strip regarding the separation/reattachment dynamics

    Red and orange laser operation of Pr:KYF4 pumped by a Nd:YAG/LBO laser at 469.1nm and a InGaN laser diode at 444nm

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    We report the basic luminescence properties and the continuous-wave (CW) laser operation of a Pr3+-doped KYF4 single crystal in the Red and Orange spectral regions by using a new pumping scheme. The pump source is an especially developed, compact, slightly tunable and intra-cavity frequency-doubled diode-pumped Nd:YAG laser delivering a CW output power up to about 1.4 W around 469.1 nm. At this pump wavelength, red and orange laser emissions are obtained at about 642.3 and 605.5 nm, with maximum output powers of 11.3 and 1 mW and associated slope efficiencies of 9.3% and 3.4%, with respect to absorbed pump powers, respectively. For comparison, the Pr:KYF4 crystal is also pumped by a InGaN blue laser diode operating around 444 nm. In this case, the same red and orange lasers are obtained, but with maximum output powers of 7.8 and 2 mW and the associated slope efficiencies of 7 and 5.8%, respectively. Wavelength tuning for the two lasers is demonstrated by slightly tilting the crystal. Orange laser operation and laser wavelength tuning are reported for the first time

    Risk prediction of major haemorrhage with surgical treatment of live cesarean scar pregnancies

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    Objective: To evaluate the association between demographic and ultrasound variables and major intra-operative blood loss during surgical transcervical evacuation of live caesarean scar pregnancies. Study Design: This was a retrospective cohort study conducted in a tertiary referral center between 2008 and 2019. We included all women diagnosed with a live caesarean scar ectopic pregnancy who chose to have surgical management in the study center. A preoperative ultrasound was performed in each patient. All women underwent transcervical suction curettage under ultrasound guidance. Our primary outcome was the rate of postoperative blood transfusion. The secondary outcomes were estimated intra-operative blood loss (ml), rate of retained products of conception, need for repeat surgery, need for uterine artery embolization and hysterectomy rate. Descriptive statistics were used to describe the variables. Univariate and multivariable logistic regression models were constructed using the relevant covariates to identify the significant predictors for severe blood loss. Results: During the study period, 80 women were diagnosed with a live caesarean scar pregnancy, of whom 62 (78%) opted for surgical management at our center. The median crown-rump length was 9.3 mm (range 1.4–85.7). Median blood loss at the time of surgery was 100 ml (range, 10–2300), and six women (10%; 95%CI 3.6–20) required blood transfusion. Crown-rump length and presence of placental lacunae were significant predictive factors for the need for blood transfusion and blood loss > 500 ml at univariate analysis (p < .01); on multivariate analysis, only crown-rump length was a significant predictor for need for blood transfusion (OR = 1.072; 95% CI 1.02–1.11). Blood transfusion was required in 6/18 (33%) cases with the crown-rump length ≥ 23 mm (≥9+0 weeks of gestation), but in none of 44 women presenting with a crown-rump length < 23 mm (p < .01). Conclusion: The risk of severe intraoperative bleeding and need for blood transfusion during or after surgical evacuation of live caesarean scar pregnancies increases with gestational age and is higher in the presence of placental lacunae. One third of women presenting at ≥ 9 weeks of gestation required blood transfusion and their treatment should be ideally arranged in specialized tertiary centers

    Impact of location on placentation in live tubal and cesarean scar ectopic pregnancies

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    INTRODUCTION: The objective of this study was to evaluate the impact of implantation outside the normal intra-uterine endometrium on development of the gestational sac. METHODS: We reviewed and compared the ultrasound measurements and vascularity score around the gestational sac in 69 women diagnosed with a live tubal ectopic pregnancy (TEP) and 54 with a cesarean scar ectopic pregnancy (CSP) at 6-11 weeks of gestation who were certain of their last menstrual period. RESULTS: The rate of a fetus with a cardiac activity in the study population was significantly (P < 0.001) higher in CSPs than in TEPs. The median maternal age, gravidity and parity were significantly (P =.005; P < 0.001 and P < 0.001, respectively) lower in the TEP than in the CSP group. The number of gestational sac size <5th centile for gestational age was significantly (P < 0.001) higher in the TEP than in the CSP group. There were no differences between the groups for the other ultrasound measurements. In cases matched for gestational age, the gestational sac size was significantly (P < 0.001) smaller in the TEP compared to the CSP group. There was a significant (P < 0.001) difference in the distribution of blood flow score with CSP presenting with higher incidence of moderate and high vascularity than TEP. DISCUSSION: Both TEP and CSP are associated with a higher rate of miscarriage than intrauterine pregnancies and the slow development of the gestation sac is more pronounced in TEPs probably as a consequence of a limited access to decidual gland secretions

    Development of the utero-placental circulation in cesarean scar pregnancies: A case-control study

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    BACKGROUND: Cesarean scar pregnancies (CSP) are at high risk of pregnancy complications including placenta previa with antepartum hemorrhage, placenta accreta spectrum (PAS) and uterine rupture. OBJECTIVE: To evaluate the development of the utero-placental circulation in the first half of pregnancy in ongoing CSP and compare it to pregnancies implanted in the lower uterine segment above a prior cesarean section scar with no evidence of PAS at delivery. MATERIAL AND METHODS: This was a retrospective case-control study conducted in two tertiary referral centers. The study group included 27 women diagnosed with a live caesarean scar pregnancy in the first trimester of pregnancy who elected to conservative management. The control group included 27 women diagnosed with a low-lying/placenta previa at 19-22 weeks of gestation who had a first and an early second trimester ultrasound examinations. In both groups, the first ultrasound examination was carried out at 6-10 weeks to establish pregnancy location, viability and to confirm the gestational age. The utero-placental and intra-placental vasculatures were examined using color Doppler imaging (CDI) and described semi quantitatively using CDI score 1-4. The remaining myometrial thickness (RMT) was recorded in the study group whereas in the controls the ultrasound features of prior cesarean scar were noted including the presence of a niche. Both CSP and controls had also ultrasound examinations at 11-14 and 19-22 weeks of gestation. RESULTS: The mean CDI vascularity score at the 6-10 weeks ultrasound examination was significantly (P <.001) higher in the CSP group than in the controls. The high vascularity scores 3 and 4 were recorded in 20/27 (74%) cases of the CSP group. There was no vascularity score of 4 and only 3/27 (11%) controls had vascularity score of 3. In 15/27 (55.6%) CSPs the RMT was < 2 mm. At the 11-14 weeks ultrasound examination, there was no significant difference between the groups for the number of cases with increased subplacental vascularity but 12 CSPs (44%) presented with one or more placental lacunae whereas there was no case with lacunae in the controls. In the 18 CSP that progressed into the third trimester, ten were diagnosed with placenta previa creta at birth, including 4 creta and 6 increta. At the 19-22 weeks ultrasound examination, eight of the ten PAS presented with subplacental hypervascularity out of which, six showed also placental lacunae. CONCLUSION: The vascular changes in the utero-placental and intervillous circulations in CSPs are due to the loss of the normal uterine structure in the scar area and the development of placental tissue in proximity of large diameter arteries of the outer uterine wall. The intensity of these vascular changes, development of PAS and risk of uterine rupture depend on the RMT of the cesarean scar defect at the start of pregnancy. A better understanding of the pathophysiology of the utero-placental vascular changes associated with CSP should help in identifying those cases that may develop major complications and thus contribute to counselling women about the risks associated with different management strategies

    Physical resolution of tubal ectopic pregnancy on ultrasound imaging following successful expectant management

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    RESEARCH QUESTION What is the time required for complete physical resolution of tubal ectopic pregnancies diagnosed on ultrasound imaging in women undergoing successful expectant management? DESIGN A prospective observational cohort study of 177 women who had successful expectant management of tubal ectopic pregnancy, who attended a single Early Pregnancy Unit between January 2014 and December 2018. All participants were monitored until their serum β-hCG dropped to non-pregnant levels and with two-weekly follow-up ultrasound scans until resolution of the pregnancy. RESULTS 112/177 (63.8%, 95% CI 56.3-70.9) of tubal ectopic pregnancies were indiscernible on ultrasound 2 weeks after serum β-hCG had returned to non-pregnant levels. In 8/177 (4.5%, 95% CI 2.0-8.7) physical resolution took longer than 78 days. There was a positive correlation between biochemical and physical resolution of tubal ectopic pregnancy (r=0.21, p=0.006). CONCLUSIONS Physical resolution of tubal ectopic pregnancy is often prolonged and is positively correlated with initial and maximum β-hCG levels. Our results indicate that β-hCG resolution cannot be used as the end-point of expectant management of tubal ectopic pregnancy, which should be considered when counselling women and planning for future pregnancies. KEY MESSAGE In a significant proportion, physical resolution of tubal ectopic pregnancy takes several weeks following the return of serum β-hCG to non-pregnant levels. Women should be advised to delay trying for another pregnancy for three months, to avoid resolving pregnancies being misdiagnosed as new ones and to reduce the theoretical risk of recurrent ectopic, due to temporary tubal blockage by the resolving trophoblast

    Neoadjuvant eribulin mesylate following anthracycline and taxane in triple negative breast cancer: Results from the HOPE study

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    Background Eribulin mesylate (E) is indicated for metastatic breast cancer patients previously treated with anthracycline and taxane. We argued that E could also benefit patients eligible for neoadjuvant chemotherapy. Methods Patients with primary triple negative breast cancer 2 cm received doxorubicin 60 mg/m2 and paclitaxel 200 mg/m2 x 4 cycles (AT) followed by E 1.4 mg/m2 x 4 cycles. Primary endpoint was pathological complete response (pCR) rate; secondary and explorative endpoints included clinical/metabolic response rates and safety, and biomarker analysis, respectively. Using a two-stage Simon design, 43 patients were to be included provided that 4 of 13 patients had achieved pCR in the first stage of the study. Results In stage I of the study 13 women were enrolled, median age 43 years, tumor size 2–5 cm in 9/13 (69%), positive nodal status in 8/13 (61%). Main grade 3 adverse event was neutropenia (related to AT and E in 4 and 2 cases, respectively). AT followed by E induced clinical complete + partial responses in 11/13 patients (85%), pCR in 3/13 (23%). Median measurements of maximum standardized uptake value (SUVmax) resulted 13, 3, and 1.9 at baseline, after AT and E, respectively. Complete metabolic response (CMR) occurred after AT and after E in 2 and 3 cases, respectively. Notably, 2 of the 5 (40%) patients with CMR achieved pCR at surgery. Immunostaining of paired pre-/post-treatment tumor specimens showed a reduction of β-catenin, CyclinD1, Zeb-1, and c-myc expression, in the absence of N-cadherin modulation. The study was interrupted at stage I due to the lack of the required patients with pCR. Conclusions Despite the early study closure, preoperative E following AT showed clinical and biological activity in triple negative breast cancer patients. Furthermore, the modulation of β-catenin pathway core proteins, supposedly outside the domain of epithelial–mesenchymal transition, claims for further investigation. Trial registration EU Clinical Trial Register, EudraCT number 2012-004956-12

    A modeling approach to assess the hydrological response of small mediterranean catchments to the variability of soil characteristics in a context of extreme events

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    This paper presents a modeling study aiming at quantifying the possible impact of soil characteristics on the hydrological response of small ungauged catchments in a context of extreme events. The study focuses on the September 2002 event in the Gard region (South-Eastern France), which led to catastrophic flash-floods. The proposed modeling approach is able to take into account rainfall variability and soil profiles variability. Its spatial discretization is determined using Digital Elevation Model (DEM) and a soil map. The model computes infiltration, ponding and vertical soil water distribution, as well as river discharge. In order to be applicable to ungauged catchments, the model is set up without any calibration and the soil parameter specification is based on an existing soil database. The model verification is based on a regional evaluation using 17 estimated discharges obtained from an extensive post-flood investigation. Thus, this approach provides a spatial view of the hydrological response across a large range of scales. To perform the simulations, radar rainfall estimations are used at a 1 km&lt;sup&gt;2&lt;/sup&gt; and 5 min resolution. To specify the soil hydraulic properties, two types of pedotransfer function (PTF) are compared. It is shown that the PTF including information about soil structure reflects better the spatial variability that can be encountered in the field. The study is focused on four small ungauged catchments of less than 10 km&lt;sup&gt;2&lt;/sup&gt;, which experienced casualties. Simulated specific peak discharges are found to be in agreement with estimations from a post-event in situ investigation. Examining the dynamics of simulated infiltration and saturation degrees, two different behaviors are shown which correspond to different runoff production mechanisms that could be encountered within catchments of less than 10 km&lt;sup&gt;2&lt;/sup&gt;. They produce simulated runoff coefficients that evolve in time and highlight the variability of the infiltration capacity of the various soil types. Therefore, we propose a cartography distinguishing between areas prone to saturation excess and areas prone only to infiltration excess mechanisms. The questions raised by this modeling study will be useful to improve field observations, aiming at better understanding runoff generation for these extreme events and examine the possibility for early warning, even in very small ungauged catchments

    Tetrameric Complexes of Human Histocompatibility Leukocyte Antigen (HLA)-G Bind to Peripheral Blood Myelomonocytic Cells

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    The nonclassical MHC class I molecule human histocompatibility leukocyte antigen (HLA)-G is selectively expressed on fetal trophoblast tissue at the maternal–fetal interface in pregnancy. It has long been suggested that HLA-G may inhibit maternal natural killer (NK) cells through interaction with particular NK cell receptors (KIRs). To investigate interactions of HLA-G, we constructed phycoerythrin-labeled tetrameric complexes of HLA-G refolded with a self-peptide. These HLA-G tetramers failed to bind to NK cells and cells transfected with CD94/NKG2 and killer immunoglobulin-like NK receptors. In contrast, HLA-G tetramers did bind to peripheral blood monocytes, staining a CD16+CD14mid subset with greater intensity. On transfectants, HLA-G tetramers bound to inhibitory immunoglobulin-like transcript (ILT)2 and ILT4 receptors. However, staining in the presence of antibodies reactive with ILT receptors revealed that the interaction of HLA-G tetramers with blood monocytes was largely due to binding to ILT4. These results suggest that the primary role of HLA-G may be the modulation of myelomonocytic cell behavior in pregnancy
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