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Objective: To evaluate which parameters of a sonographic cervical length measurement are associated with preterm birth in women with ultrasound- or exam-indicated cerclage. Methods: This was a retrospective cohort study of women with singleton pregnancies who underwent ultrasound- or exam-indicated Shirodkar cerclage by a single maternal–fetal medicine practice between 2011 and 2019. All patients underwent sonographic cervical length measurement 2–3 weeks after cerclage placement, and then every 2–4 weeks up to 32 weeks. The images from the first and second post-cerclage cervical lengths were reviewed. Total cervical length, upper cervical length (from the internal cervical os to the cerclage), and lower cervical length (from the cerclage to the external os) were measured. The primary outcome for this study was gestational age at delivery. Results: A total of 114 women with cerclage were included (85 (74.6%) ultrasound-indicated and 29 (25.4%) exam-indicated). The first and second total cervical lengths correlated with gestational age at delivery (r = 0.26, p=.005; r = 0.33, p<.001, respectively), and the change from first to second was inversely correlated with gestational age at delivery (r = 0.20, p=.032). The first and second upper cervical lengths also correlated with gestational age at delivery (r = 0.22, p = .019; r = 0.33, p<.001, respectively), and the change from first to second upper cervical length was inversely correlated with gestational age at delivery (r= 0.20, r = 0.029). Neither the first nor the second lower cervical lengths were significantly associated with gestational age at delivery. On regression analysis, total cervical length and upper cervical length were not independently associated with gestational age at delivery (p = .108 and p=.806, respectively, for the first scan; p = .153 and p=.166, respectively, for the second scan). Conclusions: Postcerclage total cervical length and upper cervical length are both associated with gestational age at delivery and risk of preterm birth, but not independently. After ultrasound- or exam-indicated cerclage, sonographic monitoring of either the total cervical length or the upper cervical length might be predictive of gestational age at delivery and the risk of preterm birth. [ABSTRACT FROM AUTHOR]

Even though significant progress has been made on raising awareness about equity and diversity issues in science education in the last two decades, the current push to address the Next Generation Science Standards' (NGSS) emphasis on integrating engineering and scientific practices has opened up new pitfalls. Here, I describe seven of the most salient pitfalls we should all seek to avoid if we are committed to making STEM education more culturally and socially relevant. Suggestions are provided to encourage educators, researchers, and curriculum developers to distinguish and stress the importance of engaging children in STEM instead of teaching STEM to students. [ABSTRACT FROM AUTHOR]

Making engineering and science culturally and socially relevant requires teachers to have broader content knowledge and an increased repertoire of pedagogical skills. One aspect of being an effective and culturally inclusive teacher that is seldom discussed is the ability to engage with the emotions associated with working for social justice. In other words, teachers need to be prepared to address the mixed emotions and desire to effect social change that students (children or adults) often experience when exposed to the very real social inequalities present in their own communities or in the world. This issue is particularly important now that the Next Generation Science Education Standards, and its emphasis on engineering practices, calls for students to engage in more problem solving of real world issues. This article seeks to raise awareness aboutcritical emotional pedagogyandcritical emotional literacyas 2 additional tools that are likely to augment teachers and researchers’ professional tool kit when interested in building a culturally inclusive and socially relevant learning environment. [ABSTRACT FROM PUBLISHER]

The aim of this study was to determine whether markers of inflammation and coagulation are associated with short-term particulate matter exposure and predict major adverse cardiovascular events at 360 d in patients with acute coronary syndrome (ACS). We included 307 consecutive patients, and assessed the average concentrations of data on atmospheric pollution in ambient air and meteorological variables from 1 d up to 7 d prior to admission. In patients with ACS, the markers of endothelial activation and coagulation, but not black carbon exposure, are associated with major adverse cardiovascular events at one-year follow-up. [ABSTRACT FROM AUTHOR]

Objective: Calculate the risk of miscarriage in women with a viable (defined as presence of fetal heart rate on ultrasound) first trimester singleton pregnancy and to create a model for stratified risk-assessment for pregnancy loss based on significant risk factors. Study Design: Retrospective cohort study of unselected women with singleton pregnancies in a large obstetrical practice who presented for prenatal care prior to 14 weeks over a three-year period. All women underwent a formal first-trimester ultrasound, and we only included women with viable pregnancies with fetal heart activity seen on that ultrasound. Our primary outcome was pregnancy loss prior to 20 weeks. Statistical modeling was used to create a risk-assessment tool from adjusted likelihood ratios of pregnancy loss based on risk factors independently associated with this outcome. Results: From January 2015-December 2017, 2,446 women met the inclusion criteria for the study and 132 (5.4%) had a pregnancy loss <20 weeks. On regression analysis, the independent risk factors for pregnancy loss were earlier gestational age (aOR 0.72, 95% CI 0.65-0.80) and increasing number of prior miscarriages (aOR 1.56, 95% CI 1.32-1.83). Using these risk factors, we calculated the stratified risk of pregnancy loss, which ranged from 0.8% in women at 13 weeks of gestation with no prior miscarriages to 33.7% in women at six weeks of gestation with three or more prior miscarriages. Conclusion: In first trimester singleton pregnancies, the overall risk of pregnancy loss <20 weeks after confirmation of fetal heart activity is 5.4%, but can be stratified for each woman and ranges from 0.8% to 33.7% based on the gestational age and number of prior pregnancy losses. [ABSTRACT FROM AUTHOR]

Low circulating melatonin levels predict poor outcome in patients with ST-segment elevation myocardial infarction (STEMI). In the present study, we investigated whether a relationship between myocardial deformation in parameters measured by echocardiography and circulating melatonin level exists. We prospectively included 112 patients with STEMI who performed echocardiography and simultaneous measurement of serum melatonin, during the light period within 72 h of admission. We found a negative correlation between circulating melatonin levels and global longitudinal strain ( p = 0.006, r = −0.33). In conclusion, melatonin levels have a correlation with two-dimensional speckle tracking in patients with STEMI. [ABSTRACT FROM AUTHOR]

The mechanism of coronary thrombus formation is a complex phenomenon that involves different cellular components. ARTERIA is a prospective, multicenter study that will include patients presenting with a diagnosis of ST-elevation acute coronary syndrome undergoing thrombus aspiration during an emergency primary percutaneous coronary revascularization. The purpose of the ARTERIA study is to try to clarify whether there is an association between inflammatory markers measured in blood and in intracoronary thrombi and, if any, what set of molecules provides better prognostic information in these patients. Our study will help to elucidate the complex relationship between thrombus and circulating blood. [ABSTRACT FROM AUTHOR]

This article describes a prospective study of 1,200 participants, half of whom were offspring of trauma survivors, and their emotional symptom levels before and after the Corralito, an economic crisis that occurred in Argentina at the end of 2001. The authors report pre- and postcrisis data on anxiety and depression in a group of adult offspring of victims of the Dirty War (1976–1983) in an attempt to ascertain whether they are at greater risk than a control group for developing anxiety and depression in response to an economic crisis. The results indicated the offspring of war victims experienced greater emotional distress than the control subjects before, but not after the imposition of the Corralito. [ABSTRACT FROM AUTHOR]

Context: Neopterin serum concentration increases in the presence of renal dysfunction. Objective: We sought to determine the relationship between admission serum neopterin levels and worsening renal function (WRF) in patients with heart failure (HF). Methods: We prospectively measured serum neopterin levels in patients with HF and the patients were subdivided into two groups: with and without WRF during hospital admission. Results: Logistic regression analysis showed that high serum neopterin levels at admission were associated with a greater likelihood of developing WRF. Conclusions: Patients admitted to hospital with HF, elevated serum neopterin levels are associated with an increased risk of developing WRF. [ABSTRACT FROM AUTHOR]

Background: Ischemia-modified albumin has been proposed as a useful rule-out marker for the diagnosis of acute coronary syndrome in the emergency department. Objective: To perform a review of ischemia-modified albumin use in the clinical practice. Methods: We performed a comprehensive literature search by using electronic bibliographic databases. Conclusion: Although the main limitation of ischemia-modified albumin at present is its low specificity, it may be a useful test to rule out acute coronary syndrome from low to moderate pre-test probability conditions with negative cardiac troponins and a negative ECG. [ABSTRACT FROM AUTHOR]

Background: The aim of the present study was to evaluate whether or not an elevated ischaemia-modified albumin (IMA) level provides any additional prognostic information to the validated Thrombolysis In Myocardial Infarction (TIMI) risk score in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI). Methods: One hundred seven consecutive STEMI patients treated with primary PCI were included. The incidence of 30-day death was the prespecified primary end point. Serum IMA was measured immediately at hospital arrival. Results: The incidence of the primary end point was 6.5%. A significant predictive value of IMA in relation to the primary end point was indicated by an area under the ROC curve of 0.71 (p = 0.01). In the multivariate analysis, increased IMA remained a significant predictor of the primary end point after adjustment for TIMI risk predictors (p = 0.019). The area under the ROC curve for the TIMI risk score was 0.68 (p = 0.03). The addition of IMA to the TIMI risk score did not improve its prognostic value (area under the ROC curve 0.60, p = 0.25). Conclusion: IMA levels obtained at admission are a powerful indicator of short-term mortality in STEMI patients treated with primary PCI, but do not seem to be a marker that adds prognostic information to the validated STEMI TIMI risk score. [ABSTRACT FROM AUTHOR]

Explores the contradictions in the National Science Education Standards on ethnicity in the United States. Exclusion of ethnic groups in science and technology related courses; Use of student-centered and collaborative methods of teaching; Problems in reporting science academic achievements of Asian and Latino students; Advantages of the application of the standards.

At present, thrombolysis remains the principal reperfusion strategy for ST-elevation acute coronary syndromes in most countries, due to the limited availability of primary angioplasty. Haemorrhagic complications, which are among the most frequent side effects, are usually not very important. As a matter of fact, 70% of the bleeding takes place at venepuncture sites and does not require special treatment. We report an unusual case of vocal cord haematoma after thrombolysis with tenecteplase in a patient with acute myocardial infarction. As far as we know, this type of side effect has only been described once in the literature, namely, after thrombolysis with tissue plasminogen activator in deep vein thrombosis. [ABSTRACT FROM AUTHOR]