The effect of backing material on the transmitting response level and bandwidth of a wideband underwater transmitting transducer using 1-3 piezocomposite material

AbstractIncreasing operating depths of autonomous underwater vehicles have necessitated the development of underwater transducers that can operate at a greater depth. This paper investigates the possibility of incorporating rigid backing material into the transducer design to increase its stiffness and depth capability without adversely affecting its wide bandwidth and high transmitting levels. The transducer design under consideration uses 1-3 piezocomposite material, matching layer, coupling layer, stiff backing material (backing plates) and operates at 300 kHz with 200 kHz 6dB bandwidth

Prediction of stillbirth from maternal demographic and pregnancy characteristics

Objectives: To develop a model for prediction of stillbirth based on maternal characteristics and components of medical history and evaluate the performance of screening of this model for all stillbirths and those due to impaired placentation and unexplained causes. Methods: This was a prospective screening study of 113,415 singleton pregnancies at 11+0-13+6 and 19+0-24+6 weeks’ gestation. The population included 113,019 live births and 396 (0.35%) antepartum stillbirths; 230 (58%) were secondary to impaired placentation and 166 (42%) were due to other or unexplained causes. Multivariate logistic regression analysis was used to determine the factors from maternal characteristics and medical history which provided a significant contribution to the prediction of stillbirth. Results: The risk for stillbirth increased with maternal weight (OR 1.01 per kg after 69 kg), was higher in women of Afro-Caribbean race (OR 2.01), assisted conception (OR 1.79), cigarette smokers (OR 1.71), those with a history of chronic hypertension (OR 2.62), SLE/APS (OR 3.61) or diabetes mellitus (OR 2.55) and was increased in parous women with a history of previous stillbirth (OR 4.81). The model predicted 26% of unexplained stillbirths and 31% of those due to impaired placentation at FPR of 10%; within the impaired placentation group the DR of stillbirth at 37 weeks (38% vs 28%). Conclusions: A model based on maternal characteristics and medical history recorded in early pregnancy can potentially predict one third of subsequent stillbirths. The extent to which such stillbirths could be prevented remains to be determined

Synoptic and dynamic characteristics of selected deep depressions over Cyprus

International audienceIn this study, the spatial and temporal distributions of dynamic and synoptic characteristics of a selection of 32 deep baroclinic depressions have been investigated. The study covers the cold period months of November till March, in the period from 1 November 1986 to 31 March 2003. For the needs of the study, several synoptic characteristics of these depressions have been extracted. Also, several dynamic characteristics during the evolution of the depressions were studied: relative vorticity, divergence, vertical motion and a static stability parameter. The results are presented in the form of isobaric distributions over, three tropospheric isobaric levels, namely the lower 850 hPa, the middle 500 hPa and the upper 300 hPa

The cold frontal depression that affected the area of Cyprus between 28 and 29 January 2008

The baroclinic depression that affected the area of Cyprus during the cold period, between 28 and 29 January 2008 was thoroughly studied and is presented in the present paper. A small perturbation on a northwesterly flow to the north of Cyprus has initiated the generation of the depression and in 24 h this developed into a deep baroclinic system. This depression was associated with intense weather phenomena, such as heavy thunderstorms with hail and near gale force winds. Strong cold advection resulted in a significant temperature decrease; precipitation even in lower altitudes was in the form of snow, while the accumulated rainfall corresponded to the 25% of the monthly normal. January 2008 is considered as a dry month, despite the fact that, on the average, January is considered as the wettest month of the year. In this study, the evolution and development of the depression was investigated from synoptic, dynamic, energetic and thermodynamic perspectives, in order to enhance our knowledge on the life cycle and behaviour of similar depressions over the area with extreme characteristics

Reply

post-print50 K

Value of routine ultrasound examination at 35-37 weeks' gestation in diagnosis of fetal abnormalities

Objective: To investigate the potential value of routine ultrasound examination at 35-37 weeks’ gestation in the diagnosis of previously unknown fetal abnormalities. Methods: This was a prospective study in 52,401 singleton pregnancies attending for a routine ultrasound examination at 35+0 - 36+6 weeks’ gestation; all pregnancies had a previous scan at 18-24 weeks and 47,215 also had a scan at 11-13 weeks. We included pregnancies resulting in livebirth or stillbirth but excluded those with known chromosomal abnormalities. The abnormalities were classified according to affected major organ system and the type and incidence of new abnormalities was determined. Results: In the study population the incidence of fetal abnormalities was 2.2% (1,168 / 52,401), including 847 (72.5%) that had been previously diagnosed during the first and / or second trimester, 247 (21.2%) that were detected for the first time at 35-37 weeks and 74 (6.3%) that were detected for the first time postnatally. The most common abnormalities that were diagnosed during the first and / or second trimester, that were also observed at 35-37 weeks, included aberrant right subclavian artery, ventricular septal defect, talipes, unilateral renal agenesis and / or pelvic kidney, hydronephrosis, duplex kidney or unilateral multicystic kidney, cystic pulmonary airway malformation, ventriculomegaly, cleft lip and palate, polydactyly,abdominal cyst or gastroschisis. The most common abnormalities seen at 35-37 weeks were hydronephrosis, mild ventriculomegaly, ventricular septal defect, duplex kidney, ovarian cyst and arachnoid cyst. The incidence of abnormalities first seen at 35-37 weeks was 0.5% and the most common were ovarian cysts, microcephaly, achondroplasia, dacryocystocele and hematocolpos. The incidence of abnormalities first seen postnatally was 0.1% and the most common were isolated cleft palate, polydactyly or syndactyly and ambiguous genitalia or hypospadias; prenatal examination of the genitalia was not a compulsory part of the protocol. Conclusions: A high proportion of fetal abnormalities are detected for the first time during a routine ultrasound examination at 35-37 weeks’ gestation. Such diagnosis and subsequent management, including selection of time and place for delivery and postnatal investigations, could potentially improve postnatal outcome

Comparison of different methods of measuring angle of progression in prediction of labor outcome

Objective: First, to compare the manual sagittal and para-sagittal and automated para-sagittal methods of measuring the angle of progression (AOP) by transperineal ultrasound during labor, and second, to develop models for the prediction of time-to-delivery and need for cesarean section (CS) for failure to progress (FTP) in a population of patients undergoing induction of labor. Methods: This was a prospective observational study of transperineal ultrasound on a cohort of 512 women with singleton pregnancies undergiong induction of labor. A random selection of 50 stored images was assessed for inter- and intra-observer reliability between methods. In the cases of vaginal delivery univariate linear, multivariate linear and quantile regression were performed to predict time-to-delivery. Univariate and multivariate binomial logistic regression were performed to predict CS for FTP in the first stage of labor. Results: The intra correlation coefficients (ICC) for the manual para-sagittal method for a single observer was 0.97 (CI 0.95-0.98) and for two observers was 0.96 (CI 0.93-0.98) indicating good reliability. The ICC for the sagittal method for a single observer was 0.93 (0.88-0.96) and for two observers was 0.74 (0.58-0.84) indicating moderate reliabilty for a single observer and poor reliability between two observers. Bland-Altman analysis demonstrated narrower limits of agreement for the manual para-saggittal approach than for the sagittal approach for both single and two observers. The automated para-sagittal method failed to capture an image in 19% of cases. The mean difference between sagittal and para-sagittal methods was 110. In pregnancies resulting in vaginal delivery, 54% of the variation in time-to-delivery was explained in a model combining parity, epidural and syntocinon use during labour and the sonographic findings of fetal head position and AOP. In the prediction of CS for FTP in the first stage of labour a model which combined maternal factors with the sonographic measurements of AOP and estimated fetal weight was superior to one utilising maternal factors alone (area under the curve 0.80 vs 0.76). Conclusions: First, the method of measuring AOP with greatest reliability is the manual parasagittal technique and future research should focus on this technique, second, over half of the variation in time to vaginal delivery can be explained by a model that combines maternal factors, pregnancy characteristics and ultrasound findings, and third, the ability of AOP to provide clinically useful prediction CS for FTP in the first stage of labour is limited

Prediction of stillbirth from maternal factors, fetal biometry and uterine artery Doppler at 19-24 weeks

Objectives: To evaluate the performance of screening for all stillbirths and those due to impaired placentation and unexplained or other causes by a combination of maternal factors, fetal biometry and uterine artery pulsatility index (UT-PI) at 19-24 weeks’ gestation and compare this performance to that of screening by UT-PI alone. Methods: This was a prospective screening study of 70,003 singleton pregnancies including 69,735 live births and 268 (0.38%) antepartum stillbirths; 159 (59%) were secondary to impaired placentation and 109 (41%) were due to other or unexplained causes. Multivariate logistic regression analysis was used to develop a model for prediction of stillbirth based on a combination of maternal factors, fetal biometry and UT-PI. Results: Combined screening predicted 55% of all stillbirths, including 75% of those due to impaired placentation and 23% of those that were due to other causes or unexplained, at false positive rate of 10%; within the impaired placentation group the detection rate of stillbirth at 37 weeks (88% vs 46%; p<0.001). The performance of screening by the combined test was superior to that of selecting the high-risk group on the basis of UT-PI being above the 90th percentile for gestational age, which predicted 48% of all stillbirths, 70% of those due to impaired placentation and 15% of those that were due to other causes or unexplained. Conclusions: Second-trimester screening by a combination of UT-PI with maternal factors and fetal biometry can predict a high proportion of stillbirths and in particular those due to impaired placentation

Fetal Medicine Foundation fetal and neonatal population weight charts

Objective: To develop fetal and neonatal population weight charts. The rationale for this objective is that while reference ranges of estimated fetal weight (EFW) are representative of the whole population, the traditional approach of deriving birth-weight (BW) charts is misleading because a high proportion of babies born preterm arises from pathological pregnancies. We propose that the reference population for BW charts, as in the case of EFW charts, should be all babies at a given gestational age including those still in utero. Patients: Two sources of data were used for this study and in both the inclusion criteria were singleton pregnancy, dating by fetal crown-rump length at 11+0 to 13+6 weeks’ gestation, ultrasonographic measurements of fetal head circumference (HC), abdominal circumference (AC) and femur length (FL), and livebirth of phenotypically normal neonate. Dataset 1, comprised a sample of 5,163 paired measurements of EFW and BW; the ultrasound scans were carried out at 22-43 weeks’ gestation and birth occurred within 2 days of the ultrasound examination. The EFW was derived from the measurements of HC, AC and FL using the formula reported by Hadlock et al. in 1985. Dataset 2, comprised a sample of 95,579 pregnancies with EFW obtained by routine ultrasonographic fetal biometry at 20+0 to 23+6 weeks’ gestation (n=45,034), or at 31+0 to 33+6 weeks (n=19,224) or at 35+0 to 36+6 weeks (n=31,321); for the purpose of this study we included data for only one of the three visits. Methods: In the development of reference ranges of EFW and BW with gestational age the following assumptions were made: first, the EFW and BW have a common median, dependent on gestational age and second, deviations from the median occur in both EFW and BW and these deviations are correlated with different levels of spread for EFW and BW, dependent on gestational age. We adopted a Bayesian approach to inference combining information from the two datasets using Markov Chain Monte–Carlo sampling (MCMC). The fitted model assumed that the mean log transformed measurements of EFW and BW are related to gestational age according to a cubic equation and that deviations about the mean follow a bivariate Gaussian distribution. Results: In the case of EFW in dataset 2 there was a good distribution of values 90th, >95th and >97th percentiles of the reference range of EFW with gestational age throughout the gestational age range of 20+0- 36+6 weeks. In the case of BW there was a good distribution of values only for the cases born at >39 weeks’ gestation. For preterm births, particularly at 27-36 weeks, the BW was below the 3rd, 5th and 10th percentiles in a very high proportion of cases and this was particularly marked for cases of iatrogenic birth. The incidence of SGA fetuses and neonates in the respective EFW and BW charts was higher in women of Black than White racial origin. Conclusion: We established a BW chart for the population of all babies at a given gestational age, including those still in utero, which overcomes the problem of underestimation of growth restriction in preterm births. The BW and EFW charts have a common median but they differ in the levels of spread from the median