The fetal cerebroplacental ratio in pregnancies complicated by gestational diabetes mellitus

To assess the relationship between the cerebroplacental ratio (CPR) and intrapartum and perinatal outcomes in pregnancies complicated by gestational diabetes mellitus (GDM).This was a retrospective cohort study of women with a non-anomalous singleton pregnancy diagnosed with GDM who delivered at Mater Mothers' Hospital between 2007 and 2015. CPR was measured in 1089 cases between 34 + 0 and 36 + 6 weeks' gestation. CPR values were compared between groups categorized according to GDM treatment (by diet, oral hypoglycemic agent (OHA) or insulin). The association between CPR and intrapartum and perinatal outcomes was evaluated.No difference in CPR was observed between treatment groups. Fetuses with CPR < 10 centile were significantly more likely to have adverse composite perinatal outcome (odds ratio (OR) = 2.93 (95% CI, 1.95-4.40)), preterm delivery and low birth weight than fetuses with CPR ≥ 10 centile (all P < 0.001). These associations were present regardless of the type of GDM treatment. Fetuses of women with insulin-controlled GDM had poorer neonatal outcomes than did fetuses of women treated with OHA or dietary control alone. The risk of adverse outcome was significantly increased in the insulin-treated group (OR = 1.75 (95% CI, 1.34-2.28); P < 0.001), which also had higher rates of preterm delivery and higher birth weight.Regardless of the type of treatment, a low CPR is associated with poorer neonatal outcome in women with GDM. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd

Maternal Vitamin D levels and the risk of perinatal death

Objective: To determine the association between maternal vitamin D levels and perinatal death. Methods: A retrospective cross-sectional study of all non-anomalous, singleton births (≥24 weeks) with perinatal death compared to a matched control group. Only pregnancies with a recorded vitamin D level at booking (8–19 weeks gestation) were included for analysis. Maternal vitamin D levels were categorized into normal, deficient and insufficient cohorts and variables compared between the three groups. Results: There were 31 perinatal deaths which were compared to 111 controls. Median vitamin D levels were lower in the perinatal death cohort compared to the control group (55 nmol/L versus 64 nmol/L, p = 0.43). There was no significant increase in deaths between the normal and deficient (p = 0.33) or insufficient (p = 0.09) groups. Conclusions: Low maternal vitamin D levels at booking were not associated with an increased risk of perinatal demise

Term small-for-gestational-age infants from low risk women are at significantly greater risk of adverse neonatal outcomes

Small-for-gestational age (SGA) infants (birthweight 37 weeks gestation). This is compounded by the fact that late pregnancy ultrasound is not the norm in many jurisdictions for this cohort of women. We thus investigated the relationship between birthweigh

Maternal age potentiates the impact of operative birth on serious neonatal outcomes

BACKGROUND: Pregnancies at the extremes of maternal age ( 35) are associated with adverse obstetric and perinatal outcomes. There is limited evidence regarding the influence of maternal age on serious neonatal outcomes by mode of delivery. The aim of this study thus was to assess the relationship between maternal age and mode of delivery and its impact on a composite of serious neonatal outcomes. METHODS: This was a retrospective cohort study of low risk women birthing at term in Australia's largest maternity hospital over a 7-year period. Intrapartum and perinatal outcomes were collated and a composite of severe adverse neonatal outcomes (SANO) was generated. Multiple regression was applied to adjust for confounders and generate adjusted odds ratios for the risk of SANO according to mode of delivery and maternal age. RESULTS: A total of 84 698 women were included in this study of which 1572 (1.9%) were aged < 20 years, 7471 (8.8%) were aged 20-24 years, 20 125 (23.8%) were aged 25-29 years, 31 594 (37.3%) were aged 30-34 years, 19 371 (22.9%) were aged 35-40 years, 4280 (5.1%) were aged 40-44 years and 285 (0.3%) were aged ≥ 45 years. The incidence of SANO was significantly greater among adolescents compared to all other age groups. Overall, SANO was most likely to occur following Emergency Caesarean Section (EmCS) for severe intrapartum haemorrhage/uterine rupture compared to all other indications. Instrumental delivery was associated with the greatest odds of SANO (adjusted odds ratios (aOR) 3.31, 95%CI 3.08-3.55, p < 0.001) whilst spontaneous vaginal delivery (SVD) was associated with the lowest odds (aOR 0.46, 95%CI 0.43-0.48, p < 0.001). The adjusted odds for SANO was lowest in women aged 30-34 years (aOR 0.92, 95%CI 0.87-0.97, p < 0.001). The odds of SANO following an SVD increased with maternal age, with women aged 40-44 years having the highest odds. Similarly, the odds of SANO following an instrumental delivery increased with maternal age (age < 20 years: aOR 2.21, 95%CI 1.38-3.54, p < 0.001 versus age 35-39 years: aOR 3.76, 95%CI 3.16-4.48, p < 0.001). CONCLUSION: This large retrospective cohort study has demonstrated that maternal age not only affects the mode of delivery and the incidence of adverse neonatal outcomes but that the effect of mode of delivery upon the risk of SANO is not independent of maternal age

Placental weight centiles adjusted for age, parity and fetal sex

Introduction The weight of the placenta can be indicative of efficacy in nutrient and oxygen supply. Furthermore, it has been suggested that a measure of the placenta's ability to adequately supply nutrients to the fetus can be found in the relationship between birth weight and placental weight expressed as a ratio. Our aim was to develop age adjusted placenta weight and birth weight to placenta weight ratio reference curves that are stratified by maternal parity and fetal sex. Methods We included singleton, non-anomalous births with a gestational age inclusive of 28 + 0 weeks to 42 + 6 weeks. Excluded were pregnancies of multiplicity, fetuses with congenital abnormalities, stillbirths and pregnancies that had placental complications (ie placenta previa or abruption). Generalised additive model for location, shape and scale (GAMLSS) was used to fit reference curves. Results We stratified 97,882 pregnancies by maternal nulliparity status and fetal sex. Extensive assessment model goodness-of-fit showed appropriate modeling and accurate fit to the four parameters of distribution. Our results show accurate model fit of the reference curves to the data. We demonstrated that the influence that parity has on the placenta weight is far greater than that exerted by fetal sex, and that the difference is dependent on gestational age. Discussion This is the largest presentation of age and parity adjusted placenta weight and feto-placental weight ratio reference ranges to date. The difference observed between nulliparous and multiparous pregnancies could be explained by biological memory and the remnants of maternal endo-myometrial vascularity after the first pregnancy.publishedVersio

SSIVP: Spacecraft Supercomputing Experiment for STP-H6

The Department of Defense Space Test Program (STP) provides spaceflight opportunities for conducting on-orbit research and technology demonstrations to advance the future of spacecraft. STP-H6, the next mission of the program to the International Space Station (ISS), will include a prototype spacecraft supercomputing experiment and framework, called Spacecraft Supercomputing for Image and Video Processing (SSIVP), developed at the National Science Foundation (NSF) Center for High-Performance Reconfigurable Computing (CHREC) at the University of Pittsburgh. SSIVP introduces scalable, high-performance computing (HPC) principles to a CubeSat form-factor to advance the state of the art in space computing. SSIVP adopts the CHREC Space Processor (CSP) concept, a multifaceted design philosophy for a hybrid system of commercial and radiation-hardened (rad-hard) components supplemented with fault-tolerant computing, and a hybrid processor combining fixed-logic CPU and reconfigurable-logic FPGA. SSIVP features five flight-qualified CSPv1 computers as compute nodes, to facilitate this supercomputing concept, and one μCSP smart module, for running a Gallium Nitride (GaN)-based power converter sub-experiment. SSIVP is a versatile, heterogenous platform capable of processing application workloads in the processor or on runtime-reconfigurable FPGA accelerators. In this paper, we present the flight hardware and software, frameworks for parallel and dependable computing, and mission objectives for SSIVP

Maternal dietary selenium intake during pregnancy and neonatal outcomes in the norwegian mother, father, and child cohort study

Properly working antioxidant defence systems are important for fetal development. One of the nutrients with antioxidant activity is selenium. Increased maternal selenium intake has been associated with reduced risk for being small for gestational age and preterm delivery. Based on the Norwegian Mother, Father, and Child Cohort Study and the Medical Birth Registry of Norway, we in-vestigated the association of maternal selenium intake from food and dietary supplements during the first half of pregnancy (n = 71,728 women) and selenium status in mid-pregnancy (n = 2628 women) with neonatal health, measured as two composite variables (neonatal morbidity/mortality and neonatal intervention). Low maternal dietary selenium intake (&lt;30 \ub5g/day) was associated with increased risk for neonatal morbidity/mortality (adjusted odds ratio (adjOR) 1.36, 95% confidence interval (95% CI) 1.08–1.69) and neonatal intervention (adjOR 1.16, 95% CI 1.01–1.34). Using continuous variables, there were no associations between maternal selenium intake (from diet or supplements) or whole-blood selenium concentration and neonatal outcome in the adjusted models. Our findings suggest that sufficient maternal dietary selenium intake is associated with neonatal outcome. Adher-ing to the dietary recommendations may help ensure an adequate supply of selenium for a healthy pregnancy and optimal fetal development

SpaceCube v3.0 NASA Next-Generation High-Performance Processor for Science Applications

Electronics for space systems must address several considerable challenges including achieving operational resiliency within the hazardous space environment and also meeting application performance needs while simultaneously managing size, weight, and power requirements. To drive the future revolution in space processing, onboard systems need to be more flexible, affordable, and robust. In order to provide a robust solution to a variety of missions and instruments, the Science Data Processing Branch at NASA Goddard Space Flight Center (GSFC)has pioneered a hybrid-processing approach that combines radiation-hardened and commercial components while emphasizing a novel architecture harmonizing the best capabilities of CPUs, DSPs, and FPGAs. This hybrid approach is realized through the SpaceCube family of processor cards that have extensive flight heritage on a variety of mission classes. The latest addition to the SpaceCube family, SpaceCube v3.0, will function as the next evolutionary step for upcoming missions, allow for prototyping of designs and software, and provide a flexible, mature architecture that is also ready to adopt the radiation-hardened High-Performance Spaceflight Computing (HPSC) chiplet when it is released. The research showcased in this paper describes the design methodology, analysis, and capabilities of the SpaceCube v3.0 SpaceVPX Lite (VITA 78.1) 3U-220mm form-factor processor card

CSP Hybrid Space Computing for STP-H5/ISEM on ISS

The Space Test Program (STP) at the Department of Defense (DoD) supports the development, evaluation, and advancement of new technologies needed for the future of spaceflight. STP-Houston provides opportunities for DoD and civilian space agencies to perform on-orbit research and technology demonstrations from the International Space Station (ISS). The STP-H5/ISEM (STP-Houston 5, ISS SpaceCube Experiment Mini) payload is scheduled for launch on the upcoming SpaceX 10 mission and will feature new technologies, including a hybrid space computer developed by the NSF CHREC Center, working closely with the NASA SpaceCube Team, known as the CHREC Space Processor (CSP). In this paper, we present the novel concepts behind CSP and the CSPv1 flight technologies on the ISEM mission. The ISEM-CSP system was subjected to environmental testing, including a thermal vacuum test, a vibration test, and two radiation tests, and results were encouraging and are presented. Primary objectives for ISEM-CSP are highlighted, which include processing, compression, and downlink of terrestrial-scene images for display on Earth, and monitoring of upset rates in various subsystems to provide environmental information for future missions. Secondary objectives are also presented, including experiments with features for fault-tolerant computing, reliable middleware services, FPGA partial reconfiguration, device virtualization, and dynamic synthesis