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Objectives: During human pregnancy, placental extravillous trophoblasts replace vascular smooth muscle and elastic tissue within the walls of the uterine spiral arteries, thereby remodeling them into distensible low‐resistance vessels to promote placental perfusion. The present study determined whether B‐flow/spatiotemporal image correlation (STIC) M‐mode ultrasonography provides an in‐vivo imaging method able to digitally quantify spiral artery luminal distensibility as a physiological index of spiral artery remodeling during the advancing stages of normal human pregnancy. Methods: A prospective, longitudinal, observational study was conducted to quantify spiral artery distensibility (i.e. vessel luminal diameter at systole minus diameter at diastole) by B‐flow/STIC M‐mode ultrasonography during the first, second and third trimesters in 290 women exhibiting a normal pregnancy. Maternal serum levels of placental growth factor (PlGF) and soluble fms‐like tyrosine kinase‐1 (sFlt‐1), growth factors that modulate important events in spiral artery remodeling, were quantified in a subset of the women in the first, second and third trimesters of pregnancy. Results: Median (interquartile range (IQR)) spiral artery distensibility increased progressively between the first (0.17 (0.14–0.21) cm), second (0.23 (0.18–0.28) cm) and third (0.26 (0.21–0.35) cm) trimesters of pregnancy (P < 0.0001 for all). Median (IQR) spiral artery volume flow increased progressively between the first (2.49 (1.38–4.99) mL/cardiac cycle), second (3.86 (2.06–6.91) mL/cardiac cycle) and third (7.79 (3.83–14.98) mL/cardiac cycle) trimesters (P < 0.001 for all). In accordance with the elevation in spiral artery distensibility, the median (IQR) ratio of serum PlGF/sFlt‐1 × 103 levels increased between the first (7.2 (4.5–10.0)), second (22.7 (18.6–42.2)) and third (56.2 (41.9–92.5)) trimesters (P < 0.001 for all). Conclusions: The present study shows that B‐flow/STIC M‐mode ultrasonography provides an in‐vivo imaging technology to quantify digitally the structural and physiological expansion of the walls of the spiral arteries during the cardiac cycle as a consequence of their transformation into compliant vessels during advancing stages of normal human pregnancy. © 2024 International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

BACKGROUND: Factors that determine the need for Gastrostomy tube (G-tube) placement in infants with complex congenital heart defects (CHD) are variable. We aim to identify factors that improve counseling of expectant parents regarding postnatal outcomes and management. METHODS: We performed a retrospective review of medical record of infants with prenatal diagnoses of complex CHD between 2015-2019 in a single tertiary care center and assessed risk factors for G-tube placement with linear regression. RESULTS: Of the 105 eligible infants with complex CHD, 44 infants required G-tube (42%). No significant association was observed between G-tube placement and chromosomal abnormalities, cardiopulmonary bypass time or type of CHD. Median days on noninvasive ventilation (4 [IQR 2-12] vs. 3 [IQR 1-8], p = 0.035), time at which gavage-tube feeds were started postoperatively (3 [IQR 2-8] vs. 2 [IQR 0-4], p = 0.0013), time to reach full-volume gavage-tube feeds (6 [IQR 3-14] vs. 5 [IQR 0-8], p = 0.038) and intensive care unit (ICU) length of stay (LOS) (41 [IQR: 21 – 90] vs. 18 [IQR: 7 – 23], p < 0.01) were associated with G-tube placement. Infants with ICU LOS duration longer than median had almost 7 times the odds of requiring a G-tube (OR: 7.23, 95% CI: 2.71-19.32; by regression). CONCLUSIONS: Delay in initiation and in reaching full-volume gavage-tube feeds after cardiac surgery, increased number of days spent on non-invasive ventilation and in the ICU were found to be significant predictors for G-tube placement. The type of CHD and the need for cardiac surgery were not significant predictors for G-tube placement. [ABSTRACT FROM AUTHOR]

Objective: To determine if B-flow/spatiotemporal image correlation (STIC) M-mode ultrasonography detects a decrease in spiral artery luminal diameter and volume flow during the first trimester in a non-human primate model of impaired spiral artery remodeling (SAR).Methods: Pregnant baboons were treated daily with estradiol benzoate on days 25-59 of the first trimester (term, 184 days), or remained untreated. On day 60 of gestation, spiral artery luminal diameter (in seven untreated and 12 estradiol-treated baboons) and volume flow (in four untreated and eight estradiol-treated baboons) were quantified by B-flow/STIC M-mode ultrasonography. In addition, in 15 untreated and 18 estradiol-treated baboons, the percent of spiral arteries remodeled by extravillous trophoblasts was quantified ex vivo by immunohistochemical image analysis on placental basal plate tissue collected via Cesarean section on day 60. Findings were compared between treated and untreated animals. The correlation between spiral artery luminal diameter and percent of SAR was assessed in three untreated and six estradiol-treated baboons which underwent both B-flow/STIC M-mode ultrasound and quantification of SAR.Results: The proportion of spiral arteries greater than 50 µm in diameter remodeled by extravillous trophoblasts was 70% lower in estradiol-treated baboons than in untreated animals (P = 0.000001). Spiral artery luminal diameter in systole and diastole, as quantified by B-flow/STIC M-mode in the first trimester of pregnancy, was 31% (P = 0.014) and 50% (P = 0.005) lower, respectively, and volume flow was 85% lower (P = 0.014), in SAR-suppressed baboons compared with untreated animals. There was a significant correlation between spiral artery luminal diameter as quantified by B-flow/STIC M-mode ultrasonography and the percent of SAR (P < 0.05).Conclusion: B-flow/STIC M-mode ultrasonography provides a novel real-time non-invasive method to detect a decrease in uterine spiral artery luminal diameter and volume flow during the cardiac cycle, reflecting decreased distensibility of the vessel wall, in the first trimester in a non-human primate model of defective SAR. © 2021 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

The other application of SlowflowHD to first-trimester heart assessment is demonstration of the pulmonary veins and inferior and superior vena cava drainage into the left and right atria, respectively (Figure 2). The importance of the 11-14-week ultrasound exam beyond screening for chromosomal abnormalities is becoming more apparent in the era of non-invasive prenatal testing1,2. As a Doppler technology, it appears to be very useful in the small first-trimester heart and has the potential to expand the spectrum of cardiac anomalies detected beyond four-chamber and outflow-tract abnormalities. First-trimester fetal heart evaluation: time to move forward. [Extracted from the article]

Summary: Li can find itself a wide range of applications since it is the lightest metal. However, Li detection by microscopy‐based techniques is problematic because of the highly susceptible nature during electron beam irradiation. ToF‐SIMS is a versatile technique to detect Li but the detection of light materials is also problematic due to the large ion contaminated zone and low sputtering yield. By combining ToF‐SIMS with a recently launched Xe ion source FIB‐SEM, which has small ion contamination and high sputtering yield features, can produce more realistic data at near surface and below the surface region especially for the detection of lightweight materials such as Li. In this study, Li detection and mapping capabilities of ToF‐SIMS attached to the FIB‐SEM with Ga and Xe ion sources were discussed for Al incorporated Li7La3Zr2O12 solid electrolyte sample that contains Li and Al rich regions at triple junctions. In spite of smoother milling from Ga source, Xe performs more precisely in Li mapping. Low ion contaminated zone, high sputtering yield and low straggling obtained from Monte Carlo simulations are the main advantages of Xe ion sources. The Li detection efficiency for Xe is higher than Ga source discriminating the LiAlO2 phase placed at the triple junctions of grains and La2Zr2O7 regions placed at the outer side of LLZO neighbouring the LiAlO2 phase. Lay Description: Li can find itself a wide range of applications since it is the lightest metal. However, Li detection by microscopy‐based techniques is problematic because of the highly susceptible nature during electron beam irradiation. ToF‐SIMS is a versatile technique to detect Li but the detection of light materials is also problematic due to the large ion contaminated zone and low sputtering yield. By combining ToF‐SIMS with a recently launched Xe ion source FIB‐SEM, which has small ion contamination and high sputtering yield features, can produce more realistic data at near surface and below the surface region especially for the detection of lightweight materials such as Li. In this study, Li detection and mapping capabilities of ToF‐SIMS attached to the FIB‐SEM with Ga and Xe ion sources were discussed for Al incorporated Li7La3Zr2O12 solid electrolyte sample that contains Li and Al rich regions at triple junctions. In spite of smoother milling from Ga source, Xe performs more precisely in Li mapping. Results were also supported from Monte Carlo simulations of ion‐atom interactions. The Li detection resolution of xenon is much higher than gallium source discriminating the LiAlO2 phase placed at the triple junctions of grains and La2Zr2O7 regions placed at the outer side of LLZO neighbouring the LiAlO2 phase. [ABSTRACT FROM AUTHOR]

Aims: To describe the baseline clinical and laboratory findings and treatment modalities of 367 children and adolescents diagnosed with Type 2 diabetes in various paediatric endocrinology centres in Turkey. Methods: A standard questionnaire regarding clinical and laboratory characteristics at onset was uploaded to an online national database system. Data for 367 children (aged 6–18 years) newly diagnosed with Type 2 diabetes at 37 different paediatric endocrinology centres were analysed. Results: After exclusion of the children with a BMI Z‐score < 1 SD, those with genetic syndromes associated with Type 2 diabetes, and those whose C‐peptide and/or insulin levels were not available, 227 cases were included in the study. Mean age was 13.8 ± 2.2 (range 6.5–17.8) years, with female preponderance (68%). Family history of Type 2 diabetes was positive in 86% of the children. The mean BMI was 31.3 ± 6.5 kg/m2 (range 18.7–61) and BMI Z‐score was 2.4 ± 0.8 (range 1–5). More than half (57%) of the children were identified by an opportunistic diabetes screening due to existing risk markers without typical symptoms of diabetes. Only 13% (n = 29) were treated solely by lifestyle modification, while 40.5% (n = 92) were treated with metformin, 13% (n = 30) were treated with insulin, and 33.5% (n = 76) were treated with a combination of insulin and metformin initially. Mean HbA1C levels of the insulin and combination of insulin and metformin groups were 98 (11.1%) and 102 mmol/mol (11.5%), respectively, and also were significantly higher than the lifestyle modification only and metformin groups mean HbA1C levels (70(8.6%) and 67 mmol/mol (8.3%), respectively). Conclusions: An opportunistic screening of children who are at high risk of Type 2 diabetes is essential, as our data showed that > 50% of the children were asymptomatic at diagnosis. The other important result of our study was the high rate of exclusion from the initial registration (38%), suggesting that accurate diagnosis of Type 2 diabetes in youth is still problematic, even for paediatric endocrinologists. What's new?: Female gender and positive family history were strongly associated with Type 2 diabetes in Turkish children as well as children in western countries.More than half (57%) of the participants were identified by opportunistic diabetes screening due to existing risk markers, without typical symptoms of diabetes.Approximately half of the children (47%) with Type 2 diabetes were treated with insulin while only 13% were treated solely by lifestyle modification. [ABSTRACT FROM AUTHOR]

Olive oil industry generates huge amounts of by-products that are discarded and can be a serious environmental problem. In this study, the antioxidant activity of olive mill wastewater (OMWW), and olive pomace (OP) extracts (at different concentrations) with soy lecithin, on the thermal oxidative stability of sunflower oil (SO) were determined. The results generally showed that the higher the extract concentration added to SO, the higher the thermal stability of SO. OMWW and OP extracts had similar antioxidant activity in linoleic acid emulsion (87.59% and 97.74%). Trolox equivalent antioxidant capacity (TEAC) of extracts ranged between 6.7-27.1 μM. When extracts with lecithin were added to SO, the induction periods (IP) and protective factors of SO were higher. In addition, the extracts were more effective when added together with lecithin. OMWW extract was more efficient in lowering the conjugated diene (CD) content in SO samples than the OP extract during the thermal oxidation test at 180°C. SO enriched with OMWW extract and lecithin, had lower p-anisidine values, higher tocopherol content and higher IP than SO enriched with butylated hydroxytoluene (BHT) at the end of 40 h. [ABSTRACT FROM AUTHOR]

The potential application of olive mill wastewater (OMWW) and olive pomace (OP) extracts with lecithin (L) as antioxidants to enhance the stability of refined sunflower oil (SFO) during deep-frying (at 180°C) was investigated. Changes in SFO during deep-frying conditions were evaluated according to some physical and chemical parameters. p-anisidine value (p-AV), conjugated dienes (CD), tocopherols, total polar compounds, free fatty acids (FFA), color (L*, a*, b*), viscosity and fatty acid composition were determined. According to the results, the addition of OMWW and OP extracts combined with lecithin inhibited lipid deterioration and retarded lipid oxidation. The oil containing extracts and/or lecithin showed a slight darkening as compared to the control. Profiles in the fatty acids were similar during deep-frying. The enrichment of SFO with OMWW and OP extracts is a beneficial application in the deep-frying oils and these extracts could be used with lecithin to retard lipid oxidation of oils during deepfrying. [ABSTRACT FROM AUTHOR]

In this study, purification of used frying sunflower oil was investigated using different adsorbents and their mixtures. The effective adsorbents in reducing the free fatty acid (FFA) content, total polar material (TPM) and the p-Anisidine value (AV) as well as in lightening of the colour, when used in single-use, were aluminium oxide (AO), silica gel (SG), activated charcoal (AC) and bleaching earth (BE). Increasing the adsorbent ratio from 3% to 6% improved the quality of the used oil. Among the binary adsorbent mixtures, 6%AO+6%AC reduced FFA content by 79.1% and the AV by 56.8%. The ternary adsorbent mixtures reduced the conjugated diene (CD) content of oil in the following order 3%SG+3%M+3%B, 3%AO+3%AC+6%Z, 3%AO+3%M+3%B and 3%AO+3%M+3%Z, respectively, providing a percentage improvement (PI) in the range of 60-100%. The binary adsorbent mixture reduced the viscosity of the used oil. The highest value was 3%AO+6%SG (42.6%), whereas the following ternary mixtures of 3%AO+3%SG+3%AC (48.4%) and 3%AO+3%SG+3%B (47.6%) were the most successful. The utilisation of adsorbents singly or in either binary or ternary mixtures resulted in increasing the L* value of the used oil and decreasing the a* and b* values. The adsorbents and their mixtures are believed to be useful in the purification of used oil. [ABSTRACT FROM AUTHOR]

We report a novel metal-organic framework (MOF) based on a cobalt arylphosphonate, namely, [Co2(H4-MTPPA)]·3NMP·H2O (1·3NMP·H2O), which was prepared solvothermically from the tetrahedral linker tetraphenylmethane tetrakis-4-phosphonic acid (H8-MTPPA) and CoSO4·7H2O in N-methyl-2-pyrrolidone (NMP). Compound 1 has the highest porosity (BET surface area of 1034 m2 g−1) ever reported for a MOF based on an aryl phosphonic acid linker. The indigo blue crystals of 1·3NMP·H2O are composed of edge-shared eight-membered Co2P2O4 rings, and are thermally very stable up to 500 °C. [ABSTRACT FROM AUTHOR]

Cerebrovascular resistance may be affected I in utero i in the presence of CHD, which is evaluated easily by fetal middle cerebral artery (MCA) pulsatility index (PI). With advancing gestation, MCA findings may reflect the progression of the disease, as demonstrated by a significant change in MCA-PI from initial diagnosis to final examination in non-survivors. [Extracted from the article]

The aim of the study is to synthesize hydrated calcium hexaborates via a hydrothermal method with the use of local (obtained from Turkish deposits) boric acid. The effects of temperature and boric acid to water and calcium oxide to boric acid ratios on the phase formation were examined via X-ray diffractometry and scanning electron microscopy. Fourier transform infrared spectroscopy (FTIR) was used to study of chemical bonding and simultaneous thermal analysis (STA) was used to characterize thermal properties of the synthesized hydrated calcium hexaborate. The ideal synthesis conditions for the formation of calcium hexaborate pentahydrate were determined as 100 °C for temperature, 0.5 for boric acid to water molar ratio, and 0.05 for calcium oxide to boric acid molar ratio with the use of ammonium polymethacrylate as a dispersant. It was also found that impure iron from the local source results in a higher photoluminescence intensity in comparison to the one obtained from pure boric acid. [ABSTRACT FROM AUTHOR]

Summary: Background: Hypothalamic obesity (HyOb) is a common complication of childhood hypothalamic tumours. Patients with HyOb probably have a higher mortality rate than those with other types of obesity due in many cases to obstructive sleep apnoea/hypoventilation. Objectives: To identify predictive factors for mortality caused by HyOb in children. Methods: Twenty children with HyOb secondary to hypothalamic tumours that were followed‐up for ≥3 years and aged <15 years at diagnosis, and received supraphysiological glucocorticoid treatment for ≤1 month. Results: Mean age at diagnosis was 6.36 ± 3.60 years. Mean body mass index (BMI) Standard deviation of the samples (SDS) increased from 0.77 ± 1.26 to 2.66 ± 1.45 during the first 6 months, but slowed from month 6–12 (2.73 ± 1.35). ΔBMI SDS at 0–6 months was significantly higher in patients aged <6 years at diagnosis than in those aged >6 years at diagnosis (3.71 ± 1.96 vs. 0.83 ± 0.73, P < 0.001). Maximum BMI SDS was also significantly higher in the younger group (3.88 ± 1.39 vs. 2.79 ± 0.64, P < 0.05). In all, four patients died and the mortality rate was significantly higher in the patients with a further increase in BMI SDS > 1 SDS after 6 months of therapy (RR: 8.4, P < 0.05). Both overall mortality and obesity‐related mortality rates were higher in the patients aged <6 years at diagnosis (4.5‐fold, 7.2‐fold higher, respectively, P > 0.05). The mortality rate was also 3.7‐fold higher in the patients with a maximum BMI SDS ≥ 3 at any time during the first 3 years after therapy(P > 0.05). Conclusions: An increase in BMI SDS after 6 months of therapy was observed to be a risk factor for mortality caused by HyOb. In addition, age <6 years at diagnosis and a maximum BMI SDS ≥ 3 were associated with a higher mortality rate, indicating that earlier and more aggressive treatment of obesity is required. [ABSTRACT FROM AUTHOR]

Chitosan is a linear polysaccharide that has many biomedical applications. We compared the effects of chitosan, in both solution and membranous form, on intercellular adhesion of Swiss 3T3 mouse fibroblasts. Cells were grown as spheroidal cell cultures. Some control cell spheroids were cultured without chitosan and two experimental groups were cultured with chitosan. Chitosan in solution was used for one experimental group and chitosan in membranous form was used for the other. For each group, intercellular adhesion was investigated on days 5 and 10 of culture. Transmission electron microscopy revealed well-defined cellular projections that were more prominent in cells exposed to either membranous or solution forms of chitosan than to the chitosan-free control. Immunocytochemical staining of ICAM-1 and e-cadherin was used to determine the development of intercellular junctions. Compared to the weakly stained control, strong reactions were observed in both chitosan exposed groups at both 5 and 10 days. Cells were treated with 5-bromo-2-deoxyuridine (BrdU) and incubated with anti-BrdU primary antibody to assess proliferation. Both the solution and membranous forms of chitosan increased proliferation at both 5 and 10 days. Cellular viability was assessed using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT). The MTT assay indicated high cell viability; maximum viability was obtained with the solution form of chitosan at day 5. Chitosan exposure increased the number of intercellular junctions and showed a significant proliferative effect on 3T3 mouse fibroblasts. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective A four-dimensional (4D) fetal echocardiographic technique utilizing spatiotemporal image correlation, tomographic ultrasound imaging display (STIC-TUI echo) and color Doppler has previously been shown to be effective in displaying the examination planes constituting the extended cardiac examination. The aim of this study was to evaluate the performance of this first-trimester STIC-TUI echo technique in identifying complex congenital heart disease (CHD) in high-risk pregnancies. Methods This was a prospective study of patients presenting at first-trimester screening who were at high risk for CHD owing to pregestational diabetes, in-vitro fertilization (IVF), increased nuchal translucency (NT) thickness, first-trimester tricuspid regurgitation or reversed ductus venosus (DV) a-wave, a previous child with CHD or who were on anticonvulsant medication. First-trimester STIC-TUI echo was performed, and the findings were correlated with second-trimester echocardiography and post-delivery echo findings in survivors. Results One hundred and sixty-four fetuses from 152 patients were enrolled (77 diabetics, 38 IVF, 14 with increased NT, 23 cases of tricuspid regurgitation or reversed a-wave in the DV, 22 with prior CHD and two on anticonvulsants). STIC-TUI echo was abnormal in 20 (12%), showing atrioventricular canal defect ( n = 9), hypoplastic left heart ( n = 2), pulmonary stenosis ( n = 2), right aortic arch ( n = 1), interrupted aortic arch ( n = 1), tricuspid atresia ( n = 1), heterotaxy ( n = 1), persistent truncus arteriosus ( n = 1), double outlet right ventricle and ventricular septal defect ( n = 1) and double inlet ventricle with transposition of the great arteries ( n = 1). 85% of these anomalies were evident in the four-chamber view plane of the TUI display, and the remainder were diagnosed in the outflow tract planes with color Doppler imaging. In 13, CHD was isolated while seven had extracardiac anomalies. Thirteen fetuses had aneuploidy and all 13 underwent first-trimester termination of pregnancy. In the remaining seven, second-trimester echocardiography and neonatal echo/postmortem examination confirmed anomalies (two stillborn neonates, one neonatal death, four live births). Two cases of CHD missed by first-trimester STIC-TUI echo were diagnosed on second-trimester echo. Accordingly, first-trimester STIC-TUI echo had 91% sensitivity and 100% specificity for the detection of CHD. Conclusions First-trimester 4D echocardiography using a standardized application of STIC, TUI and color Doppler imaging is effective in displaying the imaging planes that are necessary for achieving the diagnosis of complex cardiac anomalies in high-risk patients. Optimal imaging of the four-chamber view with two-dimensional ultrasound is the major determinant of successful volume acquisition. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

46, XY disorders of sex development ( DSD) are caused by disorders of gonadal development, androgen biosynthesis and receptor ( AR) defects. Although, clinical/biochemical features help in distinguishing specific aetiologies, there are overlaps which necessitate molecular analyses for the definitive diagnosis. To test precision of our clinical diagnosis of androgen insensitivity ( AIS) by analysing AR and then SRD5A2 genes, patients were recruited at Marmara University Hospital and molecular analyses were performed at Vall d'Hebron Research Institute. Among 101 46, XY DSD patients, 46 index and five siblings (nine complete, 42 partial) with clinical/biochemical data suggestive of AIS and stimulated T/ DHT ratio <25 were selected. AR and then SRD5A2 genes were sequenced. We detected AR mutations in 11 patients [seven index and four siblings (22% of all and 15% of index patients)] and SRD5A2 mutations in six [five index and one sibling (12% of all and 11% of index)]. AR mutation detection rate was 6/9 in all CAIS and 4/7 in the index (67 and 57% respectively) and 5/42 in all PAIS and 3/40 in the index (12 and 7.5% respectively). The eight mutations detected in the AR gene were as follows: p.Q58L, p.P392S, p.R609K, p.R775H, p.R856H, p.A871A, p.V890M and p.F892L, with p.A871A and p.F892L being novel. Further six patients had SRD5A2 mutations which were as follows: p.L73WfsX59, p.Y91H, p.R171S and p.G196S, the first being novel. Hormonal data in those with AR mutations, SRD5A2 mutations and no mutations were not statistically different. In conclusion, a significant proportion of children with presumptive diagnosis of AIS has a normal AR gene. The less severe the phenotype, the less likely is the chance of demonstrating a mutation. Furthermore, a significant number of children with presumptive diagnosis of AIS have mutations in SRD5A2 gene and are clinically and biochemically indistinguishable from AIS. [ABSTRACT FROM AUTHOR]

ABSTRACT Objectives To identify the range of waveform abnormalities in the ductus venosus ( DV) characterized by their timing in the cardiac cycle and to evaluate if they can be categorized into distinct patterns. Methods DV velocity ratios were calculated from peak velocities during ventricular systole (S), end-systolic ventricular relaxation (v), early diastole (D) and atrial systole (a) (S/v, S/D, v/D, S/a, v/a and D/a ratios). The ratios were converted to their Z-scores and elevation > 2 SD was assigned as abnormal. Combinations of ratio abnormalities were grouped to define distinct waveform patterns and their distribution was related to the clinical presentation. Results Five-hundred and forty-two abnormal DV waveforms fell into three principal patterns. In Pattern 1 only the a-wave-related ratios were abnormal (180, 33.2%), in Pattern 2 the v/D ratio was abnormal (143, 26.3%) and in Pattern 3 combinations of a-wave abnormalities in the presence of a normal v/D ratio were normal (94, 17.3%). Conclusions Interpretation of venous waveform patterns is complex because the multiphasic waveforms reflect events in the cardiac cycle that may be differentially affected by clinical pathology. We sought to present a classification for the DV flow profile that characterizes abnormal flow confined to atrial systole and occurs during ventricular relaxation or during holodiastole. Further research is warranted to determine the significance of these patterns in specific fetal conditions. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective To examine the relationships between the ductus venosus ( DV) pulsatility index for veins ( PIV), individual DV velocity ratios and diastolic and global myocardial cardiac function. Methods Doppler measurements of the DV, atrioventricular ( AV) valves and ventricular in- and outflow were analyzed. The DV-PIV and velocity ratios for individual phases (systole (S), end-systolic relaxation (v), early diastole (D), atrial systole (a), and S/v, S/D, S/a, v/D, v/a and D/a ratios) were calculated. The ratio of early and late diastolic peak velocities across AV valves was calculated (E/A ratio). Left modified myocardial performance index ( MPI) was calculated from time intervals between valve clicks defining isovolumetric contraction/relaxation and ejection times. All values were transformed to Z-scores. The distributions of DV velocity ratios and DV-PIV were correlated with cardiac Doppler parameters. Results A total of 1163 examinations from 213 fetuses, most of which were at risk for cardiac dysfunction, were included in the study. In 742 the PIV was normal and in 421 PIV was elevated > 2 SD above the normal mean. The DV-PIV correlated with velocity ratios ( P < 0.0001) but not with E/A ratios and the MPI. S/v and v/D ratios were related to tricuspid and mitral E/A ratios and left ventricular MPI. The S/D ratio was only related to both E/A ratios. There was no relationship between a-wave-related velocity ratios and cardiac function. Conclusions Velocity ratios of the DV show relationships with cardiac function that are not reflected by the PIV alone. In cases of suspected fetal cardiac dysfunction based on elevated DV-PIV, analysis of velocity ratios or direct cardiac evaluation is suggested to determine the underlying pathophysiology. Copyright © 2013 ISUOG. Published by John Wiley & Sons Ltd. [ABSTRACT FROM AUTHOR]

A solvent-free fabrication of TiO2 and ZnO nanonetworks is demonstrated by using supramolecular nanotemplates with high coating conformity, uniformity, and atomic scale size control. Deposition of TiO2 and ZnO on three-dimensional nanofibrous network template is accomplished. Ultrafine control over nanotube diameter allows robust and systematic evaluation of the electrochemical properties of TiO2 and ZnO nanonetworks in terms of size-function relationship. We observe hypsochromic shift in UV absorbance maxima correlated with decrease in wall thickness of the nanotubes. Photocatalytic activities of anatase TiO2 and hexagonal wurtzite ZnO nanonetworks are found to be dependent on both the wall thickness and total surface area per unit of mass. Wall thickness has effect on photoexcitation properties of both TiO2 and ZnO due to band gap energies and total surface area per unit of mass. The present work is a successful example that concentrates on nanofabrication of intact three-dimensional semiconductor nanonetworks with controlled band gap energies. [ABSTRACT FROM AUTHOR]

A general drawback of supramolecular peptide networks is their weak mechanical properties. In order to overcome a similar challenge, mussels have adapted to a pH-dependent iron complexation strategy for adhesion and curing. This strategy also provides successful stiffening and self-healing properties. The present study is inspired by the mussel curing strategy to establish iron cross-link points in self-assembled peptide networks. The impact of peptide-iron complexation on the morphology and secondary structure of the supramolecular nanofibers is characterized by scanning electron microscopy, circular dichroism and Fourier transform infrared spectroscopy. Mechanical properties of the cross-linked network are probed by small angle oscillatory rheology and nanoindentation by atomic force microscopy. It is shown that iron complexation has no influence on self-assembly and β-sheet-driven elongation of the nanofibers. On the other hand, the organic-inorganic hybrid network of iron cross-linked nanofibers demonstrates strong mechanical properties comparable to that of covalently cross-linked network. Strikingly, iron cross-linking does not inhibit intrinsic reversibility of supramolecular peptide polymers into disassembled building blocks and the self-healing ability upon high shear load. The strategy described here could be extended to improve mechanical properties of a wide range of supramolecular polymer networks. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective To determine which prenatal ultrasound findings indicate the need to also obtain PCR studies for viral genome in women undergoing midtrimester amniocentesis. Methods This was a retrospective observational study on women that underwent amniotic fluid karyotyping and viral PCR testing for history or ultrasound based indication. Amniotic fluid was tested for adenovirus, cytomegalovirus, respiratory syncytial virus, enterovirus, Epstein-Barr virus, and parvovirus B19 using multiplex PCR study with multiple appropriate controls. Ultrasound findings were coded as normal or abnormal with 34 categories of ultrasound abnormality stratified into 18 subgroups. Relationships between these subgroups and karyotype/PCR results were tested by Pearson chi-square method or Fisher's exact test and overall logistic regression analysis. Results Amniotic fluid samples from 1191 patients were obtained for the study. Abnormal karyotype was detected in 5.4% of cases (64/1191), and PCR was positive in 6.5% of cases (77/1191). Abnormal fetal ultrasonographic findings were observed in 28.4% of cases (338/1191). There was an association between intrauterine growth restriction, nonimmune hydrops fetalis, hand/foot anomalies or neural tube defects (NTDs), and PCR positivity. NTDs were associated with PCR positivity in fetuses with normal karyotype and nuchal thickening, cardiac or ventral wall defects were specifically associated with aneuploidy. Conclusion Amniotic fluid viral PCR testing should be considered for fetuses with intrauterine growth restriction, nonimmune hydrops fetalis, hand/foot anomalies, or NTDs. After aneuploidy is excluded, NTDs are associated with PCR positivity. © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective To study if the duration of individual Doppler abnormalities is an independent predictor of adverse outcome in fetal growth restriction (FGR) caused by placental dysfunction. Methods This was a secondary analysis of patients with FGR (abdominal circumference < 5 th percentile and umbilical artery (UA) pulsatility index (PI) elevation) who had at least three examinations before delivery. Days of duration of absent/reversed UA end-diastolic velocity (UA-AREDV), low middle cerebral artery PI (brain sparing), ductus venosus (DV) and umbilical vein Doppler abnormalities were related to stillbirth, major neonatal morbidity and intact survival. Results One hundred and seventy-seven study participants underwent a total of 1069 examinations. The duration of an absent/reversed a-wave in the DV (DV-RAV) was significantly higher in stillbirths (median, 6 days) compared with intact survivors and those with major morbidity (median, 0 days for both; P = 0.006 and P = 0.001, respectively). Duration of brain sparing was also longer in stillbirth cases compared with intact survivors (median, 19 days vs. 9 days, P = 0.02). Stepwise multinomial logistic regression showed that gestational age at delivery was a significant codeterminant of outcome for all arterial Doppler abnormalities when the DV a-wave was antegrade. However, when present, the duration of DV-RAV was the only contributor to stillbirth (probability of stillbirth = 1/(1 + exp − (interval to delivery × 1.03 − 2.28)), r2 = 0.73). Receiver-operating characteristics curve statistics showed that a DV-RAV for > 7 days predicted stillbirth (100% sensitivity, 80% specificity, likelihood ratio = 5.0, P < 0.0001). In contrast, neither neonatal death nor neonatal morbidity was predicted by the days of persistent DV-RAV. Conclusions The duration of absent or reversed flow during atrial systole in the DV is a strong predictor of stillbirth that is independent of gestational age. While prematurity remains the strongest predictor of neonatal risks it is unlikely that pregnancy can be prolonged by more than 1 week in this setting. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective In- vitro animal studies suggest that high glucose levels impair fetal cardiac function early in gestation. We aimed to study whether evidence of first-trimester myocardial dysfunction can be detected in fetuses of women with pregestational diabetes mellitus. Methods Women with diabetes mellitus underwent fetal echocardiography at 11-14 weeks' gestational age. In fetuses with normal anatomy, the cardiac preload, diastolic function, global myocardial performance and placental afterload were studied by Doppler of the ductus venosus (DV), mitral and tricuspid early/atrial (E/A) ratios, left and right ventricular myocardial performance index (MPI) and umbilical artery (UA) Doppler, respectively. Cases were matched for gestational age and UA and DV Doppler with controls that had no diabetes mellitus. Results Sixty-three singleton diabetic pregnancies were matched with 63 controls. Mean gestational age at enrollment was 12.6 (range, 11.1-13.6) weeks. Diabetic mothers had moderate to poor glycemic control (median (range) glycosylated hemoglobin A1 (HbA1c), 7.5 (5.1-12.7)%, and the HbA1c level was ≥ 7% in 37 (59%)). Fetuses of diabetic mothers exhibited worse measures of diastolic dysfunction: the isovolumetric relaxation time (IRT) was significantly prolonged (left ventricle: 36.9 ± 7.4 ms vs. 45.8 ± 6.8 ms; right ventricle: 35.6 ± 8 ms vs. 46.4 ± 7.3 ms, P < 0.0001 for both). The mitral E/A ratio was lower in diabetics (0.55 ± 0.06 vs. 0.51 ± 0.08, P = 0.03), and the global myocardial performance was lower in both ventricles (left ventricle MPI: 0.5 ± 0.08; right ventricle MPI: 0.52 ± 0.08, P = 0.03 and P < 0.0001, respectively). This lower global myocardial performance was caused by a prolonged myocardial relaxation time, which was most marked in diabetics with an HbA1c of ≥ 7% ( P < 0.001 vs. controls for both ventricles). There were no significant correlations between cardiac Doppler parameters and DV, UA indices and fetal heart rate ( P > 0.05 for all). Conclusions Fetuses of poorly controlled diabetic mothers demonstrate significant differences in first-trimester diastolic myocardial function compared with non-diabetic controls. The decrease in myocardial performance is more marked with increasing HbA1c and appears to be independent of preload and afterload. The ability to document these cardiac functional changes this early in pregnancy opens potential new avenues to understand the consequences of maternal glycemic status. Copyright © 2011 ISUOG. Published by John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Granulocyte macrophage colony stimulating factor, a potent hematopoietic cytokine, has been shown to stimulate production of white blood cells following chemotherapy. Therefore, the granulocyte macrophage colony stimulating factor gene is a potential candidate for the treatment of different pathological conditions. The purpose of this study is to investigate the suitability of chitosan as carrier for pORF-hGMCSF plasmid encoding granulocyte macrophage colony stimulating factor gene and also to study the effect of complexes on protein production and cell proliferation. Chitosan/pGM-CSF complexes were prepared using different (+/-) ratios (from 0.01/1 to 5/1). Complex formation was checked with agarose gel electrophoresis. The size and zeta potential values were measured. Enzyme and serum stability of complexes were studied. In vitro transfection properties of complexes were studied in HeLa cells. According to agarose gel electrophoresis, full complexation was obtained at 0.1/1 and higher chitosan/ pGM-CSF ratios. Complexes having about 132 nm size and +13.7 mV zeta potential value were obtained. Chitosan complexes protected plasmid against enzymatic and serum effects. The gene expression-dependent cell proliferation after transfection of chitosan/pGM-CSF complexes at 72 h was markedly increased in comparison with the level of control group. These results indicate that the effect of chitosan/pGM-CSF complexes on cell proliferation was changed with N/P ratio and time-dependently. For GM-CSF therapy, chitosan/pGM-CSF complexes may be used as alternative to conventional protein treatments. Chitosan may be a good carrier for pORF-hGMCSF. Further, in vivo study is ongoing. [ABSTRACT FROM AUTHOR]

Background: Ankaferd Blood Stopper® (ABS) is a folkloric medicinal plant extract used as a hemostatic agent in traditional Turkish medicine. This experimental study investigated the histopathological and immunohistochemical effects of ABS on vascular tissue in a rat model of aortic bleeding. Methods: Four groups of 11 Wistar albino rats were used. The abdominal aortas of the rats were wounded; an ABS-soaked tampon was applied to rats in Groups 1 and 3, and a plain gauze tampon was applied to rats in Groups 2 and 4 until the bleeding stopped. The bleeding time was recorded. Immediately following sacrificing, the arteriotomy sites from Groups 1 and 2 were removed. The abdominal incisions in Groups 3 and 4 were closed following hemostasis. On Day 7 of the study, Group 3 and 4 rats were sacrificed and the abdominal aorta arteriotomy sites were removed for histopathological and immunohistochemical evaluation. Results: The mean bleeding time in 15 animals in Groups 2 and 4 was 4.9 ± 0.6 s, and in 22 animals in Groups 1 and 3 was 3.1 ± 0.6 s. Distal aortic occlusion was not observed on either Day 1 or 7 in any group. Significantly more widespread and dense endothelial nitric oxide synthase (eNOS) staining was observed in Group 1 animals than Group 2. On Days 1 and 7 after application of ABS, histopathological changes, consisting of necrosis, inflammation, and endothelial cell loss, in the rat abdominal aortas did not differ between Groups 1 and 2. The basophilic discoloration in the ABS group on the operation day was a result of a foreign body reaction and hemosiderin-loaded histiocyte accumulation, which occurred on Day 7. Conclusions: In this study, hemostasis was successfully achieved with ABS in rat abdominal aortas. No histopathological change was found in the rat abdominal aortas between the ABS and control groups on Days 1 and 7. Further studies on the long-term effects of foreign body reactions and hemosiderin-loaded histiocyte accumulation are required. [ABSTRACT FROM AUTHOR]

The article presents a study which standardized the first-trimester three-dimensional (3D) imaging to the examination of the fetal heart. The researchers conducted fetal cardiac examinations through 107 low-risk women who had undergone cardiac ultrasound using spatiotemporal image correlation (STIC), tomographic ultrasound imaging (TUI), and color Doppler imaging. The study revealed a standardized STIC-TIU technique which provides detailed display of the fetal heart anatomy.

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SiAlON ceramics have found applications in many different areas due to their excellent engineering properties such as high hardness, fracture toughness, good thermal shock and oxidation resistance. SiAlON exist mainly in two different polymorphs: a (MxSi12-(m+n)Al(m+n)OnN16-n; M: metal and rare earth cations, x≈0,35 and n≤1,35) and β (β-Si6-zAlzOzN8-z; 0≤z≤4). In general, stable alpha and beta phases separately as well as in combination of α and β are obtained by incorporation of metal and rare earth cations as sintering additives. The metal cations such as Li, Mg, Ca, Y, and most lanthanide cations with the exception of La, Ce, Pr and Eu are able to stabilise α-SiAlON structure. Ekstrom et al. 1991 found that cerium can not occupy interstitial sites in α-SiAlON structure due to the fact that ionic radius of Ce3+ (0.103 nm) is too large, whereas ionic radius of Ce4+ (0.080 nm) is too small to stabilise α-SiAlON structure. After this work, several studies carried out to incorporate cerium cations into α-SiAlON structure. It was shown that cerium cation alone can be incorporated into α-SiAlON if the samples are either fast cooled after sintering, or when the samples are spark plasma sintered. On the other hand, cerium can also be incorporated into the α-SiAlON structure when it is used as a sintering additive together with a smaller α-SiAlON stabiliser cation such as Yb or Ca. Similar results were observed in other multi-cation doped SiAlONS that non α-SiAlON stabiliser cations like Sr2+ (0.112 nm) and La3+ (0.106 nm) are able to stabilise α-SiAlON when used together with α-SiAlON stabiliser cations such as Ca or Yb. Although it was shown that cerium existed in mixed valance state at domain boundaries in Ce-doped and spark plasma sintered α-SiAlON, there is no work on the valance determination of cerium in sintered α-SiAlON which has no domain boundaries. Therefore, in this study; it was aimed to incorporate cerium into α-SiAlON structure by combining with Yb3+ and the determination of possible cerium valence states (Ce3+/Ce4+) in both α-SiAlON grains and secondary phases. [ABSTRACT FROM PUBLISHER]

The article presents a study which evaluates the longitudinal progression of arterial and venous Doppler ultrasound parameters from clinical onset of intrauterine growth restriction in individual pregnancies. The study found that most of the subjects, by the time of the delivery, had elevated umbilical artery blood flow resistance, had brain sparing and had an elevated venous Doppler index. It is observed that the Doppler abnormalities had shorter duration and is related to gestational age.

Background: Our aim was to determine the effects of cardiopulmonary bypass procedures on the optic nerve by retinal nerve fiber layer thickness measurements. Methods: Retinal nerve fiber layer thickness was measured using the GDx Nerve Fiber Analyser, 1 day before the surgery and on postoperative days 1, 5 and 30 in 20 patients undergoing coronary artery bypass grafting surgery. Results: Postoperative mean values for retinal nerve fiber layer thickness, except symmetry on the first day and except symmetry and superior nasal ratio on the fifth day, were statsitically decreased. Only the value for the inferior ratio was significantly lower at the end of the first month. Conclusions: Cardiopulmonary bypass procedures cause a temporary decrease in retinal nerve fiber layer thickness. [ABSTRACT FROM AUTHOR]

The article examines the performance of nonstress testing, computerized fetal heart rate analysis, biophysical profile scoring and arterial and venous Doppler ultrasound investigation in the prediction of acid-base status in fetal growth restriction. The study involved a selected population of fetuses with severe placental insufficiency. It is pointed out that growth-restricted fetuses require antenatal testing using multiple surveillance modalities to enhance prediction of birth pH.

Objectives:The effect of economic status (ES) on growth, insulin-like growth factor (IGF)-I and IGF-binding protein (IGFBP)-3 in healthy children is not well characterized. We aimed to study the interrelationship between height, weight, IGF-I, IGFBP-3, mid-parental height (MPH) and ES.Design/subjects:Eight hundred and fourteen healthy children (428 boys, 386 girls; age 3–18 years) were classified according to income of the families as low, middle and high. Standard deviation scores (SDSs) of height, weight, MPH, IGF-I and IGFBP-3 were compared between the groups. The combined effect of these parameters and ES on height SDS was investigated with complex statistical models.Results:There was a significant trend for height and weight SDSs to increase with higher income levels in boys, but not in girls. Body mass index (BMI) SDSs were similar in three groups. There was a general trend for MPH SDS to increase with income levels in both sexes. In boys, IGF-I SDS was significantly higher in high ES group than low ES. In girls, IGFBP-3 SDSs were significantly higher in high ES group than in middle ES group. For both genders, height SDS was highly correlated with weight SDS and moderately correlated with BMI SDS, MPH SDS and IGF-1 SDS. All correlations were significant and positive. Complex models showed that MPH (19%), IGF-I (13%) and ES (3%) in boys, and MPH (16%) and IGF-I (7%) in girls have significant contribution to height SDSs.Conclusions:ES per se, independent of overt malnutrition, affects height, weight, IGF-I and IGFBP-3 with some gender differences in healthy children. Influence of income on height and weight show sexual dimorphism, a slight but significant effect is observed only in boys. MPH is the most prominent variable effecting height in healthy children. Higher height and MPH SDSs observed in higher income groups suggest that secular trend in growth still exists, at least in boys, in a country of favorable economic development.European Journal of Clinical Nutrition (2007) 61, 752–758; doi:10.1038/sj.ejcn.1602575; published online 13 December 2006 [ABSTRACT FROM AUTHOR]

The article focuses on patient safety issues in implementing the National Institute for Clinical Excellence published guidelines for the management of head injury. It cites the risks associated with additional exposure to skull radiation and additional workload. It discusses the medico-legal issues concerning the application of the head injury guidelines.

Aim: Breath-holding spells are common in infancy and early childhood, and patients are frequently referred to paediatric cardiology clinics for exclusion of heart disease. Recent data reveal subsequent development of epilepsy and neurocardiogenic syncope. Autonomic dysregulation and increased vagal stimulation leading to cardiac arrest and cerebral ischaemia is considered as the cause. Iron deficiency anaemia may be associated with these spells. We studied QT dispersion for the assessment of ventricular repolarization in these patients. Methods: The study group consisted of 19 girls and 24 boys between 3 and 108 mo of age (mean ± SD = 22.7 ± 17.7 mo); and the control group consisted of 13 girls and 12 boys between 3 and 57 mo of age (mean ± SD = 22.9 ± 15.1 mo). QT interval was measured; corrected QT interval (QTc), QT dispersion (QTd) and QTc dispersion (QTcd) were calculated from 12-lead surface electrocardiograms of the patients and the control group. Results: There was no statistically significant difference in terms of QT and QTc intervals between patient and control groups, while QTd and QTcd values were significantly increased in patients with breath-holding spells compared to the healthy children. QT dispersion was 59.5 ± 35.9 ms and 44.8 ± 11.9 ms, respectively, in patients and controls ( p < 0.05). QTc dispersion was 102.1 ± 41.9 ms and 79.6 ± 24.6 ms, respectively ( p < 0.01). The presence of iron deficiency did not effect the QT and QTc dispersion. Conclusion: QT dispersion is increased in patients with breath-holding spells, and this finding justifies further investigation for rhythm abnormalities and autonomic dysfunction in this patient group. [ABSTRACT FROM AUTHOR]