Accuracy of fetal echocardiography diagnosis and anticipated perinatal and early postnatal care in congenital heart disease in mid-gestation

Introduction The aim of this study was to determine discrepancies in fetal congenital heart disease (CHD) diagnoses and anticipated early postnatal care and outcomes. Material and methods A retrospective review of 462 randomly selected cases (23% of all cases) referred to a fetal cardiac assessment during the second trimester (mean 26 weeks) at the Children's Hospital in Helsinki between October 2010 and December 2020. Discrepancy between prenatal and postnatal CHD case evaluations was assessed with independently provided cardiac severity and surgical complexity scores. Results In all, 250 cases, 181 CHD and 69 normal, with complete prenatal and postnatal live birth data as well as seven fetal autopsy reports available were included in the analysis. There were 12 false normal and seven false abnormal prenatal assessments. The prenatally anticipated level of early neonatal care was actualized in 62% and prostaglandin infusion in 95%. In total, 32.7% (84/257) cardiac severity scores were discrepant and in 12,4% (32/257) cases the discrepancies were considered significant (>= +/- 2 scores). Among significant discrepancies, CHD severity score was overestimated in 13 and underestimated in 19 in fetal assessment. Progression of CHD severity after mid-gestation and during early neonatal phase explained eight of 19 underestimated fetal assessments. The most common discrepant diagnostic categories included ventricular septal defects (n = 7), borderline ventricles (n = 7; 5 left heart, 1 right heart and 1 double outlet right ventricle/transposition of the great arteries), arch anomalies including coarctations (n = 5) and tricuspid valve dysplasias (n = 4) with a significant change in postnatal diagnoses and treatment. Conclusions Although fetal CHD diagnosis and counseling is accurate and reliable in general, the study elaborates specific areas of uncertainty in clinical fetal cardiology practice that may be important to consider in fetal CHD evaluation and counseling provided in mid-gestation.Peer reviewe

EISCAT and Cluster observations in the vicinity of the dynamical polar cap boundary

The dynamics of the polar cap boundary and auroral oval in the nightside ionosphere are studied during late expansion and recovery of a substorm from the region between Tromsø (66.6° cgmLat) and Longyearbyen (75.2° cgmLat) on 27 February 2004 by using the coordinated EISCAT incoherent scatter radar, MIRACLE magnetometer and Cluster satellite measurements. During the late substorm expansion/early recovery phase, the polar cap boundary (PCB) made zig-zag-type motion with amplitude of 2.5° cgmLat and period of about 30 min near magnetic midnight. We suggest that the poleward motions of the PCB were produced by bursts of enhanced reconnection at the near-Earth neutral line (NENL). The subsequent equatorward motions of the PCB would then represent the recovery of the merging line towards the equilibrium state (Cowley and Lockwood, 1992). The observed bursts of enhanced westward electrojet just equatorward of the polar cap boundary during poleward expansions were produced plausibly by particles accelerated in the vicinity of the neutral line and thus lend evidence to the Cowley-Lockwood paradigm. <br><br> During the substorm recovery phase, the footpoints of the Cluster satellites at a geocentric distance of 4.4 <I>R<sub>E</sub></I> mapped in the vicinity of EISCAT measurements. Cluster data indicate that outflow of H<sup>+</sup> and O<sup>+</sup> ions took place within the plasma sheet boundary layer (PSBL) as noted in some earlier studies as well. We show that in this case the PSBL corresponded to a region of enhanced electron temperature in the ionospheric F region. It is suggested that the ion outflow originates from the F region as a result of increased ambipolar diffusion. At higher altitudes, the ions could be further energized by waves, which at Cluster altitudes were observed as BBELF (broad band extra low frequency) fluctuations. <br><br> The four-satellite configuration of Cluster revealed a sudden poleward expansion of the PSBL by 2° during ~5 min. The beginning of the poleward motion of the PCB was associated with an intensification of the downward FAC at the boundary. We suggest that the downward FAC sheet at the PCB is the high-altitude counterpart of the Earthward flowing FAC produced in the vicinity of the magnetotail neutral line by the Hall effect (Sonnerup, 1979) during a short-lived reconnection pulse

Автономизация вузов в Украине как драйвер перехода к образовательной модели медицинского предпринимательского университета

УНИВЕРСИТЕТ 3.0ПРЕДПРИНИМАТЕЛЬСКИЕ КОМПЕТЕНЦИИОБРАЗОВАНИЕ МЕДИЦИНСКОЕСТУДЕНТЫ МЕДИЦИНСКИХ УЧЕБНЫХ ЗАВЕДЕНИЙОБРАЗОВАТЕЛЬНЫЕ МОДЕЛИПРЕДПРИНИМАТЕЛЬСКИЕ УНИВЕРСИТЕТЫУКРАИН

Functionality of spruce galactoglucomannans in oil-in-water emulsions

For a sustainable food chain, the demand for plant-based, functional, and cost-effective food hydrocolloids is on a high-rise. Hemicelluloses from the renewable lignocellulosic biomass are available in abundance from side-streams of the forestry industry to fulfill this demand. Their effective valorization requires a safe, economic extraction method that can be up-scaled to an industrial scale and, simultaneously, understanding of their functionality to develop applications. In this study, an aqueous-based extraction method, pressurized hot water extraction (PHWE) of spruce saw meal was used to obtain galactoglucomannans (GGM), "spruce gum". Ethanol precipitation was performed to remove non-polysaccharide extractives such as free phenolic compounds, and the emulsion component ratio-dependent interfacial saturation capacity of the remaining purified fraction was studied to understand its functionality. GGM resulted in good to excellent emulsification and stabilization of oil-in-water emulsions and exhibited adsorption at the oil droplet interface, which depended on the amount of oil and droplet size of emulsions. The adsorbed GGM content was determined by gas chromatography after acid methanolysis, and their macromolecular characteristics were studied by size-exclusion chromatography. At GGM to oil ratios 2, 1, and 0.4, stable emulsions with predicted several months of shelf life at room temperature were achieved. The results indicated mechanisms affecting the physical stabilization and breakdown of emulsions containing spruce gum, a novel sustainable hydrocolloid. (C) 2018 Elsevier Ltd. All rights reserved.Peer reviewe

Wood lignocellulosic stabilizers : effect of their characteristics on stability and rheological properties of emulsions

Lignocellulosic materials from the forest industry have shown potential to be used as sustainable hydrocolloids to stabilize emulsions for many applications in life science and chemical industries. However, the effect of wood species and recovery method on the product’s properties and ability to stabilize emulsions of isolated lignocellulosic compounds is not well understood. Hemicelluloses, abundant lignocellulosic side stream, exhibit differences in their water solubility, anionic character, lignin content, and degree of acetylation. Here, we explored stability and rheological properties of model emulsions (5% hexadecane and 1% stabilizer, w/w) stabilized by different grades of sprucewood galactoglucomannan (GGM) and birchwood glucuronoxylan (GX) hemicelluloses. The results were compared to known soluble, insoluble, charged, and non-charged cellulosic stabilizers, namely methyl cellulose (MC), carboxymethyl cellulose (CMC), anionic- and nonionic-cellulose nanocrystals (aCNC and dCNC). The results showed that GX emulsions were highly stable compared to GGM emulsions, and that deacetylation and lignin removal markedly reduced emulsion stability of GGM. Carboxymethylation to increase anionic characters enhanced the emulsion stabilization capacity of GGM, but not that of GX. Investigating flow behaviors of emulsions indicated that hemicelluloses primarily stabilize emulsions by adsorption of insoluble particles, as their flow behaviors were similar to those of cellulose nanocrystals rather than those of soluble celluloses. Understanding the impact of the variations in composition and properties of hemicellulose stabilizers to stabilize emulsions allows tailoring of their recovery processes to obtain desirable hydrocolloids for different applications.Peer reviewe

Health endowment and later-life outcomes in the labour market: Evidence using genetic risk scores and reduced-form models

This paper examines the relationship between health endowment and later-life outcomes in the labour market. The analysis is based on reduced-form models in which labour market outcomes are regressed on genetic variants related to the increased risk of cardiovascular diseases. We use linked Finnish data that have many strengths. Genetic risk scores constitute exogenous measures for health endowment, and accurate administrative tax records on earnings, employment and social income transfers provide a comprehensive account of an individual’s long-term performance in the labour market. The results show that although the direction of an effect is generally consistent with theoretical reasoning, the effects of health endowment on outcomes are statistically weak, and the hypothesis of no effect can be rejected only in one case: genetic endowment related to obesity influences male earnings and employment in prime age. Due to the sample size (N = 1651), the results should be interpreted with caution and should be confirmed in larger samples and in other institutional settings.</p