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Objectives: Twin pregnancies are at higher risk of stillbirth compared to singletons. Fetal growth restriction (FGR) is a major cause of perinatal mortality, but its impact on twins vs singletons remains unclear. The primary objective of this study was to investigate the association of FGR and small‐for‐gestational age (SGA) with stillbirth in twin compared with singleton pregnancies. A secondary objective was to assess these associations stratified by gestational age at delivery. Furthermore, we aimed to compare the associations of FGR and SGA with stillbirth in twin pregnancies using twin‐specific vs singleton birth‐weight charts, stratified by chorionicity. Methods: This was a retrospective cross‐sectional study of pregnancies receiving obstetric care and giving birth between 1999 and 2022 at St George's Hospital, London, UK. The exclusion criteria included triplet and higher‐order pregnancies, those resulting in miscarriage or live birth at ≤ 23 + 6 weeks, termination of pregnancy and missing data regarding birth weight or gestational age at birth. Birth‐weight data were collected and FGR and SGA were defined as birth weight <5th and <10th centiles, respectively. While standard logistic regression was used for singleton pregnancies, the association of FGR and SGA with stillbirth in twin pregnancies was investigated using mixed‐effects logistic regression models. For twin pregnancies, intercepts were allowed to vary for twin pairs to account for intertwin dependency. Analyses were stratified by gestational age at delivery and chorionicity. Statistical significance was set at P ≤ 0.001. Results: The study included 95 342 singleton and 3576 twin pregnancies. There were 494 (0.52%) stillbirths in singleton and 41 (1.15%) stillbirths in twin pregnancies (17 dichorionic and 24 monochorionic). SGA and FGR were associated significantly with stillbirth in singleton pregnancies across all gestational ages at delivery: the odds ratios (ORs) for SGA and FGR were 2.36 ((95% CI, 1.78–3.13), P < 0.001) and 2.67 ((95% CI, 2.02–3.55), P < 0.001), respectively, for delivery before 32 weeks; 2.70 ((95% CI, 1.71–4.31), P < 0.001) and 2.82 ((95% CI, 1.78–4.47), P < 0.001), respectively, for delivery between 32 and 36 weeks; and 3.85 ((95% CI, 2.83–5.21), P < 0.001) and 4.43 ((95% CI, 3.16–6.12), P < 0.001), respectively, for delivery after 36 weeks. In twin pregnancies, when stratified by gestational age at delivery, both SGA and FGR determined by twin‐specific birth‐weight charts were associated with increased odds of stillbirth for those delivered before 32 weeks (SGA: OR, 3.87 (95% CI, 1.56–9.50), P = 0.003 and FGR: OR, 5.26 (95% CI, 2.11–13.01), P = 0.001), those delivered between 32 and 36 weeks (SGA: OR, 6.67 (95% CI, 2.11–20.41), P = 0.001 and FGR: OR, 9.54 (95% CI, 3.01–29.40), P < 0.001) and those delivered beyond 36 weeks (SGA: OR, 12.68 (95% CI, 2.47–58.15), P = 0.001 and FGR: OR, 23.84 (95% CI, 4.62–110.25), P < 0.001). However, the association of stillbirth with SGA and FGR in twin pregnancies was non‐significant when diagnosis was based on singleton charts (before 32 weeks: SGA, P = 0.014 and FGR, P = 0.005; 32–36 weeks: SGA, P = 0.036 and FGR, P = 0.008; after 36 weeks: SGA, P = 0.080 and FGR, P = 0.063). Conclusion: Our study demonstrates that SGA and, especially, FGR are associated significantly with an increased risk of stillbirth across all gestational ages in singleton pregnancies, and in twin pregnancies when twin‐specific birth‐weight charts are used. © 2024 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. Linked article: There is a comment on this article by Nicolaides et al. Click here to view the Correspondence. [ABSTRACT FROM AUTHOR]

Enterovirus D68 (EV‐D68) is an emerging agent for which data on the susceptible adult population is scarce. We performed a 6‐year analysis of respiratory samples from influenza‐like illness (ILI) admitted during 2014‐2020 in 4‐10 hospitals in the Valencia Region, Spain. EV‐D68 was identified in 68 (3.1%) among 2210 Enterovirus (EV)/Rhinovirus (HRV) positive samples. Phylogeny of 59 VP1 sequences showed isolates from 2014 clustering in B2 (6/12), B1 (5/12), and A2/D1 (1/12) subclades; those from 2015 (n = 1) and 2016 (n = 1) in B3 and A2/D1, respectively; and isolates from 2018 in A2/D3 (42/45), and B3 (3/45). B1 and B2 viruses were mainly detected in children (80% and 67%, respectively); B3 were equally distributed between children and adults; whereas A2/D1 and A2/D3 were observed only in adults. B3 viruses showed up to 16 amino acid changes at predicted antigenic sites. In conclusion, two EV‐D68 epidemics linked to ILI hospitalized cases occurred in the Valencia Region in 2014 and 2018, with three fatal outcomes and one ICU admission. A2/D3 strains from 2018 were associated with severe respiratory infection in adults. Because of the significant impact of non‐polio enteroviruses in ILI and the potential neurotropism, year‐round surveillance in respiratory samples should be pursued. [ABSTRACT FROM AUTHOR]

Introduction: Cerebroplacental ratio (CPR) has been shown to be an independent predictor of adverse perinatal outcome at term and a marker of failure to reach the growth potential (FRGP) regardless of fetal size, being abnormal in compromised fetuses with birthweight above the 10th centile. The main aim of this study was to propose a risk‐based approach for the management of pregnancies with normal estimated fetal weight (EFW) and abnormal CPR near term. Material and methods: This was a retrospective study of 943 pregnancies, that underwent an ultrasound evaluation of EFW and CPR at or beyond 34 weeks. CPR values were converted into multiples of the median (MoM) and EFW into centiles according to local references. Pregnancies were then divided into four groups: normal fetuses (defined as EFW ≥10th centile and CPR ≥0.6765 MoM), small for gestational age (EFW <10th centile and CPR ≥0.6765 MoM), fetal growth restriction (EFW <10th centile and CPR <0.6765 MoM), and fetuses with apparent normal growth (EFW ≥10th centile) and abnormal CPR (<0.6765 MoM), that present FRGP. Intrapartum fetal compromise (IFC) was defined as an abnormal intrapartum cardiotocogram or pH requiring cesarean delivery. Risk comparisons were performed among the four groups, based on the different frequencies of IFC. The risks of IFC were subsequently extrapolated into a gestational age scale, defining the optimal gestation to plan the birth for each of the four groups. Results: Fetal growth restriction was the group with the highest frequency of IFC followed by FRGP, small for gestational age, and normal groups. The "a priori" risks of the fetal growth restriction and normal groups were used to determine the limits of two scales. One defining the IFC risk and the other defining the appropriate gestational age for delivery. Extrapolation of the risk between both scales placed the optimal gestational age for delivery at 39 weeks of gestation in the case of FRGP and at 40 weeks in the case of small for gestational age. Conclusions: Fetuses near term may be evaluated according to the CPR and EFW defining four groups that present a progressive risk of IFC. Fetuses in pregnancies complicated by FRGP are likely to benefit from being delivered at 39 weeks of gestation. [ABSTRACT FROM AUTHOR]

Summary: Background: Molecular biomarkers of maternal leptin resistance associated with infant weight are needed. Objectives: To evaluate gene expression of leptin receptor (LEPR), suppressor of cytokine signalling 3 (SOCS3) and insulin receptor in peripheral blood mononuclear cells (PBMCs) of lactating women and their relationship with infant body weight and adiposity. Methods: At day 10 postpartum, maternal gene expression in PBMCs as well as leptin and insulin concentrations in plasma and milk were assessed (n = 68). Infant weight and BMI z‐scores, skinfolds and arm circumference were obtained at 10 days and/or at 3 months old. Results: In mothers with pre‐pregnancy overweight or obesity (OW/OB), LEPR expression was reduced (p = 0.013) whereas plasma and milk leptin and milk insulin concentrations were elevated. LEPR expression was positively related with infant weight z‐score (Beta (95% CI): 0.40 (0.17, 0.63), p = 0.001) but not with leptin concentrations. SOCS3 expression was positively related with infant weight z‐score (Beta (95% CI): 0.28 (0.04, 0.51), p = 0.024) and arm circumference (Beta (95% CI): 0.57 (0.32, 0.82), p < 0.001). Relationships remained significant after adjusting for maternal and infant confounders. Conclusions: LEPR and SOCS3 gene expression in PBMCs are novel maternal molecular biomarkers that reflect leptin resistance and are associated with infant body weight and adiposity. [ABSTRACT FROM AUTHOR]

Background and purpose: Vitamin D is considered to play a role in multiple sclerosis (MS) etiopathogenesis. A polymorphism in the CYP24A1 gene, rs2762943, was recently identified that was associated with an increased MS risk. CYP24A1 encodes a protein involved in the catabolism of the active form of vitamin D. The immunological effects of carrying the rs2762943 risk allele were investigated, as well as its role as genetic modifier. Methods: Serum levels of 25‐hydroxyvitamin D and 1,25‐dihydroxyvitamin D (1,25(OH)2D) were measured in a cohort of 167 MS patients. In a subgroup of patients, expression levels of major histocompatibility complex class II and co‐stimulatory molecules were determined by flow cytometry, and serum levels of pro‐inflammatory (interferon gamma, granulocyte macrophage colony‐stimulating factor, C‐X‐C motif chemokine ligand 13) and anti‐inflammatory (interleukin 10) cytokines and neurofilament light chain were measured by single‐molecule array assays. The effect of the rs2762943 polymorphism on disease activity and disability measures was evaluated in 340 MS patients. Results: Compared to non‐carriers, carriers of the rs2762943 risk allele were characterized by reduced levels of 1,25(OH)2D (p = 0.0001) and elevated levels of interferon gamma (p = 0.03) and granulocyte macrophage colony‐stimulating factor (p = 0.008), whereas no significant differences were observed for the other markers. The presence of the rs2762943 risk allele had no significant impact on disease activity and disability outcomes during follow‐up. However, risk allele carriers were younger at disease onset (p = 0.04). Conclusions: These findings suggest that the CYP24A1 rs2762943 polymorphism plays a more important role in MS susceptibility than in disease prognosis and is associated with lower 1,25(OH)2D levels and a heightened pro‐inflammatory environment in MS patients. [ABSTRACT FROM AUTHOR]

We investigated the entire butterfly fauna of the Samoan Archipelago (Pacific Ocean) by combining COI barcode sequences for specimens from these islands with those available in repositories at larger biogeographic scale. Haplotype networks and a generalized mixed Yule‐coalescent (GMYC) model were applied to identify evolutionary significant units (ESUs). The ESUs from Samoan islands were compared with ESUs of the same or sister taxa regionally and worldwide to explore the level of endemicity and of congruence between established taxonomy and COI barcodes. The level of ESUs endemicity was similar to that shown by species and subspecies. Australia was the most frequent origin for Samoan lineages, followed by Orient‐Asia. When comparing the agreement and mismatch between established taxonomy and ESUs between the Australia‐Oceania region and Europe and North America, the COI molecular marker revealed a similar performance in taxonomic identification. Despite this overall convergent pattern, the degree of mtDNA divergence and the analysis of functional traits suggested that the mechanisms producing patterns of genetic differentiation in temperate butterflies over ancient continental lands differ to those occurring across a vast ocean into geologically young islands. Mechanisms on Samoan islands include relatively recent and exceptional oceanic dispersal, possibly followed by repeated extinction events. In the Australia‐Oceania region we found a similar fraction of species showing introgression with the maintenance of phenotypic differences as it occurs on the mainland, but the phenomenon was limited to sectors of each species distribution area. Regular gene flow among the Samoan islands seems to prevent allopatric speciation within the archipelago. [ABSTRACT FROM AUTHOR]

Background and Aims: Factors associated with the concomitant occurrence of low muscle mass and low muscle radiodensity are unclear. This study investigated whether different skeletal muscle phenotypes are associated with functional impairment, serum inflammatory markers, and survival in patients with incurable cancer. Methods: Three hundred and twenty‐six patients (median age, 60 years; 67.5% female) who had abdominal or pelvic computed tomography (CT) scans up to 30 days before the initial assessment were enrolled in the study. CT images were used for the assessment of skeletal muscle index (SMI) and skeletal muscle radiodensity (SMD). Optimal stratification analysis was used to derive cohort‐specific cutoff points to define SMI and SMD groups with a higher risk for mortality (SMI, males <45.0 cm2/m2 and females <44.0 cm2/m2; SMD, males <34 Hounsfield units [HU] and females <30 HU). Based on these cutoffs, participants were classified into four phenotypes: low‐risk SMI + low‐risk SMD, high‐risk SMI + low‐risk SMD, low‐risk SMI + high‐risk SMD, and high‐risk SMI + high‐risk SMD. Results: Phenotypes with high‐risk SMI or high‐risk SMD, especially when combined, were associated with low handgrip strength, poor performance status, higher C‐reactive protein, and lower serum albumin levels. The phenotypes with high‐risk SMD, regardless of low‐risk SMI (hazard ratio [HR], 1.74; 95% CI, 1.05–2.88) or high‐risk SMI (HR, 1.99; 95% CI, 1.29–3.05) were associated with higher 90 days' mortality risk. Conclusion: In patients with incurable cancer, phenotype groups with high‐risk SMI and high‐risk SMD, particularly when combined, were associated with worse functional impairment and inflammation. Moreover, high‐risk SMD was associated with increased mortality risk. [ABSTRACT FROM AUTHOR]

Gender dysphoria affects 0.5% of people worldwide. Transgender men display a divergence between the female genetic sex and the gender male identity. To the best of our knowledge, we describe the first case report with regard to a transgender man with a dichorionic diamniotic twin pregnancy obtained by artificial insemination using donor sperm as a monoparental family, presenting early fetal growth restriction of both twins. The patient is a 35-year-old transgender man who had previously received gender-affirming hormone therapy based on testosterone for five years and had a prior bilateral mastectomy as gender-affirming surgery. Whether assisted reproductive techniques have any influence on obstetrical outcomes among these patients and whether prior long-term intake of gender-affirming hormone therapy has an impact on pregnancy and obstetrical outcomes remain to be elucidated. [ABSTRACT FROM AUTHOR]

The record of open‐air Middle Palaeolithic sites in the Iberian Peninsula—specifically in the Mediterranean basin—is scarce, hampering the interpretation of the landscape use strategies developed by Neanderthals in this area. In this work, we present Los Aljezares, a new Middle Palaeolithic site found in Pleistocene fluvio‐lacustrine deposits in the sedimentary basin of the Vinalopó River. A U/Th age (132 ± 10 ka) from associated carbonate deposits allows us to attribute the site to the uppermost part of the Middle Pleistocene to Late Pleistocene (marine isotope stage 6/5). To date, a total of two levels of human occupation have been identified in which the density of lithic remains is low compared with cave and rock shelter sites in the region. The first results of technology and use‐wear, raw material procurement and geological data indicate a settlement in Los Aljezares along a territory characterised by ephemeral channels and their associated palustrine and lacustrine zones. This palaeoenvironmental setting provided biotic and abiotic resources in a transit area between inland and coastal locations. [ABSTRACT FROM AUTHOR]

Background: The Patient‐Generated Subjective Global Assessment Short Form (PG‐SGA SF) is a standardized tool for assessing nutrition risk in patients with cancer. The aim of this study was to propose and validate a cutoff point for the PG‐SGA SF related to the prognosis of patients with incurable cancer in exclusive palliative care. Methods: This is a prospective cohort study of patients with incurable cancer at the National Cancer Institute in Brazil. A total sample (n = 2,144) was randomly divided into groups: (1) training (n = 1,072), to determine the most accurate PG‐SGA SF cutoff, and (2) validation (n = 1,072), to test the predictive accuracy of this cutoff point. The receiver operating characteristic curve was plotted to determine the best cutoff point of the PG‐SGA SF related to death. Concordance statistics (C statistic) were used to test the predictive accuracy of the models. Kaplan‐Meier curve and the Cox hazard model were used to verify a prognostic value of the cutoff point. Results: PG‐SGA SF score ≥15 was found to be the best cutoff based on 90‐day mortality with good accuracy discrimination (C statistic ≥ 0.74). Patients whose PG‐SGA SF score was ≥15 had a shorter survival of 32 (interquartile range [IQR], 12–75) vs 83 days (IQR, 31–90) (p‐value <.001) and higher risk of death (hazard ratio: 2.20; 95% CI, 1.64–2.95). Conclusions: The proposed PG‐SGA SF cutoff score is valid and, alongside its usefulness in nutrition triage, could provide prognostic value for patients with incurable cancer. [ABSTRACT FROM AUTHOR]

Neanderthals and modern humans from the Early Upper Palaeolithic had a highly developed knowledge of their environment, where they found the essential resources for their subsistence. Therefore, changes in the local landscape and available resources should have influenced their behaviour, as indicated by faunal and plant remains recovered from archaeological sites. In the central‐eastern Iberian Mediterranean region, the archaeological sites of Cova Negra, Abrigo de la Quebrada, Cova de les Malladetes and Cova de les Cendres have provided wood charcoal, seeds and fauna. The combination of these data allows an accurate reconstruction of the regional landscape from MIS 5 to the beginning of MIS 2. The available evidence suggests that this region could be defined as a refugium in which biodiversity persisted. This type of refugium, containing a high diversity of biotopes and some endemic species, which has lasted until the present day, can be seen at a regional scale, but also locally, especially near the coast. These special characteristics of the region – relatively stable climatic conditions with oscillations mainly in aridity and humidity, and a high diversity of flora and fauna – could explain the high density of Palaeolithic sites throughout Middle and Upper Palaeolithic here. [ABSTRACT FROM AUTHOR]

Objectives: Cohort variation in adult height expresses both the impact of socio‐economic change on human biology in a wide temporal perspective and social inequalities within populations. We aimed to test the use of joinpoint regressions to identify periods in which changes in height trends were statistically significant. Methods: Data correspond to the height recorded in Madrid City (Spain) for 65 313 conscripts between 1936 and 1974 (cohorts from 1915 to 1953), a period of social and political turmoil. Secular trends in height were analyzed in eight districts with contrasting socio‐economic conditions, grouped in two categories, lower‐class and middle‐ and upper‐class. Trends in height were evaluated by quadratic regressions and by joinpoint regressions to identify the cut‐off years when trends changed significantly. Results: Height increased in both socio‐economic categories of districts, more among conscripts from the lower‐class ones. However, results clearly show differences in trends according to district of residence. Whereas the increase in height in conscripts from the middle‐ and upper‐class districts was steady, it was slower in those from the lower classes, with declines in height during the Civil War and first years of the Franco dictatorship. Conclusions: Joinpoint analysis reveals the association between urban living conditions and adult height, and that the disparities intensified during critical historical periods of Spain. [ABSTRACT FROM AUTHOR]

Purpose: A Monte Carlo (MC) modeling of single axial and helical CT scan modes has been developed to compute single and accumulated dose distributions. The radiation emission characteristics of an MDCT scanner has been modeled and used to evaluate the dose deposition in infinitely long head and body PMMA phantoms. The simulated accumulated dose distributions determined the approach to equilibrium function, H(L). From these H(L) curves, dose‐related information was calculated for different head and body clinical protocols. Methods: The PENELOPE/penEasy package has been used to model the single axial and helical procedures and the radiation transport of photons and electrons in the phantoms. The bowtie filters, heel effect, focal‐spot angle, and fan‐beam geometry were incorporated. Head and body protocols with different pitch values were modeled for x‐ray spectra corresponding to 80, 100, 120, and 140 kV. The analytical formulation for the single dose distributions and experimental measurements of single and accumulated dose distributions were employed to validate the MC results. The experimental dose distributions were measured with OSLDs and a thimble ion chamber inserted into PMMA phantoms. Also, the experimental values of the CTDI100 along the center and peripheral axes of the CTDI phantom served to calibrate the simulated single and accumulated dose distributions. Results: The match of the simulated dose distributions with the reference data supports the correct modeling of the heel effect and the radiation transport in the phantom material reflected in the tails of the dose distributions. The validation of the x‐ray source model was done comparing the CTDI ratios between simulated, measured and CTDosimetry data. The average difference of these ratios for head and body protocols between the simulated and measured data was in the range of 13–17% and between simulated and CTDosimetry data varied 10–13%. The distributions of simulated doses and those measured with the thimble ion chamber are compatible within 3%. In this study, it was demonstrated that the efficiencies of the CTDI100 measurements in head phantoms with nT = 20 mm and 120 kV are 80.6% and 87.8% at central and peripheral axes, respectively. In the body phantoms with nT= 40 mm and 120 kV, the efficiencies are 56.5% and 86.2% at central and peripheral axes, respectively. In general terms, the clinical parameters such as pitch, beam intensity, and voltage affect the Deq values with the increase of the pitch decreasing the Deq and the beam intensity and the voltage increasing its value. The H(L) function does not change with the pitch values, but depends on the phantom axis (central or peripheral). Conclusions: The computation of the pitch‐equilibrium dose product, D̂eq, evidenced the limitations of the CTDI100 method to determine the dose delivered by a CT scanner. Therefore, quantities derived from the CTDI100 propagate this limitation. The developed MC model shows excellent compatibility with both measurements and literature quantities defined by AAPM Reports 111 and 200. These results demonstrate the robustness and versatility of the proposed modeling method. [ABSTRACT FROM AUTHOR]

Objective: Obesity-associated hypoandrogenemia is increasing in parallel to the obesity epidemic. The prevalence of hypoandrogenemia in nondiabetic young men with obesity is not known. This study aimed to evaluate the prevalence of hypoandrogenemia and associated risk factors in this population.Methods: This cross-sectional study included 266 nondiabetic men < 50 years of age with obesity who were referred from primary care. Total testosterone (high-performance liquid chromatography mass spectrometry), sex hormone-binding globulin, free testosterone (FT), luteinizing hormone (LH), high-sensitivity C-reactive protein, and homeostatic model assessment of insulin resistance were determined. Body composition and erectile function were also assessed. Hypoandrogenemia was defined as FT level < 70 pg/mL.Results: Subnormal FT concentrations were found in 25.6% of participants. Hypoandrogenemia prevalence was different along the BMI continuum, being > 75% in individuals with BMI ≥ 50 kg/m2 . A multivariate regression analysis indicated that increasing BMI (P < 0.001), age (P = 0.049), and reduced LH levels (P = 0.003) were independent risk factors for hypoandrogenemia.Conclusions: In a primary care-based cohort of nondiabetic young men with obesity, hypoandrogenemia was a very prevalent finding and was directly associated with adiposity. Obesity, age, and reduced LH levels were independent risk factors associated with hypoandrogenemia. Further prospective studies are needed to evaluate the long-term consequences of hypoandrogenemia in this population. [ABSTRACT FROM AUTHOR]

This article discusses the controversy surrounding the use of cerebral Doppler in monitoring fetal wellbeing. The study examines the middle cerebral artery (MCA) pulsatility index (PI) of 37 normal fetuses during periods of fetal activity and rest. The findings show that during fetal activity, the MCA-PI appears abnormally low, but normalizes during rest. The study suggests that MCA-PI is not a static parameter and fluctuates depending on fetal activity and repose. These findings have implications for the evaluation of fetal wellbeing and the accuracy of MCA-PI assessment. [Extracted from the article]

Background. Vertical transmission of the Coronavirus Disease 2019 (COVID-19) is still controversial. Additionally, the consequences of the infection during pregnancy in the offspring also are unknown. Case. A transitory fetal skin edema and polyhydramnios have been demonstrated by ultrasound in a pregnant patient with COVID-19 after a negative RT-PCR for SARS-CoV-2. The fetal findings presented a spontaneous resolution in utero, and abnormal findings were not found in the newborn. Conclusion. Women who have undergone SARS-CoV-2 infection during pregnancy should receive a subsequent appropriate follow-up in order to clarify the fetal consequences of the novel coronavirus, if any. [ABSTRACT FROM AUTHOR]

Hypospadias is a congenital malformation of the male lower urinary tract, consisting of a ventral urethral opening proximal to the glans penis. This condition is corrected surgically in the paediatric age, with a great variety of techniques available. Traditionally, a tubularized genital skin was used for one- or two-stage repairs. Nowadays, the tendency is to use preputial or oral mucosa grafts, dorsally located, to avoid diverticula formation and prevent hair growth in the neourethra. We present a case of a patient born with proximal hypospadias with penoscrotal transposition, surgically corrected in his childhood, using dorsal penile skin island flap. The patient is referred to urology consultation in his adulthood for a weak urinary stream, recurrent infections, and a large amount of hair exiting through the urethral meatus. [ABSTRACT FROM AUTHOR]

Objectives: Plasticity in the growth of body segments between populations has been researched in relation to migration, temporal change and high‐altitude studies. We study the within population variation in body segments, thus controlling for some of the environmental and genetic differences that could be at play in between populations studies. We test a version of the thrifty phenotype hypothesis, where the growth of head‐trunk and hand are prioritized due to their functional significance over height and leg growth. Materials and methods: A total of 3913 Guatemalan, rural, semi‐urban and urban, Maya and Ladino children 6 to 15 years old were studied. Height, sitting height, leg length, and metacarpal length were studied in relation to three proxies for living conditions: height‐ and leg length‐for‐age, and maternal education. Estimation statistics and null hypothesis significance testing were used to analyze the data. Results: Metatarsal length and sitting height values were higher than height and leg length respectively. Relative metacarpal length was conserved across height‐for‐age groups. Females were less affected than males for metacarpal length and sitting height, but more affected for leg length. Conclusion: Our results agree with the thrifty phenotype hypothesis, where metacarpal and sitting height growth would be prioritized over height and leg length due to greater functional significance. [ABSTRACT FROM AUTHOR]

Although genome‐wide association studies have identified a number of common variants associated with multiple sclerosis (MS) susceptibility, little is known about the relevance of rare variants. Here, we aimed to explore the role of rare variants in 14 MS risk genes (FCRL1, RGS1, TIMMDC1, HHEX, CXCR5, LTBR, TSFM, GALC, TRAF3, STAT3, TNFSF14, IFI30, CD40, and CYP24A1) by targeted resequencing in an Iberian population of 524 MS cases and 546 healthy controls. Four rare variants‐enriched regions within CYP24A1, FCRL1, RGS1, and TRAF3 were identified as significantly associated with MS. Functional studies revealed significantly decreased regulator of G protein signaling 1 (RGS1) gene expression levels in peripheral blood mononuclear cells from MS patients with RGS1 rare variants compared to noncarriers, whereas no significant differences in gene expression were observed for CYP24A1, FCRL1, and TRAF3 between rare variants carriers and noncarriers. Immunophenotyping showed significant decrease in RGS1 expression in peripheral blood B lymphocytes from MS patients with RGS1 rare variants relative to noncarriers. Lastly, peripheral blood mononuclear cell from MS patients carrying RGS1 rare variants showed significantly lower induction of RGS1 gene expression by interferon‐β compared to MS patients lacking RGS1 variants. The presence of rare variants in RGS1 reinforce the ideas of high genetic heterogeneity and a role of rare variants in MS pathogenesis. [ABSTRACT FROM AUTHOR]

Social a/r/tography combines three dimensions of a/r/tography (artistic creation, education and research) incorporating a fourth collaborative, participatory community‐based approach. This ongoing project began in two primary and secondary schools located in the slums of Tegucigalpa, Honduras, as cooperative action for curricular development in art education. As participatory action, students created a mural drawing inspired by Sol Lewitt's wall drawings, as well as photo pairs on the theme of body and nature inspired by a lithograph by Uta Barth. The drawings and photographs created by the students in Honduras were presented at an event in the Exchange space of the Tate gallery in Liverpool as visual provocation for the creation of drawings and visual metaphors. The concept of visual dialogue, which we define as 'to teach human beings to have visual conversations with other humans through the visual content of images', helps us to consider images as questions which are answered with new images whose meaning is subsequently transformed in function of artistic, school and social contexts. [ABSTRACT FROM AUTHOR]

Urethral haemangiomas are rare benign vascular tumours. They usually cause painless urethral bleeding and haematospermia. Urethroscopy is the preferred diagnostic tool, while complementary radiologic studies could describe the extension of the tumour. Treatment should be tailored to each case, considering size, location, and number of lesions. We present a case of a male patient diagnosed with urethral haemangiomas following painless spontaneous urethral bleeding associated with voiding symptoms. [ABSTRACT FROM AUTHOR]

Bluetooth Low Energy (BLE) 4.0 beacons will play a major role in the deployment of energy-efficient indoor localization mechanisms. Since BLE4.0 is highly sensitive to fast fading impairments, numerous ongoing studies are currently exploring the use of supervised learning algorithm as an alternative approach to exploit the information provided by the indoor radio maps. Despite the large number of results reported in the literature, there are still many open issues on the performance evaluation of such approach. In this paper, we start by identifying, in a simple setup, the main system parameters to be taken into account on the design of BLE4.0 beacons-based indoor localization mechanisms. In order to shed some light on the evaluation process using supervised learning algorithm, we carry out an in-depth experimental evaluation in terms of the mean localization error, local prediction accuracy, and global prediction accuracy. Based on our results, we argue that, in order to fully assess the capabilities of supervised learning algorithms, it is necessary to include all the three metrics. [ABSTRACT FROM AUTHOR]

ABSTRACT Single-walled carbon nanotubes (SWCNT)/expanded graphite (EG)/poly(trimethylene terephthalate) (PTT) hybrid nanocomposites were prepared via in situ polymerization. Raman spectroscopy and scanning electron microscopy (SEM) were employed to determine both, purity and morphology of the nanofillers and the dispersion of nanotubes and nanosheets. The electrical and optical properties of thin polymer films based on both 'single' nanocomposites and hybrid nanocomposites were studied. For PTT/SWCNT nanocomposites, results confirmed that films optical transmittance decreases as the concentration of SWCNT increases, attaining almost no optical transmittance for 0.3 wt % of nanofiller. Conversely, the electrical conductivity of nanocomposites was found to increase by increasing the nanofiller amount and the σdc values indicate that percolation occurs at a very low SWCNT content (around 0.05 wt %). In the case of PTT/SWCNT + EG nanocomposites, when the content of SWCNT is 0.05%, the hybrid system presents lower conductivity than that corresponding to the 'single' nanocomposite. The incorporation of additional EG to the PTT/SWCNT nanocomposite has a small effect on the electrical conductivity but inhibits the transparency of the system. © 2016 Wiley Periodicals, Inc. J. Appl. Polym. Sci. 2017, 134, 44370. [ABSTRACT FROM AUTHOR]

We studied the full-energy peak efficiency of a Si drift detector (SDD) and a Si(Li) detector (SLD) using the formalisms proposed by Seltzer [ Nucl. Instrum. Meth. 188 (1981) 133] and O'Meara and Campbell [ X-Ray Spectrom. 33 (2004) 146]. The respective adjustable parameters were fitted to full-energy peak efficiencies measured with certified point radioactive sources. Seltzer's model was able to reproduce the experimental data for the SDD and the SLD in the 6-40 keV and 6-100 keV energy ranges, respectively. In turn, O'Meara and Campbell's formula also performed well for the SDD between 6 and 40 keV and proved to fit satisfactorily in the energy interval 6-60 keV for the SLD. Copyright © 2016 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Objective: To evaluate whether maintenance treatment with vaginal progesterone after an arrested preterm labour reduces the incidence of preterm delivery.Design: Multicentre, randomised, double-blind, placebo-controlled trial.Setting: Twelve tertiary care centres in Spain.Population: A total of 265 women with singleton pregnancy, preterm labour successfully arrested with tocolytic treatment, and cervical length of <25 mm.Methods: Randomisation was stratified by gestational age (from 24.0 to <31.0 weeks of gestation and from 31.0 to <34.0 weeks of gestation) and centre. Patients were randomly assigned, in a 1 : 1 ratio, to either daily vaginal capsules of 200 mg progesterone or placebo until delivery or 36.6 weeks of gestation, whichever occurred first.Main Outcome Measures: Primary outcome was delivery before 34.0 and 37.0 weeks of gestation. Secondary outcomes were discharge-to-delivery time, readmissions because of preterm labour, emergency service use, and neonatal morbidity and mortality.Results: From June 2008 through June 2012, 1419 women were screened: 472 met the inclusion criteria and 265 were randomised. The final analysis included 258 women: 126 in the progesterone group and 132 in the placebo group. There were no significant differences between the progesterone and placebo groups in terms of delivery at <34 weeks of gestation [9/126 (7.1%) versus 10/132 (7.6%), P = 0.91] or <37 weeks of gestation [36/126 (28.6%) versus 29/132 (22.0%), P = 0.22]. There were no differences observed between groups when considering the two strata of gestational age at inclusion.Conclusions: A maintenance treatment of 200 mg of daily vaginal progesterone capsules in women discharged home after an episode of arrested preterm labour did not significantly reduce the rate of preterm delivery.Tweetable Abstract: Maintenance progesterone in 258 women after arrested PTL showed no benefit. [ABSTRACT FROM AUTHOR]

Dopamine D2 receptors (D2R) in the medial prefrontal cortex (mPFC) are key players in the etiology and therapeutics of schizophrenia. The overactivation of these receptors contributes to mPFC dysfunction. Chronic treatment with D2R agonists modifies the expression of molecules implicated in neuronal structural plasticity, synaptic function, and inhibitory neurotransmission, which are also altered in schizophrenia. These changes are dependent on the expression of the polysialylated form of the neural cell adhesion molecule (PSA-NCAM), a plasticity-related molecule, but nothing is known about the effects of D2R and PSA-NCAM on excitatory neurotransmission and the structure of mPFC pyramidal neurons, two additional features affected in schizophrenia. To evaluate these parameters, we have chronically treated adult rats with PPHT (a D2R agonist) after enzymatic removal of PSA with Endo-N. Both treatments decreased spine density in apical dendrites of pyramidal neurons without affecting their inhibitory innervation. Endo-N also reduced the expression of vesicular glutamate transporter-1. These results indicate that D2R and PSA-NCAM are important players in the regulation of the structural plasticity of mPFC excitatory neurons. This is relevant to our understanding of the neurobiological basis of schizophrenia, in which structural alterations of pyramidal neurons and altered expression of D2R and PSA-NCAM have been found. [ABSTRACT FROM AUTHOR]

The functionalization of the primary sites of alkanes is one of the more challenging areas in catalysis. In this context, a novel effect has been discovered that is responsible for an enhancement in the reactivity of the primary C−H bonds of alkanes in a catalytic system. The copper complex Cu(NCMe) ( =hydrotris{[3,5-bis(trifluoromethyl)-4-bromo]-pyrazol-1-yl}borate) catalyzes the functionalization of C nH2 n+2 with ethyl diazoacetate upon inserting the CHCO2Et unit into C−H bonds. In addition, the selectivity of the reaction toward the primary sites significantly increased relative to that obtained in neat alkane upon using supercritical carbon dioxide as the reaction medium. This was attributed to the effect of the carbon dioxide molecules that withdraw electron density from the fluorine atoms of the ligand, which enhances the electrophilic nature of the metal center. DFT studies validated this proposal. [ABSTRACT FROM AUTHOR]

This prospective longitudinal study aimed at comparing maternal immune response among naturally conceived (NC; n=25), in vitro fertilization (IVF; n=25), and egg donation (ED; n=25) pregnancies. The main outcome measures were, firstly, to follow up plasma levels of interleukin (IL) 1beta, IL2, IL4, IL5, IL6, IL8, IL10, IL17, interferon gamma, tumor necrosis factor-alpha (TNFα), transforming growth factor-beta (TGFβ), regulated upon activation normal T-cell expressed and secreted (RANTES), stromal cell-derived factor 1 alpha (SDF1α), and decidual granulocyte-macrophage colony-stimulating factor (GM-CSF) during the three trimesters of pregnancy during the three trimesters of pregnancy; secondly, to evaluate if the cytokine and chemokine pattern of ED pregnant women differs from that of those with autologous oocytes and, thirdly, to assess if women with preeclampsia show different cytokine and chemokine profile throughout pregnancy versus women with uneventful pregnancies. Pregnant women in the three study groups displayed similar cytokine and chemokine pattern throughout pregnancy. The levels of all quantified cytokines and chemokines, except RANTES, TNFα, IL8, TGFβ, and SDF1α, rose in the second trimester compared with the first, and these higher values remained in the third trimester. ED pregnancies showed lower SDF1α levels in the third trimester compared with NC and IVF pregnancies. Patients who developed preeclampsia displayed higher SDF1α plasma levels in the third trimester. [ABSTRACT FROM AUTHOR]

Aim To identify how the severity of dementia influences functional recovery and mortality in elderly patients hospitalized for hip fracture. Methods An observational retrospective study of 1258 patients aged older than 69 years and diagnosed with hip fracture who received care within an orthogeriatrics unit from 2004 to 2008 was carried out. During a 12-month follow-up period, functional recovery and mortality outcomes were measured. Results Dementia was present in 383 (28.1%) patients: it was mild in 183 (48%), moderate in 102 (26.5%) and severe in 98 (25.5%). Compared with patients with preserved cognitive status, patients with dementia had the following statistically significant differences (means [standard deviation] or percentage): older age (preserved, 82.29 years [6.5 years]; mild, 83.63 years [6.1 years]; moderate, 83.47 years [5.9 years]; severe, 84.46 years [6.1 years]; P < 0.001); lower Barthel Index (89.7 [21.6], 72.7 [24.6], 58.9 [28.6], 38.0 [28.1]; P < 0.001); delirium (11.7%, 25.6%, 37.6%, 44.7%; P < 0.001); less ambulation at 6 months postdischarge (83.9%, 72.8%, 56.9%, 41.7%; P < 0.001); and higher mortality at discharge (4%, 5.7%, 8.2%, 10.6%; P < 0.001) and 12 months after discharge (21.2%, 32.3%, 46.3%, 53.5%; P < 0.001). Patients with severe dementia had lower probability of functional recovery at discharge ( OR 0.272, 95% CI 0.140-0.526, P < 0.001) and 6 months after discharge ( OR 0.439, 95% CI 0.197-0.979, P = 0.04), as well as a greater probability of dying ( HR 1.640, 95% CI 1.020-2.635, P = 0.04). Conclusions We observed higher 12-month mortality and less functional recovery with increasing severity of dementia. Geriatr Gerontol Int 2015; 15: 289-295. [ABSTRACT FROM AUTHOR]

The Carboniferous succession in the Tindouf Basin of southern Morocco, North Africa, displays Mississippian to Early Pennsylvanian marine beds, followed by Pennsylvanian continental deposits. The marine beds comprise a shallow water cyclic platform sequence, dominated by shales and fine-grained sandstones with thin but laterally persistent limestone/dolostone beds. Foraminiferal assemblages have been studied in the limestone beds in several sections from the Djebel Ouarkziz range in the northern limb of the Tindouf Syncline; they indicate that the age of the limestones range from late Asbian (late Viséan) to Krasnopolyanian (early Bashkirian). The foraminiferal assemblages are abundant and diverse, and much richer in diversity than those suggested by previous studies in the region, as well as for other areas of the western Palaeotethys. The richest assemblages are recorded in the Serpukhovian but, unusually, they contain several taxa which appear much earlier in Western European basins (in the latest Viséan). In contrast, conodont assemblages are scarce due to the shallow-water facies, although some important taxa are recorded in the youngest limestones. Copyright © 2013 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Maternofetal immune tolerance is essential to maintain pregnancy. The maternal immunological tolerance to the semiallogeneic fetus becomes greater in egg donation pregnancies with unrelated donors as the complete fetal genome is allogeneic to the mother. Instead of being rejected, the allogeneic fetus is tolerated by the pregnant woman in egg donation pregnancies. It has been reported that maternal morbidity during egg donation pregnancies is higher as compared with spontaneous or in vitro fertilization pregnancies. Particularly, egg donation pregnancies are associated with a higher incidence of pregnancy-induced hypertension and placental pathology. Preeclampsia, a pregnancy-specific disease characterized by the development of both hypertension and proteinuria, remains the leading cause of maternal and perinatal mortality and morbidity. The aim of this review is to characterize and relate the maternofetal immunological tolerance phenomenon during pregnancies with a semiallogenic fetus, which are the spontaneously conceived pregnancies and in vitro fertilization pregnancies, and those with an allogeneic fetus or egg donation pregnancies. Maternofetal immune tolerance in uncomplicated pregnancies and pathological pregnancies, such as those with preeclampsia, has also been assessed. Moreover, whether an inadequate maternal immunological response to the allogenic fetus could lead to a higher prevalence of preeclampsia in egg donation pregnancies has been addressed. [ABSTRACT FROM AUTHOR]

A literary criticism is presented of the comic-book series "The Amazing Spider-Man," (or "TAS") by Steve Ditko. Particular focus is given to the theme of the objectivism within the comic book series, including as portrayed in the comic book's superhero Spider-Man and the philosopher Ayn Rand's political ideology.

Purpose: The LIonTrack (Light Ion Track) Monte Carlo (MC) code for the simulation of H+, He2+, and other light ions in liquid water is presented together with the results of a novel investigation of energy-deposition site properties from single ion tracks. Methods: The continuum distorted-wave formalism with the eikonal initial state approximation (CDW-EIS) is employed to generate the initial energy and angle of the electrons emitted in ionizing collisions of the ions with H2O molecules. The model of Dingfelder et al. ['Electron inelastic-scattering cross sections in liquid water,' Radiat. Phys. Chem. 53, 1-18 (1998); 'Comparisons of calculations with PARTRAC and NOREC: Transport of electrons in liquid water,' Radiat. Res. 169, 584-594 (2008)] is linked to the general-purpose MC code PENELOPE/penEasy to simulate the inelastic interactions of the secondary electrons in liquid water. In this way, the extended PENELOPE/penEasy code may provide an improved description of the 3D distribution of energy deposits (EDs), making it suitable for applications at the micrometer and nanometer scales. Results: Single-ionization cross sections calculated with the ab initio CDW-EIS formalism are compared to available experimental values, some of them reported very recently, and the theoretical electronic stopping powers are benchmarked against those recommended by the ICRU. The authors also analyze distinct aspects of the spatial patterns of EDs, such as the frequency of nearest-neighbor distances for various radiation qualities, and the variation of the mean specific energy imparted in nanoscopic targets located around the track. For 1 MeV/u particles, the C6+ ions generate about 15 times more clusters of six EDs within an ED distance of 3 nm than H+. Conclusions: On average clusters of two to three EDs for 1 MeV/u H+ and clusters of four to five EDs for 1 MeV/u C6+ could be expected for a modeling double strand break distance of 3.4 nm. [ABSTRACT FROM AUTHOR]

The polysialylated form of the neuronal cell adhesion molecule (PSA-NCAM) is expressed by immature neurons in the amygdala of adult mammals, including non-human primates. In a recent report we have also described the presence of PSA-NCAM-expressing cells in the amygdala of adult humans. Although many of these cells have been classified as mature interneurons, some of them lacked mature neuronal markers, suggesting the presence of immature neurons. We have studied, using immunohistochemistry, the existence and distribution of these immature neurons using post mortem material. We have also analysed the presence of proliferating cells and the association between immature neurons and specialised astrocytes. These parameters have also been studied for comparative purposes in the amygdalae of cats and squirrel monkeys. Our results demonstrate that cells coexpressing doublecortin and PSA-NCAM, but lacking neuronal nuclear antigen expression, were present in the amygdala of adult humans. These cells were organised in elongated clusters, which were located between the white matter of the dorsal hippocampus and the basolateral amygdaloid nucleus. These clusters were not associated with astroglial specialised structures. No cells expressing the proliferative marker Ki67 were observed in the amygdaloid parenchyma, although some of them were found in the vicinity of the lateral ventricle. Immature neurons were also present in the amygdala of squirrel monkeys and cats. These cells also appeared clustered in monkeys, although not as organised as in humans. In cats these cells are scarce, appear isolated and most of the PSA-NCAM-expressing structures corresponded to processes apparently originating from the paleocortical layer II. [ABSTRACT FROM AUTHOR]

Objectives: Previous studies generally agree that in Homo sapiens births without medical intervention occur mostly at night, although with a less accentuated pattern than in other primate species. The present study has three main objectives: (a) to establish the hourly pattern of births in a modern medicalized population, (b) to explore the association between the hour of birth and maternal and fetal variables and mode of delivery, and (c) to evaluate the risk for medical intervention at different hours of the day. Methods: The hourly distribution of 25,779 deliveries at the 'La Paz' Madrid University Maternity Hospital (Spain) has been analyzed. Two different multivariate analyses have been used to evaluate, respectively, the relationships between maternal and fetal characteristics and the type of birth and hour of delivery. Results: The increasing of unnecessary hospital interventions seems to have transformed the nocturnal pattern of birth into a diurnal one and may be contributing to the rise of preterm and low birth weight deliveries, reducing their probability of being breastfeed, and eliminating or transforming emotional and social support. Immigrant women present a higher frequency of the nocturnal pattern of delivery than their Spanish counterparts. Conclusions: The predominant nocturnal pattern of birth seems to have disappeared in a Spanish highly medicalized population. However, the hallmark of primate nocturnal deliveries is evident when multiple births, malpresentation, Caesarean sections, and vaginal interventions are excluded. Possible consequences of diurnal birth include reduced infant-mother bonding, breast feeding, and later life reductions to health. Am. J. Hum. Biol., 2012. © 2011 Wiley Periodicals, Inc. [ABSTRACT FROM AUTHOR]

Oestradiol acts in the brain by multiple mechanisms, including the regulation of transcriptional activity through classical oestrogen receptors, α and β, and by the activation of membrane/cytoplasm-initiated signalling cascades. In neuroblastoma cells, primary neurones in culture and in the brain in vivo, oestradiol activates the phosphoinositide 3-kinase/Akt/glycogen synthase kinase 3 signalling pathway by a mechanism involving oestrogen receptor α. Through this pathway, oestradiol regulates the stability of β-catenin, induces the translocation of β-catenin to the cell nucleus and regulates β-catenin-mediated transcription through the T cell factor/DNA complex. Genomic analyses in neuroblastoma cells have revealed that the set of genes regulated by oestradiol through β-catenin is not identical to that regulated by the Wnt signalling pathway, revealing a new mechanism for oestradiol signalling in neurones. [ABSTRACT FROM AUTHOR]

We present a case of a twin pregnancy in which one fetus developed a rapidly growing unilateral intrathoracic tumor. While a cystic adenomatoidmalformation was suspected in the ultrasound scan, the magnetic resonance scan suggested a pulmonary blastoma or a bronchioalveolar carcinoma. Postnatal chest radiography and contrast-enhanced computed tomography of the affected newborn were performed, and it was ruled out the possibility of malignant origin. Finally, the anatomopathologic exam revealed the presence of a mesenchymal hamartoma in the chest wall. Nevertheless, parents refused any treatment for the newborn. [ABSTRACT FROM AUTHOR]