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Despite its importance in planet formation and biology1, phosphorus has been identified only in the inner 12 kpc of the Galaxy2–19. The study of this element has been hindered in part by unfavourable atomic transitions2,4,20. Phosphorus is thought to be created by neutron capture on 29Si and 30Si in massive stars20,21, and released into the interstellar medium by Type II supernova explosions2,22. However, models of galactic chemical evolution must arbitrarily increase the supernovae production23 to match observed abundances. Here we present the detection of gas-phase phosphorus in the Outer Galaxy through millimetre spectra of PO and PN. Rotational lines of these molecules were observed in the dense cloud WB89-621, located 22.6 kpc from the Galactic Centre24. The abundances of PO and PN in WB89-621 are comparable to values near the Solar System25. Supernovae are not present in the Outer Galaxy26, suggesting another source of phosphorus, such as ‘Galactic Fountains’, where supernova material is redistributed through the halo and circumgalactic medium27. However, fountain-enriched clouds are not found at such large distances. Any extragalactic source, such as the Magellanic Clouds, is unlikely to be metal rich28. Phosphorus instead may be produced by neutron-capture processes in lower mass asymptotic giant branch stars29 which are present in the Outer Galaxy. Asymptotic giant branch stars also produce carbon21, flattening the extrapolated metallicity gradient and accounting for the high abundances of C-containing molecules in WB89-621.We report the presence of gas-phase phosphorous at the edge of the Galaxy and suggest it is produced by neutron-capture processes in lower mass asymptotic giant branch stars. [ABSTRACT FROM AUTHOR]

Observations of HCN and HCO+ have been carried out toward 13 planetary nebulae (PNe) using the facilities of the Arizona Radio Observatory (ARO). These nebulae represent a wide range of morphologies and ages (∼2000â€"28,000 yr). For both molecules, the J = 1 â†' 0 transitions at 88â€"89 GHz and the J = 3 â†' 2 lines at 265â€"267 GHz were measured, together with CO lines (J = 1 â†' 0, 2 â†' 1, and 3 â†' 2, depending on the source), using the ARO 12 m and Submillimeter Telescopes. HCN and HCO+ were detected with at least one transition in 10 nebulae: He 2-459, Hu 1-1, K3-52, K3-65, M1-8, M1-40, M1-59, M2-53, M4-17, and NGC 6445. HCO+ was additionally identified via two transitions in Na 2. Some observed line profiles were complex, with multiple velocity components tracing varied outflows. From radiative transfer modeling, column densities were established for HCN and HCO+: N tot(HCN) = 0.005â€"1.1 Ă— 1014 and N tot(HCO+) = 0.008â€"9.5 Ă— 1013 cmâˆ'2. Gas densities of n (H2) ∼ 105â€"107 cmâˆ'3 were also determined for all PNe. Fractional abundances with respect to H2, calculated using CO as a proxy, are f (HCN) ∼ 0.2â€"1.5 Ă— 10âˆ'7 and f (HCO+) ∼ 0.3â€"5.1 Ă— 10âˆ'8. The abundances of HCN and HCO+ did not significantly vary with nebular age to 28,000 yr. Combined with previous observations, at least 30 PNe contain HCN and/or HCO+, indicating that polyatomic molecules are common constituents of these objects. The data strongly support a scenario where dense ejecta from PNe seed the interstellar medium with molecular material. [ABSTRACT FROM AUTHOR]

Background: Stillbirth has a profound impact on women, families, and healthcare workers. The burden is highest in low- and middle-income countries (LMICs). There is need for respectful and supportive care for women, partners, and families after bereavement.Objective: To perform a qualitative meta-summary of parents' and healthcare professionals' experiences of care after stillbirth in LMICs.Search Strategy: Search terms were formulated by identifying all synonyms, thesaurus terms, and variations for stillbirth. Databases searched were AMED, EMBASE, MEDLINE, PsychINFO, BNI, CINAHL.Selection Criteria: Qualitative, quantitative, and mixed method studies that addressed parents' or healthcare professionals' experience of care after stillbirth in LMICs.Data Collection and Analysis: Studies were screened, and data extracted in duplicate. Data were analysed using the Sandelowski meta-summary technique that calculates frequency and intensity effect sizes (FES/IES).Main Results: In all, 118 full texts were screened, and 34 studies from 17 countries were included. FES range was 15-68%. Most studies had IES 1.5-4.5. Women experience a broad range of manifestations of grief following stillbirth, which may not be recognised by healthcare workers or in their communities. Lack of recognition exacerbates negative experiences of stigmatisation, blame, devaluation, and loss of social status. Adequately developed health systems, with trained and supported staff, are best equipped to provide the support and information that women want after stillbirth.Conclusions: Basic interventions could have an immediate impact on the experiences of women and their families after stillbirth. Examples include public education to reduce stigma, promoting the respectful maternity care agenda, and investigating stillbirth appropriately.Tweetable Abstract: Reducing stigma, promoting respectful care and investigating stillbirth have a positive impact after stillbirth for women and families in LMICs. [ABSTRACT FROM AUTHOR]

Background: Stillbirth is a global health problem. The World Health Organization (WHO) application of the International Classification of Diseases for perinatal mortality (ICD-PM) aims to improve data on stillbirth to enable prevention.Objectives: To identify globally reported causes of stillbirth, classification systems, and alignment with the ICD-PM.Search Strategy: We searched CINAHL, EMBASE, Medline, Global Health, and Pubmed from 2009 to 2016.Selection Criteria: Reports of stillbirth causes in unselective cohorts.Data Collection and Analysis: Pooled estimates of causes were derived for country representative reports. Systems and causes were assessed for alignment with the ICD-PM. Data are presented by income setting (low, middle, and high income countries; LIC, MIC, HIC).Main Results: Eighty-five reports from 50 countries (489 089 stillbirths) were included. The most frequent categories were Unexplained, Antepartum haemorrhage, and Other (all settings); Infection and Hypoxic peripartum (LIC), and Placental (MIC, HIC). Overall report quality was low. Only one classification system fully aligned with ICD-PM. All stillbirth causes mapped to ICD-PM. In a subset from HIC, mapping obscured major causes.Conclusions: There is a paucity of quality information on causes of stillbirth globally. Improving investigation of stillbirths and standardisation of audit and classification is urgently needed and should be achievable in all well-resourced settings. Implementation of the WHO Perinatal Mortality Audit and Review guide is needed, particularly across high burden settings.Funding: HR, SH, SHL, and AW were supported by an NHMRC-CRE grant (APP1116640). VF was funded by an NHMRC-CDF (APP1123611).Tweetable Abstract: Urgent need to improve data on causes of stillbirths across all settings to meet global targets.Plain Language Summary: Background and methods Nearly three million babies are stillborn every year. These deaths have deep and long-lasting effects on parents, healthcare providers, and the society. One of the major challenges to preventing stillbirths is the lack of information about why they happen. In this study, we collected reports on the causes of stillbirth from high-, middle-, and low-income countries to: (1) Understand the causes of stillbirth, and (2) Understand how to improve reporting of stillbirths. Findings We found 85 reports from 50 different countries. The information available from the reports was inconsistent and often of poor quality, so it was hard to get a clear picture about what are the causes of stillbirth across the world. Many different definitions of stillbirth were used. There was also wide variation in what investigations of the mother and baby were undertaken to identify the cause of stillbirth. Stillbirths in all income settings (low-, middle-, and high-income countries) were most frequently reported as Unexplained, Other, and Haemorrhage (bleeding). Unexplained and Other are not helpful in understanding why a baby was stillborn. In low-income countries, stillbirths were often attributed to Infection and Complications during labour and birth. In middle- and high-income countries, stillbirths were often reported as Placental complications. Limitations We may have missed some reports as searches were carried out in English only. The available reports were of poor quality. Implications Many countries, particularly those where the majority of stillbirths occur, do not report any information about these deaths. Where there are reports, the quality is often poor. It is important to improve the investigation and reporting of stillbirth using a standardised system so that policy makers and healthcare workers can develop effective stillbirth prevention programs. All stillbirths should be investigated and reported in line with the World Health Organization standards. [ABSTRACT FROM AUTHOR]

This study sought to identify delivery complications associated with stillbirth labour and delivery. We conducted a retrospective chart review evaluating stillbirth demographics, pregnancy and maternal risk factors, and complications of labour and delivery. We performed bivariable analysis and multivariable logistic regression to evaluate factors associated with medical complications and variations by race. Our cohort included 543 mothers with stillbirth, of which two-thirds were African-American. We noted high rates of shoulder dystocia, clinical chorioamnionitis, postpartum haemorrhage and retained placenta in women with stillbirths. Thirty-three women (6%) experienced at least one serious maternal complication. Complication rates did not vary by maternal race. Providers who perform obstetrical care should be alert to the high rate of maternal medical complications associated with labour and delivery of a stillbirth foetus. [ABSTRACT FROM AUTHOR]

Introduction:Health care providers are on the front lines of care when a baby dies, but there is no consensus about which behaviors are most helpful or harmful for families.Materials and Methods:This systematic review of more than 1100 English-language articles from 1966 to 2006 addressed fetal and early infant loss and extracted information about interactions with health providers.Results:Sixty-one studies, covering over 6000 parents, met criteria. Nurses were generally viewed as more emotionally supportive than physicians. Parents valued emotional support, attention to mother and baby and grief education. Avoidance, insensitivity and poor staff communication were the most distressing behaviors encountered.Discussion:Interactions with health providers has profound effects on parents with perinatal losses. Grieving parents perceive many behaviors to be thoughtless or insensitive. Physicians and nurses may benefit from increased training in bereavement support.Journal of Perinatology (2007) 27, 230–237. doi:10.1038/sj.jp.7211676 [ABSTRACT FROM AUTHOR]

Most robots are designed to operate in environments that are either highly constrained (as is the case in an assembly line) or extremely hazardous (such as the surface of Mars). Machine learning has been an effective tool in both of these environments by augmenting the flexibility and reliability of robotic systems, but this is often a very difficult problem because the complexity of learning in the real world introduces very high dimensional state spaces and applies severe penalties for mistakes. Human children are raised in environments that are just as complex (or even more so) than those typically studied in robot learning scenarios. However, the presence of parents and other caregivers radically changes the type of learning that is possible. Consciously and unconsciously, adults tailor their action and the environment to the child. They draw attention to important aspects of a task, help in identifying the cause of errors and generally tailor the task to the child's capabilities. Our research group builds robots that learn in the same type of supportive environment that human children have and develop skills incrementally through their interactions. Our robots interact socially with human adults using the same natural conventions that a human child would use. Our work sits at the intersection of the fields of social robotics (Fong et al., 2003; Breazeal and Scawellan, 2002) and autonomous mental development (Weng et al., 2000). Together, these two fields offer the vision of a machine that can learn incrementally, directly from humans, in the same ways that humans learn from each other. In this article, we introduce some of the challenges, goals, and applications of this research [ABSTRACT FROM PUBLISHER]

Background: Magnetic resonance imaging (MRI) of the breast has been proposed as a noninvasive diagnostic test for evaluation of suspicious ("index") lesions noted on mammography and/or clinical breast examination (CBE). However, women may have incidental ("serendipitous") lesions detected by MRI that are not found on mammography or CBE. To understand better whether or not biopsy procedures should be performed to evaluate serendipitous lesions, we estimated the breast cancer risk for women with this type of lesion.Methods: A decision analysis model was used to estimate the positive predictive value (i.e., the chance that a woman with a serendipitous lesion has cancer) of MRI for serendipitous lesions in women who had an abnormal mammogram and/or CBE suspicious for cancer (where a biopsy procedure is recommended). We restricted the analysis to data from women whose index lesions were noncancerous and used meta-analysis of published medical literature to determine the likelihood ratios (measures of how test results change the probability of having cancer) for MRI and the combination of CBE and mammography. The positive predictive value of MRI was calculated using the U.S. population prevalence of cancer (derived from registry data) and the likelihood ratios of the diagnostic tests.Results: Under a wide variety of assumptions, the positive predictive value of MRI was extremely low for serendipitous lesions. For instance, assuming sensitivity and specificity values for MRI of 95.6% and 68.6%, respectively, approximately four of 1000 55- to 59-year-old women with serendipitous lesions would be expected to have cancer (positive predictive value = 0.44%, 95% confidence interval = 0.24%-0.67%).Conclusion: In women with a suspicious lesion discovered by mammography and/or CBE that is found to be benign, serendipitous breast lesions detected by MRI are extremely unlikely to represent invasive breast cancer. Immediate biopsy of such serendipitous lesions may, therefore, not be required. [ABSTRACT FROM AUTHOR]

Objectives: To identify predictors of utilization of breast-ovarian cancer susceptibility (BRCA1 gene) testing and to evaluate outcomes of participation in a testing program.Design: Prospective cohort study with baseline interview assessment of predictor variables (eg, sociodemographic factors, knowledge about hereditary cancer and genetic testing, perceptions of testing benefits, limitations, and risks). BRCA1 test results were offered after an education and counseling session in a research setting. Outcome variables (including depression, functional health status, and prophylactic surgery plans [follow-up only]) were assessed at baseline and 1-month follow-up interviews.Participants: Adult male and female members (n=279) of families with BRCA1-linked hereditary breast-ovarian cancer (HBOC).Results: Of subjects who completed a baseline interview (n=192), 60% requested BRCA1 test results (43% of all study subjects requested results). Requests for results were more frequent for persons with health insurance (odds ration [OR], 3.74; 95% confidence interval [CI], 2.06-6.80); more first-degree relatives affected with breast cancer (OR, 1.59; 95% CI, 1.16-2.16); more knowledge about BRCA1 testing (OR, 1.85; 95% CI, 1.36-2.50); and indicating that test benefits are important (OR, 1.45; 95% CI, 1.13-1.86). At follow-up, noncarriers of BRCA1 mutations showed statistically significant reductions in depressive symptoms and functional impairment compared with carriers and nontested individuals. Individuals identified as mutation carriers did not exhibit increases in depression and functional impairment. Among unaffected women with no prior prophylactic surgery, 17% of carriers (2/12) intended to have mastectomies and 33% (4/12) to have oophorectomies.Conclusions: Only a subset of HBOC family members are likely to request BRCA1 testing when available. Rates of test use may be higher in persons of a higher socioeconomic status and those with more relatives affected with breast cancer. For some high-risk individuals who receive test results in a research setting that includes counseling, there may be psychological benefits. More research is needed to assess the generalizability of these results and evaluate the long-term consequences of BRCA1 testing. [ABSTRACT FROM AUTHOR]

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Microgametes have been detected for a species of Tintinnida for the first time. Apparently this method of sexual reproduction occurs rather infrequently in nature, whereas it is the predominant sexual process in vitro. Culturing conditions and the maintenance medium undoubtedly have a profound influence on microgamete appearance. The rate of division of Tintinnopsis beroidea is related to the degree of sexuality of the cells. Newly isolated cells have a doubling time of 0.8 to 1.1 day at an optimum ratio of food: protozoa. The new cultures have a low incidence of microgamete production. [ABSTRACT FROM AUTHOR]

A vigorous strain of Tintinnopsis beroidea was established in vitro by mixing several isolates obtained during the period January to March, 1969. More than 1,000 cells/ml were routinely obtained within a few weeks. On one occasion 3,000 cells/ml were obtained in just over a month. The period required for ciliate populations to double was 2.5 to 6 days. Growth curve data has been obtained with cultures receiving single doses of food at the time the flasks were inoculated with protozoa. The initial concentration of food had a noticeable effect on ciliate growth. Excessive amounts of food were somewhat inhibitory; insufficient amounts resulted in rapid starvation. Conjugation patterns characteristic of wild populations of tintinnids were not observed. However, there was evidence of sexual activity in the cultures: (1) pairing of cells occurred; (2) protrusions were seen in the oral region indicative of preconjugation activity; (3) very high cell yields and rapid division rates were obtained after more than 1.5 years in culture. [ABSTRACT FROM AUTHOR]

Copyright of Helgoland Marine Research is the property of BioMed Central and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The relation between the timing of do-not-resuscitate (DNR) orders and the cost of medical care is not well understood. This prospective observational study compares hospital costs and length of stay of 265 terminally ill patients with admission DNR orders, delayed DNR orders (occurring after 24 hours), or no DNR orders (full code). Patients whose orders remained full code throughout a hospital stay had similar lengths of stay, total hospital costs, and daily costs as patients with admission DNR orders. Patients with delayed DNR orders, by contrast, had a greater mortality, longer length of stay, and higher total costs than full code or admission DNR patients, but similar daily costs. The causes of delay in DNR orders and the associated higher costs are a matter for future research. [ABSTRACT FROM AUTHOR]