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To compare the ability of three fetal growth charts (Fetal Medicine Foundation (FMF), Hadlock and National Institutes of Child Health and Human Development (NICHD) race/ethnicity-specific) to predict large-for-gestational age (LGA) at birth in pregnant individuals with pregestational diabetes, and to determine whether inclusion of hemoglobin A1c (HbA1c) level improves the predictive performance of the growth charts.This was a retrospective analysis of individuals with Type-1 or Type-2 diabetes with a singleton pregnancy that resulted in a non-anomalous live birth. Fetal biometry was performed between 28 + 0 and 36 + 6 weeks of gestation. The primary exposure was suspected LGA, defined as estimated fetal weight ≥ 90Of 358 assessed pregnant individuals with pregestational diabetes (34% with Type 1 and 66% with Type 2), 147 (41%) had a LGA infant at birth. Suspected LGA was identified in 123 (34.4%) by the Hadlock, 152 (42.5%) by the FMF and 152 (42.5%) by the NICHD growth chart. The FMF growth chart had the highest sensitivity (77% vs 69% (NICHD) vs 63% (Hadlock)) and the Hadlock growth chart had the highest specificity (86% vs 76% (NICHD) and 82% (FMF)) for predicting LGA at birth. The FMF growth chart had a significantly higher AUC (0.79 (95% CI, 0.74-0.84)) for LGA at birth compared with the NICHD (AUC, 0.72 (95% CI, 0.68-0.77); P 0.001) and Hadlock (AUC, 0.75 (95% CI, 0.70-0.79); P 0.01) growth charts. Prediction of LGA improved for all three growth charts with the inclusion of HbA1c measurement in comparison to each growth chart alone (P 0.001 for all); the FMF growth chart remained more predictive of LGA at birth (AUC, 0.85 (95% CI, 0.81-0.90)) compared with the NICHD (AUC, 0.79 (95% CI, 0.73-0.84)) and Hadlock (AUC, 0.81 (95% CI, 0.76-0.86)) growth charts.The FMF fetal growth chart had the best predictive performance for LGA at birth in comparison with the Hadlock and NICHD race/ethnicity-specific growth charts in pregnant individuals with pregestational diabetes. Inclusion of HbA1c improved further the prediction of LGA for all three charts. © 2022 The Authors. Ultrasound in ObstetricsGynecology published by John WileySons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

To examine the association between initial COVID-19 vaccine hesitancy and subsequent vaccination among pregnant and postpartum individuals.Prospective cohort.A Midwestern tertiary-care academic medical center. Individuals completed a baseline vaccine hesitancy assessment from 22 March 2021 to 2 April 2021, with subsequent ascertainment of vaccination status at 3-6 months follow-up.We used multivariable Poisson regression to estimate the relative risk of vaccination by baseline vaccine hesitancy status, and then characteristics associated with vaccination.Self-report of COVID-19 vaccination, and secondarily, consideration of COVID-19 vaccination among those not vaccinated.Of 456 individuals (93% pregnant, 7% postpartum) initially surveyed, 290 individuals (64%; 23% pregnant, 77% postpartum) provided subsequent vaccination status (median = 17 weeks). Of these 290 individuals, 40% (116/290) reported COVID-19 vaccine hesitancy upon enrolment, of whom 52% reported subsequent vaccination at follow-up. Few individuals transitioned during the study period from vaccine hesitant to vaccinated (10%); in comparison, 80% of those who were not vaccine hesitant were vaccinated at follow-up (aRR 0.19, 95% CI 0.11-0.33). Among those who remained unvaccinated at follow-up, 38% who were vaccine hesitant at baseline were considering vaccination, compared with 71% who were not vaccine hesitant (aRR 0.48, 95% CI 0.33-0.67). Individuals who were older, parous, employed and of higher educational attainment were more likely to be vaccinated, and those who identified as non-Hispanic black, were Medicaid beneficiaries, and were still pregnant at follow-up were less likely to be vaccinated.COVID-19 vaccine hesitancy persisted over time in the peripartum period, and few individuals who reported hesitancy at baseline were later vaccinated. Interventions that address vaccine hesitancy in pregnancy are needed.

To assess the frequency and associated characteristics of COVID-19 vaccine hesitancy among pregnant and postpartum individuals.Cross-sectional study.Prenatal care at a single academic tertiary care centre.Pregnant and postpartum individuals enrolled in prenatal care at a single academic tertiary care centre from 22 March 2021 to 2 April 2021, concurrent with state guidelines recommending COVID-19 vaccination in pregnancy.We used logistic regression to identify characteristics associated with COVID-19 vaccine hesitancy, and adjusted for: age, parity, race, trimester of pregnancy, and chronic comorbidities.COVID-19 vaccine hesitancy, defined as uncertainty or refusal of the vaccine, despite the availability of vaccine services, in accordance with the World Health Organization (WHO) Strategic Advisory Group of Experts (SAGE) on vaccine hesitancy.Of the 485 individuals screened and approached, 456 (94%) enrolled and completed the survey (435/456, 95% pregnant). The frequency of COVID-19 vaccine hesitancy was 46% (95% CI 41%-51%). Sociodemographic characteristics, including non-Hispanic Black race, younger age, lower education, public health insurance receipt, parity1, and reported substance use, were associated with a higher odds of COVID-19 vaccine hesitancy, but not clinical risk conditions. Individuals who had a family or friend vaccinated for COVID-19, prior or planned vaccination for tetanus, diphtheria and acellular pertussis (Tdap) and/or influenza, and who perceived that vaccination benefited the baby were less likely to express COVID-19 vaccine hesitancy.COVID-19 vaccine hesitancy was frequent among pregnant and postpartum individuals. Those who may face barriers to accessing healthcare services were more likely to report vaccine hesitancy. These results can inform interventions to increase COVID-19 vaccine uptake in pregnancy.COVID-19 vaccination hesitancy is frequent among pregnant and postpartum individuals, and those who face barriers to accessing healthcare services are more likely to report COVID-19 vaccine hesitancy.

OBJECTIVE This study aimed to investigate the association between excess and less than recommended gestational weight gain (GWG) and adverse maternal and neonatal outcomes in women with pregestational and gestational diabetes. STUDY DESIGN We conducted a secondary analysis of the National Institute of Child Health and Human Development (NICHD) Consortium on Safe Labor (CSL) study. We included deliveries >23 weeks of nonanomalous singletons with either pregestational or gestational diabetes. The exposure was GWG greater than or less than compared with the U.S. Institute of Medicine recommendations for total pregnancy weight gain per prepregnancy body mass index. Consistent with the 2020 Delphi outcome for diabetes in pregnancy, maternal outcomes included cesarean delivery and preeclampsia and neonatal outcomes included small for gestational age (SGA), large for gestational age (LGA), macrosomia >4,000 g, preterm birth

OBJECTIVE To evaluate differences between fasting and nonfasting bile acid levels in asymptomatic and symptomatic pregnant women. METHODS This is a report of two prospective cohort studies describing bile acid levels in the fasting and nonfasting state in pregnancy. The first cohort included asymptomatic women with singleton pregnancies. Women with a diagnosis of cholestasis, symptoms of cholestasis, or intolerance to components of a standardized meal were excluded. Bile acid levels were measured during the second and third trimesters after fasting and again 2 hours after a standardized meal. The second cohort included symptomatic women with singleton pregnancies in whom fasting and nonfasting bile acid levels were measured at the time of symptom evaluation. A cutoff of 10 micromoles/L was used for diagnosis. RESULTS A total of 27 women were included in the asymptomatic cohort. Median [interquartile range] fasting bile acid levels were significantly lower than nonfasting levels in both the second trimester (4.65 micromoles/L [1.02-29.57] vs 13.62 micromoles/L [2.03-40.26]; P

To evaluate the association of community-level social vulnerability with COVID-19 vaccine hesitancy and vaccination among pregnant and postpartum individuals.Prospective cohort study assessing COVID-19 vaccine hesitancy among pregnant and postpartum individuals. We performed a baseline survey on COVID-19 vaccine hesitancy from 03/22/21 to 04/02/21, and a follow-up survey on COVD-19 vaccination status 3- to 6-months later. The primary exposure was the Centers for Disease Control and Prevention SVI (Social Vulnerability Index), measured in quartiles. Higher SVI quartiles indicated greater community-level social vulnerability with the lowest quartile (quartile 1) as the referent group. The primary outcome was COVID-19 vaccine hesitancy on the baseline survey (uncertainty or refusal of the vaccine), and the secondary outcome was self-report of not being vaccinated (unvaccinated) for COVID-19 on the follow-up survey.Of 456 assessed individuals, 46% reported COVID-19 vaccine hesitancy on the baseline survey; and of 290 individuals (290/456, 64%) who completed the follow-up survey, 48% (140/290) were unvaccinated. The frequency of baseline vaccine hesitancy ranged from 25% in quartile 1 (low SVI) to 68% in quartile 4 (high SVI), and being unvaccinated at follow-up ranged from 29% in quartile 1 to 77% in quartile 4. As social vulnerability increased, the risk of COVID-19 vaccine hesitancy at baseline increased (quartile 2 aRR (adjusted relative risk): 1.46; 95% CI:0.98 to 2.19; quartile 3 aRR: 1.86; 95% CI:1.28 to 2.71; and quartile 4 aRR: 2.24; 95% CI:1.56 to 3.21), as did the risk of being unvaccinated at follow-up (quartile 2 aRR: 1.00; 95% CI:0.66 to 1.51; quartile 3 aRR: 1.68; 95% CI:1.17 to 2.41; and quartile 4 aRR: 1.82; 95% CI:1.30 to 2.56).Pregnant and postpartum individuals living in an area with higher community-level social vulnerability were more likely to report COVID-19 vaccine hesitancy and subsequently to be unvaccinated at follow-up.

Despite current guidelines recommending universal vaccination, the frequency of vaccination in pregnancy for influenza and tetanus-diphtheria-acellular pertussis remains low.This study aimed to evaluate the association between community-level social vulnerability and influenza and anticipated tetanus-diphtheria-acellular pertussis vaccinations among pregnant and postpartum individuals.We conducted a cross-sectional survey of vaccine hesitancy in the peripartum period among pregnant and postpartum participants enrolled in prenatal care at a single tertiary care center from March 22, 2021, to April 02, 2021. Participant addresses were geocoded using ArcGIS and linked at the census tract level. The primary exposure was community-level social vulnerability as measured by the US Centers for Disease Control and Prevention's Social Vulnerability Index. This index incorporates 15 census variables to produce a composite score and subscores across 4 major thematic domains (socioeconomic status, household composition and disability, minority status and language, and housing type and transportation). The scores range from 0 to 1, with higher values indicating greater social vulnerability. The primary outcomes were self-reported influenza vaccination during the current influenza season and having received or planning to receive the tetanus-diphtheria-acellular pertussis vaccination in pregnancy. We used multivariable logistic regression and adjusted for age, self-reported race and ethnicity, parity, trimester of pregnancy, and chronic comorbid conditions.Of 456 assessed individuals (95% pregnant individuals and 5% postpartum individuals), the frequency of influenza vaccination was 58% (95% confidence interval, 53-62), and the anticipated tetanus-diphtheria-acellular pertussis vaccination was 72% (95% confidence interval, 68-76). Individuals from communities with a higher Social Vulnerability Index were less likely to report vaccination in pregnancy than those from communities with a lower Social Vulnerability Index. Specifically, for each 0.1-unit increase in the Social Vulnerability Index, the odds of influenza vaccination (adjusted odds ratio, 0.23; 95% confidence interval, 0.11-0.46) and anticipated tetanus-diphtheria-acellular pertussis vaccination (adjusted odds ratio, 0.24; 95% confidence interval, 0.11-0.53) decreased by70%. By domain, the Social Vulnerability Index subscores of socioeconomic status (influenza adjusted odds ratio, 0.20 [95% confidence interval, 0.10-0.40]; tetanus-diphtheria-acellular pertussis adjusted odds ratio, 0.25 [95% confidence interval, 0.12-0.53]) and housing type and transportation (influenza adjusted odds ratio, 0.41 [95% confidence interval, 0.19-0.84; tetanus-diphtheria-acellular pertussis adjusted odds ratio, 0.39 [95% confidence interval, 0.18-0.87) were inversely associated with a lower odds of influenza and tetanus-diphtheria-acellular pertussis vaccinations.Pregnant and postpartum individuals living in areas with higher social vulnerability were less likely to report influenza and anticipated tetanus-diphtheria-acellular pertussis vaccinations in pregnancy. The Social Vulnerability Index could be used as a tool to improve vaccine equity and address disparities in vaccination in pregnancy.

Biologic agents have revolutionized treatment of immune mediated inflammatory diseases (IMIDs). However, despite the benefits of treatment, there is limited data on its use during pregnancy leading to significant variation in practices. We evaluated maternal, neonatal, and disease-related outcomes in pregnant women with IMIDs, comparing those with biologic exposure during pregnancy to those without exposure. Our hypothesis was that there would be no difference in outcomes between the two groups.This is a retrospective cohort study conducted at a single tertiary care center including women with Crohn's disease (CD), ulcerative colitis (UC), ankylosing spondylitis (AS), rheumatoid arthritis (RA), or psoriasis/psoriatic arthritis (PS/PsA) who delivered between 2010 and 2018 at The Ohio State University Wexner Medical Center. Conditions were identified by ICD-9/ICD-10 code and confirmed by chart review. Demographic data, pregnancy outcomes and disease-related data were collected.There were 338 pregnancies including 100 with CD, 74 with UC, 15 with AS, 61 with RA, and 90 with PS/PsA. 23% of IMID patients had biologic exposure (biologic use within 3 months of conception) and 18% continued therapy during pregnancy. Those with biologic exposure had increased risk of post-partum disease flare (OR 3.44; 95% CI 1.29, 9.15) and were less likely to breastfeed (OR 0.44; 95% CI 0.23, 0.87). In subgroup analysis of patients with IBD, those with biologic exposure also had increased risk of post-partum flare (OR 4.55; 95% CI 1.27, 16.35). Maternal and neonatal pregnancy outcomes were similar.Among pregnant women with IMIDs, those that continued biologics during pregnancy had increased rates of major infection, disease related hospital admission, glucocorticoid use, and disease flare within 6 months post-partum, without any significant change in maternal or neonatal outcomes.

To determine whether a net decline in glycosylated haemoglobin (HbAA retrospective analysis from 2012 to 2016 at a tertiary care centre. The exposure was the net change in HbAAmong 347 women with pregestational diabetes, HbAWomen with pregestational diabetes with a reduction in HbA

Problem Limited data exists on the temporal trend of the Sars‐CoV‐2 immunologic response and duration of protection following natural infection. We sought to investigate the presence and duration of Sars‐CoV‐2 serum antibodies in obstetrical healthcare workers (HCW) on serial assessments over a 6‐month period, and to assess rates of vaccine acceptance and reported vaccine side effects among this cohort. Method of study A prospective cohort study of a convenience sample of obstetrical HCWs at a tertiary hospital. Serum Sars‐CoV‐2 antibodies for Immunoglobulin G (IgG) and Immunoglobulin M (IgM) were measured longitudinally at four intervals: baseline, 4 weeks, 12 weeks, and 6 months. Participants completed voluntary surveys on COVID19 testing, high‐risk exposures, vaccine acceptance, and vaccine side effects. Results One hundred twenty‐six of 150 (84%) HCWs who volunteered for participation completed all four blood draws. Prevalence of seropositive HCWs based on positive Sars‐CoV‐2 IgG antibodies increased from 2% at baseline to 31% at 12 weeks but declined to 21% by 6 months. Forty‐two percent (19/43) of the participants considered seropositive for Sars‐CoV‐2 IgG antibodies at any of the initial three blood draws converted to seronegative status at the 6‐month follow‐up. Eighty‐seven percent (72/83) of participants who responded to a follow‐up survey were willing to accept the COVID19 vaccine. Rates of acceptance did not differ by participant antibody status. Those that experienced symptoms with the first injection were more likely to have positive Sars‐CoV‐2 IgG antibodies (36.8% vs. 9.6%, p = .01). Conclusion Sars‐CoV‐2 IgG antibodies wane over time and may not provide prolonged and robust immune protection. This underscores the importance of vaccination and continued research in this area while the COVID19 pandemic continues.

In addition to supporting visibility, parking lot lighting should enable people to feel safe and secure while they are walking through a parking lot at night. Previously published research has indicated that perceptions of safety and security under outdoor illumination are correlated with perceptions of scene brightness, which in turn are influenced by the light level in the lot, by the spectral distribution of the illumination, and the uniformity of illumination. However, the interactions and interplay among these factors are not well understood. To address this knowledge gap, two laboratory experiments were conducted using a scale model parking lot scene and a controllable light-emitting diode (LED) lighting system that allowed parametric variations in light level, spectrum and uniformity. From the results, a mathematical model of overall brightness and safety perceptions was developed to predict how different lighting configurations are perceived. The model can be used to help specifiers select lighting systems for parking lot illumination that meet the objectives of reinforcing sensations of personal safety while balancing energy use and cost concerns.

Kinetic profile predictions of ITER PFPO-1 plasmas require high accuracy in the central electron temperatures to be applied to the calculation of third harmonic electron cyclotron absorption. Correctly predicting the transition from L-mode to H-mode further requires precise estimates of the ion heat flux in the periphery of the plasma. Recent versions of the quasi-linear transport models TGLF and QuaLiKiz were tested against an extensive set of experimental results from ASDEX Upgrade (AUG) and JET-ILW, where the focus was put on AUG plasmas heated by ECRH. Spectra obtained from TGLF are compared to a set of linear gyrokinetic simulations performed with GKW. Electron and ion temperature profiles obtained with TGLF-SAT1geo show good agreement with the experimental profiles, but there is a slight tendency to underpredict central T e and T i at high ratios T e/T i. QuaLiKiz yields reasonable results for T e and T i profiles in plasmas where the ion temperature gradient mode is dominant, but predicts a significantly too weak transport in the presence of dominant trapped electron modes in conditions of strong central electron heating.

In this work we present the application of a novel multi-step performance loss algorithm for PV systems and its practical implications. We try to better understand performance impairing effects and common occurrence patterns. The algorithm automatically detects the amount and position of breakpoints in non-linear performance ratio time series of PV systems, divides the time series into sub-parts and evaluates them independently in a linear fashion. Afterwards, based on the position of the breakpoints, system inspection data are used to find root causes for related changes in performance. The methodology is applied to two systems with an overall linear performance loss clearly below 1%/a. The results show similar performance loss patterns. The systems are two medium sized non-residential plants. After applying tailored data filter both systems experience a nearly linear performance loss over time with a slight performance fluctuation at the beginning of operation. This work focuses on system data and issues on system level. The study of the breakpoint-root causes correlation highlighted the necessity of tailoring the initial data filtering to the final objective of the analysis. It has been shown, that the presented algorithm simplifies the detection of performance instances which deviate from the norm.

The calibration of the electrical performance of seven photovoltaic (PV) modules was compared between four reference laboratories on three continents. The devices included two samples in standard and two in high-efficiency crystalline silicon technology, two CI(G)S and one CdTe module. The reference value for each PV module parameter was calculated from the average of the results of all four laboratories, weighted by the respective measurement uncertainties. All single results were then analysed with respect to this reference value using the En number approach. For the four modules in crystalline silicon technology, the results agreed in general within ±0.5%, with all values within ±1% and all En numbers well within [−1, 1], indicating further scope for reducing quoted measurement uncertainty. Regarding the three thin-film modules, deviations were on average roughly twice as large, i.e. in general from ±1% to ±2%. A number of inconsistent results were observable, although within the 5% that can be statistically expected on the basis of the En number approach. Most inconsistencies can be traced to the preconditioning procedure of one participant, although contribution of other factors cannot be ruled out. After removing these obvious inconsistent results, only two real outliers remained, representing less than 2% of the total number of measurands. The results presented show improved agreement for the calibration of PV modules with respect to previous international exercises. For thin-film PV modules, the preconditioning of the devices prior to calibration measurements is the most critical factor for obtaining consistent results, while the measurement processes seem consistent and repeatable.

Infectious diseases have a profound impact on our health and many studies suggest that host genetics play a major role in the pathogenesis of most of them. We perform 23 genome-wide association studies for common infections and infection-associated procedures, including chickenpox, shingles, cold sores, mononucleosis, mumps, hepatitis B, plantar warts, positive tuberculosis test results, strep throat, scarlet fever, pneumonia, bacterial meningitis, yeast infections, urinary tract infections, tonsillectomy, childhood ear infections, myringotomy, measles, hepatitis A, rheumatic fever, common colds, rubella and chronic sinus infection, in over 200,000 individuals of European ancestry. We detect 59 genome-wide significant (P, Susceptibility to infectious diseases is, among others, influenced by the genetic landscape of the host. Here, Tian and colleagues perform genome-wide association studies for 23 common infections and find 59 risk loci for 17 of these, both within the HLA region and non-HLA loci.

Background Although an elevated early pregnancy hemoglobin A1c has been associated with both spontaneous abortion and congenital anomalies, it is unclear whether A1c assessment is of value beyond the first trimester in pregnancies complicated by pregestational diabetes. Objective We sought to investigate the prognostic ability of longitudinal A1c assessment to predict obstetric and neonatal adverse outcomes based on degree of glycemic control in early and late pregnancy. Materials and Methods This was a retrospective cohort study of all pregnancies complicated by pregestational diabetes from January 2012 to December 2016 at The Ohio State University Wexner Medical Center with both an early A1c ( 26 weeks’ gestation) available for analysis. Patients were categorized by good (early and late A1c 6.5% and late A1c 6.5%) glycemic control. A multivariate regression model was used to calculate adjusted odds ratios for each identified obstetric and neonatal outcome, controlling for maternal age, body mass index, race/ethnicity, type of diabetes, and gestational age at delivery compared to good control as the referent group. Results A total of 341 patients met inclusion criteria during the study period. The median A1c values improved from early to late gestation in the good (5.7% [interquartile range, 5.4−6.1%] versus 5.4%; [interquartile range, 5.2−5.7%]), improved (7.5% [interquartile range, 6.7−8.5] versus 5.9% [interquartile range, 5.6−6.1%]) and poor (8.3% [interquartile range, 7.1−9.6%] versus 7.3% [interquartile range, 6.8−7.9%]) glycemic control groups. There were no statistically significant differences in the rate of adverse outcomes between the good and improved groups except for an increased rate of neonatal intensive care unit (NICU) admissions in the improved group (adjusted odds ratio, 3.7; confidence interval, 1.9−7.3). In contrast, the poor control group had an increased rate of shoulder dystocia (adjusted odds ratio, 6.8; confidence interval, 1.4−34.0), preterm delivery (adjusted odds ratio, 3.9; confidence interval, 2.1−7.3), neonatal intensive care unit admission (adjusted odds ratio, 2.8; confidence interval, 1.4−5.3), respiratory distress syndrome (adjusted odds ratio, 3.0; confidence interval, 1.1−8.0), hypoglycemia (adjusted odds ratio, 3.2; confidence interval, 1.5−6.9), large for gestational age weight at birth (adjusted odds ratio, 2.5; confidence interval, 1.4−4.4), neonatal length of stay >4 days (adjusted odds ratio, 4.2; confidence interval, 1.9−9.6) and preeclampsia (adjusted odds ratio, 2.4; confidence interval, 1.2−4.6). There were no differences in rates of cesarean delivery, umbilical artery pH Conclusion Antenatal hemoglobin A1c values are useful for objective risk stratification of patients with pregestational diabetes. Strict glycemic control throughout pregnancy with a late pregnancy A1c target of

Objective To evaluate the accuracy of antenatal diagnosis of congenital heart disease (CHD) using screening methods including a combination of elevated hemoglobin A1c, detailed anatomy ultrasound, and fetal echocardiography. Study Design This is a retrospective cohort study of all pregnancies complicated by pregestational diabetes from January 2012 to December 2016. The sensitivity, specificity, positive predictive value, and negative predictive value were calculated for each screening regimen. The incremental cost-effectiveness ratio (ICER) was calculated for each regimen with effectiveness defined as additional CHD diagnosed. Results A total of 378 patients met inclusion criteria with an overall prevalence of CHD of 4.0% (n = 15). When compared with a detailed ultrasound, fetal echocardiography had a higher sensitivity (73.3 vs. 40.0%). However, all cases of major CHD were detected by detailed ultrasound (n = 6). Using an elevated early A1c > 7.7% and a detailed ultrasound resulted in a sensitivity and specificity of 60.0 and 99.4%, respectively. The use of selective fetal echocardiography for an A1c > 7.7% or abnormal detailed anatomy ultrasound would result in a 63.3% reduction in cost per each additional minor CHD diagnosed (ICER: $18,290.52 vs. $28,875.67). Conclusion Fetal echocardiography appears to have limited diagnostic value in women with pregestational diabetes. However, these results may not be generalizable outside of a high-volume academic setting.

Yield predictions are performed to predict the solar resource, the performance and the energy production over the expected lifetime of a photovoltaic (PV) system. In this study, we compare yield predictions and monitored data for 26 PV power plants located in southern Germany and Spain. The monitoring data include in-plane irradiance for comparison with the estimated solar resource and energy yield for comparison with predicted performance. The results show that because of increased irradiance in recent years (‘global brightening’) the yield predictions systematically underestimate the energy yield of PV systems by about 5%. Because common irradiance databases and averaging times were used for the yield predictions analysed in this paper, it is concluded that yield predictions for areas where the global brightening effect occurred in general underestimated the energy yield by the same magnitude. Using recent satellite-derived irradiance time series avoids this underestimation. The observed performance ratio of the analysed systems decreases by 0.5%/year in average with a relatively high spread between individual systems. This decrease is a main factor for the combined uncertainty of yield predictions. It is attributed to non-reversible degradation of PV cells or modules and to reversible effects, like soiling. Based on the results of the validation, the combined uncertainty of state of the art yield predictions using recent solar irradiance data is estimated to about 8%. Copyright © 2015 John Wiley & Sons, Ltd.

Background To date, no genome-wide association study (GWAS) has considered the combined phenotype of asthma with hay fever. Previous analyses of family data from the Tasmanian Longitudinal Health Study provide evidence that this phenotype has a stronger genetic cause than asthma without hay fever. Objective We sought to perform a GWAS of asthma with hay fever to identify variants associated with having both diseases. Methods We performed a meta-analysis of GWASs comparing persons with both physician-diagnosed asthma and hay fever (n = 6,685) with persons with neither disease (n = 14,091). Results At genome-wide significance, we identified 11 independent variants associated with the risk of having asthma with hay fever, including 2 associations reaching this level of significance with allergic disease for the first time: ZBTB10 (rs7009110; odds ratio [OR], 1.14; P = 4 × 10 −9 ) and CLEC16A (rs62026376; OR, 1.17; P = 1 × 10 −8 ). The rs62026376:C allele associated with increased asthma with hay fever risk has been found to be associated also with decreased expression of the nearby DEXI gene in monocytes. The 11 variants were associated with the risk of asthma and hay fever separately, but the estimated associations with the individual phenotypes were weaker than with the combined asthma with hay fever phenotype. A variant near LRRC32 was a stronger risk factor for hay fever than for asthma, whereas the reverse was observed for variants in/near GSDMA and TSLP . Single nucleotide polymorphisms with suggestive evidence for association with asthma with hay fever risk included rs41295115 near IL2RA (OR, 1.28; P = 5 × 10 −7 ) and rs76043829 in TNS1 (OR, 1.23; P = 2 × 10 −6 ). Conclusion By focusing on the combined phenotype of asthma with hay fever, variants associated with the risk of allergic disease can be identified with greater efficiency.

TO THE EDITOR Striae distensae, or stretch marks, are a common skin condition that appear initially as red, and later on as white, lines on the skin. These lines represent scars of the dermis, and are characterized by linear bundles of collagen lying parallel to the surface of the skin, as well as eventual loss of collagen and elastin. Reports differ on the level of fragmentation of elastic fibers (Zheng et al., 1985; Sheu et al., 1991). Estimates of the prevalence of stretch marks range from 50 to 80% (Atwal et al., 2006; Cho et al., 2006). Although stretch marks are only harmful in extreme cases (Dosal et al., 2012), even mild stretch marks can cause distress to the bearer. The causes of stretch marks are not well understood. Excessive skin distension (such as that which occurs during pregnancy, growth spurts in puberty, or rapid weight gain), prolonged exposure to cortisol (such as in individuals with Cushing syndrome), and genetics may all have a role (Elsaie et al., 2009). A few monogenic connective tissue diseases, including Marfan syndrome and congenital contractural arachnodactyly, are known to be associated with stretch marks. These syndromes are caused by mutations in genes that encode extracellular matrix proteins (fibrillin-1 and fibrillin-2, respectively) that are part of elastic microfibrils present in skin and other tissues. However, to date, no genetic variants are known to be associated with isolated stretch marks that afflict the general population. To identify variants associated with the development of stretch marks, we conducted a genome-wide association analysis of stretch marks in a discovery cohort of 33,930 unrelated 23andMe customers (Supplementary Table S1 online) of European descent. There were a total of 13,068 cases and 20,862 controls. The 18,650 men in the cohort were much less likely to report stretch marks (25% versus 55% of women), which is consistent with other reports (Elsaie et al., 2009). We further evaluated the associated variants in a cohort consisting of 4,967 female 23andMe customers of European descent (disjoint from the first group) who reported on severity of stretch marks during pregnancy (also known as striae gravidarum, a closely related phenotype). See Supplemental Methods for additional details on phenotyping. The protocol for this study was approved by an independent institutional review board (EI all study participants provided informed consent online, which was recorded in an electronic database. See Supplementary Methods for details on genotyping and imputation. All analyses used logistic (discovery cohort) or linear (pregnancy cohort) regression against imputed allele dosages, controlling for age, population structure (using five principal components), and (except for the pregnancy cohort) sex. Because the prevalence of stretch marks differs between men and women, we checked for but did not observe differing effects for the single-nucleotide polymorphisms (SNPs) in men and women. Four regions were significantly (P

Allergic disease is very common and carries substantial public-health burdens. We conducted a meta-analysis of genome-wide associations with self-reported cat, dust-mite and pollen allergies in 53,862 individuals. We used generalized estimating equations to model shared and allergy-specific genetic effects. We identified 16 shared susceptibility loci with association P

Item does not contain fulltext The pathogenesis of androgenetic alopecia (AGA, male-pattern baldness) is driven by androgens, and genetic predisposition is the major prerequisite. Candidate gene and genome-wide association studies have reported that single-nucleotide polymorphisms (SNPs) at eight different genomic loci are associated with AGA development. However, a significant fraction of the overall heritable risk still awaits identification. Furthermore, the understanding of the pathophysiology of AGA is incomplete, and each newly associated locus may provide novel insights into contributing biological pathways. The aim of this study was to identify unknown AGA risk loci by replicating SNPs at the 12 genomic loci that showed suggestive association (5 x 10(-8)

Background Neointimal hyperplasia limits the longevity of vascular interventions. Nitric oxide (NO) is well known to inhibit neointimal hyperplasia. However, delivery of NO to the vasculature is challenging. Our study aims to evaluate the efficacy of delivering NO to the site of injury using a permeable balloon catheter. Our hypothesis is that ultra-short duration NO delivery using a permeable balloon catheter will inhibit neointimal hyperplasia. Materials and methods Ten-week-old male Sprague-Dawley rats underwent carotid artery balloon injury. Groups included: (1) control, (2) injury, (3) injury + periadventitial NO, and (4) injury + endoluminal NO via permeable balloon catheter. The catheter was inflated to 5 atm pressure for 5 min. Arteries were harvested 2 wk following injury. Morphometric assessment for neointimal hyperplasia and immunohistochemical staining for inflammatory markers were performed. Results Injury increased neointimal hyperplasia compared with control (intima/media area [I/M] ratio 1.07 versus 0.11, respectively, P < 0.001). Periadventitial delivery of NO reduced the I/M area ratio compared with injury alone (55% decrease, P < 0.001). Endoluminal delivery of NO also reduced the I/M area ratio compared with injury alone (65% decrease; P < 0.001). Both endoluminal and periadventitial NO affected the I/M ratio by reducing the intimal area (64% and 46%, respectively, P < 0.001) whereas neither affected the medial area. Periadventitial NO delivery increased lumen area (P < 0.05), whereas endoluminal NO delivery increased circumference (P < 0.05). Periadventitial NO delivery inhibited macrophage intimal infiltration compared with injury alone (P < 0.05). Conclusions These data demonstrate that short-duration endoluminal NO delivery via permeable balloon catheters inhibits neointimal hyperplasia following arterial interventions. Endoluminal delivery of NO could become a focus for future clinical interventions.

An updated assessment has been made of the proposed hypothesis that galactic cosmic rays (GCRs) are positively correlated with lower-troposphere global cloudiness. A brief review of the many conflicting studies that attempt to prove or disprove this hypothesis is also presented. It has been determined in this assessment that the recent extended quiet period between solar cycles 23 and 24 has led to a record-high level of GCRs, which in turn has been accompanied by a record-low level of lower-troposphere global cloudiness. This represents a possible observational disconnect, and the update presented here continues to support the need for further research on the GCR–cloud hypothesis and its possible role in the science of climate change.

In this study, we investigate the performance ratio (PR) of about 100 German photovoltaic system installations. Monitored PR is found to be systematically lower by ~2–4% when calculated with irradiation data obtained by pyranometers (henceforth denoted as PRPyr) as compared with irradiation amounts measured by reference cells (denoted as PRSi). Annual PRSi for the ~100 systems is found to be between ~70% and ~90% for the year 2010, with a median PR of ~84%. Next, simulations were performed to determine loss mechanisms of the top 10 performing systems, revealing a number of these loss mechanisms may still allow for some optimization. Despite the fact that we do not see such values from our monitoring data base up to now, we believe PRSi values above 90% are realistic even today, using today's commercially available components, and should be expected more frequently in the future. This contribution may help in deepening our knowledge on both energy loss mechanisms and efficiency limits on the system level and standardization processes of system-related aspects. Copyright © 2012 John Wiley & Sons, Ltd.

Leukocyte telomere shortening can serve as a biomarker of aging, as telomere length (TL) can decline with age and shortening is positively associated with morbidity and mortality. It is therefore important to identify psychological and behavioral factors linked to accelerated telomere shortening. Stress and poorer metabolic health (greater adiposity, insulin resistance, and cortisol) correlate with shorter telomeres. Self-reported dietary restraint (DR), defined as chronic preoccupation with weight and attempts at restricting food intake, is linked to greater perceived stress, cortisol, and weight gain, when assessed in community studies (versus in weight loss programs).To test for an association between DR and TL in healthy women across a range of ages.We examined whether DR is linked to TL in two samples, one of premenopausal women (aged 20-50 years;N = 36) and one of postmenopausal women (aged 53-69 years; N = 20).In both samples, higher levels of DR were associated with shorter leukocyte TL, independent of body mass index, smoking, and age.Chronic DR, as assessed by self-report (i.e. not caloric restriction), may be a risk factor for premature telomere shortening. Potential mechanisms are discussed.

Men receive conflicting messages about their sexual roles in heterosexual relationships. Men are socialized to initiate and direct sexual activities with women; yet societal norms also proscribe the sexual domination and coercion of women. The authors test these competing hypotheses by assessing whether men inhibit the link between sex and dominance. In Studies 1a and b, using a subliminal priming procedure embedded in a lexical decision task, the authors demonstrate that men automatically suppress the concept of dominance following exposure to subliminal sex primes relative to neutral primes. In Studies 2 and 3, the authors show that men who are less likely to perceive sexual assertiveness as necessary, to refrain from dominant sexual behavior, and who do not invest in masculine gender ideals are more likely to inhibit dominant thoughts following sex primes. Implications for theories of automatic cognitive networks and gender-based sexual roles are discussed.