Data management study, volume 5. Appendix A - Contractor data package technical description and system engineering /SE/ Final report

Technical description and systems engineering contractor data package for Voyager spacecraf

Double-balloon catheter for induction of labour in women with a previous cesarean section, could it be the best choice?

INTRODUCTION: We analysed the efficacy and safety of double-balloon catheter for cervical ripening in women with a previous cesarean section and which were the most important variables associated with an increased risk of repeated cesarean delivery. MATERIALS AND METHODS: We designed an observational retrospective study of 418 women with unfavourable cervices (Bishop Score <5), a prior cesarean delivery, and induction of labour with a double-balloon catheter. Baseline maternal data and perinatal outcomes were recorded for a descriptive, bivariate, and multivariate analysis. A p value <0.05 was considered statistically significant. RESULTS: Most women improved their initial Bishop Score (89.5%) although only a 20.8% of them went into spontaneous active labour. Finally, 51.4% of the women achieved a vaginal delivery. Five cases of intrapartum uterine rupture (1.2%) occurred. After multivariate analysis, main risk factors for repeated cesarean section were dystocia in the previous pregnancy (OR 1.744; CI 95% 1.066–2.846), the absence of previous vaginal delivery (OR 2.590; CI 95% 1.066–6.290), suspected fetal macrosomia (OR 2.410; CI 95% 0.959–6.054), and duration of oxytocin induction period (OR 1.005; CI 95% 1.004–1.006). The area under the curve was 0.789 (p < 0.001). CONCLUSIONS: Double-balloon catheter seems to be safe and effective for cervical ripening in women with a previous cesarean delivery and unfavourable cervix. In our study, most women could have a vaginal delivery in spite of their risk factors for cesarean delivery. A multivariate model based on some clinical variables has moderate predictive value for intrapartum cesarean section

Effects of warm ischaemia combined with cold preservation on the hypoxia-inducible factor 1α pathway in an experimental renal autotransplantation model

International audienceBackgroundThe increased use of marginal donors highlights the importance of organ quality in transplantation and the identification of prognostic biomarkers. This experimental study investigated modulation of the hypoxia-inducible factor (HIF) 1 pathway in kidney grafts in relation to different degrees of ischaemia. MethodsIn a porcine autotransplantation model, two different kidney graft protocols were compared: standard 24-h cold storage (CS) and 24-h CS preceded by 1h warm ischaemia (WI+CS). The renal HIF-1 pathway and tubular dedifferentiation were analysed in the early phase of reperfusion and at 3months. ResultsThere was a relationship between the degree of ischaemic injury and the outcome of the kidney graft. During the first week of reperfusion, WI+CS grafts showed a higher degree of injury. The observed tubular dedifferentiation was associated with delayed HIF-1 expression, and with loss of its role in transcription. In highly injured kidneys, deregulation of the HIF-1 pathway was also observed in the chronic phase, with reduced production of vascular endothelial growth factor (VEGF) A, and upregulation of VEGF receptor 1 (Flt-1) and thrombospondin 1. In addition, these kidneys displayed altered kidney histology and decreased function. ConclusionThe HIF-1 pathway appears to be abolished early in response to severe ischaemia. A high degree of ischaemic injury also results in chronic activation of the HIF-1 pathway, diverting it away from the beneficial activation of angiogenesis. Further studies on the finely tuned balance of signals in this pathway may provide diagnostic biomarkers that can determine organ quality during kidney transplantation

Isolated lymph node recurrence in epithelial ovarian cancer: recurrence with better prognosis?

International audienceIntroduction The aim of this study was to compare overall survival (OS) between women with isolated lymph node recurrence (ILNR) and those with isolated peritoneal localization of recurrence (ICR), in patients managed for epithelial ovarian cancer.Methods Data from 1508 patients with ovarian cancer were collected retrospectively from1 January 2000 to 31 December 2016, from the FRANCOGYN database, pooling data from 11 centres specialized in ovary treatment. Median overall survival was determined using the Kaplan-Meier method. Univariate and multivariate analyses were performed to define prognostic factors of overall survival. Patients included had a first recurrence defined as ILNR or ICR during their follow up.Results 79 patients (5.2 %) presented with ILNR, and 247 (16.4 %) patients had isolated carcinomatosis recurrence. Complete lymphadenectomy was performed more frequently in the ILNR group vs. the ICR group (67.1 % vs. 53.4 %, p = 0.004) and the number of pelvic lymph nodes involved was higher (2.4 vs. 1.1, p = 0.008). The number of involved pelvic LN was an independent predictor of ILNR (OR = 1.231, 95 % CI [1.074–1.412], p = 0.0024). The 3-year and 5-year OS rates in the ILNR group were 85.2 % and 53.7 % respectively, compared to 68.1 % and 46.8 % in patients with ICR. There was no significant difference in terms of OS after initial diagnosis (p = 0.18). 3- year and 5-year OS rates after diagnosis of recurrence were 62.6 % and 15.6 % in the ILNR group, and 44 % and 15.7 % in patients with ICR (p = 0.21).Conclusion ILNR does not seem to be associated with a better prognosis in terms of OS

Detection and measurement of phase transformation in steels using electromagnetic sensors – experimental results and modelling simulations.

An electromagnetic (EM) sensor, capable of detecting the formation of ferromagnetic ferrite from paramagnetic austenite below the Curie temperature, has been developed and assessed. In this article, results obtained using an a.c. EM sensor for a medium (0.45 wt pct)—carbon steel slow cooled through its transformation-temperature range are presented. It was found that the EM sensor can successfully detect the formation of ferrite below the Curie temperature, but that the transimpedance values can be significantly affected by the formation of a decarburized ferrite ring around the samples. It was also found that the transimpedance value is monotonically (nonlinearly) related to the ferrite volume fraction and depends on the morphology/distribution of the ferromagnetic phase and, hence, is influenced by the prior-austenite grain size. Results from finite-element (FE) simulations designed to enable prediction of the transimpedance from the microstructure are also presented, showing that two-dimensional (2-D) FE simulations can be successfully used to model the experimental trends observed. The combination of modeling and measurement has shown that EM sensors can be used to indirectly monitor the ferrite transformation (below the Curie temperature), thus providing a measure of ferrite volume fraction and also a means of identifying the ferrite distribution in the microstructure