[Directive clinique n 440 : Prise en charge de la grossesse gémellaire monochoriale].

Objectif: Cette directive clinique passe en revue les données probantes sur la prise en charge de la grossesse gémellaire monochoriale normale et compliquée.

Population Cible: Les femmes menant une grossesse gémellaire ou multiple de haut rang. BéNéFICES, RISQUES ET COûTS: L'application des recommandations de cette directive devrait améliorer la prise en charge des grossesses gémellaires (ou multiples de haut rang) monochoriales compliquées et non compliquées.

Guideline No. 440: Management of Monochorionic Twin Pregnancies.

Objective: This guideline reviews the evidence-based management of normal and complicated monochorionic twin pregnancies.

Target Population: Women with monochorionic twin or higher order multiple pregnancies.

Benefits, Harms, And Costs: Implementation of these recommendations should improve the management of both complicated and uncomplicated monochorionic (and higher order multiple) twin pregnancies.

Bi-allelic MYH3 loss-of-function variants cause a lethal form of contractures, pterygia, and spondylocarpotarsal fusion syndrome 1B.

Arthrogryposis is a consequence of reduced fetal movements and arises due to environmental factors or underlying genetic defects, with extensive genetic heterogeneity. In many instances, the genes responsible are involved in neuromuscular function. Missense variants in the gene encoding embryonic myosin heavy chain (MYH3) usually cause distal arthrogryposis.

The elements of success in a comprehensive state-wide program to safely reduce the rate of preterm birth.

Background: In 2014, a whole-of-population and multi-faceted preterm birth prevention program was introduced in Western Australia with the single aim of safely lowering the rate of preterm birth. The program included new clinical guidelines, print and social media, and a dedicated new clinic. In the first full calendar year the rate of preterm birth fell by 7.

Hyperglycemia aggravates decrease in alpha-synuclein expression in a middle cerebral artery occlusion model.

Hyperglycemia is one of the major risk factors for stroke. Hyperglycemia can lead to a more extensive infarct volume, aggravate neuronal damage after cerebral ischemia. α-Synuclein is especially abundant in neuronal tissue, where it underlies the etiopathology of several neurodegenerative diseases.

Congenital diaphragmatic hernia: Impact of contemporary management strategies on perinatal outcomes.

Objective: This study aims to review temporal changes in perinatal management and 1-year survival outcomes of cases of congenital diaphragmatic hernia (CDH) from 1996 to 2015 in Western Australia (WA).

Method: This research is a retrospective study of all cases of CDH in WA from 1996 to 2015 identified from five independent databases within the WA health network. Detailed information pertaining to pregnancy and survival outcomes were obtained from review of maternal and infant medical records.

Reducing preterm birth by a statewide multifaceted program: an implementation study.

Background: A comprehensive preterm birth prevention program was introduced in the state of Western Australia encompassing new clinical guidelines, an outreach program for health care practitioners, a public health program for women and their families based on print and social media, and a new clinic at the state's sole tertiary level perinatal center for referral of those pregnant women at highest risk. The initiative had the single aim of safely lowering the rate of preterm birth.

Objective: The objective of the study was to evaluate the outcomes of the initiative on the rates of preterm birth both statewide and in the single tertiary level perinatal referral center.

Error analysis of moment-based modal wavefront sensing.

The shape of a focus-modulated point spread function (PSF) is used as a quick visual assessment tool of aberration modes in the PSF. Further analysis in terms of shape moments can permit quantifying the modal coefficients with an accuracy comparable to that of typical wavefront sensors. In this Letter, the error of the moment-based wavefront sensing is analytically described in terms of the pixelation and photon/readout noise.

Improved quantification of islet transplants by magnetic resonance imaging with Resovist.

Objectives: We aimed to develop an accurate and reproducible method to quantify transplanted islets and monitor their functional status in vivo. To support this aim, we investigated the cytotoxic effect of Resovist on islet function and survival.

Methods: The average pixel number for a single Resovist-labeled islet was measured.

Moment analysis of focus-diverse point spread functions for modal wavefront sensing of uniformly illuminated circular-pupil systems.

A new concept of using focus-diverse point spread functions (PSFs) for modal wavefront sensing (WFS) is explored. This concept is based on relatively straightforward image moment analysis of measured PSFs, which differentiates it from other focal-plane WFS techniques. The presented geometric analysis shows that the image moments are nonlinear functions of wave aberration coefficients but notes that focus diversity essentially decouples the coefficients of interest from others, resulting in a set of linear equations whose solution corresponds to modal coefficient estimates.

Optimal collimation of misaligned optical systems by concentering primary field aberrations.

A collimation method of misaligned optical systems is proposed. The method is based on selectively nullifying main alignment-driven aberration components. This selective compensation is achieved by the optimal adjustment of chosen alignment parameters.

Use of Zernike polynomials for efficient estimation of orthonormal aberration coefficients over variable noncircular pupils.

An efficient way of estimating orthonormal aberration coefficients on variable noncircular pupils is proposed. The method is based on the fact that all necessary pieces of information for constructing orthonormal polynomials (via the Gram-Schmidt process) can be numerically obtained during a routine least-squares fit of Zernike polynomials to wavefront data. This allows the method to use the usual Zernike polynomial fitting with an additional procedure that swiftly estimates the desired orthonormal aberration coefficients without having to use the functional forms of orthonormal polynomials.

Computer-guided alignment III: description of inter-element alignment effect in circular-pupil optical systems.

We present an analytic description of the inter-element alignment effect of misaligned optical systems with circular pupils. The description shows that decenter and tilt produce lateral displacement of the field and pupil coordinates, whilst a despace directly modifies the aberration coefficients by perturbing paraxial distances and scale factors of the two coordinates. This reveals that a misaligned surface not only changes its aberration characteristics, but also affects those of subsequent surfaces, which is the essence of the inter-element alignment effect.

Computer-guided alignment II :Optical system alignment using differential wavefront sampling.

We present a differential wavefront sampling method for the efficient alignment of centred optical systems. Using the inter-element effects reported in our previous study, this method generates a linear symmetric matrix that relates the optical wavefront to misalignments within the system. The solution vector of this matrix equation provides a unique description of decentre and tilt misalignments of the system.

Computer-guided alignment I : Phase and amplitude modulation of alignment-influenced optical wavefront.

As the first part of a development programme on computer-guided alignment (CGA), we model the alignment influence on the optical wavefront in terms of the phase and amplitude modulation. This modulation is derived from the interaction between alignment parameters and influence functions, both expressed in complex form. The alignment influence model is used to approximate the ray-traced target wavefront of a randomly mis-aligned multi-element system.

Pregnancy is associated with suppression of the nuclear factor kappaB/IkappaB activation pathway in peripheral blood mononuclear cells.

Modulations of maternal immune cell function are critical for successful growth and development of an antigenically distinct fetus. It has been proposed that pregnancy is associated both with suppression of the adaptive immune system and a generalised maternal inflammatory response with changes in immune function resembling those associated with septicemia, and these changes are more exaggerated when pregnancies are complicated with pre-eclampsia. The nuclear factor (NF)-kappaB family of transcription factors play a significant role in immune regulation.