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Conclusions The RPI seems a valuable anatomic landmark to define normal kidneys position on a coronal view in the first trimester (figure 1A). To define the normal position of fetal kidneys at 1st trimester. [Extracted from the article]

Objectives: To evaluate the role of the cervical sliding sign (CSS) in the prediction of the outcome of induction of labor (IOL)., Study Design: Two-center prospective observational cohort study involving a non-consecutive series of uncomplicated singleton term pregnancies, planned for IOL, with a fetus in cephalic presentation and unfavorable cervix as defined by a Bishop score ≤ 6. The Bishop score was evaluated by transvaginal digital examination and the cervical length and CSS by transvaginal ultrasound. The presence of CSS was defined as the sliding of the anterior cervical lip on the posterior one under gentle pressure of the transvaginal probe. The primary outcome of the study was successful vaginal delivery within 24 h. The secondary outcome was the induction-to-active-labor time. The interobserver agreement for the CSS was also evaluated., Results: Over a period of 12 months, 179 women were included. The CSS was found in 86 (48.0 %) patients and was associated with an increased likelihood of vaginal delivery within 24 h (60/86 or 69.8 % vs 27/93 or 29.0 %, P < 0.001) and a shorter induction-to-active-labor time (954 ± 618 min vs 1416 ± 660 min, P < 0.001). Multivariable regression analysis showed that the CSS was an independent predictor of vaginal delivery within 24 h (aOR 5.37, 95 % CI 2.26-12.75) and shorter induction-to-active-labor time interval (HR 1.81, 95 % CI 1.19-2.74). The interobserver variability based on intraclass correlation coefficient for the CSS was excellent (ICC = 0.90)., Conclusion: In women undergoing IOL with an unfavorable cervix, the CSS is associated with a higher frequency of vaginal delivery within 24 h and a shorter induction-to-active-labor time., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

Introduction: A baseline fetal heart rate between 110 and 160 bpm is considered normal. However, among normal fetuses the average baseline heart rate has been shown to diminish progressively and the 90th centile of the fetal heart rate at 40 weeks of gestation has been consistently found at around 150 bpm. The aim of our study was to assess the labor and neonatal outcome of fetuses at 40 gestational weeks or beyond, whose intrapartum baseline fetal heart rate was between 150 and 160 bpm., Material and Methods: Retrospective cohort study including singleton pregnancies with spontaneous onset of labor, gestational age between 40 +0 and 42 +0 weeks, category I CTG trace according to the FIGO guidelines 2015 with baseline fetal heart rate between 110 and 160 bpm during the first 60 minutes of active labor. Exclusion criteria were maternal hyperpyrexia at admission, fetal arrhythmias, maternal tachycardia (>110 bpm) and uterine tachysystole (>5 contractions/10 minutes). The following outcomes were compared between fetuses with a baseline ranging between 110 and 149 bpm and those with a baseline ranging between 150 and 160 bpm: incidence of meconium-stained amniotic fluid, intrapartum hyperpyrexia, mode of delivery, Apgar at 5 minutes <7, arterial pH <7.1 and Neonatal Intensive Care Unit admission, incidence of a composite adverse neonatal outcome., Results: In all, 1004 CTG traces were included in the analysis, 860 in Group 110-149 bpm and 144 in Group 150-160 bpm. Group 150-160 bpm had a significantly higher incidence of meconium-stained amniotic fluid (odds ratio [OR] 2.6; 95% CI 1.8-3.8), maternal intrapartum hyperpyrexia (OR 4.7; 95% CI 1.1-14.6), urgent/emergent cesarean section for suspected fetal distress (OR 13.4; 95% CI 3.3-54.3), Apgar <7 at 5th min (OR 9.13; 95% CI 1.5-55.1) and neonatal acidemia (OR 3.5; 95% CI 1.5-55.1). Logistic regression including adjustiing for potential confounders showed that fetal heart rate between 150 and 160 bpm is an independent predictor of meconium-stained amniotic fluid (adjusted odds ratio [aOR] 2.2; 95% CI 1.5-3.3), cesarean section during labor for fetal distress (aOR 10.7; 95% CI 2.9-44.6), neonatal acidemia (aOR 2.6; 95% CI 1.1-6.7) and adverse composite neonatal outcome (aOR 2.6; 95% CI 1.2-5.6)., Conclusions: In fetuses at 40 weeks or beyond, an intrapartum fetal heart rate baseline ranging between 150 and 160 bpm seems associated with a higher incidence of labor complications., (© 2020 Nordic Federation of Societies of Obstetrics and Gynecology.)

Telling about emotionally significant events is a basic activity in human relationships and plays an integral role in the process of psychotherapy, in film and literature, and in other contexts where emotional experiences are shared using language. Bringing events and images to mind activates feelings anew; talking about them may further activate and perhaps alter the experiences as registered in the speaker's memory. We review the results of five studies where participants were asked to bring an emotionally significant event to mind and report how they felt at the time (time 1); report how they feel now in the moment of thinking about it (time 2); tell about the event, and report how they felt after telling (time 3). Overall, we see a pattern whereby participants' ratings of emotional intensity are high at time 1, lower at time 2 and high again at time 3. Most participants reported some change in the characterization of their emotions after describing the event, e.g. angry to neutral, and a smaller proportion reported more marked changes e.g. happy to sad. Language style indicating the presence of a referential process was shown to be moderately related to change in characterization of emotion in two of the three studies in which language measures were applied. In combination the studies suggest that change in emotional characterization comes about in the context of the referential process associated with an increase in reflection. Revisions of the paradigm in future research are discussed.

The regulation of integrins expressed on leukocytes must be controlled precisely, and members of different integrin subfamilies have to act in concert to ensure the proper traffic of immune cells to sites of inflammation. The activation of β2 family integrins through the T cell receptor or by chemokines leads to the inactivation of very late antigen 4. The mechanism(s) of this cross-talk has not been known. We have now elucidated in detail how the signals are transmitted from leukocyte function-associated antigen 1 and show that, after its activation, the signaling involves specific phosphorylations of β2 integrin followed by interactions with cytoplasmic signaling proteins. This results in loss of β1 phosphorylation and a decrease in very late antigen 4 binding to its ligand vascular cell adhesion molecule 1. Our results show how a member of one integrin family regulates the activity of another integrin. This is important for the understanding of integrin-mediated processes., (© 2014 by The American Society for Biochemistry and Molecular Biology, Inc.)

Natural killer (NK) cells and dendritic cells (DCs) are two distinct cell types of innate immunity. It is known that the in vitro interaction of human NK cells with autologous DCs results in DC lysis. Here we show that contact-dependent interactions between activated human NK cells and immature DCs (iDCs) provides a "control switch" for the immune system. At low NK/DC ratios, this interaction dramatically amplifies DC responses, whereas at high ratios it completely turns off their responses. Specifically, culture of activated human NK cells with iDCs, at low NK/DC ratios (1:5), led to exponential increases in DC cytokine production, which were completely dependent on cell-to-cell contact. DC maturation was also driven by cognate interactions with NK cells and maturation was dependent on endogenously produced TNF-alpha in the culture. At slightly higher NK/DC ratios (5:1), inhibition of DC functions was the dominant feature due to potent killing by the autologous NK cells. Resting NK cells also stimulated autologous DC maturation in a TNF-alpha/contact-dependent manner, however, increasing the NK/DC ratio only led to an enhancement of this effect.

The fetal prognosis in pregnancy in a diabetic woman depends mainly on the blood sugar equilibrium of the mother that can be obtained, since the normal range lessens the chances of fetal abnormalities. This has been demonstrated in this series, since a system that uses the continuous automatic administration of insulin has been used. Six diabetic women were treated with continuous subcutaneous perfusion of insulin in the second half of pregnancy. The quality of the maternal blood sugar equilibrium has been proved by the normal values of glycosylated haemoglobin and the values of venous blood sugar which were always within the mean of the normal range. The tolerance of the technique is excellent (83 days in mean without a single complication). In 4 out of the 6 cases the baby was born at the 38th week of pregnancy and studies show that there was no increase in weight and a very low level of neonatal hypoglycaemia. It seems desirable to use this kind of insulin therapy which should help to contribute to a better fetal prognosis in diabetic pregnancies.