Reporting a measurement procedure and its analytical performance following method evaluation in a peer-reviewed journal is an important means for clinical laboratory practitioners to share their findings. It also represents an important source of evidence base to help others make informed decisions about their practice. At present, there are significant variations in the information reported in laboratory medicine journal publications describing the analytical performance of measurement procedures. These variations also challenge authors, readers, reviewers, and editors in deciding the quality of a submitted manuscript. The International Federation of Clinical Chemistry and Laboratory Medicine Working Group on Method Evaluation Protocols (IFCC WG-MEP) developed a checklist and recommends its adoption to enable a consistent approach to reporting method evaluation and analytical performance characteristics of measurement procedures in laboratory medicine journals. It is envisioned that the Laboratory Evaluation and Analytical Performance Characteristics (LEAP) checklist will improve the standardisation of journal publications describing method evaluation and analytical performance characteristics, improving the quality of the evidence base that is relied upon by practitioners.

Cardiotocography measures the human fetal heart rate and uterine activity using ultrasound. While it has been a mainstay in antepartum care since the 1960s, cardiotocograms consist of complex signals that have proven difficult for clinicians to interpret accurately and as such clinical inference is often difficult and unreliable. Previous attempts at codifying approaches to analyzing the features within these signals have failed to demonstrate reliability or gain sufficient traction. Since the early 1990s, the Dawes-Redman system of automated computer analysis of cardiotocography signals has enabled robust analysis of cardiotocographic signal features, employing empirically-derived criteria for assessing fetal wellbeing in the antepartum. Over the past 30 years, the Dawes-Redman system has been iteratively updated, now incorporating analyses from over 100,000 pregnancies. In this review, we examine the history of cardiotocography, signal processing methodologies and feature identification, the development of the Dawes-Redman system, and its clinical applications.

Cardiotocography measures the human fetal heart rate and uterine activity using ultrasound. While it has been a mainstay in antepartum care since the 1960s, cardiotocograms consist of complex signals that have proven difficult for clinicians to interpret accurately and as such clinical inference is often difficult and unreliable. Previous attempts at codifying approaches to analyzing the features within these signals have failed to demonstrate reliability or gain sufficient traction. Since the early 1990s, the Dawes-Redman system of automated computer analysis of cardiotocography signals has enabled robust analysis of cardiotocographic signal features, employing empirically-derived criteria for assessing fetal wellbeing in the antepartum. Over the past 30 years, the Dawes-Redman system has been iteratively updated, now incorporating analyses from over 100,000 pregnancies. In this review, we examine the history of cardiotocography, signal processing methodologies and feature identification, the development of the Dawes-Redman system, and its clinical applications.

The syncytiotrophoblast, a fused single-cell layer between mother and fetus, constitutively releases extracellular vesicles (STBEV) directly into the maternal circulation. STBEV contain a variety of proteins and RNA which can be targeted to specific cells. In preeclampsia, asymptomatic placental oxidative stress is a precursor to later multi-organ dysfunction in the mother. Increased STBEV release in preeclampsia is considered a manifestation of syncytiotrophoblast stress, which may play a key role in signaling between fetus and mother. STBEV release in preeclampsia changes, both in terms of volume and content. In this review, we outline the latest advances in STBEV isolation and detection. We consider evidence for differential STBEV release, protein cargo and RNA content in preeclampsia, highlighting common pitfalls in study design. We summarise studies to date demonstrating STBEV actions on target cells. Ultimately, we consider how STBEV fit into the pathophysiology of the heterogeneous syndrome of preeclampsia. The key unifying concept in early- and late-onset preeclampsia is syncytiotrophoblast stress. We submit that STBEV are the key stress signal in preeclampsia. We believe that further investigation of STBEV release, content, and actions may offer valuable insights into preeclampsia pathophysiology and potential new clinical diagnostics and therapeutic targets.

The syncytiotrophoblast, a fused single-cell layer between mother and fetus, constitutively releases extracellular vesicles (STBEV) directly into the maternal circulation. STBEV contain a variety of proteins and RNA which can be targeted to specific cells. In preeclampsia, asymptomatic placental oxidative stress is a precursor to later multi-organ dysfunction in the mother. Increased STBEV release in preeclampsia is considered a manifestation of syncytiotrophoblast stress, which may play a key role in signaling between fetus and mother. STBEV release in preeclampsia changes, both in terms of volume and content. In this review, we outline the latest advances in STBEV isolation and detection. We consider evidence for differential STBEV release, protein cargo and RNA content in preeclampsia, highlighting common pitfalls in study design. We summarise studies to date demonstrating STBEV actions on target cells. Ultimately, we consider how STBEV fit into the pathophysiology of the heterogeneous syndrome of preeclampsia. The key unifying concept in early- and late-onset preeclampsia is syncytiotrophoblast stress. We submit that STBEV are the key stress signal in preeclampsia. We believe that further investigation of STBEV release, content, and actions may offer valuable insights into preeclampsia pathophysiology and potential new clinical diagnostics and therapeutic targets.

Twenty years after the first surveys of liver disease were done cirrhosis and hepatocellular carcinoma were still found to be the most important liver diseases in Papua New Guinea. Hepatitis B virus appears to be the main cause of both these conditions. Data from a number of different sources suggest a prevalence of hepatitis B positivity of about 17%. The most significant new finding was grade 3 iron deposition in 8 patients. This raises the question as to whether iron storage disease may now contribute to the spectrum of liver disease in Papua New Guinea. Many biopsies in the 1960s and 1980s were interpreted as nonspecific hepatitis; in the light of recent observations, at least some of these may have been due to hepatitis C infection.