Comparison between a prenatal sonographic scoring system and a clinical grading at delivery for Placenta Accreta Spectrum disorders

OBJECTIVE: Placenta Accreta Spectrum (PAS) disorders have become a major iatrogenic obstetric complication worldwide. Data on the accuracy of ultrasound examination diagnosis are limited by incomplete confirmation and variability in the description of the different grades of PAS at delivery. The aim of this study was to compare our prenatal routine sonographic screening and diagnostic scoring system with a standardized clinical grading system at birth in patient at risk of PAS. STUDY DESIGN: This is a retrospective cohort study of 607 pregnant patients with at least one prior cesarean delivery between December 2013 and December 2018. All patients were assessed for PAS using our institutional prenatal sonographic scoring system and the corresponding ultrasound findings were compared with those of a standardized clinical intra-operative macroscopic grading system of the degree of accreta placentation at vaginal birth or laparotomy. RESULTS: PAS was diagnosed clinically at birth in 50 (8.2%) cases, 17 of which were confirmed by histopathology. A low (score ≤ 5), medium (score 6-7), high (score ≥ 8) probability for PAS was reported in 502, 61 and 44 cases, respectively. The probability score increased significantly (p < .001) in women ≥2 prior cesarean deliveries, with an anterior low-lying/placenta previa, with absent clear space, increased in retroplacental vascularity and with the size and numbers of lacunae. The number of cases classified clinically as grade 1 (non-PAS) and 3 (adherent PAS) was significantly (p < .001) lower in women with a high probability score whereas the rates of the other grades was significantly (p < .001) higher. The widest discrepancy between ultrasound probability score and clinical grade was found for grade 2 which, describes a partial placental adherence and grades 4 and 5 which, refer to placental percreta which describes tissue having invade trough the uterine serosa and beyond. CONCLUSIONS: Both ends of the spectrum of accreta placentation remain difficult to diagnose antenatal and clinically at birth, in particular when no histopathologic confirmation is available. There is a need to develop ultrasound accuracy score systems that can differentiate between the different grades of PAS and which are validated by standardized clinical and pathology protocols

Vortex Imaging in the pi-Band of Magnesium Diboride

We report scanning tunneling spectroscopy imaging of the vortex lattice in single crystalline MgB2. By tunneling parallel to the c-axis, a single superconducting gap (Delta = 2.2 meV) associated with the pi-band is observed. The vortices in the pi-band have a large core size compared to estimates based on Hc2, and show an absence of localized states in the core. Furthermore, superconductivity between the vortices is rapidly suppressed by an applied field. These results suggest that superconductivity in the pi-band is, at least partially, induced by the intrinsically superconducting sigma-band.Comment: 4 pages, 3 figure

Direct simulation of ion beam induced stressing and amorphization of silicon

Using molecular dynamics (MD) simulation, we investigate the mechanical response of silicon to high dose ion-irradiation. We employ a realistic and efficient model to directly simulate ion beam induced amorphization. Structural properties of the amorphized sample are compared with experimental data and results of other simulation studies. We find the behavior of the irradiated material is related to the rate at which it can relax. Depending upon the ability to deform, we observe either the generation of a high compressive stress and subsequent expansion of the material, or generation of tensile stress and densification. We note that statistical material properties, such as radial distribution functions are not sufficient to differentiate between different densities of amorphous samples. For any reasonable deformation rate, we observe an expansion of the target upon amorphization in agreement with experimental observations. This is in contrast to simulations of quenching which usually result in denser structures relative to crystalline Si. We conclude that although there is substantial agreement between experimental measurements and most simulation results, the amorphous structures being investigated may have fundamental differences; the difference in density can be attributed to local defects within the amorphous network. Finally we show that annealing simulations of our amorphized samples can lead to a reduction of high energy local defects without a large scale rearrangement of the amorphous network. This supports the proposal that defects in amorphous silicon are analogous to those in crystalline silicon.Comment: 13 pages, 12 figure

Thermal bremsstrahlung probing the thermodynamical state of multifragmenting systems

Inclusive and exclusive hard-photon (E$_\gamma >$ 30 MeV) production in five different heavy-ion reactions ($^{36}$Ar+$^{197}$Au, $^{107}$Ag, $^{58}$Ni, $^{12}$C at 60{\it A} MeV and $^{129}$Xe+$^{120}$Sn at 50{\it A} MeV) has been studied coupling the TAPS photon spectrometer with several charged-particle multidetectors covering more than 80% of 4$\pi$. The measured spectra, slope parameters and source velocities as well as their target-dependence, confirm the existence of thermal bremsstrahlung emission from secondary nucleon-nucleon collisions that accounts for roughly 20% of the total hard-photon yield. The thermal slopes are a direct measure of the temperature of the excited nuclear systems produced during the reaction.Comment: 4 pages, 3 figures, Proceedings CRIS 2000, 3rd Catania Relativistic Ion Studies, "Phase Transitions in Strong Interactions: Status and Perspectives", Acicastello, Italy, May 22-26, 2000 (to be published in Nuc. Phys. A

The effect of absent blood flow on the zebrafish cerebral and trunk vasculature

The role of blood flow in vascular development is complex and context-dependent. In this study, we quantify the effect of the lack of blood flow on embryonic vascular development on two vascular beds, namely the cerebral and trunk vasculature in zebrafish. We perform this by analysing vascular topology, endothelial cell (EC) number, EC distribution, apoptosis, and inflammatory response in animals with normal blood flow or absent blood flow. We find that absent blood flow reduced vascular area and EC number significantly in both examined vascular beds, but the effect is more severe in the cerebral vasculature, and severity increases over time. Absent blood flow leads to an increase in non-EC-specific apoptosis without increasing tissue inflammation, as quantified by cerebral immune cell numbers and nitric oxide. Similarly, while stereotypic vascular patterning in the trunk is maintained, intra-cerebral vessels show altered patterning, which is likely to be due to vessels failing to initiate effective fusion and anastomosis rather than sprouting or path-seeking. In conclusion, blood flow is essential for cellular survival in both the trunk and cerebral vasculature, but particularly intra-cerebral vessels are affected by the lack of blood flow, suggesting that responses to blood flow differ between these two vascular beds

Symmetric Skyrmions

We present candidates for the global minimum energy solitons of charge one to nine in the Skyrme model, generated using sophisticated numerical algorithms. Assuming the Skyrme model accurately represents the low energy limit of QCD, these configurations correspond to the classical nuclear ground states of the light elements. The solitons found are particularly symmetric, for example, the charge seven skyrmion has icosahedral symmetry, and the shapes are shown to fit a remarkable sequence defined by a geometric energy minimization (GEM) rule. We also calculate the energies and sizes to within at least a few percent accuracy. These calculations provide the basis for a future investigation of the low energy vibrational modes of skyrmions and hence the possibility of testing the Skyrme model against experiment.Comment: latex, 9 pages, 1 figure (fig1.gif

Emission patterns of neutral pions in 40 A MeV Ta+Au reactions

Differential cross sections of neutral pions emitted in 181Ta + 197Au collisions at a beam energy of 39.5A MeV have been measured with the photon spectrometer TAPS. The kinetic energy and transverse momentum spectra of neutral pions cannot be properly described in the framework of the thermal model, nor when the reabsorption of pions is accounted for in a phenomenological model. However, high energy and high momentum tails of the pion spectra can be well fitted through thermal distributions with unexpectedly soft temperature parameters below 10 MeV.Comment: 16 pages (double-spaced), 5 figures; corrections after referee's comments and suggestion

Towards device-size atomistic models of amorphous silicon

The atomic structure of amorphous materials is believed to be well described by the continuous random network model. We present an algorithm for the generation of large, high-quality continuous random networks. The algorithm is a variation of the "sillium" approach introduced by Wooten, Winer, and Weaire. By employing local relaxation techniques, local atomic rearrangements can be tried that scale almost independently of system size. This scaling property of the algorithm paves the way for the generation of realistic device-size atomic networks.Comment: 7 pages, 3 figure

Use of electrostatic gridded lenses in the laser ion source at CERN

The GEL LEBT provides high efficiency beam transport and matching to the RFQ acceptance in the 4-dimensional phase space. The rms emittance growth is relatively small even for 60 kV extraction voltage. The number of particles occupying the 4-D RFQ acceptance strongly depends from the beam emittance at the entrance of the GEL LEBT. In most realistic case with the input emittance equal to the measured one, which is 320 p×mm×mrad (4×rms emittance) the number of particles inside the 4-D space with the projection emittance of 200 p×mm×mrad is 38% at the entrance and 35% at the output of GEL LEBT, which means that LEBT does not practically destroy beam emittance. The experimental value of the yield to the double aperture is 35% and confirms the expected performance of the GEL LEBT

Phase-fluctuation induced reduction of the kinetic energy at the superconducting transition

Recent reflectivity measurements provide evidence for a "violation" of the in-plane optical integral in the underdoped high-T_c compound Bi_2Sr_2CaCu_2O_{8+\delta} up to frequencies much higher than expected by standard BCS theory. The sum rule violation may be related to a loss of in-plane kinetic energy at the superconducting transition. Here, we show that a model based on phase fluctuations of the superconducting order parameter can account for this change of in-plane kinetic energy at T_c. The change is due to a transition from a phase-incoherent Cooper-pair motion in the pseudogap regime above T_c to a phase-coherent motion at T_c.Comment: 5 pages, 3 eps-figure