Cardiac time intervals and myocardial performance index for prediction of twin-twin transfusion syndrome

Objectives To explore whether intertwin discordance in myocardial performance index (MPI) or cardiac time intervals enables the prediction of twin-twin transfusion syndrome (TTTS) in monochorionic diamniotic (MCDA) pregnancies with amniotic fluid discordance.Methods Prospective cohort study of MCDA pregnancies with amniotic fluid discordance >= 4 cm. Serial ultrasound examinations consisted of evaluation of amniotic fluid, fetal Dopplers and fetal cardiac function.Results We included 21 "future-TTTS" (group I), 18 selective fetal growth restriction (sFGR; group II) and 20 uncomplicated MCDA twin pairs (group III). Group I had a higher intertwin difference in left ventricle (LV) MPI and right ventricle (RV) MPI compared to group II and III. The intertwin difference in global heart relaxation time was significantly higher in group I compared to group III. Future recipient twins had significantly higher relaxation times of the global heart and RV and lower contraction times of the global heart and RV compared to the "expected recipients" in group II and III.Conclusion Intertwin discordance in LV-MPI and RV-MPI differentiate between TTTS and MCDA pregnancies with transient discordant amniotic fluid volume. Cardiac time intervals identify future recipient twins. The clinical utility of cardiac time intervals and MPI should be investigated in large prospective studies.Research into fetal development and medicin

Underground railroads: citizen entitlements and unauthorized mobility in the antebellum period and today

In recent years, some scholars and prominent political figures have advocated the deepening of North American integration on roughly the European Union model, including the creation of new political institutions and the free movement of workers across borders. The construction of such a North American Union, if it included even a very thin trans-state citizenship regime, could represent the most significant expansion of individual entitlements in the region since citizenship was extended to former slaves in the United States. With such a possibility as its starting point, this article explores some striking parallels between the mass, legally prohibited movement across boundaries by fugitive slaves in the pre-Civil War period, and that by current unauthorized migrants to the United States. Both were, or are, met on their journeys by historically parallel groups of would-be helpers and hinderers. Their unauthorized movements in both periods serve as important signals of incomplete entitlements or institutional protections. Most crucially, moral arguments for extending fuller entitlements to both groups are shown here to be less distinct than may be prima facie evident, reinforcing the case for expanding and deepening the regional membership regime

Performance and genetic assessment of rubber tree clones in Southern Thailand

Thailand is the world leader in the production of latex extracted from the rubber tree (Hevea brasiliensis). However, the most cultivated clone RRIM 600, is highly susceptible to diseases, and there is economic incentive to develop new rubber tree clones. Four rubber tree clones (T2, SK1, NK1 and SK3) that have high latex yield potential from plantations in Southern Thailand were selected for this study. Yield performance, latex biochemical parameters and anatomical characteristics of bark were monitored for two years, using RRIM 600 clones in the same fields as paired controls. The average yields of the clones SK1, NK1 and SK3 were 129.3, 74.2 and 53.9 g per tree per tapping, respectively, surpassing the paired RRIM 600 controls (94.3, 49.9 and 43.9 g per tree per tapping in matching order). There was a difference in girth increment of SK1, SK3 and T2 clones when compared with RRIM 600, whereas the clones SK1 and T2 had higher renewed bark thickness than the paired RRIM 600. The anatomical measurements showed that the diameter of the latex vessels and density of latex vessels mm−2 were the highest in clone NK1, which also had the best latex biochemical parameters. This indicates NK1 is superior, and supports its use in Hevea breeding programs to improve latex yield. Our genetic characterization and assessment of the four clones selected used Random Amplified Polymorphic DNA (RAPD) and Simple Sequence Repeats (SSR). Seventeen recommended rubber clones were included as references. The clones SK3 and SK1 were closely related to RRIM 600 with similarity coefficients of 0.891 and 0.809, while NK1 and T2 were closely related to RRIT 250 (0.836) and RRIC 110 (0.864), respectively

The value of echocardiography and Doppler in the prediction of fetal demise after laser coagulation for TTTS: A systematic review and meta-analysis

Obstetric

The value of echocardiography and Doppler in the prediction of fetal demise after laser coagulation for TTTS: A systematic review and meta‐analysis

Obstetric

Cardiac time intervals and myocardial performance index for prediction of twin‐twin transfusion syndrome

Objectives To explore whether intertwin discordance in myocardial performance index (MPI) or cardiac time intervals enables the prediction of twin-twin transfusion syndrome (TTTS) in monochorionic diamniotic (MCDA) pregnancies with amniotic fluid discordance.Methods Prospective cohort study of MCDA pregnancies with amniotic fluid discordance >= 4 cm. Serial ultrasound examinations consisted of evaluation of amniotic fluid, fetal Dopplers and fetal cardiac function.Results We included 21 "future-TTTS" (group I), 18 selective fetal growth restriction (sFGR; group II) and 20 uncomplicated MCDA twin pairs (group III). Group I had a higher intertwin difference in left ventricle (LV) MPI and right ventricle (RV) MPI compared to group II and III. The intertwin difference in global heart relaxation time was significantly higher in group I compared to group III. Future recipient twins had significantly higher relaxation times of the global heart and RV and lower contraction times of the global heart and RV compared to the "expected recipients" in group II and III.Conclusion Intertwin discordance in LV-MPI and RV-MPI differentiate between TTTS and MCDA pregnancies with transient discordant amniotic fluid volume. Cardiac time intervals identify future recipient twins. The clinical utility of cardiac time intervals and MPI should be investigated in large prospective studies.Research into fetal development and medicin

Acquired right ventricular outflow tract obstruction in twin-to-twin transfusion syndrome; a prospective longitudinal study

Research into fetal development and medicin