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Objective: Social support, an individual's social relationships (both online and offline), may provide protection against adverse mental health outcomes, such as anxiety and depression, which are high in women who have been hospitalised with high-risk pregnancy. This study explored the social support available to women at higher risk of preeclampsia during pregnancy by examining personal social networks., Design: Semi-structured interviews were accompanied by social network mapping using the web-based social networking tool GENIE., Setting: England., Participants: Twenty-one women were recruited, of whom 18 were interviewed both during pregnancy and postnatally between April 2019 and April 2020. Nineteen women completed maps pre-natally, 17 women completed maps pre-natally and post-natally. Women were taking part in the BUMP study, a randomised clinical trial that included 2441 pregnant individuals at higher risk of preeclampsia and recruited at a mean of 20 weeks' gestation from 15 hospital maternity units in England between November 2018 and October 2019., Results: Women's social networks tightened during pregnancy. The inner network changed most dramatically postnatally with women reporting fewer network members. Interviews revealed networks were primarily 'real-life' rather than online social networks, with members providing emotional, informational, and practical support. Women with a high-risk pregnancy valued the relationships they developed with health professionals during pregnancy, and would like their midwife to have a more central role in their networks by providing informational and, where needed, emotional support. The social network mapping data supported the qualitative accounts of changing networks across high-risk pregnancy., Conclusion: Women with a high-risk pregnancy seek to build "nesting networks" to support them through pregnancy into motherhood. Different types of support are sought from trusted sources. Midwives can play a key role., Practice Implications: As well as highlighting other potential needs during pregnancy and the ways in which they can be met, support from midwives has a key role. Through talking to women early in their pregnancy, signposting information and explaining ways to contact health professionals regarding informational or emotional support would fill a gap that currently is met by other aspects of their network., Competing Interests: Conflict of Interest COI forms uploaded., (Copyright © 2023. Published by Elsevier Ltd.)

Chemical sensors based on optical absorption require accurate knowledge of the optical pathlength of the sample cell. Integrating spheres offer increased pathlengths compared to single pass cells combined with tolerance to misalignment, making them attractive for use in challenging environments subject to vibration. However, the equivalent optical pathlength can be degraded by dirt and / or condensation on the inner surface of the sphere. We present a new scheme for in-situ calibration that uses a ratiometric two-beam approach. Results are presented for an integrating sphere used in the measurement of methane by tunable diode laser spectroscopy (TDLS) at 1651nm. Reduced sphere reflectivity was simulated by applying small areas of black tape on the inner surface. At methane concentrations of 1500ppm and 3125 ppm, for areas of contamination up to 2.3% of the sphere wall, the technique reduced the error from over 50% to within ±4%. At a concentration of 6250 ppm and the most severe fouling corresponding to 2.9% wall coverage, the technique reduced the error from 55-65% to within ±11%.

We present the development of an external cavity Bragg grating stabilized laser for tunable diode laser spectroscopy (TDLS). Our design uses a planar integrated silica-on-silicon platform incorporating a custom written Bragg grating as the wavelength-selective element of the laser cavity. We have developed a prototype singlemode laser at 1651 nm and performed a detailed characterization of its performance for the purpose of spectroscopic measurement of methane at this wavelength using a 25 cm path-length single-pass cell. Mode hop-free tuning of 0.13 nm has been demonstrated at frequencies of up to 10 kHz. A single-point limit of detection for TDLS of ΔI/I 0  = 8.3 × 10 -5 AU was achieved, which is consistent with the performance of standard distributed feedback lasers. The new device exhibits a side-mode suppression ratio of -40 dB and a low RIN of <-150 dB/Hz, and thus avoids the high levels of noise or instability normally associated with larger, mechanically driven external cavity lasers. The silica-on-silicon platform has the potential for low-volume manufacturing of special lasers at the custom wavelengths required for gas detection, without the need for investment in foundry solutions.

We present a case of symptomatic trochanteric non-union following total hip replacement treated initially with a Dall-Miles grip plate. After failure of this treatment, the patient had a two-stage revision. Trochanteric non-union is one of the well-described complications after total hip replacement. It is frequently difficult to treat, while potentially causing weakness, altered gait and instability of the artificial joint. We believe that reattachment of the trochanter combined with a staged revision of the femoral stem using a posterior approach for the second stage could be a valuable technique to be added to the orthopaedic armamentarium for recurrent and symptomatic trochanteric non-unions after primary total hip replacement, particularly after failure to treat with all the other techniques described in literature.

A laser diode's junction voltage is a sensitive measure of its temperature and can be used in a thermal control feedback loop. To compensate for the temperature dependence of the laser's internal resistance, we have measured the dynamic resistance, ∂V/∂I, by modulating the injection current and measuring the demodulated voltage. The junction voltage was thus controlled while operating at fixed DC injection current. Over an external temperature range of 15°C to 35°C, this stabilised the centre frequency (wavelength) of a 1651 nm DFB laser diode with a residual mean frequency shift of 60 MHz (0.5pm), less than the uncertainty on the centre frequency of 80 MHz (0.7 pm). Under the same conditions, conventional thermistor control gave a systematic wavelength shift of -8.4 GHz (-76 pm), and control of the uncompensated forward voltage gave a shift of 9.9 GHz (90 pm).

INTRODUCTION Acetabular impaction bone grafting with a cemented polyethylene socket aims to reconstitute the bone stock in hip revision. This is an effective but resource intensive and time consuming technique. Usually, the articular cartilage is removed from the femoral head allograft. Our objective was to assess the late results of using the whole femoral head, retaining the cartilage. METHODS Forty-two acetabular revisions using impacted morselised bone graft (retaining the articular cartilage) and a cemented socket were studied retrospectively. The mean follow-up duration was 9.3 years (range: 6-13 years). Clinical and radiological assessment was made using the Oxford hip score, the classification of Hodgkinson et al (1988) for socket loosening and the classification of Gie et al (1993) for evaluation of allograft incorporation. RESULTS Twenty-seven sockets (75.0%) were radiologically stable, six (16.7%) were radiologically loose and three (8.3%) had migrated. Thirty cases (83.3%) showed good trabecular remodelling and six (16.74%) showed trabecular incorporation without remodelling. Six patients were lost to follow-up. Kaplan-Meier analysis calculated a survival rate of 94.5% at a mean of 9.3 years (95% confidence interval: 8.1-10.4 years) for all reasons of failure, with two re-revisions. CONCLUSIONS The nine-year results of the aforementioned technique are comparable with other major studies. Particularly when the supply of allograft and operative time are limited, retaining the articular cartilage of the femoral head is a safe and successful alternative.

Enhancing the effectiveness of aspirin by tailoring administration regimens is an important question among health professionals. We conducted a systematic review to evaluate the evidence on the effects of different aspirin regimens in terms of timing (chronotherapy) or frequency of dosing in the prevention of cardiovascular disease. Only two out of the 28 included studies reported long-term cardiovascular outcomes, highlighting an evidence gap that future research should address. The remaining 26 studies used surrogate outcomes., (© 2016 American Society for Clinical Pharmacology and Therapeutics.)

We present a four beam ratiometric setup for an integrating sphere based gas cell, which can correct for changes in pathlength due to sphere wall contamination. This allows for the gas absorption coefficient to be determined continuously without needing to recalibrate the setup. We demonstrate the technique experimentally, measuring methane gas at 1651nm. For example, contamination covering 1.2% of the sphere wall resulted in an uncompensated error in gas absorption coefficient of ≈41%. With the ratiometric scheme, this error was reduced to ≈2%. Potential limitations of the technique, due to subsequent deviations from mathematical assumptions are discussed, including severe sphere window contamination.

Sedimentary basins around the world considered suitable for carbon storage usually contain other natural resources such as petroleum, coal, geothermal energy and groundwater. Storing carbon dioxide in geological formations in the basins adds to the competition for access to the subsurface and the use of pore space where other resource-based industries also operate. Managing potential impacts that industrial-scale injection of carbon dioxide may have on other resource development must be focused to prevent potential conflicts and enhance synergies where possible. Such a sustainable coexistence of various resource developments can be accomplished by implementing a Framework for Basin Resource Management strategy (FBRM). The FBRM strategy utilizes the concept of an Area of Review (AOR) for guiding development and regulation of CO2 geological storage projects and for assessing their potential impact on other resources. The AOR is determined by the expected physical distribution of the CO2 plume in the subsurface and the modelled extent of reservoir pressure increase resulting from the injection of the CO2. This information is used to define the region to be characterised and monitored for a CO2 injection project. The geological characterisation and risk- and performance-based monitoring will be most comprehensive within the region of the reservoir containing the carbon dioxide plume and should consider geological features and wells continuously above the plume through to its surface projection; this region defines where increases in reservoir pressure will be greatest and where potential for unplanned migration of carbon dioxide is highest. Beyond the expanse of the carbon dioxide plume, geological characterisation and monitoring should focus only on identified features that could be a potential migration conduit for either formation water or carbon dioxide.

Diploid (2n = 2x = 20) and triploid (2n = 3x = 30) Fasciola hepatica have been reported in the UK, and in Asia diploid, triploid and mixoploid (2x/3x) Fasciola spp. exist but there is little information to indicate how common triploidy is, particularly in UK fluke. Here the ploidy of 565 adult F. hepatica from 66 naturally infected British sheep and 150 adult F. hepatica from 35 naturally infected British cattle was determined. All 715 of these parasites were diploid, based on observation of 10 bivalent chromosomes and sperm (n = 335) or, since triploids are aspermic, sperm alone (n = 380). This constitutes the first extensive analysis of the ploidy of F. hepatica field isolates from Great Britain and shows that most F. hepatica isolated from cattle and sheep are diploid and have the capacity to sexually reproduce. These data suggest that triploidy, and by extension parthenogenesis, is rare or non-existent in wild British F. hepatica populations. Given that F. hepatica is the only species of Fasciola present in Britain our results indicate that the parasite is predominantly diploid in areas where F. hepatica exists in isolation and suggests that triploidy may only originate in natural populations where co-infection of F. hepatica and its sister species Fasciola gigantica commonly occurs.

Despite years of investigation into triclabendazole (TCBZ) resistance in Fasciola hepatica, the genetic mechanisms responsible remain unknown. Extensive analysis of multiple triclabendazole-susceptible and -resistant isolates using a combination of experimental in vivo and in vitro approaches has been carried out, yet few, if any, genes have been demonstrated experimentally to be associated with resistance phenotypes in the field. In this review we summarize the current understanding of TCBZ resistance from the approaches employed to date. We report the current genomic and genetic resources for F. hepatica that are available to facilitate novel functional genomics and genetic experiments for this parasite in the future. Finally, we describe our own non-biased approach to mapping the major genetic loci involved in conferring TCBZ resistance in F. hepatica.

Objective: To determine the relative accuracy of clinic measurements and home blood pressure monitoring compared with ambulatory blood pressure monitoring as a reference standard for the diagnosis of hypertension., Design: Systematic review with meta-analysis with hierarchical summary receiver operating characteristic models. Methodological quality was appraised, including evidence of validation of blood pressure measurement equipment., Data Sources: Medline (from 1966), Embase (from 1980), Cochrane Database of Systematic Reviews, DARE, Medion, ARIF, and TRIP up to May 2010. Eligibility criteria for selecting studies Eligible studies examined diagnosis of hypertension in adults of all ages using home and/or clinic blood pressure measurement compared with those made using ambulatory monitoring that clearly defined thresholds to diagnose hypertension., Results: The 20 eligible studies used various thresholds for the diagnosis of hypertension, and only seven studies (clinic) and three studies (home) could be directly compared with ambulatory monitoring. Compared with ambulatory monitoring thresholds of 135/85 mm Hg, clinic measurements over 140/90 mm Hg had mean sensitivity and specificity of 74.6% (95% confidence interval 60.7% to 84.8%) and 74.6% (47.9% to 90.4%), respectively, whereas home measurements over 135/85 mm Hg had mean sensitivity and specificity of 85.7% (78.0% to 91.0%) and 62.4% (48.0% to 75.0%)., Conclusions: Neither clinic nor home measurement had sufficient sensitivity or specificity to be recommended as a single diagnostic test. If ambulatory monitoring is taken as the reference standard, then treatment decisions based on clinic or home blood pressure alone might result in substantial overdiagnosis. Ambulatory monitoring before the start of lifelong drug treatment might lead to more appropriate targeting of treatment, particularly around the diagnostic threshold.

Background: Atrial fibrillation (AF) is the commonest rhythm disorder and has major impact on patients. Controversy remains about the best treatment strategy between rate and rhythm control (in addition to adequate thromboprophylaxis). Rhythm control agents are associated with clinically important adverse events., Aim: The aim of this study was to assess the risk of adverse events in patients with AF receiving rhythm control agents., Design of Study: This is a retrospective case control note review and outcome linkage analysis., Setting: Setting of this study included patients with a diagnosis of AF receiving amiodarone, flecainide or sotalol in practices registered with the General Practice Research Database (GPRD) in the UK., Method: This is a retrospective case control note review and outcome linkage analysis on the GPRD routine clinical dataset to evaluate the adverse events and predictors of treatment discontinuation in patients using licenced rhythm modifying medication., Results: Adverse events are more common in patients currently or previously taking amiodarone, flecainide or sotalol than age- and gender-matched controls. All three antiarrhythmics were associated with increased all-cause mortality. Congestive heart failure was more common in all amiodarone and sotalol users as well as past users of flecainide. Thyroid disease was more common in patients treated with amiodarone and sotalol but only amiodarone had an increased risk of pulmonary toxicity. The number of patients with liver failure was too small in all cases for statistical analysis., Conclusion: The rhythm control agents amiodarone, flecainide and sotalol have significant adverse effects which can lead to discontinuation of their use. This should be considered when deciding the most appropriate treatment option for patients with AF.

We have developed a quantitative model of the performance of laser pointer style gas leak detectors, which are based on remote detection of backscattered radiation. The model incorporates instrumental noise limits, the reflectivity of the target background surface and a mathematical description of gas leak dispersion in constant wind speed and turbulence conditions. We have investigated optimum instrument performance and limits of detection in simulated leak detection situations. We predict that the optimum height for instruments is at eye level or above, giving an operating range of 10 m or more for most background surfaces, in wind speeds of up to 2.5 ms(-1). For ground based leak sources, we find laser pointer measurements are dominated by gas concentrations over a short distance close to the target surface, making their readings intuitive to end users in most cases. This finding is consistent with the results of field trials.

Aims: To compare arterial blood gas (ABG) readings obtained with a multiparameter intra-arterial sensor with those from an ABG analyser., Methods: An MPIAS with the ability to measure continuously pH, PaCO2, and PaO2 was introduced via an umbilical arterial catheter in 27 neonates requiring intensive care. They underwent 3260 hours of MPIAS monitoring, during which 753 ABG readings were performed., Results: Overall bias (mean difference: MPIAS-ABG) and precision (standard deviation of differences) values were: -0.002 and 0.022, respectively, for pH; +0.26 and 0.52 for PaCO2 (kPa); and -0.19 and 0.99 for PaO2 (kPa). This gave 95% limits of agreement as: -0.047 to +0.042 for pH, -0.76 to +1.28 kPa for PaCO2, and -2.13 to +1.75 kDa for PaO2. For each variable, precision across readings from the same individual was better than overall precision for all data. No complications related to the use of the catheter were observed., Conclusions: Continuous MPIAS ABG monitoring is an exciting development, with the potential to reduce blood transfusions and improve ABG homeostasis.

The basic structure and functional properties of smooth muscle thin filaments were established about 10 years ago. Since then we and others have been working on the details of how tropomyosin, caldesmon and the Ca(2+)-binding protein regulate actin interaction with myosin. Our work has tended to emphasize the similarities between caldesmon and troponin function whilst others have been more concerned with the differences. The need to resolve the resulting differences has stimulated us to find new and more direct ways of investigating the mechanism of thin filament regulation. In recent years an apparent divergence has opened up between functional measurements, which indicate an allosteric-cooperative regulatory mechanism in which caldesmon and Ca(2+)-binding protein control actin-tropomyosin state in the same way as troponin, and structural measurements which show thin filament structures unlike striated muscle thin filaments. The challenge is to interpret function in terms of structure. We have combined functional studies with expression and mutagenesis of caldesmon and with structural methods including X-ray crystalography of tropomyosin-caldesmon crystals, electron microscopy and helical reconstruction of actin-tropomyosin-caldesmon complexes and high resolution nuclear magnetic resonance spectroscopy of the C-terminus of caldesmon in interaction with actin and calmodulin. We have used this information to propose a structural mechanism for caldesmon regulation of the smooth muscle thin filament.

Visible-light-emitting diodes of three different colors have been used to detect an absorbing compound (potassium permanganate) in trace quantities in aqueous solution. Photothermal absorption in a closed cell caused deflection of a water meniscus held at a small pinhole. The displacement was monitored with optical-fiber interferometry. The technique was limited by LED emission intensities and environmental acoustic noise, giving minimum detectable absorption coefficients of 2 x 10(-4) cm(-1) at 478 and 658 nm and 3 x 10(-4) cm(-1) at 524 nm. The magnitude and form of meniscus deflection signals were shown to be in good agreement with theory.

Objective: We wished to determine the prevalence of polycystic ovaries (PCO) and relate morphological appearance to fertility., Design: We sent postal invitations to a random sample of women born in the years 1952-1969 from a list of a single Group Practice to attend for reproductive history questionnaire, examination, ultrasound scan of the ovaries and hormone measurements within 5 days of the onset of menstruation., Subjects: Of 1065 women potentially available for study, 571 (54%) replied of whom 353 (62%) agreed to participate. One hundred and ninety (18%) completed the study, 163 were deferred (57 because of current or very recent pregnancy, 106 because of inconvenience at time approached), and 18 additional women volunteered., Measurements: Prevalence of polycystic ovaries, ovarian size and morphology, menstrual history, features of androgen excess, fertility status, serum hormone levels., Results: The prevalence of PCO was 22% (41/190). PCO and non-PCO women were similar with respect to age, body mass index, oral contraceptive pill (OCP) usage, acne, and menstrual pattern but hirsutism (Ferriman and Gallwey score > 7) was significantly (P = 0.006) more frequent among PCO women. Proven prior fertility was the same in PCO (56%) and non-PCO (64%) women and an equal proportion in each group had not yet tested their fertility. Of those women with previously proven fertility, self-perceived difficulty in conception occurred in similar proportions of women with and without PCO. Unresolved primary or secondary infertility (2.5-4%) was similar in both groups. Ovarian volume (each ovary separately) was larger in women with PCO irrespective of current OCP usage. Serum levels of oestradiol and FSH were similar in PCO and non-PCO women, but LH was distributed around a higher median in PCO women. Median testosterone and androstenedione levels were the same in PCO and non-PCO women., Conclusions: The prevalence of polycystic ovarian morphology is high but, in this sample of women, was accompanied by minimal clinical manifestations and apparently no deleterious effects on earlier fertility. An isolated finding of polycystic ovaries may be a normal variation and should not necessarily imply altered fertility potential.

A comprehensive index has been developed for coding and cataloguing alcohol literature. A system has been implemented using a commercial data base management program and a micro computer for computerising the references. In addition to the index code and citation the user can also enter an abstract and a description of the article. References can be added to the computer, edited, searched for, displayed on screen, typed on paper, or sent to a text file using a selection of criteria entered by the user. When a search is performed the printout can include the abstract of each paper similar to that obtained from larger bibliographic services. Such a system is beneficial for personal study, for writing books, articles and theses and for use by departments and small libraries.