Stillbirth risk across pregnancy by size for gestational age in Western Cape Province, South Africa: Application of the fetuses-at-risk approach using perinatal audit data

Background. There is little published work on the risk of stillbirth across pregnancy for small-for-gestational-age (SGA) and large-for-gestational (LGA) pregnancies in low-resource settings.Objectives. To compare stillbirth risk across pregnancy between SGA and appropriate-for-gestational-age (AGA) pregnancies in Western Cape Province, South Africa (SA).Methods. A retrospective audit of perinatal mortality data using data from the SA Perinatal Problem Identification Program was conducted. All audited stillbirths with information on size for gestational age (N=677) in the Western Cape between October 2013 and August 2015 were included in the study. The Western Cape has antenatal care (ANC) appointments at booking and at 20, 26, 32, 34, 36, 38 and 41 (if required) weeks’ gestation. A fetuses-at-risk approach was adopted to examine stillbirth risk (28 - 42 weeks’ gestation, ≥1 000 g) across gestation by size for gestational age (SGA <10th centile Theron growth curves, LGA >90th centile). Stillbirth risk was compared between SGA/LGA and AGA pregnancies.Results. SGA pregnancies were at an increased risk of stillbirth compared with AGA pregnancies between 30 and 40 weeks’ gestation, with the relative risk (RR) ranging from 3.5 (95% confidence interval (CI) 1.6 - 7.6) at 30 weeks’ gestation to 15.3 (95% CI 8.8 - 26.4) at 33 weeks’ gestation (p<0.001). The risk for LGA babies increased by at least 3.5-fold in the later stages of pregnancy (from 37 weeks) (p<0.001). At 38  weeks, the greatest increased risk was seen for LGA pregnancies (RR 6.6, 95% CI 3.1 - 14.2; p<0.001).Conclusions. There is an increased risk of stillbirth for SGA pregnancies, specifically between 33 and 40 weeks’ gestation, despite fortnightly ANC visits during this time. LGA pregnancies are at an increased risk of stillbirth after 37 weeks’ gestation. This high-risk period highlights potential issues with the detection of fetuses at risk of stillbirth even when ANC is frequent.

INTERGROWTH-21st v. local South African growth standards (Theron-Thompson) for identification of small-for-gestational-age fetuses in stillbirths : a closer look at variation across pregnancy

CITATION: Lavin, T., et al. 2019. INTERGROWTH-21st v. local South African growth standards (Theron-Thompson) for identification of small-for-gestational-age fetuses in stillbirths : a closer look at variation across pregnancy. South African Medical Journal, 109(7):519-525, doi:10.7196/SAMJ.2019.v109i7.13485.The original publication is available at http://www.samj.org.zaBackground. Global growth standards for fetuses were recently developed (INTERGROWTH-21st). It has been advocated that professional bodies should adopt these global standards. Objectives. To compare the ability of INTERGROWTH-21st with local standards (Theron-Thompson) to identify small-for-gestational-age (SGA) fetuses in stillbirths in the South African (SA) setting. Methods. Stillbirths across SA were investigated (>500 g, 28 - 40 weeks) between October 2013 and December 2016 (N=14 776). The study applied the INTERGROWTH-21st standards to classify stillbirths as <10th centile (SGA) compared with Theron-Thompson growth charts, across pregnancy overall and at specific gestational ages. Results. The prevalence of SGA was estimated at 32.2% and 31.1% by INTERGROWTH-21st and Theron-Thompson, respectively. INTERGROWTH-21st captured 13.8% more stillbirths as SGA in the earlier gestations (28 - 30 weeks, p<0.001), but 4.0% (n=315) fewer between 33 and 38 weeks (p<0.001). Observed agreement and the Kappa coefficient were lower at earlier gestations and at 34 - 36 weeks. Conclusions. Our findings demonstrated differences in the proportion of stillbirths considered SGA at each gestational age between the INTERGROWTH-21st and the local SA standard, which have not been considered previously by other studies.http://www.samj.org.za/index.php/samj/article/view/12640Publisher's versio

DNA Sequence Variation among Conspecific Accessions of the Legume Coursetia caribaea Reveals Geographically Localized Clades Here Ranked as Species

 This is the author accepted manuscript. The final version is available from ASPT via the DOI in this recordCoursetia caribaea is geographically and morphologically the most variable species in the genus Coursetia and in the tribe Robinieae (Leguminosae, Papilionoideae). Because of potentially undetected species, we assessed the phylogenetic relationships among the eight taxonomic varieties of C. caribaea. Sampling included nuclear ribosomal internal transcribed spacer sequences from 489 Robinieae accessions representing all varieties of C. caribaea and 38 of the 40 species of Coursetia, in addition to chloroplast trnD-trnT sequences from 186 accessions. Separate and combined phylogenetic analyses resolved a clade of conspecific accessions of the Bolivian C. caribaea var. astragalina as sister to the central Andean Coursetia grandiflora clade. Also distantly related to Coursetia caribaea var. caribaea accessions were those of the coastal Oaxacan C. caribaea var. pacifica, which formed the sister clade to accessions of the central Andean C. caribaea var. ochroleuca. The estimated mean ages of the stem clades for these three lineages, 11, 7.7, and 7.7 Ma, respectively, contrasted to the estimated mean ages of the corresponding crown clades of 0, 0, and 1.5 Ma. The contrasting stem and crown ages suggest that these taxa, appropriately ranked as species, Coursetia astragalina , Coursetia diversifolia , and Coursetia ochroleuca , each have persisted over evolutionary time frames as distinct geographically localized populations in seasonally dry tropical forests and woodlands.USDA National Institute of Food and Agricultur

Primary physical education, coaches and continuing professional development

This is an Author's Accepted Manuscript of an article published in Sport, Education and Society, 16(4), 485 - 505, 2011, copyright @ Taylor & Francis, available online at: http://www.tandfonline.com/10.1080/13573322.2011.589645.Physical education (PE) in primary schools has traditionally been taught by qualified primary teachers. More recently, some teaching of PE in primary schools has been undertaken by coaches (mostly football coaches). These coaches hold national governing body awards but do not hold teaching qualifications. Thus, coaches may not be adequately prepared to teach PE in curriculum time. The purpose of this study was to evaluate the perceptions of a group of community-based football coaches working in primary schools for the impact of a Continuing Professional Development (CPD) programme on their ability to undertake ‘specified work’ to cover PE in primary schools. The programme focused on four areas identified as important to enable coaches to cover specified work: short- and medium-term planning, pedagogy, knowledge of the curriculum and reflection. Results showed that for the majority of coaches the CPD programme had made them more aware of the importance of these four areas and had helped to develop their knowledge and ability to put this into practice in covering planning, preparation and assessment time. However, further input is still required to develop coaches’ knowledge and understanding in all four areas, but especially their curriculum knowledge, as well as their ability to put these into practice consistently. These findings are discussed in relation to the implications of employing coaches to cover the teaching of PE in primary schools and, if employed, what CPD coaches need to develop the necessary knowledge, skill and understanding for covering specified work in schools

Routine blood monitoring in maintenance immunoglobulin treatment of inflammatory neuropathy: Is it clinically relevant?

Background: Pre-treatment screening for IgA deficiency and close monitoring of full blood count(FBC) and renal function is recommended with intravenous immunoglobulin(IVIg) therapy in neurological diseases. / Aims: To examine the frequency of biochemically defined and clinically significant episodes of treatment associated haemolysis, neutropenia, thrombocytopenia and acute kidney injury(AKI) in a cohort of patients on maintenance Immunoglobulin(Ig) therapy for inflammatory neuropathy. / Methods: A retrospective review of routine blood monitoring in patients from two UK specialist peripheral nerve centres. Accepted definitions for clinically and biochemically significant haemolysis, neutropenia, thrombocytopenia and AKI were used. / Results: 1919 infusion episodes in 90 patients were analysed. Age(mean(S.D)) = 58.09(14.4)years, 63% male, 72% CIDP(28% MMN), 97% IVIg(3% SCIg). Dose = 1.57(0.79)g/kg/month or 97.1(37.3)g/infusion, frequency:3.9(1.4) weeks. Relative IgA deficiency was noted in 2 individuals (prevalence:2.2%, 95%C.I.:0–5.2) who received a combined total of 38 infusions(3800 g IVIg) without adverse event. No clinically significant episodes of haemolysis, neutropenia, thrombocytopenia or AKI occurred in relation to treatment. An asymptomatic drop>10 g/L haemoglobin(Hb) occurred in 3.5%(95%CI:2.7–4.3) of treatment episodes in 38 individuals, mean reduction:17.7(7.4)g/L; lowest Hb:86 g/L. Lower pre-treatment haemoglobin correlated with risk of recurrent Ig-related drop(p:0.007). Two patients with chronic renal failure(stage 1 and 3) received 28(IV) and 104(SC) infusions respectively(6416 g) without impact on estimated glomerular filtration rate(eGFR). / Conclusions: No clinically significant Ig-related episodes of haemolysis or AKI were identified in this representative cohort. This suggests that routine monitoring is not essential in long-term Ig use but should be considered when clinically indicated

Chemical pressure effects on the spectroscopic properties of Nd3+-doped gallium nano-garnets

[EN] Nd3+-doped RE3Ga5O12 (RE = Gd, Y, and Lu) nano-crystalline garnets of 40-45 nm in size have been synthesized by a sol-gel method. With the decrease of the RE atom size, the chemical pressure related to the decreasing volumes of the GaO4 tetrahedral, GaO6 octahedral and REO8 dodecahedral units drive the nano-garnets toward a more compacted structure, which is evidenced by the change of the vibrational phonon mode frequencies. The chemical pressure also increases the crystal-field strength felt by the RE3+ ions while decreases the orthorhombic distortion of the REO8 local environment. These effects alter the absorption and emission properties of the Nd3+ ion measured in the near-infrared luminescence range from 0.87 to 1.43 ¿m associated with the 4 F3/2¿4 IJ (J = 9/2, 11/2, 13/2) transitions. The 4 F3/2 luminescence decay curves show non-exponential behavior due to dipole-dipole energy transfer interactions among Nd3+ ions that increases with pressure.Authors are grateful to The Governments of Spain and India for the Indo-Spanish Joint Programme of Bilateral Cooperation in Science and Technology (PRI-PIBIN-2011-1153/DST-INT-Spain-P-38-11). Dr. Venkatramu is grateful to DAE-BRNS, Government of India for the award of DAE Research Award for Young Scientist (No. 2010/20/34/5/BRNS/2223). This work have been partially supported by MINECO under The National Program of Materials (MAT2013-46649-C4-2-P/-3-P/-4-P), The Consolider-Ingenio 2010 Program (MALTA CSD2007-00045), by Fundacion CajaCanarias (ENER-01), and by the EU-FEDER funds. V. Monteseguro wishes to thank MICINN for the FPI grant (BES-2011-044596). Authors also thank Agencia Canaria de Investigacion, Innovacion y Sociedad de la Informacion for the funds given to Universidad de La Laguna, co-financed by The European Social Fund by a percentage of 85%.Monteseguro, V.; Rathaiah, M.; Linganna, K.; Lozano-Gorrin, AD.; Hernandez-Rodriguez, MA.; Martin, IR.; Babu, P.... (2015). Chemical pressure effects on the spectroscopic properties of Nd3+-doped gallium nano-garnets. Optical Materials Express. 5(8):1661-1673. https://doi.org/10.1364/OME.5.001661S1661167358Pollnau, M., Hardman, P. ., Clarkson, W. ., & Hanna, D. . (1998). Upconversion, lifetime quenching, and ground-state bleaching in Nd3+:LiYF4. Optics Communications, 147(1-3), 203-211. doi:10.1016/s0030-4018(97)00524-5Brandle, C. D., & Barns, R. L. (1974). Crystal stoichiometry of Czochralski grown rare-earth gallium garnets. Journal of Crystal Growth, 26(1), 169-170. doi:10.1016/0022-0248(74)90223-1Venkatramu, V., Giarola, M., Mariotto, G., Enzo, S., Polizzi, S., Jayasankar, C. K., … Speghini, A. (2010). Nanocrystalline lanthanide-doped Lu3Ga5O12garnets: interesting materials for light-emitting devices. Nanotechnology, 21(17), 175703. doi:10.1088/0957-4484/21/17/175703Speghini, A., Piccinelli, F., & Bettinelli, M. (2011). Synthesis, characterization and luminescence spectroscopy of oxide nanopowders activated with trivalent lanthanide ions: The garnet family. Optical Materials, 33(3), 247-257. doi:10.1016/j.optmat.2010.10.039Krsmanović, R., Morozov, V. A., Lebedev, O. I., Polizzi, S., Speghini, A., Bettinelli, M., & Tendeloo, G. V. (2007). Structural and luminescence investigation on gadolinium gallium garnet nanocrystalline powders prepared by solution combustion synthesis. Nanotechnology, 18(32), 325604. doi:10.1088/0957-4484/18/32/325604Naccache, R., Vetrone, F., Speghini, A., Bettinelli, M., & Capobianco, J. A. (2008). Cross-Relaxation and Upconversion Processes in Pr3+ Singly Doped and Pr3+/Yb3+ Codoped Nanocrystalline Gd3Ga5O12: The Sensitizer/Activator Relationship. The Journal of Physical Chemistry C, 112(20), 7750-7756. doi:10.1021/jp711494dAntic-Fidancev, E., Hölsä, J., Lastusaari, M., & Lupei, A. (2001). Dopant-host relationships in rare-earth oxides and garnets doped with trivalent rare-earth ions. Physical Review B, 64(19). doi:10.1103/physrevb.64.195108Rodríguez-Carvajal, J. (1993). Recent advances in magnetic structure determination by neutron powder diffraction. Physica B: Condensed Matter, 192(1-2), 55-69. doi:10.1016/0921-4526(93)90108-iMonteseguro, V., Rodríguez-Hernández, P., Ortiz, H. M., Venkatramu, V., Manjón, F. J., Jayasankar, C. K., … Muñoz, A. (2015). Structural, elastic and vibrational properties of nanocrystalline lutetium gallium garnet under high pressure. Physical Chemistry Chemical Physics, 17(14), 9454-9464. doi:10.1039/c4cp05903dRay, S., León-Luis, S. F., Manjón, F. J., Mollar, M. A., Gomis, Ó., Rodríguez-Mendoza, U. R., … Lavín, V. (2014). Broadband, site selective and time resolved photoluminescence spectroscopic studies of finely size-modulated Y2O3:Eu3+ phosphors synthesized by a complex based precursor solution method. Current Applied Physics, 14(1), 72-81. doi:10.1016/j.cap.2013.07.027Nekvasil, V. (1978). The Crystal Field for Nd3+ in Garnets. Physica Status Solidi (b), 87(1), 317-323. doi:10.1002/pssb.2220870137Rodríguez-Mendoza, U. R., León-Luis, S. F., Muñoz-Santiuste, J. E., Jaque, D., & Lavín, V. (2013). Nd3+-doped Ca3Ga2Ge3O12garnet: A new optical pressure sensor. Journal of Applied Physics, 113(21), 213517. doi:10.1063/1.4809217Kaminska, A., Buczko, R., Paszkowicz, W., Przybylińska, H., Werner-Malento, E., Suchocki, A., … Saxena, S. (2011). Merging of the4F3/2level states of Nd3+ions in the photoluminescence spectra of gadolinium-gallium garnets under high pressure. Physical Review B, 84(7). doi:10.1103/physrevb.84.075483Allik, T. H., Stewart, S. A., Sardar, D. K., Quarles, G. J., Powell, R. C., Morrison, C. A., … Pinto, A. A. (1988). Preparation, structure, and spectroscopic properties ofNd3+:{La1−xLux}3[Lu1−yGay]2Ga3O12crystals. Physical Review B, 37(16), 9129-9139. doi:10.1103/physrevb.37.9129Wu, K., Yao, B., Zhang, H., Yu, H., Wang, Z., Wang, J., & Jiang, M. (2010). Growth and properties of Nd:Lu3Ga5O12 laser crystal by floating-zone method. Journal of Crystal Growth, 312(24), 3631-3636. doi:10.1016/j.jcrysgro.2010.09.029Jia, Z., Arcangeli, A., Tao, X., Zhang, J., Dong, C., Jiang, M., … Tonelli, M. (2009). Efficient Nd3+→Yb3+ energy transfer in Nd3+,Yb3+:Gd3Ga5O12 multicenter garnet crystal. Journal of Applied Physics, 105(8), 083113. doi:10.1063/1.3115442Guillot-Noel, O., Bellamy, B., Viana, B., & Gourier, D. (1999). Correlation between rare-earth oscillator strengths and rare-earth–valence-band interactions in neodymium-dopedYMO4(M=V,P, As),Y3Al5O12,andLiYF4matrices. Physical Review B, 60(3), 1668-1677. doi:10.1103/physrevb.60.1668Demidovich, A. A., Shkadarevich, A. P., Danailov, M. B., Apai, P., Gasmi, T., Gribkovskii, V. P., … Batay, L. E. (1998). Comparison of cw laser performance of Nd:KGW, Nd:YAG, Nd:BEL, and Nd:YVO 4 under laser diode pumping. Applied Physics B: Lasers and Optics, 67(1), 11-15. doi:10.1007/s003400050467Inokuti, M., & Hirayama, F. (1965). Influence of Energy Transfer by the Exchange Mechanism on Donor Luminescence. The Journal of Chemical Physics, 43(6), 1978-1989. doi:10.1063/1.1697063Lupei, V., & Lupei, A. (2000). Emission dynamics of the4F3/2level ofNd3+in YAG at low pump intensities. Physical Review B, 61(12), 8087-8098. doi:10.1103/physrevb.61.8087Maeda, K., Wada, N., Umino, M., Abe, M., Takada, Y., Nakano, N., & Kuroda, H. (1984). Concentration Dependence of Fluorescence Lifetime of Nd3+-Doped Gd3Ga5O12Lasers. Japanese Journal of Applied Physics, 23(Part 2, No. 10), L759-L760. doi:10.1143/jjap.23.l759Geusic, J. 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Diet Soda Intake and Risk of Incident Metabolic Syndrome and Type 2 Diabetes in the Multi-Ethnic Study of Atherosclerosis (MESA)*

Stereo imaging is an important area of image and video processing, with exploding progress in the last decades. An open issue in this field is the understanding of the conditions under which the straightforward application of a given image processing operator to both the left and right image of a stereo pair preserves the stereoscopic perception. In this paper, we explore this problem with application to artistic imaging and we prove that, unlike other methods, artistic operators based on edge preserving smoothing have this desirable property. We also present a novel multiresolution artistic operator, purposely designed for stereo images, which enhances the perception of three-dimensionality by means of a depth driven local scale control.

Extrapyramidal side effects and suicidal ideation under fluoxetine treatment: a case report

<p>Abstract</p> <p>Background</p> <p>We present the case of a 52-year-old woman with depression who developed extrapyramidal symptoms (mainly parkinsonism) and suicidal ideation while on fluoxetine.</p> <p>Methods</p> <p>The patient underwent neurological and neuroimaging examination.</p> <p>Results</p> <p>The patient's neurological and neuroimaging examinations were normal and there was no other cause of extrapyramidal symptoms. The patient showed remission of the aforementioned symptomatology when fluoxetine was discontinued.</p> <p>Conclusions</p> <p>This case shows that fluoxetine can be associated with extrapyramidal symptoms, and this may have an aggravating affect on clinical depression progress and the emergence of suicidal ideation.</p