Semi-Automatic Measurement of Fetal Cardiac Axis in Fetuses with Congenital Heart Disease (CHD) with Fetal Intelligent Navigation Echocardiography (FINE)

Congenital heart disease (CHD) is one of the most common organ-specific birth defects and a major cause of infant morbidity and mortality. Despite ultrasound screening guidelines, the detection rate of CHD is limited. Fetal intelligent navigation echocardiography (FINE) has been introduced to extract reference planes and cardiac axis from cardiac spatiotemporal image correlation (STIC) volume datasets. This study analyses the cardiac axis in fetuses affected by CHD/thoracic masses (n = 545) compared to healthy fetuses (n = 1543) generated by FINE. After marking seven anatomical structures, the FINE software generated semi-automatically nine echocardiography standard planes and calculated the cardiac axis. Our study reveals that depending on the type of CHD, the cardiac axis varies. In approximately 86% (471 of 542 volumes) of our pathological cases, an abnormal cardiac axis (normal median = 40-45(degrees)) was detectable. Significant differences between the fetal axis of the normal heart versus CHD were detected in HLHS, pulmonary atresia, TOF (p-value < 0.0001), RAA, situs ambiguus (p-value = 0.0001-0.001) and absent pulmonary valve syndrome, DORV, thoracic masses (p-value = 0.001-0.01). This analysis confirms that in fetuses with CHD, the cardiac axis can significantly deviate from the normal range. FINE appears to be a valuable tool to identify cardiac defects

Glucose Levels of the Oral Glucose Tolerance Test (oGTT) Can Predict Adverse Pregnancy Outcomes in Women with Gestational Diabetes (GDM)

Objectives and Background: Gestational diabetes (GDM) is a common pregnancy complication defined as a glucose intolerance diagnosis during pregnancy. GDM is strongly associated with adverse fetal and maternal outcomes. In Germany, to screen and diagnose GDM we use a 1 h 50 g oGCT (oral glucose challenge test) followed by a 2 h 75 g oGTT if the first was pathological. This analysis examines the correlation of 75 g oGTT glucose levels and fetomaternal outcome. Methods: Data from 1664 patients from a gestational diabetes consultation clinic at the Charité University Hospital in Berlin, Germany, were analyzed retrospectively from 2015 to 2022. The 75 g oGTT blood glucose levels were categorized into isolated fasting hyperglycemia (GDM-IFH), isolated post-load hyperglycemia (GDM-IPH) and combined hyperglycemia (GDM-CH), using the levels of the fasting, 1 h and 2 h values, after glucose application. These subtypes were compared based on their baseline characteristics as well as fetal and maternal outcome. Results: GDM-IFH and GDM-CH women displayed higher pre-conceptional BMI and required insulin therapy more frequently (p < 0.001). The GDM-IFH group was at higher risk of having a primary cesarean section (p = 0.047), while GDM-IPH women were significantly more likely to have an emergent cesarean section (p = 0.013). The offspring of GDM-IFH and GDM-CH women were born with a significantly higher mean birthweight (p < 0.001) and birth weight percentiles (p < 0.001) and were at increased risk of being large for gestational age (LGA) (p = 0.004). Women from the GDM-IPH group delivered significantly more neonates who were small for gestational age (p = 0.027) or with low fetal weight <30th percentile (p = 0.003). Conclusion: This analysis shows a strong association between the glucose response pattern in the 75 g oGTT and adverse perinatal fetomaternal outcome. The differences among the subgroups, specifically concerning insulin therapy, mode of delivery and fetal growth, suggest an individualized approach to prenatal care after a GDM diagnosis

Application of a column selection system and DryLab software for high-performance liquid chromatography method development

Abstract This paper describes a strategy for the development of chromatographic methods for drug candidates based upon the use of simple MS compatible mobile phases and optimization of the chromatographic selectivity through variations of the stationary phase and mobile phase pH. The strategy employs an automated column selection system and a series of HPLC columns, varying in hydrophobicity and silanol activity, in combination with DryLab software to develop chromatographic methods for the separation of mixtures of bupivacaine and its metabolites; acidic, basic, and neutral compounds; and atenolol, nitrendipine, and their degradation products

Pharmaceutical Cost-Sharing Systems and Savings for Health Care Systems from Parallel Trade

This paper analyzes the consequences of parallel trade on health care systems in a two-country model with a vertical distributor relationship. In particular, two cost-sharing systems - coinsurance and indemnity insurance - are compared with respect to changes in copayments and public health expenditure. Under both cost-sharing systems, parallel trade generates a price-decreasing competition effect in the destination country and a price-increasing double marginalization effect in the source country. In the destination country, copayments for patients decrease to a larger extent under indemnity insurance, whereas reductions of public health expenditure occur only under coinsurance. In the source country, copayments increase less under coinsurance, whereas health expenditure is reduced more under indemnity insurance. This illustrates that a harmonization of health care systems would not make sense

Transfusion-transmitted infections

Although the risk of transfusion-transmitted infections today is lower than ever, the supply of safe blood products remains subject to contamination with known and yet to be identified human pathogens. Only continuous improvement and implementation of donor selection, sensitive screening tests and effective inactivation procedures can ensure the elimination, or at least reduction, of the risk of acquiring transfusion transmitted infections. In addition, ongoing education and up-to-date information regarding infectious agents that are potentially transmitted via blood components is necessary to promote the reporting of adverse events, an important component of transfusion transmitted disease surveillance. Thus, the collaboration of all parties involved in transfusion medicine, including national haemovigilance systems, is crucial for protecting a secure blood product supply from known and emerging blood-borne pathogens

Maternal Effects and Egg Size Variation in Fishes: General Patterns and the Influence of System Size

The need to protect size and age structures from selective harvest in order to maintain sustainable fish stocks has been emphasized in recent literature. The Big Old Fat Fecund Female Fish (BOFFFF) hypothesis has been influential in discussions of changing stock management strategies, and postulates that larger, older females have a disproportionate input into stock recruitment due to physiological advantages. In this study, we utilize a meta-analysis approach to test the assumption of the BOFFFF hypothesis, that larger female fish produce larger eggs and more viable offspring, at a broad scale. Following the meta-analyses, we assess whether larger females from a subset of studies use their gonadal investment more efficiently than small females. From our meta-analyses, we found positive, significant intraspecific relationships between female size and egg size. Moreover, we found positive associations between egg size and offspring viability (offspring size and survival). However, we found in a subset of studies that although proportional survival of offspring often increases with egg size, females that produced larger eggs yielded fewer surviving offspring per unit gonadal investment. This reduced efficiency in reproductive investment is a product of the trade-off between egg size and fecundity. We conclude that although larger females may appear to produce more viable individual offspring, their input to stock recruitment, according to total stock gonadal biomass, may not be disproportionate, as stated by the BOFFFF hypothesis. However, we did not account for whether the benefits of maternal effects extend beyond the larval stage. The theory of optimal egg size implies that fish trade off between fecundity and individual gonad investment according to their environment. Past interspecific studies suggest that in general, fishes in large, marine systems produce smaller eggs than those in small, freshwater systems. This study aims to compare egg size intraspecifically among small and large systems. In particular, we focus on populations from the Laurentian Great Lakes, which exhibit similar broadscale physical processes as marine systems, and smaller inland lakes (\u3c1,000 ha), whose ecosystems contain many of the same species. In 2018 and 2019, we collected egg samples from spawning walleye (Sander vitreus) and yellow perch (Perca flavescens) in both inland lake and Great Lake populations. From each female, we recorded total lengths, and measured average diameters of ten eggs. Using ANCOVA models, we compared mean length-adjusted egg diameters intraspecifically among populations of both species. For both walleye and yellow perch, we found that females from inland lakes produced larger mean length-adjusted egg diameters than those of the Great Lakes. This pattern was particularly evident for yellow perch, whereas for walleye the pattern was relatively weak, potentially due to stocking eroding population-specific selection for egg size. These intraspecific patterns are consistent with cross-system interspecific variation in fish egg size

Assessment of Arctic grayling habitat suitability in two Burt Lake tributaries

Limnologyhttps://deepblue.lib.umich.edu/bitstream/2027.42/143549/1/Chames_Gagne_Koenigbauer_2017.pdfDescription of Chames_Gagne_Koenigbauer_2017.pdf : Access restricted to on-site users at the U-M Biological Station

A preliminary design study for an expander liquid oxygen turbopump

In the recent years, Airbus DS GmbH started a turbopump initiative to buildup fundamental capabilities in analyzing and designing turbomachinery within a German national funded program “TARES.” Turbomachinery is widely used in different rocket propulsion systems and include such parts as pumps and turbines. Turbines are used for generating power required by pumps in order to feed the propellants to the thrust chamber. The paper is dedicated to present an overview about currently ongoing conceptual design activities of turbomachinery covering the main design phases like TPA (TurboPump Assembly) layout tradeoff; rotational speed selection with respect to efficiency and cavitation; flow path design techniques including blade profiling; computer-aided design (CAD) work; and preliminary structural analyses. This paper presents the main outcome applying the established design logic to a liquid oxygen (LOx) turbomachinery. The component is designed based on a dedicated specification for an expander cycle type engine. This includes a LOx pump unit comprising inducer and impeller as well as a subsonic single stage reaction turbine. For the turbine drive, gaseous hydrogen (GH2) heated within the thrust chamber cooling circuit is used. Within this paper, a general overview about the preliminary work results of pump and turbine sizing, profiling, performance estimation as well as structural aspects is given