Preconception laparoscopic transabdominal cervical cerclage for the prevention of midtrimester pregnancy loss and preterm birth: a single centre experience

Background: A recent Cochrane review concluded that cervical cerclage reduces preterm birth before 37, 34 and 28 weeks of gestation and also probably reduces the risk of perinatal death. Transabdominal cerclage was developed for a subgroup in whom transvaginal cerclage had failed or was not possible. This approach appeared more effective in improving foetal survival rates or obstetric outcomes. Most commonly transabdominal cervical cerclage is placed at laparotomy (open transabdominal cerclage), but with the advance of minimal access techniques, laparoscopic transabdominal cervical cerclage is replacing the traditional open operation. The objective of this prospective case series is to explore the outcomes of pre-conception laparoscopic transabdominal cerclage procedures. Method: Data was prospectively collected from 54 women at high risk of second trimester miscarriage and preterm delivery due to cervical insufficiency undergoing pre-conception laparoscopic transabdominal cerclage by a single operator. This included demographics, obstetric and gynaecological history (including previous cervical cerclage procedures), surgical complication rates, conception and subsequent pregnancy outcomes. Results: There were 36 pregnancies progressing beyond the first trimester with a "take home baby" rate of 89% (32/36), a live birth rate of 92% (33/36) and neonatal survival rate of 97% (32/33). The mid-trimester loss (MTL) rate was 8% (3/36) with delivery rates after 37 weeks of 75% (27/36) and between 34 -37 weeks of 8% (3/36) and 23-34 weeks of 8% (3/36). Conclusions: Our prospective case series provides further evidence that laparoscopic transabdominal cerclage (TAC) is feasible, safe and effective when transvaginal cerclage fails or is not possible

Alcohol drinking in one's thirties and forties is associated with body mass index in men, but not in women: A longitudinal analysis of the 1970 British Cohort Study

Our objective was to investigate longitudinal associations between alcohol drinking and body mass index (BMI). Alcohol drinking (exposure), BMI (outcome), smoking habit, occupation, longstanding illness, and leisure time physical activity (potential confounders) were assessed at ages 30, 34, 42, and 46 in the 1970 British Birth Cohort Study. Multilevel models were used to cope with the problem of correlated observations. There were 15,708 observations in 5931 men and 14,077 observations in 5656 women. Drinking was associated with BMI in men. According to the regression coefficients, BMI was expected to increase by 0.36 (95% confidence interval: 0.11, 0.60) kg/m2 per year in men who drank once a week and by 0.40 (0.14, 0.15) kg/m2 per year in men who drank most days. In ten years, BMI was expected to increase by 5.4 kg/m2 in men who drank and by 2.9 kg/m2 in men who drank and were physically active. Drinking was not associated with BMI in women. Rather, BMI was expected to increase by 0.25 (0.07, 0.43) kg/m2 per year in women who were former smokers. In ten years, BMI was expected to increase by 4.3 kg/m2 in women who were former smokers and by 0.8 kg/m2 in women who were former smokers and who were physically active. Associations between drinking and BMI were similar after further adjustment for problematic drinking and diet. These longitudinal data suggest that drinking is associated with BMI in men and that drinking is not associated with BMI in women independent of other lifestyle risk factors

Phosphorus Retention and sorption by constructed wetland soils.

End of Project ReportPhosphorus plays a major role in the eutrophication of freshwater systems. Wetland systems either natural or constructed have an inherent ability to cycle and retain P. Physical, chemical and biological processes regulate P retention in wetland soils and sediments. Of those processes, sorption and precipitation are important in retaining P. Sorption is typically greater under aerobic soil/sediment conditions than anaerobic conditions. Under anaerobic conditions, Fe plays a major role in P dynamics, whereas Al is not affected by changes in redox. Precipitation of P as insoluble Ca bound P is a dominant transformation at high pH. Long-term P retention by wetland systems includes accretion and decomposition of organic and detrital material, and its associated P content. Case studies reviewed illustrated that P retention in natural and constructed wetland systems can vary by several orders of 30 magnitude depending on site-specific factors. The literature reviewed also indicates that using wetlands to retain P from agricultural practices is significant and variable

Fatness, fitness, and cardiometabolic risk factors in middle-aged white men.

The objective was to test the hypothesis that traditional and novel cardiometabolic risk factors would be significantly different in groups of men of different fatness and fitness. Total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, glucose, insulin, high-sensitivity C-reactive protein, alanine aminotransferase, aspartate aminotransferase, γ-glutamyltransferase, leptin, adiponectin, tumor necrosis factor-α, interleukin-6, interleukin-10, fibrinogen, and insulin resistance were assessed in 183 nonsmoking white men aged 35 to 53 years, including 62 who were slim and fit (waist girth ≤90 cm and maximal oxygen consumption [VO(2)max] above average), 24 who were slim and unfit (waist girth ≤90 cm and VO(2)max average or below), 39 who were fat and fit (waist girth ≥100 cm and VO(2)max above average), and 19 who were fat and unfit (waist girth ≥100 cm and VO(2)max average or below). Seventy-six percent gave blood on 2 occasions, and the average of 1 or 2 blood tests was used in statistical tests. Waist girth (centimeters) and fitness (milliliters of oxygen per kilogram of fat-free mass) were associated with high-density lipoprotein cholesterol, leptin, and insulin resistance after adjustment for age, saturated fat intake, and total energy intake. High-density lipoprotein cholesterol, triglycerides, alanine aminotransferase, and insulin resistance were significantly different in men who were fat and fit and those who were fat and unfit. These data suggest that differences in lipid and lipoprotein concentrations, liver function, and insulin resistance may explain why the risks of chronic disease are lower in men who are fat and fit than those who are fat and unfit

A Farm Scale integrated constructed wetland to treat farmyard dirty water.

End of Project ReportIn Ireland, the use of constructed wetlands to manage agricultural waters such as farm yard dirty water has been primarily based on an ecosystems approach. Integrated constructed wetlands, which are a design specific approach of conventional surface flow constructed wetlands, were first used in the Anne Valley, Waterford, Ireland (Harrington and Ryder, 2002). At present, 13 farms in the Anne Valley catchment use integrated constructed wetlands to manage farmyard dirty water (Harrington et al., 2004). Fundamental to their design is water quality improvement, landscape fit (designing the wetland into the topography of the landscape) and that the wetland provides an ecological habitat within the agricultural landscape. Typically, integrated constructed wetlands have greater land area requirements than conventional surface flow constructed wetlands in order to provide for these other fundamental ecological services. Few studies (Ryan, 1990) have addressed the issue of quality and quantity of farmyard dirty generated at farm-scales in Ireland. No studies were readily available documenting the effectiveness of a farm-scale constructed or integrated constructed wetland in Ireland to remove nutrients such as phosphorus (P) from dairy farmyard dirty water on a mass basis. To address such, the main objectives of this research were to (i) determine the quality and quantity of farmyard dirty water generated at a farm-scale (ii) determine the effectiveness of three treatment cells of an integrated constructed wetland to treat farmyard dirty, using the difference between input and output mass loadings, (iii) investigate if there were seasonal effects in the wetland’s performance to retain phosphorus, and (iv) assess the impact of the integrated constructed wetland on the receiving environment by monitoring soil-water parameter concentrations up gradient, down gradient and within the wetland system using piezometers at different soil depths.Teagasc Walsh Fellowship Programm

Labour efficiency on-farm

End of project reportImprovements in milking efficiency have a greater influence than any other aspect of the dairy farmers work on overall farm labour inputs (Whipp, 1992). In order to facilitate the examination of milking process labour inputs, the milking process may be divided into the following three components: herding pre and post milking (transfer of cows to and from the milking parlour); milking (milking tasks / work routines within the parlour); and washing (washing of milking machine and yard). Meanwhile, within milking specifically, the number of cows milked per operator per hour is the best measure of both the performance of the operator and the milking installation (Clough, 1978). This is affected by the following three factors: the milking times of the cows, the number and arrangement of the milking units, and the operator’s work routine (Whipp, 1992). The addition of extra milking units will only increase milking performance if the operator has idle time during milking (Hansen, 1999)

Estimated cardiorespiratory fitness in childhood and cardiometabolic health in adulthood: 1970 British Cohort Study

BACKGROUND Associations of cardiorespiratory fitness in childhood and adulthood with adult cardiometabolic risk factors are poorly understood, not least because of the paucity of studies. OBJECTIVES We investigated associations between nonexercise testing cardiorespiratory fitness (NETCRF) in childhood/adulthood and cardiometabolic risk factors in adulthood. METHODS Based on an established algorithm comprising gender, age, body mass index, resting heart rate, and self‐reported physical activity at age 10, we computed NETCRF. Risk factors were assessed at age 46 in 5,009 participants when NETCRF was again calculated. Linear regression was used to summarise associations between NETCRF in childhood and risk factors in adulthood and, additionally, the relationship between NETCRF in adulthood and risk factors in adulthood after adjusting for childhood NETCRF. RESULTS Inconsistent associations were observed between childhood NETCRF and adult risk factors. NETCRF in adulthood was associated with blood pressure [‐5.8 (‐6.7, ‐4.9)], glycated haemoglobin [‐3.41 (‐4.06, ‐2.76)], total cholesterol [‐0.16 (‐0.24, ‐0.08)], HDL‐cholesterol [0.19 (0.16, 0.22)], triglycerides [‐0.68 (‐0.85, ‐0.50)] and C‐reactive protein [‐0.29 (‐0.35, ‐0.22)] in adult males. Similar associations were observed in adult females. Compared to those with low estimated fitness in both childhood and adulthood, participants with low fitness in childhood and high fitness in adulthood had a lower risk of two or more cardiometabolic risk factors (odds ratio: 0.22; 95% confidence interval: 0.16, 0.30). CONCLUSION Associations between estimated fitness and risk factors are stronger in adulthood than from childhood to adulthood. Adults with previously sedentary childhoods may still gain benefits from improving their fitness

Absolute properties of the low-mass eclipsing binary CM Draconis

Spectroscopic and eclipsing binary systems offer the best means for determining accurate physical properties of stars, including their masses and radii. The data available for low-mass stars have yielded firm evidence that stellar structure models predict smaller radii and higher effective temperatures than observed, but the number of systems with detailed analyses is still small. In this paper we present a complete reanalysis of one of such eclipsing systems, CM Dra, composed of two dM4.5 stars. New and existing light curves as well as a radial velocity curve are modeled to measure the physical properties of both components. The masses and radii determined for the components of CM Dra are M1=0.2310+/-0.0009 Msun, M2=0.2141+/-0.0010 Msun, R1=0.2534+/-0.0019 Rsun, and R2=0.2396+/-0.0015 Rsun. With relative uncertainties well below the 1% level, these values constitute the most accurate properties to date for fully convective stars. This makes CM Dra a valuable benchmark for testing theoretical models. In comparing our measurements with theory, we confirm the discrepancies reported previously for other low-mass eclipsing binaries. These discrepancies seem likely to be due to the effects of magnetic activity. We find that the orbit of this system is slightly eccentric, and we have made use of eclipse timings spanning three decades to infer the apsidal motion and other related properties.Comment: 19 pages, 9 figures. Accepted for publication in Ap