162 research outputs found
Maternal cardiovascular adaptation to twin pregnancy: A population-based prospective cohort study
Background: In women with singleton pregnancies, maternal adaptation is considered a stress test for later life cardiovascular disease. The aim of this study was to assess maternal adaptation in women with twin pregnancies compared to women carrying singletons during and after pregnancy. Methods: This was a population based prospective cohort study of 91 women with twin pregnancies and 8107 women carrying singletons. The association of twin pregnancy and maternal adaptation was examined using regression analyses. In pregnancy, we measured soluble fms-like tyrosine kinase-1 (sFLT-1), placental growth (PGF) factor, systolic (SBP) and diastolic blood pressure (DBP), and the occurrence of pre-eclampsia (PE). After pregnancy, measurements were obtained on SBP and DBP, cardiac function, retinal calibres, intima media thickness and distensibility of the common carotid artery. Results: sFLT-1 and PGF concentrations were higher in early (13.4 weeks) and mid-pregnancy (20.4 weeks) in women with twin pregnancies compared to women with singleton pregnancies. Women with twin pregnancies had a different DBP pattern in pregnancy. Women with twin pregnancies were more likely to have PE (odds ratio 3.63; 95% CI [1.76 to 7.48]). Six and ten years after pregnancy, no differences in maternal adaptation were observed. Conclusions: Women with twin pregnancies show an altered adaptation during pregnancy compared to women with singleton pregnancies. This is associated with a substantially increased incidence of PE, but does not lead to persistent altered maternal adaptation years after pregnancy
Interpreting ambiguous âtraceâ results in Schistosoma mansoni CCA Tests: Estimating sensitivity and specificity of ambiguous results with no gold standard
Background The development of new diagnostics is an important tool in the fight against disease. Latent Class Analysis (LCA) is used to estimate the sensitivity and specificity of tests in the absence of a gold standard. The main field diagnostic for Schistosoma mansoni infection, Kato-Katz (KK), is not very sensitive at low infection intensities. A point-of-care circulating cathodic antigen (CCA) test has been shown to be more sensitive than KK. However, CCA can return an ambiguous âtraceâ result between âpositiveâ and ânegativeâ, and much debate has focused on interpretation of traces results. Methodology/Principle findings We show how LCA can be extended to include ambiguous trace results and analyse S. mansoni studies from both CĂŽte dâIvoire (CdI) and Uganda. We compare the diagnostic performance of KK and CCA and the observed results by each test to the estimated infection prevalence in the population. Prevalence by KK was higher in CdI (13.4%) than in Uganda (6.1%), but prevalence by CCA was similar between countries, both when trace was assumed to be negative (CCAtn: 11.7% in CdI and 9.7% in Uganda) and positive (CCAtp: 20.1% in CdI and 22.5% in Uganda). The estimated sensitivity of CCA was more consistent between countries than the estimated sensitivity of KK, and estimated infection prevalence did not significantly differ between CdI (20.5%) and Uganda (19.1%). The prevalence by CCA with trace as positive did not differ significantly from estimates of infection prevalence in either country, whereas both KK and CCA with trace as negative significantly underestimated infection prevalence in both countries. Conclusions Incorporation of ambiguous results into an LCA enables the effect of different treatment thresholds to be directly assessed and is applicable in many fields. Our results showed that CCA with trace as positive most accurately estimated infection prevalence
Fetal sex and maternal pregnancy outcomes: a systematic review and meta-analysis
BACKGROUND: Since the placenta also has a sex, fetal sex-specific differences in the occurrence of placenta-mediated complications could exist. OBJECTIVE: To determine the association of fetal sex with multiple maternal pregnancy complications. SEARCH STRATEGY: Six electronic databases Ovid MEDLINE, EMBASE, Cochrane Central, Web-of-Science, PubMed, and Google Scholar were systematically searched to identify eligible studies. Reference lists of the included studies and contact with experts were also used for identification of studies. SELECTION CRITERIA: Observational studies that assessed fetal sex and the presence of maternal pregnancy complications within singleton pregnancies. DATA COLLECTION AND ANALYSES: Data were extracted by 2 independent reviewers using a predesigned data collection form. MAIN RESULTS: From 6522 original references, 74 studies were selected, including over 12,5 million women. Male fetal sex was associated with term pre-eclampsia (pooled OR 1.07 [95%CI 1.06 to 1.09]) and gestational diabetes (pooled OR 1.04 [1.02 to 1.07]). All other pregnancy complications (i.e., gestational hypertension, total pre-eclampsia, eclampsia, placental abruption, and post-partum hemorrhage) tended to be associated with male fetal sex, except for preterm pre-eclampsia, which was more associated with female fetal sex. Overall quality of the included studies was good. Between-study heterogeneity was high due to differences in study population and outcome definition. CONCLUSION: This meta-analysis suggests that the occurrence of pregnancy complications differ according to fetal sex with a higher cardiovascular an
Treatment as Prevention: Characterization of Partner Infections in the HIV Prevention Trials Network 052 Trial
HIV Prevention Trials Network (HPTN) 052 demonstrated that antiretroviral therapy (ART) prevents HIV transmission in serodiscordant couples. HIV from index-partner pairs was analyzed to determine the genetic linkage status of partner infections. Forty-six infections were classified as linked, indicating that the index was the likely source of the partnerâs infection. Lack of viral suppression and higher index viral load were associated with linked infection. Eight linked infections were diagnosed after the index started ART: four near the time of ART initiation and four after ART failure. Linked infections were not observed when the index participant was stably suppressed on ART
International comparisons of behavioral and emotional problems in preschool children: parentsâ reports from 24 societies
International comparisons were conducted of preschool childrenâs behavioral and
emotional problems as reported on the Child Behavior Checklist for Ages 1Âœâ5 by parents
in 24 societies (NŒ19,850). Item ratings were aggregated into scores on syndromes; Diagnostic
and Statistical Manual of Mental Disordersâoriented scales; a Stress Problems scale;
and Internalizing, Externalizing, and Total Problems scales. Effect sizes for scale score differences
among the 24 societies ranged from small to medium (3â12%). Although societies
differed greatly in language, culture, and other characteristics, Total Problems scores for
18 of the 24 societies were within 7.1 points of the omnicultural mean of 33.3 (on a scale of
0â198). Gender and age differences, as well as gender and age interactions with society,
were all very small (effect sizes<1%). Across all pairs of societies, correlations between
mean item ratings averaged .78, and correlations between internal consistency alphas
for the scales averaged .92, indicating that the rank orders of mean item ratings and internal
consistencies of scales were very similar across diverse societies
The science of european marine reserves: Status, efficacy, and future needs
The ecologically and socio-economically important marine ecosystems of Europe are facing severe
threats from a variety of human impacts. To mitigate and potentially reverse some of these impacts, the
European Union (EU) has mandated the implementation of the Marine Strategy Framework Directive
(MSFD) in order to achieve Good Environmental Status (GES) in EU waters by 2020. The primary
initiative for achieving GES is the implementation of coherent networks of marine protected areas
(MPAs). Marine reserves are an important type of MPA in which no extraction is allowed, but their
usefulness depends upon a number of ecological, management, and political factors. This paper
provides a synthesis of the ecological effects of existing European marine reserves and the factors
(social and ecological) underlying their effectiveness. Results show that existing European marine
reserves foster significant positive increases in key biological variables (density, biomass, body size, and
species richness) compared with areas receiving less protection, a pattern mirrored by marine reserves
around the globe. For marine reserves to achieve their ecological and social goals, however, they must
be designed, managed, and enforced properly. In addition, identifying whether protected areas are
ecologically connected as a network, as well as where new MPAs should be established according to the
MSFD, requires information on the connectivity of populations across large areas. The adoption of the
MSFD demonstrates willingness to achieve the long-term protection of Europeâs marine ecosystems,
but whether the political will (local, regional, and continent wide) is strong enough to see its mandates
through remains to be seen. Although the MSFD does not explicitly require marine reserves, an
important step towards the protection of Europeâs marine ecosystems is the establishment of marine
reserves within wider-use MPAs as connected networks across large spatial scales
Magnetic Fields toward Ophiuchus-B Derived from SCUBA-2 Polarization Measurements
We present the results of dust emission polarization measurements of Ophiuchus-B (Oph-B) carried out using the Submillimetre Common-User Bolometer Array 2 (SCUBA-2) camera with its associated polarimeter (POL-2) on the James Clerk Maxwell Telescope in Hawaii. This work is part of the B-fields in Star-forming Region Observations survey initiated to understand the role of magnetic fields in star formation for nearby star-forming molecular clouds. We present a first look at the geometry and strength of magnetic fields in Oph-B. The field geometry is traced over ~0.2 pc, with clear detection of both of the sub-clumps of Oph-B. The field pattern appears significantly disordered in sub-clump Oph-B1. The field geometry in Oph-B2 is more ordered, with a tendency to be along the major axis of the clump, parallel to the filamentary structure within which it lies. The degree of polarization decreases systematically toward the dense core material in the two sub-clumps. The field lines in the lower density material along the periphery are smoothly joined to the large-scale magnetic fields probed by NIR polarization observations. We estimated a magnetic field strength of 630 ± 410 ÎŒG in the Oph-B2 sub-clump using a DavisâChandrasekharâFermi analysis. With this magnetic field strength, we find a mass-to-flux ratio λ = 1.6 ± 1.1, which suggests that the Oph-B2 clump is slightly magnetically supercritical
Photography-based taxonomy is inadequate, unnecessary, and potentially harmful for biological sciences
The question whether taxonomic descriptions naming new animal species without type specimen(s) deposited in collections should be accepted for publication by scientific journals and allowed by the Code has already been discussed in Zootaxa (Dubois & NemĂ©sio 2007; Donegan 2008, 2009; NemĂ©sio 2009aâb; Dubois 2009; Gentile & Snell 2009; Minelli 2009; Cianferoni & Bartolozzi 2016; Amorim et al. 2016). This question was again raised in a letter supported
by 35 signatories published in the journal Nature (Pape et al. 2016) on 15 September 2016. On 25 September 2016, the following rebuttal (strictly limited to 300 words as per the editorial rules of Nature) was submitted to Nature, which on
18 October 2016 refused to publish it. As we think this problem is a very important one for zoological taxonomy, this text is published here exactly as submitted to Nature, followed by the list of the 493 taxonomists and collection-based
researchers who signed it in the short time span from 20 September to 6 October 2016
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