Pregnancy complications and maternal cardiovascular risk: opportunities for intervention and screening?

The link between defective nutrition of the fetus and vascular disease in later life is now well established. Naveed Sattar and Ian Greer report on the intriguing probability that complications in pregnancy also predispose mothers to later vascular and metabolic disease

Mechanical compatibility of sol–gel annealing with titanium for orthopaedic prostheses

Sol–gel processing is an attractive method for large-scale surface coating due to its facile and inexpensive preparation, even with the inclusion of precision nanotopographies. These are desirable traits for metal orthopaedic prostheses where ceramic coatings are known to be osteoinductive and the effects may be amplified through nanotexturing. However there are a few concerns associated with the application of sol–gel technology to orthopaedics. Primarily, the annealing stage required to transform the sol–gel into a ceramic may compromise the physical integrity of the underlying metal. Secondly, loose particles on medical implants can be carcinogenic and cause inflammation so the coating needs to be strongly bonded to the implant. These concerns are addressed in this paper. Titanium, the dominant material for orthopaedics at present, is examined before and after sol–gel processing for changes in hardness and flexural modulus. Wear resistance, bending and pull tests are also performed to evaluate the ceramic coating. The findings suggest that sol–gel coatings will be compatible with titanium implants for an optimum temperature of 500 °C

Creaming and parking in marketized employment services: an Anglo-German comparison

The delivery of public services by nonprofit and for-profit providers alters the nature of services and jobs, often in unintended and undesired ways. We argue that these effects depend on the degree to which the service is ‘marketised’, i.e. whether its funder subjects it to price-based competition. Using case studies of British and German employment services, this paper scrutinises the link between funding practices and service quality. Of particular concern in marketised employment services is the problem of ‘creaming and parking’, in which providers select job-ready clients for services and neglect clients more distant from the labour market. We explore three questions. What are the mechanisms through which marketization produces creaming and parking? What are the differences between these mechanisms in commercial and non-commercial service providers? Which national institutions might serve as a buffer for the landscape of service provision facing price-based competition

Welfare, work, and the conditions of social solidarity: British campaigns to defend healthcare and social security

When the welfare state is under attack from neoliberal reformers, how can trade unionists and other campaigners build solidarity to defend it? Based on 45 qualitative interviews, this article compares campaigns to defend British health services and social security benefits between 2007 and 2016. Building on the macro-insights of comparative welfare-state literature and the more micro-level insights of studies on mobilisation, community unionism, and union strategy, we examine the effects of welfare-state architectures on the building of solidarity. We find that building solidarity is more difficult when defending targeted benefits than universal ones, not only because of differences in public opinion and political support for services, but also because the labour process associated with targeting benefits, namely the assessing and sanctioning of clients, can generate conflicts among campaigners

Genetic Structure of the Rice Blast Pathogen (Magnaporthe oryzae) over a Decade in North Central California Rice Fields.

Rice blast, caused by the ascomycete Magnaporthe oryzae, is one of the most destructive rice diseases worldwide. Even though the disease has been present in California since 1996, there is no data for the pathogen population biology in the state. Using amplified fragment length polymorphisms and mating-type markers, the M. oryzae population diversity was investigated using isolates collected when the disease was first established in California and isolates collected a decade later. While in the 1990 samples, a single multilocus genotype (MLG) was identified (MLG1), over a decade later, we found 14 additional MLGs in the 2000 isolates. Some of these MLGs were found to infect the only rice blast-resistant cultivar (M-208) available for commercial production in California. The same samples also had a significant decrease of MLG1. MLG1 was found infecting the resistant rice cultivar M-208 on one occasion whereas MLG7 was the most common genotype infecting the M-208. MLG7 was identified in the 2000 samples, and it was not present in the M. oryzae population a decade earlier. Our results demonstrate a significant increase in genotypic diversity over time with no evidence of sexual reproduction and suggest a recent introduction of new virulent race(s) of the pathogen. In addition, our data could provide information regarding the durability of the Pi-z resistance gene of the M-208. This information will be critical to plant breeders in developing strategies for deployment of other rice blast resistance genes/cultivars in the future

Insertion as an alternative to workfare: active labour-market schemes in the Parisian suburbs

Many governments have tightened the link between welfare and work by attaching conditionality to out-of-work benefits, extending these requirements to new client groups, and imposing market competition and greater managerial control in service delivery – principles typically characterised as ‘workfare’. Based on field research in Seine-Saint-Denis, we examine French ‘insertion’ schemes aimed at disadvantaged but potentially job-ready clients, characterized by weak conditionality, low marketization, strong professional autonomy, and local network control. We show that insertion systems have resisted policy attempts to expand workfare-derived principles, reflecting street-level actors’ belief in the key advantages of the former over the latter. In contrast with arguments stressing institutional and cultural stickiness, our explanation for this resistance thus highlights the decentralized network governance of front-line services and the limits to central government power

Oral contraceptives, hormone replacement therapy, thrombophilias and risk of venous thromboembolism: a systematic review The Thrombosis: Risk and Economic Assessment of Thrombophilia Screening (TREATS) Study

Combined oral contraceptives,oral hormone replacement therapy and thrombophilias are recognised risk factors for venous thromboembolism in women.The objective of this study was to assess the risk of thromboembolism among women with thrombophilia who are taking oral contraceptives or hormone replacement therapy, conducting a systematic review and metaanalysis. Of 201 studies identified, only nine met the inclusion criteria. Seven studies included pre-menopausal women on oral contraceptives and two studies included peri-menopausal women on hormone replacement therapy. For oral contraceptive use, significant associations of the risk of venous thromboembolism were found in women with factor V Leiden (OR 15.62; 95%CI 8.66 to 28.15); deficiencies of antithrombin (OR 12.60; 95%CI 1.37 to 115.79), protein C (OR 6.33; 95%CI 1.68 to 23.87), or protein S (OR 4.88; 95%CI 1.39 to 17.10), elevated levels of factor VIIIc (OR 8.80; 95%CI 4.13 to 18.75); and factor V Leiden and prothrombin G20210A (OR 7.85; 95%CI 1.65 to 37.41). For hormone replacement therapy, a significant association was found in women with factor V Leiden (OR 13.16; 95%CI 4.28 to 40.47).Although limited by the small number of studies, the findings of this study support the presence of interaction between thrombophilia and venous thromboembolism among women taking oral contraceptives. However, further studies are required to establish with greater confidence the associations of these, and other, thrombophilias with venous thromboembolism among hormone users

Fast-heating-induced formation of metallic-glass/crystal composites with enhanced plasticity

Bulk metallic glasses are known to have poor plasticity which limits their application as structural materials. Due to the lack of atomic periodicity in metallic glasses, their mechanical properties cannot be controlled the same way as in crystalline materials. Fast-heating-induced, a heating rate of 10 K s−1 and higher, crystallization of ductile nanocrystalline phase(s) leads to enhanced plasticity of metallic-glass/crystal composites. Here, an overview of controlling the microstructure on fast heating, the suggested crystallization mechanism of metastable phases and the principle of enhanced plasticity of the composites is presented and discussed, with a special focus on Cu–Zr-based metallic glasses

Preeclampsia is associated with compromized maternal synthesis of long chain polyunsaturated fatty acids leading to offspring deficiency

Obesity and excessive lipolysis are implicated in preeclampsia (PE). Intrauterine growth restriction is associated with low maternal body mass index and decreased lipolysis. Our aim was to assess how maternal and offspring fatty acid metabolism is altered in mothers in the third trimester of pregnancy with PE (n=62) or intrauterine growth restriction (n=23) compared with healthy pregnancies (n=164). Markers of lipid metabolism and erythrocyte fatty acid concentrations were measured. Maternal adipose tissue fatty acid composition and mRNA expression of adipose tissue fatty acid–metabolizing enzymes and placental fatty acid transporters were compared. Mothers with PE had higher plasma triglyceride (21%, P<0.001) and nonesterified fatty acid (50%, P<0.001) concentrations than controls. Concentrations of major n−6 and n−3 long-chain polyunsaturated fatty acids in erythrocytes were 23% to 60% lower (all P<0.005) in PE and intrauterine growth restriction mothers and offspring compared with controls. Subcutaneous adipose tissue Δ−5 and Δ−6 desaturase and very long-chain fatty acid elongase mRNA expression was lower in PE than controls (respectively, mean [SD] control 3.38 [2.96] versus PE 1.83 [1.91], P=0.030; 3.33 [2.25] versus 1.03 [0.96], P<0.001; 0.40 [0.81] versus 0.00 [0.00], P=0.038 expression relative to control gene [square root]). Low maternal and fetal long-chain polyunsaturated fatty acid concentrations in PE may be the result of decreased maternal synthesis