No abstract

Objective The objective of this study was to determine whether the improved prediction of risk for perinatal mortality obtained with the use of a customised birthweight standard can also be obtained with the use of a non-customised but intrauterine-based standard.Design Population-based cohort study.Setting Sweden.Population Births in the Swedish Medical Birth Register between 1992 and 2001 (n = 782 303) with complete data on birthweight, gestational age, sex, maternal age, pre-pregnancy body mass index, height, parity, and ethnicity.Methods We calculated the relative risks (RRs) of stillbirth and early neonatal mortality among small-for-gestational-age (SGA) births as established by (1) a customised standard, (2) a population standard based on birthweights, and (3) a population standard based on a best estimate of intrauterine weights. Main outcome measures Stillbirth and early neonatal mortality (<7 days).Results The RRs of stillbirth and early neonatal mortality among SGA births as classified by the intrauterine standard were similar to those among SGA births as classified by the customised standard and much higher than those among SGA births as classified by the birthweight standard.Conclusions A non-customised but intrauterine-based standard has a similar ability to predict risk for stillbirth and early neonatal mortality as a customised birthweight standard. The process of customising population weight-for-gestational-age standards to account for maternal characteristics does little to improve prediction of perinatal mortality.

BackgroundAlthough pregnant women are considered at high risk for severe influenza disease, comparative studies of maternal influenza and birth outcomes have not been comprehensively summarised.ObjectiveTo review comparative studies evaluating maternal influenza disease and birth outcomes.Search strategyWe searched bibliographic databases from inception to December 2014.Selection criteriaStudies of preterm birth, small‐for‐gestational‐age (SGA) birth or fetal death, comparing women with and without clinical influenza illness or laboratory‐confirmed influenza infection during pregnancy.Data collection and analysisTwo reviewers independently abstracted data and assessed study quality.Main resultsHeterogeneity across 16 studies reporting preterm birth precluded meta‐analysis. In a subgroup of the highest‐quality studies, two reported significantly increased preterm birth (risk ratios (RR) from 2.4 to 4.0) following severe 2009 pandemic H1N1 (pH1N1) influenza illness, whereas those assessing mild‐to‐moderate pH1N1 or seasonal influenza found no association. Five studies of SGA birth showed no discernible patterns with respect to influenza disease severity (pooled odds ratio 1.24; 95% CI 0.96–1.59). Two fetal death studies were of sufficient quality and size to permit meaningful interpretation. Both reported an increased risk of fetal death following maternal pH1N1 disease (RR 1.9 for mild‐to‐moderate disease and 4.2 for severe disease).ConclusionsComparative studies of preterm birth, SGA birth and fetal death following maternal influenza disease are limited in number and quality. An association between severe pH1N1 disease and preterm birth and fetal death was reported by several studies; however, these limited data do not permit firm conclusions on the magnitude of any association.Tweetable abstractComparative studies are limited in quality but suggest severe pandemic H1N1 influenza increases preterm birth.

ObjectiveIncreases in atonic postpartum haemorrhage (PPH) have been reported from several countries in recent years. We attempted to determine the potential cause of the increase in atonic and severe atonic PPH.DesignPopulation-based retrospective cohort study.SettingBritish Columbia, Canada, 2001–2009.PopulationAll women with live births or stillbirths.MethodsDetailed clinical information was obtained for 371 193 women from the British Columbia Perinatal Data Registry. Outcomes of interest were atonic PPH and severe atonic PPH (atonic PPH with blood transfusion ≥1 unit; atonic PPH with blood transfusion ≥3 units or procedures to control bleeding), whereas determinants studied included maternal characteristics (e.g. age, parity, and body mass index) and obstetrics practice factors (e.g. labour induction, augmentation, and caesarean delivery). Year-specific unadjusted and adjusted odds ratios for the outcomes were compared using logistic regression.Main outcome measuresAtonic PPH and severe atonic PPH.ResultsAtonic PPH increased from 4.8% in 2001 to 6.3% in 2009, atonic PPH with blood transfusion ≥1 unit increased from 16.6 in 2001 to 25.5 per 10 000 deliveries in 2009, and atonic PPH with blood transfusion ≥3 units or procedures to control bleeding increased from 11.9 to 17.6 per 10 000 deliveries. The crude 34% (95% CI 26–42%) increase in atonic PPH between 2001 and 2009 remained unchanged (42% increase, 95% CI 34–51%) after adjustment for determinants of PPH. Similarly, adjustment did not explain the increase in severe atonic PPH.ConclusionsChanges in maternal characteristics and obstetric practice do not explain the recent increase in atonic and severe atonic PPH.

Abstract-We introduce a curvature sensor composed of a thin, transparent elastomer film (polydimethylsiloxane, PDMS) embedded with a microchannel of conductive liquid (eutectic Gallium Indium, eGaIn) and a sensing element. Bending the sensor exerts pressure on the embedded microchannel via the sensing element. Deformation of the cross-section of the microchannel leads to a change in electrical resistance. We demonstrate the functionality of the sensor through testing on a finger joint. The film is wrapped around a finger with the sensing element positioned on top of the knuckle. Finger bending both stretches the elastomer and exerts pressure on the sensing element, leading to an enhanced change in the electrical resistance. Because the sensor is soft (elastic modulus E ∼ 1 MPa) and stretchable (>350%), it conforms to the host bending without interfering with the natural mechanics of motion. This sensor represents the first use of liquid-embedded elastomer electronics to monitor human or robotic motion.

Most patients with HCV-related cirrhosis do not receive regular imaging-based surveillance. The effectiveness of HCC surveillance tests in current clinical practice is rather modest in reducing HCC-related mortality.

ELI-Beamlines (ELI-BL), one of the three pillars of the Extreme Light Infrastructure endeavour, will be in a unique position to perform research in high-energy-density-physics (HEDP), plasma physics and ultra-high intensity (UHI) (1022W/cm2) laser–plasma interaction. Recently the need for HED laboratory physics was identified and the P3 (plasma physics platform) installation under construction in ELI-BL will be an answer. The ELI-BL 10 PW laser makes possible fundamental research topics from high-field physics to new extreme states of matter such as radiation-dominated ones, high-pressure quantum ones, warm dense matter (WDM) and ultra-relativistic plasmas. HEDP is of fundamental importance for research in the field of laboratory astrophysics and inertial confinement fusion (ICF). Reaching such extreme states of matter now and in the future will depend on the use of plasma optics for amplifying and focusing laser pulses. This article will present the relevant technological infrastructure being built in ELI-BL for HEDP and UHI, and gives a brief overview of some research under way in the field of UHI, laboratory astrophysics, ICF, WDM, and plasma optics.

No abstract