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Quantum dots (QDs) have recently attracted considerable attention in the biomedical fields because of their unique and excellent optical properties. However, information on their health effects, particularly in the reproductive system, is limited. The present study focuses on the effects of intravenous injection of CdSe/ZnS QDs on the reproductive system and embryo development at various stages of pregnancy in mice. The CdSe/ZnS QDs intravenously injected in mice during pregnancy accumulated in the maternal liver, uterus and placenta. This accumulation affected the growth and development of the embryo during the early and middle stages of pregnancy. Moreover, genotoxicity to the placenta after exposure to CdSe/ZnS QDs was demonstrated by the increased expression levels of genes related to oxidative stress and apoptosis and the reduced expression levels of genes related to the nutrient and waste transportation. Alterations in the gene expression levels have hindered the transport of metabolites across the placenta, which in turn affected the ability of the fetus to obtain nutrients.

Pregnancy increases the risk of pulmonary embolism. Computed tomography pulmonary angiography (CTPA) is used for diagnosis. CT generates ionising radiation, and thus, abdominal shielding may be used. This phantom study investigated the effects of patient shielding and scan length reduction on the fetal and maternal ionising radiation dose from CTPA. The absorbed dose to the fetus was measured using thermoluminescent dosemeters. Estimated effective doses to the pregnant patient were based on the dose-length products. Shielding increased both the effective dose to the patient by 47% and the mean absorbed dose to the fetus (0.10 vs. 0.12 mGy; p

Over the past decades, paper-based lateral flow immunoassays (LFIAs) have been extensively developed for rapid, facile, and low-cost detection of a wide array of target analytes in a point-of-care manner. Conventional home pregnancy tests are the most significant example of LFAs, which detect elevated concentrations of human chorionic gonadotrophin (hCG) in body fluids to identify early pregnancy. In this work, we have upgraded these platforms to a higher version by developing a customized microfluidic paper-based analytical device (μPAD), as the new generation of paper-based point-of-care platforms, for colorimetric immunosensing. This will offer a cost-efficient and environmentally friendly alternative platform for paper-based immunosensing, eliminating the need for nitrocellulose (NC) membrane as the substrate material. The performance of the developed platform is demonstrated by detection of hCG (as a model case) in urine samples and subsequently indicating positive or negative pregnancy. A dual-functional silane-based composite was used to treat filter paper in order to enhance the colorimetric signal intensity in the detection zones of μPADs. In addition, microfluidic pathways were designed in a manner to provide the desired regulated fluid flow, generating sufficient incubation time (delays) at the designated detection zones, and consequently enhancing the obtained signal intensity. The presented approaches allow to overcome the existing limitations of μPADs in immunosensing and will broaden their applicability to a wider range of assays. Although, the application of the developed hCG μPAD assay is mainly in qualitative (i.e., positive or negative) detection of pregnancy, the semi-quantitative measurement of hCG was also investigated, indicating the viability of this assay for sensitive detection of the target hCG analyte within the related physiological range (i.e., 10–500 ng/mL) with a LOD value down to 10 ng/mL.

BackgroundInvestigating obstetric near misses (life-threatening obstetric complications) provides crucial information to prevent maternal mortality and morbidity.AimsTo investigate the rate and type of obstetric near misses among women with serious mental illness (SMI).MethodWe conducted a historical cohort study, using de-identified electronic mental health records linked with maternity data from Hospital Episode Statistics. The English Maternal Morbidity Outcome Indicator was used to identify obstetric near misses at the time of delivery in two cohorts: (1) exposed cohort – all women with a live or still birth in 2007–2016, and a history of secondary mental healthcare before delivery in south-east London (n = 13 570); (2) unexposed cohort – all women with a live or still birth in 2007–2016, resident within south-east London, with no history of mental healthcare before delivery (n = 223 274).ResultsThe rate of obstetric near misses was 884.3/100 000 (95% CI 733.2–1057.4) maternities in the exposed group compared with 575.1/100 000 (95% CI 544.0–607.4) maternities in the unexposed group (adjusted odds ratio 1.6, 95% CI 1.3–2.0, P < 0.001). Highest risks were for acute renal failure (adjusted odds ratio 2.1, 95% CI 1.1–3.8, P = 0.022); cardiac arrest, failure or infarction (adjusted odds ratio 2.3, 95% CI 1.1–4.8, P = 0.028); and obstetric embolism (adjusted odds ratio 3.1, 95% CI 1.6–5.8, P < 0.001).ConclusionsFindings emphasise the importance of integrated physical and mental healthcare before and during pregnancy for women with SMI.

Poverty and teenage pregnancy are common in low‐and‐middle‐income countries and can impede the development of healthy parent‐child relationships. This study aimed to test whether a home‐visiting intervention could improve early attachment relationships between adolescent mothers and their infants living in poverty in Brazil. Analyses were conducted on secondary outcomes from a randomized controlled trial (NCT0280718) testing the efficacy of a home‐visiting program, Primeiros Laços, on adolescent mothers’ health and parenting skills and their infants’ development. Pregnant youth were randomized to intervention (n = 40) or care‐as‐usual (CAU, n = 40) from the first trimester of pregnancy until infants were aged 24 months. Mother‐infant attachment was coded during a mother‐infant interaction when the infants were aged 12 months. Electrophysiological correlates of social processing (mean amplitude of the Nc component) were measured while infants viewed facial images of the mother and a stranger at age 6 months. Infants in the intervention group were more securely attached and more involved with their mothers than those receiving CAU at 12 months. Smaller Nc amplitudes to the mother's face at 6 months were associated with better social behavior at 12 months. Our findings indicate that the Primeiros Laços Program is effective in enhancing the development of mother‐infant attachment.

The influence of excess iodine on human health has been paid more and more attention. Although numerous studies have reported that excess iodine may cause deleterious effects, the mental damage and its mechanism is yet to be identified. Using Sprague-Dawley rats exposed to excess iodine from pregnancy to 6 months post-delivery as in vivo model, this study explored the impacts of long-term repetitive excess iodine administration on the hippocampus of offspring rats, focusing on mitochondrial apoptosis pathway, with changes in monoamine neurotransmitters. The results showed that excess iodine could increase urinary iodine and brain organ coefficient in offspring of both genders, change the hippocampal cell structure, and damage the spatial learning and memory capacities. Poly ADP-ribose polymerase (PARP), P53, Cleaved Caspase-3, and cytochrome C proteins expression increased and Bcl2 protein expression decreased in hippocampus of excess iodine-treated offspring, indicating that excess iodine could activate the mitochondrial apoptosis pathway. Besides, excess iodine showed different effects on monoamine neurotransmitter in different gender. Collectively, our experimental data indicated that the learning and memory impairment induced by excess iodine may be mediated via mitochondrial apoptotic pathway. Long-term repetitive excess iodine exposure affected monoamine neurotransmitters in hippocampus of offspring rats.

Significance: Placenta is an essential organ for fetal development and successful reproduction. Placental insufficiency can lead to fetal hypoxia and, in extreme cases anoxia, leading to fetal death. Of the 145 million deliveries per year worldwide, ∼15 million neonates are small for gestational age and, therefore, at risk for antepartum and intrapartum hypoxia. Clinical methods to assess placental function largely rely on the assessment of fetal heart rate changes but do not assess placental oxygenation. Near-infrared spectroscopy (NIRS) allows non-invasive, real-time assessment of tissue oxygenation in intact organs, which can be used to assess placental oxygenation. However, tissue optical properties can affect the accuracy of methods to measure tissue oxygenation. Aim: This study was performed to estimate the scattering coefficient of the human placenta. We have computed the scattering coefficients of the human placenta for the range of 659 to 840 nm using two methods of diffuse reflectance spectroscopy (DRS). Approach: Measurements were performed using an in-house DRS device and a well-established frequency-domain diffuse optical spectroscopic system (DOSI). Measurements were performed in eight placentas obtained after cesarean deliveries. Placentas were perfused with normal saline to minimize the effects of absorption due to blood. Three sites per placenta were measured. Absorption and scattering coefficients were then calculated from the measured reflectance using the random walk theory for DRS and frequency-domain algorithm for DOSI. Results: Average reduced scattering coefficient (μs ′ ) was 0.943 ± 0.015 mm − 1 at 760 nm and 0.831 ± 0.009 mm − 1 at 840 nm, and a power function μs ′ = 1.6619 (λ/500 nm) − 1.426 was derived for the human placental scattering coefficient. Conclusion: We report for the first time the scattering coefficient of the human placenta. This information can be used to assess baseline scattering and improve measurements of placental oxygen saturation with NIRS.

Some of the ethically most sensitive issues in radiation protection arise at imaging of pregnant—and potentially pregnant—patients and of newborn. This article reviews the current literature and recommendations on imaging during pregnancy and breastfeeding. Risks related to alternative non-ionizing radiation methods are also considered. With few exceptions, exposure of the fetus through radiography, computed tomography (CT) and nuclear medicine imaging can be limited to safe levels, although studies such as abdominal-pelvic CT cannot avoid significant exposure to fetuses. Eight to 10 weeks post-conception, the fetus has a thyroid which starts to concentrate iodide having crossed the placenta barrier resulting in unacceptably high doses to the fetal thyroid after administration of 131I- and even 123I-iodide and other radiopharmaceuticals with a high content of free radioiodine. Many radiopharmaceuticals are excreted through breast milk. Breastfeeding interruption recommendations should be followed to keep the effective dose to the infant below 1 mSv.

Significance: Prenatal exposure to ethanol causes several morphological and neurobehavioral deficits. While there are some studies on the effects of ethanol exposure on blood flow, research focusing on acute changes in the microvasculature is limited. Aim: The first aim of this study was to assess the dose-dependent changes in murine fetal brain microvasculature of developing fetuses in response to maternal alcohol consumption. The second aim was to quantify changes in vasculature occurring concurrently in the mother’s hindlimb and the fetus’s brain after maternal exposure to alcohol. Approach: Correlation mapping optical coherence angiography was used to evaluate the effects of prenatal exposure to different doses of ethanol (3, 1.5, and 0.75 g / kg) on murine fetal brain vasculature in utero. Additionally, simultaneous imaging of maternal peripheral vessels and the fetal brain vasculature was performed to assess changes of the vasculature occurring concurrently in response to ethanol consumption. Results: The fetal brain vessel diameters (VDs) decreased by ∼47 % , 30%, and 14% in response to ethanol doses of 3, 1.5, and 0.75 g / kg, respectively. However, the mother’s hindlimb VD increased by 63% in response to ethanol at a dose of 3 g / kg. Conclusions: Results showed a dose-dependent reduction in vascular blood flow in fetal brain vessels when the mother was exposed to ethanol, whereas vessels in the maternal hindlimb exhibited concurrent vasodilation.

Objective The role of antiphospholipid antibodies (aPL) during apparently normal pregnancy is still unclear. IgA aPL are prevalent in populations of African origin. Our aim was to measure all isotypes of anticardiolipin (anti-CL) and anti–β2 glycoprotein I (anti-β2GPI) in healthy pregnant and non-pregnant women of different ethnicities. Methods Healthy Sudanese pregnant women ( n = 165; 53 sampled shortly after delivery), 96 age-matched Sudanese female controls and 42 healthy pregnant and 249 non-pregnant Swedish women were included. IgA/G/M anti-CL and anti-β2GPI were tested at one time point only with two independent assays in Sudanese and serially in pregnant Swedes. IgA anti-β2GPI domain 1 and as controls IgA/G/M rheumatoid factor (RF), IgG anti–cyclic citrullinated peptide 2 (anti-CCP2) and anti–thyroid peroxidase (anti-TPO) were investigated in Sudanese females. Results Pregnant Sudanese women had significantly higher median levels of IgA anti-CL, IgA anti-β2GPI ( p 2GPI (both assays; p 2GPI occurrence was increased among Sudanese pregnant women compared with national controls. No corresponding increase during pregnancy was found for IgA anti-β2GPI domain 1 antibodies. Both IgG anti-CL and IgG control autoantibodies decreased during and directly after pregnancy among Sudanese. Serially followed Swedish women showed no changes in IgA aPL, whereas IgG/M anti-CL decreased. Conclusions IgA aPL are increased in Sudanese but not in Swedish women, without corresponding increase in IgA domain 1. Whether due to ethnicity and/or environmental influences the occurrence of IgA aPL during Sudanese pregnancies, and its clinical significance, is yet to be determined.

BACKGROUND: The partograph has been endorsed by World Health Organization (WHO) since 1994 which presents an algorithm for assessing maternal and foetal conditions and labor progression. Monitoring labour with a partograph can reduce adverse pregnancy outcomes such as prolonged labor, emergency C-sections, birth asphyxia and stillbirths. However, partograph use is still very low, particularly in low and middle income countries (LMICs). In Bangladesh the reported partograph user rate varies from 1.4% to 33.0%. Recently, an electronic version of the partograph, with the provision of online data entry and user aid for emergency clinical support, has been tested successfully in different settings. With this proven evidence, we conducted and operations research to test the feasibility and effectiveness of implementing an e-partograph, for the first time, in 2 public hospitals in Bangladesh.METHODS: We followed a prospective crossover design. Two secondary level referral hospitals, Jessore and Kushtia District Hospital (DH) were the study sites. All pregnant women who delivered in the study hospitals were the study participants. All nurse-midwives working in the labor ward of study hospitals were trained on appropriate use of both types of partograph along with standard labour management guidelines. Collected quantitative data was analyzed using SPSS 23 statistical software. Discrete variables were expressed as percentages and presented as frequency distribution and cross tabulations. Chi square tests were employed to test the association between exposure and outcome variables. Potential confounding factors were adjusted using multivariate binary logistic regression methods. Ethical approval was obtained from the institutional review board of the International Centre for Diarrheal Disease Research, Bangladesh (icddr,b).FINDINGS: In total 2918 deliveries were conducted at Jessore DH and 2312 at Kushtia DH during one-year study period. Of them, 1012 (506 in each facility) deliveries were monitored using partograph (paper or electronic). The trends of facility based C-section rates was downwards in both the hospitals; 43% to 37% in Jessore and from 36% to 25% in Kushtia Hospital. There was a significant reduction of prolonged labour with e-partograph use. In Kushtia DH, the prolonged labour rate was 42% during phase 1 with the paper version which came down to 29% during phase-2 with the e-partograph use. The similar result was observed in Jessore DH where the prolonged labour rate reduced to 7% with paper partograph from the reported 30% prolonged labour with e-partograph. The e-partograph user rate was higher than the paper partograph during both phases (phase 1: 3.31, CI: 2.04-5.38, p < .001 and in phase 2: 15.20 CI: 6.36-36.33, p < .001) after adjusting for maternal age, parity, gestational age, religion, mother's education, husband's education, and fetal sex.CONCLUSION: The partograph user rate has significantly improved with the e- partograph and was associated with an overall reduction in cesarean births. Use of the e-partograph was also associated with reduced rates of prolonged labour. This study has added to the growing body of evidence on the positive impact of e-partograph use. We recommend implementing e-partograph intervention at scale in both public and private hospitals in Bangladesh.TRIAL REGISTRATION: ClinicalTrials.gov NCT03509103.

We report the development of a surface-enhanced Raman spectroscopy sensor chip by decorating gold nanoparticles (AuNPs) on ZnO nanorod (ZnO NR) arrays vertically grown on cellulose paper (C). We show that these chips can enhance the Raman signal by 1.25 × 107 with an excellent reproducibility of 92% clinical sensitivity and specificity. Our technology has the potential to be used for the early detection of prenatal diseases and can be adapted for point-of-care applications.

The objective of this study was to determine the effect on pregnancy outcome of either inseminating heifers twice (at 48 and 72 hours after withdrawal of a controlled internal drug release insert (CIDR) containing progesterone) or once (56 hours after CIDR withdrawal) following a seven-day CIDR synchronisation protocol. Dairy heifers (n=267) from five farms, with an age range of 388-736 days, were randomly assigned to one of two treatment groups (group A heifers were inseminated twice; group B heifers were inseminated once). Both groups received a CIDR on day (D) 0 and an intramuscular injection of d-cloprostenol on D6; the CIDR was withdrawn on D7. Measurements of withers height, body condition score and hearth girth (used to estimate weight) were taken on D0. The diameter of the largest follicles and corpora lutea was recorded on both D0 and D6. Data were analysed with the use of multivariable logistic regression modelling. Treatment group and farm were not statistically significantly associated with pregnancy per treatment (P/T). Age and dominant follicle size on D6 were significantly associated with P/T. Heifers with the largest dominant follicle sizes (16-22 mm) were 5.54 times less likely to be pregnant than those heifers with the smallest dominant follicles (8-10 mm) on D6. It was shown that the cost associated with inseminating heifers twice after a seven-day CIDR synchronisation protocol is not justified.

Relatively few imaging and sensing technologies are employed to study human lactation physiology. In particular, human mammary development during pregnancy as well as mammary involution after lactation have been poorly described, despite their importance for breast cancer diagnosis and treatment during these phases. Our case study shows the potential of diffuse optical spectroscopic imaging (DOSI) to uniquely study the spatiotemporal changes in mammary tissue composition during the involution of the lactating breast toward its pre-pregnant state. At nine time intervals over a period of eight months after the cessation of breastfeeding, we reconstructed 2-D maps of mammary water content, lipid content, total hemoglobin (THb) concentration, oxygen saturation (StO2), and tissue optical scattering. Mammary lipid content in the nonareolar region showed a significant relative increase of 59%, whereas water content and THb concentration showed a significant relative decrease of 50% and 48%, respectively. Significant changes were also found in StO2 and tissue optical scattering. Our findings are consistent with the gradual replacement of fibroglandular tissue by adipose tissue and vascular regression during mammary involution. Moreover, our data provide unique insight into the dynamics of breast tissue composition and demonstrate the effectiveness of DOSI as a technique to study human lactation physiology.

Background Women with bipolar disorder are at increased risk of having a severe episode of illness associated with childbirth. Aims To explore the factors that influence the decision-making of women with bipolar disorder regarding pregnancy and childbirth. Method Qualitative study with a purposive sample of women with bipolar disorder considering pregnancy, or currently or previously pregnant, supplemented by data from an online forum. Data were analysed using thematic analysis. Results Twenty-one women with bipolar disorder from an NHS organisation were interviewed, and data were used from 50 women's comments via the online forum of the UK's national bipolar charity. The centrality of motherhood, social and economic contextual factors, stigma and fear were major themes. Within these themes, new findings included women considering an elective Caesarian section in an attempt to avoid the deleterious effects of a long labour and loss of sleep, or trying to avoid the risks of pregnancy altogether by means of adoption or surrogacy. Conclusions This study highlights the information needs of women with bipolar disorder, both pre-conception and when childbearing, and the need for improved training for all health professionals working with women with bipolar disorder of childbearing age to reduce stigmatising attitudes and increase knowledge of the evidence base on treatment in the perinatal period.

This paper describes the development of an original micro-solid phase extraction device and its evaluation for the isolation of F2-isoprostanes (F2-IsoPs) from cord and maternal plasma samples. The unit is very simple and consists in a rotating disc (1.8 cm diameter) of oxidized buckypaper (BP), enwrapped in a polypropylene mesh pouch. Even if the selected F2-IsoPs have logP and pKa values that make them suitable candidates for their sorption on BP, several parameters were optimized to maximize recoveries: time of adsorption and desorption; stirring speed; volume, pH and ionic strength of the sample; type, volume, and fractions of the elution solvent; oxidation grade of BP. Among all, the last one was crucial in affecting extraction yields because of the analyte interactions with polar functionalities, introduced by a preliminary oxidative acid treatment. The investigation established the optimal oxidation time and highlighted the pros and cons of the acid activation step. All extracts were analyzed by means of liquid chromatography-tandem mass spectrometry (LC–MS/MS). Validation was performed according to the main FDA guidelines for bioanalytical methods. Depending on the spike level and analyte, recoveries ranged between 30 and 120% with precision and accuracy values lower than 20%. Quantitative analysis was accomplished by matrix-matched calibration curves whose determination coefficients were higher than 0.95. Lower limit of quantitation (LLOQ) spanned the range 2.45–6.77 μg L−1. The validated method was applied to the analysis of eight pairs of mother/child plasma samples, revealing the presence of 8-iso-15-keto-PGF2α and 8-iso-PGE2 at a concentration of about 10 μg L−1 in most cord plasma samples of preterm newborns.

Background Parturition and the initial postpartum period are important moments in the reproductive cycle of dogs. Methods A study assessed the effect of ADAPTIL, a dog-appeasing pheromone, on maternal behaviour during peripartum. Bitches were continuously exposed to ADAPTIL (n=20) or placebo (n=21) in double-blinded conditions from an average of about seven days before parturition up to 21 days postpartum. Differences in maternal behaviour in relation to the treatment were evaluated by the observation of specific activities through video recordings, such as the time spent by the bitch in close contact with the puppies, oronasal interaction and nursing duration and position. Videos were recorded at four time points (W0: within the first 48 hours of whelping; W1: one week after parturition; W2: two weeks after parturition; and W3: three weeks after parturition). In addition, the perception of breeders in relation to the quality of maternal care, puppies’ wellbeing and overall relationship between the bitches and the puppies was evaluated using Visual Analogue Scale at the same time points. Moreover, the daily activity of the bitches was measured by using an electronic device (FitBark dog activity trackers, Kansas City, Missouri). Results For all observed maternal behaviours, there was a steady decrease in levels as the puppies developed, independently of treatment. However, bitches exposed to ADAPTIL tended to nurse significantly more in lying position, while those exposed to the placebo nursed more in a seated position, especially at W1 (P=0.06) and W3 (P=0.005). According to the breeders, the attention scores of bitches towards puppies were significantly higher in ADAPTIL than in the placebo group at each time point (P=0.01). Moreover, a difference according to parity was observed (P=0.004), with greater attention score displayed by primiparous bitches exposed to ADAPTIL compared with placebo on W0 (P=0.02), W1 and W3 (P

Premature cervical remodeling is a critical precursor of spontaneous preterm birth, and the remodeling process is characterized by an increase in tissue hydration. Nevertheless, current clinical measurements of cervical remodeling are subjective and detect only late events, such as cervical effacement and dilation. Here, we present a photoacoustic endoscope that can quantify tissue hydration by measuring near-infrared cervical spectra. We quantify the water contents of tissue-mimicking hydrogel phantoms as an analog of cervical connective tissue. Applying this method to pregnant women in vivo, we observed an increase in the water content of the cervix throughout pregnancy. The application of this technique in maternal healthcare may advance our understanding of cervical remodeling and provide a sensitive method for predicting preterm birth.

Clinical and subclinical hypocalcaemia are common in dairy cows, yet evidence in the literature assessing their impact on fertility is inconsistent. The aim of this prospective cohort study was to examine associations between blood ionised calcium concentration at calving and fertility outcomes in dairy cattle. Blood samples were taken from 137 Holstein cows from four commercial dairy herds within 24 hours of calving and analysed for blood ionised calcium using an Epocal Point of Care Analyser (Epocal, Ottawa, Canada). Data collected from routine veterinary fertility examinations and herd records were used to investigate the association of ionised calcium with the outcomes: time to first service, time to conception and endometritis. There were significant negative associations between blood ionised calcium concentration and time to first service (HR 1.33, P=0.001) and blood ionised calcium concentration and time to conception (HR 1.16, P=0.04). There was no significant association between blood ionised calcium concentration and endometritis. The results of this study imply that management policies that minimise the reduction in blood ionised calcium concentration in the periparturient dairy cow are likely to improve reproductive outcomes and should be considered as part of the multifactorial approach to optimising dairy cow fertility.

Here we describe methods for creating tissue-mimicking ultrasound phantoms based on patient anatomy using a soft material called gel wax. To recreate acoustically realistic tissue properties, two additives to gel wax were considered: paraffin wax to increase acoustic attenuation, and solid glass spheres to increase backscattering. The frequency dependence of ultrasound attenuation was well described with a power law over the measured range of 3-10 MHz. With the addition of paraffin wax in concentrations of 0 to 8 w/w%, attenuation varied from 0.72 to 2.91 dB cmat 3 MHz and from 6.84 to 26.63 dB cmat 10 MHz. With solid glass sphere concentrations in the range of 0.025-0.9 w/w%, acoustic backscattering consistent with a wide range of ultrasonic appearances was achieved. Native gel wax maintained its integrity during compressive deformations up to 60%; its Young's modulus was 17.4 ± 1.4 kPa. The gel wax with additives was shaped by melting and pouring it into 3D printed moulds. Three different phantoms were constructed: a nerve and vessel phantom for peripheral nerve blocks, a heart atrium phantom, and a placental phantom for minimally-invasive fetal interventions. In the first, nerves and vessels were represented as hyperechoic and hypoechoic tubular structures, respectively, in a homogeneous background. The second phantom comprised atria derived from an MRI scan of a patient with an intervening septum and adjoining vena cavae. The third comprised the chorionic surface of a placenta with superficial fetal vessels derived from an image of a post-partum human placenta. Gel wax is a material with widely tuneable ultrasound properties and mechanical characteristics that are well suited for creating patient-specific ultrasound phantoms in several clinical disciplines. ispartof: Physics in Medicine and Biology vol:63 issue:1 pages:015033- ispartof: location:England status: published

BackgroundIt is not known whether associations between child problem behaviours and maternal depression can be accounted for by comorbid borderline personality disorder (BPD) dysfunction.AimTo examine the contributions of maternal depression and BPD symptoms to child problem behaviours.MethodDepression trajectories over the fist-year postpartum were generated using repeated measurement from a general population sample of 997 mothers recruited in pregnancy. In a stratified subsample of 251, maternal depression and BPD symptoms were examined as predictors of child problem behaviours at 2.5 years.ResultsChild problem behaviours were predicted by a high maternal depression trajectory prior to the inclusion of BPD symptoms. This association was no longer significant after the introduction of BPD symptoms.ConclusionsRisks for child problem behaviours currently attributed to maternal depression may arise from more persistent and pervasive difficulties found in borderline personality dysfunction.

Diagnostic assays can provide valuable information about the health status of a patient, which include detection of biomarkers that indicate the presence of an infection, the progression or regression of a disease, and the efficacy of a course of treatment. Critical healthcare decisions must often be made at the point-of-care, far from the infrastructure and diagnostic capabilities of centralized laboratories. There exists an obvious need for diagnostic tools that are designed to address the unique challenges encountered by healthcare workers in limited-resource settings. Paper, a readily-available and inexpensive commodity, is an attractive medium with which to develop diagnostic assays for use in limited-resource settings. In this article, we describe a device architecture to perform immunoassays in patterned paper. These paper-based devices use a combination of lateral and vertical flow to control the wicking of fluid in three-dimensions. We provide guidelines to aid in the design of these devices and we illustrate how patterning can be used to tune the duration and performance of the assay. We demonstrate the use of these paper-based devices by developing a sandwich immunoassay for human chorionic gonadotropin (hCG) in urine, a biomarker of pregnancy. We then directly compare the qualitative and quantitative results of these paper-based immunoassays to commercially available lateral flow tests (i.e., the home pregnancy test). Our results suggest paper-based devices may find broad utility in the development of immunoassays for use at the point-of-care.

This study investigated Mycoplasma hyopneumoniae colonisation and lung lesions at slaughter in pigs from vaccinated (V) and non-vaccinated (NV) sows, in two herds (A and B). In each herd, two sow batches were V against M. hyopneumoniae with a commercial bacterin at six and three weeks before farrowing and two sow batches remained NV. From each sow batch, laryngeal swabs were collected from the litters of five primiparous sows at weaning and seven days post-weaning. All samples were tested for M. hyopneumoniae by nested PCR. In total, 488 piglets were sampled. At slaughter, the extent of Mycoplasma-like pneumonia lesions (lung lesion score (LLS)) was assessed. The colonisation rates with M. hyopneumoniae at weaning and seven days post-weaning were (V-A=14.2, NV-A=20.0 (P=0.225); V-B=0.9, NV-B=0.8 (P=0.948)) and (V-A=0.8, NV-A=7.0 (P=0.039); V-B=1.8, NV-B=2.5 (P=0.738)), respectively. The average LLS (in per cent) was V-A=15.5, NV-A=26.4 (P=0.021); V-B=9.7, NV-B=8.4 (P=0.541). In conclusion, in herd A, with a substantially higher level of piglet colonisation at weaning than herd B, offspring from V sows had a significantly lower colonisation rate seven days post-weaning and a significantly lower LLS at slaughter compared with the offspring of the NV sows. This implies that sow vaccination might be useful for control of M. hyopneumoniae infections, although significant results may not be achieved at all times (such as in herd B).

Congenital vertebral malformations (CVM) pose a significant health problem because they can be associated with spinal deformities, such as congenital scoliosis and kyphosis, in addition to various syndromes and other congenital malformations. Additional information remains to be learned regarding the natural history of congenital scoliosis and related health problems. Although significant progress has been made in understanding the process of somite formation, which gives rise to vertebral bodies, there is a wide gap in our understanding of how genetic factors contribute to CVM development. Maternal diabetes during pregnancy most commonly contributes to the occurrence of CVM, followed by other factors such as hypoxia and anticonvulsant medications. This review highlights several emerging clinical issues related to CVM, including pulmonary and orthopedic outcome in congenital scoliosis. Recent breakthroughs in genetics related to gene and environment interactions associated with CVM development are discussed. The Klippel-Feil syndrome which is associated with cervical segmentation abnormalities is illustrated as an example in which animal models, such as the zebrafish, can be utilized to provide functional evidence of pathogenicity of identified mutations.

Current variant discovery approaches often rely on an initial read mapping to the reference sequence. Their effectiveness is limited by the presence of gaps, potential misassemblies, regions of duplicates with a high-sequence similarity and regions of high-sequence divergence in the reference. Also, mapping-based approaches are less sensitive to large INDELs and complex variations and provide little phase information in personal genomes. A few de novo assemblers have been developed to identify variants through direct variant calling from the assembly graph, micro-assembly and whole-genome assembly, but mainly for whole-genome sequencing (WGS) data. We developed SGVar, a de novo assembly workflow for haplotype-based variant discovery from whole-exome sequencing (WES) data. Using simulated human exome data, we compared SGVar with five variation-aware de novo assemblers and with BWA-MEM together with three haplotype- or local de novo assembly-based callers. SGVar outperforms the other assemblers in sensitivity and tolerance of sequencing errors. We recapitulated the findings on whole-genome and exome data from a Utah residents with Northern and Western European ancestry (CEU) trio, showing that SGVar had high sensitivity both in the highly divergent human leukocyte antigen (HLA) region and in non-HLA regions of chromosome 6. In particular, SGVar is robust to sequencing error, k-mer selection, divergence level and coverage depth. Unlike mapping-based approaches, SGVar is capable of resolving long-range phase and identifying large INDELs from WES, more prominently from WGS. We conclude that SGVar represents an ideal platform for WES-based variant discovery in highly divergent regions and across the whole genome.

BackgroundMental disorders of women during the postnatal period are a major public health problem. Compared with women's mental disorders, much less attention has been paid to men's mental disorders in the perinatal period. To date, there have been no reports in the literature describing secular changes of both maternal and paternal hospital admissions for mental disorders over the period covering the year before pregnancy (non-parents), during pregnancy (expectant parents) and up to the first year after birth (parents) based on linked parental data. The co-occurrences of couples' hospital admissions for mental disorders have not previously been investigated.AimsTo describe maternal and paternal hospital admissions for mental disorders before and after birth. To compare the co-occurrences of parents' hospital admissions for mental disorder in the perinatal period.MethodThis is a cohort study using paired parents' population data from the New South Wales (NSW) Perinatal Data Collection (PDC), Registry of Births, Deaths and Marriages (RBDM) and Admitted Patients Data Collection (APDC). The study included all parents (n=196 669 couples) who gave birth to their first child in NSW between 1 January 2003 and 31 December 2009.ResultsThe hospital admission rate for women with a principal mental disorder diagnosis in the period between the year before pregnancy and the first year after birth was significantly higher than that for men. Parents' mental disorders influenced each other. If a man was admitted to hospital with a principal mental disorder diagnosis, his wife or partner was more likely to be admitted to hospital with a principal mental disorder diagnosis compared with women whose partner had not had a hospital admission, andvice versa.ConclusionsMothers' mental disorders after birth increased more significantly than fathers. However, fathers' mental disorders significantly impacted the co-occurrence of mothers' mental disorders.

Cryopreservation of bovine embryos can be performed by a variety of methods with variable degree of success. Here, we report a new, easy to perform, simple, inexpensive, and successful method for vitrification of bovine blastocysts. In vitro produced bovine blastocysts were exposed to vitrification solution (5.5 m ethylene glycol, 10% serum and 1% sucrose) in one single step for 20 s, loaded on a paper container prepared from commonly available non-slippery, absorbent writing paper, and then were directly plunged into liquid nitrogen for storage. Vitrified blastocysts were warmed by serial rinsing in 0.5, 0.25 and 0.125 m sucrose solution for 1 min each. Results showed that one step exposure of bovine blastocysts to cryoprotective agents was sufficient to achieve successful cryopreservation. Under these conditions, more than 95% of blastocysts survived the vitrification-warming on paper containers which was significantly higher than those obtained from other containers, such as electron microscope (EM) grid (78.1%), open pulled straw (OPS; 80.2%), cryoloop (76.2%) or plastic straw (73.9%). Embryo transfer of blastocysts vitrified-warmed on paper container resulted in successful conception (19.3%) and full-term live birth of offspring (12.3%) which were lower (P0.05) than those obtained from non-vitrified blastocysts (38.0 and 32.7%) but were comparable (P0.05) to those obtained from blastocysts vitrified-warmed on EM grid (23.3 and 14.2%). Our results, therefore, suggest that paper may be an inexpensive and useful container for the cryopreservation of animal embryos.

Background: Peer review of university classroom teaching can increase the quality of teaching but is not universally practiced in Australian universities. Aim: To report an evaluation of paired peer-review process using both paper and web based teaching evaluation tools. Methods: Twenty university teachers in one metropolitan Australian School of Nursing and Midwifery were randomly paired and then randomly assigned to a paper based or web-based peer review tool. Each teacher reviewed each other's classroom teaching as part of a peer review program. The participants then completed an 18 question survey evaluating the peer review tool and paired evaluation process. Responses were analyzed using frequencies and percentages. Results: Regardless of the tool used, participants found this process of peer review positive (75%), collegial (78%), supportive (61%) and non-threatening (71%). Participants reported that the peer review will improve their own classroom delivery (61%), teaching evaluation (61%) and planning (53%). The web-based tool was found to be easier to use and allowed more space than the paper-based tool. Conclusion: Implementation of a web-based paired peer review system can be a positive method of peer review of university classroom teaching. Pairing of teachers to review each other's classroom teaching is a promising strategy and has the potential to improve teaching in teaching universities. Refereed/Peer-reviewed

Background/Aims: Accumulating evidence from a relatively small number of prospective studies indicates that exposure to prenatal stress profoundly influences the developing human fetus with consequences that persist into childhood and very likely forever. Methods: Maternal/fetal dyads are assessed at ∼20, ∼25, ∼31 and ∼36 weeks of gestation. Infant assessments begin 24 h after delivery with the collection of cortisol and behavioral responses to the painful stress of the heel-stick procedure and measures of neonatal neuromuscular maturity. Infant cognitive, neuromotor development, stress and emotional regulation are evaluated at 3, 6 12 and 24 months of age. Maternal psychosocial stress and demographic information is collected in parallel with infant assessments. Child neurodevelopment is assessed with cognitive tests, measures of adjustment and brain imaging between 5 and 8 years of age. Results:Psychobiological markers of stress during pregnancy, especially early in gestation, result in delayed fetal maturation, disrupted emotional regulation and impaired cognitive performance during infancy and decreased brain volume in areas associated with learning and memory in 6- to 8-year-old children. We review findings from our projects that maternal endocrine alterations that accompany pregnancy and influence fetal/infant/child development are associated with decreased affective responses to stress, altered memory function and increased risk for postpartum depression. Conclusions: Our findings indicate that the mother and her fetus both are influenced by exposure to psychosocial and biological stress. The findings that fetal and maternal programming occur in parallel may have important implications for long-term child development and mother/child interactions.

An emerging area of research in autism spectrum disorder (ASD) is the role of prenatal exposure to inflammatory mediators during critical developmental periods. Epidemiological data has highlighted this relationship showing significant correlations between prenatal exposure to pathogens, including influenza, and the occurrence of ASD. Although there has not been a definitive molecular mechanism established, researchers have begun to investigate this relationship as animal models of maternal infection have support- ed epidemiological findings. Several groups utilizing these animal models have found that activation of the maternal immune system, termed maternal immune activation (MIA), and more specifically the exposure of the developing fetus to maternal cytokines precipitate the neurological, immunological and behavioral abnormalities observed in the offspring of these animals. These abnormalities have correlated with clinical findings of immune dysregulation, neurological and behavioral abnormalities in some autistic individuals. Additionally, researchers have observed genetic variations in these models in genes which regulate neurological and immunological development, similar to what is observed clinically in ASD. Altogether, the role of MIA and cytokine dysregulation, as a key mediator in the neuropathological, behavioral and possibly genetic irregularities observed clinically in autism are important factors that warrant further investigation.

Digital storage of cardiotocographic (CTG) tracings by fetal central monitoring systems (fCMS) obviates the need for printing, or alternatively, the tracings can be printed in regular paper instead of CTG thermal paper. We aimed at evaluating the impact of the introduction of the Omniview-SisPorto(®) system on CTG paper costs in a large university hospital. After introduction of the fCMS, there was an 87% reduction in median annual expenses with CTG paper in the labour ward (p = 0.011) and a 78% decrease in the prenatal clinic (p = 0.017), despite a more than 40% increase in the median number of observed women. Routine use of fCMS may provide an important reduction in hospital expenses associated with the use of thermal CTG paper, thus reducing the investment made in their acquisition and maintenance.

Evidence of seasonality in oestrus in bitches within specialist breeding programmes, such as those for assistance dogs, may support colony management through tailoring the distribution of resources required for breeding throughout the year. However, at present there are conflicting data regarding seasonality in oestrus (and litter size) in domestic dogs. The primary objective of this study was to investigate seasonal variations in oestrus and litter size in a large assistance dog breeding colony in the UK in order to optimise colony management. The authors analysed the annual distribution of 3624 observations of oestrus collected from 568 brood bitches from January 2005 to June 2014. The authors also evaluated the relationship between month and litter size for 1609 litters observed during the same period. There was no evidence of regular seasonal variations in oestrus or litter size by meteorological season or month. The lack of seasonality in oestrus may be a function of dogs in the UK, particularly valuable breeding bitches, being exposed to fairly constant environmental conditions throughout the year as a consequence of artificial light and heating during the winter months. The authors' findings suggest that special consideration of the annual distribution of oestrus and litter size is unnecessary for the management of assistance dog breeding colonies similar to those in the UK.

Introduction: Organic acids were examined from normal and Down syndrome pregnancies to identify possible differences between the amniotic fluid from fetuses with Down Syndrome compared with that of normal fetuses. Materials and Methods: Amniotic fluids were obtained from prior amniocenteses. Forty-one normal and 22 Down syndrome specimens were assayed using gas chromatography/mass spectrometry. Results and Discussion: 5-Hydroxycaproate, methylsuccinate, α-ketoglutarate, and adipate were significantly elevated in Down syndrome, suggesting riboflavin deficiency. Phenylpyruvate was also significantly elevated in fetuses with Down syndrome. Phenylpyruvate inhibits the metabolism of tetrahydrobiopterin, which is necessary for neurotransmitter metabolism. Elevated phenylpyruvate is consistent with previous research, suggesting a disturbance of tetrahydrobiopterin metabolism in Down syndrome. Conclusion: Organic acid markers for B2 deficiency are elevated in the amniotic fluid of fetuses with Down syndrome. Elevation of phenylpyruvate may impair neurotransmitter metabolism. Organic acid markers for B12 levels are not different between the Down syndrome and normal group.

Objective To compare pregnancy rates with fresh and frozen embryo transfer in patients admitted to Royal Jubilee Maternity Service (RJMS), Belfast between January 1st 2004 and December 31st 2005 with ovarian hyperstimulation syndrome (OHSS). Method A retrospective analysis of all ART cycles (2,283) carried out in RJMS between January 1st 2004 and December 31st 2005 and of all patients admitted to RJMS within 3 weeks of assisted reproduction therapy (ART). Results The incidence of OHSS requiring admission was 2.01%, which represented 80.70% of post-ART emergency admissions. The eventual pregnancy rate was 52.27% in all women admitted with OHSS. The pregnancy outcome in OHSS patients who received fresh embryo transfer was 56.52% and with frozen embryo transfer 50%. The main indications for fertility treatment in OHSS cases were male factor (31%) and polycystic ovarian syndrome (14%). Two distinct incidence peaks of OHSS were identified – early and late. 77.77% of women who suffered from late onset OHSS had a concurrent positive pregnancy test. Conclusion The pregnancy rate in OHSS cases, both with fresh and subsequently with frozen embryo transfer, was exceptionally high. There was no statistically significant difference between fresh and frozen embryo transfer pregnancy rates. An elective embryo freezing policy to moderate the severity and duration of OHSS does not compromise outcome for women at risk of OHSS.

Objective: To determine whether any common maternal-fetal variable has prenatal predictive value of prosthetic repair in congenital diaphragmatic hernia. Methods: This was a 5-year single-center retrospective review of fetal congenital diaphragmatic hernia referrals. Multiple prenatal variables were correlated with the need for a prosthetic repair. Statistical analyses were by Fisher’s exact and Mann-Whitney U-tests, as appropriate (p < 0.05). Results: Fetal liver position was a predictor of prosthetic repair. The presence or absence of liver herniation was correlated with prosthetic repair rates of 83.3 and 23.1%, respectively (p < 0.001). All patients with moderate/severe liver herniation required a prosthetic patch. Conclusion: Liver herniation has prenatal predictive value for the need for prosthetic repair in congenital diaphragmatic hernia. This finding should be valuable during prenatal counseling for clinical trials of engineered diaphragmatic repair.

Introduction: Some studies of children with Down syndrome have found mild abnormalities in the metabolism of pyridoxine (vitamin B6); therefore the present question is whether such abnormalities might also be present in the amniotic fluid of fetuses with Down syndrome. Materials and Methods: Archived specimens of amniotic fluid were obtained from chromosomally normal and from fetuses with Down syndrome. Gas chromatography/mass spectrometry quantitized B-related metabolites, including oxalate, xanthurenate, kynurenine and 4-pyridoxic acid. Results: Oxalate, a marker of pyridoxine deficiency, was elevated in the amniotic fluid of fetuses with Down syndrome. This result was statistically significant. The other marker results were not statistically significant. Conclusion: A marker of pyridoxine deficiency, oxalate is elevated in the amniotic fluid of fetuses with Down syndrome. These results in amniotic fluid are consistent with previous studies done in the urine of young children.

Clinical and laboratory characteristics of 39 patients with adult onset subacute sclerosing panencephalitis (SSPE) are described and compared to those of juvenile onset patients regarding preceding measles, age at onset, gender, interval between onset and diagnosis, clinical profile, and course during follow up. Diagnosis was based on clinical and electroencephalographic findings and raised anti-measles antibody titres in cerebrospinal fluid. Mean age at SSPE symptom onset was 20.9+/-4.9 years and mean interval from onset to diagnosis was 6.3+/-9.6 months. Referral diagnosis was accurate in only 12 patients. Presenting symptoms included myoclonus, behavioural changes, seizures, and cognitive, visual, and extrapyramidal disturbance. All patients received symptomatic therapy; 19 also received disease modifying agents. Five of seven pregnant women had successful deliveries. The follow-up period varied widely (maximum 60 months, median 9 months). The profile of adult onset SSPE did not differ from the rest of the cohort, except for a longer interval between measles infection and symptom onset (p

The traditional focus of newborn screening for inherited metabolic diseases is to test infants for medical conditions that may cause significant morbidity and mortality unless treatment is initiated early. A major change began with the application of tandem mass spectrometry to the quantitative analysis of amino acids and acylcarnitines in dried blood spots. Beyond the lack of a consensus on disease selection, the pace of introduction for expanded screening programs has been slow and patchy among and within countries. Universal metabolic screening poses important ethical issues, related to possible ambiguous findings, late-onset diseases, conditions, such as lysosomal storage disorders, with no clear-cut evidence on when and how to start a therapy. The possible application of next generation sequencing to newborn screening has been recently proposed. In the near future it will be also possible to perform a genetic and mutational scan across the whole genome of the fetus in a non-invasive manner by analyzing cell-free fetal DNA in maternal blood as early as the 5th week of gestational age. These high-throughput methods applied to neonatal and non-invasive prenatal screening of genetic diseases, including inborn errors of metabolism, are raising further technical, political and ethical issues.

This study examines a paper hand-held record and a shared electronic health record in an Australian tertiary hospital healthcare maternity setting and the role that both types of records play in facilitating integrated care among healthcare providers. A qualitative research design was used where five focus groups were conducted in two phases with 69 hospital healthcare providers. In total, 32 interviews were also carried out with general practitioners. Transcripts were analysed using qualitative content analysis. Three key themes were identified: (1) selective use of records; (2) records as communication of care; and (3) negativity about the use of records. This study demonstrates that healthcare providers do not effectively share information using either a paper hand-held record or a shared electronic health record. Considering a national commitment to e-health innovation, a multi-professional input, organisational support and continuing education are identified as crucial to realising the potential of a maternity shared electronic health record to facilitate integrated care.