Male fetal loss in the U.S. following the terrorist attacks of September 11, 2001

Background: The secondary sex ratio (i.e., the odds of a male birth) reportedly declines following natural disasters, pollution events, and economic collapse. It remains unclear whether this decline results from an excess of male fetal loss or reduced male conceptions. The literature also does not converge as to whether the terrorist attacks of September 11, 2001 induced "communal bereavement", or the widespread feeling of distress among persons who never met those directly involved in the attacks. We test the communal bereavement hypothesis among gravid women by examining whether male fetal deaths rose above expected levels in the US following September 11, 2001. Methods: We apply interrupted time-series methods to all fetal deaths at or greater than the 20(th) week of gestation in the US from 1996 to 2002. Time-series methods control for trends, seasonality, and other forms of autocorrelation that could induce spurious associations. Results: Results support the hypothesis in that the fetal death sex ratio (i.e., the odds of a male fetal death) increased above its expected value in September 2001. Additional analysis of the secondary sex ratio indirectly supports that the terrorist attacks may have threatened the gestation of male more than female fetuses. Conclusions: Societal responses to events such as September 11, 2001 do not appear confined only to persons who have ever met the deceased. The fetal death sex ratio in the US population may serve as a sentinel indicator of the degree to which pregnant women react to population stressors

Reducing Versatile Bat Wing Conformations to a 1-DoF Machine

Recent works have shown success in mimicking the flapping flight of bats on the robotic platform Bat Bot (B2). This robot has only five actuators but retains the ability to flap and fold-unfold its wings in flight. However, this bat-like robot has been unable to perform folding-unfolding of its wings within the period of a wingbeat cycle, about 100 ms. The DC motors operating the spindle mechanisms cannot attain this folding speed. Biological bats rely on this periodic folding of their wings during the upstroke of the wingbeat cycle. It reduces the moment of inertia of the wings and limits the negative lift generated during the upstroke. Thus, we consider it important to achieve wing folding during the upstroke. A mechanism was designed to couple the flapping cycle to the folding cycle of the robot. We then use biological data to further optimize the mechanism such that the kinematic synergies of the robot best match those of a biological bat. This ensures that folding is performed at the correct point in the wingbeat cycle

Idiopathic adult intussusception

Intussusception is an uncommon cause of abdominal pain in adults and poses diagnostic challenges for emergency physicians, due to its varied presenting symptoms and time course. Diagnosis is thus often delayed and results in surgical intervention due to the development of bowel ischaemia. We report on a young patient who presented with an ileo-ileal intussusception in whom there were no underlying lesions identified as a causal factor

Investigation of low 5-year relative survival for breast cancer in a London cancer network

BACKGROUND: Breast cancer 5-year relative survival is low in the North East London Cancer Network (NELCN). METHODS: We compared breast cancer that was diagnosed during 2001-2005 with that in the rest of London. RESULTS: North East London Cancer Network women more often lived in socioeconomic quintile 5 (42 vs 21%) and presented with advanced disease (11 vs 7%). Cox regression analysis showed the survival difference (hazard ratio: 1.27, 95% confidence interval (CI): 1.15-1.41) reduced to 1.00 (95% CI: 0.89-1.11) after adjustment for age, stage, socioeconomic deprivation, ethnicity and treatment. Major drivers were stage and deprivation. Excess mortality was in the first year. CONCLUSION: Late diagnosis occurs in NELCN

Mother's occupation and sex ratio at birth

<p>Abstract</p> <p>Background</p> <p>Many women are working outside of the home, occupying a multitude of jobs with varying degrees of responsibilities and levels of psychological stress. We investigated whether different job types in women are associated with child sex at birth, with the hypothesis that women in job types, which are categorized as "high psychological stress" jobs, would be more likely to give birth to a daughter than a son, as females are less vulnerable to unfavourable conditions during conception, pregnancy and after parturition, and are less costly to carry to term.</p> <p>Methods</p> <p>We investigated the effects of mother's age, maternal and paternal job type (and associated psychological stress levels) and paternal income on sex ratio at birth. Our analyses were based on 16,384 incidences of birth from a six-year (2000 to 2005 inclusive) childbirth dataset from Addenbrooke's Hospital in Cambridge, UK. We obtained a restricted data set from Addenbrooke's hospital with: maternal age, maternal and paternal occupations, and whether or not the child was first-born.</p> <p>Results</p> <p>Women in job types that were categorized as "high stress" were more likely to give birth to daughters, whereas women in job types that were categorized as "low stress" had equal sex ratios or a slight male bias in offspring. We also investigated whether maternal age, and her partner's income could be associated with reversed offspring sex ratio. We found no association between mother's age, her partner's job stress category or partner income on child sex. However, there was an important interaction between job stress category and partner income in some of the analyses. Partner income appears to attenuate the association between maternal job stress and sex ratios at moderate-income levels, and reverse it at high-income levels.</p> <p>Conclusions</p> <p>To our knowledge this is the first report on the association between women's job type stress categories and offspring sex ratio in humans, and the potential mitigating effect of their partners' income.</p

Relic neutrino masses and the highest energy cosmic rays

We consider the possibility that a large fraction of the ultrahigh energy cosmic rays are decay products of Z bosons which were produced in the scattering of ultrahigh energy cosmic neutrinos on cosmological relic neutrinos. We compare the observed ultrahigh energy cosmic ray spectrum with the one predicted in the above Z-burst scenario and determine the required mass of the heaviest relic neutrino as well as the necessary ultrahigh energy cosmic neutrino flux via a maximum likelihood analysis. We show that the value of the neutrino mass obtained in this way is fairly robust against variations in presently unknown quantities, like the amount of neutrino clustering, the universal radio background, and the extragalactic magnetic field, within their anticipated uncertainties. Much stronger systematics arises from different possible assumptions about the diffuse background of ordinary cosmic rays from unresolved astrophysical sources. In the most plausible case that these ordinary cosmic rays are protons of extragalactic origin, one is lead to a required neutrino mass in the range 0.08 eV - 1.3 eV at the 68 % confidence level. This range narrows down considerably if a particular universal radio background is assumed, e.g. to 0.08 eV - 0.40 eV for a large one. The required flux of ultrahigh energy cosmic neutrinos near the resonant energy should be detected in the near future by AMANDA, RICE, and the Pierre Auger Observatory, otherwise the Z-burst scenario will be ruled out.Comment: 19 pages, 22 figures, REVTeX

Survival in dialysis patients is not different between patients with diabetes as primary renal disease and patients with diabetes as a co-morbid condition

On dialysis, survival among patients with diabetes mellitus is inferior to survival of non-diabetic patients. We hypothesized that patients with diabetes as primary renal disease have worse survival compared to patients with diabetes as a co-morbid condition and aimed to compare all-cause mortality between these patient groups. Data were collected from the Netherlands Cooperative Study on the Adequacy of Dialysis (NECOSAD), a multicenter, prospective cohort study in which new patients with end stage renal disease (ESRD) were monitored until transplantation or death. Patients with diabetes as primary cause of ESRD were compared with patients with diabetes as co-morbid condition and both of these patient groups were compared to patients without diabetes. Analysis was performed using Kaplan-Meier and Cox regression. Fifteen % of the patients had diabetic nephropathy as primary renal disease (N = 281); 6% had diabetes as co-morbid condition (N = 107) and 79% had no diabetes (N = 1465). During follow-up 42% of patients (N = 787) died. Compared to non-diabetic patients, mortality risk was increased for both patients with diabetes as primary renal disease HR: 1.9 (95% CI 1.6, 2.3) and for patients with diabetes as co-morbid condition HR: 1.7 (95% CI 1.3, 2.2). Mortality was not significantly higher in patients with diabetes as primary renal disease compared to patients with diabetes as co-morbid condition (HR 1.06; 95% CI 0.79, 1.43). This study in patients with ESRD showed no survival difference between patients with diabetes as primary renal disease and patients with diabetes as a co-morbid condition. Both conditions were associated with increased mortality risk compared to non-diabetic patient

Hypoxia and Prostaglandin E Receptor 4 Signalling Pathways Synergise to Promote Endometrial Adenocarcinoma Cell Proliferation and Tumour Growth

The prostaglandin endoperoxide synthase (PTGS) pathway is a potent driver of tumour development in humans by enhancing the biosynthesis and signalling of prostaglandin (PG) E2. PTGS2 expression and PGE2 biosynthesis is elevated in endometrial adenocarcinoma, however the mechanism whereby PTGS and PGE2 regulate endometrial tumour growth is unknown. Here we investigated (a) the expression profile of the PGE synthase enzymes (PTGES, PTGES-2, PTGES-3) and PGE receptors (PTGER1–4) in endometrial adenocarcinomas compared with normal endometrium and (b) the role of PTGER4 in endometrial tumorigenesis in vivo. We found elevated expression of PTGES2 and PTGER4 and suppression of PTGER1 and PTGER3 in endometrial adenocarcinomas compared with normal endometrium. Using WT Ishikawa endometrial adenocarcinoma cells and Ishikawa cells stably transfected with the full length PTGER4 cDNA (PTGER4 cells) xenografted in the dorsal flanks of nude mice, we show that PTGER4 rapidly and significantly enhances tumour growth rate. Coincident with enhanced PTGER4-mediated tumour growth we found elevated expression of PTGS2 in PTGER4 xenografts compared with WT xenografts. Furthermore we found that the augmented growth rate of the PTGER4 xenografts was not due to enhanced angiogenesis, but regulated by an increased proliferation index and hypoxia. In vitro, we found that PGE2 and hypoxia independently induce expression of PTGER4 indicating two independent pathways regulating prostanoid receptor expression. Finally we have shown that PGE2 and hypoxia synergise to promote cellular proliferation of endometrial adenocarcinoma cells

Continuity of midwifery care and gestational weight gain in obese women: a randomised controlled trial

Background: The increased prevalence of obesity in pregnant women in Australia and other developed countries is a significant public health concern. Obese women are at increased risk of serious perinatal complications and guidelines recommend weight gain restriction and additional care. There is limited evidence to support the effectiveness of dietary and physical activity lifestyle interventions in preventing adverse perinatal outcomes and new strategies need to be evaluated. The primary aim of this project is to evaluate the effect of continuity of midwifery care on restricting gestational weight gain in obese women to the recommended range. The secondary aims of the study are to assess the impact of continuity of midwifery care on: women&rsquo;s experience of pregnancy care; women&rsquo;s satisfaction with care and a range of psychological factors.Methods/Design: A two arm randomised controlled trial (RCT) will be conducted with primigravid women recruited from maternity services in Victoria, Australia. Participants will be primigravid women, with a BMI&ge;30 who are less than 17 weeks gestation. Women allocated to the intervention arm will be cared for in a midwifery continuity of care model and receive an informational leaflet on managing weight gain in pregnancy. Women allocated to the control group will receive routine care in addition to the same informational leaflet. Weight gain during pregnancy, standards of care, medical and obstetric information will be extracted from medical records. Data collected at recruitment (self administered survey) and at 36 weeks by postal survey will include sociodemographic information and the use of validated scales to measure secondary outcomes.Discussion: Continuity of midwifery care models are well aligned with current Victorian, Australian and many international government policies on maternity care. Increasingly, midwifery continuity models of care are being introduced in low risk maternity care, and information on their application in high risk populations is required. There is an identified need to trial alternative antenatal interventions to reduce perinatal risk factors for women who are obese and the findings from this project may have application in other maternity services. In addition this study will inform a larger trial that will focus on birth and postnatal outcomes.<br /