Obstetric and neonatal outcome among women presenting with reduced fetal movements in third trimester

Background: Reduced maternal perception of fetal movements allows early identification, timely evaluation and intervention for fetuses at risk of adverse outcome. The primary objective of this study was to assess the pregnancy characteristics and outcomes of pregnant women presenting to hospital with reduced fetal movements (RFM).Methods: Prospective observational study, recruiting all women with singleton pregnancy at or beyond 28 weeks of gestation presenting with a subjective perception of RFM from April 2015 to December 2016. Maternal characteristics, antenatal risk factors, management pathways and perinatal outcome studied.Results: 47% belonged to high risk pregnancy. Among high risk women, although only 39% showed poor BPP at the first presentation, 58% were delivered irrespective of their gestational age, out of which 32.75% had poor neonatal outcome. Among low risk who had >2 episodes of RFM, 50% had poor neonatal outcome. 7% among high risk pregnancies and 18% among low risk, presented with RFM within 48 hours following steroid prophylaxis.24% of high risk women showed liquor volume abnormalities as compared to low risk (6.3%).Conclusions: Significant proportion of those with RFM belonged to high risk pregnancy. Among high risk group, there were high rates of stillbirth and poor BPP at the time of admission when compared to low risk group. Due to early approach to the hospital and timely intervention, significant women with abnormal BPP had good perinatal outcome. All those fetuses who were delivered on first episode of RFM in low risk group did not show evidence of compromise at birth, probably indicating unnecessary delivery. More than 2 episodes of RFM even among low risk group seems significant as good number of fetuses were compromised at birth. Steroids prophylaxis for the fetal lung maturity causes transient changes in BPP, hence unnecessary delivery should be avoided especially those among low risk pregnancy

Negative Thermal Expansion Near the Precipice of Structural Stability in Open Perovskites

Negative thermal expansion (NTE) describes the anomalous propensity of materials to shrink when heated. Since its discovery, the NTE effect has been found in a wide variety of materials with an array of magnetic, electronic and structural properties. In some cases, the NTE originates from phase competition arising from the electronic or magnetic degrees of freedom but we here focus on a particular class of NTE which originates from intrinsic dynamical origins related to the lattice degrees of freedom, a property we term structural negative thermal expansion (SNTE). Here we review some select cases of NTE which strictly arise from anharmonic phonon dynamics, with a focus on open perovskite lattices. We find that NTE is often present close in proximity to competing structural phases, with structural phase transition lines terminating near T=0 K yielding the most prominent displays of the SNTE effect. We further provide a theoretical model to make precise the proposed relationship among the signature behavior of SNTE, the proximity of these systems to structural quantum phase transitions and the effects of phase fluctuations near these unique regions of the structural phase diagram. The effects of compositional disorder on NTE and structural phase stability in perovskites are discussed

Morphometry-based radiomics for predicting therapeutic response in patients with gliomas following radiotherapy

IntroductionGliomas are still considered as challenging in oncologic management despite the developments in treatment approaches. The complete elimination of a glioma might not be possible even after a treatment and assessment of therapeutic response is important to determine the future course of actions for patients with such cancers. In the recent years radiomics has emerged as a promising solution with potential applications including prediction of therapeutic response. Hence, this study was focused on investigating whether morphometry-based radiomics signature could be used to predict therapeutic response in patients with gliomas following radiotherapy.Methods105 magnetic resonance (MR) images including segmented and non-segmented images were used to extract morphometric features and develop a morphometry-based radiomics signature. After determining the appropriate machine learning algorithm, a prediction model was developed to predict the therapeutic response eliminating the highly correlated features as well as without eliminating the highly correlated features. Then the model performance was evaluated.ResultsTumor grade had the highest contribution to develop the morphometry-based signature. Random forest provided the highest accuracy to train the prediction model derived from the morphometry-based radiomics signature. An accuracy of 86% and area under the curve (AUC) value of 0.91 were achieved for the prediction model evaluated without eliminating the highly correlated features whereas accuracy and AUC value were 84% and 0.92 respectively for the prediction model evaluated after eliminating the highly correlated features.DiscussionNonetheless, the developed morphometry-based radiomics signature could be utilized as a noninvasive biomarker for therapeutic response in patients with gliomas following radiotherapy

Potential implementation strategies, acceptability, and feasibility of new and repurposed TB vaccines

Recently, two Phase 2B tuberculosis vaccine trials reported positive efficacy results in adolescents and adults. However, experience in vaccinating these age groups is limited. We identified potential implementation strategies for the M72/AS01E vaccination and BCG-revaccination-like candidates and explored their acceptability and feasibility. We conducted in-depth semi-structured interviews among key decision makers to identify implementation strategies and target groups in South Africa, India, and China. Thematic and deductive analysis using a coding framework were used to identify themes across and within settings. In all three countries there was interest in novel TB vaccines, with school-attending adolescents named as a likely target group. In China and India, older people were also identified as a target group. Routine vaccination was preferred in all countries due to stigma and logistical issues with targeted mass campaigns. Perceived benefits for implementation of M72/AS01E were the likely efficacy in individuals with Mycobacterium tuberculosis (Mtb) infection and efficacy for people living with HIV. Perceived challenges for M72/AS01E included the infrastructure and the two-dose regimen required. Stakeholders valued the familiarity of BCG but were concerned about the adverse effects in people living with HIV, a particular concern in South Africa. Implementation challenges and opportunities were identified in all three countries. Our study provides crucial information for implementing novel TB vaccines in specific target groups and on country specific acceptability and feasibility. Key groups for vaccine implementation in these settings were identified, and should be included in clinical trials and implementation planning

Feasibility of novel adult tuberculosis vaccination in South Africa: a cost-effectiveness and budget impact analysis.

Early trials of novel vaccines against tuberculosis (TB) in adults have suggested substantial protection against TB. However, little is known about the feasibility and affordability of rolling out such vaccines in practice. We conducted expert interviews to identify plausible vaccination implementation strategies for the novel M72/AS01E vaccine candidate. The strategies were defined in terms of target population, coverage, vaccination schedule and delivery mode. We modelled these strategies to estimate long-term resource requirements and health benefits arising from vaccination over 2025-2050. We presented these to experts who excluded strategies that were deemed infeasible, and estimated cost-effectiveness and budget impact for each remaining strategy. The four strategies modelled combined target populations: either everyone aged 18-50, or all adults living with HIV, with delivery strategies: either a mass campaign followed by routine vaccination of 18-year olds, or two mass campaigns 10 years apart. Delivering two mass campaigns to all 18-50-year olds was found to be the most cost-effective strategy conferring the greatest net health benefit of 1.2 million DALYs averted having a probability of being cost-effective of 65-70%. This strategy required 38 million vaccine courses to be delivered at a cost of USD 507 million, reducing TB-related costs by USD 184 million while increasing ART costs by USD 79 million. A suitably designed adult TB vaccination programme built around novel TB vaccines is likely to be cost-effective and affordable given the resource and budget constraints in South Africa

Potential implementation strategies, acceptability, and feasibility of new and repurposed TB vaccines

Recently, two Phase 2B tuberculosis vaccine trials reported positive efficacy results in adolescents and adults. However, experience in vaccinating these age groups is limited. We identified potential implementation strategies for the M72/AS01 vaccination and BCG-revaccination-like candidates and explored their acceptability and feasibility. We conducted in-depth semi-structured interviews among key decision makers to identify implementation strategies and target groups in South Africa, India, and China. Thematic and deductive analysis using a coding framework were used to identify themes across and within settings. In all three countries there was interest in novel TB vaccines, with school-attending adolescents named as a likely target group. In China and India, older people were also identified as a target group. Routine vaccination was preferred in all countries due to stigma and logistical issues with targeted mass campaigns. Perceived benefits for implementation of M72/AS01 were the likely efficacy in individuals with Mycobacterium tuberculosis (Mtb) infection and efficacy for people living with HIV. Perceived challenges for M72/AS01 included the infrastructure and the two-dose regimen required. Stakeholders valued the familiarity of BCG but were concerned about the adverse effects in people living with HIV, a particular concern in South Africa. Implementation challenges and opportunities were identified in all three countries. Our study provides crucial information for implementing novel TB vaccines in specific target groups and on country specific acceptability and feasibility. Key groups for vaccine implementation in these settings were identified, and should be included in clinical trials and implementation planning

Large isotropic negative thermal expansion above a structural quantum phase transition

Perovskite structured materials contain myriad tunable ordered phases of electronic and magnetic origin with proven technological importance and strong promise for a variety of energy solutions. An always-contributing influence beneath these cooperative and competing interactions is the lattice, whose physics may be obscured in complex perovskites by the many coupled degrees of freedom, which makes these systems interesting. Here, we report signatures of an approach to a quantum phase transition very near the ground state of the nonmagnetic, ionic insulating, simple cubic perovskite material ScF3, and show that its physical properties are strongly effected as much as 100 K above the putative transition. Spatial and temporal correlations in the high-symmetry cubic phase determined using energy- and momentum-resolved inelastic x-ray scattering as well as x-ray diffraction reveal that soft mode, central peak, and thermal expansion phenomena are all strongly influenced by the transition.National Science Foundation Award No. DMR-1506825US Department of Energy, Office of Basic Energy Sciences under Contract No. DE- AC02-06CH11357Yale Prize Postdoctoral FellowshipNSF Grant No. DMR-0115852Universidad de Costa Rica. Vicerrectoría de Investigación Projecto No. 816-B5-220UCR::Vicerrectoría de Investigación::Unidades de Investigación::Ciencias Básicas::Centro de Investigación en Ciencia e Ingeniería de Materiales (CICIMA

Phylogenetic Diversity and Ecological Pattern of Ammonia-oxidizing Archaea in the Surface Sediments of the Western Pacific

The phylogenetic diversity of ammonia-oxidizing archaea (AOA) was surveyed in the surface sediments from the northern part of the South China Sea (SCS). The distribution pattern of AOA in the western Pacific was discussed through comparing the SCS with other areas in the western Pacific including Changjiang Estuary and the adjacent East China Sea where high input of anthropogenic nitrogen was evident, the tropical West Pacific Continental Margins close to the Philippines, the deep-sea methane seep sediments in the Okhotsk Sea, the cold deep sea of Northeastern Japan Sea, and the hydrothermal field in the Southern Okinawa Trough. These various environments provide a wide spectrum of physical and chemical conditions for a better understanding of the distribution pattern and diversities of AOA in the western Pacific. Under these different conditions, the distinct community composition between shallow and deep-sea sediments was clearly delineated based on the UniFrac PCoA and Jackknife Environmental Cluster analyses. Phylogenetic analyses showed that a few ammonia-oxidizing archaeal subclades in the marine water column/sediment clade and endemic lineages were indicative phylotypes for some environments. Higher phylogenetic diversity was observed in the Philippines while lower diversity in the hydrothermal vent habitat. Water depth and possibly with other environmental factors could be the main driving forces to shape the phylogenetic diversity of AOA observed, not only in the SCS but also in the whole western Pacific. The multivariate regression tree analysis also supported this observation consistently. Moreover, the functions of current and other climate factors were also discussed in comparison of phylogenetic diversity. The information collectively provides important insights into the ecophysiological requirements of uncultured ammonia-oxidizing archaeal lineages in the western Pacific Ocean

Community shift of ammonia-oxidizing bacteria along an anthropogenic pollution gradient from the Pearl River Delta to the South China Sea

The phylogenetic diversity and abundance of ammonia-oxidizing beta-proteobacteria (beta-AOB) was analyzed along an anthropogenic pollution gradient from the coastal Pearl River Delta to the South China Sea using the ammonia monooxygenase subunit A (amoA) gene. Along the gradient from coastal to the open ocean, the phylogenetic diversity of the dominant genus changed from Nitrosomonas to Nitrosospira, indicating the niche specificity by these two genera as both salinity and anthropogenic influence were major factors involved. The diversity of bacterial amoA gene was also variable along the gradient, with the highest in the deep-sea sediments, followed by the marshes sediments and the lowest in the coastal areas. Within the Nitrosomonas-related clade, four distinct lineages were identified including a putative new one (A5-16) from the different sites over the large geographical area. In the Nitrosospira-related clade, the habitat-specific lineages to the deep-sea and coastal sediments were identified. This study also provides strong support that Nitrosomonas genus, especially Nitrosomonas oligotropha lineage (6a) could be a potential bio-indicator species for pollution or freshwater/wastewater input into coastal environments. A suite of statistical analyses used showed that water depth and temperature were major factors shaping the community structure of beta-AOB in this study area

Ruthenium oxide-carbon-based nanofiller-reinforced conducting polymer nanocomposites and their supercapacitor applications.

In this review article, we have presented for the first time the new applications of supercapacitor technologies and working principles of the family of RuO2-carbon-based nanofiller-reinforced conducting polymer nanocomposites. Our review focuses on pseudocapacitors and symmetric and asymmetric supercapacitors. Over the last years, the supercapacitors as a new technology in energy storage systems have attracted more and more attention. They have some unique characteristics such as fast charge/discharge capability, high energy and power densities, and long stability. However, the need for economic, compatible, and easy synthesis materials for supercapacitors have led to the development of RuO2-carbon-based nanofiller-reinforced conducting polymer nanocomposites with RuO2. Therefore, the aim of this manuscript was to review RuO2-carbon-based nanofiller-reinforced conducting polymer nanocomposites with RuO2 over the last 17 years