Tobacco use in the third trimester of pregnancy and its relationship to birth weight. A prospective study in Spain

Background Few studies have been carried out in Spain examining the use of tobacco amongst expectant mothers and its effect on birth weight. Aims To observe the proportion of expectant mothers who smoke during their pregnancy, and the impact of tobacco consumption on maternal and birth weight. We also aimed to identify the trimester of pregnancy in which tobacco use produced the greatest reduction in birth weight. Methods Prospective observational study in Spain. A random sampling strategy was used to select health centres and participant women. A total of 137 individuals were enrolled in the study. Exposure to tobacco was measured through a self-reported questionnaire. Regressions were performed to obtain a predictive model for birth weight related to smoking. Findings Overall, 35% of study participants were smokers during the pre-gestational period (27% in the first trimester, 21.9% in the second and 21.2% in the third). 38.7% of smoking cessation attempts took place in the third-trimester. Pregnant women who smoked up to the third trimester had a higher risk of giving birth to a baby under 3000 g, compared to non-smokers (OR = 5.94, CI 95%: 1.94–18.16). Each additional unit of tobacco consumed daily in the 3rd trimester led to a 32 g reduction in birth weight. Conclusion An important proportion of pregnant women in Spain smoke during pregnancy. Pregnant women exposed to tobacco have newborns with lower birth weight. Smoking during the 3rd trimester of pregnancy is associated with the greatest risk of lower birth weight

Rapid Spatial Mapping of Focused Ultrasound Fields Using a Planar Fabry-Pérot Sensor

Measurement of high acoustic pressures is necessary in order to fully characterise clinical high-intensity focused ultrasound (HIFU) fields, and for accurate validation of computational models of ultrasound propagation. However, many existing measurement devices are unable to withstand the extreme pressures generated in these fields, and those that can often exhibit low sensitivity. Here, a planar Fabry-Pérot interferometer with hard dielectric mirrors and spacer was designed, fabricated, and characterised and its suitability for measurement of nonlinear focused ultrasound fields was investigated. The noise equivalent pressure of the scanning system scaled with the adjustable pressure detection range between 49 kPa for pressures up to 8 MPa and 152 kPa for measurements up to 25 MPa, over a 125 MHz measurement bandwidth. Measurements of the frequency response of the sensor showed that it varied by less than 3 dB in the range 1 - 62 MHz. The effective element size of the sensor was 65 μm and waveforms were acquired at a rate of 200 Hz. The device was used to measure the acoustic pressure in the field of a 1.1 MHz single element spherically focused bowl transducer. Measurements of the acoustic field at low pressures compared well with measurements made using a PVDF needle hydrophone. At high pressures, the measured peak focal pressures agreed well with the focal pressure modelled using the Khokhlov-Zabolotskaya-Kuznetsov equation. Maximum peak positive pressures of 25 MPa, and peak negative pressures of 12 MPa were measured, and planar field scans were acquired in scan times on the order of 1 minute. The properties of the sensor and scanning system are well suited to measurement of nonlinear focused ultrasound fields, in both the focal region and the low pressure peripheral regions. The fast acquisition speed of the system and its low noise equivalent pressure are advantageous, and with further development of the sensor, it has potential in application to HIFU metrology

Microscopic origin of universality in Casimir forces

The microscopic mechanisms for universality of Casimir forces between macroscopic conductors are displayed in a model of classical charged fluids. The model consists of two slabs in empty space at distance $d$ containing classical charged particles in thermal equilibrium (plasma, electrolyte). A direct computation of the average force per unit surface yields, at large distance, the usual form of the Casimir force in the classical limit (up to a factor 2 due to the fact that the model does not incorporate the magnetic part of the force). Universality originates from perfect screening sum rules obeyed by the microscopic charge correlations in conductors. If one of the slabs is replaced by a macroscopic dielectric medium, the result of Lifshitz theory for the force is retrieved. The techniques used are Mayer expansions and integral equations for charged fluids.Comment: 31 pages, 0 figures, submitted to Journal of Statistical Physic

Benchmarking tomographic acquisition schemes for high-resolution structural biology

Cryo electron tomography with subsequent subtomogram averaging is a powerful technique to structurally analyze macromolecular complexes in their native context. Although close to atomic resolution in principle can be obtained, it is not clear how individual experimental parameters contribute to the attainable resolution. Here, we have used immature HIV-1 lattice as a benchmarking sample to optimize the attainable resolution for subtomogram averaging. We systematically tested various experimental parameters such as the order of projections, different angular increments and the use of the Volta phase plate. We find that although any of the prominently used acquisition schemes is sufficient to obtain subnanometer resolution, dose-symmetric acquisition provides considerably better outcome. We discuss our findings in order to provide guidance for data acquisition. Our data is publicly available and might be used to further develop processing routines

Doppler ultrasound - a valid and reliable tool to assess spondyloarthritis

Enthesitis is the hallmark of spondyloarthritis and is observed in all subtypes. Namely, a wide information on spondyloarthritis abnormalities, including synovitis, bursitis, tendinitis, enthesitis and cortical bone abnormalities (erosions and enthesophytes), can be efficiently perceived by ultrasound power Doppler. Furthermore, several studies on imaging of enthesis showed that imaging techniques are better than clinical examination to detect pathology at asymptomatic enthesis. Vascularized enthesitis detected by ultrasound power Doppler appears to be a valuable diagnostic tool to confirm spondyloarthritis diagnosis. This article focuses on the validity and reliability of ultrasound enthesitis assessment in the management of spondyloarthritis patients

Constriction imposed by basement membrane regulates developmental cell migration

The basement membrane (BM) is a specialized extracellular matrix (ECM), which underlies or encases developing tissues. Mechanical properties of encasing BMs have been shown to profoundly influence the shaping of associated tissues. Here, we use the migration of the border cells (BCs) of the Drosophila egg chamber to unravel a new role of encasing BMs in cell migration. BCs move between a group of cells, the nurse cells (NCs), that are enclosed by a monolayer of follicle cells (FCs), which is, in turn, surrounded by a BM, the follicle BM. We show that increasing or reducing the stiffness of the follicle BM, by altering laminins or type IV collagen levels, conversely affects BC migration speed and alters migration mode and dynamics. Follicle BM stiffness also controls pairwise NC and FC cortical tension. We propose that constraints imposed by the follicle BM influence NC and FC cortical tension, which, in turn, regulate BC migration. Encasing BMs emerge as key players in the regulation of collective cell migration during morphogenesis

Evaluation of care and treatment clinics using a four-year retrospective cohort of patients receiving anti-retroviral therapy in Mbeya Region, Tanzania

Evaluations of sub-national anti-retroviral therapy (ART) programmes’ performance are important to support regional programme planning and epidemic response. We constructed a four-year retrospective cohort of clients from 10 care and treatment clinics (CTC) in the Mbeya region of Tanzania using routinely collected data from patients initiating ART between January 1, 2008 and March 31, 2012. Our primary outcomes were mortality rate and lost to follow up. We calculated ART coverage based on regional prevalence estimates and used medical cards, drug registers and quarterly reports to assess data quality. We enrolled 17,813 participants into the cohort. More patients initiated ART at WHO stages 3 (58.9%), and at CD4 cell counts between 50-199 cells/µl (56%). The proportion of patients initiating ARTs at a CD4 counts <50 cells/µl decreased from 40.7% in 2008 to 33.8% in 2012 (p-value <0.001). A total of 10,155 (57.0%) patients were lost to follow up (LTFU) during the 4 years of follow up; 59.2% were female. The overall mortality rate was 17.8 per 1000 person years; the six-month mortality was 6.2 per 1000 person years. The risk of mortality for patients at WHO stage III and IV was more than twice as high (hazard ratio [HR] 2.15; 95% confidence interval [CI], 1.05-4.39 and HR 2.29; 95% CI, 1.39-6.37, respectively) as compared to stage I and II. Those patients initiating ART with CD4 cell count between 50 and 199 cells/µl had significantly lower hazard of death compared to those initiating ART with CD4 cells counts <50 cells/µl (HR 0.51, 95% CI 0.34-0.78). In conclusion, during the study, a high proportion of patients were lost to follow up, and the majority of them were female. Most patients initiated ARTs at lower CD4 count (<200 cells/mm3) and at WHO stages III and IV, and they had higher risk of mortality compared to those initiated at higher CD4 counts and WHO stage I and II. Emphasis needs to be placed on strategies of early diagnosis of HIV infection, prompt initiation of ART, and support for ART adherence to minimise lost to follow up

Evaluating cognitive rehabilitation in multiple sclerosis: on the bumpy road to establishing evidence

There is marked enfeeblement of the memory; conceptions are formed slowly; the intellectual and emotional faculties are blunted in their totality,” Charcot (1877) reportedly noted about people with multiple sclerosis (MS) [1]. Despite these early observations of what we now refer to as ‘cognitive deficits’ and ‘mood disorders’, the magnitude and severity of these problems in MS were not considered seriously until over 100 years later. By the early 1990s, studies had begun to consistently demonstrate that people with MS reported cognitive problems