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Physical activity is associated with beneficial health effects for both mother and her future child, as well as the course of pregnancy. The aim of this review was the comparison of international guidelines with Polish recommendations. Data were collected from PubMed platform and international guidelines and narrowed to open access studies published between 1990-2023 in English, German and Polish. The existing literature shows an increase of interest in the impact of body activity during pregnancy and pelvic floor muscle training (PFMT). The recommendations move away from the more conservative approach, that previously suggested limitation of all exercise-related activities. Recently, The Polish Society of Gynecologists and Obstetricians and Polish Society of Sports Medicine announced a planned release of joint recommendations on physical activity during pregnancy and after childbirth, as well as the translation of the "Get Active Questionnaire for Pregnancy", a screening tool for pregnant women, doctors and midwives, developed in accordance with the recommendations of international gynecological societies. [ABSTRACT FROM AUTHOR]

Objectives: The impact of infection with novel coronavirus -- SARS-CoV-2 -- on women's and fetus' was unclear; therefore, it was the reason for many worries. We wanted to understand and describe the worries of pregnant women, assess mental well-being, and analyse the problems affecting prenatal care and hospital stay in this unprecedented time. Material and methods: We designed an original 23-question survey aimed at women who were pregnant during the pandemic or who gave birth at that time. The survey included demographic data, questions about prenatal care, mental status and worries, and hospitalisation. Results: Our study included 1321 women: 1010 (76.5%) during pregnancy and 311 (23.5%) after the delivery in the studied time. For 1168 (88,4%) respondents, the pandemic had a negative impact on their mood. The three main concerns were: the need for isolation from the child (n = 498, 37.7%), the childbirth without a partner/trusted companion (n = 417, 31.6%) and the risk of infection of the child in hospital (n = 381, 28.8%). Conclusions: The novel coronavirus pandemic affects the mental health of pregnant women. Pregnant patients should be considered a group of particular concerns. Patients consider remote obstetrical consultations as an insufficient approach. The reason for the highest worries of pregnant patients is a lack of companionship during labour. There was no difference between the rate of childbirth via caesarean sections over vaginal delivery during the "first wave" of the pandemic. [ABSTRACT FROM AUTHOR]

Over the past centuries maternal and neonatal morbidity and mortality has fallen dramatically. This is mainly due to the fact that we achieved a lot in the field of medicine in a very short amount of time. Evidence, mostly from Europe but also from US, suggested that home birth can be relatively safe provided the appropriate conditions are met. The question is "What if something goes wrong?" How to increase patient safety in the case of birth before arrival (BBA) or it may not be associated with any increased risk? Our study review nowadays available articles and describes rates, obstetrical characteristics and perinatal and maternal outcome of unplanned out-of-hospital deliveries. [ABSTRACT FROM AUTHOR]

The consequence of each cesarean section is the uterine scar formation. In some patients, uterine scar after cesarean section heals incompletely and as a result, the uterine niche is formed. Most of the small niches are asymptomatic, but the large cesarean scar niches in nonpregnant women may cause a cesarean scar syndrome, which manifest itself as abnormal uterine bleeding, dysmenorrhea and secondary infertility. Among pregnant women, the presence of large niches may be associated with potentially life-threatening consequences, such as cesarean scar dehiscence and uterine rupture, placenta accreta spectrum disorders, placenta previa, cesarean scar pregnancy. Due to the possibility of dangerous consequences related to the occurrence of a uterine niche, in recent years many studies have focused on the term of cesarean scar niche, its risk factors, diagnostic methods and treatment options. Uterine niche can be examined using two- or three-dimensional transvaginal ultrasonography, as well as two- and three-dimensional sonohysterography, hysterosalpingography, hysteroscopy or magnetic resonance imaging. However, neither of the above diagnostic method is considered as the "gold standard". There are no unambiguous guidelines on some aspect concerning the diagnosis of cesarean scar niche. The aim of this study is to analyze and describe the diagnostic methods of cesarean section niche. [ABSTRACT FROM AUTHOR]

Objectives: Incomplete healing of the uterine scar after cesarean section may result in formation of a niche. The aim of this study is to identify the potential risk factors for the improper uterine healing after cesarean section in women with single layer, full thickness uterine closure with the use of two- and three-dimensional transvaginal ultrasonography. Material and methods: 204 women with a history of at least one low transverse cesarean section (CS) with a single layer uterine closure participated in the study. Residual myometrial thickness (RMT), adjacent myometrial thickness (AMT), width (W), depth (D) and volume of the niche, RMT/AMT, RMT/D, RMT/W ratio and clinical characteristics were analyzed. Results: A niche after cesarean section was found in 153 cases. However only five patients had a RMT < 2.2 mm, and 35 had an RMT/AMT ratio ≤ 0.5. The RMT and RMT/AMT ratio among women who had undergone more than one cesarean section was lower than among women who underwent the first cesarean section. No statistically significant relationship was found between the incidence of niche, its parameters and cervical dilation, uterine contractions, cesarean section in the second stage of labor, type of uterus incision expansion and flexion, operator's experience. Conclusion: Healing of the uterine cesarean section scar in women with single-layer continuous suture covering the entire thickness of the myometrium, excluding the decidua is not affected by the mode of caesarean section, type of uterine incision expansion and flexion, operator's experience, stage of labor at the time of caesarean section. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the balloon occlusion of the internal iliac arteries during a caesarean section in the group of patients with placenta accreta spectrum. Material and methods: We analysed 29 pregnant women with placenta accreta spectrum. The study group consisted of 15 patients, who underwent a caesarean delivery with temporary bilateral internal iliac artery occlusion. In the control group, we examined 14 women who had a standard caesarean delivery without any radiologic procedure. We compared pre- and post-operative haemoglobin level, necessity of blood transfusion, intraoperative blood loss, intensive care requirement, complications, duration of surgery, anaesthesia and hospital stay. Results: The history and obstetric outcomes were similar in both groups. The study group required fewer blood transfusions than the control group (p = 0.0176). We administered less packed red blood cells and fresh frozen plasma. Complications were more frequent in the control group (p = 0.0014). Complications related to occlusion of the internal iliac arteries did not occur. The intensive care unit transfer was more frequent in the control group (p = 0.0329). The duration of surgery and hospital stay did not differ between groups. The anaesthesia time was longer in a study group, which related to the radiologic procedure. Conclusions: Caesarean delivery for placenta accreta spectrum with bilateral balloon occlusion of the internal iliac arteries requires fewer transfusions. It contributes to a decrease in the complication rate and maternal morbidity. [ABSTRACT FROM AUTHOR]

The publication presents recommendations on the performance of surgical procedures in gynecology during the COVID- 19 pandemic. The recommendations were prepared by the Polish Society of Gynecologists and Obstetricians, based on current knowledge of SARS CoV-2. These recommendations contain the latest guidelines of scientific societies related to the subject of operational procedures. [ABSTRACT FROM AUTHOR]

The recommendations represent the current procedure, which may be modified and changed where justified, after a thorough analysis of the given clinical situation, which may be the basis for their modification and updating in the future. [ABSTRACT FROM AUTHOR]

Objectives: Cervical cancer is rated fourth in terms of incidence and cancer-related mortality in women. Cytology-based screening programs and colposcopy provided insufficient rates of detecting cervical intraepithelial neoplasia (CIN) prompting researchers to develop new tools. The aim of this study was to evaluate whether folate receptor-mediated staining is useful in detecting CIN2+ during gynecological examination with colposcopy. Material and methods: In total 96 women with abnormal cytology findings were enrolled. The study was conducted on the Polish population. The diagnostic process consisted of colposcopy, receptor-mediated diagnosis (FRD), and histopathology examination. All women were subjected to the same diagnostic procedure. Results: The patient mean age of 96 women was 38 ± 14.5 years. On colposcopy, high-grade lesions were detected in 83 women. The FRD gave positive results in 63 women. Histopathology revealed 1 case of carcinoma plano epithelial akeratodes, 21 cases of high-grade squamous intraepithelial lesions, 13 cases of low-grade squamous intraepithelial lesions. A total of 61 cases presented no pathology. FRD as an adjunct to colposcopy gave the following test results in detecting CIN2+ lesions: sensitivity -- 94.29%, specificity -- 46.67%, PPV -- 50.77%, NPV -- 93.33%, and accuracy -- 64.21%. Using both techniques provided better results than using each of the tests alone. Conclusions: FRD is a promising test for the diagnosing CIN2+ cervical pathologies because it can increase the probability of detecting CIN2+ without any additional burden posed on patients. Further studies should be conducted on large and various populations to complement current evidence. [ABSTRACT FROM AUTHOR]

We present recommendations on performance and safety measures of ultrasound examinations in obstetrics and gynecology during the SARS COV-2 pandemic. The statement was prepared based on the current knowledge on the coronavirus by the Ultrasound Section of the Polish Society of Obstetrics and Gynecology. It has to be noted that the presented guidance is based on limited evidence and is primarily based on experiences published by authors from areas most affected by the virus thus far, such as China, Singapore, Hong Kong, and Italy. We realize that the pandemic situation is very dynamic. New data is published every day. Despite the imposed limitations related to the necessity of social distancing, it is crucial to remember that providing optimal care in safe conditions should remain the primary goal of healthcare providers. We plan to update the current guidelines as the situation develops. [ABSTRACT FROM AUTHOR]

Featured Application: We propose a novel approach enabling the fabrication of high resolution alpha sources with interest for a range of spectroscopy applications. In this work, we investigate a novel approach to prepare high-performance alpha-particle solid sources fabricated on diamond thin support layers, offering the properties of diamond such as a low-Z material with corrosion and mechanical hardness. As-prepared solid sources onto boron-doped-diamond (BDD) substrate exhibited high performance of the autoradiography and spectroscopic resolution at the level of other more conventional materials such as stainless steel. A straightforward precipitation process in the Na2SO4 or NaNO3 simple electrolytes under mild experimental conditions with a low current of several mA.cm−2 were successfully developed onto BDD substrates for deposition of single 241Am as well as 239Pu, 241Am, and 244Cm mixed radionuclides. The results demonstrate that solid sources deposited onto such BDD substrates can match the performance of those prepared onto stainless steel substrates with excellent uniformity and high-resolution spectroscopy, together combining the robustness, chemical resilience, and X-ray transparence of the diamond. Alpha-particle spectra exhibiting a low full width at half maximum (FWHM) of 12.5 keV at the energy of 5.485 MeV (241Am) could be practically obtained for BDD substrates. [ABSTRACT FROM AUTHOR]

The performance of a diamond X‐ray beam position monitor is reported. This detector consists of an ionization solid‐state chamber based on a thin single‐crystal chemical‐vapour‐deposition diamond with position‐sensitive resistive electrodes in a duo‐lateral configuration. The detector's linearity, homogeneity and responsivity were studied on beamlines at Synchrotron SOLEIL with various beam sizes, intensities and energies. These measurements demonstrate the large and homogeneous (absorption variation of less than 0.7% over 500 µm × 500 µm) active area of the detector, with linear responses independent of the X‐ray beam spatial distribution. Due to the excellent charge collection efficiency (approaching 100%) and intensity sensitivity (0.05%), the detector allows monitoring of the incident beam flux precisely. In addition, the in‐beam position resolution was compared with a theoretical analysis providing an estimation of the detector's beam position resolution capability depending on the experimental conditions (X‐ray flux, energy and readout acquisition time). [ABSTRACT FROM AUTHOR]

We report the development of thin single crystal diamond membranes suitable for dose control in targeted cell irradiation experiments with a proton microbeam. A specific design was achieved to deliver single protons with a hit detection efficiency approaching 100%. The membranes have thicknesses between 1.8 and 3 μm and are used as vacuum windows on the microbeam line. The impact of these transmission detectors on the microbeam spot size is estimated by Monte-Carlo simulations, indicating that a beam lateral resolution below 2 μm is achieved. This is confirmed by experiments showing the accumulation online of X-ray Repair Cross-Complementing protein 1 (XRCC1)-Green Fluorescent Protein (GFP) at DNA damaged sites in living cells. [ABSTRACT FROM AUTHOR]

Results of measurements made at the SIRIUS beamline of the SOLEIL synchrotron for a new X-ray beam position monitor based on a super-thin single crystal of diamond grown by chemical vapor deposition (CVD) are presented. This detector is a quadrant electrode design processed on a 3 mm-thick membrane obtained by argon-oxygen plasma etching the central area of a CVD-grown diamond plate of 60 mm thickness. The membrane transmits more than 50% of the incident 1.3 keV energy X-ray beam. The diamond plate was of moderate purity (1 p.p.m. nitrogen), but the X-ray beam induced current (XBIC) measurements nevertheless showed a photo-charge collection efficiency approaching 100% for an electric field of 2 V mm1, corresponding to an applied bias voltage of only 6 V. XBIC mapping of the membrane showed an inhomogeneity of more than 10% across the membrane, corresponding to the measured variation in the thickness of the diamond plate before the plasma etching process. The measured XBIC signal-to-dark-current ratio of the device was greater than 105, and the X-ray beam position resolution of the device was better than a micrometer for a 1 kHz sampling rate. [ABSTRACT FROM AUTHOR]

The study aimed at investigating the impact of late prematurity (LPT) on neonatal outcome in twins and neonatal morbidity and mortality within LPT with regard to the completed weeks of gestation. The study was conducted in six tertiary obstetric departments from different provinces of Poland (Warsaw, Lublin, Poznan, Wroclaw, Bytom). It included 465 twin deliveries in the above centers in 2012. A comparative analysis of maternal factors, the course of pregnancy and delivery and neonatal outcome between LPT (34 + 0–36 + 6 weeks of gestation) and term groups (completed 37 weeks) was performed. The neonatal outcome included short-term morbidities. The analysis of neonatal complication rates according to completed gestational weeks was carried out. Out of 465 twin deliveries 213 (44.8%) were LPT and 156 (33.55%) were term. There were no neonatal deaths among LPT and term twins. One-third of LPT newborns suffered from respiratory disorders or required antibiotics, 40% had jaundice requiring phototherapy, and 30% were admitted to NICU. The analysis of neonatal morbidity with regard to each gestational week at delivery showed that most analyzed complications occurred less frequently with the advancing gestational age, especially respiratory disorders and NICU admissions. The only two factors with significant influence on neonatal morbidity rate were neonatal birth weight (OR = 0.43, 95% CI = 0.2–0.9, p = .02) and gestational age at delivery (OR = 0.62, 95% CI = 0.5–0.8, p < .01). LPT have a higher risk of neonatal morbidity than term twins. Gestational age and neonatal birth weight seem to play a crucial role in neonatal outcome in twins. [ABSTRACT FROM PUBLISHER]

Background: Every year 1.5 million cesarean section procedures are performed worldwide. As many women decide to get pregnant again, the population of pregnant women with a history of cesarean section is growing rapidly. For these women prediction of cesarean section scar performance is still a serious clinical problem. The purpose of the study was to assess whether the parameters of cesarean section scar in the nonpregnant uterus as determined using ultrasound can be used to predict uterine dehiscence in the next pregnancy. Methods: Starting in 2005, the study included 308 nonpregnant women with a history of low transverse cesarean section. The following ultrasonographic parameters of the cesarean section scar in the nonpregnant uterus were assessed: the residual myometrial thickness (RMT) and the width (W) and the depth (D) of the triangular hypoechoic scar niche. During 8 years of follow-up, 41 of these women were referred to our department for delivery. In all cases, a repeat cesarean section was performed and the lower uterine segment was assessed. Two independent statistical methods namely the logit model and Decision Tree analysis were used to determine the relation between the appearance of the cesarean section scar in the nonpregnat state and the performance of the scar in the next pregnancy. Results: The logit model revealed that the D/RMT ratio showed significant correlation with cesarean section scar dehiscence (P-value of 0.007). Specifically, a D/RMT ratio value greater than 1.3035 indicated that the likelihood of dehiscence was greater than 50%. The Decision Tree analysis revealed that a diagnosis of dehiscence versus non-dehiscence could be based solely on one criterion, a D/RMT ratio of at least 0.785. The sensitivity of this method was 71%, and the specificity was 94%. Conclusions: Assessment of the cesarean section scar in the nonpregant uterus can be used to predict the occurrence of scar dehiscence in the next pregnancy. [ABSTRACT FROM AUTHOR]

We propose to use the non-electronic grade (nitrogen content 5 ppb < [N] < 5 ppm) single crystal (sc) chemical vapour deposited (CVD) diamond as a thin-membrane radiation detector. Using deep Ar/O2 plasma etching it is possible to produce self-supported few micrometres thick scCVD membranes of a size approaching 7 mm × 7 mm, with a very good surface quality. After metallization and contacting, electrical properties of diamond membrane detectors were probed with 5.486 MeV α-particles as an ionization source. Despite nitrogen impurity, scCVD membrane detectors exhibit stable operation, charge collection efficiency close to 100%, with homogenous response, and extraordinary dielectric strength up to 30 V/μm. [ABSTRACT FROM AUTHOR]

Placental mesenchymal dysplasia (PMD) is a rare benign vascular anomaly of the placenta. It can be misdiagnosed as a molar pregnancy resulting in unnecessary termination of pregnancy. A 30-year-old woman was referred to our hospital at 18 gestational weeks due to suspicion of molar pregnancy. The ultrasound showed a bulky placenta with multiple cysts. Oligohydramnion and fetal hypoechogenic cystic area without doppler flow were diagnosed at 23 weeks. The baby was operated on after delivery, and an 80 mm multifocal cyst originating from the right lobe of the liver was removed. The placenta demonstrated swelling stem villi with enlarged vessels and increased interstitial cells without trophoblast proliferation. PMD and fetal hepatic cyst can coexist; however, the relationship between those conditions remains to be elucidated. PMD is associated with adverse pregnancy outcomes but also with a good prognosis. [ABSTRACT FROM AUTHOR]

The rising global incidence of cervical cancer is estimated to have affected more than 600,000 women, and nearly 350,000 women are predicted to have died from the disease in 2020 alone. Novel advances in cancer prevention, screening, diagnosis and treatment have all but reduced the burden of cervical cancer in developed nations. Unfortunately, cervical cancer is still the number one gynecological cancer globally. A limiting factor in managing cervical cancer globally is access to healthcare systems and trained medical personnel. Any methodology or procedure that may simplify or assist cervical cancer screening is desirable. Herein, we assess the use of artificial intelligence (AI)-assisted colposcopy in a tertiary hospital cervical diagnostic pathology unit. The study group consisted of 48 women (mean age 34) who were referred to the clinic for a routine colposcopy by their gynecologist. Cervical images were taken by an EVA-Visualcheck TM colposcope and run through an AI algorithm that gave real-time binary results of the cervical images as being either normal or abnormal. The primary endpoint of the study assessed the AI algorithm's ability to correctly identify histopathology results of CIN2+ as being abnormal. A secondary endpoint was a comparison between the AI algorithm and the clinical assessment results. Overall, we saw lower sensitivity of AI (66.7%; 12/18) compared with the clinical assessment (100%; 18/18), and histopathology results as the gold standard. The positive predictive value (PPV) was comparable between AI (42.9%; 12/28) and the clinical assessment (41.8%; 18/43). The specificity, however, was higher in the AI algorithm (46.7%; 14/30) compared to the clinical assessment (16.7%; 5/30). Comparing the congruence between the AI algorithm and histopathology results showed agreement 54.2% of the time and disagreement 45.8% of the time. A trained colposcopist was in agreement 47.9% and disagreement 52.1% of the time. Assessing these results, there is currently no added benefit of using the AI algorithm as a tool of speeding up diagnosis. However, given the steady improvements in the AI field, we believe that AI-assisted colposcopy may be of use in the future. [ABSTRACT FROM AUTHOR]

A single crystal chemical vapor deposition (scCVD) diamond membrane-based microdosimetric system was used to perform simultaneous measurements of dose profile and microdosimetric spectra with the Y1 proton passive scattering beamline of the Center of Proton Therapy, Institute Curie in Orsay, France. To qualify the performance of the set-up in clinical conditions of hadrontherapy, the dose, dose rate and energy loss pulse-height spectra in a diamond microdosimeter were recorded at multiple points along depth of a water-equivalent plastic phantom. The dose-mean lineal energy ( y ¯ D ) values were computed from experimental data and compared to silicon on insulator (SOI) microdosimeter literature results. In addition, the measured dose profile, pulse height spectra and y ¯ D values were benchmarked with a numerical simulation using TOPAS and Geant4 toolkits. These first clinical tests of a novel system confirm that diamond is a promising candidate for a tissue equivalent, radiation hard, high spatial resolution microdosimeter in beam quality assurance of proton therapy. [ABSTRACT FROM AUTHOR]

Diamond, as a wide band-gap semiconductor material, has the potential to be exploited under a wide range of extreme operating conditions, including those used for radiation detectors. The radiation tolerance of a single-crystal chemical vapor deposition (scCVD) diamond detector was therefore investigated while heating the device to elevated temperatures. In this way, operation under both high-temperature and high-radiation conditions could be tested simultaneously. To selectively introduce damage in small areas of the detector material, a 5 MeV scanning proton microbeam was used as damaging radiation. The charge collection efficiency (CCE) in the damaged areas was monitored using 2 MeV protons and the ion beam induced charge (IBIC) technique, indicating that the CCE decreases with increasing temperature. This decreasing trend saturates in the temperature range of approximately 660 K, after which CCE recovery is observed. These results suggest that the radiation hardness of diamond detectors deteriorates at elevated temperatures, despite the annealing effects that are also observed. It should be noted that the diamond detector investigated herein retained its very good spectroscopic properties even at an operation temperature of 725 K (≈2% for 2 MeV protons). [ABSTRACT FROM AUTHOR]

Hadron therapy is an innovative mode of radiotherapy (RT) for cancer treatment which enables tumor cells to be more effectively destroyed than conventional RT using photons. The precise knowledge of the lineal energy of particles is used in the field of microdosimetry (MKM model) as a fundamental parameter in the prediction of the relative biological efficiency (RBE) of clinical beams. Based on single‐crystal CVD (scCVD) super‐thin diamond membranes obtained using deep Ar/O2 plasma etching, prototypes of solid‐state microdosimeters for lineal energy measurements are produced at the Diamond Sensors Laboratory of CEA‐LIST. The response of a diamond membrane microdosimeter to single projectiles is investigated in ion microbeams. The microdosimeter is irradiated using a raster scanning method and the charge transport properties of the device are determined with sub‐micron precision by measuring the charge collection efficiency (CCE), the μSVs 3D spatial definition and the pulse‐height spectra. A prototype of this novel microdosimeter is then tested in a 100 MeV therapeutic proton beam at the Institute Curie − Proton Therapy Centre in Orsay. All results effectively demonstrate the great potential for this device to be used for studies of the RBE in clinical applications. Active micro‐sensitive volumes (μSVs) of the tested scCVD diamond membrane based microdosimeter. The colored pixels represent detected ion hits (interactions/pixel) during the ion beam induced charge − IBIC − collection study at AIFIRA facility in CENBG, Bordeaux in France. [ABSTRACT FROM AUTHOR]

As well as being a significant source of environmental radiation exposure, α-particles are increasingly considered for use in targeted radiation therapy. A better understanding of α-particle induced damage at the DNA scale can be achieved by following their tracks in real-time in targeted living cells. Focused α-particle microbeams can facilitate this but, due to their low energy (up to a few MeV) and limited range, α-particles detection, delivery, and follow-up observations of radiation-induced damage remain difficult. In this study, we developed a thin Boron-doped Nano-Crystalline Diamond membrane that allows reliable single α-particles detection and single cell irradiation with negligible beam scattering. The radiation-induced responses of single 3 MeV α-particles delivered with focused microbeam are visualized in situ over thirty minutes after irradiation by the accumulation of the GFP-tagged RNF8 protein at DNA damaged sites. [ABSTRACT FROM AUTHOR]

We have used an original approach for diamond detectors where three dimensional buried graphitic electrodes are processed in the bulk of a diamond substrate via laser-induced graphitization. Prototype made of polycrystalline chemical vapor deposition diamond was fabricated using a nanosecond UV laser. Its charge collection efficiency was evaluated using α-particles emitted by a 241-Americium source. An improved charge collection efficiency was measured proving that laser micro-machining of diamond is a valid option for the future fabrication of three dimensional diamond detectors. [ABSTRACT FROM AUTHOR]

We measured the radiation tolerance of commercially available diamonds grown by the Chemical Vapor Deposition process by measuring the charge created by a 120 GeV hadron beam in a 50 μm pitch strip detector fabricated on each diamond sample before and after irradiation. We irradiated one group of samples with 70 MeV protons, a second group of samples with fast reactor neutrons (defined as energy greater than 0.1 MeV), and a third group of samples with 200 MeV pions, in steps, to (8.8±0.9) × 10 15 protons/cm 2 , (1.43±0.14) × 10 16 neutrons/cm 2 , and (6.5±1.4) × 10 14 pions/cm 2 , respectively. By observing the charge induced due to the separation of electron-hole pairs created by the passage of the hadron beam through each sample, on an event-by-event basis, as a function of irradiation fluence, we conclude all datasets can be described by a first-order damage equation and independently calculate the damage constant for 70 MeV protons, fast reactor neutrons, and 200 MeV pions. We find the damage constant for diamond irradiated with 70 MeV protons to be 1.62±0.07(stat)±0.16(syst)× 10 -18 cm 2 /(p μm), the damage constant for diamond irradiated with fast reactor neutrons to be 2.65±0.13(stat)±0.18(syst)× 10 -18 cm 2 /(n μm), and the damage constant for diamond irradiated with 200 MeV pions to be 2.0±0.2(stat)±0.5(syst)× 10 -18 cm 2 /(π μm). The damage constants from this measurement were analyzed together with our previously published 24 GeV proton irradiation and 800 MeV proton irradiation damage constant data to derive the first comprehensive set of relative damage constants for Chemical Vapor Deposition diamond. We find 70 MeV protons are 2.60 ± 0.29 times more damaging than 24 GeV protons, fast reactor neutrons are 4.3 ± 0.4 times more damaging than 24 GeV protons, and 200 MeV pions are 3.2 ± 0.8 more damaging than 24 GeV protons. We also observe the measured data can be described by a universal damage curve for all proton, neutron, and pion irradiations we performed of Chemical Vapor Deposition diamond. Finally, we confirm the spatial uniformity of the collected charge increases with fluence for polycrystalline Chemical Vapor Deposition diamond, and this effect can also be described by a universal curve.

Objectives: Screening with cytology decreases cervical cancer burden, but new methods have emerged. We assessed thediagnostic value of electrical impedance spectroscopy (EIS) in the real-world gynecological setting. The study aimed todetermine the diagnostic usefulness of EIS used as an adjunct to colposcopies in the diagnosis of high-grade squamousintraepithelial lesions in women with abnormal cytology findings., Material and Methods: A cross-sectional, single center, observational study considered 143 women. All were subjected toa colposcopy and EIS with ZedScan. ZedScan-guided or colposcopically-guided biopsies were carried out., Results: Data from 118 women were analyzed. The average age of the included women was 38.29 } 12.52 years (range:22-86 years). Overall, 27 had a diagnosis of CIN2+ and above on histopathological examination, 99 had low-grade colposcopyresults, 18 had high-grade colposcopy results, and 80 had positive ZedScan examination. No adverse events relatedto the examination with ZedScan were observed. EIS used as an adjunct to colposcopies showed sensitivity of 96.30%(95% CI: 81.03-99.91) and specificity of 39.56% (95% CI: 29.46-50.36), and accuracy of 52.54% (95% CI: 43.15-61.81). Theprocedure allowed to detect 11 additional cases with positive histo-pathological result in comparison to colposcopies alone., Conclusions: Colposcopies performed with ZedScan as an adjunct were effective in detecting high-grade cervical lesions.Advantages of ZedScan include real-time result display, no additional diagnostic burden posed on the patient, andgood safety profile. Studies on large patient cohorts are needed for further evaluations of this diagnostic procedure andfactors which may affect its diagnostic accuracy.

The scope of this work was to develop a synthetic single crystal diamond dosimeter (SCDD-Pro) for accurate relative dose measurements of clinical proton beams in water. Monte Carlo simulations were carried out based on the MCNPX code in order to investigate and reduce the dose curve perturbation caused by the SCDD-Pro. In particular, various diamond thicknesses were simulated to evaluate the influence of the active volume thickness (e AV ) as well as the influence of the addition of a front silver resin (250 µm in thickness in front of the diamond crystal) on depth-dose curves. The simulations indicated that the diamond crystal alone, with a small e AV of just 5 µm, already affects the dose at Bragg peak position (Bragg peak dose) by more than 2% with respect to the Bragg peak dose deposited in water. The optimal design that resulted from the Monte Carlo simulations consists of a diamond crystal of 1 mm in width and 150 µm in thickness with the front silver resin, enclosed by a water-equivalent packaging. This design leads to a deviation between the Bragg peak dose from the full detector modeling and the Bragg peak dose deposited in water of less than 1.2%. Based on those optimizations, an SCDD-Pro prototype was built and evaluated in broad passive scattering proton beams. The experimental evaluation led to probed SCDD-Pro repeatability, dose rate dependence and linearity, that were better than 0.2%, 0.4% (in the 1.0-5.5 Gy min -1 range) and 0.4% (for dose higher than 0.05 Gy), respectively. The depth-dose curves in the 90-160 MeV energy range, measured with the SCDD-Pro without applying any correction, were in good agreement with those measured using a commercial IBA PPC05 plane-parallel ionization chamber, differing by less than 1.6%. The experimental results confirmed that this SCDD-Pro is suitable for measurements with standard electrometers and that the depth-dose curve perturbation is negligible, with no energy dependence and no significant dose rate dependence.

Objective: Infertility problem affects more than 70 million couples worldwide, 5-15% of which are couples in their reproductive age. Less and less invasive endoscopic methods like transvaginal hydrolaparoscopy have been developed by technological progress. This method enables not only precise identification, but is now increasingly used for treatment of tubal and peritoneal factor pathology, which cause approximately 35 per cent of female infertility., Aim: Evaluation of transvaginal hydrolaparoscopy (HLTV) usefulness for diagnosis of tubal infertility comparing to standard laparoscopy and hysterosalpingography (HSG)., Results: In evaluation of patent fallopian tubes results of HLTV and HSG examinations are coincide in 87%, while obstruction diagnosed in HSG is confirmed only in 37% during HLTV examination. Transvaginal hydrolaparoscopy and HSG have similar sensitivity and specificity in diagnosis of hydrosalpinx, which is up to 100% . In comparison with HLTV histerosalpingography is less effective in evaluation of peritubal dilatations and adhesions. Both laparoscopic surgery and transvaginal laparoscopy have the same high sensitivity in diagnostics of the fallopian tubes patency and hydrosalpinx, which is up to 100%. In evaluation of peritubal adhesions and dilatations the results are very similar., Conclusions: 1. HLTV is a highly useful method in evaluation of the fallopian tubes pathologies which is significantly more sensitive than HSG in evaluation of such lesions as peritubal adhesions and obstructed fallopian tubes. 2. HLTV is as effective as laparoscopy in evaluation of patency and lesions of the fallopian tubes. 3. HLTV is a less invasive method, much better tolerated than laparoscopy and more suitable for the group of overweight patients. 4. Final assessment of HTLV technique will be possible following performance of a greater number of studies, where the foregoing conclusions present only initial observations.

Background: Most authors agree that the twin pregnancies have a higher risk of complications compared to singleton pregnancies. However, there is no unanimity as to whether the risk of complications in twin pregnancies resulting from in vitro fertilization is higher than in twin pregnancies resulting from spontaneous conception., Objective: The aim of this study was to estimate the frequency rates of complications in the second and third trimester of dichorionic-diamniotic twin pregnancies resulting from IVF (group I) compared to dichorionic-diamniotic and monochorionic-diamniotic twin pregnancies resulting from spontaneous conception (group II and III)., Results: The rate of cesarean section and cervical cerclage was significantly higher in the group I. Polyhydramnios occurred less frequently in group I than in group III. The discordant growth of fetuses occurred significantly more frequently in the group I. The frequency of other complications did not differ in the studied groups. The Apgar score was similar in the group I and II but significantly lower in the group III compared to the group I., Conclusions: 1) The frequency of complications in twin pregnancies after IVF is similar to those in the twin pregnancies conceived spontaneously. 2) In the twin pregnancies after IVF it is necessary to expect only a higher frequency of caesarean sections, cervical incompetence and a discordant growth of the twins when comparing with twin pregnancies conceived spontaneously. 3) In the twin pregnancies after IVF the intrauterine fetal demise and polyhydramnios occurred less frequently than in monochorionic-diamniotic pregnancies after spontaneous conception.

Objective: The aim of this study was to determine the characteristic features of the umbilical cord morphology in selected cases of intrauterine growth restriction (IUGR): tobacco smoking, pregnancy-induced hypertension and idiopathic IUGR., Materials and Methods: 136 pregnant women were included in the study - 86 patients with IUGR (IUGR group) and 50 women with uncomplicated course of pregnancy (control group). In the IUGR group 31 women were smokers, 27 suffered from pregnancy-induced hypertension, and 28 had an unknown reason for IUGR. Each of them underwent ultrasound examination to measure fetal growth and to assess morphological parameters of the umbilical cord., Results: Significant differences between the control group and the whole IUGR group in terms of the diameter of the umbilical cord and diameter of the umbilical vein - smaller diameters in the IUGR group than in the control group. Significant differences among IUGR subgroups in terms of area of Wharton's jelly and diameters of the umbilical cord, vein and artery. Significant difference in the length of the uncoiled section among the IUGR subgroups., Conclusions: 1. The umbilical cord in IUGR and concomitant tobacco smoking is hyper-coiled with coiling index independent of fetal weight and high content of Wharton's jelly. 2. The umbilical cord in IUGR and concomitant pregnancy-induced hypertension is thinnest with thinnest vessels and the smallest content of Wharton's jelly. 3. The assessment of umbilical cord morphology should become an integral part of ultrasound exam in pregnancies complicated by IUGR.

Background: Nonimmune hydrops fetalis (NHF) is an abnormal accumulation of fluid - especially serous - in visceral cavities and soft tissues. This condition may be caused by: cardiovascular diseases, chromosomal disorders, infections, lung, stomach, intestinal, kidneys, urinary tract and blood diseases, metabolic disorders and tumors. NHF may by diagnosed by an ultrasound scan. THE AIM of the study was to present diagnostic and therapeutic difficulties as well as management with reference to NHF., Case Study: An abnormal accumulation of fluid in visceral cavities and subcutaneous tissue of two fetuses was diagnosed by an ultrasound scan. Despite a detailed and specific diagnostic proceeding which included: infections, congenital malformations, chromosomal abnormalities etc. it was impossible to establish the cause of NHF. The symptomatic therapy was performed: periodic cordocentesis with an injection of human albumin solutions. In case of the first fetus therapeutic thoracocentesis was performed. The fetuses were delivered in 32nd and 31st week of pregnancy. Both neonates survived but even after the delivery it was impossible to establish the cause of NHF., Conclusions: Multidirectional diagnostic approach is essential for the implementation of causal treatment of NHF. In case of idiopathic NHF the only management is symptomatic therapy, fetal monitoring and preterm delivery.

A 20 year old primigravida with a double uterus was admitted with a viable fetus in the right uterus and pus oozing from the left one. Management consisted of a regimen of intravenous antibiotics and intravaginal antibiotic tablets. Tocolysis was used to arrest imminent preterm labor. In the course of pregnancy IUGR was diagnosed. At 38 weeks of pregnancy a SGA baby boy of 2,440 g was delivered by cesarean section. The mother and the baby were discharged from the hospital in good general condition.

We present a case of a pregnancy in a 24 year old woman who was born with ectopia vesicae, split pelvis and hypoplasia of ischial bones. From childhood to adulthood she had undergone reconstructive surgeries of the abdomen and perineum, as well as urine diversion surgery. During pregnancy she experienced recurrent urinary tract infections which were treated with antibiotics. In spite of tocolysis, she delivered by cesarean section a premature baby boy at 35th week of gestation due to premature uterine contractions. The postoperative period was uneventful and they were discharged from the hospital in a good general condition.