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Westerway, Susan Lyn Campbell. "Ultrasonic assessment of fetal size and growth." University of Sydney, 2006. http://hdl.handle.net/2123/2626.
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Doctor of Philosophy (Medicine)This work investigates a number of issues. Firstly it examines ultrasonic fetal biometry, the parameters and techniques for accurate measuring and reviews the procedure adopted for graph formation and application of regression analysis for a mathematical model to describe the relationship between fetal size and weeks of gestation. Next it establishes new Australian fetal measurement charts for the crown rump length, head circumference and abdominal circumference, based on an Australian population, to replace the charts currently in use that are over 20 years old and relate to middle class white American and British women. The new graphs, along with previous work completed by the author in 1999 on the BPD, OFD femur and humerus length, were subsequently accepted by the Australasian Society for Ultrasound in Medicine (ASUM) in 2001 as the new Australian standard for ultrasonic fetal measurements. The accuracy of first trimester ultrasound dating is also investigated, displaying the variations seen in the crown-rump length due to fetal flexion and the implications of inaccurate measuring. The third study examines inter- and intra-sonographer ultrasonic fetal measurement reproducibility in the final 6 weeks of pregnancy. The study highlights the importance of sonographer competence, standardised measuring protocols, image planes and reference charts, particularly for patients undergoing ultrasound examinations for fetal growth assessment at different practices. The fourth study looks at the incidence of fetal macrosomia and birth complications in Chinese women and Caucasian women in two time periods, 1992 and 1999/2000. The results showed a rise in macrosomic babies born to Chinese immigrants from 4% of total Chinese births in 1992 to 9.8% in 1999/2000. There was also a rise in the rate of macrosomia among Caucasian women with respective rates of 11 and 14% for the same periods. The incidence of post partum haemorrhage increased significantly over this time in both Chinese immigrant and Caucasian women. Interventions declined in all Caucasian birth-weight ranges whilst interventions for Chinese births remained stable except between 3500grams and 4000grams, where interventions rose from 35.7% to 60.5%. Fetal macrosomia is a complication of pregnancy that is increasing in incidence. One of the causes of fetal overgrowth is uncontrolled gestational diabetes mellitus and so if women thus diagnosed are closely monitored, the risks of a macrosomic baby and associated birth complications may be reduced. The final study examines the effect of gestational diabetes mellitus (GDM) on fetal growth. GDM is a complication of mid to late pregnancy caused by glucose intolerance. In the Australian population up to 8% of all pregnancies can be affected. In the Australian Chinese community the GDM rate is as high as 15% compared with 4% in Caucasian women. The risks to the fetus as a result of GDM include increased perinatal mortality, large for gestational dates, macrosomia and prematurity. The aim of this study was to determine whether the fetuses of women diagnosed with GDM were significantly larger for dates for any of the commonly ultrasonically measured fetal parameters, than in the general pregnant population. The results show that if the glycaemic levels are properly controlled, fetal size should not be compromised. The abdominal circumference measurement appears to be the important marker for fetal macrosomia, particularly in the Chinese population. The study also assessed fetal weight gain from 36 weeks gestation to term in Caucasian women with GDM and Chinese pregnancies both with and without GDM. No statistically significant difference was seen in daily weight gain between the groups investigated.
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Westerway, Susan Lyn Campbell. "Ultrasonic assessment of fetal size and growth." Thesis, The University of Sydney, 2005. http://hdl.handle.net/2123/2626.
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This work investigates a number of issues. Firstly it examines ultrasonic fetal biometry, the parameters and techniques for accurate measuring and reviews the procedure adopted for graph formation and application of regression analysis for a mathematical model to describe the relationship between fetal size and weeks of gestation. Next it establishes new Australian fetal measurement charts for the crown rump length, head circumference and abdominal circumference, based on an Australian population, to replace the charts currently in use that are over 20 years old and relate to middle class white American and British women. The new graphs, along with previous work completed by the author in 1999 on the BPD, OFD femur and humerus length, were subsequently accepted by the Australasian Society for Ultrasound in Medicine (ASUM) in 2001 as the new Australian standard for ultrasonic fetal measurements. The accuracy of first trimester ultrasound dating is also investigated, displaying the variations seen in the crown-rump length due to fetal flexion and the implications of inaccurate measuring. The third study examines inter- and intra-sonographer ultrasonic fetal measurement reproducibility in the final 6 weeks of pregnancy. The study highlights the importance of sonographer competence, standardised measuring protocols, image planes and reference charts, particularly for patients undergoing ultrasound examinations for fetal growth assessment at different practices. The fourth study looks at the incidence of fetal macrosomia and birth complications in Chinese women and Caucasian women in two time periods, 1992 and 1999/2000. The results showed a rise in macrosomic babies born to Chinese immigrants from 4% of total Chinese births in 1992 to 9.8% in 1999/2000. There was also a rise in the rate of macrosomia among Caucasian women with respective rates of 11 and 14% for the same periods. The incidence of post partum haemorrhage increased significantly over this time in both Chinese immigrant and Caucasian women. Interventions declined in all Caucasian birth-weight ranges whilst interventions for Chinese births remained stable except between 3500grams and 4000grams, where interventions rose from 35.7% to 60.5%. Fetal macrosomia is a complication of pregnancy that is increasing in incidence. One of the causes of fetal overgrowth is uncontrolled gestational diabetes mellitus and so if women thus diagnosed are closely monitored, the risks of a macrosomic baby and associated birth complications may be reduced. The final study examines the effect of gestational diabetes mellitus (GDM) on fetal growth. GDM is a complication of mid to late pregnancy caused by glucose intolerance. In the Australian population up to 8% of all pregnancies can be affected. In the Australian Chinese community the GDM rate is as high as 15% compared with 4% in Caucasian women. The risks to the fetus as a result of GDM include increased perinatal mortality, large for gestational dates, macrosomia and prematurity. The aim of this study was to determine whether the fetuses of women diagnosed with GDM were significantly larger for dates for any of the commonly ultrasonically measured fetal parameters, than in the general pregnant population. The results show that if the glycaemic levels are properly controlled, fetal size should not be compromised. The abdominal circumference measurement appears to be the important marker for fetal macrosomia, particularly in the Chinese population. The study also assessed fetal weight gain from 36 weeks gestation to term in Caucasian women with GDM and Chinese pregnancies both with and without GDM. No statistically significant difference was seen in daily weight gain between the groups investigated.
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Shivkumar, Sushmita. "A fetal weight reference for twins based on ultrasound measurements." Thesis, McGill University, 2012. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=106242.
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Background and ObjectiveFetal growth and size are known indicators of perinatal health, although the etiology of this relationship is unclear, and twins are known to differ from singletons with respect to fetal growth trajectories over the course of pregnancy. With a lack of research on ultrasound-based fetal weight references in twin populations, this study aimed to construct ultrasound-based in utero fetal weight references for each gestational age for a twin population.MethodsTwins delivered at a tertiary care hospital in Montreal were used in this study. Fetal weight was calculated using a published formula that was validated in this population. Fetal growth was then modeled in twins using serial ultrasound measurements of fetal weight, and adjusting for sex and chorionicity. Linear mixed models were used to adjust for the correlation between twins from the same pregnancy, and for the use of multiple ultrasound measurements for each fetus. Restricted cubic splines were used to account for the non-linear growth of fetuses over the course of pregnancy. Predictions were made from this regression model for the 1st, 10th, 50th, 90th and 99th fetal weight percentiles for the gestational period between weeks 22 and 37.ResultsMedian gestational age at birth was 37 weeks, with a predicted median birth weight of 2686 g. The rate of change in fetal weight was observed to be S-shaped over the course of pregnancy, with a period of accelerated growth in the second trimester, and slower growth in the third trimester. Ultrasound-based fetal weight references constructed from this population corroborated other published ultrasound-based fetal weight references in twin populations. As expected, fetal weight in twins was consistently lower than singletons over the course of pregnancy, when compared with other published fetal weight references.ConclusionsThe ultrasound-based fetal weight reference and predicts fetal weight at each gestational age, estimates which could be used to assess fetal size at each gestational age in twin pregnancies. This study additionally validates the use of formulae to estimate fetal weight in a twin population, and adds to literature published in this field.Considérations préliminaires et objectifLa croissance in utero des jumeaux diffère de celle des enfants uniques. La croissance et la taille foetale sont des indicateurs communs de santé périnatale, bien que la nature exacte du lien de causalité soit encore incertaine. La surveillance de la taille foetale s'inscrit naturellement dans le suivi des grossesses. L'imagerie par ultrasons a permis l'élaboration de normes pondérales ultrasonographiques in utero pour les enfants uniques. Moins d'efforts ont été déployés pour quantifier les variations de taille des jumeaux au cours de la grossesse. Le présent ouvrage cherche à proposer une norme pondérale in utero pour les jumeaux.MéthodeLe poids foetal a été estimé grâce à une formule validée pour la population retenue. La croissance intrautérine des jumeaux a été modélisée à l'aide d'estimés pondéraux ultrasonographiques prenant compte du sexe et de la chorionicité. Des splines cubiques naturels ont été utilisés pour rendre compte de la non-linéarité de la croissance foetale. Le modèle de régression a permis d'obtenir des prédictions pour les 1er, 10e, 50e, 90e et 99e centiles du poids foetal de la 22e à la 37e semaine de grossesse. RésultatsLa norme pondérale ultrasonographique élaborée à partir de la population retenue était compatible avec des normes de même nature publiées précédemment. Tel que prévu, le modèle a révélé que le poids in utero des jumeaux était systématiquement plus bas que celui des enfants uniques, les valeurs de référence pour ce dernier étant tirées d'une norme pondérale reconnue. ConclusionLa norme pondérale ultrasonographique in utero pour les jumeaux tirée de cette étude complémente la littérature traitant de la croissance intrautérine des jumeaux, peu étoffée en comparaison avec celle portant sur la croissance intrautérine des enfants uniques. Après validation externe, elle pourrait se révéler utile en pratique clinique.
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Hall, Angus John. "Electronic measurements of area and perimeter in ultrasonic images." Thesis, University of Leeds, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.328883.
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Sarris, Ippokratis. "Creation of a new fetal biometry image quality scoring tool to improve the accuracy of fetal biometric measurements." Thesis, University of Oxford, 2012. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.595667.
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The hypothesis of this work is that through establishing the background variation of ultrasonographic fetal biometry measurements and elucidating the parameters that influence these measurements, a new Fetal Ultrasound Biometry Quality (FUB-Q) image-scoring tool can be created which will be reproducible and able to quantify the accuracy of fetal measurements. Six studies are included, each answering a specific research question. The aim of the first study was to ascertain whether pre-existing image quality scoring methods reflect measurement accuracy and reproducibility. It demonstrated that during the course of an exercise where there was demonstrable improvement in the consistency of measurements performed - by a group of sonographers, this was not mirrored by the pre-existing image scoring system. The aim of the second study was to establish the intra- and inter- observer variability of fetal biometry measurements throughout pregnancy by expert sonographers. This study demonstrated that ultrasound variability of fetal biometry increases with advancing gestation when expressed in measurement values, but is constant as a percentage of the fetal dimensions or when reported as a z score. Calliper placement was the major component of the overall variability. The values from this study served as the background variability, "reference standard", for the FUB-Q tool. The third study had two aims. The first was to establish how 3D scanning performs compared to conventional, real-time, 20. The second aim was to assess whether off-line 3D volume manipulation can be used as a tool to substitute real-time 20 ultrasound for the subsequent studies. It demonstrated that measurements using 3D volume acquisitions exhibit good agreement with real-time 20 scanning, with no systematic error but with a higher random error. However, it also demonstrated that 3D scanning is slower to perform and, similar to real-time 2D, it is not always possible to acquire a 3D volume from a desired orientation. Furthermore, not all 3D volume acquisitions were amenable to reconstruction. However, this study showed that saved 3D volumes can be used as a mean to store large volumes of data for later detailed analysis. The aim of the fourth study was to create the FUB-Q scoring tool. This was done by establishing the difference in measurement resulting from optimal and different forms of suboptimal images in a systematic fashion. For any . t " given image, and its derived measurement, the observer inserts in the model the various image scoring point parameters. The model then gives a prediction about the confidence interval within which the optimal, "gold standard", measurement should be. The aim of the fifth study was to validate on an independent test set the predictive ability of the newly developed FUB-Q scoring tool. It demonstrated that the FUB-Q tool can correctly predict the confidence interval within which measurements recorded from correctly acquired images should be in relation to measurements acquired from incorrectly acquired ones. The aim of the sixth, and final , study was to evaluate the reproducibility of obtaining the relevant scores for the FUB-Q tool. It demonstrated that the FUB-Q tool has good intra- and inter- observer reproducibility and is a reliable system for assessing the quality of fetal biometry based on ultrasound images. In conclusion, the FUB-Q tool could be a useful system used for audit of clinical practice and quality control as well as for training purposes .
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Canto, Moreira Nuno. "MRI Studies of the Fetal Brain and Cranium." Doctoral thesis, Uppsala universitet, Enheten för radiologi, 2012. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-164685.
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Ultrasound is the primary modality for fetal imaging, but Magnetic Resonance Imaging nowadays has a valuable complementary role as it often reveals findings that alter pregnancy management. Knowledge on some clinically relevant areas of the normal fetal development is still lacking, and this was the aim of this project. We wanted 1) to obtain reference MRI data of normal brain measurements before 24 gestation weeks (GW), 2) to study the development of the hippocampus, 3) to study the development of the ear and 4) to test the ability of MRI for evaluating the lip and palate. For this, we retrospectively analysed a database with 464 in vivo and 21 post mortem fetal MRI examinations. Study I evaluated a series of 70 normal fetuses. A table of normal brain measurements from 17 to 23 GW was built, the first in the literature that includes ages below 20 GW. Study II focused on the evolution of the hippocampus from 18 to 38 GW by evaluating 3 post mortem and 60 in vivo MRI examinations. Our results suggested this area to develop later and more asymmetrically than previously thought. Study III analysed a series of 122 normal MRI in vivo and 16 MRI post mortem. We described the development of the fetal ear in vivo for the first time in the literature, realizing that the value of MRI is limited by the size of the structures evaluated. In study IV, 60 brain-targeted MRI examinations of 55 normal fetuses and 5 fetuses with orofacial clefts were blindly reviewed by two readers, focusing on the lips and palates. Our results suggest a high accuracy of MRI in the evaluation of this area, regardless of fetal age or previous ultrasound findings. This thesis brings new knowledge on the normal development of the fetal brain and cranium.
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Yaqub, Mohammad. "Automatic measurements of femoral characteristics using 3D ultrasound images in utero." Thesis, University of Oxford, 2011. http://ora.ox.ac.uk/objects/uuid:857a12d2-ffe3-4fa6-89c3-0d8319ee2fbb.
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Vitamin D is very important for endochondral ossification and it is commonly insufficient during pregnancy (Javaid et al., 2006). Insufficiency of vitamin D during pregnancy predicts bone mass and hence predicts adult osteoporosis (Javaid et al., 2006). The relationship between maternal vitamin D and manually measured fetal biometry has been studied (Mahon et al., 2009). However, manual fetal biometry especially volumetric measurements are subjective, time-consuming and possibly irreproducible. Computerised measurements can overcome or at least reduce such problems. This thesis concerns the development and evaluation of novel methods to do this. This thesis makes three contributions. Firstly, we have developed a novel technique based on the Random Forests (RF) classifier to segment and measure several fetal femoral characteristics from 3D ultrasound volumes automatically. We propose a feature selection step in the training stage to eliminate irrelevant features and utilise the "good" ones. We also develop a weighted voting mechanism to weight tree probabilistic decisions in the RF classifier. We show that the new RF classifier is more accurate than the classic method (Yaqub et al., 2010b, Yaqub et al., 2011b). We achieved 83% segmentation precision using the proposed technique compared to manually segmented volumes. The proposed segmentation technique was also validated on segmenting adult brain structures in MR images and it showed excellent accuracy. The second contribution is a wavelet-based image fusion technique to enhance the quality of the fetal femur and to compensate for missing information in one volume due to signal attenuation and acoustic shadowing. We show that using image fusion to increase the image quality of ultrasound images of bony structures leads to a more accurate and reproducible assessment and measurement qualitatively and quantitatively (Yaqub et al., 2010a, Yaqub et al., 2011a). The third contribution concerns the analysis of data from a cohort study of 450 fetal femoral ultrasound volumes (18-21 week gestation). The femur length, cross-sectional areas, volume, splaying indices and angles were automatically measured using the RF method. The relationship between these measurements and the fetal gestational age and maternal vitamin D was investigated. Segmentation of a fetal femur is fast (2.3s/volume), thanks to the parallel implementation. The femur volume, length, splaying index were found to significantly correlate with fetal gestational age. Furthermore, significant correlations between the automatic measurements and 10 nmol increment in maternal 25OHD during second trimester were found.
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Økland, Inger. "Biases in second-trimester ultrasound dating related to prediction models and fetal measurements." Doctoral thesis, Norges teknisk-naturvitenskapelige universitet, Institutt for laboratoriemedisin, barne- og kvinnesykdommer, 2012. http://urn.kb.se/resolve?urn=urn:nbn:no:ntnu:diva-16221.
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FEILKILDER VED ULTRALYD-BASERT TERMINFASTSETTELSE I 2. TRIMESTER, RELATERT TIL PREDIKSJONSMETODER OG MÅLINGER Rutineundersøkelsen med ultralyd rundt svangerskapsuke 17–19 har vært en viktig del av norsk svangerskapsomsorg siden den ble innført i 1986. Når skjer fødselen? — altså sikker fastsettelse av fødselstermin, er ett av spørsmålene rutineundersøkelsen skal gi svar på. Terminen er blitt bestemt ved at fosterstørrelsen måles med ultralyd og relateres til antatt fosteralder og derfra til beregnet ultralydtermin. Termindato er vanligvis basert på målinger av fosterets hodestørrelse, men lengden av lårbeinet kan også brukes. Det er viktig at modellene som brukes til terminberegning og målingene de baserer seg på, ikke har svakheter som fører til utilsiktede, systematiske feil i ultralydterminene. Vi har undersøkt 3 norske modeller for terminbestemmelse, ‘Snurra’, ‘Terminhjulet’ og ‘eSnurra’, og sammenliknet terminen som ble fastsatt med hver modell med det faktiske fødselstidspunktet. Vi har også gjort en studie der vi har vurdert om ultralydmålingene av fosterlårbein endres over tid som følge av tekniske forbedringer i ultralydmaskinene. Studie 1: I en database med 41 343 rutineundersøkelser utført ved St. Olavs Hospital, Trondheim, sammenliknet vi kvaliteten på terminene som ble fastsatt med de 2 tradisjonelle modellene Snurra og Terminhjulet. Vi fant systematiske avvik; Snurra beregnet termin for seint og Terminhjulet for tidlig i forhold til reelt fødselstidspunkt. Avvikene varierte med fosterstørrelsen på undersøkelsestidspunktet, de strakte seg fra 0 til 4 dager og i hver sin retning. Sannsynligvis skyldes avvikene at det litt snevre datagrunnlaget til de tradisjonelle modellene ikke er godt nok tilpasset den populasjonen de brukes i. Studie 2: I tillegg til de 2 tradisjonelle modellenes beregninger, så vi nå også på terminene som ble bestemt med en ny populasjonsbasert modell, eSnurra. Vi brukte en database med 9046 rutineundersøkelser fra Stavanger Universitetssjukehus. Resultatene for de 2 første modellene tilsvarte resultatene i Studie 1 både for terminer beregnet fra hodemål og fra lårbeinsmål. eSnurra predikerte stabile, korrekte ultralydterminer, uavhengig av fosterstørrelsen ved undersøkelsen. Studie 3: Vi ønsket å se om resultatene fra Studie 1 og 2 lot seg reprodusere også i en tredje populasjon og analyserte derfor 23 020 rutineundersøkelse fra Oppland fylke. Også her var resultatene stabile for eSnurra; avviket mellom fødselstidspunkt og ultralydtermin var stort sett mindre enn 1 døgn. For de 2 andre modellene var mønsteret det samme som tidligere påvist. Avvikene virker uunngåelige med de tradisjonelle, seleksjonsbaserte modellene. Studie 4: Strålebredden i ultralydapparatene blir smalere når teknologien blir bedre. Dette kan tenkes å påvirke lengdemålinger av strukturer som måles på tvers av lydstrålens retning. Vi sammenliknet strålebredde i gamle og nye maskiner og analyserte deretter 41 941 ultralydmålinger av fosterlårbein, samlet over en 18-års periode. Tekniske forbedringer har redusert strålebredden, og dette påvirker enkelte ultralydmålinger ved at strukturen blir målt kortere. Gamle måletabeller kan gi feil resultat. Konklusjon: En undersøkelse som tilbyes alle gravide bør være standardisert og resultatene til å stole på. En termindato med avvik på 4 dager kan ha konsekvenser både for behandling av svært preterme fostre og for håndtering av overtidige svangerskap. En populasjonsbasert modell for terminfastsettelse (eSnurra) synes å være bedre tilpasset norske svangerskap enn de tradisjonelle modellene.
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Bergman, Eva. "Symphysis Fundus Measurements for Detection of Intrauterine Growth Retardation." Doctoral thesis, Uppsala : Acta Universitatis Upsaliensis : Universitetsbiblioteket [distributör], 2010. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-122256.
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Connor, Jillian. "Measurement of, and relationship between, placental size and fetal cardiac development." Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/397649/.
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Introduction -Fetal programming is the concept by which a fetus adapts to the intrauterine environment by altering blood flow to various organs which may induce permanent structural and/or functional change in those organs, altering disease susceptibility in later life. We hypothesised that the heart is a susceptible organ and that alterations in blood flow from the placenta in relation to maternal factors may have different effects on each side of the heart. We therefore aimed to assess the feasibility of measuring placental volume and growth, cardiac structure and cardiac function and assess the relationships between these measurements and also to maternal characteristics. Methods - We undertook a prospective, cross-sectional cohort study of low-risk women. 144 scans were performed on 127 women, 89 in the first trimester (10+6-13+6 weeks gestation) and 55 in the second trimester (18+0-20+6 weeks gestation). 17 of these women were scanned in both trimesters. Measurements performed were the left and right myocardial performance index to assess cardiac function and 3D placental volume. Second trimester cardiac structure was assessed by 2D measurements of total cardiac circumference, total ventricular circumference and internal left and right ventricular circumferences. These measurements were then correlated with each other, standard fetal biometry, maternal body composition, and birth and placental weights. Results - We developed reliable and reproducible techniques for measuring placental volume in the first and second trimester and relative cardiac chamber sizes in the second trimester, but had difficulty reliably measuring cardiac function by means of the myocardial performance index. We did not find any significant relationships between maternal body composition and fetal cardiac function or structure within our small cohort. Conclusions - Assessment of fetal cardiac function and structure in relation to maternal nutritional status and stress has the potential for detecting fetuses adapting to an adverse intra-uterine environment. This could assist identification of the maternal factors which lead to increased risk of disease in adult life and facilitate the development of targeted diet and lifestyle interventions.
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Pennell, Craig Edward. "The role of lactate measurement in the prediction of fetal hypoxic-ischaemic brain injury during labour." University of Western Australia. School of Women's and Infants' Health, 2004. http://theses.library.uwa.edu.au/adt-WU2003.0037.
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[Truncated abstract] In this thesis the role of lactate measurement has been evaluated in intrapartum assessment of fetal wellbeing. Specifically, I have addressed the question of whether fetal lactate measurement is better than the assessment of fetal heart rate patterns or the measurement of pH at predicting fetal brain injury after intrapartum asphyxia. Using an ovine model of repeated umbilical cord occlusion designed to mimic events which may occur during human labour, I have shown that the measurement of fetal lactate levels after repeated cord occlusion is significantly associated with the severity of brain injury after the asphyxial insult. No significant associations were identified with fetal pH measurements or with the duration of decelerative or compound fetal heart rate patterns; however, this is the first study to describe an association between the duration of both increased fetal heart rate variability and fetal heart rate overshoot with the severity of subsequent brain injury. Although no significant association was identified between fetal arterial pressure measured between umbilical cord occlusions and the grade of brain injury, the studies performed in this thesis are the first to show a strong correlation between the duration of specific arterial pressure responses during cord occlusions and the grade of brain injury, accounting for approximately 90% of the variability seen in the severity of injury. The mechanism responsible for the improved ability of lactate measurement to predict fetal brain injury is unknown. It may be because fetal lactate levels are a more stable marker of anaerobic metabolism of glucose than fetal pH levels, which are influenced by both increasing levels of carbon dioxide and anaerobic metabolism of amino-acids and fatty acids. In addition fetal pH levels can be rapidly normalised through placental exchange of carbon dioxide whereas fetal lactate levels are slow to normalise across the placenta as they rely on facilitated diffusion.
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Peterson, Alexander. "The Fecal Incontinence Quality of Life Scale (FIQL) : improving outcomes measurement." Thesis, University of British Columbia, 2017. http://hdl.handle.net/2429/61085.
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The Fecal Incontinence Quality of Life scale (FIQL) is a patient reported outcome measure (PROM) that is used to measure the effect that fecal incontinence has on quality of life, and has previously demonstrated high reliability and validity. It measures four domains of quality of life: lifestyle, coping/behavior, depression/self-perception, and embarrassment. Despite its wide use, previous studies have not applied rigorous modern methods to evaluate the FIQL's psychometric properties at the item and test level.
This thesis used a cohort of prospectively recruited patients from an elective surgical registry and applied methods from classical test theory (CTT), exploratory factor analysis (EFA), item response theory (IRT), and differential item and test functioning (DIF) to identify strengths and weaknesses in the FIQL. Specifically, this thesis aims to 1) confirm the reliability of the instrument, 2) describe the domains of quality of life measured by the instrument, 3) identify high and low quality items, and 4) determine whether one's score on the FIQL is influenced by gender or surgical procedure.
Out of 317 completed questionnaires from 880 total eligible patients, 236 were included for analysis. Reliability for all four domains was high as measured by Cronbach's α. Exploratory factor analysis failed to identify the four domains the FIQL claims to measure. Individual items demonstrated high discrimination but most had low difficulty. Items 2c, 2l, 3a, and 3h failed to demonstrate good separation between response categories. Five item pairs demonstrated local item dependence, most from question 3. Only item 2g demonstrated differential item functioning, based on gender. Differential test functioning was minimal.
The FIQL demonstrated a high degree of reliability, and the lifestyle domain can be used as is or with minor improvements. The FIQL can be improved by making response options consistent, distributing items from different domains evenly throughout the instrument, adding items with higher difficulty and better response separation, and removing items 2c, 2l, 3a, and 3h. Further research is needed before the FIQL can be used confidently as a stand-alone measure of fecal incontinence-related quality of life.Medicine, Faculty of
Population and Public Health (SPPH), School of
Graduate
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Yin, Kai-Ming. "Stereology and automated measurement of the human brain." Thesis, University of Edinburgh, 2018. http://hdl.handle.net/1842/31286.
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Stereology supplies image sampling rules to estimate geometric quantities such as volume, surface area, feature length and number. The method is well suited to non-invasive image acquisition methods such as Magnetic Resonance Imaging (MRI). Meanwhile, in Magnetic Resonance (MR) images analysis area, automated software packages have been continuously developed and become well-established tools especially in human brainMR images processing. The aims of the thesis are (1) to combine proper rules to sample MR images with automated or semi-automated data acquisition methods, in order to implement four different design unbiased stereological volume estimators in the study of the human brain, and (2) to compare volume estimates with those obtained from automated software packages.
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Wahlstrom, Meghan. "Drinking Water in the Developing World: Sources of Fecal Contamination in Pitcher Pump Systems and Measurement Alternatives." Scholar Commons, 2014. https://scholarcommons.usf.edu/etd/5146.
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It has been reported that globally we have achieved Millennium Development Goal (MDG) Target 7C, to halve the proportion of the population without access to safe drinking water; however, there is a major flaw with this statement. While Target 7C calls for access to `safe' drinking water, what is actually being measured and reported is access to an `improved' water source. The World Health Organization (WHO) maintains that they must use this proxy measure because the methods for water quality testing are too expensive and logistically complicated, but by doing so, they may be over reporting safe water coverage.
This was shown to be true in Tamatave, Madagascar, where thermotolerant coliforms were detected in water from a type of `improved' source, the Pitcher Pump system. This research looked at several parameters - Pitcher Pump system depth, sampling neighborhood, requirement of pump priming, frequency that the system was repaired, distance from on-site sanitation, and number of users - to see if they were influencing water quality. Of all the parameters tested, only priming was found to be significantly associated with the levels of thermotolerant coliforms detected (Fisher exact test p = 0.03). Using a Mann-Whitney U test, it was shown that the median thermotolerant coliform concentration was significantly higher in primed wells (41.3 cfu/100 ml) than unprimed wells (3.5) (p = 0.01 cfu/100 ml).
A pilot study was conducted to look at only the effect of depth and to determine if a depth could be identified that could provide safe drinking water. The result of the pilot study showed that, while thermotolerant coliform concentration did decrease with increasing depth, even at the deepest well of 9.4 m, levels were still above 100 cfu/100 ml.
Additional research was conducted to investigate the performance and cost of three test kits for both total coliform and Escherichia coli quantification for water quality analysis in developing countries. IDEXX Colilert Quanti-trays[reg] (Colilert), Micrology Laboratories Coliscan[reg] Membrane Filtration tests (Coliscan MF) and a modified method for 3-M PetrifilmTM Coliform/E. coli plates (modified 3-M) were compared with standard membrane filtration (standard MF) methods under a range of incubation temperature conditions (22.0, 35.0 and 44.5[deg]C). Each test method was also performed by inexperienced volunteers, with the results compared to those of an experienced technician. At non-standard temperatures, Coliscan MF proved to be the most accurate when compared to standard methods, with a significant difference with only total coliforms at 44.5[deg]C. Modified 3-M had the poorest correlation with standard MF over the range of temperatures tested, with significant differences noted for all the temperatures except for E. coli at 44.5[deg]C. Inexperienced university volunteers found Colilert easiest to use, but Coliscan MF produced E. coli results that were most similar to the experts. Coliscan MF was found to have the overall best performance and lowest cost in this study; however, it did produce high numbers of false positive results.
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Vítek, Milan. "Kardiotokograf - sledování kontrakcí." Master's thesis, Vysoké učení technické v Brně. Fakulta elektrotechniky a komunikačních technologií, 2015. http://www.nusl.cz/ntk/nusl-221358.
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Purpose of this thesis is to study the principle of operation of cardiotocography in monitoring fetal life, further defining the main requirements for this equipment and defining the parameters of monitored biosignals. These findings are supported by the literature. Based on the gained knowledge, the system design of cardiotocography is made with focus on reading contractions. Main parameters of the function blocks are defined. Circuit solution for sensing contractions is suggested, including the design of the sensor. Designed circuits are verified on a prototype.
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Stenberg, Maria. "Testverktyg för prestandamätningar av feta klienter : - En fallstudie med fokus på identifiering av testverktyg och beskrivning av viktiga kriterier för dessa." Thesis, Högskolan Dalarna, Informatik, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:du-25610.
Full textAbstract:
Denna studie syftar till att beskriva prestandatest av feta klienter, ibland också kallade skrivbordsapplikationer. Studien syftar även till att kartlägga testverktyg som kan användas för att utföra prestandatest av feta klienter och att identifiera vilka egenskaper som anses vara viktiga kriterier för dessa testverktyg. Undersökningen är skapad som en fallstudie som undersökningsstrategi där fallets utgångspunkt är Trafikverkets behov men undersökning och dess resultat kan även appliceras på andra verksamheter där testarbete utförs. Både kvalitativ och kvantitativ datainsamling användes i undersökningen genom intervjuer och dokumentstudier samt enkätformulär. Då insamlat data i undersökningen är av både kvalitativ och kvantitativ form så användes också en blandning av en kvalitativ tematisk analys och kvantitativ dataanalys. En del av analysen är en utvärdering av ett testverktygsurval mot sammanställda kriterier, en kriteriebaserad utvärderingsmetod. Tillvägagångssättet för val och utvärdering av testverktyg som tillämpats genom studien är baserat på tidigare befintliga teorier som funnits genom litteraturstudier. Litteraturstudierna har även stått till grund för att definiera undersökningens centrala begrepp och bidrar till resultat genom en jämförelse med insamlat data. Resultatet från undersökningen bidrar med ett beslutsunderlag för verksamheter som står inför ett val av testverktyg för prestandatest av feta klienter och en utvärdering av dessa innan licenser införskaffas. Undersökningen bidrar även med en karakterisering av prestandatest av feta klienter. I just detta fall var de mest passande testverktygen för syftet HP LoadRunner samt två testverktyg från eggPlant i kombination (eggPlant Functional och eggPlant Performance).The aim of this study is to describe performance testing on thick clients, sometimes also referred to as desktop applications. Another aim with this study is to map out a selection of testing tools that can be used for performance testing of thick clients and to identify what qualities that is considered to be important criteria for these testing tools. The study is based on the research strategy called case study where the case is grounded the needs from Trafikverket but the results from this study could be applied on other business organizations that works with testing. Both qualitative and quantitative data collecting methods where used in this study, in the form och interviews, document studies and questionnaires. Since the collected data in the study where in both qualitative and quantitative form the use of a mix between a qualitative thematical data analysis and a quantitative data analysis had to be done. A part of the analysis was an evaluation on a selection of testing tools towards a compiled list of criteria, as an evaluation method based on criteria. The course of action for choosing and evaluation a testing tool that has been applied throughout the study is based on preexisting theories that has been found through reviews of literature. The reviews of literature have also been the ground for defining the central concepts of the study and contributes to the result by comparing what’s been found in literature to the collected data. The result of the study contributes with a basis for decision for companies and organizations that is in the process of getting a testing tool for performance testing thick clients och how to evaluate these before obtaining the testing tool licenses. The study also contributes with a characterization of performance testing thick clients. In this particular case, the most suitable testing tools came to be HP LoadRunner and also two testing tools from eggPlant combined (eggPlant Functional and eggPlant Performance).
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Pai, Shih-Han, and 白詩涵. "Using artificial neural network model with clinical ultrasound measurements for fetal weight prediction." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/41522739977019074640.
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Wang, Shyh-Roei, and 王世蕊. "3-D Image Display and Measurement for Fetal Ultrasound." Thesis, 1998. http://ndltd.ncl.edu.tw/handle/65380163887008902279.
Full textAbstract:
碩士國立成功大學
資訊工程學系
86
The techniques using ultrasound as a diagnosis tool have been highly developed with rapid advances in technology in recent years. Due to the properties of convenience and non-invasion, ultrasound has become an essential tool for diagnosis of fetal abnormality during women pregnancy in obstetrics. It surely helps the physicians and patient''s family to make a proper decision before the birth of the baby. Therefore, the health insurance covers the expenses of these examinations. Conventionally, the judgment of whether the fetus is abnormal is made according to the two-dimensional ultrasonography. However, in spite of a significant amount of speckle noises, the lack of three-dimensional information may affect the accuracy of the prognosis. As the increasing need in the efficacy and efficiency of fetal diagnosis, it is highly demanding by the physicians for developing of a handy system to reconstruct the three-dimensional fetal ultrasonography, and also, to analyze , to display, aIn this thesis, we developed a prototype system for 3-D sonographic analysis and display in obstetrics under Microsoft windows environment. The functions of this system include noise removal, sequential image display, Maximum Intensity Projection (MIP), surface rendering, and fetal measurement. It can render the clear boundary of fetus, and measure the relevant parameters of fetus semi-automatically.In brief, the proposed computer system has been found a good assistance to the physicians in fetal diagnosis . It is also helpful to developing the technology of manufacturing medical devices and instrument in our country.
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Huang, Hsiao-Han, and 黃筱涵. "Measurement of Fetal Craniofacial Structure Using Model-based Segmentation from 3D Ultrasound Images." Thesis, 2009. http://ndltd.ncl.edu.tw/handle/75907055763926886081.
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碩士國立成功大學
醫學資訊研究所
97
In evaluation of the fetal growth in uterus, ultrasound is the most convenient and powerful tool in clinic due to its real time, low cost, easy to use and non-invasive nature. The doctors diagnose many anomaly syndromes of fetuses according to the measurement of fetal craniofacial structure. Since the ultrasound images have the disadvantages of low signal-to-noise ratio (SNR) and ambiguous anatomical structure, the human error and high variance may happen when the doctors measure the landmarks. However, it is also difficult to develop the automatic measurement system for fetal craniofacial structure. In this thesis, we propose a model-based segmentation approach to achieve automatic fetal craniofacial structure segmentation from 3D ultrasound images to assist the physician in measuring the eight meaningful craniofacial structure landmarks in clinics. In the proposed segmentation method, we construct a template model which contains the geometric shape information of fetal craniofacial structure and ask an expert to define landmarks from a fetal phantom. Then, the template model is modified to the 3D ultrasound images by using a framework of model deformation. In the segmentation process, we propose a feature-based registration method to initialize template model position successfully and we design an energy function which combines the shape constraint of the template model and image properties to achieve 3D deformation of template model. We overcome the above-mentioned drawbacks of ultrasound images and successfully segment the fetal craniofacial structure. In the experiments, we achieve good consistency by comparing the automatic measurements with the manual ones.
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Chen, Tzong-Rong, and 陳張宗榮. "Complexity Measurement of Fetal Cortical Surfaces from Magnetic Resonance Images using Fractal Dimension Analysis." Thesis, 2010. http://ndltd.ncl.edu.tw/handle/16783238617586647807.
Full textAbstract:
博士國立中央大學
電機工程研究所
98
Although fractal dimension (FD) analyses of adult human brain complexity have been performed for several years; the use of FD analysis for complexity measurement of the developmental fetal cortical surface has not been investigated. This work aims to measure complexity of the developmental fetal cortical surface from magnetic resonant images (MRI) using the concept of FD analysis. To quantify the FD that clarifies the complexity of fetal cortical surface, four methods of FD analysis were presented and extended from 2D to 3D. The presented 3D methods of FD analysis were then adopted to estimate the FD for complexity of developmental fetal cortical surface of 32 normal brains and 6 testing brains at a gestational age (GA) of 27–37 weeks. The results for normal brains reveal that the increase in complexity of cortical surface is correlated with the gestational age of the fetus. The FD results of the twins are lower than that of normal cases, showing a delay of 2-3 weeks may occur in the twins. Observation of cortical dysplasia has low FD, indicating that cortical dysplasia may mean less cortical complexity. These results are in good agreement with fetal brain development and demonstrate that the proposed methods of FD analysis are an effective means for complexity measurement of fetal cortical surface.
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Brennan, Sonja. "The renal parenchyma – evaluation of a novel ultrasound measurement to assess fetal renal development." Thesis, 2020. https://researchonline.jcu.edu.au/68404/1/JCU_68404_Brennan_2020_thesis.pdf.
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Sonja Brennan used a novel ultrasound measurement of the renal parenchyma to evaluate fetal kidney growth. Normal ranges of fetal renal parenchymal thickness were developed to aid diagnosis of kidney disease and help predict future kidney function. The effects of abnormal fetal growth and diabetes on the developing kidneys was explored.
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Mojdehbakhsh, Rachel. "Serial fecal ASCA measurements in the evaluation of children with Crohn's disease." Thesis, 2015. https://hdl.handle.net/2144/16025.
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BACKGROUND: Pediatric patients with Inflammatory Bowel Disease (IBD) undergo costly and invasive investigations to diagnose and treat their chronic disease. To that end, it is important for researchers and physicians to continue to work to find novel tools to improve diagnosis and treatment processes. One of the main challenges is differentiating between the two main forms of IBD, Crohn disease (CD) and ulcerative colitis (UC). Physicians currently rely on a combination of endoscopic evaluations, mucosal biopsies, radiology studies, and biochemical testing to assess for the presence and extent of inflammation in the gastrointestinal (GI) tract. Serologic biomarkers can be useful to some extent, but changes in these markers do not typically reflect disease specific to the GI tract, or the state of inflammation related to a patient's IBD. In contrast, fecal biomarkers have the unique potential to provide specific information about inflammation in the GI tract. While serum antibody levels have been well studied for use in the diagnosis of patients with IBD, fecal antibody levels and anti-saccharomyces cerevisiae antibody (ASCA) in particular, have not been extensively evaluated. In this study, we will assess the dynamic range of fecal ASCA levels in acute and convalescent fecal samples collected from children and adolescents with CD and UC.
METHODS: We recruited pediatric patients from inpatient and ambulatory settings at the Gastroenterology Program at Boston Children's Hospital. Patients had a diagnosis of either CD or UC. We collected baseline stool samples during a point of active disease, and follow-up samples three to six months later during a point of inactive disease. Samples were analyzed for fecal ASCA as well as lactoferrin (FLA), another marker of inflammation that can be measured in the stool.
RESULTS: In patients with CD, fecal ASCA levels were significantly higher during active disease than during inactive disease. Additionally, fecal ASCA levels were higher in patients with CD than in patients with UC, regardless of disease activity. When compared to FLA, ASCA was shown to differentiate between CD and UC, with greater changes in the level of fecal ASCA (active - inactive) correlating with a diagnosis of CD. In patients with CD, FLA levels were significantly higher in the context of active disease than in inactive disease. However, FLA did not differentiate between CD and UC.
CONCLUSIONS: Our results suggest that fecal ASCA may be a new marker of inflammation in the GI tract. Unlike FLA, changes in fecal ASCA levels appear more dynamic in patients with CD. Future studies are required to further demonstrate both how changes in fecal ASCA may help physicians distinguish between different forms of IBD as well as how measurement of fecal ASCA may help assess disease activity and response to therapy in patients with CD.
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Hui-HsuanShih and 石慧萱. "Model-based Segmentation for Measurement of Head and Trunk Structures from 3D Fetal Ultrasound Images." Thesis, 2012. http://ndltd.ncl.edu.tw/handle/47059843866671581979.
Full textAbstract:
碩士國立成功大學
資訊工程學系碩博士班
100
Ultrasound image (US) has been widely used for the diagnosis in clinical of gynecology. As the US image is inexpensive, easy to use, non-invasive real time and without radiation hazards, it has become the most popular imaging modality in recent years. More specifically, doctors can observe the real-time posture of fetus and evaluate the fetal growth in the uterus by using 3D ultrasound images during prenatal care. However, due to the difficulties in treating highly-noise US images, the fully automatic image segmentation tool for the fetal ultrasound is still lack. Different to previous studies in US image segmentations for the second or the third trimester, we focus on the analysis of fetus image of the first trimester. In addition to the speckle noise and fuzzy boundaries, there are other important artifacts in the first-trimester fetal US image; such as the blurred image boundaries due to poor fetal development, or the weak edges due to the attachment of endometrium to fetus. Thus, we proposed a model-based segmentation method to automatically segment the fetal head and trunk structures, which assist doctors to measure the fetal parameters for clinical evaluations. First, we construct the statistical shape models of both fetal head and trunk by using the expert-adjusted mesh shapes from training volume images. Second, by using some anatomical feature points in target volume image, we define the local coordinate system to initially align the shape model and image data. Third, we apply the Active Shape Model (ASM) mechanism to adjust the shape model with a limited number of shape components. Thus, the global shape of the deformed model can mostly fit to the fetal boundaries. However, some local shape deviations still exist between the deformed shape and the actual image boundaries. Consequently, we design a 3D freeform deformation by using snake algorithm to improve the fitness between model and image. The experimental results show that the proposed method overcomes the difficulties and achieves good consistency between the automatic and manual measurements.
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Moxley, Erika Michelle. "Serial fecal biomarker measurements predict response to biologic therapy in children with IBD." Thesis, 2019. https://hdl.handle.net/2144/36580.
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INTRODUCTION: The techniques currently in practice to diagnose and assess interval disease activity in patients with inflammatory bowel disease (IBD) are costly and invasive. Physicians typically rely on information derived from a combination of endoscopic, radiologic, and histologic studies to diagnose and determine the extent and severity of the two most common forms of IBD, Crohn disease (CD) and ulcerative colitis (UC). The development of noninvasive methods of assessing response to therapy is of increasing importance to pediatric healthcare providers. Previous studies have demonstrated that serum and fecal biomarkers are reliable measures of inflammation in the gastrointestinal tract. However, existing biomarkers are non-specific and their levels can be elevated in the context of either acute and chronic inflammation (IBD) or infection. As such, further studies are required to develop newer and novel biomarkers that have greater specificity for use in the diagnosis and interval assessment in children and adults with IBD.
OBJECTIVES: The goal of this study is to further assess the relationship between biomarkers in the stool and serum of patients with IBD that are being treated with the anti-TNF therapy, infliximab (Remicade). To accomplish this, we will assess the changes in serum and fecal biomarker levels over the course of treatment and correlate the changes in fecal and serum biomarker levels with clinical, biochemical, and endoscopic outcome variables.
METHODS: We conducted a prospective longitudinal cohort study in pediatric patients with IBD receiving long-term immunosuppressive therapy with Remicade. Pediatric patients diagnosed with either CD or UC who receive Remicade at Boston Children’s Hospital were recruited. Patients were drawn from subsets of patients that were either naïve to Remicade, had received Remicade for less than 6 months, or had received Remicade for more than one year at the time of enrollment. We collected longitudinal data over the course of their first 6 consecutive infusions following enrollment, including blood and stool samples, disease activity indexes, as well as a patient-reported outcome measure (IMPACT-III Questionnaire) at each infusion session.
RESULTS: A total of 33 patients with IBD who fit our eligibility criteria and provided informed consent were enrolled to date. Of these, 20 had a CD diagnosis and 13 had a UC diagnosis. We collected baseline serum, fecal, and IMPACT-III score data and followed enrolled patients over the course of subsequent infusions. Mean baseline fecal ASCA levels from 8 CD and 6 UC patients were 0.08±0.021 OD and 0.02±0.0015 OD, respectively. At baseline, serum lactoferrin (p<0.10), calprotectin (p<0.10), ESR (p<0.05), and CRP (p<0.10) were significantly higher among CD patients.
CONCLUSION: Our data demonstrate the potential for serum and fecal biomarkers to evaluate therapeutic response to Remicade. Completion of study enrollment and data collection will be necessary to determine if individual or combinations of fecal and serum biomarkers yield the most robust measures for use in the diagnosis and interval assessment of children and adults with IBD.
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Dick, Linda K. "Fecal Bacteroidetes host distributions and environmental source tracking." Thesis, 2004. http://hdl.handle.net/1957/29752.
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Contamination of recreational and shellfish waters with fecal pollution is a
major water quality issue with associated economic impacts and human health risks.
Reliable fecal source identification and rapid, quantitative analyses are essential
components of risk assessment. Enteric bacteria that are endemic to specific hosts
have a potential role as public health indicators of fecal pollution. Building on
previous work to discriminate ruminant and human fecal contamination, we cloned
class Bacteroidetes 16S rRNA genes from pig, elk, dog, cat, and seagull fecal DNAs.
Unique restriction patterns were identified among clones from each of the host species
using Terminal Restriction Fragment Length Polymorphisms (T-RFLP). Clones
exhibiting unique patterns were sequenced and analyzed phylogenetically, along with
human, horse, and cattle sequences recovered from previous work. The analysis
revealed both endemic and cosmopolitan (global) host distributions. The sequence
data were used to identify host-specific genetic markers for pig and horse feces, and
to design PCR primers that identify these sources of fecal pollution in water. There
was a high degree of sequence overlap among the fecal Bacteroidetes of wild and
domestic ruminants, and among human, domestic pet, and seagull Bacteroidetes. We
compared fecal Bacteroidetes rRNA genes from these hosts using subtractive
hybridization, a method that identifies differences between closely related genomes or
gene sequences. A Bacteroidetes rDNA marker that distinguishes elk and cow feces
was identified, as well as a host-specific marker for dog fecal Bacteroidetes. The four
newly designed PCR primers were tested for specificity and sensitivity, and the dog
primer was successfully used, along with the human and ruminant-specific primers, in
a collaborative study comparing fecal source tracking methods. We also developed a
real time Taq nuclease assay for quantification of fecal Bacteroidetes 16S rDNA, and
compared it with an EPA-approved enumeration method for the current standard
public health indicator, Escherichia coli, in serial dilutions of sewage primary influent.
There was a strong, positive correlation between the methods, and the Taq nuclease
assay was sensitive and much more rapid than the E. coli assay. PCR source
identification and enumeration of fecal Bacteroidetes 16S rDNA show promise for
application in a health risk-based analysis of fecal pollution.Graduation date: 2005
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Mandehr, Kellen Franklyn. "The utility of fecal lactoferrin measurements in predicting disease activity of hospitalized patients with ulcerative colitis." Thesis, 2014. https://hdl.handle.net/2144/14313.
Full textAbstract:
BACKGROUND: Early identification of pediatric patients with Inflammatory Bowel Disease (IBD), including ulcerative colitis and Crohn disease, is important to help clinicians design optimal treatment regimens. Existing endoscopic techniques are effective in identifying disease activity. However, these methods are invasive, expensive, and less amenable to serial measurement. Recent studies have identified potential serologic and fecal biomarkers that may have the potential to provide clinicians with a more objective evaluation of disease activity. In the case of ulcerative colitis (UC), in which disease is confined to the large intestine, the information provided by fecal biomarkers is likely to be more specific than that provided by serologic biomarkers. Fecal lactoferrin (FLA) is one such biomarker that has shown to be useful not only in identifying levels of colonic inflammation, but also for use as a predictor of disease relapse and treatment efficacy. Measurement of fecal lactoferrin, in conjunction with information provided by other diagnostic modalities could expedite patient assessment and treatment. Additionally, it has been suggested that fecal lactoferrin levels may also provide prognostic information about response to treatment and disease outcome in pediatric patients with UC. The goal of this study is to explore the relationship between changes in FLA levels and response to medical therapy in hospitalized pediatric patients with UC.
METHODS: Serial stool samples were collected daily from 10 patients admitted for management of severe active UC. Of these 10 patients, 3 responded favorably to standard treatment with intravenous corticosteroid therapy and were discharged to complete a course of oral steroids. 7 were unresponsive to steroid therapy and went on to require rescue (more intensive) medical therapy. Changes in FLA were correlated with steroid response and medical disposition at the time of discharge.
RESULTS: A t-test was performed to determine the significance of the differences in percent change in FLA levels between patients discharged on steroids and patients discharged on rescue therapy. Patients discharged on steroids demonstrated a net decrease in FLA levels over the course of the first three days of steroid treatment while patients ultimately requiring rescue medical therapy demonstrated a net increase in FLA levels (mean values = -64.4% and +203.8%, respectively). A difference was found between the averages; however, this value did not reach statistical significance when analyzed with a t-test (p = 0.18).
CONCLUSIONS: This study suggests that quantitative FLA levels may prove useful in predicting clinical course and discharge outcome in pediatric patients with ulcerative colitis. Future research in this field should seek larger sample sizes, increased longitudinal sample collection, and the potential for a composite assessment that will yield additional objective measures of disease activity.
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You, Kun Ming, and 游坤明. "The measurement of fetal heart rate using multi-channel textile electrodes,digital signal processor and independent component analysis." Thesis, 2015. http://ndltd.ncl.edu.tw/handle/37631377783536889039.
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Kapke, Cynthia A. "Identification and measurement of estradiol and progesterone metabolities in white-tailed deer feces fecal assay validation techniques for a new species /." 1996. http://catalog.hathitrust.org/api/volumes/oclc/36774161.html.
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Thesis (M.S.)--University of Wisconsin--Madison, 1996.Typescript. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 34-38).
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Burke, Kathrin. "Development and Analytical Validation of an Enzyme-linked Immunosorbent Assay (ELISA) for the Measurement of Feline Alpha1-proteinase Inhibitor (fa1-PI) in Serum and Feces and the Evaluation of Fecal fa1-PI Concentrations in Cats with Idiopathic Inflammatory Bowel Disease or Gastrointestinal Neoplasia." Thesis, 2012. http://hdl.handle.net/1969.1/ETD-TAMU-2012-08-11693.
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Alpha1-proteinase inhibitor (alpha1-PI) has been shown to be a useful marker of gastrointestinal protein loss in some species. The objectives of this study were, first, to develop and analytically validate an ELISA for the measurement of alpha1-PI in feces and serum from cats, and, second, to evaluate fecal alpha1-PI concentrations in healthy cats and cats with chronic gastrointestinal disease. The lower detection limits of the ELISA were 0.02 g/L for serum and 0.04 microgram/gram for feces. The observed-to-expected (O/E) ratios for serial dilutions of serum and fecal samples ranged from 100.0 to 129.7% (mean +/- SD: 112.2 +/- 9.9%) and 103.5 to 141.6% (115.6 +/- 12.8%), respectively. The O/E ratios for samples spiked with seven known concentrations of alpha1-PI ranged from 82.3 to 107.8% (94.7 +/- 7.6%) for serum and 78.5 to 148.7% (96.8 +/- 18.2%) for feces. The coefficients of variation for intra-assay and inter-assay variability were <7.9% and <12.1% for serum, and 5.3%, 11.8%, and 14.2% and 7.7%, 10.2%, and 20.4% for feces, respectively. Reference intervals were 0.6 to 1.4 g/L for serum and up to 1.6 microgram/g for feces. We conclude that this ELISA is sufficiently linear, accurate, precise, and reproducible.
For the clinical evaluation, twenty cats with clinical signs of chronic gastrointestinal disease and 20 healthy control cats were enrolled. The diseased cats were grouped into two groups: mild to moderate idiopathic inflammatory bowel disease (IBD) (Group A; n=8) and severe IBD or neoplastic disease (Group B; n=12), based on histopathology results of endoscopic biopsies. Fecal alpha1-PI concentrations and serum concentrations of total protein, albumin, globulin, cobalamin, folate, pancreatic lipase immunoreactivity, and trypsin-like immunoreactivity were determined. Nineteen of the 20 diseased cats had increased fecal alpha1-PI concentrations, ranging from 1.9 to 233.6 microgram/g (normal range: <= 1.6 microgram/g). Fecal alpha1-PI concentrations were statistically significantly different between healthy cats and cats of Group A (median: 3.9 microgram/g, range: 1.3 to 9.2 microgram/g, P<0.001) or cats of Group B (median: 20.6 microgram/g, 4.3 to 233.6 microgram/g; P<0.001), and also between cats of Groups A and B (P<0.01). Hypoalbuminemia, hypoproteinemia, and hypocobalaminemia were detected in 88%, 83%, and 56% of the diseased cats, respectively. Our study suggests that increased fecal alpha1-PI concentrations in association with hypoalbuminemia may be a common finding in cats with IBD or GI neoplasia. Furthermore, alpha1-PI concentrations appear to be higher in cats with severe IBD or confirmed GI neoplasia when compared to cats with mild to moderate IBD.