Cardiovascular disease and associated comorbid conditions as determinants of adverse perinatal outcomes in pregnancy - an analysis of the results of the register of pregnant BEREG.

AIM: the Aim of the BEREG Registry was to analyze the prevalence and structure of cardiovascular diseases, associated comorbid conditions and assess their effects on pregnancy and perinatal outcomes in real clinical practice. MATERIALS AND METHODS: In Tula city regional perinatal center the observation study named "Assessment of the clinical condition of the pregnant women with cardiovascular disease during gestation, at child delivery, at the early postpartum period and at twelve months after childbirth and assesment of perinatal outcomes, condition of the fetus and the newborn and the quality of treatment of these patients groups.  All eligibly pregnant women hospitalized in 2014 to "Tula regional perinatal center" have been recruited in the Registry. Clinical and demographic data at admission, obstetric history, laboratory and instrumental examination data, previous medical history have been investigated. The following endpoints were evaluated: maternal mortality, death of the fetus and newborn baby; preeclampsia or/and eclampsia, heart failure, arrhythmia, thromboembolism events.  Statistical processing of obtained data was carried out using the software package STATISTICA 10.0 (StatSoft, USA). RESULTS: The study included 3214 women delivered babies in the perinatal center in 2014, of which 691 (21,4%) were diagnosed with cardiovascular disease (CVD) in most cases (451 women, 65,9%) - these were different clinical variants of arterial hypertension (AH). Five women (0.7%) had acquired and 23 women ( 3.3%,) congenital heart defect, non-significant heart development abnormities were found in 80 subjects, (11.6%). and Cardiac arrhythmias and conductivity disturbance have been revealed in 116 and 16 cases (16.8% and 2.3%) correspondingly. Patients with CVD were significantly older than women without CVD and more often had a variety of disorders of carbohydrate metabolism, overweight, obesity and chronic varicose disease of the lower extremities. Pregnancy in women with CVD significantly more often was complicated by the threat of interruption, placental insufficiency, preterm and operative babies delivery. Arterial hypertension as well as obesity, placental insufficiency and threatened miscarriage became prognostically unfavorable conditions that contributed of premature birth and fetal death. Fetal death or newborn babies death took place in 1,3% of all the subjects enrolled. In this cohort antenatal death have been registered in 43,2%, intrapartum one in 2.3% and neonatal death in 54.5%. CONCLUSION: Negative prognostic factors for low birth-weight babies were: placental insufficiency, various clinical variants of AH, obesity and infectious diseases; less input had endocrine diseases and risk of abortion. Adverse factors for the fetus death or newborn death were different clinical variants of arterial hypertension and the risk of abortion in any trimestre of pregnancy.

Ideal charge-density-wave order in the high-field state of superconducting YBCO.

The existence of charge-density-wave (CDW) correlations in cuprate superconductors has now been established. However, the nature of the CDW ground state has remained uncertain because disorder and the presence of superconductivity typically limit the CDW correlation lengths to only a dozen unit cells or less. Here we explore the field-induced 3D CDW correlations in extremely pure detwinned crystals of YBa2Cu3O2 (YBCO) ortho-II and ortho-VIII at magnetic fields in excess of the resistive upper critical field ([Formula: see text]) where superconductivity is heavily suppressed. We observe that the 3D CDW is unidirectional and possesses a long in-plane correlation length as well as significant correlations between neighboring CuO2 planes. It is significant that we observe only a single sharply defined transition at a critical field proportional to [Formula: see text], given that the field range used in this investigation overlaps with other high-field experiments including quantum oscillation measurements. The correlation volume is at least two to three orders of magnitude larger than that of the zero-field CDW. This is by far the largest CDW correlation volume observed in any cuprate crystal and so is presumably representative of the high-field ground state of an "ideal" disorder-free cuprate.

Observation of Orbital Order in the Half-Filled 4f Gd Compound.

Half-filled electron systems, even with the maximized spin angular moment, have been given little attention because of their zero-orbital angular moment according to Hund's rule. Nevertheless, there are several measurements that show evidence of a nonzero orbital moment as well as spin-orbit coupling. Here we report for the first time the orbital order in a half-filled 4f-electron system GdB_{4}, using the resonant soft x-ray scattering at Gd M_{4,5}-edges. Furthermore, we discovered that the development of this orbital order is strongly coupled with the antiferromagnetic spin order. These results clearly demonstrate that even in half-filled electron systems the orbital angular moment can be an important parameter to describe material properties, and may provide significant opportunities for tailoring new correlated electron systems.

Oxygen-vacancy-induced orbital reconstruction of Ti ions at the interface of LaAlO3/SrTiO3 heterostructures: a resonant soft-X-ray scattering study.

Resonant soft-x-ray scattering measurements have been performed to investigate interface electronic structures of (LaAlO(3)/SrTiO(3)) superlattices. Resonant scattering intensities at superlattice reflections show clear evidence of degeneracy lifting in t(2g) states of interface Ti ions. Polarization dependence of intensities indicates the energy of d(xy) states is lower by ~1 eV than two other t(2g) states. The energy splitting is insensitive to epitaxial strain. The orbital reconstruction is induced by oxygen vacancies and confined to the interface within two unit cells, indicating charge compensation at the polar interfaces.

Torsional oscillator and synchrotron X-Ray experiments on solid 4He in aerogel.

X-ray diffraction experiments show that solid 4He grown in aerogel is highly polycrystalline, with an hcp crystal structure (as in bulk) and a crystallite size of approximately 100 nm. In contrast to the expectation that the highly disordered solid will have a large supersolid fraction, torsional oscillator measurements show a behavior that is strikingly similar to high purity crystals grown from the superfluid phase. The low temperature supersolid fraction is only approximately 3 x 10(-4), and the onset temperature is approximately 100 mK.

Excitations of lithium ammonia complexes studied by inelastic x-ray scattering.

We have carried out high-resolution inelastic x-ray scattering measurements of the excitations of lithium dissolved in ammonia. The incident x-ray energy was 21.6 keV and the resolution was about 2 meV. Several different excitations are observed in the energy range of 0-60 meV (0-500 cm(-1)). In addition to acoustic phonons at low energies, we see excitations that are associated with vibrations of Li(NH3)4+ complexes. We examined these excitations as a function of momentum transfer, lithium concentration, temperature, and state of the system (solid versus liquid). Data are compared with Hartree-Fock and density-functional theory calculations of the excitations of this complex, which agree well with the measured excitation energies.

Synthesis, permeability and biocompatibility of tricomponent membranes containing polyethylene glycol, polydimethylsiloxane and polypentamethylcyclopentasiloxane domains.

The synthesis of "smart" tricomponent amphiphilic membranes containing poly(ethylene glycol) (PEG), polydimethylsiloxane (PDMS) and polypentamethylcyclopentasiloxane (PD(5)) domains is described. Contact angle hysteresis indicates that in air, the surfaces of such PEG/PD(5)/PDMS membranes are enriched by the hydrophobic components, PDMS and PD(5), while in water, the surfaces are rich in the hydrophilic PEG. The oxygen permeability of a series of membranes with varying M(c,hydrophilic) (M(n,PEG)=4600, 10,000 and 20,000 g/mol) and varying PEG/PD(5)/PDMS compositions was studied. Oxygen permeability increased with the amount of PDMS in the membrane. The molecular weight cut-off (MWCO) ranges and permeability coefficients of insulin through a series of PEG/PD(5)/PDMS(=29/14/57) membranes with varying M(c,hydrophilic) were determined. Insulin permeability is directly related to M(c,hydrophilic) of the membrane. MWCO studies show that the membranes are semipermeable to, i.e., allow the transport of smaller proteins such as insulin (M(n)=5733 g/mol, R(s)=1.34 nm) and cytochrome c (M(n)=12,400 g/mol, R(s)=1.63 nm), but are barriers to larger proteins such as albumin (M(n)=66,000 g/mol, R(s)=3.62 nm). Implantation of representative membranes in rats showed them to be biocompatible. According to these studies, PEG/PD(5)/PDMS membranes may be suitable for biological applications, e.g., immunoisolation of cells.

Electronic interactions in the expanded metal compound Li-NH3.

Inelastic x-ray scattering was used to measure the plasmon as a function of electron density in liquid lithium ammonia as well as the low temperature solid phase. As the electronic density is lowered, electronic correlation effects cause the random-phase approximation (RPA) to break down, requiring more advanced theoretical treatments. The deviation from RPA becomes greatest at the lowest electronic densities. We also see evidence for decreased electronic screening as shown by an increase in the strength of the pseudopotential at lower concentrations. Plasmon behavior in the solid is similar to that of the heavier alkali metals, but surprisingly different than in the liquid.

Resonant inelastic x-ray scattering study of charge excitations in La(2)CuO(4).

We report a resonant inelastic x-ray scattering study of the dispersion relations of charge-transfer excitations in insulating La(2)CuO(4).. These data reveal two peaks, both of which show two-dimensional characteristics. The lowest energy excitation has a gap energy of approximately 2.2 eV at the zone enter, and a dispersion of approximately 1 eV. The spectral weight of this mode becomes dramatically smaller around (pi, pi). The second peak shows a smaller dispersion ( approximately 0.5 eV) with a zone-center energy of approximately 3.9 eV. We argue that these are both highly dispersive exciton modes damped by the presence of the electron-hole continuum.

Evidence for an instability near twice the fermi wave vector in the low electronic density liquid metal Li(NH3)4.

We report high-resolution inelastic x-ray scattering measurements in the metallic liquid Li(NH3)4, which to a good approximation can be treated as a dilute alkali metal. We see a well-defined excitation out to large momentum transfers. This excitation shows a strong softening at wave vectors near the first peak in the structure factor, which occurs near twice the Fermi momentum.

Using scientific evidence to improve hospital library services: Southern Chapter/Medical Library Association journal usage study.

BACKGROUND: Journal usage studies, which are useful for budget management and for evaluating collection performance relative to library use, have generally described a single library or subject discipline. The Southern Chapter/Medical Library Association (SC/MLA) study has examined journal usage at the aggregate data level with the long-term goal of developing hospital library benchmarks for journal use. METHODS: Thirty-six SC/MLA hospital libraries, categorized for the study by size as small, medium, or large, reported current journal title use centrally for a one-year period following standardized data collection procedures. Institutional and aggregate data were analyzed for the average annual frequency of use, average costs per use and non-use, and average percent of non-used titles. Permutation F-type tests were used to measure difference among the three hospital groups. RESULTS: Averages were reported for each data set analysis. Statistical tests indicated no significant differences between the hospital groups, suggesting that benchmarks can be derived applying to all types of hospital libraries. The unanticipated lack of commonality among heavily used titles pointed to a need for uniquely tailored collections. CONCLUSION: Although the small sample size precluded definitive results, the study's findings constituted a baseline of data that can be compared against future studies.

Home use of a functional electrical stimulation system for standing and mobility in adolescents with spinal cord injury.

OBJECTIVE: Functional electrical stimulation (FES) is a technology that may allow some patients with spinal cord injury (SCI) to integrate standing and upright mobility with wheelchair mobility. The purpose of this study was to document the patterns of home and community use of a FES system for standing and mobility. DESIGN: A telephone questionnaire was administered every 1 to 4 weeks for a minimum of 1 year. An interview was given at the end of the study to probe the motivators and barriers to home use. SETTING: Training for use of the FES system was performed in an inpatient pediatric rehabilitation setting. Data collection began after the subjects were discharged to home. PARTICIPANTS: Five adolescents with complete, thoracic-level SCI. INTERVENTION: Subjects participated in a program of FES exercise followed by training in basic mobility skills such as standing transfers, maneuvering, level ambulation, one-handed and reaching activities, and stair ascent/descent. MAIN OUTCOME MEASURE: The frequency with which the FES system was used at home and the activities for which it was utilized were documented. Motivators and barriers to FES home use were examined. RESULTS: Subjects donned the FES system on the average once every 3 to 4 days. Between 51% and 84% of the times donned, the system was used for exercise. The remaining times it was used for standing activities, most commonly reaching, one-handed tasks, and standing for exercise. "Motivators" included being able to do things that would otherwise be difficult, perceiving a healthful benefit or a sense of well-being from standing and exercise, and feeling an obligation to stand as a participant in a research study. "Barriers" to FES use included not finding time to use the system, having difficulty seeing opportunities to stand, and being reluctant to wear the FES system all day.

Doppler echocardiographic assessment of an impedance-based dual-chamber rate-responsive pacemaker.

Rate-responsive pacing allows patients with chronotropic incompetence to achieve more physiologic heart rate responses to exercise. One sensor currently being investigated uses impedance-derived measurements of changes in right ventricular stroke volume to alter the pacing rate. Correlation of pacemaker-derived measurements of stroke volume with an accepted method of stroke volume measurement has not been performed. The relative changes in impedance-derived stroke volume were compared in 10 patients with an impedance-based dual-chamber rate-responsive pacemaker (Precept DR, Cardiac Pacemakers, Inc.) with simultaneous Doppler echocardiographic measurements of right and left ventricular stroke volume. These comparisons were made during pacing at 2 heart rates (70 and 100 beats/min) and 3 AV intervals (150, 200 and 250 ms) while in a supine resting state, during lower body negative pressure to -30 mm Hg, and while performing 25% maximal handgrip. Pacemaker-derived stroke volume decreased by 7 to 11% and Doppler time-velocity integral measurements decreased by 14 to 19% in response to an increase in pacing rate (p = NS). There was also no significant difference by either technique in the mean stroke volume change when the atrioventricular interval was varied. Both techniques detected a decrease in stroke volume during lower body negative pressure, ranging from -7 to -20% by pacemaker, and -17 to -38% by Doppler. Overall, the pacemaker stroke volume measurements responded in an appropriate direction to each intervention, signaling the pacemaker's ability to detect directional change in stroke volume. The Precept DR may aid in the programming of parameters such as atrioventricular interval and heart rate by allowing for optimization of stroke volume in individual patients.

Coronary aneurysms: a case report and review.

This case report describes a large coronary aneurysm and poses questions regarding management. The discussion that follows addresses what is known about the natural history of and options for management of coronary aneurysms.

Transesophageal echocardiography to assess mitral valve function and flow during cardiopulmonary resuscitation.

This study further defines the mechanism of blood flow during closed-chest compression using transesophageal Doppler echocardiography. Although the echocardiographic demonstration of mitral valve closure during closed-chest compression has been used as evidence of direct cardiac compression, mitral valve closure has also been documented to occur during resuscitation by selectively increasing intrathoracic pressure. Transesophageal Doppler echocardiography was used to assess mitral valve position and flow in 17 adult patients undergoing cardiopulmonary resuscitation with a mechanical piston compression device. Left and right ventricular fractional shortening, mitral valve position with chest compression, timing and magnitude of transmitral flow, and anteroposterior chest diameter were recorded. In 12 patients (group I), the mitral valve closed during the down-stroke of chest compression; in the remaining 5 (group II), it opened further. Peak transmitral flow occurred during the release phase and was significantly higher (p < 0.05) in group I (39.5 +/- 9.3 cm/s) than the peak flow in group II (21.3 +/- 5.9 cm/s), which occurred during the downstroke of chest compression. Left ventricular fractional shortening inversely correlated (r = -0.68; p = 0.02) with the anteroposterior chest diameter, but did not correlate with peak transmitral flow (r = 0.34; p = not significant). It is concluded that the mitral valve closes during the downstroke of chest compression in most adult patients during resuscitation. The absence of a relation between mitral valve flow and left ventricular fractional shortening supports the hypothesis that other factors such as nonuniform increases in intrathoracic pressure cause the mitral valve to open or close during chest compression.

Structure of (20R)-20,21-epoxy-19-norpregna-1,3,5(10)-triene-3,17 beta-diol.

C20H26O3, Mr = 314.4, orthorhombic, P2(1)2(1)2(1), a = 10.25 (1), b = 25.36 (2), c = 13.11 (1) A, V = 3410.14 A3, Z = 8, Dx = 1.225 g cm-3, lambda(Mo K alpha) = 0.71069 A, mu = 0.45 cm-1, F(000) = 1352, T = 293 K. The structure was solved by direct methods and refined to R = 0.051 for 2384 reflections with F/signa(F) greater than 5. Both the crystallographically independent molecules are in one 20R configuration and confirm predictions based on mechanistic and stereochemical arguments. In the crystal lattice the molecules form a two-dimensional network of hydrogen bonds approximately perpendicular to c.

The association of Streptococcus bovis fecal carriage and colon neoplasia: possible relationship with polyps and their premalignant potential.

We designed a study to evaluate the fecal carrier rate of Streptococcus bovis in patients with endoscopically proven colonic polyps. Benign polyps (n = 63), i.e., hyperplastic, inflammatory, and juvenile, had a similar fecal carrier rate as the normal control colons. Colons with polyps that are at increased risk for malignant degeneration (n = 62), i.e., tubulovillous and villous adenomas, and colons with carcinoma (n = 18), had a statistically significant increase (p less than 0.05) in the fecal carrier rate for S. bovis over the benign colon group. Overall, the incidence of S. bovis carriage in all colons with polyps was intermediary between normal colons and colons with carcinoma although the numbers did not achieve statistical significance.