Methods The Pesario Cervical para Evitar Prematuridad (PECEP) trial was undertaken in five hospitals in Spain. Pregnant women (aged 18-43 years) with a cervical length of 25 mm or less were randomly assigned according to a PRT062607 research buy computer-generated allocation sequence by use of central telephone in a 1: 1 ratio to the cervical pessary or

expectant management (without a cervical pessary) group. Because of the nature of the intervention, this study was not masked. The primary outcome was spontaneous delivery before 34 weeks of gestation. Analysis was by intention to treat. This study is registered with ClinicalTrials.gov, number NCT00706264.

Findings 385 pregnant women with a short cervix were assigned to the pessary (n=192) and expectant management groups (n=193), and 190 were analysed in each group. Spontaneous delivery before 34 weeks of gestation was significantly less frequent in the pessary group than in the expectant management group (12 [6%] vs 51 [27%], odds ratio 0.18, 95% CI 0.08-0.37; p<0.0001). No serious adverse effects associated with the use LY294002 in vivo of a cervical pessary were reported.

Interpretation Cervical pessary use could prevent preterm birth in a population of appropriately selected at-risk women previously screened for

cervical length assessment at the midtrimester scan.”
“Parental responsiveness to infant vocalizations is an essential mechanism to ensure parental care, and its importance is reflected in a specific neural substrate, the thalamocingulate circuit, which evolved through mammalian evolution subserving this responsiveness. Recent studies using functional Magnetic Resonance Imaging (fMRI) provide compelling evidence for a comparable mechanism in humans by showing thalamocingulate responses to infant crying. Furthermore, possibly acting on this common neural

substrate, steroid hormones such as estradiol and testosterone, seem to mediate parental behavior both in humans and other animals. Estradiol unmistakably increases parental care, while data for testosterone are less unequivocal. Bafilomycin A1 In humans and several other animals, testosterone levels decrease both in mothers and fathers during parenthood. However, exogenous testosterone in mice seems to increase parenting, and infant crying leads to heightened testosterone levels in human mates. Not only is the way in which testosterone is implicated in parental responsiveness unresolved, but the underlying mechanisms are fully unknown. Accordingly, using fMRI, we measured neural responses of 16 young women who were listening to crying infants in a double blind, placebo-controlled, counterbalanced, testosterone administration experiment. Crucially, heightened activation in the testosterone condition compared to placebo was shown in the thalamocingulate region, insula, and the cerebellum in response to crying.