Amniotic fluid volume: Rapid MR-based assessment at 28-32 weeks gestation

Objectives: This work evaluates rapid magnetic resonance projection hydrography (PH) based amniotic fluid volume (AFV) estimates against established routine ultrasound single deepest vertical pocket (SDVP) and amniotic fluid index (AFI) measurements, in utero, at 28-32 weeks gestation. Manual multi-section planimetry (MSP) based measurement of AFV is used as a proxy reference standard. Methods: 35 women with a healthy singleton pregnancy (20-41 years) attending routine antenatal ultrasound were recruited. SDVP and AFI were measured using ultrasound, with same day MRI assessing AFV with PH and MSP. The relationships between the respective techniques were assessed using linear regression analysis and Bland-Altman method comparison statistics. Results: When comparing estimated AFV, a highly significant relationship was observed between PH and the reference standard MSP (R2=0.802, p<0.001). For the US measurements, SDVP measurement related most closely to amniotic fluid volume, (R2=0.470, p<0.001), with AFI demonstrating a weaker relationship (R2=0.208, p=0.007). Conclusion: This study shows that rapid MRI based PH measurement is a better predictor of AFV, relating more closely to our proxy standard than established US techniques. Although larger validation studies across a range of gestational ages are required this approach could form part of MR fetal assessment, particularly where poly or oligohydramnios is suspected.This study was supported by the National Institute of Health Research, Cambridge Biomedical Research Centre. The authors also acknowledge the support of Addenbrooke’s Charitable Trust and thank the participants for their contribution to the study.This is the author accepted manuscript. The final version is available from Springer via http://dx.doi.org/10.1007/s00330-015-4179-

Textural and geochemical features of freshwater microbialites from Laguna Bacalar, Quintana Roo, Mexico

Microbialites provide some of the oldest direct evidence of life on Earth. They reached their peak during the Proterozoic and declined afterward. Their decline has been attributed to grazing and/or burrowing by metazoans, to changes in ocean chemistry, or to competition with other calcifying organisms. The freshwater microbialites at Laguna Bacalar (Mexico) provide an opportunity to better understand microbialite growth in terms of interaction between grazing organisms versus calcium carbonate precipitation. The Laguna Bacalar microbialites are described in terms of their distinct mesostructures. Stromatolites display internal lamination, attributed to the precipitation of calcite and the upward migration of cyanobacteria during periods of low sedimentation. Thrombolitic stromatolites show internal lamination in addition to internal clotting. The clotting is seen as a result of binding and/or trapping of micritic peloids by cyanobacteria and attributed to periods of high sedimentation. The carbonates in both microbialites had similar C- and O-stable–isotopic signatures, both enriched in ^(13)C relative to bivalves, suggesting photosynthetic CO_2 uptake was the trigger for carbonate precipitation. This implies that the rate of microbialite growth is largely a function of ambient carbonate saturation state, while the texture is especially dependent on accretion rates and sediment deposition on their surface. Importantly, the coexistence with grazing animals suggests no significant inhibition on microbialite growth, thereby calling into question the decline of microbialite as a result of metazoan evolution. Varying sedimentation rates are likely important in controlling the distribution of thrombolite–stromatolite packages in the geological record, given the importance of this factor at Bacalar

Fostering social innovation and building adaptive capacity for dengue control in Cambodia: a case study

Background: The social-ecological systems theory, with its unique conception of resilience (social-ecological systems & resilience, SESR), provides an operational framework that currently best meets the need for integration and adaptive governance as encouraged by the Sustainable Development Goals. SESR accounts for the complex dynamics of social-ecological systems and operationalizes transdisciplinarity by focusing on community engagement, value co-creation, decentralized leadership and social innovation. Targeting Social Innovation (SI) in the context of implementation research for vector-borne diseases (VBD) control offers a low-cost strategy to contribute to lasting and contextualized community engagement in disease control and health development in low and middle income countries of the global south. In this article we describe the processes of community engagement and transdisciplinary collaboration underpinning community-based dengue management in rural primary schools and households in two districts in Cambodia. Methods: Multiple student-led and community-based interventions have been implemented focusing on empowering education, communication for behavioral change and participatory epidemiology mapping in order to engage Cambodian communities in dengue control. We describe in particular the significance of the participatory processes that have contributed to the design of SI products that emerged following iterative consultations with community stakeholders to address the dengue problem. Results: The SI products that emerged following our interaction with community members are 1) adult mosquito traps made locally from solid waste collections, 2) revised dengue curriculum with hands-on activities for transformative learning, 3) guppy distribution systems led by community members, 4) co-design of dengue prevention communication material by students and community members, 5) community mapping. Conclusions: The initiative described in this article put in motion processes of community engagement towards creating ownership of dengue control interventions tools by community stakeholders, including school children. While the project is ongoing, the project's interventions so far implemented have contributed to the emergence of culturally relevant SI products and provided initial clues regarding 1) the conditions allowing SI to emerge, 2) specific mechanisms by which it happens and 3) how external parties can facilitate SI emergence. Overall there seems to be a strong argument to be made in supporting SI as a desirable outcome of project implementation towards building adaptive capacity and resilience and to use the protocol supporting this project implementation as an operational guiding document for other VBD adaptive management in the region

Patients' experience of shoulder disorders: a systematic review of qualitative studies for the OMERACT Shoulder Core Domain Set.

OBJECTIVES:To describe the experiences (including symptoms and perceived impacts on daily living) of people with a shoulder disorder. METHODS:Systematic review of qualitative studies. We searched for eligible qualitative studies indexed in Ovid MEDLINE, Ovid Embase, CINAHL (EBSCO), SportDiscus (EBSCO) and Ovid PsycINFO up until November 2017. Two authors independently screened studies for inclusion, appraised their methodological quality using the Critical Appraisal Skills Programme checklist, used thematic synthesis methods to generate themes describing the experiences reported by participants and assessed the confidence in the findings using the Grading of Recommendations Assessment, Development and Evaluation Confidence in Evidence from Reviews of Qualitative research (GRADE-CERQual) approach. RESULTS:The inclusion criteria were met by eight studies, which included 133 participants (49 females and 84 males) with either rotator cuff disease, adhesive capsulitis, proximal humeral fracture, shoulder instability or unspecified shoulder pain. We generated seven themes to describe what people in the included studies reported experiencing: pain; physical function/activity limitations; participation restriction; sleep disruption; cognitive dysfunction; emotional distress; and other pathophysiological manifestations (other than pain). There were interactions between the themes, with particular experiences impacting on others (e.g. pain leading to reduced activities and sleep disruption). Following grading of the evidence, we considered it likely that most of the review findings were a reasonable representation of the experiences of people with shoulder disorders. CONCLUSION:Patients with shoulder disorders contend with considerable disruption to their life. The experiences described should be considered by researchers seeking to select the most appropriate outcomes to measure in clinical trials and other research studies in people with shoulder disorders

Miopatía autoinmune necrotizante

Mujer de 21 años, procedente de Camisea, Cusco, con dos semanas de debilidad muscular progresiva que llegó inclusive a la falla ventilatoria, elevación extrema de crantina fosfocinasa sérica total, patrón miopático en la electromiografía y con presencia de necrosis masiva sin infiltrado inflamatorio en la biopsia muscular. La paciente mejoró clínica y por losestudios de laboratorio con el tratamiento inmunosupresor

Uterine artery pulsatility and resistivity indices in pregnancy: Comparison of MRI and Doppler US

Objective The aim of this work was to evaluate whether the uterine arteries (UtA) could be identified and their flow profiles measured during a fetal MRI examination. A comparison was performed against same day sonographic Doppler assessment. Methods 35 normal, healthy, singleton pregnancies at 28–32 weeks gestation underwent routine Doppler examination, followed by MRI examination. The resistivity index (RI) and pulsatility index (PI) of the left and right UtA were measured using phase contrast MRI. Bland Altman statistics were used to compare MRI and ultrasound results. Results Sixty-nine comparable vessels were analysed. Six vessels were excluded due to artefact or technical error. Bland-Altman analysis demonstrated the ultrasound indices were comparable, although systematically lower than the MRI indices; Right UtA RI bias −0.03 (95% limits of agreement (LOA) −0.27 to +0.20), and left UtA RI bias −0.06 (95% LOA −0.26 to +0.14); Right UtA PI bias −0.06 (95% LOA −0.50 to +0.38), Left UtA PI bias −0.11 (95% LOA −0.54 to +0.32). The inter-rater agreement for the MRI derived PI and RI analysis was good. Conclusion This study demonstrates that in the majority of early third trimester pregnancies, the uterine arteries can be identified, and their flow profiles measured using MRI, and that the derived PI and RI values are comparable with Doppler ultrasound values

Critical assessment of the elemental composition of Corning archeological reference glasses by LA-ICP-MS

Corning archeological reference glasses A, B, C, and D have been made to simulate different historic technologies of glass production and are used as standards in historic glass investigations. In this work, nanoseconds (193, 266 nm) and femtosecond (800 nm) laser ablation were used to study the elemental composition of Corning glasses using laser ablation inductively coupled plasma mass spectrometry. The determined concentrations of 26 oxides (Li2O, B2O3, Na2O, MgO, Al2O3, SiO2, P2O5, K2O, CaO, TiO2, V2O5, Cr2O3, MnO, Fe2O3, CoO, NiO, CuO, ZnO, Rb2O, SrO, ZrO2, SnO2, Sb2O5, BaO, PbO, Bi2O3) are compared with values reported in the literature. Results show variable discrepancies between the data, with the largest differences found for Cr2O3 in Corning A; Li2O, B2O3, and Cr2O3 in Corning B; and MnO, Sb2O5, Cr2O3, and Bi2O3 in Corning C. The best agreement between the measured and literature values was found for Corning D. However, even for this reference, glass re-evaluation of the data was necessary and new values for PbO, BaO, and Bi2O3 are proposed

Wideband-tuneable, nanotube mode-locked, fibre laser

Ultrashort-pulse lasers with spectral tuning capability have widespread applications in fields such as spectroscopy, biomedical research and telecommunications1–3. Mode-locked fibre lasers are convenient and powerful sources of ultrashort pulses4, and the inclusion of a broadband saturable absorber as a passive optical switch inside the laser cavity may offer tuneability over a range of wavelengths5. Semiconductor saturable absorber mirrors are widely used in fibre lasers4–6, but their operating range is typically limited to a few tens of nanometres7,8, and their fabrication can be challenging in the 1.3–1.5 mm wavelength region used for optical communications9,10. Single-walled carbon nanotubes are excellent saturable absorbers because of their subpicosecond recovery time, low saturation intensity, polarization insensitivity, and mechanical and environmental robustness11–16. Here, we engineer a nanotube–polycarbonate film with a wide bandwidth (>300 nm) around 1.55 mm, and then use it to demonstrate a 2.4 ps Er31-doped fibre laser that is tuneable from 1,518 to 1,558 nm. In principle, different diameters and chiralities of nanotubes could be combined to enable compact, mode-locked fibre lasers that are tuneable over a much broader range of wavelengths than other systems