Rethinking Prenatal Screening for Anomalies of Placental and Umbilical Cord Implantation

The most common anomalies of implantation of the placenta and umbilical cord include placenta previa, placenta accreta spectrum, and vasa previa, and are associated with considerable perinatal and maternal morbidity and mortality. There is moderate quality evidence that prenatal diagnosis of these conditions improves perinatal outcomes and the performance of ultrasound imaging in diagnosing them is considered excellent. The epidemiology of placenta previa is well known, and it is standard clinical practice to assess placental location at the routine screening second-trimester detailed fetal anatomy ultrasound examination. In contrast, the prevalence of placenta accreta spectrum and vasa previa in the general population is more difficult to evaluate because detailed confirmatory histopathologic data are not available in most studies. The sensitivity and specificity of ultrasonography for the diagnosis of these anomalies is also difficult to assess. Recent epidemiologic studies show an increase in the incidence of placental and umbilical cord implantation anomalies, which may be the result of increased use of assisted reproductive technology and cesarean delivery. There is good evidence to support targeted standardized protocols for women at high risk and that screening and diagnosing placenta accreta spectrum and vasa previa should be integrated into obstetric ultrasound training programs

Achieving Generalizable Robustness of Deep Neural Networks by Stability Training

We study the recently introduced stability training as a general-purpose method to increase the robustness of deep neural networks against input perturbations. In particular, we explore its use as an alternative to data augmentation and validate its performance against a number of distortion types and transformations including adversarial examples. In our image classification experiments using ImageNet data stability training performs on a par or even outperforms data augmentation for specific transformations, while consistently offering improved robustness against a broader range of distortion strengths and types unseen during training, a considerably smaller hyperparameter dependence and less potentially negative side effects compared to data augmentation.Comment: 18 pages, 25 figures; Camera-ready versio

New Kadampa Buddhists and Jungian psychological type

Building on previous studies on Canadian Anglicans and Catholics, this study examines and discusses the psychological type profile of 31 adherents to New Kadampa Buddhism. Like Anglicans and Catholics, Buddhists preferred introversion (I). Like Anglicans who preferred intuition (N) and unlike Catholics who preferred sensing (S), Buddhists displayed a preference for intuition (N). Unlike Anglicans and Catholics who both preferred feeling (F), Buddhists displayed a balance between feeling (F) and thinking (T). Like Anglicans and unlike Catholics, Buddhists preferred the Apollonian temperament (NF) over the Epimethean temperament (SJ). These data are discussed to interpret the psychological appeal of New Kadampa Buddhism

Allogeneic mesenchymal stem cell transplantation in severe and refractory systemic lupus erythematosus: 4 years of experience

Mesenchymal stem cells (MSCs) are multipotential nonhematopoietic progenitors and are capable of differentiating into several tissues of mesenchymal origin. We have shown that bone marrow-derived MSCs from both SLE patients and lupus-prone MRL/lpr mice are defective structurally and functionally. Here we observe the long-term safety and efficacy of allogeneic MSC transplantation (MSCT) in treatment-resistant SLE patients. Eighty-seven patients with persistently active SLE who were refractory to standard treatment or had life-threatening visceral involvement were enrolled. Allogeneic bone marrow or umbilical cord-derived MSCs were harvested and infused intravenously (1 × 10(6) cells/kg of body weight). Primary outcomes were rates of survival, disease remission and relapse, as well as transplantation-related adverse events. Secondary outcomes included SLE disease activity index (SLEDAI) and serologic features. During the 4-year follow-up and with a mean follow-up period of 27 months, the overall rate of survival was 94% (82/87). Complete clinical remission rate was 28% at 1 year (23/83), 31% at 2 years (12/39), 42% at 3 years (5/12), and 50% at 4 years (3/6). Rates of relapse were 12% (10/83) at 1 year, 18% (7/39) at 2 years, 17% (2/12) at 3 years, and 17% (1/6) at 4 years. The overall rate of relapse was 23% (20/87). Disease activity declined as revealed by significant changes in the SLEDAI score, levels of serum autoantibodies, albumin, and complements. A total of five patients (6%) died after MSCT from non-treatment-related events in the 4-year follow-up, and no transplantation-related adverse event was observed. Allogeneic MSCT resulted in the induction of clinical remission and improvement in organ dysfunction in drug-resistant SLE patients.published_or_final_versio

The Effect of Ambient Air Pollution during Early Pregnancy on Fetal Ultrasonic Measurements during Mid-Pregnancy

BACKGROUND: Over the past decade there has been mounting evidence that ambient air pollution during pregnancy influences fetal growth. OBJECTIVES: This study was designed to examine possible associations between fetal ultrasonic measurements collected from 15,623 scans (13–26 weeks gestation) and ambient air pollution during early pregnancy. METHODS: We calculated mothers ’ average monthly exposures over the first 4 months of pregnancy for the following pollutants: particulate matter < 10 µm aerodynamic diameter (PM10), ozone, nitrogen dioxide, and sulfur dioxide. We examined associations with fetal femur length (FL), biparietal diameter (BPD), head circumference (HC), and abdominal circumference (AC). Final analyses included scans from only those women within 2 km of an air pollution monitoring site. We controlled for long-term trend, season, temperature, gestation, mother’s age, socioeconomic status, and fetal sex. RESULTS: A reduction in fetal AC was associated with O3 during days 31–60 [–1.42 mm; 95 % confidence interval (CI), –2.74 to –0.09], SO2 during days 61–90 (–1.67 mm; 95 % CI, –2.94 to –0.40), and PM10 during days 91–120 (–0.78 mm; 95 % CI, –1.49 to –0.08). Other results showed a reduction in BPD (–0.68 mm; 95 % CI, –1.09 to –0.27) associated with SO2 during days 0–30, a reduction in HC (–1.02 mm; 95 % CI, –1.78 to –0.26) associated with PM10 during days 91–120, and a reduction in FL associated with PM10 during days 0–30 (–0.28 mm; 95 % CI, –0.48 to –0.08) and 91–120 (–0.23; 95 % CI, –0.42 to –0.04). CONCLUSION: We found strong effects of ambient air pollution on ultrasound measures. Future research, including more individually detailed data, is needed to confirm our results. KEY WORDS: air pollution, fetal growth, pregnancy, temperature, ultrasound. Environ Health Perspect 116:362–369 (2008). doi:10.1289/ehp.10720 available vi

Analysis of coding variants in the betacellulin gene in type 2 diabetes and insulin secretion in African American subjects

BACKGROUND: Betacellulin is a member of the epidermal growth factor family, expressed at the highest levels predominantly in the pancreas and thought to be involved in islet neogenesis and regeneration. Nonsynonymous coding variants were reported to be associated with type 2 diabetes in African American subjects. We tested the hypotheses that these previously identified variants were associated with type 2 diabetes in African Americans ascertained in Arkansas and that they altered insulin secretion in glucose tolerant African American subjects. METHODS: We typed three variants, exon1 Cys7Gly (C7G), exon 2 Leu44Phe (L44F), and exon 4 Leu124Met (L124M), in 188 control subjects and 364 subjects with type 2 diabetes. We tested for altered insulin secretion in 107 subjects who had undergone intravenous glucose tolerance tests to assess insulin sensitivity and insulin secretion. RESULTS: No variant was associated with type 2 diabetes, and no variant altered insulin secretion or insulin sensitivity. However, an effect on lipids was observed for all 3 variants, and variant L124M was associated with obesity measures. CONCLUSION: We were unable to confirm a role for nonsynonymous variants of betacellulin in the propensity to type 2 diabetes or to impaired insulin secretion