Adverse perinatal outcomes for obese women are influenced by the presence of comorbid diabetes and hypertensive disorders

Maternal obesity often occurs together with comorbid diabetes and hypertensive disorders. All three conditions are independently associated with negative perinatal outcomes. Our objective was to determine the risk and burden of adverse perinatal outcome that could be attributed to maternal obesity in combination with a comorbid status. We analyzed data from 324'664 singleton deliveries in Switzerland between 2005 and 2016. For the association of maternal obesity in the presence or absence of comorbidities with various perinatal outcomes, we estimated adjusted relative risk (RR) using multivariable regression modeling and determined the multivariable-adjusted attributable fraction of the population (AFp). Obesity was a main predictor for macrosomia, fracture of the clavicle, failure to progress in labor and prolonged labor. By stratifying women based on comorbidities, we identified significantly increased risk for preterm birth and early neonatal death only for women diagnosed with a comorbidity. However, various other outcomes were independently associated with either obesity or comorbidities. The AFp showed greatest reduction in comorbidities (15.4/15.0/13.2%), in macrosomia (6.3%) and in shoulder dystocia (4.8%) if all women were to become non-obese. We suggest that comorbidities such as diabetes and hypertensive disorders should be considered when relating maternal obesity to adverse perinatal outcomes

In situ assessment of carbon nanotube diameter distribution with photoelectron spectroscopy

7 págs.; 6 figs.; 1 tab. ; PACS numberssd: 73.22.2f, 79.60.Jv, 61.46.1wIn situ UV-photoelectron spectroscopy (He I and He II) was performed on multiwalled carbon nanotubes (CNTs) with clearly differentiated diameter distributions. A significant dependence of valence- and conduction-band characteristics on the mean CNT diameter was observed, which was determined by high-resolution TEM and micro-Raman spectroscopy. The decrease of relative intensity of the π states at -3 eV in the He II experiments, indicative of increasing rehybridization between orbitals, was directly correlated with decreasing mean diameters. Furthermore, a progressive broadening of the unoccupied σ* band at 7.6 eV was found in the He I spectra. © 2005 The American Physical Society.J.W.S. is grateful to the Centre Interdisciplinaire de Microscopie Electronique sCIMEd at the Ecole Polytechnique Fédérale de Lausanne sEPFLd for access to TEM and technical support. We also thank the National Centre of Competence in Research for Nanosciences NCCRd and the Swiss National Foundation for financial support.Peer Reviewe

First mirror tests for ITER: influence of material choice on the deposition/ erosion mechanisms affecting optical reflectivity

Almost all optical diagnostics systems on ITER will be based on in-vessel metallic first mirrors. The possible deterioration of their surface reflectivity as a result of erosion by charge-exchange neutrals and re-deposition of material eroded from the plasma-facing components represents a serious concern for the reliability of spectroscopic and laser signals. A concerted effort within the tokamak community has been initiated to characterize these effects and seek mitigation methods. To date, the different damaging effects (erosion and deposition) have always been considered independently, neglecting any role that may be played by the substrate. In this contribution, we attempt to assess the influence of substrate material using different approaches: laboratory simulation experiments, mirror exposures in the divertor region of the TCV tokamak and numerical simulations using the Monte-Carlo code TRIDYN. Our results have potentially important implications for the choice of ITER first mirror materials

Non-Visual Effects of Light on Melatonin, Alertness and Cognitive Performance: Can Blue-Enriched Light Keep Us Alert?

Light exposure can cascade numerous effects on the human circadian process via the non-imaging forming system, whose spectral relevance is highest in the short-wavelength range. Here we investigated if commercially available compact fluorescent lamps with different colour temperatures can impact on alertness and cognitive performance

Accelerated CMR using zonal, parallel and prior knowledge driven imaging methods

Accelerated imaging is highly relevant for many CMR applications as competing constraints with respect to spatiotemporal resolution and tolerable scan times are frequently posed. Three approaches, all involving data undersampling to increase scan efficiencies, are discussed in this review. Zonal imaging can be considered a niche but nevertheless has found application in coronary imaging and CMR flow measurements. Current work on parallel-transmit systems is expected to revive the interest in zonal imaging techniques. The second and main approach to speeding up CMR sequences has been parallel imaging. A wide range of CMR applications has benefited from parallel imaging with reduction factors of two to three routinely applied for functional assessment, perfusion, viability and coronary imaging. Large coil arrays, as are becoming increasingly available, are expected to support reduction factors greater than three to four in particular in combination with 3D imaging protocols. Despite these prospects, theoretical work has indicated fundamental limits of coil encoding at clinically available magnetic field strengths. In that respect, alternative approaches exploiting prior knowledge about the object being imaged as such or jointly with parallel imaging have attracted considerable attention. Five to eight-fold scan accelerations in cine and dynamic CMR applications have been reported and image quality has been found to be favorable relative to using parallel imaging alone

Demographic, clinical and antibody characteristics of patients with digital ulcers in systemic sclerosis: data from the DUO Registry

OBJECTIVES: The Digital Ulcers Outcome (DUO) Registry was designed to describe the clinical and antibody characteristics, disease course and outcomes of patients with digital ulcers associated with systemic sclerosis (SSc). METHODS: The DUO Registry is a European, prospective, multicentre, observational, registry of SSc patients with ongoing digital ulcer disease, irrespective of treatment regimen. Data collected included demographics, SSc duration, SSc subset, internal organ manifestations, autoantibodies, previous and ongoing interventions and complications related to digital ulcers. RESULTS: Up to 19 November 2010 a total of 2439 patients had enrolled into the registry. Most were classified as either limited cutaneous SSc (lcSSc; 52.2%) or diffuse cutaneous SSc (dcSSc; 36.9%). Digital ulcers developed earlier in patients with dcSSc compared with lcSSc. Almost all patients (95.7%) tested positive for antinuclear antibodies, 45.2% for anti-scleroderma-70 and 43.6% for anticentromere antibodies (ACA). The first digital ulcer in the anti-scleroderma-70-positive patient cohort occurred approximately 5 years earlier than the ACA-positive patient group. CONCLUSIONS: This study provides data from a large cohort of SSc patients with a history of digital ulcers. The early occurrence and high frequency of digital ulcer complications are especially seen in patients with dcSSc and/or anti-scleroderma-70 antibodies