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Introduction: Persistent pelvic pain is a prevalent condition that negatively impacts one's physical, psychological, social, and sexual wellbeing. Pain science education (PSE) involves learning about the biology of pain and is commonly integrated into the management of persistent pain. However, PSE is yet to be thoroughly investigated for persistent pelvic pain potentially due to the lack of targeted curricula, including learning concepts. The aim of this study was to gain consensus on PSE learning concepts important for persistent pelvic pain according to expert clinicians., Methods: A three-round e-Delphi survey was conducted to generate and gain consensus on important PSE learning concepts for female persistent pelvic pain among 20 international, multidisciplinary expert clinicians (e.g., physiotherapists, gynaecologists, psychologists). Learning concepts generated by clinicians were rated by importance using a six-point Likert scale. Consensus on importance rating was considered reached for items with an IQR <1.0., Results: The expert clinicians generated 125 PSE learning concepts that were considered important for persistent pelvic pain; 92 (73.6%) learning concepts reached consensus on their importance rating. Of the 125 learning concepts, 102 were generated for persistent pelvic pain in general, and were categorised into 13 overarching PSE concepts (e.g., persistent pelvic pain involves changes to the brain and nervous system). Sixteen PSE concepts were generated for specific pelvic pain conditions (e.g., endometriosis) and seven concepts for specific life stages (e.g., adolescence)., Discussion: This study provides the first list of key PSE concepts tailored for persistent pelvic pain developed by expert clinicians. These concepts provide a framework for developing and implementing PSE curricula for persistent pelvic pain in research and clinical settings., Competing Interests: AM has received speaker fees for lectures on pelvic pain. Professional bodies have reimbursed her for travel costs related to presentation of research on pelvic pain at scientific conferences. HL has received speaker fees for talks on pain. RP receives payment for lectures on pain and rehabilitation. Professional bodies have reimbursed her for travel costs related to presentation of research at scientific conferences and meetings. RP is a director of the Train Pain Academy, a not-for-profit educational organisation. GM has led a research program developing, testing, and implementing pain science education programs. Professional and scientific bodies have reimbursed him for travel costs related to presentations of research on pain education at scientific conferences/symposia. He has received speaker fees for lectures on pain and rehabilitation. He receives book royalties from NOIgroup publications, Dancing Giraffe Press & OPTP, for books on pain education. He has received support from: Institutes of Health, California; AIA Australia; Reality Health' Connect Health UK; Kaiser Permanente. KC has received speaker fees for lectures on physiotherapy and pain. Professional bodies have reimbursed her for travel costs related to presentations of research on physiotherapy and pain at scientific congresses. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2025 Mardon, Leake, Wilson, Karran, Parker, Malani, Moseley and Chalmers.)

Abstract: Physiotherapists are critically positioned to integrate education into patient care, including pain science education (PSE) to enhance management and outcomes. Anecdotally, many physiotherapists report difficulty providing PSE in private practice settings. Here, we aimed to explore current PSE use, knowledge, and barriers to implementation. A nationwide online (Qualtrics) survey of PSE-trained Australian private practice physiotherapists assessed use, knowledge (revised Neurophysiology of Pain Questionnaire [rNPQ]), concept application, implementation barriers, and resource awareness/use/preferences, exploring associations with individual/clinic-level factors (clinical experience, PSE training, work location). A total of 278 physiotherapists (62.9% female, 39.4 [11.8] years, 15.2 [11.6] years of experience, 37.2% rural/remote) completed the survey. Pain science knowledge (rNPQ: mean 10.4 [2.2]/13) and perceived PSE competence was high, although 30% supported inaccurate PSE concepts. Pain science education training via professional development course was associated with higher knowledge relative to university training (multivariable; β = 1.337, P < 0.001). Physiotherapists reported providing PSE to 61% of patients, with patient-related barriers (expecting other treatments: 94%; previous negative/contradictory PSE experiences: 89%), clinic-level barriers (time constraints: 77%; insufficient billing schedules: 57%), and clinician-specific barriers (difficulties identifying/addressing patient maladaptive beliefs/behaviours: 53%; cultural/demographic translation challenges: 46%) reported. Fewer years of clinical experience was associated with heightened worry that providing PSE might go wrong (multivariable; β = -0.034, P = 0.010) and/or damage therapeutic relationships (multivariable; β = -0.049, P < 0.001). Physiotherapists were aware of over 100 PSE resources, with varying levels of perceived use/effectiveness, yet were largely unaware of educational strategies. Physiotherapists called for reduced complexity and greater ability to individualise PSE resources. Findings will guide improvements in PSE training/resources, to maximise physiotherapists' confidence and preparedness to effectively implement PSE., (Copyright © 2025 International Association for the Study of Pain.)

Abstract: This systematic review and meta-analysis critically examined the evidence for peer support interventions to reduce pain and improve health outcomes in community-dwelling adults with chronic musculoskeletal pain (PROSPERO CRD42022356850). A systematic search (inception-January 2023) of electronic databases and grey literature was undertaken to identify relevant randomised controlled trials, with risk of bias and GRADE assessments performed on included studies. Meta-analyses used a generic, inverse-variance, random-effects model, calculating mean difference (MD) or standardised mean difference (SMD). Of 16,445 records identified, 29 records reporting on 24 studies (n = 6202 participants) were included. All evidence had unclear/high risk of bias and low-very low certainty. Peer support interventions resulted in small improvements in pain (medium-term: MD -3.48, 95% CI -6.61, -0.35; long-term: MD -1.97, 95% CI -3.53, -0.42), self-efficacy (medium-term: SMD 0.26, 95% CI 0.16, 0.36; long-term: SMD 0.21, 95% CI 0.07, 0.36), and function (long-term: SMD -0.10, 95% CI -0.19, -0.00) relative to usual care and greater self-efficacy (medium-term: SMD 0.36, 95% CI 0.20, 0.51) relative to waitlist control. Peer support interventions resulted in similar improvement as active (health professional led) interventions bar long-term self-efficacy (MD -0.41, 95% CI -0.77, -0.05), which favoured active interventions. No point estimates reached minimal clinically important difference thresholds. Pooled health service utilisation outcomes showed unclear estimates. Self-management, quality of life, and social support outcomes had mixed evidence. Despite low-very low evidence certainty, peer support interventions demonstrated small improvements over usual care and waitlist controls for some clinical outcomes, suggesting that peer support may be useful as an adjunct to other treatments for musculoskeletal pain., (Copyright © 2024 International Association for the Study of Pain.)

Importance: The pivotal approval trial for a smooth, highly cohesive, viscous, 20-mg/mL hyaluronic acid filler demonstrated sustained aesthetic improvement, with a mean injection volume of 6.65 mL. In daily practice, however, it is not often practical or necessary to use large injection volumes to achieve the desired cosmetic outcome., Objective: To assess the efficacy, longevity, and patient satisfaction associated with correction of age-related midface volume loss using the low volumes of hyaluronic acid filler more commonly used in day-to-day practice., Design, Setting, and Participants: A 2-center, retrospective cohort study examined medical records of 61 healthy patients who underwent treatment for facial volume loss with hyaluronic acid filler from November 1, 2013, through April 31, 2014. Follow-up visits were conducted at 1, 3, 6, and 12 months after the procedure. Data were pooled from a private facial plastic surgery practice in Weston, Florida, and a private cosmetic dermatology practice in San Diego, California., Interventions: Patients were treated with hyaluronic acid filler according to the investigator's usual practices., Main Outcomes and Measures: The main outcome measure was patient-graded Global Aesthetic Improvement Scale scores at 1, 3, 6, and 12 months after treatment. Scores range from 1 to 5; 1 indicates very much improved and 5, worse., Results: A total of 61 consecutive, healthy adult patients (mean [SD] age, 57.4 [12.8] years) with mild to severe facial volume loss were enrolled in the study. A total of 46 patients (75%) were white, 3 (5%) were black/African American, 9 (15%) were Hispanic/Latino, 1 (2%) was Asian/Pacific Islander, and 2 (3%) were other. Three patients (5%) were male, and 58 (95%) were female. Mean initial treatment volume was 1.6 mL. At follow-up, 29 patients (48%) elected to have a touch-up treatment; mean total touch-up volume was 1.4 mL. The patient-graded Global Aesthetic Improvement Scale scores at 1, 3, 6, and 12 months after treatment demonstrated that 73% (41 of 56) to 89% (24 of 27) of the study patients reported being very much or moderately improved. Most patients were rated by investigators on the Global Aesthetic Improvement Scale as very much or moderately improved at the 12-month follow-up. At 12 months after the procedure, 43 of 51 patients (84%) reported satisfaction with their outcome. At all time points, most patients would elect to undergo the procedure again (range, 17 [68%] to 61 [100%]). Adverse events were mild, and all resolved spontaneously within 14 days. At the 2-year follow-up, there were no reports of delayed adverse events., Conclusions and Relevance: Midface volumization using the low volumes of hyaluronic acid filler more commonly used in daily clinical practice is effective and well tolerated., Level of Evidence: 3.

DETECHIP has been used in testing analytes including caffeine, cocaine, and tetrahydrocannabinol (THC) from marijuana, as well as date rape and club drugs such as flunitrazepam, gamma-hydroxybutyric acid (GHB), and methamphetamine. This study investigates the intermolecular interaction between DETECHIP sensor eosin Y (DC1) and the analyte (caffeine) that is responsible for the fluorescence and color changes observed in the actual array. Using 1 H-NMR, 1 H-COSY, and 1 H-DOSY NMR methods, a proton exchange from C-8 of caffeine to eosin Y is proposed.

Background: Novel, blue fluorescent solids referred to as Wild Plum compounds can camouflage skin imperfections when incorporated into cosmetic products. We evaluated the relationship between sun exposure and skin fluorescence and determined if the application of Wild Plum formulations could restore lost fluorescence without harming the skin., Methods: The forehead skin of two groups of volunteers of mixed gender and age was examined for fluorescence and redness. In addition, subjects answered questions describing any adverse sensations they experienced after their skin was exposed to Wild Plum formulations for extended periods of time., Results: Fluorescence measurements of both solar and non-solar skin indicated that repeated sun exposure causes a loss of skin fluorescence. Application of Wild Plum formulations caused an increase in skin fluorescence at all concentrations, restoring solar skin fluorescence to values well beyond that of non-solar skin. Photo analysis and interview questions indicated that these formulations did not cause any symptoms of irritancy., Conclusion: Wild Plum compounds have the ability to restore fluorescence of solar skin to a level significantly higher than that associated with non-solar skin. Skin appears more luminous and therefore more youthful. This fluorescence restoration is achieved at relatively low concentrations, without any harmful side effects., (© 2012 John Wiley & Sons A/S.)

DETECHIP ® is a molecular sensing array used for identification of a large variety of substances. Previous methodology for the analysis of DETECHIP ® used human vision to distinguish color changes induced by the presence of the analyte of interest. This paper describes several analysis techniques using digital images of DETECHIP ® . Both a digital camera and flatbed desktop photo scanner were used to obtain Jpeg images. Color information within these digital images was obtained through the measurement of red-green-blue (RGB) values using software such as GIMP, Photoshop and ImageJ. Several different techniques were used to evaluate these color changes. It was determined that the flatbed scanner produced in the clearest and more reproducible images. Furthermore, codes obtained using a macro written for use within ImageJ showed improved consistency versus pervious methods.

DETECHIP ® is a novel molecular sensing array being developed for the detection and identification of a variety of compounds including controlled substances. This easy to use technology has the ability to produce a unique identifying binary code for each substance tested. Original analysis methodology relied on human vision to classify color and fluorescence changes within the array. New digital color image analysis techniques using red-green-blue (RGB) color values provided a higher degree of specificity and greater consistency. This image analysis technique was able to detect more subtle changes in color and was therefore able to properly discriminate between substances that previously produced identical codes. This technique was also expanded to analyze changes in RGB color values individually, increasing the length of the code to 48 digits and therefore potentially providing a further increase in specificity. To show the applicability of this new method, a blind study was performed, correctly identifying two unknown analytes.

Small population size, genetic diversity, and spatial patterns of vegetative spread are important aspects to consider when managing populations of rare clonal plant species. We used 5 variable nuclear simple sequence repeat nDNA loci to determine the extent of genet rhizome spread, examine the possibility of very small population sizes, and project how Bombus spp. (bumblebee) foraging may impact selfing (through geitonogamy) for a threatened lupine (Lupinus oreganus Heller) that sprawls through nonadventitious rhizomes. Genotyping identified 1 genet (27 × 13 m) that dominated about 30% of a study site, whereas 15 genets spread a maximum average distance of about 5.5 m (range 1.6 -27.1 m) and appeared to be well integrated with intervening genets. We found unexpectedly high genotype diversity, no evidence of a recent genetic bottleneck, and 5 of 6 patches had mean fixation index values that were near Hardy-Weinberg Equilibrium expectations. If the median maximum Bombus foraging distance observed in lupine patches (1.2 m) occurred within genotyped populations, a typical foraging flight would have >80% chance of occurring between different genets. Our study demonstrates that inferences associated with clonality, small population size, and inbreeding depression should be directly evaluated for rare vegetatively spreading plants.

A novel compound named Wild Plum fluoresces blue, and has been synthesized to camouflage skin imperfections, addressing the market demand for an anti-aging product. Wild Plum imparts optical brightness and fluorescence and can be used as an ingredient in cosmetic formulations. Skin appearance before and after application of Wild Plum compounds demonstrated an improved appearance of skin including a decreased number of wrinkles. When added to makeup, lotions, creams, and powders, Wild Plum conveys the glow of healthy youthful skin, replacing other costly or invasive alternatives such as cosmetic surgery.

Using exciton-coupled circular dichroism (ECCD) spectroscopy, our lab was able to differentiate between the two enantiomers of methamphetamine using a commercially available porphyrin tweezer as an achiral host. The host-guest complex formed with (+)-(S)-methamphetamine produced a negative bisignate-shaped ECCD spectrum, whereas the complex formed with (-)-(R)-methamphetamine produced a positive one. This sensitive technique could serve as an alternative method for the enantiodiscrimination of chiral methamphetamine, a commonly abused drug in the United States., (2009 Wiley-Liss, Inc.)

The design and preliminary characterization of a novel sensor for drugs of abuse, DETECHIP, is described in this proof-of-concept note. Combining both colorimetric and fluorimetric assays, DETECHIP is suitable for lab and field use. More than a conventional spot test which provides a single "yes or no" answer, DETECHIP provides twenty responses for a more complete characterization of suspect material. This is accomplished by visually noting colorimetric and fluorescent changes of carefully selected dyes upon the addition of test analytes, including drugs of abuse, with respect to controls. Color and fluorescence changes are recorded numerically so that a 20 digit identification code can be constructed for comparison of test analytes and known compounds. DETECHIP is applicable to a variety of drugs, both plant-derived and synthetic, addressing the need to use several different spot tests simultaneously for a single sample.

Newly discovered fossil fish material from the Cretaceous Dinosaur Park Formation of Alberta, Canada, documents the presence of a tropical fish in this northern area about 75 million years ago (Ma). The living relatives of this fossil fish, members of the Characiformes including the piranha and neon tetras, are restricted to tropical and subtropical regions, being limited in their distribution by colder temperatures. Although characiform fossils are known from Cretaceous through to Cenozoic deposits, none has been reported previously from North America. The modern distribution of characiforms in Mexico and southern Texas in the southernmost United States is believed to have been the result of a relatively recent colonization less than 12 Ma. The new Canadian fossils document the presence of these fish in North America in the Late Cretaceous, a time of significantly warmer global temperatures than now. Global cooling after this time apparently extirpated them from the northern areas and these fishes only survived in more southern climes. The lack of early Cenozoic characiform fossils in North America suggests that marine barriers prevented recolonization during warmer times, unlike in Europe where Eocene characiform fossils occur during times of global warmth.

The steroid hormone aldosterone maintains sodium homeostasis and is therefore important in the control of blood volume and pressure. Angiotensin II (AngII) and elevated extracellular potassium concentrations ([K(+)](e)), the prime physiologic regulators of aldosterone secretion from adrenal glomerulosa cells, activate phospholipase D (PLD) in these cells. The role of Ca(2+) in the activation by these agents is unknown, although nitrendipine, a voltage-dependent Ca(2+) channel antagonist, does not inhibit AngII-elicited PLD activation, despite the fact that this compound blocked elevated [K(+)](e)-stimulated PLD activity. PLD activation triggered by AngII was also unaffected by the T-type calcium channel inhibitor nickel. Nevertheless, Ca(2+) influx was required for AngII-induced PLD activation in both primary cultures of bovine adrenal glomerulosa cells and a glomerulosa cell model, the NCI H295R adrenocortical carcinoma cell line. The involvement of store-operated Ca(2+) (SOC) influx and Ca(2+) release-activated Ca(2+) (CRAC) influx pathways in PLD activation was investigated using thapsigargin, an endoplasmic reticulum Ca(2+) pump inhibitor that empties the store to induce SOC influx, and the SOC inhibitor YM-58483 (BTP2), as well as a CRAC inhibitor, tyrphostin A9. In bovine glomerulosa cells, tyrphostin A9 inhibited AngII-induced PLD activation without affecting elevated [K(+)](e)-stimulated enzyme activity. On the other hand, differences were observed between the bovine adrenal glomerulosa and H295R cells in the involvement of Ca(2+) influx pathways in PLD activation, with the involvement of the SOC pathway suggested in the H295R cells. In summary, our results indicate that Ca(2+) entry only through certain Ca(2+) influx pathways is linked to PLD activation.

The first step in steroidogenesis is cholesterol mobilization from cytosolic lipid droplets to the initiating rate-limiting enzyme complex located on the inner mitochondrial membrane. Angiotensin II (AngII), the primary agonist of aldosterone secretion from adrenal glomerulosa cells, is known to induce cholesterol mobilization to mitochondria. However, the role of the protein kinase C (PKC) pathway in mediating cholesterol mobilization is unknown. To determine PKC's involvement, human adrenocortical carcinoma cells were incubated with or without PKC-activating phorbol 12-myristate 13-acetate (PMA) and mitochondrial cholesterol content assayed. Like AngII, PMA significantly elevated mitochondrial cholesterol content as well as aldosterone secretion. Thus, PKC may play a role in cholesterol mobilization to mitochondria and hence steroid production. Atrial natriuretic peptide (ANP) inhibited both AngII- and PMA-stimulated mitochondrial cholesterol content. These findings suggest that the ability of ANP to inhibit steroidogenesis induced by multiple agents may be related to its capacity to reduce cholesterol mobilization.

After dispersal, seeds can germinate and establish as seedlings, persist as seeds, or die. Knowledge of these three seed fates is crucial for understanding the abundance and distribution of plant populations and ultimately, community composition and diversity. Few studies, however, have simultaneously measured these fates, while also examining the factors causing mortality. The goal of this research was to simultaneously quantify the three seed fates and factors causing death (predation and fungal disease) for four species found in prairies in western Oregon, USA. The most common seed fate for the four study species was death (44-80%). Fungal disease, which has seldom been quantified in natural ecosystems, generally caused less than 10% mortality for each of the four species. Vertebrate predation substantially reduced seed numbers only for Bromus carinatus (21%). Of the unmeasured mortality factors, indirect evidence showed invertebrate predation was a cause of death for seeds of only one species, Prunella vulgaris. In addition, competitive pressures caused seedling death for only the two grass species, Bromus carinatus and Cynosurus echinatus. Survival as established seedlings was generally much more common than survival as persistent seed, with the exception of Daucus carota, in which 14% of the sown seeds persisted the first year.

Poly(ADP-ribose) polymerase (PARP) (EC 2.4.2.30), the only enzyme known to synthesize ADP-ribose polymers from NAD+, is activated in response to DNA strand breaks and functions in the maintenance of genomic integrity. Mice homozygous for a disrupted gene encoding PARP are viable but have severe sensitivity to gamma-radiation and alkylating agents. We demonstrate here that both 3T3 and primary embryo cells derived from PARP-/- mice synthesized ADP-ribose polymers following treatment with the DNA-damaging agent, N-methyl-N'-nitro-N-nitrosoguanidine, despite the fact that no PARP protein was detected in these cells. ADP-ribose polymers isolated from PARP-/- cells were indistinguishable from that of PARP+/+ cells by several criteria. First, they bound to a boronate resin selective for ADP-ribose polymers. Second, treatment of polymers with snake venom phosphodiesterase and alkaline phosphatase yielded ribosyladenosine, a nucleoside diagnostic for the unique ribosyl-ribosyl linkages of ADP-ribose polymers. Third, they were digested by treatment with recombinant poly(ADP-ribose) glycohydrolase, an enzyme highly specific for ADP-ribose polymers. Collectively, these data demonstrate that ADP-ribose polymers are formed in PARP-/- cells in a DNA damage-dependent manner. Because the PARP gene has been disrupted, these results suggest the presence of a previously unreported activity capable of synthesizing ADP-ribose polymers in PARP-/- cells.

Because Pseudotsuga menziesii (Douglas fir), an early seral dominant in western Oregon forests, is particularly susceptible to the pathogenic root rot caused by the fungus Phellinus weirii, it was hypothesized that successional development in affected forests would be accelerated. The basal area of late successional tree species and common shrubs were compared inside and outside Phellinus weirii"infection centers". Future successional impacts indirectly caused by disease presence were assessed by comparing the abundance of regenerating tree species inside and outside of these centers. Results for old-growth sites in the lower Cascades supported the initial hypothesis. The presence of Phellinus weirii at these sites appears to push changes in the late successional species basal area along the same trajectory. At the Coast Range sites, however, shrub growth was greatly enhanced rather than the growth of Tsuga heterophylla (western hemlock), the only late successional tree species at these sites. Regeneration of trees was sparse in all areas and was negatively correlated with the basal area of existing western hemlock, and not directly correlated with the presence of the pathogen. However, because the basal area of western hemlock is influenced by the presence of disease in the Cascade sites, Phellinus weirii may be an influential indirect factor in the future successional direction of the sites. This study demonstrates the potential importance of native pathogens in determining the successional status of a community, as well as the importance of such biotic agents in the physical structure of multi-strata forested communities as a whole.

Intrauterine growth retardation, a major source of fetal/infant morbidity and mortality, remains difficult to detect reliably before birth. In a previous study from our laboratory, determination of the presence of phosphatidylglycerol (PG) in amniotic fluid was found to be potentially useful for separating the growth-retarded fetus from the appropriately grown fetus of similar size. In the current study, this finding was confirmed and a clinical model for applying this method of detecting the small-for-gestational age (SGA) fetus was developed. Among 249 pregnancies in which ultrasound examination and amniocenteses were performed at or beyond 34 weeks' gestation and within a week of delivery, a fetal biparietal diameter of less than or equal to 87 mm and the presence of PG in amniotic fluid were found to be capable of detecting 80% of all SGA fetuses. Moreover, one half of the predictions of the birth of an SGA infant would have been correct. A positive screen with the use of this model was associated with a fifteen fold increase in risk for the birth of an SGA infant. These findings suggest a series of diagnostic steps to improve the antenatal detection of the growth-retarded fetus. (1) The clinician should assess risks and have a high index of suspicion. (2) When the at-risk pregnancy is thought to be at least 34 weeks, ultrasound examination may be helpful in confirming that the fetus is small. (3) Carefully amniocentesis, with the determination of PG, may then be useful in diagnosing intrauterine growth retardation.

Reportedly, determination of several phospholipids in amniotic fluid, including phosphatidylglycerol and phosphatidylinositol, in addition to lecithin and sphingomyelin improves prediction of neonatal pulmonary function. In this study, we evaluated a two-dimensional technique for separating and measuring these phospholipids and compared it with a simpler one-dimensional procedure. The two-dimensional technique was adapted to readily available commercial plates, and a preheating step was introduced to avoid shattering of the plates during charring. The Rf values, reproducibility of each technique, and the correlation between them were examined. Even though the one-dimensional technique is faster and less expensive, we recommend the two-dimensional method for clinical use because of better precision (CV for phosphatidylglycerol 15% vs 21%) and clearer results when relatively little phosphatidylglycerol is present. The one-dimensional procedure is unreliable when blood or meconium are present. In addition, interfering compounds co-migrate with phosphatidylglycerol, phosphatidylethanolamine, and phosphatidylserine in the one-dimensional technique. Before any one-dimensional lipid separation is adopted for clinical use, it should be critically compared to the two-dimensional procedure.

Intrauterine growth retardation, a major complication of pregnancy, remains difficult to detect reliability prior to birth. In this retrospective study of 82 pregnancies which resulted in birth of small infants, preceding clinical factors and amniotic fluid (AF) maturity tests were examined for their ability to differentiate small for gestational age (SGA) from appropriate for gestational age (AGA) infants of comparable weight. AF maturity tests included phosphatidylglycerol (PG), phosphatidylinositol (PI), lecithin to sphingomyelin ratio (L/S), PG/PI, PG/S, PI/S, foam tests, and fat cell count. Discriminant analysis revealed that AF PG was potentially the most useful parameter for predicting the birth of an SGA infant. The predictive value of PG was related to the strong correlation of AF PG with term gestation. High AF PG could potentially predict SGA infants with a true positive rate of 60%; 64% of all SGA infants could be correctly identified by means of only AF PG. The results of this study suggest that, in selected high-risk pregnancies, amniocentesis late in gestation with determination of PG may be helpful in classifying small infants as either growth retarded or preterm.

A prospective study was undertaken in 107 elective repeat cesarean deliveries in which the lecithin/sphingomyelin (L/S) ratio was positive. The frequency of neonatal complications in 87 of these women having positive amniotic fluid (AF) phosphatidylglycerol (PG) was compared with the frequency in the remaining 20 patients exhibiting a negative PG. Hyaline membrane disease (HMD) did not occur in either group. However, neonatal complications and related clinical procedures were significantly increased in the PG-negative patients. These neonatal complications included increased frequency of admissions to the neonatal intensive care unit, physiologic jaundice, poor feeding, transient tachypnea, prolonged oxygen therapy, arterial blood gas determinations, chest X-ray and placement of a peripheral intravenous line. The cause of this increased frequency in neonatal complications appears to be mild prematurity in patients exhibiting a positive AF L/S with a negative PG. This study suggests that, in hospitals where PG determinations are available, neonatal complications could be reduced further by awaiting the AF PG result before electively performing a repeat cesarean section.