Non-immune fetal hydrops: etiology and outcome according to gestational age at diagnosis.

OBJECTIVE: Fetal hydrops is associated with increased perinatal morbidity and mortality. The etiology and outcome of fetal hydrops may differ according to the gestational age at diagnosis. The aim of this study was to evaluate the cause, evolution and outcome of non-immune fetal hydrops (NIFH), according to the gestational age at diagnosis. METHODS: This was a retrospective cohort study of all singleton pregnancies complicated by NIFH, at the Fetal Medicine Unit at St George's University Hospital, London, UK, between 2000 and 2018. All fetuses had detailed anomaly and cardiac ultrasound scans, karyotyping and infection screening. Prenatal diagnostic and therapeutic intervention, gestational age at diagnosis and delivery, as well as pregnancy outcome, were recorded. Regression analysis was used to test for potential association between possible risk factors and perinatal mortality. RESULTS: We included 273 fetuses with NIFH. The etiology of the condition varied significantly in the three trimesters. Excluding 30 women who declined invasive testing, the cause of NIFH was defined as unknown in 62 of the remaining 243 cases (25.5%). Chromosomal aneuploidy was the most common cause of NIFH in the first trimester. It continued to be a significant etiologic factor in the second trimester, along with congenital infection. In the third trimester, the most common etiology was cardiovascular abnormality. Among the 152 (55.7%) women continuing the pregnancy, 48 (31.6%) underwent fetal intervention, including the insertion of pleuroamniotic shunts, fetal blood transfusion and thoracentesis. Fetal intervention was associated significantly with lower perinatal mortality (odds ratio (OR), 0.30 (95% CI, 0.14-0.61); P  0.05). CONCLUSIONS: An earlier gestational age at diagnosis of NIFH was associated with an increased risk of aneuploidy and worse pregnancy outcome, including a higher risk of perinatal loss. Fetal therapy was associated significantly with lower perinatal mortality. © 2020 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology

Conductivity in organic semiconductors hybridized with the vacuum field

Organic semiconductors have generated considerable interest for their potential for creating inexpensive and flexible devices easily processed on a large scale [1-11]. However technological applications are currently limited by the low mobility of the charge carriers associated with the disorder in these materials [5-8]. Much effort over the past decades has therefore been focused on optimizing the organisation of the material or the devices to improve carrier mobility. Here we take a radically different path to solving this problem, namely by injecting carriers into states that are hybridized to the vacuum electromagnetic field. These are coherent states that can extend over as many as 10^5 molecules and should thereby favour conductivity in such materials. To test this idea, organic semiconductors were strongly coupled to the vacuum electromagnetic field on plasmonic structures to form polaritonic states with large Rabi splittings ca. 0.7 eV. Conductivity experiments show that indeed the current does increase by an order of magnitude at resonance in the coupled state, reflecting mostly a change in field-effect mobility as revealed when the structure is gated in a transistor configuration. A theoretical quantum model is presented that confirms the delocalization of the wave-functions of the hybridized states and the consequences on the conductivity. While this is a proof-of-principle study, in practice conductivity mediated by light-matter hybridized states is easy to implement and we therefore expect that it will be used to improve organic devices. More broadly our findings illustrate the potential of engineering the vacuum electromagnetic environment to modify and to improve properties of materials.Comment: 16 pages, 13 figure

Factors associated with the decision to investigate child protective services referrals: a systematic review

Background: Limited resources for child protection create challenging decision situations for child protective services (CPS) workers at the point of intake. A body of research has examined the factors associated with worker decisions and processes using a variety of methodological approaches to gain knowledge on decision-making. However, few attempts have been made to systematically review this literature. Objective: As part of a larger project on decision-making at intake, this systematic review addressed the question of the factors associated with worker decisions to investigate alleged maltreatment referrals. Methods: Quantitative studies that examined factors associated with screening decisions in CPS practice settings were included in the review. Database and other search methods were used to identify research published in English over a 35-year period (1980-2015). Findings: Of 1,147 identified sources, 18 studies were selected for full data extraction. The studies were conducted in the U.S., Canada, and Sweden and varied in methodological quality. Most studies examined case factors with few studies examining other domains. Conclusions: To inform CPS policy and practice, additional research is needed to examine the relationships between decision-making factors and case outcomes. Greater attention needs to be given to the organizational and external factors that influence decision-making

Nanomechanical Properties and Phase Transitions in a Double-Walled (5,5)@(10,10) Carbon Nanotube: ab initio Calculations

The structure and elastic properties of (5,5) and (10,10) nanotubes, as well as barriers for relative rotation of the walls and their relative sliding along the axis in a double-walled (5,5)@(10,10) carbon nanotube, are calculated using the density functional method. The results of these calculations are the basis for estimating the following physical quantities: shear strengths and diffusion coefficients for relative sliding along the axis and rotation of the walls, as well as frequencies of relative rotational and translational oscillations of the walls. The commensurability-incommensurability phase transition is analyzed. The length of the incommensurability defect is estimated on the basis of ab initio calculations. It is proposed that (5,5)@(10,10) double-walled carbon nanotube be used as a plain bearing. The possibility of experimental verification of the results is discussed.Comment: 14 page

Framing referendum campaigns: the 2014 Scottish independence referendum in the press

This article explores the framing of referendum campaigns in the press and its relationship to the framing of elections. Drawing from an empirical analysis of the newspaper coverage of the 2014 Scottish referendum and from previous research on campaigns in different contexts, it finds that frames associated with elections, like the strategic game and policy frames, were also dominant in the framing of the referendum. It argues that by framing the independence debate in similar terms to other electoral contests, the press promoted an understanding of this event as being about pragmatic decision-making on policy and political competition, rather than purely a decision about constitutional matters of self-determination

Metamorphism and aqueous alteration in low petrographic type ordinary chondrites

In order to investigate the relative importance of dry metamorphism and aqueous alteration in the history of chondruies, chondruies were hand-picked from the Semarkona (petrographic type 3.0), Bishunpur (3. 1), Chainpur (3.4), Dhajala (3.8) and Allegan (5) chondrites, and matrix samples were extracted from the first three ordinary chondrites. The thermoluminescence (TL) properties of all the samples were measured, and appropriate subsets of the samples were analyzed by electron-microprobe and radiochemical neutron activation and the water and H-isotopic composition determined. The TL data for chondrules from Semarkona and Bishunpur scatter widely showing no unambiguous trends, although group B1 chondrules tend to have lower sensitivities and lower peak temperatures compared with group A5 chondrules. It is argued that these data reflect the variety of processes accompanying chondrule formation. The chondrules show remarkably uniform contents of the highly labile elements, indicating mineralogical control on abundance and volatile loss from silicates and loss and recondensation of mobile chalcophiles and siderophiles in some cases. Very high D/H values (up to approx. 8000% SMOW) are observed in certain Semarkona chondrules, a confirmation of earlier work. With increasing petrographic type, mean TL sensitivities of the chondrules increase, the spread of values within an individual meteorite decreases, and peak temperatures and peak widths show trends indicating that the TL is mainly produced by feldspar and that dry, thermal metamorphism is the dominant secondary process experienced by the chondrules. The TL sensitivities of matrix samples also increase with petrographic type. Chainpur matrix samples show the same spread of peak temperatures and peak widths as Chainpur chondruies, indicating metamorphism-related changes in the feldspar are responsible for the TL of the matrix. The TL data for the Semarkona and Bishunpur matrix samples provide, at best, only weak evidence for aqueous alteration, but the matrix contains H with approximately terrestrial D/H values, even though it contains much water. Secondary processes (probably aqueous alteration) presumably lowered the D/H of the matrix and certain chondrules. While chondrule properties appear to be governed primarily by formation processes and subsequent metamorphism, the matrix of Semarkona has a more complex history involving aqueous alteration as a meteorite-wide process

Serratamolide is a hemolytic factor produced by Serratia marcescens

Serratia marcescens is a common contaminant of contact lens cases and lenses. Hemolytic factors of S. marcescens contribute to the virulence of this opportunistic bacterial pathogen. We took advantage of an observed hyper-hemolytic phenotype of crp mutants to investigate mechanisms of hemolysis. A genetic screen revealed that swrW is necessary for the hyper-hemolysis phenotype of crp mutants. The swrW gene is required for biosynthesis of the biosurfactant serratamolide, previously shown to be a broad-spectrum antibiotic and to contribute to swarming motility. Multicopy expression of swrW or mutation of the hexS transcription factor gene, a known inhibitor of swrW expression, led to an increase in hemolysis. Surfactant zones and expression from an swrW-transcriptional reporter were elevated in a crp mutant compared to the wild type. Purified serratamolide was hemolytic to sheep and murine red blood cells and cytotoxic to human airway and corneal limbal epithelial cells in vitro. The swrW gene was found in the majority of contact lens isolates tested. Genetic and biochemical analysis implicate the biosurfactant serratamolide as a hemolysin. This novel hemolysin may contribute to irritation and infections associated with contact lens use. © 2012 Shanks et al

Enteral lactoferrin supplementation for very preterm infants: a randomised placebo-controlled trial

Background Infections acquired in hospital are an important cause of morbidity and mortality in very preterm infants. Several small trials have suggested that supplementing the enteral diet of very preterm infants with lactoferrin, an antimicrobial protein processed from cow's milk, prevents infections and associated complications. The aim of this large randomised controlled trial was to collect data to enhance the validity and applicability of the evidence from previous trials to inform practice. Methods In this randomised placebo-controlled trial, we recruited very preterm infants born before 32 weeks' gestation in 37 UK hospitals and younger than 72 h at randomisation. Exclusion criteria were presence of a severe congenital anomaly, anticipated enteral fasting for longer than 14 days, or no realistic prospect of survival. Eligible infants were randomly assigned (1:1) to receive either enteral bovine lactoferrin (150 mg/kg per day; maximum 300 mg/day; lactoferrin group) or sucrose (same dose; control group) once daily until 34 weeks' postmenstrual age. Web-based randomisation minimised for recruitment site, gestation (completed weeks), sex, and single versus multifetal pregnancy. Parents, caregivers, and outcome assessors were unaware of group assignment. The primary outcome was microbiologically confirmed or clinically suspected late-onset infection (occurring >72 h after birth), which was assessed in all participants for whom primary outcome data was available by calculating the relative risk ratio with 95% CI between the two groups. The trial is registered with the International Standard Randomised Controlled Trial Number 88261002. Findings We recruited 2203 participants between May 7, 2014, and Sept 28, 2017, of whom 1099 were assigned to the lactoferrin group and 1104 to the control group. Four infants had consent withdrawn or unconfirmed, leaving 1098 infants in the lactoferrin group and 1101 in the sucrose group. Primary outcome data for 2182 infants (1093 [99·5%] of 1098 in the lactoferrin group and 1089 [99·0] of 1101 in the control group) were available for inclusion in the modified intention-to-treat analyses. 316 (29%) of 1093 infants in the intervention group acquired a late-onset infection versus 334 (31%) of 1089 in the control group. The risk ratio adjusted for minimisation factors was 0·95 (95% CI 0·86–1·04; p=0·233). During the trial there were 16 serious adverse events for infants in the lactoferrin group and 10 for infants in the control group. Two events in the lactoferrin group (one case of blood in stool and one death after intestinal perforation) were assessed as being possibly related to the trial intervention. Interpretation Enteral supplementation with bovine lactoferrin does not reduce the risk of late-onset infection in very preterm infants. These data do not support its routine use to prevent late-onset infection and associated morbidity or mortality in very preterm infants. Funding UK National Institute for Health Research Health Technology Assessment programme (10/57/49)

‘Team GB’ or ‘Team Scotland’? Media representations of ‘Britishness’ and ‘Scottishness’ at London 2012 and Glasgow 2014

This article critically reflects upon media coverage of the 2012 London Olympic Games and the 2014 Glasgow Commonwealth Games, scrutinising the emergent discursive constructions of ‘Britishness’ and ‘Scottishness’ through an examination of both London-based (English) and Scotland-based publications. Drawing upon Dayan and Katz’s (1992) portrayal of ‘media events’, the article explores how both events presented competing sites of symbolic struggle during a period of constitutional and political turmoil. Consideration is given to the existence of a ‘hegemonic Britishness’ in print media narratives of these events, as evident in the emergent connotations associated with ‘British nationalism’ and ‘Scottish separatism’