Objective
Examine whether small‐for‐gestational‐age (SGA) risk factors differed by prior SGA birth.
Design
Hospital‐based cohort study.
Setting
Utah, USA.
Population
Electronic medical record data ...from 25 241 women who were nulliparous at study entry with ≥2 subsequent consecutive singleton deliveries (2002–2010).
Methods
Estimated adjusted relative risks (RR) and 95% confidence intervals (95% CI) for the association between second pregnancy characteristics and SGA risk. Tested for risk factor differences between recurrence and incidence (Pdifference).
Main outcome measures
Second pregnancy incident (n = 1067) and recurrent SGA (n = 484) determined using a population‐based reference.
Results
SGA complicated 20.3 and 4.5% of deliveries to women with and without a prior SGA birth, respectively. Young maternal age (Pdifference = 0.01) and pregnancy hypertensive diseases (Pdifference = 0.03) were associated with incident but not recurrent SGA. Significant risk factors for incidence and recurrence were smoking (incident RR = 1.64 95% CI 1.22–2.19; recurrent RR = 1.59 95% CI 1.17–2.17), short stature (incident RR = 1.34 95% CI 1.16–1.54; recurrent RR = 1.54 95% CI 1.31–1.82), prepregnancy underweight (incident RR = 1.32 95% CI 1.07–1.64; recurrent RR = 1.30 95% CI 1.03–1.64), and inadequate weight gain (incident RR = 1.41 95% CI 1.22–1.64; recurrent RR = 1.33 95% CI 1.10–1.60). Race‐ethnicity, marital or insurance status, alcohol, diabetes, asthma, thyroid disease, depression, or interpregnancy interval were not associated with incidence or recurrence.
Conclusion
There was considerable overlap in the risk factors for SGA recurrence and incidence. Recurrence and incidence risk factors included smoking, short stature, underweight, and inadequate weight gain. Maternal age and hypertensive diseases increased the risk for incidence only. Regardless of the SGA definition, some potentially modifiable risk factors for recurrence were identified.
Radiotherapy and radiation oncology play a key role in the clinical management of patients suffering from oncological diseases. In clinical routine, anatomic imaging such as contrast-enhanced CT and ...MRI are widely available and are usually used to improve the target volume delineation for subsequent radiotherapy. Moreover, these modalities are also used for treatment monitoring after radiotherapy. However, some diagnostic questions cannot be sufficiently addressed by the mere use standard morphological imaging. Therefore, positron emission tomography (PET) imaging gains increasing clinical significance in the management of oncological patients undergoing radiotherapy, as PET allows the visualization and quantification of tumoral features on a molecular level beyond the mere morphological extent shown by conventional imaging, such as tumor metabolism or receptor expression. The tumor metabolism or receptor expression information derived from PET can be used as tool for visualization of tumor extent, for assessing response during and after therapy, for prediction of patterns of failure and for definition of the volume in need of dose-escalation. This review focuses on recent and current advances of PET imaging within the field of clinical radiotherapy / radiation oncology in several oncological entities (neuro-oncology, head & neck cancer, lung cancer, gastrointestinal tumors and prostate cancer) with particular emphasis on radiotherapy planning, response assessment after radiotherapy and prognostication.
•Severe lymphopenia during chemoradiation therapy was associated with poor survival outcomes.•Lymphocyte recovery after chemoradiation could not mitigate the poor long-term outcomes brought by ...high-grade lymphopenia.•Lymphocyte recovery ability was not different between patients with or without severe lymphopenia.•Lymphocyte recovery was only associated with baseline lymphocyte count.
Radiation-induced lymphopenia (RIL) during therapy is associated with poor prognosis but is often temporary and resolves after treatment completion in esophageal cancer. How lymphocyte recovery contributes to prognosis is unknown.
We reviewed 755 patients with stage I-III esophageal carcinoma who received concurrent chemoradiation therapy (CRT) with or without surgery in 2004–2015. Complete blood counts were obtained before, during, and at first follow-up after CRT. Lymphopenia was graded per the Common Terminology Criteria for Adverse Events v4.03 during CRT (G) and as recovery after CRT (Gr). Clinical factors and lymphopenia grade were tested for association with survival in univariable and multivariable Cox proportional hazard regression analyses.
During CRT, 294 patients (38.9%) had G4 lymphopenia; by the first follow-up, 406 patients (53.8%) had recovered (Gr0-1). Relative to patients with G0-3 lymphopenia during CRT, G4 lymphopenia independently predicted worse OS in multivariable analyses. However, lymphocyte recovery was not associated with a better prognosis. Patients with G4 lymphopenia during CRT and recovery (Gr0-1) afterward still had poorer 5-year OS rate than patients with G0-3 during CRT without recovery (Gr2-4) afterward (36.6% vs. 51.9%, HR = 1.40, 95% CI 1.04–1.89, P = 0.027). Moreover, the lymphocyte recovery ability (post-CRT ALC divided by pre-CRT ALC) was not affected by lymphopenia grade during CRT (0.66 in G0-3 vs. 0.65 in G4, p = 0.473). Among patients with G4 lymphopenia during treatment, lymphocyte recovery was only associated with pre-CRT lymphocyte counts.
Lymphocyte count recovery after CRT does not alter the poor long-term outcomes brought about by high-grade lymphopenia during CRT.
Three-dimensional (3D) blood vessels-on-a-chip (VoC) models integrate the biological complexity of vessel walls with dynamic microenvironmental cues, such as wall shear stress (WSS) and ...circumferential strain (CS). However, these parameters are difficult to control and are often poorly reproducible due to the high intrinsic diameter variation of individual 3D-VoCs. As a result, the throughput of current 3D systems is one-channel-at-a-time. Here, we developed a fluidic circuit board (FCB) for simultaneous perfusion of up to twelve 3D-VoCs using a single set of control parameters. By designing the internal hydraulic resistances in the FCB appropriately, it was possible to provide a pre-set WSS to all connected 3D-VoCs, despite significant variation in lumen diameters. Using this FCB, we found that variation of CS or WSS induce morphological changes to human induced pluripotent stem cell (hiPSC)-derived endothelial cells (ECs) and conclude that control of these parameters using a FCB is necessary to study 3D-VOCs.
We developed a fluidic circuit board for simultaneous perfusion of up to twelve 3D vessels-on-a-chip under comparable wall shear stress using a single set of control parameters despite high intrinsic sample diameter variation.
Angiotensin II (Ang II) is a potent vasoconstrictor with an important role in controlling blood pressure; however, there is
little information on cellular mechanisms underlying Ang II-evoked ...vasoconstrictor responses. The aim of the present study
is to investigate the effect of Ang II on cation conductances in freshly dispersed rabbit mesenteric artery myocytes at the
single-channel level using patch-clamp techniques. In cell-attached patches, bath application of low concentrations of Ang
II (1 n m ) activated cation channel currents ( I cat1 ) with conductances states of about 15, 30 and 45 pS. At relatively high concentrations, Ang II (100 n m ) inhibited I cat1 but evoked another cation channel ( I cat2 ) with a conductance of approximately 2 pS. Ang II-evoked I cat1 and I cat2 were inhibited by the AT 1 receptor antagonist losartan and the phospholipase C (PLC) inhibitor U73122. The diacylglycerol (DAG) lipase inhibitor RHC80267
initially induced I cat1 which was subsequently inhibited to reveal I cat2 . The DAG analogue 1-oleoyl-2-acetyl- sn -glycerol (1 μ m ) activated I cat1 and I cat2 but inositol 1,4,5-trisphosphate did not evoke either conductance. The protein kinase C (PKC) inhibitor chelerythrine (3
μ m ) potentiated Ang II-evoked I cat1 and inhibited I cat2 whereas the PKC activator phorbol-12,13-dibutyrate (1 μ m ) reduced Ang II-induced I cat1 but activated I cat2 . Moreover in cell-attached patches pretreated with chelerythrine, application of 100 n m Ang II activated I cat1 . These data indicate that PKC inhibits I cat1 but stimulates I cat2 . Agents that deplete intracellular Ca 2 + stores also activated cation channel currents with similar properties to I cat2 . Bath application of anti-TRPC6 and anti-TRPC1 antibodies to inside-out patches inhibited I cat1 and I cat2 , respectively. Also flufenamic acid and zero external Ca 2 + concentration, respectively, potentiated and reduced Ang II-evoked I cat1 . Immunocytochemical studies showed TRPC6 and TRPC1 expression with TRPC6 preferentially distributed in the plasma membrane
and TRPC1 expression located throughout the myocyte. These results indicate that Ang II activates two distinct cation conductances
in mesenteric artery myocytes by stimulation of AT 1 receptors linked to PLC. I cat1 is activated by DAG via a PKC-independent mechanism whereas I cat2 involves DAG acting via a PKC-dependent pathway. Higher concentrations of Ang II inhibit I cat1 by activating an inhibitory effect of PKC. It is proposed that TRPC6 and TRPC1 channel proteins are important components
of Ang II-induced I cat1 and I cat2 , respectively.
Store-operated channels (SOCs) are plasma membrane Ca 2+ -permeable cation channels which are activated by agents that deplete intracellular Ca 2+ stores. In smooth muscle SOCs are involved in ...contraction, gene expression, cell growth and proliferation. Single channel
recording has demonstrated that SOCs with different biophysical properties are expressed in smooth muscle indicating diverse
molecular identities. Moreover it is apparent that several gating mechanisms including calmodulin, protein kinase C and lysophospholipids
are involved in SOC activation. Evidence is accumulating that TRPC proteins are important components of SOCs in smooth muscle.
More recently Orai and STIM proteins have been proposed to underlie the well-described calcium-release-activated current ( I CRAC ) in non-excitable cells but at present there is little information on the role of Orai and STIM proteins in smooth muscle.
In addition it is likely that different TRPC subunits coassemble as heterotetrameric structures to form smooth muscle SOCs.
In this brief review we summarize the diverse properties and gating mechanisms of SOCs in smooth muscle. We propose that the
heterogeneity of the properties of these conductances in smooth muscle results from the formation of heterotetrameric TRPC
structures in different smooth muscle preparations.
Objective
To assess differences in small‐for‐gestational age (SGA) classifications for the detection of neonates with increased perinatal mortality risk among obese women and subsequently assess the ...association between prepregnancy body mass index (BMI) status and SGA.
Design
Hospital‐based cohort.
Setting
Twelve US clinical centres (2002–08).
Population
A total of 114 626 singleton, nonanomalous pregnancies.
Methods
Data were collected using electronic medical record ion. Relative risks (RR) with 95% CI were estimated.
Main outcome measures
SGA trends (birthweight < 10th centile) classified using population‐based (SGAPOP), intrauterine (SGAIU) and customised (SGACUST) references were assessed. The SGA‐associated perinatal mortality risk was estimated among obese women. Using the SGA method most associated with perinatal mortality, the association between prepregnancy BMI and SGA was estimated.
Results
The overall perinatal mortality prevalence was 0.55% and this increased significantly with increasing BMI (P < 0.01). Among obese women, SGAIU detected the highest proportion of perinatal mortality cases (2.49%). Perinatal mortality was 5.32 times (95% CI 3.72–7.60) more likely among SGAIU neonates than non‐SGAIU neonates. This is in comparison with the 3.71‐fold (2.49–5.53) and 4.81‐fold (3.41–6.80) increased risk observed when SGAPOP and SGACUST were used, respectively. Compared with women of normal weight, overweight women (RR = 0.82, 95% CI 0.78–0.86) and obese women (RR = 0.80; 95% CI 0.75–0.83) had a lower risk for delivering an SGAIU neonate.
Conclusion
Among obese women, the intrauterine reference best identified neonates at risk of perinatal mortality. Based on SGAIU, SGA is less common among obese women but these SGA babies are at a high risk of death and remain an important group for surveillance.
Tweetable
SGA is less common among obese women but these SGA babies are at a high risk of death.
Tweetable
SGA is less common among obese women but these SGA babies are at a high risk of death.
Twice a year in southwestern Nigeria, during a traditional bat festival, community participants enter designated caves to capture bats, which are then consumed for food or traded. We investigated the ...presence of Bartonella species in Egyptian fruit bats (Rousettus aegyptiacus) and bat flies (Eucampsipoda africana) from these caves and assessed whether Bartonella infections had occurred in persons from the surrounding communities. Our results indicate that these bats and flies harbor Bartonella strains, which multilocus sequence typing indicated probably represent a novel Bartonella species, proposed as Bartonella rousetti. In serum from 8 of 204 persons, we detected antibodies to B. rousetti without cross-reactivity to other Bartonella species. This work suggests that bat-associated Bartonella strains might be capable of infecting humans.
•Review of municipal solid waste management (MSWM) practices in the Philippines.•Use of Emissions Quantification Tool to assess climate impact of MSWM options.•Quantification of potential ...waste-related short-lived climate pollutants (SLCPs).•Findings highlight need for enhancing mitigation of CH4 from final disposal.•Black carbon (BC) can be reduced by addressing waste collection and open burning.
Municipal solid waste management (MSWM) is considered one of the serious environmental issues in the Philippines, with corresponding linkages to the climate change and Sustainable Development Goals (SDGs). However, methane (CH4) linked with indiscriminate dumping of municipal solid waste has received the much attention with regard to public health and climate change. The impacts of black carbon (BC) are less documented and understood. This paper aims to review the status of MSWM in the Philippines and makes efforts to assess the scale of short-lived climate pollutants (SLCPs), including both CH4, and BC, associated with the country’s waste sector. Utilising available national level data and following a life-cycle assessment (LCA) approach, the paper offers preliminary projections of SLCP emissions resulting from present MSWM practices. In addition, it examines model mitigation scenarios based on priority actions identified within the country’s national policy on waste management, Republic Act 2003 (RA 9003). Data analysis was conducted using an Emission Quantification Tool (EQT) developed by the Institute for Global Environmental Strategies (IGES) through its work under the Climate and Clean Air Coalition (CCAC) – Municipal Solid Waste Initiative (MSWI). Following a summary of key findings, the paper affirms that control of methane from disposal practices and of BC from waste collection and open burning requires urgent attention in the Philippines. Continued awareness raising, institutionalising regulatory policies on SLCPs, and further enhancing data collection and capacity building on waste-related BC emissions remain key priorities for the country.
Hierarchical plasmonic–photonic microspheres (PPMs) with high controllability in their structures and optical properties have been explored toward surface-enhanced Raman spectroscopy. The PPMs ...consist of gold nanocrystal (AuNC) arrays (3rd-tier) anchored on a hexagonal nanopattern (2nd-tier) assembled from silica nanoparticles (SiO2NPs) where the uniform microsphere backbone is termed the 1st-tier. The PPMs sustain both photonic stop band (PSB) properties, resulting from periodic SiO2NP arrangements of the 2nd-tier, and a surface plasmon resonance (SPR), resulting from AuNC arrays of the 3rd-tier. Thanks to the synergistic effects of the photonic crystal (PC) structure and the AuNC array, the electromagnetic (EM) field in such a multiscale composite structure can tremendously be enhanced at certain wavelengths. These effects are demonstrated by experimentally evaluating the Raman enhancement of benzenethiol (BT) as a probe molecule and are confirmed via numerical simulations. We achieve a maximum SERS enhancement factor of up to ∼108 when the resonances are tailored to coincide with the excitation wavelength by suitable structural modifications.
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