Comparison of active vs. expectant management of the third stage of labor in women with low risk of postpartum hemorrhage: a randomized controlled trial

Objectives: To compare the ‘strictly’ active management protocol in women with low risk of postpartum hemorrhage using the expectant management protocol with respect to changes in hematologic parameters, uterotonics, blood transfusions, or additional interventions. Material and methods: A randomized controlled prospective trial in which 934 singleton parturients enrolled; 654 were randomly assigned to the active and mixed management groups. The primary outcome parameter was the reduction in hemoglobin concentrations due to delivery, and the secondary outcome parameters were changes in hemoglobin of more than 3 g/dL (ΔHb ≥ 3 g/dL), durations of the third stage of labor, need for additional uterotonic agents, blood transfusions, manual removal of the placenta, and surgical evacuation of retained products of conception. Results: The mean postpartum hemoglobin concentration was significantly higher (P = 0.04) in the active management group with a significantly lower reduction (P = 0.03). Falls of hemoglobin levels of more than 3 g/dL (ΔHb ≥ 3g/dL) were less common in the active management group though not significantly (P = 0.32). The mean duration of the third stage of labor was significantly (P < 0.001) shorter in the active management group. There was no significant difference between the two groups with regard to the need for additional uterotonic agents, uterine atony, blood transfusion, manual removal of the placenta, surgical evacuation of retained products of conception, and prolonged third stage of labor. Conclusions: Although active management of the third stage of labor was associated with higher postpartum hemoglobin levels, it did not influence the risk of ‘severe postpartum hemorrhage’ in women with low risk of postpartum hemorrhage

Comparison of human B cell activation by TLR7 and TLR9 agonists

Research articl

RORγt + Treg to Th17 ratios correlate with susceptibility to Giardia infection

Funder: Fundacion Alfonso Martin EscuderoFunder: RCUK | Biotechnology and Biological Sciences Research Council (BBSRC); doi: https://doi.org/10.13039/501100000268Funder: Isaac Newton Trust; doi: https://doi.org/10.13039/501100004815Abstract: Infections with Giardia are among the most common causes of food and water-borne diarrheal disease worldwide. Here, we investigated Th17, Treg and IgA responses, and alterations in gut microbiota in two mouse lines with varying susceptibility to Giardia muris infection. Infected BALB/c mice shed significantly more cysts compared with C57BL/6 mice. Impaired control of infection in BALB/c mice was associated with lower Th17 activity and lower IgA levels compared with C57BL/6 mice. The limited metabolic activity, proliferation and cytokine production of Th17 cells in BALB/c mice was associated with higher proportions of intestinal Foxp3+RORγt+ regulatory T cells and BALB/c mice developed increased RORγt+ Treg:Th17 ratios in response to G. muris infection. Furthermore, G. muris colonization led to a significantly reduced evenness in the gut microbial communities of BALB/c mice. Our data indicate that differential susceptibility to Giardia infections may be related to RORγt+ Treg controlling Th17 activity and that changes in the microbiota composition upon Giardia infection partially depend on the host background

Comparative operando XPS and SEM spatiotemporal potential mapping of ionic liquid polarization in a coplanar electrochemical device

The polarization response of a coplanar electrochemical capacitor covered with an ionic liquid as the electrolyte has been examined using a combination of two powerful analytic techniques, X-ray photoelectron spectroscopy (XPS) and scanning electron microcopy (SEM). Spatiotemporal distribution of the ionic liquid surface potential, upon DC or AC (square wave) biasing, has been monitored via chemical element binding energy shifts using XPS and secondary electron intensity variations using SEM. SEM’s high spatial resolution and speedy imaging together with application of a data mining algorithm made mapping of the surface potential distribution across the capacitor possible. Interestingly, despite the differences in the detection principles, both techniques yield similar polarization relaxation time constants. The results demonstrate the power of a synergistic combination of the two techniques with complementary capabilities and pave the way to a deeper understanding of liquid/solid interfaces and for performance evaluation and diagnostics of electrochemical devices