Serum biomarkers and Doppler pulsatile index increases likelihood ratio for prediction of preeclampsia in the second trimester of pregnancy.

This study aims to compare the accuracy of risk prediction for preeclampsia (PE) of three calculators during the second trimester of gestation: American College of Obstetricians and Gynaecologists (ACOG), National Institute for Health and Care Excellence (NICE), and Foetal Medicine Foundation (FMF). Complete medical history, mean uterine artery Doppler pulsatile index were performed (PI) and venous blood samples for placental growth factor (PIGF), soluble fms-like tyrosine kinase-1 (sFLT-1), and Endoglin measurements were obtained from 214 women between 20-24 weeks gestation. PE frequency was 8.4% (18/214). Sensitivity and specificity were 94.4% and 37.2% and 44.4% and 74.5% for ACOG and NICE respectively. Sensitivity for FMF was 66.7% and 44.4% at <32 weeks and <36 weeks respectively and specificity was 97.2% and 98.1%. The highest positive likelihood ratio, 22, was obtained for FMF as compared to 1.49 and 1.76 for ACOG and NICE. These findings suggest that the addition of US and serum biomarkers in the FMF calculator increases accuracy for prediction of PE.Impact StatementWhat is already known on this subject? Several strategies have been implemented to evaluate risk for PE. The ACOG and NICE calculators, based on medical and anthropomorphic data, and the FMF calculator, which includes ultrasound and serum biomarkers, have been used for the prediction of PE risk in the first trimester of gestation.What do the results of this study add? Although the identification of markers for the prediction of PE during the first trimester of pregnancy has been of major clinical interest, in many countries women attend their first prenatal visit up until the second trimester of pregnancy. This is the first multicentre study in Latin American population to compare the three risk prediction systems including serum biomarkers during the second trimester of pregnancy.What are the implications of these findings for clinical practice and/or further research? We propose the FMF calculator (including PI and serum biomarkers) as a useful tool for PE risk detection during the second trimester of pregnancy. However, as this study is limited by its small sample size, larger multicenter studies are needed to confirm our findings and assert the usefulness of the FMF calculator.

Exploring the Different Degrees of Magnetic Disorder in TbxR1-xCu2 Nanoparticle Alloys.

Recently, potential technological interest has been revealed for the production of magnetocaloric alloys using Rare-Earth intermetallics. In this work, three series of TbxR1-xCu2 (R ≡ Gd, La, Y) alloys have been produced in bulk and nanoparticle sizes via arc melting and high energy ball milling. Rietveld refinements of the X-ray and Neutron diffraction patterns indicate that the crystalline structure in all alloys is consistent with TbCu2 orthorhombic Imma bulk crystalline structure. The analyses of the DC-magnetisation (MDC) and AC-susceptibility (χAC) show that three distinct degrees of disorder have been achieved by the combination of both the Tb3+ replacement (dilution) and the nanoscaling. These disordered states are characterised by transitions which are evident to MDC, χAC and specific heat. There exists an evolution from the most ordered Superantiferromagnetic arrangement of the Tb0.5La0.5Cu2 NPs with Néel temperature, TN∼ 27 K, and freezing temperature, Tf∼ 7 K, to the less ordered weakly interacting Superparamagnetism of the Tb0.1Y0.9Cu2 nanoparticles (TN absent, and TB∼ 3 K). The Super Spin Glass Tb0.5Gd0.5Cu2 nanoparticles (TN absent, and Tf∼ 20 K) are considered an intermediate disposition in between those two extremes, according to their enhanced random-bond contribution to frustration.

Magnetic Structure, Single-Crystal to Single-Crystal Transition, and Thermal Expansion Study of the (Edimim)[FeCl4] Halometalate Compound.

This contribution addresses standing questions about the nature and consequences of the ion self-assembly and magnetic structures, as well as the molecular motion of the crystalline structure as a function of the temperature, in halometalate materials based on imidazolium cation. We present the magnetic structure and magnetostructural correlations of 1-ethyl-2,3-dimethylimidazolium tetrachloridoferrate, (Edimim)[FeCl4], resolved by neutron diffraction studies. Single-crystal, synchrotron powder X-ray diffraction and powder neutron diffraction techniques have been combined to follow the temperature evolution on its crystallographic structure from 2 K close to its melting point (340 K). In this sense, slightly above room temperature (307 K) (Edimim)[FeCl4] presents a single-crystal to single-crystal transition (SCSC), from phase I (space group P21/n) to phase II (P21/m), accompanied by a notable increase in the disorder of the imidazolium cation, as well as in the metal complex anion. The temperature evolution and solid-phase transitions of the presented compound were followed in detail by synchrotron X-ray powder diffraction (SXPD), which confirms the occurrence of another phase transition at 330 K, phase III (P21/m), the crystal structure of which was elucidated from the SXPD pattern. Moreover, this material presents an anisotropic thermal expansion with a switch from axial positive to negative thermal expansion coefficients as the temperature is raised above the first phase transition, which has been correlated with the molecular motion of the imidazolium-based molecules, producing not only a shortening of the counterion···counterion distances but also the occurrence of different quasi-isoenergetic crystal structures as a function of the temperature.

3D Magnetically Ordered Open Supramolecular Architectures Based on Ferrimagnetic Cu/Adenine/Hydroxide Heptameric Wheels.

The present work provides two new examples of supramolecular metal-organic frameworks consisting of three-dimensional extended noncovalent assemblies of wheel-shaped heptanuclear [Cu7(µ-H2O)6(µ3-OH)6(µ-adeninato-κN3:κN9)6](2+) entities. The heptanuclear entity consists of a central [Cu(OH)6](4-) core connected to six additional copper(II) metal centers in a radial and planar arrangement through the hydroxides. It generates a wheel-shaped entity in which water molecules and µ-κN3:κN9 adeninato ligands bridge the peripheral copper atoms. The magnetic characterization indicates the central copper(II) center is anti-ferromagnetically coupled to external copper(II) centers, which are ferromagnetically coupled among them leading to an S = 5/2 ground state. The packing of these entities is sustained by π-π stacking interactions between the adenine nucleobases and by hydrogen bonds established among the hydroxide ligands, sulfate anions, and adenine nucleobases. The sum of both types of supramolecular interactions creates a rigid synthon that in combination with the rigidity of the heptameric entity generates an open supramolecular structure (40-50% of available space) in which additional sulfate and triethylammonium ions are located altogether with solvent molecules. These compounds represent an interesting example of materials combining both porosity and magnetic relevant features.

A magnetic ionic liquid based on tetrachloroferrate exhibits three-dimensional magnetic ordering: a combined experimental and theoretical study of the magnetic interaction mechanism.

A new magnetic ionic liquid (MIL) with 3D antiferromagnetic ordering has been synthetized and characterized. The information obtained from magnetic characterization was supplemented by analysis of DFT calculations and the magneto-structural correlations. The result gives no evidence for direct iron-iron interactions, corroborating that the 3D magnetic ordering in MILs takes place via super-exchange coupling containing two diamagnetic atoms intermediaries.

Pressure effects on Emim[FeCl4], a magnetic ionic liquid with three-dimensional magnetic ordering.

We report a combined study using magnetization and Raman spectroscopy on the magnetic ionic liquid 1-ethyl-3-methylimidazolium tetrachloroferrate, Emim[FeCl4]. This material shows a long-range antiferromagnetic ordering below the Néel temperature T(N) ≈ 3.8 K. The effects of pressure on the magnetic properties have been studied using a miniature piston-cylinder CuBe pressure cell. This three-dimensional ordering is strongly influenced when hydrostatic pressure is applied. It is observed that low applied pressure is enough to modify the magnetic interactions, inducing a transition from antiferromagnetic to ferrimagnetic ordering. Raman spectroscopy measurements reveal important information about the existence of isolated [FeCl4](-) anions and the absence of dimeric [Fe2Cl7](-) units in the liquid and solid states. These features seem to suggest that the superexchange pathways responsible for the appearance of magnetic ordering are mediated through Fe-Cl-Cl-Fe. Furthermore, the liquid-solid phase transition exhibits a magnetic hysteresis near room temperature, which can be tuned by weak pressures.

Synthesis and comparative study of Co(pym)(VO3)2 and [Co(H2O)2(VO3)2]·2H2O.

The three-dimensional Co(pym)(VO(3))(2), 1, hybrid compound, where pym is pyrimidine, has been synthesized under mild hydrothermal conditions at 120 °C. The compound has been characterized by FT-IR spectroscopy, elemental analysis, thermogravimetric measurements, thermodiffractometry, UV-Vis spectroscopy, temperature-dependent magnetic susceptibility and magnetization, and finally a study of specific heat has been performed. The crystal structure of 1 was solved using single-crystal X-ray diffraction data, taking into account that the crystals of this compound are twins of two components. It crystallizes in the monoclinic system, space group C2/c, a = 12.899(5) Å, b = 9.859(2) Å, c = 7.051(1) Å, ß = 111.41(3)°, Z = 4. The crystal structure is built up from edge sharing VO(5) trigonal bipyramid double chains and [CoO(4)pym](n) chains. This resembles the structure of the [Co(H(2)O)(2)(VO(3))(2)]·2H(2)O compound, 2. For this reason a comparative study of their properties was carried out. Magnetic measurements of 1, performed in the 2.0 to 300 K range, reveal the existence of a weak ferromagnetic order near 3 K. This fact was confirmed with magnetization measurements, which show irreversibility characteristic of soft ferromagnets. Magnetic measurements of 2 show a 3D antiferromagnetic ordering at 2.5 K. The magnetization shows a small change of curvature indicating the occurrence of a metamagnetic transition. Specific heat measurements of both compounds confirm the 3D nature of the magnetic order. The comparative study of the magneto-structural correlations reveals that the pyrimidine molecules are responsible for the different magnetic behaviour between 1 and 2.

A new partially deprotonated mixed-valence manganese(II,III) hydroxide-arsenate with electronic conductivity: magnetic properties of high- and room-temperature sarkinite.

A new three-dimensional hydroxide-arsenate compound called compound 2 has been synthesized by heating (in air) of the sarkinite phase, Mn(2)(OH)AsO(4) (compound 1), with temperature and time control. The crystal structure of this high-temperature compound has been solved by Patterson-function direct methods. A relevant feature of this new material is that it is actually the first member of the adamite-type family with mixed-valence manganese(II,III) and electronic conductivity. Crystal data: a = 6.7367(5) Å, b = 7.5220(6) Å, c = 9.8117(6) Å, α = 92.410(4)°, ß = 109.840(4)°, γ = 115.946(4)°, P1̅. The unit cell content derived from Rietveld refinement is Mn(8)(O(4)H(x))(AsO(4))(4). Its framework, projected along [111], is characterized by rings of eight Mn atoms with the OH(-)/O(2-) inside the rings. These rings form an almost perfect hexagonal arrangement with the AsO(4) groups placed in between. Bond-valence analysis indicates both partial deprotonation (x ≅ 3) and the presence of Mn in two different oxidation states (II and III), which is consistent with the electronic conductivity above 300 °C from electrochemical measurements. The electron paramagnetic resonance spectra of compound 1 and of its high-temperature form compound 2 show the presence of antiferromagnetic interactions with stronger magnetic coupling for the high-temperature phase. Magnetization measurements of room-temperature compound 1 show a complex magnetic behavior, with a three-dimensional antiferromagnetic ordering and magnetic anomalies at low temperatures, whereas for compound 2, an ordered state is not reached. Magnetostructural correlations indicate that superexchange interactions via oxygen are present in both compounds. The values of the magnetic exchange pathways [Mn-O-Mn] are characteristic of antiferromagnetic couplings. Notwithstanding, the existence of competition between different magnetic interactions through superexchange pathways can cause the complex magnetic behavior of compound 1. The loss of three-dimensional magnetic ordering by heating of compound 1 could well be based on the presence of Mn(3+) ions (d(4)) in compound 2.

Synthesis of superparamagnetic iron(III) oxide nanowires in double-walled carbon nanotubes.

The synthesis and characterization of superparamagnetic iron(iii) oxide nanowires confined within double-walled carbon nanotubes by capillary filling with a melted precursor (iron iodide) followed by thermal treatment is reported for the first time.

Utilización de la opinión de los pacientes para la mejora: 5 años de seguimiento (2001-2005) / Using patients’ opinions for quality improvement: a 5-year follow-up (2001-2005)

Objetivo: Evaluar, desde la perspectiva de los pacientes, la evolución de la calidad en los últimos 5 años con el fin de acercarnos a sus expectativas en el nuevo hospital. Método: El procedimiento utiliza como referencia los resultados de un estudio de opinión realizado en el hospital, en el año 2001, para contrastar con los resultados de las encuestas anuales y complementar con información procedente de reclamaciones escritas y demandas de responsabilidad patrimonial. Resultados: Se han recibido y procesado, en el período considerado, 821 encuestas (tasa de respuesta del 22,3%), 3.756 reclamaciones y 105 demandas de responsabilidad administrativa. Las encuestas han mostrado un grado de satisfacción del 96% y el estudio de evolución ha detectado diferencias significativas en confortabilidad y capacidad de respuesta. Los motivos de reclamación más frecuentes han sido: transporte sanitario (15,3%), demora en la asistencia (12,6%) y lista de espera (9,3%). Las demandas, estimadas positivamente sólo el 20%, destacan como motivo final principal la muerte o el resultado secundario grave (59%), y como causas primordiales, la omisión de acción (42,9%) y la práctica no adecuada (22,9%). Discusión: Se ha detectado un ligero empeoramiento de la opinión del paciente en los últimos 5 años, que se relaciona con un incremento de las expectativas del paciente. Los motivos de reclamaciones y demandas son independientes de los problemas destacados en el aspecto de opinión y evidencian dimensiones distintas pero coinciden en ciertos aspectos. Queda pendiente una nota de atención en el área de urgencias y, por supuesto, los problemas relacionados con el confort, cuya mejoría es fácil y evidente con la inauguración del nuevo hospital

Objective: To evaluate changes in quality over a 5-year period from the perspective of patients, in an attempt to meet their expectations in a new hospital. Method: The procedure takes as a reference the results of an opinion survey carried out in the hospital in 2001 and compares these results with those of annual surveys and completes them with information from written complaints and demands for accountability. Results: During the period studied, 821 surveys (a response rate of 22.3%), 3,756 complaints and 105 demands for administrative accountability were received and processed. The surveys revealed a degree of satisfaction of 96%, and study of the changes detected significant differences in comfort and response capacity. The most common reasons for complaints were medical transport (15.3%), delays in receiving care (12.6%), and waiting lists (9.3%). The main reasons for demands for accountability (only 20% of which were accepted) were death or serious secondary outcomes (59%), and the principal causes were related to omissions (42.9%) or malpractice (22.9%). Discussion: Patients' opinions tended to worsen slightly over the 5-year period studied, related to their increased expectations. Although the reasons for making complaints and demands were independent of the problems identified in patients' opinions and showed different dimensions, there were certain areas of overlap. Greater efforts are required in the area of emergency services and, of course, in problems related to comfort, improvement of which is easily achievable and evident with the inauguration of the new hospital

[Not Available]. / Utilización de la opinión de los pacientes para la mejora: 5 años de seguimiento (2001-2005).

OBJECTIVE: To evaluate changes in quality over a 5-year period from the perspective of patients, in an attempt to meet their expectations in a new hospital. METHOD: The procedure takes as a reference the results of an opinion survey carried out in the hospital in 2001 and compares these results with those of annual surveys and completes them with information from written complaints and demands for accountability. RESULTS: During the period studied, 821 surveys (a response rate of 22.3%), 3,756 complaints and 105 demands for administrative accountability were received and processed. The surveys revealed a degree of satisfaction of 96%, and study of the changes detected significant differences in comfort and response capacity. The most common reasons for complaints were medical transport (15.3%), delays in receiving care (12.6%), and waiting lists (9.3%). The main reasons for demands for accountability (only 20% of which were accepted) were death or serious secondary outcomes (59%), and the principal causes were related to omissions (42.9%) or malpractice (22.9%). DISCUSSION: Patients' opinions tended to worsen slightly over the 5-year period studied, related to their increased expectations. Although the reasons for making complaints and demands were independent of the problems identified in patients' opinions and showed different dimensions, there were certain areas of overlap. Greater efforts are required in the area of emergency services and, of course, in problems related to comfort, improvement of which is easily achievable and evident with the inauguration of the new hospital.

[Active management of labor with cesarean index 6.4% and very good materno-fetal outcome]. / Manejo activo del trabajo de parto con índice de cesárea de 6.4% y muy buenos resultados maternos-fetales.

OBJECTIVE: The objective of this study is to reduce the incidence of cesarean section and to evaluate the impact on fetal-maternal morbidity and mortality by strictly following the guidelines of the National Health Office (Secretaria de Salud) at the Hospital of Gynecology and Obstetrics of Garza Garcia in Nuevo Leon, Mexico. METHOD: A prospective and observational study was made. All the patients who culminated their pregnancy on Saturdays and Sundays between 7:00 and 19:00 hrs, in the period June 2000 to June 2001, were included in this study. The incidence of Cesarean sections and its impact on maternal-fetal morbidity and mortality were observed. RESULTS: A total of 798 patients were included in the study. The total number of newborns was 801. The age average was of 23.4 years (14 years-40 years). Of the 798 patients, 280 (35.1%) presented dystocia at vaginal delivery, 467 patients (58.5%) had an eutocic vaginal delivery and 51 patients (6.4%) went through a Caesarean section. The Apgar scores were: 8 at the first minute and 9 at the fifth minute for 681 neonates (85.01%); and 7/9 for 53 (6.6%). CONCLUSIONS: According to the results obtained in the present study we can conclude that the incidence of Cesarean section can be reduced by strictly following the guidelines of the National Health Office without affecting the maternal-fetal morbidity and mortality.