More on 'universal' versus 'selected' screening for thrombophilia: the hidden costs of false-positive diagnosis - response to Favaloro and Keeling

Abstract not availabl

A living systematic review and meta-analysis characterising treatment regimes, clinical outcomes and complications associated with extracorporeal life support (ELS) for critical COVID-19 in women in pregnancy and the puerperium compared to non-pregnant women of reproductive age and comparing materno-fetal outcomes to pregnant women without COVID-19

Review question 1. To characterise the prevalence, treatment regimes, clinical outcomes and complications of COVID-19-related extracorporeal life support (ELS) as therapy for women in pregnancy/ puerperium compared to non-pregnant women of reproductive age with COVID-19. 2. To characterise maternal and fetal clinical outcomes for pregnant and puerperal patients with critical COVID-19-managed by ELS compared to pregnant women without COVID-19

Solution to the problem of the poor cyclic fatigue resistance of bulk metallic glasses

The recent development of metallic glass-matrix composites represents a particular milestone in engineering materials for structural applications owing to their remarkable combination of strength and toughness. However, metallic glasses are highly susceptible to cyclic fatigue damage, and previous attempts to solve this problem have been largely disappointing. Here, we propose and demonstrate a microstructural design strategy to overcome this limitation by matching the microstructural length scales (of the second phase) to mechanical crack-length scales. Specifically, semisolid processing is used to optimize the volume fraction, morphology, and size of second-phase dendrites to confine any initial deformation (shear banding) to the glassy regions separating dendrite arms having length scales of ≈2 μm, i.e., to less than the critical crack size for failure. Confinement of the damage to such interdendritic regions results in enhancement of fatigue lifetimes and increases the fatigue limit by an order of magnitude, making these “designed” composites as resistant to fatigue damage as high-strength steels and aluminum alloys. These design strategies can be universally applied to any other metallic glass systems

Sepsis: precision-based medicine for pregnancy and the puerperium

Sepsis contributes significantly to global morbidity and mortality, particularly in vulnerable populations. Pregnant and recently pregnant women are particularly prone to rapid progression to sepsis and septic shock, with 11% of maternal deaths worldwide being attributed to sepsis. The impact on the neonate is considerable, with 1 million neonatal deaths annually attributed to maternal infection or sepsis. Pregnancy specific physiological and immunological adaptations are likely to contribute to a greater impact of infection, but current approaches to the management of sepsis are based on those developed for the non-pregnant population. Pregnancy-specific strategies are required to optimise recognition and management of these patients. We review current knowledge of the physiology and immunology of pregnancy and propose areas of research, which may advance the development of pregnancy-specific diagnostic and therapeutic approaches to optimise the care of pregnant women and their babies

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

EPOC Comparison Between Resistance Training and High-Intensity Interval Training in Aerobically Fit Women

International Journal of Exercise Science 14(2): 1027-1035, 2021. Previous research has shown that various modes of exercise may elicit significant increases in resting metabolism for up to 24 hours post-exercise, but typically using untrained or moderately active subjects. The purpose of the present study was to compare excess post-exercise oxygen consumption (EPOC) between circuit-style resistance training (RT) and high-intensity interval training (HIIT) in young, aerobically fit women. During the follicular phase of the menstrual cycle, seven participants reported to the laboratory for evening and morning baseline resting metabolic rate (RMR) measurements via indirect calorimetry. Participants fasted and slept overnight in the laboratory between RMR measurements. Following the morning RMR measurement, participants were randomly assigned to complete either a total-body, circuit-style RT protocol (30 seconds of lifting at 80% 1RM:one minute rest) or treadmill HIIT (30-second run at 90% VO2 max:one minute stationary recovery). RMR was repeated 14 and 24 hours post-exercise. All procedures were replicated during the follicular phase of the next menstrual cycle using the remaining exercise protocol. Resting VO2 was significantly (p\u3c0.05) higher 14 hours after RT (3.8±0.3 ml/kg/min) compared to baseline (3.4±0.3 ml/kg/min), however HIIT showed no significant change (3.7±0.3 ml/kg/min). Both RT and HIIT showed significantly higher energy expenditure 14 hours post-exercise (33±5 and 33±4 kcals/30 minutes, respectively) compared to baseline (30±3 kcal). Neither protocol sustained a RMR change at 24 hours. Based on the magnitude and duration of post-exercise energy expenditure, EPOC responses may be a worthwhile consideration when prescribing exercise for weight maintenance in young, fit women

A new approach to wind energy: Opportunities and challenges

Despite common characterizations of modern wind energy technology as mature, there remains a persistent disconnect between the vast global wind energy resource—which is 20 times greater than total global power consumption—and the limited penetration of existing wind energy technologies as a means for electricity generation worldwide. We describe an approach to wind energy harvesting that has the potential to resolve this disconnect by geographically distributing wind power generators in a manner that more closely mirrors the physical resource itself. To this end, technology development is focused on large arrays of small wind turbines that can harvest wind energy at low altitudes by using new concepts of biology-inspired engineering. This approach dramatically extends the reach of wind energy, as smaller wind turbines can be installed in many places that larger systems cannot, especially in built environments. Moreover, they have lower visual, acoustic, and radar signatures, and they may pose significantly less risk to birds and bats. These features can be leveraged to attain cultural acceptance and rapid adoption of this new technology, thereby enabling significantly faster achievement of state and national renewable energy targets than with existing technology alone. Favorable economics stem from an orders-of-magnitude reduction in the number of components in a new generation of simple, mass-manufacturable (even 3D-printable), vertical-axis wind turbines. However, this vision can only be achieved by overcoming significant scientific challenges that have limited progress over the past three decades. The following essay summarizes our approach as well as the opportunities and challenges associated with it, with the aim of motivating a concerted effort in basic and applied research in this area