Prediction of Outcome for Transabdominal Cerclage in Women with Cervical Insufficiency

We investigated pregnancy outcome following transabdominal cerclage (TAC) in women with cervical insufficiency (CI) and explored parameters for predicting pregnancy outcomes following TAC. In this retrospective cohort study, we included 161 women with TAC. We considered demographic, obstetric, and gynecologic histories, pre- and postoperative cervical length (CL), and CL at 20–24 weeks as parameters for predicting outcomes following TAC. Univariate and multivariate analyses were used to identify risk factors for predicting delivery before 34 weeks after TAC. 182 pregnancies occurred after TAC, and 290 pregnancies prior to TAC were identified. The rate of delivery <34 weeks significantly decreased following TAC (5% versus 82%, P<0.001). Univariate analysis demonstrated that a short CL (<25 mm) at 20–24 weeks and adenomyosis were associated with delivery at <34 weeks’ gestation following TAC (P=0.015 and P=0.005, resp.). However, multivariate analysis demonstrated that only a short CL (<25 mm) at 20–24 weeks was a significant predictor (P=0.005). TAC is an efficacious procedure that prolongs pregnancy in women with CI. A short CL at 20–24 weeks may predict the delivery at <34 weeks’ gestation following TAC

Prognostic Significance of Neutrophil-to-Lymphocyte Ratio for Repeat Cerclage in Women with Prolapsed Membranes

Objective. Cerclage is a surgical option for preventing preterm birth (PTB). Repeat cerclage (RC) could prevent impending PTB in women with prolapsed membrane who already had primary cerclage. PTB is associated with a state of inflammation. It has been widely known that neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) reflect systemic inflammation. We aimed to investigate whether NLR and PLR could be used as reliable markers in predicting pregnancy outcome following RC. Methods. The study group consisted of 26 patients, who underwent RC resulting from prolapsed membrane after primary cerclage. NLR and PLR at the time of primary cerclage and RC were calculated. ROC curve analysis and multivariate analysis were performed for determining predictive factors. The study group was divided into two groups according to NLR 4.7 at RC: High NLR group was defined as NLR > 4.7, and low NLR group was defined as NLR ≤ 4.7. We compared pregnancy outcomes, such as delivery at gestational age, and rate of delivery 4.7 (high NLR group). High NLR group showed worse pregnancy outcome compared to low NLR group: there were significant differences in gestational age at delivery, and neonatal survival rate between two groups (31.5 weeks vs. 25.9 weeks, p=0.02; 100% (8/8) vs. 55.6% (10/18), p=0.03, respectively). Survival analysis demonstrated a lower incidence of delivery < 28 weeks of gestation in low NLR group compared with high NLR group (p<0.01, log-rank test). Conclusion. NLR might be used as a reliable factor for predicting pregnancy outcome following RC

The Role of Antimicrobial Peptides in Preterm Birth

Antimicrobial peptides (AMPs) are short cationic amphipathic peptides with a wide range of antimicrobial properties and play an important role in the maintenance of immune homeostasis by modulating immune responses in the reproductive tract. As intra-amniotic infection and microbial dysbiosis emerge as common causes of preterm births (PTBs), a better understanding of the AMPs involved in the development of PTB is essential. The altered expression of AMPs has been reported in PTB-related clinical presentations, such as preterm labor, intra-amniotic infection/inflammation, premature rupture of membranes, and cervical insufficiency. Moreover, it was previously reported that dysregulation of AMPs may affect the pregnancy prognosis. This review aims to describe the expression of AMPs associated with PTBs and to provide new perspectives on the role of AMPs in PTB

Danazol as a Treatment for Uterine Arteriovenous Malformation: A Case Report

Uterine arteriovenous malformation (AVM) is associated with a risk of massive uterine bleeding. Although uterine artery embolization remains the first-line treatment for AVM, there has been a recent exploration of pharmacological options. Danazol is known to reduce blood flow to the uterus; however, our understanding of its therapeutic efficacy for AVM remains limited. Herein, we present the results of danazol use in patients with uterine AVM. We retrospectively reviewed the medical records of patients who received danazol for the treatment of AVM between January 2013 and November 2022. The cohort comprised 10 patients who developed AVM after dilatation and curettage (D&C), abortion, or cesarean section. Danazol was administered twice daily at a total dose of 400 mg/day, and was employed for AVM treatment in hemodynamically stable patients who provided consent and were devoid of massive bleeding. Outpatient follow-ups (ultrasound measurements of AVM size and symptom assessment) were performed every 2 weeks. AVM was successfully treated with danazol in most patients with no adverse event. Eight postabortal patients had complete resolution of AVM after an average of 45 days (range 14–70 days). Of two patients who developed AVM after a cesarean section, one experienced AVM reduction, and the other developed massive bleeding, requiring emergency uterine artery embolization. In light of these outcomes, danazol can be potentially prioritized over uterine artery embolization in the treatment of AVM after abortion in hemodynamically stable patients

Outcomes after transabdominal cerclage in twin pregnancy with previous unsuccessful transvaginal cerclage.

Transabdominal cerclage (TAC) is reported to be effective for preventing preterm birth in women with unsuccessful transvaginal cerclage (TVC) history. However, TAC has rarely been performed in twin pregnancy given the lack of sufficient evidence and the technical difficulty of the operation. Thus, it is unclear whether TAC is an effective procedure for twin pregnancy in women with a history of unsuccessful TVC. The aim of this study is to compare the characteristics and pregnancy outcomes after TAC in twin pregnancy versus singleton pregnancy, to examine whether twin pregnancy is a risk factor for very preterm birth (before 32 weeks) after TAC, and to determine whether TAC is effective in preventing preterm birth in twin pregnancy. This single-center retrospective cohort study included women who underwent TAC because of unsuccessful TVC history between January 2007 and June 2018. Of 165 women who underwent TAC, 19 had twins and 146 had singletons. Our results showed that the neonatal survival rate improved dramatically when TAC was performed (15.4% (prior pregnancy) vs 94.0% (after TAC) in twins, p<0.01; 22.8% (prior pregnancy) vs 91.1% (after TAC) in singletons, p<0.01). Moreover, the risk of very preterm birth was significantly decreased after TAC in both groups (36/39 (92.3%) (prior pregnancy) vs 2/19 (10.5%) (after TAC) in twins, p<0.01; 290/337 (86.1%) (prior pregnancy) vs 17/146 (11.6%) (after TAC) in singletons, p<0.01). More advanced maternal age and history of prior preterm delivery between 26+0 and 36+6 weeks were independently associated with very preterm birth, whereas the presence of a twin pregnancy was not associated with very preterm birth on multivariate logistic regression analysis. These results suggest that TAC is associated with successful prevention of very preterm birth and improved neonatal survival rates in the absence of procedure-related major complications in women with twin pregnancy and previous unsuccessful TVC history

In Situ Liquid Phase TEM of Nanoparticle Formation and Diffusion in a Phase-Separated Medium

Colloidal nanoparticles are synthesized in a complex reaction mixture that has an inhomogeneous chemical environment induced by local phase separation of the medium. Nanoparticle syntheses based on micelles, emulsions, flow of different fluids, injection of ionic precursors in organic solvents, and mixing the metal organic phase of precursors with an aqueous phase of reducing agents are well established. However, the formation mechanism of nanoparticles in the phase-separated medium is not well understood because of the complexity originating from the presence of phase boundaries as well as nonuniform chemical species, concentrations, and viscosity in different phases. Herein, we investigate the formation mechanism and diffusion of silver nanoparticles in a phase-separated medium by using liquid phase transmission electron microscopy and many-body dissipative particle dynamics simulations. A quantitative analysis of the individual growth trajectories reveals that a large portion of silver nanoparticles nucleate and grow rapidly at the phase boundaries, where metal ion precursors and reducing agents from the two separated phases react to form monomers. The results suggest that the motion of the silver nanoparticles at the interfaces is highly affected by the interaction with polymers and exhibits superdiffusive dynamics because of the polymer relaxation.11Nsciescopu

Group IV Transition Metal (M = Zr, Hf) Precursors for High-kappa Metal Oxide Thin Films

This paper describes the synthesis of eight novel zirconium and hafnium complexes containing N-alkoxy carbox-amidate-type ligands, as potential precursors for metal oxides and atomic layer deposition (ALD) for HfO2. A series of ligands, viz., N-ethoxy-2,2-dimethylpropanamide (edpaH), N-ethoxy-2-methylpropanamide (empaH), and N-methoxy-2,2-dimethylpropanamide (mdpaH), were used to afford complexes Zr(edpa)(4) (1), Hf(edpa)(4) (2), Zr(empa)(4) (3), Hf(empa)(4) (4), Zr(mdpa)(4) (5), Hf(mdpa)(4) (6), ZrCp(edpa)(3) (7), and HfCp(edpa)(3) (8). Thermogravimetric analysis curves assessed for the evaporation characteristics of complexes 1-8 revealed single-step weight losses with low residues, except for the mdpa-containing complexes. Single-crystal X-ray diffraction studies of 1, 2, 5, and 6 revealed that all the complexes have monomeric molecular structures, with the central metal ion surrounded by eight oxygen atoms from the four bidentate alkoxyalkoxide ligands. Among the complexes prepared, 8 exhibited a low melting point (64 degrees C), good volatility (1 Torr at 112 degrees C), high thermal stability, and excellent endurance over 6 weeks at 120 degrees C. Therefore, an ALD process for the growth of HfO2 was developed using HfCp(edpa)(3) (8) as a novel precursor. Furthermore, the HfO2 film exhibited a low capacitance equivalent oxide thickness of similar to 1.5 nm, with J(g) as low as similar to 3 X 10(-4) A/cm(2) at V-g-1 V in a metal-insulator-semiconductor capacitor (Au/HfO2/p-Si)

Comprehensive Comparison of Chemical Composition and Antioxidant Activity of Panax ginseng Sprouts by Different Cultivation Systems in a Plant Factory

In this study, the primary (such as amino acids, fatty acids, and minerals) and secondary (including ginsenosides, phenolic acids, and flavonols) metabolites and antioxidant effects of Panax ginseng sprouts (PGSs) by different cultivation systems, such as soil&ndash;substrate cultivation (SSC) and deep-water cultivation (DWC), in a plant factory has been observed. There was no significant difference in the total fatty acid (FA) contents. Particularly, the major FAs of PGSs were palmitic acid (207.4 mg/100 g) of saturated FAs and linoleic acid (397.6 mg/100 g) and &alpha;-linolenic acid (222.6 mg/100 g) of unsaturated FAs in the SSC system. The values of total amino acids were all higher in SSC than in DWC. In the case of ginsenosides, the total protopanaxtriol product was 30.88 mg/g in SSC, while the total protopanaxdiol product was 34.83 mg/g in DWC. In particular, the values of total phenolic acids and total flavonols were 133.36 and 388.19 ug/g, respectively, and SSC had a higher content than DWC. In conclusion, the SSC system was shown to be higher in nutritional constituents and antioxidant activities in soil cultivation, suggesting that PGS with SSC has a positive effect on the quality of PGS in a plant factory