Division of Maternal-Fetal Medicine

The Division of Maternal-Fetal Medicine presently includes maternal-fetal specialists. They are: Kimberly K. Leslie, MD (Department Head), Stephen K. Hunter, MD, PhD, (Division Director), Jennifer R. Niebyl, MD, Asha Rijhsinghani, MD, and Mark Santillan, MD, and Jennifer Krupp, MD. Dr. Roger A. Williamson, double boarded in Genetics and Obstetrics, is an Emeritus member of the Division

Division of Maternal Fetal Medicine

The Division of Maternal Fetal Medicine at the University of Iowa provides care for women with medical, surgical, and obstetrical complications of pregnancy. The patients are cared for in a series of clinics, including the High Risk Obstetric Clinic and the multidisciplinary Fetal Diagnosis and Therapy Unit. The majority of level II scans, anomaly consultations, and interventional fetal procedures in Iowa are performed by this unit

Space Traffic Management Concepts Leveraging Existing Frameworks

Leveraging existing U.S. regulatory frameworks, as well as international organizations, will dramatically shorten the time needed to develop an effective Space Traffic Management concept. Both the Department of Defense and the Department of Transportation have been working with the U.S. Congress to define and develop a Space Traffic Management concept that will allow the Office of Commercial Space Launch to begin a new mission that will help to ensure the safety and resilience of the space domain. Outside observers can easily see forward progress toward this, still, undeveloped concept. This paper explores potential final U.S. Space Traffic Management concepts that would be consistent with on-going U.S. Government work using existing frameworks and regulatory templates. Further, this paper explores far-term expansion of the U.S. Space Traffic Management concept in the international arena by extrapolating existing concepts and using existing organizations. This paper argues that the international, “top-down”, approach hinders the process of developing a usable global Space Traffic Management concept and, by taking a leadership role, the U.S. can develop a useful concept for U.S. entities that can be expanded to an international audience more easily and in a manner much more palatable to non-U.S. entities. This paper further explores the benefits to the commercial, civil, and military sectors by using the “bottom-up” approach and discusses recent international venues in which this concept was used to explore space domain resilience

Standup of the Joint Interagency Comined Space Operations Center

On 23 June 2015, Deputy Defense Secretary Bob Work announced the development of the Joint Interagency Combined Space Operations Center (JICSpOC) and a backup for the Joint Space Operations Center (JSPoC). Initial standup for testing and experimentation is scheduled for 1 October 2015 with an anticipated initial operational capability of 1 May 2016. After development is completed, the JICSpOC will officially be declared the backup to the JSpOC. The JICSpOC is designed to created unity of effect and information in space operations among the Department of Defense, Intelligence Community, Interagency, allied, and commercial satellite industries. The initial need for the JICSpOC is to ensure the National Security Space Enterprise meets and out-paces emerging and advanced space threats and continues to provide vital information, capabilities and effects for national leadership, allies, partners and the Joint Force. The JICSpOC will enhance the deterrent posture of National Security Space by further demonstrating the United States is prepared should an adversary attack our space capabilities and thereby enhances the space contributions to national security. The center will have the capability to develop, test, validate and integrate National Space Systems Tactics, Techniques and Procedures. The Department of Defense is committed to creating space resiliency and is working with the Intelligence Community to build the JICSpOC to take a giant leap forward toward that goal. While the details on the JICSpOC are still being worked out, the US Government recognizes that our nation’s space architecture faces increasing threats. It is important that the Department of Defense and Intelligence Community work together to address those threats and better integrate space capabilities. Together they will develop innovative approaches to space control

Evaluation of the VNTR region in the IDO promoter in women with preeclampsia

Indoleamine 2,3 – dioxygenase (IDO) is an enzyme that aids in immunosuppression and tolerance. Previous studies have shown decreased IDO activity in pregnancies affected by preeclampsia, but the mechanism for this altered activity is unknown. Our study was designed to analyze the promoter region of IDO in preeclamptic and control women and identify the frequency of a VNTR genotype that has been shown to be significantly correlated with tryptophan levels in women; a surrogate marker for IDO activity

The Conceptual and Methodological Mayhem of "Screen Time".

Debates concerning the impacts of screen time are widespread. Existing research presents mixed findings, and lacks longitudinal evidence for any causal or long-term effects. We present a critical account of the current shortcomings of the screen time literature. These include poor conceptualisation, the use of non-standardised measures that are predominantly self-report, and issues with measuring screen time over time and context. Based on these issues, we make a series of recommendations as a basis for furthering academic and public debate. These include drawing on a user-focused approach in order to seek the various affordances gained from "screen use". Within this, we can better understand the way in which these vary across time and context, and make distinction between objective measures of "screen time" compared to those more subjective experiences of uses or affordances, and the differential impacts these may bring

Genetic variation in the SIM1 locus is associated with erectile dysfunction.

Erectile dysfunction affects millions of men worldwide. Twin studies support the role of genetic risk factors underlying erectile dysfunction, but no specific genetic variants have been identified. We conducted a large-scale genome-wide association study of erectile dysfunction in 36,649 men in the multiethnic Kaiser Permanente Northern California Genetic Epidemiology Research in Adult Health and Aging cohort. We also undertook replication analyses in 222,358 men from the UK Biobank. In the discovery cohort, we identified a single locus (rs17185536-T) on chromosome 6 near the single-minded family basic helix-loop-helix transcription factor 1 (SIM1) gene that was significantly associated with the risk of erectile dysfunction (odds ratio = 1.26, P = 3.4 × 10-25). The association replicated in the UK Biobank sample (odds ratio = 1.25, P = 6.8 × 10-14), and the effect is independent of known erectile dysfunction risk factors, including body mass index (BMI). The risk locus resides on the same topologically associating domain as SIM1 and interacts with the SIM1 promoter, and the rs17185536-T risk allele showed differential enhancer activity. SIM1 is part of the leptin-melanocortin system, which has an established role in body weight homeostasis and sexual function. Because the variants associated with erectile dysfunction are not associated with differences in BMI, our findings suggest a mechanism that is specific to sexual function

The effects of preeclampsia on signaling to hematopoietic progenitor cells

Background: The role of the microenvironment is important in cell differentiation. The effect of placental disease on the growth and differentiation and hematopoietic stem cells has not been well-studied. Methods: Enzyme linked immunoassay was used to measure erythropoietin and osteopontin in plasma from umbilical cord blood of children born to normotensive and preeclamptic women. Additionally, CD34+ cells were isolated from umbilical cord blood and grown in complete methylcellulose media. Colony types were identified and enumerated. Results: Differences in the concentration of erythropoietin in the cord blood between the controls and the preeclamptics approached significance (P = 0.067) using a Mann-Whitney U test. In the plasma of cord blood from children born to normotensive women, the median erythropoietin was 0.186 mIU/mL compared to 1.986 mIU/mL in children of preeclamptic women. We did not find any significant differences in the number and types of colonies; however, there was a trend toward increased BFU-E in the preeclamptic samples. Furthermore, this trend for increased BFU-E colonies was also seen from CD34+ cells isolated from umbilical cord blood of severe preeclamptics compared to mild. Conclusion: Our preliminary studies suggest that abnormalities in the placenta, such as those found when the mother experiences preeclampsia, may affect the ability of hematopoietic stem cells to grow and differentiate

Flow mediated vasodilation predicts the development of gestational diabetes mellitus

To prospectively measure flow mediated vasodilation (FMD) in a cohort of women with risk factors for preeclampsia and to identify poor obstetrical outcomes associated with changes in FMD