40 research outputs found
Ursodeoxycholic acid to reduce adverse perinatal outcomes for intrahepatic cholestasis of pregnancy: the PITCHES RCT
No full textBackground:
Intrahepatic cholestasis of pregnancy, characterised by maternal pruritus and raised serum bile acid concentrations, is associated with increased rates of stillbirth, preterm birth and neonatal unit admission. Ursodeoxycholic acid is widely used as a treatment, but without an adequate evidence base. /
Objective:
We aimed to evaluate whether or not ursodeoxycholic acid reduces adverse perinatal outcomes in affected women. /
Design:
Multicentre, masked, randomised, placebo-controlled, two-arm, parallel-group trial. /
Setting:
Thirty-three UK maternity units. /
Participants:
Women with intrahepatic cholestasis of pregnancy aged ≥ 18 years, between 20+0 and 40+6 weeks’ gestation with a singleton or twin pregnancy and no known lethal fetal anomaly. /
Interventions:
Women were randomly assigned (1 : 1 allocation ratio) to take ursodeoxycholic acid tablets or matched placebo tablets, at an equivalent dose of 1000 mg daily, titrated as needed. /
Main outcome measures:
The primary outcome was a composite of perinatal death (in utero fetal death after randomisation or known neonatal death up to 7 days) or preterm delivery (< 37 weeks’ gestation) or neonatal unit admission for at least 4 hours (from birth until hospital discharge). Each infant was counted once within this composite. Analyses were by intention to treat. /
Results:
Between 23 December 2015 and 7 August 2018, 605 women were randomised, with 305 women allocated to the ursodeoxycholic acid arm and 300 women to the placebo arm. There was no evidence of a significant difference in the incidence of the primary outcome between the groups: 23.0% (74 out of 322 infants) in the ursodeoxycholic acid group compared with 26.7% (85 out of 318 infants) in the placebo group; adjusted risk ratio 0.85 (95% confidence interval 0.62 to 1.15). There was no evidence of a significant difference in total costs (maternal, infant and the cost of ursodeoxycholic acid) between the two trial groups. There were two serious adverse events in the ursodeoxycholic acid group and six in the placebo group. /
Limitations:
Limitations include a primary outcome event rate in the control group that was lower than that estimated for the sample size calculation, but the lack of evidence of effect in all analyses suggests that it is unlikely that the trial had insufficient power. /
Conclusions:
In this clinical trial of ursodeoxycholic acid in women with intrahepatic cholestasis of pregnancy, there is no evidence that it is effective in reducing a composite of adverse perinatal outcomes. /
Future work:
Future research should aim to elucidate the aetiology and pathophysiology of adverse perinatal outcomes, particularly stillbirth, in women with intrahepatic cholestasis of pregnancy to assist the development of an effective preventative treatment. Further exploratory analyses may identify groups of women who might respond to ursodeoxycholic acid treatment. /
Trial registration:
Current Controlled Trials ISRCTN91918806. /
Funding:
This project was funded by the Efficacy and Mechanism Evaluation (EME) Programme, a Medical Research Council and National Institute for Health Research (NIHR) partnership. This will be published in full in Efficacy and Mechanism Evaluation; Vol. 7, No. 9. See the NIHR Journals Library website for further project information
Short-term stress relaxation of porcine periodontal ligament - Finding an appropriate visco-elastic model
No full textFindings are presented here from a prototype palpation device for making load-displacement measurements, intended ultimately for in vivo use on humans. Here, the device is applied in vitro to a number of pig-jaws to assess its ability to distinguish visco-elastic properties of the PDL. Four jaws were tested, each test consisting of the application of a series of step displacements to the second mandibular premolar, and allowing the stress to relax over a period of up to 35 seconds. The resulting stress relaxation curves are fit to a number of simple visco-elastic models to assess the most appropriate method of assessing short- and medium-term visco-elastic properties. The results indicate that four-parameter models give significantly better results than three-parameter models and that the time of testing is critical in determining longer time-constant effects. © 2009 Springer-Verlag.</p
Factors Influencing Exclusive Breastfeeding Among HIV Positive Mothers at Ilala Municipality Dar es Salaam
No full textExclusive breast feeding practices to infants from birth to six months of age are declining as their age increases despite the associated benefits. Knowledge on the factors influencing exclusive breastfeeding among HIV positive mothers will create awareness on feeding practices that are risk to the infant’s health. To determine factors that influence exclusive breastfeeding among HIV positive mothers of infants aged 6-12 months old attending Reproductive and child Health clinic and care and treatment clinic at Ilala Municipality. Materials and Methods: A cross-sectional survey was conducted among HIV positive mothers with infants aged 6-12 months at three health facilities of Ilala Municipality namely: Amana hospital, Mnazi Mmoja and Buguruni Health Centres. Both quantitative and qualitative data collection methods were used. A questionnaire was administered to 200 HIV positive mothers to collect information and to characterize infants feeding practices. In depth Interview guide was used to explore infant feeding practices to five mothers of the same group. Exclusive breastfeeding was reported to be 46%. The other feeding practices reported were: mixed feeding 14% and exclusive replacement feeding 6%. Prelacteal and early complementary feeding was reported to be 34%. Exclusive breastfeeding practice was influenced mainly by health workers and mother’s perception that breast milk is sufficient for infant’s body requirements for the first six months of life. Early cessation of breastfeeding was reported to be result of mother’s fear of infecting the child and also infant’s HIV test results being negative after DNA-PCR test. However, lack of HIV status disclosure, breast problem, family and social pressures were found to be barriers in practicing exclusive breastfeeding. HIV positive mothers are faced with multiple challenges as they strive to practice exclusive breastfeeding. Despite nearly half of the mothers reporting practicing exclusive breastfeeding, the rates are still not satisfactory. More extensive and comprehensive approach of infant feeding counseling that embrace all stakeholders, with emphasis to significant others should be put in place in order to increase exclusive breastfeeding rates
A Simulation Driven Deep Learning Approach for Separating Mergers and Star Forming Galaxies: The Formation Histories of Clumpy Galaxies in all the CANDELS Fields
No full textBeing able to distinguish between galaxies that have recently undergone major
merger events, or are experiencing intense star formation, is crucial for
making progress in our understanding of the formation and evolution of
galaxies. As such, we have developed a machine learning framework based on a
convolutional neural network (CNN) to separate star forming galaxies from
post-mergers using a dataset of 160,000 simulated images from IllustrisTNG100
that resemble observed deep imaging of galaxies with Hubble. We improve upon
previous methods of machine learning with imaging by developing a new approach
to deal with the complexities of contamination from neighbouring sources in
crowded fields and define a quality control limit based on overlapping sources
and background flux. Our pipeline successfully separates post-mergers from star
forming galaxies in IllustrisTNG of the time, which is an improvement by
at least 25\% in comparison to a classification using the asymmetry () of
the galaxy. Compared with measured S\'ersic profiles, we show that star forming
galaxies in the CANDELS fields are predominantly disc-dominated systems while
post-mergers show distributions of transitioning discs to bulge-dominated
galaxies. With these new measurements, we trace the rate of post-mergers among
asymmetric galaxies in the universe finding an increase from at
to at . Additionally, we do not find strong evidence that the
scattering above the Star Forming Main Sequence (SFMS) can be attributed to
major post-mergers. Finally, we use our new approach to update our previous
measurements of galaxy merger rates Comment: Accepted for publication in ApJ. 28 pages, 18 Figures, 2 Tables.
Pretrained models available at https://github.com/astroferreira/FERREIRA202
Measurement of the short-term viscoelastic properties of the periodontal ligament using stress relaxation
No full textThe periodontal ligament (PDL) plays an important role in initiating tooth movement when loads are applied to teeth with orthodontic appliances. It is also the most accessible ligament in the human body as it can be directly manipulated (via the teeth) without surgical intervention.Findings are presented here from a prototype palpation device for making load-displacement measurements, intended ultimately for in vivo use on humans. Here, the device is applied in vitro to a number of pig-jaws to assess its ability to distinguish visco-elastic properties of the PDL.Four jaws were tested, each test consisting of the application of a series of step displacements to the second mandibular premolar, and allowing the stress to relax over a period of up to 35 seconds. The resulting stress relaxation curves are described by a three-parameter visco-elastic model with two elastic parameters and one viscous parameter. The values of these parameters are consistent between animals and between tests on a given animal, and are reasonably consistent with other authors.</p
[WFAA News Clips and B-roll, ca. October 31, 1971]
No full text0:00, 0:52 - Brief shot of a man dressed as a witch for Halloween; additional footage of children standing before a giant jack-o-lantern cutout and of a man dressed as Dracula, who is seen rising from a mock grave; in an interview, the witch says that the purpose of this event is to prove the existence of the Great Pumpkin. 0:19, 3:27, 7:08 - (October 31, 1971) The Dallas Chaparrals defeat the Indiana Pacers, 125-108, at Southern Methodist University's (SMU) Moody Coliseum; the Chaps honor the late WFAA reporter Gene Thomas with ""Gene Thomas Memorial Night"" at the game; Chaps' announcer Terry Stembridge, standing next to WFAA's Bob Gooding, reads a printed statement (Silent); Gooding addresses the crowd. 2:03, 4:12 - (October 31, 1971) Jim Pittman, head football coach of the Texas Christian University (TCU) Horned Frogs, died after suffering a heart attack on the field during a game in Waco; Billy Tohill, Pittman's assistant coach, is named acting head coach for the rest of the season; Tohill, TCU Chancellor James M. Moudy, and athletic director Abe Martin hold a press conference; Moudy talks about the selection of Tohill, and Tohill says that he's proud that people have confidence in him. 2:21, 5:18 - Garry Weber, Dallas City Councilman, is interviewed about his support of a sign ordinance recommended by the City Plan Commission (Silent); additional silent footage of business signs along Lemmon Avenue, including signs for El Fenix, Pussycat A' Go Go, Shakey's Pizza Parlor, and der Cheese n' Wurst; Weber goes on to discuss the proposed ordinance; Judi Hanna reporting. 3:09, 6:23 - Herb Cooke, executive director of the Classroom Teachers of Dallas (CTD), is interviewed (Silent); he says that the CTD was able to reach an agreement with the Dallas Independent School District (DISD) to employ 18 teachers whose contracts with the federal Title I program have ended – they will become permanent substitute teachers through the end of the current school year; Gene McIntyre reporting. 7:33, 17:26, 21:26, 22:55 - (November 1, 1971) The Dallas City Council holds a public hearing in the Memorial Auditorium Theater to hear comments about a proposed interim sign ordinance; Jack Brown of the Dallas-Fort Worth Metropolitan Sign Association criticizes the strict interim ordinance; City Plan Commission director James M. Schroeder Jr. says that these are just interim regulations; another man says that this order should have no impact on businesses; a report goes on to describe the hearing and the battle between environmentalists who object to the continued ''visual pollution'' and advertisers; additional silent footage of the hearing and of various signs around Dallas (mostly on Knox Street); Phil Reynolds reporting. 9:22, 21:54 - (November 1, 1971) A report on the new permanent courtroom for the United States Tax Court in Dallas in the U.S. Post Office building at Bryan and Ervay; in an interview, presiding Judge Charles R. Simpson (blind since childhood) describes the type of taxpayers who need the services of his court; additional silent footage of the courtroom and of Simpson on the bench; Jim Mitchell reporting (Silent). 12:38 - (November 1, 1971) A meeting of the Fort Worth City Council is underway (Silent). 13:32 - (November 1, 1971) A memorial service is held at the University Christian Church (2720 S. University) in Fort Worth for Jim Pittman, head coach of the TCU Horned Frogs who died during a recent game with Baylor; various shots of the exterior of the church and of those attending, including members of the football team and Lt. Gov. Ben Barnes (Silent). 14:18 - (November 1, 1971) A report on the 40th annual National Water Resources Association convention at the Statler-Hilton in Dallas and this year's theme, ""The Thinking Man's Environment""; in an interview, Ellis Armstrong, commissioner of the U.S. Bureau of Reclamation, talks about the plans to solve Texas' water problems, including cloud-seeding and the possibility of diverting water from the Mississippi River; Judi Hanna reporting. 16:24 - A fire at the Ross Downs Feed Store in Colleyville requires 6 area departments to battle the blaze; various shots of the nighttime fire, of Tarrant County Fire Marshal Mason Lankford, and of the aftermath the following day (Silent). 19:54, 24:07 - (November 1, 1971) Willard Johnson, vice president of Zero Population Growth (ZPG), holds a press conference, during which he talks about the population stabilization resolution before Congress, which would require a balance of births and deaths in the country in order to control over-population; additional silent footage of the press conference; Johnson is in Dallas to give lectures at the First Unitarian Church and SMU; Donna Witkowski reporting. 22:38 - Brief shot of a meeting of the Tarrant County Commissioners Court (Silent). 24:02 - Brief shot of a sign for ""Texas Wesleyan College Sustentation Fund Goal - $200,000."
Measurement of the short-term viscoelastic properties of the periodontal ligament using stress relaxation
No full textThe periodontal ligament (PDL) plays an important role in initiating tooth movement when loads are applied to teeth with orthodontic appliances. It is also the most accessible ligament in the human body as it can be directly manipulated (via the teeth) without surgical intervention. Findings are presented here from a prototype palpation device for making load-displacement measurements, intended ultimately for in vivo use on humans. Here, the device is applied in vitro to a number of pig-jaws to assess its ability to distinguish visco-elastic properties of the PDL. Four jaws were tested, each test consisting of the application of a series of step displacements to the second mandibular premolar, and allowing the stress to relax over a period of up to 35 seconds. The resulting stress relaxation curves are described by a three-parameter visco-elastic model with two elastic parameters and one viscous parameter. The values of these parameters are consistent between animals and between tests on a given animal, and are reasonably consistent with other authors. © 2009 Springer Berlin Heidelberg.</p
Clinical and biochemical correlates of serum L-ergothioneine concentrations in community-dwelling middle-aged and older adults
No full textBackground: Despite the increasing interest towards the biological role of L-ergothioneine, little is known about the serum concentrations of this unusual aminothiol in older adults. We addressed this issue in a representative sample of communitydwelling middle-aged and older adults.
Methods: Body mass index, estimated glomerular filtration rate, serum concentrations of L-ergothioneine, taurine, homocysteine, cysteine, glutathione, cysteinylglycine, and glutamylcysteine were evaluated in 439 subjects (age 55–85 years) randomly selected from the Hunter Community Study.
Results: Median L-ergothioneine concentration in the entire cohort was 1.01 IQR 0.78–1.33 mmol/L. Concentrations were not affected by gender (P = 0.41) or by presence of chronic medical conditions (P = 0.15). By considering only healthy subjects, we defined a reference interval for L-ergothioneine serum concentrations from 0.36 (90% CI 0.31–0.44) to 3.08 (90% CI 2.45–3.76) mmol/L. Using stepwise multiple linear regression analysis L-ergothioneine was negatively correlated with age (rpartial =20.15; P = 0.0018) and with glutamylcysteine concentrations (rpartial =20.13; P = 0.0063).
Conclusions: A thorough analysis of serum L-ergothioneine concentrations was performed in a large group of communitydwelling middle-aged and older adults. Reference intervals were established. Age and glutamylcysteine were independently negatively associated with L-ergothioneine serum concentration.</br
Risk factors and clinical findings of Gardnerella vaginalis infection in women referring to Tabriz health centers
No full textBackground: Bacterial vaginosis (BV) is the most common type of vaginitis during reproductive period. Preterm labor, tubal infertility and pelvic inflammatory disease are more prevalent among women with vaginosis. Regarding high amount of refers and lack of data about their risk factors, this study was conducted.
Materials and methods: In this descriptive- analytic study, 1000 women referred to Tabriz health centers were randomly selected. Data were collected by a questionnaire containing demographic and fertility characteristics, previous history of treatment of symptoms as well as individual and sexual hygiene, researcher’s observations and results laboratory tests. Three samples were obtained from vaginal and cervical secretion and were used for microscopic observation and culture. Amsel’s diagnostic criteria were used for bacterial vaginosis. Data were analyzed by chi-square, t-test, exact Fisher test and logistic regression.
Results: Gardnerella Vaginalis was found in 9.2% of vaginal discharges. Risk factors of BV included number of delivery, vaginal delivery, abortion, IUD utilization, individual and sexual hygiene and duration of antibiotic use. Number of vaginal delivery and abortion, vaginal pH, sexual hygiene, women’s education and husband’s occupation were predictive factors of BV.
Conclusion: This study showed that diagnosis and treatment of BV based on symptoms could not be appropriate. It is recommended that laboratory testing should be added to clinical observation and examination to detect BV, especially before IUD insertio
