Substantial Current Interest Research Articles

Roles of the Debye Length and Skin Depth in the Characterization of Space Charge Interactions in Semiconductor Nanoparticles

Non-degenerate semiconductor nanoparticles with bulk plasma frequency in the terahertz frequency range are of substantial current interest for device and sensing applications in that part of the electromagnetic spectrum. The penetration of electromagnetic field in a material containing mobile charges is governed by two length scales, namely the Debye length and the skin depth. Their relative influence on the response of a semiconductor nanoparticle to an external terahertz electric field is examined in this Letter. A transport-based formulation to describe charge-field interactions by coupling the Boltzmann equation with the field equations is employed to characterize space-charge effects. Numerical results computed with the charge transport formulation reveal that plasmonic interactions in a semiconductor nanoparticle remains a surface phenomenon up to the surface plasmon resonance frequency, beyond which it evolves into a bulk phenomenon as the inertia effect of the charge carriers subdues their response to the field, which penetrates deeper into the particle as the frequency is increased. Examination of the spectra of charge, field, and current distributions allows for the identification of the influence of particle size, Debye length and skin depth on space charge interactions in a semiconductor nanoparticle.

The effects of multipactor on the quality of a complex signal propagating in a transmission line

Multipactor is a much studied resonant AC discharge that is harmful to microwave components and circuits. There is substantial current interest in this topic because of its threat to satellite communications. In this paper, an analytical transmission line model is presented to assess the effects of multipactor, should it happen, on the distortion of a signal. The model is applicable to any input signal (analog or digital) once the electron multipactor current it causes is specified. Examples using planar and coaxial transmission lines are given on a simple dynamical model of the multipactor current. Single and multitone signals are treated, with some results presented in the In-phase and Quadrature plots.

A Postdecisional Neural Marker of Confidence Predicts Information-Seeking in Decision-Making.

Theoretical work predicts that decisions made with low confidence should lead to increased information-seeking. This is an adaptive strategy because it can increase the quality of a decision, and previous behavioral work has shown that decision-makers engage in such confidence-driven information-seeking. The present study aimed to characterize the neural markers that mediate the relationship between confidence and information-seeking. A paradigm was used in which 17 human participants (9 male) made an initial perceptual decision, and then decided whether or not they wanted to sample more evidence before committing to a final decision and confidence judgment. Predecisional and postdecisional event-related potential components were similarly modulated by the level of confidence and by information-seeking choices. Time-resolved multivariate decoding of scalp EEG signals first revealed that both information-seeking choices and decision confidence could be decoded from the time of the initial decision to the time of the subsequent information-seeking choice (within-condition decoding). No above-chance decoding was visible in the preresponse time window. Crucially, a classifier trained to decode high versus low confidence predicted information-seeking choices after the initial perceptual decision (across-condition decoding). This time window corresponds to that of a postdecisional neural marker of confidence. Collectively, our findings demonstrate, for the first time, that neural indices of confidence are functionally involved in information-seeking decisions.SIGNIFICANCE STATEMENT Despite substantial current interest in neural signatures of our sense of confidence, it remains largely unknown how confidence is used to regulate behavior. Here, we devised a task in which human participants could decide whether or not to sample additional decision-relevant information at a small monetary cost. Using neural recordings, we could predict such information-seeking choices based on a neural signature of decision confidence. Our study illuminates a neural link between decision confidence and adaptive behavioral control.

Does Village Chicken-Keeping Contribute to Young Children's Diets and Growth? A Longitudinal Observational Study in Rural Tanzania.

There is substantial current interest in linkages between livestock-keeping and human nutrition in resource-poor settings. These may include benefits of improved diet quality, through animal-source food consumption and nutritious food purchases using livestock-derived income, and hazards of infectious disease or environmental enteric dysfunction associated with exposure to livestock feces. Particular concerns center on free-roaming chickens, given their proximity to children in rural settings, but findings to date have been inconclusive. This longitudinal study of 503 households with a child under 24 months at enrolment was conducted in villages of Manyoni District, Tanzania between May 2014, and May 2016. Questionnaires encompassed demographic characteristics, assets, livestock ownership, chicken housing practices, maternal education, water and sanitation, and dietary diversity. Twice-monthly household visits provided information on chicken numbers, breastfeeding and child diarrhea, and anthropometry was collected six-monthly. Multivariable mixed model analyses evaluated associations between demographic, socioeconomic and livestock-associated variables and (a) maternal and child diets, (b) children’s height-for-age and (c) children’s diarrhea frequency. Alongside modest contributions of chicken-keeping to some improved dietary outcomes, this study importantly (and of substantial practical significance if confirmed) found no indication of a heightened risk of stunting or greater frequency of diarrhea being associated with chicken-keeping or the practice of keeping chickens within human dwellings overnight.

Putting the "dynamic" back into dynamic functional connectivity.

The study of fluctuations in time-resolved functional connectivity is a topic of substantial current interest. As the term “dynamic functional connectivity” implies, such fluctuations are believed to arise from dynamics in the neuronal systems generating these signals. While considerable activity currently attends to methodological and statistical issues regarding dynamic functional connectivity, less attention has been paid toward its candidate causes. Here, we review candidate scenarios for dynamic (functional) connectivity that arise in dynamical systems with two or more subsystems; generalized synchronization, itinerancy (a form of metastability), and multistability. Each of these scenarios arises under different configurations of local dynamics and intersystem coupling: We show how they generate time series data with nonlinear and/or nonstationary multivariate statistics. The key issue is that time series generated by coupled nonlinear systems contain a richer temporal structure than matched multivariate (linear) stochastic processes. In turn, this temporal structure yields many of the phenomena proposed as important to large-scale communication and computation in the brain, such as phase-amplitude coupling, complexity, and flexibility. The code for simulating these dynamics is available in a freeware software platform, the Brain Dynamics Toolbox.

TU-FG-BRC-01: Cancer and the Immune System: The Basics!

There is substantial current interest in the potential of radiation therapy for synergizing with novel immunotherapies to transform irradiated tumor into an immunogenic hub with capacity to ignite a powerful and adaptive longterm anti-cancer response. Interest stems from new insights into fundamental mechanisms underlying interactions between cancer, radiation and the immune system. Radically new immunotherapy approaches have been proposed, which target the immune system, rather than the cancer itself. Promising preliminary results on subsets of patients have led to a surge in research and clinical trials investigating the potential for combining new immunomodulatory agents with radiation therapy. In this symposia, we undertake a basic review of key topics and questions relating to the potential for combining radiation therapy and new immunotherapy approaches, including a focus on opportunities for medical physicists. Learning Objectives: 1.Gain insight into approaches to combining immunotherapy and radiation therapy. 2.Review latest clinical trial data investigating radiation and immunotherapy. 3.Consider how radiation therapy can better stimulate immunogenicity. 4.Explore opportunities for medical physicists in radiation and immunotherapy M Oldham has funding support from Immunolioght Llc

TU-FG-BRC-04: Opportunities for Medical Physics Contributions to Radiation Immunotherapy

There is substantial current interest in the potential of radiation therapy for synergizing with novel immunotherapies to transform irradiated tumor into an immunogenic hub with capacity to ignite a powerful and adaptive longterm anti-cancer response. Interest stems from new insights into fundamental mechanisms underlying interactions between cancer, radiation and the immune system. Radically new immunotherapy approaches have been proposed, which target the immune system, rather than the cancer itself. Promising preliminary results on subsets of patients have led to a surge in research and clinical trials investigating the potential for combining new immunomodulatory agents with radiation therapy. In this symposia, we undertake a basic review of key topics and questions relating to the potential for combining radiation therapy and new immunotherapy approaches, including a focus on opportunities for medical physicists. Learning Objectives: 1. Gain insight into approaches to combining immunotherapy and radiation therapy. 2. Review latest clinical trial data investigating radiation and immunotherapy. 3. Consider how radiation therapy can better stimulate immunogenicity. 4. Explore opportunities for medical physicists in radiation and immunotherapy M Oldham has funding support from Immunolioght Llc

TU-FG-BRC-02: Radiation Therapy to Ignite An Anti-Cancer Immune Response

There is substantial current interest in the potential of radiation therapy for synergizing with novel immunotherapies to transform irradiated tumor into an immunogenic hub with capacity to ignite a powerful and adaptive longterm anti-cancer response. Interest stems from new insights into fundamental mechanisms underlying interactions between cancer, radiation and the immune system. Radically new immunotherapy approaches have been proposed, which target the immune system, rather than the cancer itself. Promising preliminary results on subsets of patients have led to a surge in research and clinical trials investigating the potential for combining new immunomodulatory agents with radiation therapy. In this symposia, we undertake a basic review of key topics and questions relating to the potential for combining radiation therapy and new immunotherapy approaches, including a focus on opportunities for medical physicists. Learning Objectives: 1. Gain insight into approaches to combining immunotherapy and radiation therapy. 2. Review latest clinical trial data investigating radiation and immunotherapy. 3. Consider how radiation therapy can better stimulate immunogenicity. 4. Explore opportunities for medical physicists in radiation and immunotherapy M Oldham has funding support from Immunolioght Llc

TU-FG-BRC-00: Radiation and Immunotherapy: How to Ignite Long Term Anti-Cancer Response

There is substantial current interest in the potential of radiation therapy for synergizing with novel immunotherapies to transform irradiated tumor into an immunogenic hub with capacity to ignite a powerful and adaptive longterm anti-cancer response. Interest stems from new insights into fundamental mechanisms underlying interactions between cancer, radiation and the immune system. Radically new immunotherapy approaches have been proposed, which target the immune system, rather than the cancer itself. Promising preliminary results on subsets of patients have led to a surge in research and clinical trials investigating the potential for combining new immunomodulatory agents with radiation therapy. In this symposia, we undertake a basic review of key topics and questions relating to the potential for combining radiation therapy and new immunotherapy approaches, including a focus on opportunities for medical physicists. Learning Objectives: 1. Gain insight into approaches to combining immunotherapy and radiation therapy. 2. Review latest clinical trial data investigating radiation and immunotherapy. 3. Consider how radiation therapy can better stimulate immunogenicity. 4. Explore opportunities for medical physicists in radiation and immunotherapy M Oldham has funding support from Immunolioght Llc

TU-FG-BRC-03: Current Clinical Trials Using Radiation and Immunomodulatory Agents

There is substantial current interest in the potential of radiation therapy for synergizing with novel immunotherapies to transform irradiated tumor into an immunogenic hub with capacity to ignite a powerful and adaptive longterm anti-cancer response. Interest stems from new insights into fundamental mechanisms underlying interactions between cancer, radiation and the immune system. Radically new immunotherapy approaches have been proposed, which target the immune system, rather than the cancer itself. Promising preliminary results on subsets of patients have led to a surge in research and clinical trials investigating the potential for combining new immunomodulatory agents with radiation therapy. In this symposia, we undertake a basic review of key topics and questions relating to the potential for combining radiation therapy and new immunotherapy approaches, including a focus on opportunities for medical physicists. Learning Objectives: 1. Gain insight into approaches to combining immunotherapy and radiation therapy. 2. Review latest clinical trial data investigating radiation and immunotherapy. 3. Consider how radiation therapy can better stimulate immunogenicity. 4. Explore opportunities for medical physicists in radiation and immunotherapy M Oldham has funding support from Immunolioght Llc

In vivo imaging of tau pathology using multi-parametric quantitative MRI

As the number of people diagnosed with Alzheimer's disease (AD) reaches epidemic proportions, there is an urgent need to develop effective treatment strategies to tackle the social and economic costs of this fatal condition. Dozens of candidate therapeutics are currently being tested in clinical trials, and compounds targeting the aberrant accumulation of tau proteins into neurofibrillary tangles (NFTs) are the focus of substantial current interest. Reliable, translatable biomarkers sensitive to both tau pathology and its modulation by treatment along with animal models that faithfully reflect aspects of the human disease are urgently required. Magnetic resonance imaging (MRI) is well established as a valuable tool for monitoring the structural brain changes that accompany AD progression. However the descent into dementia is not defined by macroscopic brain matter loss alone: non-invasive imaging measurements sensitive to protein accumulation, white matter integrity and cerebral haemodynamics probe distinct aspects of AD pathophysiology and may serve as superior biomarkers for assessing drug efficacy. Here we employ a multi-parametric array of five translatable MRI techniques to characterise the in vivo pathophysiological phenotype of the rTg4510 mouse model of tauopathy (structural imaging, diffusion tensor imaging (DTI), arterial spin labelling (ASL), chemical exchange saturation transfer (CEST) and glucose CEST). Tau-induced pathological changes included grey matter atrophy, increased radial diffusivity in the white matter, decreased amide proton transfer and hyperperfusion. We demonstrate that the above markers unambiguously discriminate between the transgenic group and age-matched controls and provide a comprehensive profile of the multifaceted neuropathological processes underlying the rTg4510 model. Furthermore, we show that ASL and DTI techniques offer heightened sensitivity to processes believed to precede detectable structural changes and, as such, provides a platform for the study of disease mechanisms and therapeutic intervention.

An immersed boundary method for two-fluid mixtures

We present an immersed boundary method for interactions between elastic boundaries and mixtures of two fluids. Each fluid has its own velocity field and volume-fraction. A penalty method is used to enforce the condition that both fluidsʼ velocities agree with that of the elastic boundaries. The method is applied to several problems: Taylorʼs swimming sheet problem for a mixture of two viscous fluids, peristaltic pumping of a mixture of two viscous fluids, with and without immersed particles, and peristaltic pumping of a mixture of a viscous fluid and a viscoelastic fluid. The swimming sheet and peristalsis problems have received much attention recently in the context of a single viscoelastic fluid. Numerical results demonstrate that the method converges and show its capability to handle a number of flow problems of substantial current interest. They illustrate that for each of these problems, the relative motion between the two fluids changes the observed behaviors profoundly compared to the single fluid case.

Multifaceted half-sandwich arene–ruthenium complexes: interactions with biomolecules, photoactivation, and multinuclearity approach

Biological properties of the arene–ruthenium complexes have attracted substantial current interest. Their activity is appreciably defined and controlled by the arene moieties, organic ligands and the metal center. In this review, we discuss the interaction of arene–ruthenium complexes with significant biomolecular targets (DNA and enzymes). Principally, active complexes may interact with the biomolecular targets DNA or nucleobases either by direct coordination facilitated by aquation of the complex or by intercalation/stacking of the pendant planar part of the complex, usually from the planar ancillary ligands or arenes with extended rings, between the DNA base pairs. On the other hand, kinetically inert metal complexes can also provide a potential tool (as enzyme inhibitors) for the targeting of important biomolecules (other than DNA), such as protein kinases. At the same time, coordination with a metal facilitates the outreach of the organic molecules in the intracellular region. This review also highlights the photodriven activation of arene–ruthenium complexes, important metal–drug interactions and the potential of multinuclear scaffolds as important drug candidates (e.g., metallodendrimers) and drug carriers (e.g. metallacages) for targeted delivery and activity.

Sub-Anesthetic Ketamine Modulates Intrinsic BOLD Connectivity Within the Hippocampal-Prefrontal Circuit in the Rat

Dysfunctional connectivity within the hippocampal-prefrontal circuit (HC-PFC) is associated with schizophrenia, major depression, and neurodegenerative disorders, and both the hippocampus and prefrontal cortex have dense populations of N-methyl-D-aspartate (NMDA) receptors. Ketamine, a potent NMDA receptor antagonist, is of substantial current interest as a mechanistic model of glutamatergic dysfunction in animal and human studies, a psychotomimetic agent and a rapidly acting antidepressant. In this study, we sought to understand the modulatory effect of acute ketamine administration on functional connectivity in the HC-PFC system of the rat brain using resting-state fMRI. Sprague-Dawley rats in four parallel groups (N=9 per group) received either saline or one of three behaviorally relevant, sub-anesthetic doses of S-ketamine (5, 10, and 25 mg/kg, s.c.), and connectivity changes 15- and 30-min post-injection were studied. The strongest effects were dose- and exposure-dependent increases in functional connectivity within the prefrontal cortex and in anterior-posterior connections between the posterior hippocampus and retrosplenial cortex, and prefrontal regions. The increased prefrontal connectivity is consistent with ketamine-induced increases in HC-PFC electroencephalographic gamma band power, possibly reflecting a psychotomimetic aspect of ketamine's effect, and is contrary to the data from chronic schizophrenic patients suggesting that ketamine effect does not necessarily parallel the disease pattern but might rather reflect a hyperglutamatergic state. These findings may help to clarify the brain systems underlying different dose-dependent behavioral profiles of ketamine in the rat.

Making Sense of Mental Illness as a Full Human Experience: Perspective of Illness and Recovery Held by People With a Mental Illness Living in the Community

There is substantial current interest in building evidence about recovery from mental illness in order to inform comprehensive practice in health and social paradigms. This article presents accounts related to recovery and illness expressed by eight people through a Participatory Action Research project. The research facilitated entry to their subjective experiences of living in the community as an artist with a mental illness. Specific concern was raised of recovery as a clinical term with its requirement to meet distinct conventions of recovery formulated by health workers. This article emphasizes that individualized values of mental illness and recovery are interconnected to dynamic and complex perceptions drawn from experiencing life and experiencing things in their life.

Environmental chemicals and human neurotoxicity: magnitude, prognosis and markers

The neurotoxic effects of exposure to chemicals in the environment, though insufficiently recognized, remains a topic of substantial current concern and interest. Neurotoxicities may be protean; expressed as neuropathologic or as altered neurocthemical, electrophysiological or behavioural functions. The adverse effects of neurotoxicity are among the most feared ill health in humans because they adversely affect the quality of life, and have broad health, social and economic implications. Though the magnitude of neurotoxicity is not exactly known, in some advanced countries over 30 million individuals suffer from neurobehavioural illness with only 20% seeking medical attention. In the United States for instance, of the 63 million youths under 18 years of age about 10% have diagnosable neurobehavioural problems with only 20% receiving therapy. Data developed by the massive Global Burden of Disease (GBD) revealed that neurobehavioural impairment ranks only second to cancer and coronary heart disease combined. These data may indeed be more gruesome owing to the poor regulation of exposure to environmental chemicals in resource poor countries. Biomarkers play a major role in detecting, predicting and screening for neurotoxicity. Development of inexpensive and specific biomarkers of neurotoxicity is a challenge to the scientific community. Undoubtedly, the magnitude and potential severity of neurotoxicity problems make it imperative to invest in resources required to strengthen the basis for preventive intervention, the forerunner of which is the development of biomarkers for neurotoxicity at the individual and population levels. Health education on chemicals and potential for neurotoxicity is also desirable. (Afr. J. Biomed. Res. 11: 1 -12)Key Words; Environmental Chemicals, Neurotoxicity, Markers, Micronutrients, Pollution.

Small-Molecule Fluorescent Sensors for Investigating Zinc Metalloneurochemistry

The metalloneurochemistry of Zn(II) is of substantial current interest. Zinc is the second most abundant d-block metal ion in the human brain, and its distribution varies with relatively high concentrations found in the hippocampus. Brain zinc is generally divided into two types, protein-bound and loosely bound, the latter also being termed histochemically observable, chelatable, labile, or mobile zinc. The neurophysiological and neuropathological significance of mobile Zn(II) remains enigmatic. Studies of Zn(II) distribution, translocation, and function in vivo require tools for its detection. Because Zn(II) has a closed-shell d(10) configuration and no convenient spectroscopic signature, fluorescence is a well-suited method for monitoring Zn(II) in biological contexts. This Account summarizes work by our laboratory addressing the design, preparation, characterization, and use of small-molecule fluorescent sensors for imaging Zn(II) in living cells and samples of brain tissue. These sensors provide "turn-on" or ratiometric Zn(II) detection in aqueous solution at neutral pH. By making alterations to the Zn(II)-binding unit and fluorophore platform, we have devised sensors with varied photophysical and metal-binding properties. Several of these probes have been applied to image Zn(II) distribution, uptake, and mobilization in a variety of cell types, including neuronal cultures.

COX-2 expression and function in the hyperalgesic response to paw inflammation in mice

Peripheral inflammation and edema are often accompanied by primary and secondary hyperalgesia which are mediated by both peripheral and central mechanisms. The role of cyclooxygenase-2 (COX-2)-mediated prostanoid production in hyperalgesia is a topic of substantial current interest. We have established a murine foot-pad inflammation model in which both pharmacologic and genetic tools can be used to characterize the role of COX-2 in hyperalgesia. Zymosan, an extract from yeast, injected into the plantar surface of the hindpaw induces an edema response and an increase in COX-2 expression in the hindpaw, spinal cord and brain. Zymosan-induced primary hyperalgesia, measured as a decrease in hindpaw withdrawal latency in response to a thermal stimulus, is long-lasting and is not inhibited by pre-treatment with the systemic COX-2 selective inhibitor, parecoxib (20 mg/kg). In contrast, the central component of hyperalgesia, measured as a reduction in tail flick latency in response to heat, is reduced by parecoxib. Zymosan-induced primary hyperalgesia in Cox-2 −/− mice is similar to that of their Cox-2 +/+ littermate controls. However, the central component of hyperalgesia is substantially reduced in Cox-2 −/− versus Cox-2 +/+ mice, and returns to baseline values much more rapidly. Thus pharmacological data suggest, and genetic experiments confirm, (i) that primary hyperalgesia in response to zymosan inflammation in the mouse paw is not mediated by COX-2 function and (ii) that COX-2 function plays a major role in the central component of hyperalgesia in this model of inflammation.

Distinguishing familiarity-based from source-based memory performance in patients with schizophrenia

Background There is substantial current interest in the cognitive deficits associated with schizophrenia, particularly those in the realm of memory. Yet the exact nature of these deficits remains a matter of some debate. This study sought to examine performance on two distinct aspects of memory performance: familiarity-based and source-based memory processes. Methods Eighteen medicated outpatients with schizophrenia and eighteen healthy adult control subjects performed an external source memory task. Key measures included the ability to distinguish old (previously experienced) items from new items, the ability to correctly identify the source (male voice or female voice) of previously experienced items, and the reaction time associated with these responses. Results Patients with schizophrenia showed an impaired ability to distinguish old from new items, but intact performance in correctly identifying the source of items recognized as old. Whereas control subjects showed a rapid response to items deemed unfamiliar, particularly in rejecting novel items, these responses were slowed in patients with schizophrenia. This was not attributable to a generalized diminution in processing speed, as reaction times to correctly recognized old items (regardless of source accuracy) did not differ between the two groups. Conclusions Patients with schizophrenia demonstrated impaired familiarity-based and intact source-based memory performance. In addition, the reaction time for novelty detection, an important component of familiarity-based memory, was significantly delayed in patients compared to controls, while the response times for source-based decisions were completely overlapping. Considered together, these findings suggest a deficit in the familiarity-based aspect of episodic memory in at least some patients with schizophrenia.

Book Review

Sturdee D, Oláh K, Purdie D, Declan K, editors. The Yearbook of Obstetrics and Gynecology, Volume 10. 420 pages, London: RCOG Press, 2002. ISBN 1-900364-72-7. Retail price: GBP 48.00. The tenth volume of The Yearbook of Obstetrics and Gynecology is a stimulating collection of 33 updated reviews ranging from historic to the present. Each chapter is followed by an extensive reference list. The invited authors are mainly from the UK, but there are also contributions from the USA, Australia, Spain and Uganda. The volume starts with a description of the reproductive performance of English queens from 1673 to 1783. Few women can have had such a dramatic and unsuccessful childbearing history as Queen Anne, who had 17 pregnancies and no living child. Surgical topics cover the increasing demand for cesarean section, urogynecologic updates, hysterectomy, surgery for intersex and postoperative adhesions. Women with tocophobia, a profound dread and avoidance of childbirth, may present to obstetricians demanding a cesarean section. We are advised to continue to listen and assess a balance between surgical and psychiatric morbidity. The chapters entitled “Short cuts” and “Tension-free vaginal tape: the minimalist approach to continence surgery” demonstrate the increasing range of surgical options that allows tailoring of surgery to suit individual women to relieve or diminish the symptoms of stress incontinence. There is also a chapter demonstrating the advantages of vaginal compared to abdominal hysterectomy, in having less morbidity, reducing the hospital stay and being less expensive. A topic of substantial current interest is alternative medicine for hormone replacement therapy. Many women continue to use these remedies despite the limited evidence to support their efficacy or indeed their safety. Practitioners with appropriate qualifications and experience are few and far between. The yearbook gives us a useful introduction to this field. Other endocrinological topics include nonreproductive actions of the estrogens, problems with hormone implants, modern management of hirsutism and the risk of endometrial cancer in women taking hormone replacement therapy. There are also updates on endometrial ablation for menorrhagia and infections that are relevant such as human papilloma virus in cervical cancer and vulvovaginal candidiasis. Pregnancy is a critical period for women with systemic lupus erythematosus and antiphospholipid syndrome. This book includes a chapter on the obstetric and medical surveillance of pregnant women with such diseases, today fortunately with frequent successful outcomes if well managed. Another fairly unfamiliar topic covered is the outcome of pregnancy in women with cystic fibrosis. I recommend this book as interesting and useful reading for practitioners and researchers in the field of gynecology and obstetrics.