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To evaluate the effectiveness of cervical pessary for preventing spontaneous preterm birth (SPTB) in singleton gestations with a second trimester short cervix. Electronic databases were searched from their inception until February 2016. We included randomized clinical trials (RCTs) comparing the use of the cervical pessary with expectant management in singletons pregnancies with transvaginal ultrasound cervical length (TVU CL) ≤25 mm. The primary outcome was incidence of SPTB <34 weeks. The summary measures were reported as relative risk (RR) with 95% confidence interval (CI). Three RCTs (n = 1,420) were included. The mean gestational age (GA) at randomization was approximately 22 weeks. The Arabin pessary was used as intervention in all three trials, and was removed by vaginal examination at approximately 37 weeks. Cervical pessary was not associated with prevention of SPTB <37 (20.2% vs 50.2%; RR 0.50, 95% CI 0.23 to 1.09), <34, <32, and <28 weeks, compared to no pessary. No differences were found in the mean of GA at, interval from randomization to delivery, incidence of preterm premature rupture of membranes and of cesarean delivery, and in neonatal outcomes. The Arabin pessary was associated with a significantly higher risk of vaginal discharge. In singleton pregnancies with a TVU CL ≤25mm at 200–246weeks, the Arabin pessary does not reduce the rate of spontaneous preterm delivery or improve perinatal outcome. Individual patient data meta‐analysis may clarify whether cervical pessary may be beneficial in subgroups, such as only singleton gestations without prior SPTB or by different CL cutoffs.

Picture sharing through social networks has become a prominent phenomenon, producing a large amount of data that law enforcers may be entitled to use, under the proper legal framework, as a source of information for investigating a crime. In this work, the authors exploit digital camera ‘fingerprinting’ based on noise residuals (sensor pattern noise or SPN) to achieve a novel forensic task, named picture-to-identity linking. It consists of finding social network accounts that possibly belong to the author of a certain photo (e.g. showing illegal content). The rationale is that the author of the offending photo has likely used the same camera for taking other (legal) pictures, and posted them in a social network account. The authors extend a previous work on the topic by coupling SPN with visual image similarity, a useful cue when pictures have been taken in the same environment (e.g. a room). The authors also improve the framework by allowing for multiple-image queries, and thoroughly evaluate the performance on two corpora of images from social network accounts, including the impact of image modifications. Reported results show a robust improvement with respect to the previous work, and prove the usefulness of picture-to-identity as an aid for digital forensic investigations.

To provide pharmacists in community practice a framework for using national health observances as opportunities to promote patients' health through education and screenings, to discuss obstacles pharmacists may encounter when developing services within their pharmacies, and to outline examples of activities pharmacists can perform for specific health observances.

After 1 year of exposure to trichloroethylene, reversible neuropsychological impairment and persistent EEG paroxysms were observed in one patient. The improvement of neuropsychological performances and the persistence of severe EEG abnormalities after withdrawal of the toxin suggest “functional” cerebral damage after prolonged exposure to trichloroethylene.

(Acta Obstet Gynecol Scand. 2018;97:235–247)Management for women with gestational diabetes mellitus (GDM) and pregestational diabetes mellitus (DM), includes diet, physical activity, and oral hypoglycemic agents or insulin as needed. However, the optimal schedule, frequency, and timing of glucose monitoring as well as the ideal therapeutic glucose level remain inconclusive. Results from randomized controlled trials (RCTs) have not been able to define any specific criteria for pharmacologic therapy dose adjustment. Therefore, these investigators undertook a systematic review of RCTs in order to analyze the criteria being used for pharmacologic therapy dose adjustment.