77 research outputs found
Conflict, Rockets, and Birth Outcomes: Evidence from Israel's Operation Protective Edge
No full textIn summer 2014, southern Israel experienced rocket attacks from the Hamas-ruled Gaza strip on a nearly daily basis for over 50 consecutive days. We exploit this unexpected escalation in the Israeli-Palestinian conflict and variation across localities in Israel in the amount of sirens that warned of rocket attacks to measure the effect of conflict intensity on birth weight and gestation length among mothers who were pregnant during this period. In addition to the common notion that conflict intensity induces stress and anxiety, we also show that conflict intensity is correlated with absences from work and lack of prenatal care. Results on changes in birth outcomes are consistent with a detrimental effect of stress and reduced prenatal care and a beneficial effect of reduced work attendance during pregnancy. Our results demonstrate that multiple factors can impact birth outcomes when evaluating the effect of armed conflict and that the effects can also be qualitatively different
Recurrent congenital cytomegalovirus infection in a sequential pregnancy with severe sequelae, and a possible association with prophylactic valacyclovir treatment: a case report
No full textRecurrent congenital cytomegalovirus infections in consecutive pregnancies are rarely reported. Due to the risk of fetal infection from preconception maternal infection, a 6-month interval after primary maternal infection is generally advised before a new conception. Recently, high-dose valacyclovir treatment was shown to prevent fetal infection in first trimester primary infections. We present a case of first trimester primary infection treated with high-dose valacyclovir but resulting in polymerase chain reaction–confirmed fetal infection. Cytomegalovirus-specific immunoglobulin G titers remained very low during treatment and rose only after cessation of antiviral treatment. Six months after primary seroconversion, in a sequential pregnancy, recurrent fetal infection was diagnosed and resulted in severe fetal sequella. Whole genome sequencing of both amniotic fluid isolates proved them to be identical. Both pregnancies were terminated. We hypothesize that valacyclovir treatment, although unsuccessful in preventing fetal infection, had delayed the adaptive maternal immune response and might have contributed to fetal infection during the sequential pregnancy. We suggest that a longer delay might be warranted after valacyclovir treatment and before a new conception
The prediction of early preeclampsia
No full textTo identify maternal plasma protein markers for early preeclampsia (delivery <34 weeks of gestation) and to determine whether the prediction performance is affected by disease severity and presence of placental lesions consistent with maternal vascular malperfusion (MVM) among cases.This longitudinal case-control study included 90 patients with a normal pregnancy and 33 patients with early preeclampsia. Two to six maternal plasma samples were collected throughout gestation from each woman. The abundance of 1,125 proteins was measured using high-affinity aptamer-based proteomic assays, and data were modeled using linear mixed-effects models. After data transformation into multiples of the mean values for gestational age, parsimonious linear discriminant analysis risk models were fit for each gestational-age interval (8-16, 16.1-22, 22.1-28, 28.1-32 weeks). Proteomic profiles of early preeclampsia cases were also compared to those of a combined set of controls and late preeclampsia cases (n = 76) reported previously. Prediction performance was estimated via bootstrap.We found that 1) multi-protein models at 16.1-22 weeks of gestation predicted early preeclampsia with a sensitivity of 71% at a false-positive rate (FPR) of 10%. High abundance of matrix metalloproteinase-7 and glycoprotein IIbIIIa complex were the most reliable predictors at this gestational age; 2) at 22.1-28 weeks of gestation, lower abundance of placental growth factor (PlGF) and vascular endothelial growth factor A, isoform 121 (VEGF-121), as well as elevated sialic acid binding immunoglobulin-like lectin 6 (siglec-6) and activin-A, were the best predictors of the subsequent development of early preeclampsia (81% sensitivity, FPR = 10%); 3) at 28.1-32 weeks of gestation, the sensitivity of multi-protein models was 85% (FPR = 10%) with the best predictors being activated leukocyte cell adhesion molecule, siglec-6, and VEGF-121; 4) the increase in siglec-6, activin-A, and VEGF-121 at 22.1-28 weeks of gestation differentiated women who subsequently developed early preeclampsia from those who had a normal pregnancy or developed late preeclampsia (sensitivity 77%, FPR = 10%); 5) the sensitivity of risk models was higher for early preeclampsia with placental MVM lesions than for the entire early preeclampsia group (90% versus 71% at 16.1-22 weeks; 87% versus 81% at 22.1-28 weeks; and 90% versus 85% at 28.1-32 weeks, all FPR = 10%); and 6) the sensitivity of prediction models was higher for severe early preeclampsia than for the entire early preeclampsia group (84% versus 71% at 16.1-22 weeks).We have presented herein a catalogue of proteome changes in maternal plasma proteome that precede the diagnosis of preeclampsia and can distinguish among early and late phenotypes. The sensitivity of maternal plasma protein models for early preeclampsia is higher in women with underlying vascular placental disease and in those with a severe phenotype
Hypothyroidism and diabetes mellitus – a risky dual gestational endocrinopathy
No full textObjectives. Diabetes mellitus (DM) and hypothyroidism are each associated with increased rate of pregnancy complications. However, their combined morbidity during gestation is poorly studied. Therefore, the aims of this study were to determine the prevalence of the combined morbidity of DM & hypothyroidism and whether it is associated with adverse maternal and neonatal outcome.Study design. This population based retrospective cohort study included 87,213 women who had 232,293 deliveries. All deliveries were divided into the following groups: (1) hypothyroidism & DM (n = 171); (2) hypothyroidism (n = 1502); (3) DM (n = 13,324); and (4) deliveries of women with neither endocrinopathy, who served as a control group (n = 217, 296).Results. The prevalence of DM & hypothyroidism in our population was 0.17%. In comparisons to the other study groups, women with DM & hypothyroidism had higher rates of infertility (p < 0.001), preeclampsia (p < 0.001), chronic hypertension (p < 0.001), preterm birth (p < 0.001), and cesarean deliveries (p < 0.001). In Generalized Estimating Equations (GEE) model, hypothyroidism & DM was an independent risk factor for cesarean section (OR 3.46; 95% CI 2.53–4.75) and for preeclampsia (OR 1.82; 95%CI 1.16–2.84).Conclusion. The combination of DM & hypothyroidism is rare, yet it is associated with higher rate of infertility, cesarean sections, preterm deliveries, and hypertensive disorders of pregnancy than the rest of the population. This dual endocrinological combination is an independent risk factor for preeclampsia and cesarean section. These findings suggest that these patients are at risk for perinatal complications and should be followed and delivered as high risk pregnancies
Development of intuitive rules: Evaluating the application of the dual-system framework to understanding children’s intuitive reasoning
No full textThis is an author-created version of this article, which was subsequently published by Springer in Psychonomic Bulletin & Review
December 2006, Volume 13, Issue 6, pp 935-953 http://dx.doi.org/10.3758/BF03213907. The final publication is available at www.springerlink.comTheories of adult reasoning propose that reasoning consists of two functionally distinct systems that operate under entirely different mechanisms. This theoretical framework has been used to account for a wide range of phenomena, which now encompasses developmental research on reasoning and problem solving. We begin this review by contrasting three main dual-system theories of adult reasoning (Evans & Over, 1996; Sloman, 1996; Stanovich & West, 2000) with a well-established developmental account that also incorporates a dual-system framework (Brainerd & Reyna, 2001). We use developmental studies of the formation and application of intuitive rules in science and mathematics to evaluate the claims that these theories make. Overall, the evidence reviewed suggests that what is crucial to understanding how children reason is the saliency of the features that are presented within a task. By highlighting the importance of saliency as a way of understanding reasoning, we aim to provide clarity concerning the benefits and limitations of adopting a dual-system framework to account for evidence from developmental studies of intuitive reasoning
The association between cervical inflammation and histologic evidence of HPV in PAP smears and adverse pregnancy outcome in low risk population
No full textFrom Monsters to Patients: A History of Disability
No full textabstract: This dissertation addresses the tendency among some disability scholars to overlook the importance of congenital deformity and disability in the pre-modern West. It argues that congenital deformity and disability deviated so greatly from able-bodied norms that they have played a pivotal role in the history of Western Civilization. In particular, it explores the evolution of two seemingly separate, but ultimately related, ideas from classical antiquity through the First World War: (1) the idea that there was some type of significance, whether supernatural or natural, to the existence of congenital deformity and (2) the idea that the existence of disabled people has resulted in a disability problem for western societies because many disabilities can hinder labor productivity to such an extent that large numbers of the disabled cannot survive without taking precious resources from their more productive, able-bodied counterparts. It also looks at how certain categories of disabled people, including, monsters, hunchbacks, cripples, the blind, the deaf and dumb, and dwarfs, which signified aesthetic and functional deviations from able-bodied norms, often reinforced able-bodied prejudices against the disabled.Dissertation/ThesisPh.D. History 201
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