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Gabos, Kelly A. "The Perils of Singleton v. Norris: Ethics and beyond." American Journal of Law & Medicine 32, no. 1 (2006): 117–32. http://dx.doi.org/10.1177/009885880603200104.
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Nearly 20 years ago, in Ford v. Wainright, the Supreme Court held that it is unconstitutional to execute a legally incompetent inmate. Due to advancements in pharmacological therapy and the ability to make inmates legally competent through medication, various courts since Ford have determined the mechanisms by which competency through medication can be accomplished. Those decisions led to cases involving the legality of forcibly medicating inmates to make them competent to stand trial and to be executed. One recent case involving execution competency is the Eighth Circuit’s decision in Singleton v. Norris.In Singleton, the Eighth Circuit held that execution as an ultimate consequence of administering psychotropic medication to legally incompetent inmates cannot be considered in the determination of whether it was proper to forcibly medicate that inmate. The Eighth Circuit’s decision permitted the execution of Charles Singleton, a schizophrenic who fought against involuntary administration of the medications that rendered him competent to be executed.
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Isariyapalakul, Supachoke, Witsarut Pho-on, and Varanoot Khemmani. "The true twin classes-based investigation for connected local dimensions of connected graphs." AIMS Mathematics 9, no. 4 (2024): 9435–46. http://dx.doi.org/10.3934/math.2024460.
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<abstract><p>Let $ G $ be a connected graph of order $ n $. The representation of a vertex $ v $ of $ G $ with respect to an ordered set $ W = \{w_1, w_2, ..., w_k\} $ is the $ k $-vector $ r(v|W) = (d(v, w_1), d(v, w_2), ..., d(v, w_k)) $, where $ d(v, w_i) $ represents the distance between vertices $ v $ and $ w_i $ for $ 1\leq i\leq k $. An ordered set $ W $ is called a connected local resolving set of $ G $ if distinct adjacent vertices have distinct representations with respect to $ W $, and the subgraph $ \langle W\rangle $ induced by $ W $ is connected. A connected local resolving set of $ G $ of minimum cardinality is a connected local basis of $ G $, and this cardinality is the connected local dimension $ \mathop{\text{cld}}(G) $ of $ G $. Two vertices $ u $ and $ v $ of $ G $ are true twins if $ N[u] = N[v] $. In this paper, we establish a fundamental property of a connected local basis of a connected graph $ G $. We analyze the connected local dimension of a connected graph without a singleton true twin class and explore cases involving singleton true twin classes. Our investigation reveals that a graph of order $ n $ contains at most two non-singleton true twin classes when $ \mathop{\text{cld}}(G) = n-2 $. Essentially, our work contributes to the characterization of graphs with a connected local dimension of $ n-2 $.</p></abstract>
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Haynes, Teresa W., Jason T. Hedetniemi, Stephen T. Hedetniemi, Alice A. McRae, and Raghuveer Mohan. "Self-coalition graphs." Opuscula Mathematica 43, no. 2 (2023): 173–83. http://dx.doi.org/10.7494/opmath.2023.43.2.173.
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A coalition in a graph \(G = (V, E)\) consists of two disjoint sets \(V_1\) and \(V_2\) of vertices, such that neither \(V_1\) nor \(V_2\) is a dominating set, but the union \(V_1 \cup V_2\) is a dominating set of \(G\). A coalition partition in a graph \(G\) of order \(n = |V|\) is a vertex partition \(\pi = \{V_1, V_2, \ldots, V_k\}\) such that every set \(V_i\) either is a dominating set consisting of a single vertex of degree \(n-1\), or is not a dominating set but forms a coalition with another set \(V_j\) which is not a dominating set. Associated with every coalition partition \(\pi\) of a graph \(G\) is a graph called the coalition graph of \(G\) with respect to \(\pi\), denoted \(CG(G,\pi)\), the vertices of which correspond one-to-one with the sets \(V_1, V_2, \ldots, V_k\) of \(\pi\) and two vertices are adjacent in \(CG(G,\pi)\) if and only if their corresponding sets in \(\pi\) form a coalition. The singleton partition \(\pi_1\) of the vertex set of \(G\) is a partition of order \(|V|\), that is, each vertex of \(G\) is in a singleton set of the partition. A graph \(G\) is called a self-coalition graph if \(G\) is isomorphic to its coalition graph \(CG(G,\pi_1)\), where \(\pi_1\) is the singleton partition of \(G\). In this paper, we characterize self-coalition graphs.
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KENDZIORRA, ANDREAS, and STEFAN E. SCHMIDT. "NETWORK CODING WITH MODULAR LATTICES." Journal of Algebra and Its Applications 10, no. 06 (2011): 1319–42. http://dx.doi.org/10.1142/s0219498811005208.
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Kötter and Kschischang presented in 2008 a new model for error correcting codes in network coding. The alphabet in this model is the subspace lattice of a given vector space, a code is a subset of this lattice and the used metric on this alphabet is the map d : (U, V) ↦ dim (U+V)- dim (U∩V). In this paper we generalize this model to arbitrary modular lattices, i.e. we consider codes, which are subsets of modular lattices. The used metric in this general case is the map d : (u, v) ↦ h(u ∨ v) - h(u ∧ v), where h is the height function of the lattice. We apply this model to submodule lattices. Moreover, we show a method to compute the size of spheres in certain modular lattices and present a sphere packing bound, a sphere covering bound, and a Singleton bound for codes, which are subsets of modular lattices.
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NEVILS, B. "Cervical cerclage for treatment of symptomatic placenta previa in singleton gestation." Journal of the Society for Gynecologic Investigation 2, no. 2 (1995): 303. http://dx.doi.org/10.1016/1071-5576(95)94434-v.
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Sudev, N. K., K. P. Chithra, and K. A. Germina. "The sparing number of certain graph powers." Acta Universitatis Sapientiae, Mathematica 11, no. 1 (2019): 186–202. http://dx.doi.org/10.2478/ausm-2019-0015.
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Abstract Let ℕ0 be the set of all non-negative integers and 𝒫(ℕ0) be its power set. Then, an integer additive set-indexer (IASI) of a given graph G is an injective function f : V(G) → P(ℕ0) such that the induced function f+ : E(G) → 𝒫(ℕ0) defined by f+(uv) = f(u) + f(v) is also injective. An IASI f is said to be a weak IASI if |f+(uv)| = max(|f(u)|, |f(v)|) for all u, v ∈ V(G). A graph which admits a weak IASI may be called a weak IASI graph. The set-indexing number of an element of a graph G, a vertex or an edge, is the cardinality of its set-labels. The sparing number of a graph G is the minimum number of edges with singleton set-labels, required for a graph G to admit a weak IASI. In this paper, we study the admissibility of weak IASI by certain graph powers and their corresponding sparing numbers.
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Wallace, Jacqueline M., John S. Milne, and Raymond P. Aitken. "The effect of overnourishing singleton-bearing adult ewes on nutrient partitioning to the gravid uterus." British Journal of Nutrition 94, no. 4 (2005): 533–39. http://dx.doi.org/10.1079/bjn20041398.
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Overnourishing the singleton-bearing adolescent sheep throughout pregnancy promotes maternal tissue synthesis at the expense of the nutrient requirements of the gravid uterus. Consequently, the growth of the placenta is impaired and results in the premature delivery of low-birth-weight lambs relative to moderately fed adolescents of equivalent age. To establish if this phenomenon is unique to the growing animal, singleton pregnancies to a single sire were established by embryo transfer into primiparous adult ewes who had attained the normal mature body size for their genotype. Thereafter ewes were offered a maintenance or a high level of a complete diet throughout gestation. High maternal intakes resulted in elevated maternal insulin, no significant change in growth hormone or glucose, and attenuated progesterone and NEFA concentrations. Live weight gain during the first 93 d of gestation was 48 and 244 g/d, and adiposity score at term was 2·4 and 3·7 in the maintenance and high groups, respectively (P<0·001). In spite of achieving levels of adiposity similar to overnourished adolescents, placental (477 (sem 30) v. 518 (sem 41) g) and fetal (5190 (sem 320) v. 5420 (sem 250) g) weights were equivalent in maintenance and high groups. Gestation length was shorter (P<0·01) and colostrum yield at parturition lower (P<0·05) in high v. maintenance dams. Thus, adult sheep appear to be relatively insensitive to the oversupply of nutrients during pregnancy and have the ability to meet the nutrient requirements for normal conceptus growth in spite of their increased adiposity.
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Forster, T. E. "Term models for weak set theories with a universal set." Journal of Symbolic Logic 52, no. 2 (1987): 374–87. http://dx.doi.org/10.2307/2274387.
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We shall be concerned here with weak axiomatic systems of set theory with a universal set. The language in which they are expressed is that of set theory—two primitive predicates, = and ϵ, and no function symbols (though some function symbols will be introduced by definitional abbreviation). All the theories will have stratified axioms only, and they will all have Ext (extensionality: (∀x)(∀y)(x = y· ↔ ·(∀z)(z ϵ x ↔ z ϵ y))). In fact, in addition to extensionality, they have only axioms saying that the universe is closed under certain set-theoretic operations, viz. all of the formand these will always include singleton, i.e., ι′x exists if x does (the iota notation for singleton, due to Russell and Whitehead, is used here to avoid confusion with {x: Φ}, set abstraction), and also x ∪ y, x ∩ y and − x (the complement of x). The system with these axioms is called NF2 in the literature (see [F]). The other axioms we consider will be those giving ⋃x, ⋂x, {y: y ⊆x} and {y: x ⊆ y}. We will frequently have occasion to bear in mind that 〈 V, ⊆ 〉 is a Boolean algebra in any theory extending NF2. There is no use of the axiom of choice at any point in this paper. Since the systems with which we will be concerned exhibit this feature of having, in addition to extensionality, only axioms stating that V is closed under certain operations, we will be very interested in terms of the theories in question. A T-term, for T such a theory, is a thing (with no free variables) built up from V or ∧ by means of the T-operations, which are of course the operations that the axioms of T say the universe is closed under.
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Xu, Lihua, Dengfeng Li, Yigang Tong, et al. "A Novel Singleton Giant Phage Yong-XC31 Lytic to the Pyropia Pathogen Vibrio mediterranei." Applied Sciences 11, no. 4 (2021): 1602. http://dx.doi.org/10.3390/app11041602.
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Vibrio mediterranei 117-T6 is extensively pathogenic to several Pyropia species, leading to the death of conchocelis. In this study, the first V. mediterranei phage (named Vibrio phage Yong-XC31, abbreviated as Yong-XC31) was isolated. Yong-XC31 is a giant phage containing an icosahedral head about 113 nm in diameter and a contractible tail about 219 nm in length. The latent period of Yong-XC31 is 30 min, and burst size is 64,227. Adsorption rate of Yong-XC31 to V. mediterranei 117-T6 can reach 93.8% in 2 min. The phage genome consisted of a linear, double-stranded 290,532 bp DNA molecule with a G + C content of 45.87%. Bioinformatic analyses predicted 318 open reading frames (ORFs), 80 of which had no similarity to protein sequences in current (26 January 2021) public databases. Yong-XC31 shared the highest pair-wise average nucleotide identity (ANI) value of 58.65% (below the ≥95% boundary to define a species) and the highest nucleotide sequence similarity of 11.71% (below the >50% boundary to define a genus) with the closest related phage. In the proteomic tree based on genome-wide sequence similarities, Yong-XC31 and three unclassified giant phages clustered in a monophyletic clade independently between the family Drexlerviridae and Herelleviridae. Results demonstrated Yong-XC31 as a new evolutionary lineage of phage. We propose a new phage family in Caudovirales order. This study provides new insights and fundamental data for the study and application of giant phages.
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Kholmatov, Shokhrukh Yu, Ahmad Khalkhuzhaev, and Mardon Pardabaev. "Expansion of eigenvalues of the perturbed discrete bilaplacian." Monatshefte für Mathematik 197, no. 4 (2022): 607–33. http://dx.doi.org/10.1007/s00605-022-01678-1.
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AbstractWe consider the family $$\begin{aligned} {\widehat{{ H}}}_\mu := {\widehat{\varDelta }} {\widehat{\varDelta }} - \mu {\widehat{{ V}}},\qquad \mu \in {\mathbb {R}}, \end{aligned}$$ H ^ μ : = Δ ^ Δ ^ - μ V ^ , μ ∈ R , of discrete Schrödinger-type operators in d-dimensional lattice $${\mathbb {Z}}^d$$ Z d , where $${\widehat{\varDelta }}$$ Δ ^ is the discrete Laplacian and $${\widehat{{ V}}}$$ V ^ is of rank-one. We prove that there exist coupling constant thresholds $$\mu _o,\mu ^o\ge 0$$ μ o , μ o ≥ 0 such that for any $$\mu \in [-\mu ^o,\mu _o]$$ μ ∈ [ - μ o , μ o ] the discrete spectrum of $${\widehat{{ H}_\mu }}$$ H μ ^ is empty and for any $$\mu \in {\mathbb {R}}\setminus [-\mu ^o,\mu _o]$$ μ ∈ R \ [ - μ o , μ o ] the discrete spectrum of $${\widehat{{ H}_\mu }}$$ H μ ^ is a singleton $$\{e(\mu )\},$$ { e ( μ ) } , and $$e(\mu )<0$$ e ( μ ) < 0 for $$\mu >\mu _o$$ μ > μ o and $$e(\mu )>4d^2$$ e ( μ ) > 4 d 2 for $$\mu <-\mu ^o.$$ μ < - μ o . Moreover, we study the asymptotics of $$e(\mu )$$ e ( μ ) as $$\mu \searrow \mu _o$$ μ ↘ μ o and $$\mu \nearrow -\mu ^o$$ μ ↗ - μ o as well as $$\mu \rightarrow \pm \infty .$$ μ → ± ∞ . The asymptotics highly depends on d and $${\widehat{{ V}}}.$$ V ^ .
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Batty, G. David, Erik L. Mortensen, and Merete Osler. "Childhood IQ in relation to later psychiatric disorder." British Journal of Psychiatry 187, no. 2 (2005): 180–81. http://dx.doi.org/10.1192/bjp.187.2.180.
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SummaryStudies examining the relationship between early-life IQ and the risk of subsequent psychiatric disorder in adulthood are scarce. In the present investigation, the childhood IQ scores of 7022 singleton-born Danish males were linked to psychiatric hospital discharge records in adulthood. IQ scores were inversely related to the risk of total psychiatric illness, with the highest levels apparent in the lowest scoring IQ group (HRlowest quintile v. highest = 1.70, 95% Cl 1.34–2.14). Adjusting for paternal occupational social class and birth weight had only a small attenuating effect. Low childhood IQ may have an aetiological role in the development of adult total psychiatric disorder.
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Ewing, Korin K. "Establishing an Equal Playing Field for Criminal Defendants in the Aftermath of United States v. Singleton." Duke Law Journal 49, no. 5 (2000): 1371. http://dx.doi.org/10.2307/1373014.
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Hristova, Irena R., Joana I. Simeonova, Nadezdha H. Hinkova, and Slavcho T. Tomov. "Norms for Physical Growth of the Full-Term Babies Born from Singleton Pregnancy in Pleven." Journal of Biomedical and Clinical Research 12, no. 2 (2019): 117–23. http://dx.doi.org/10.2478/jbcr-2019-0017.
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Summary The aim of the study was to develop the norms for physical growth (birth weight-, birth height- and head circumference- for age) of the full-term babies born from singleton pregnancy in UMHAT „Dr. G. Stranski” – Pleven (total, by gender and gestational age at birth). A cross-sectional study was carried-out in 2017; 1092 live infants born from singleton pregnancy between 38 and 42 weeks were included in the study. We obtained information about three anthropometric measurements (birth weight-, birth height- and head circumference-for age). Data were processed by SPSS v.24.0. Norm group ranges (3, 5 and 7 groups) were developed for three indicators using percentile methods. Kruskal-Wallis test was used. The mean birth weight- and height-for age were higher for baby boys (P50, 3280 g and 50 cm) compared with baby girls (P50, 3150 g and 49 cm). Baby boys and girls weighed <2570 g at birth fell into the group ,,very slow growth” (P3). A ,,very fast growth” (P97) was found in baby boys weighed >4120 g at birth (vs. >3870 g for baby girls). Norm group ranges allow to identify the newborns with a higher risk and to focus efforts and health resources to them; it should be updated periodically.
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Bhattarai, Bharosha, Sagar Panthi, Gopal Kumar Yadav, et al. "Association of geographic distribution and birth weight with sociodemographic factors of the maternal and newborn child of hilly and mountain regions of eastern Nepal: a cross-sectional study." BMJ Paediatrics Open 6, no. 1 (2022): e001579. http://dx.doi.org/10.1136/bmjpo-2022-001579.
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ObjectivesTo determine the association of geographic distribution, and birth weight with sociodemographic factors of the maternal and newborn child of hilly region (lower altitude) and mountain region (high altitude) of eastern Nepal as well as the prevalence of low birth weight (LBW) and large for gestational age (LGA) among term singleton deliveries in eastern Nepal.MethodologyA cross-sectional study was conducted in the district-level hospitals of Dhankuta, Tehrathum, Solukhumbu and Taplejung districts of eastern Nepal of Province 1. Mothers with preterm or post-term delivery, multiple pregnancies, stillbirth/intrauterine fetal death and incomplete records were excluded from the study with only 1386 term pregnancies (37–42 weeks) delivered at the respective facilities between 17 July 2019 and 16 July 2020 were included. The appropriate data were entered in Microsoft Excel 2019 V.16.0 and statistical analysis was performed by using the statistical package for social sciences, IBM SPSS V.29.ResultsThe low maternal age, Dalit ethnic group, low gravidity, low parity, higher antenatal care (ANC) visits (≥4), incomplete deworming and dT vaccination status, breech deliveries and LBW newborns were significantly attributed to hilly region (lower altitude) (p value <0.05). Similarly, the hilly region, lower and/or no ANC visits and early term gestation had significant negative association with birth weight at the lower quantiles only. Meanwhile, the female newborn had significant and negative association with birth weight distribution at all seven quantiles. The prevalence of the LBW, average for gestational age and LGA newborn child among term singleton deliveries in Eastern Nepal is 6.6%, 85.8% and 7.6%, respectively.ConclusionsThe local organisations should focus on adequate antenatal care visits in mountain region and coverage of dT vaccine and deworming medications in hilly region. Appropriate measures and programmes should be initiated to bring down LBW in hilly region.
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Norman, R. J., J. W. McLoughlin, G. M. Borthwick, et al. "Inhibin and relaxin concentrations in early singleton, multiple, and failing pregnancy: Relationship to gonadotropin and steroid profiles." International Journal of Gynecology & Obstetrics 42, no. 3 (1993): 325. http://dx.doi.org/10.1016/0020-7292(93)90249-v.
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Zsiga, Elizabeth C. "ARTICULATORY TIMING IN A SECOND LANGUAGE." Studies in Second Language Acquisition 25, no. 3 (2003): 399–432. http://dx.doi.org/10.1017/s0272263103000160.
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This study compares patterns of consonant-to-consonant timing at word boundaries in English and Russian and investigates the roles of transfer and the emergence of linguistic universals in second language (L2) articulation. Native Russian speakers learning English and native English speakers learning Russian produced phrases in English and Russian contrasting VC#CV, VC#V, and V#CV sequences. The duration of all stop closures was measured as well as the percentage of consonant sequences in which the first consonant was audibly released. In their native language (L1), Russian speakers had a higher percentage of released final consonants than did English speakers in their L1 as well as a higher ratio of sequence-to-singleton duration. Examination of the timing patterns across different clusters revealed different articulatory strategies for the two languages. The native Russian pattern transferred to L2 English, but the native English pattern did not transfer to L2 Russian. Evidence was found for both articulatory transfer and the emergence of a default pattern of articulation, characteristic of neither L1 nor L2.
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Singhania, Shraddha, Akhita Singhania, and Saherish Khan. "Study of the Significance of Fetal Doppler Flow Velocimetry in the Perinatal Outcome of Growth-restricted Fetuses." International Journal of Infertility & Fetal Medicine 8, no. 2 (2017): 83–88. http://dx.doi.org/10.5005/jp-journals-10016-1153.
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ABSTRACT Purpose To evaluate clinically suspected cases of intrauterine growth restriction (IUGR) for Doppler study of uterine artery, umbilical artery, and fetal middle cerebral artery. To compare the various indices of the three vessels in predicting perinatal outcome. To evaluate the positive predictive value among these parameters. To compare the Doppler findings with fetal outcome. Materials and methods One hundred and two singleton pregnancies complicated by IUGR and severe preeclampsia or both were prospectively examined with Doppler ultrasound of the umbilical artery, middle cerebral artery, and umbilical vein which were compared with 104 uncomplicated pregnancies that formed the control group. Observation and Results One hundred and two singleton pregnancies included in the study population had at least one major or minor adverse outcome. Major adverse outcome criteria included perinatal deaths — including intrauterine and early neonatal deaths, etc. Minor outcomes included cesarean delivery for fetal distress, APGAR score below 7 at 5 minutes, and admission to neonatal intensive care unit for treatment. Conclusion Low diastolic and high indices characterize the pregnancies with abnormal outcomes. The uterine artery had a better sensitivity and specificity as compared with the umbilical arteries and diastolic notch had the highest sensitivity and specificity. Doppler also provides a noninvasive method of assessing the fetal and maternal circulation during pregnancy. How to cite this article Kumar V, Sharma G, Khan S, Singhania A, Singhania S. Study of the Significance of Fetal Doppler Flow Velocimetry in the Perinatal Outcome of Growth-restricted Fetuses. Int J Infertil Fetal Med 2017;8(2):83-88.
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Jarulis, Jarulis, Apin Saputra, and Risky Hadi Wibowo. "Genetic Characteristics of Chloropsis cochinchinensis Gmelin, 1789 Based on The Mitochondrial DNA COI Gene." Jurnal Biodjati 8, no. 1 (2023): 1–12. http://dx.doi.org/10.15575/biodjati.v8i1.20260.
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The rate of illegal poaching of blue-winged leafbirds (Chloropsis cochinchinensis) throughout Indonesia, particularly Bengkulu, is quite high. However, only minimal molecular information is available for this species. We performed mtDNA COI gene sequencing to explore genetic characters (conservative site, variable site, parsimony site, and singleton site) of blue-winged leafbirds. Using Qiagen's DNeasy® Blood and Tissue Kit based on the Spin-Column Protocol, total DNA was isolated, and PCR amplification methods were performed. DNA derived from a PCR reaction was forwarded to PT. First Base Malaysia for sequencing. Using MEGA 10.0 and BIOEDIT, the COI gene nucleotide sequence data were assembled, edited, and analyzed to explore of single nucleotide polymorphism, genetic distance, and phylogeny. The 616 bp COI genes contained 566 conservative sites (C), 50 variation sites (V), 24 information parsimony sites (Pi), and 26 singleton sites (S), as indicated by the results. The greatest nucleotide base composition was cytosine (34.1–34.9%), while the lowest was guanine (15.7–16.2%). The proportion of adenine-thymine nucleotide base pairs was greater than that of guanine-cytosine (50.3%). There were 26 barcode-specific mutation sites, 17 transition substitution mutation sites, and 9 transverse substitution mutation sites. The average genetic distance between C. cochinchinensis individuals was 2.2%, but the average genetic difference between species was 9.0%. All C. cochinchinensis individuals in our sample clustered within the same clade and were distinguished from other species within the same genus. The COI gene sequences of C. cochinchinensis that we acquired are novel and can be utilized for molecular identification of the species.
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Kornacka, M. K., E. Burzyńska, and J. Gadzinowski. "Renal Blood Flow in Twins." Acta geneticae medicae et gemellologiae: twin research 47, no. 3-4 (1998): 161–69. http://dx.doi.org/10.1017/s0001566000000052.
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AbstractThe aim of this preliminary study was the estimation of renal blood flow in 16 premature newborns from twin pregnancies with mean body weight 1270 g and mean gestational age 29 weeks.In control group we have 16 singleton newborns with mean gestational age 29 weeks and mean birth weight 1240 g. In both intervention and control group we have the similar clinical symptoms. The renal blood flow was carried out in the first day of life with the Acuson 128 XP Colour Doppler using the 6 and 7 MHz linear transducer. The renal blood flow parameters-PI, RI, Vmax, Vmin Vmean were measured in right and left renal arteries in theirs courses from the aorta to the renal hilus, by color sinal. In the investigation group the mean value of RI in right and left renal artery was 0,88. Mean PI in right vessel was 1,67 and in left 1,56. Mean V min in right and in left artery was 0,03 and mean V max in right artery was 0,34 and in left 0,33. Mean value of mean velocity in right vessels was 0,18 and in left 0,19.In control group we observed in right artery mean value of PI 1,74 and in left 1,6. Mean RI was 0,86 and 0,86 in right vessel in left vessel. Mean V min was 0,05 in right and 0,04 in left artery. Mean V max was 0,37 in right and 0,34 in left artery. Mean value of V mean was 0,19 in right artery and 0,18 in left artery.Using the student, Mann-Whitney and Shapiro-Wilk tests we have not observed statistically significant difference of Doppler parameters between control and investigation group and between the left and right artery. Although in newborns with broad PDA we noted significant higher value of RI (0,97, 0,98) than in newborns without PDA (0,78, 0,81).
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Ashfaq, Naila, Naureen Ghani Ruqia Zafar, Wafa Aalam, and Sameer Touqir. "HC/AC Ratio as a Predictor of Intrauterine Growth Retardation during Pregnancy: Diagnostic Tool." Pakistan Journal of Medical and Health Sciences 16, no. 6 (2022): 138–39. http://dx.doi.org/10.53350/pjmhs22166138.
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Fetal wellbeing is predicted by his growth assessment during pregnancy. Aim: To evaluate HC/AC ratio as a predictor of intrauterine growth retardation during pregnancy. Study design: Cross sectional study. Methodology: Total of 80 singleton pregnant females with an age ranging from 18-40 years having 20 weeks gestation were enrolled at Combined Military Hospital Kharian. Ultrasound abdomen was done for all enrolled subjects while HC/AC ratio was calculated. All data was noted on Performa. Consent was taken before enrollment. SPSS v.26 analyzed the data. Frequency and percentages were used for quantitative parameters. Results: The mean HC/AC on ultrasound was 1.46±0.14. There were 35 (43.75%) positive for IUGR while 45 (56.25%) were negative for IUGR. Conclusion: It was concluded that HC/AC ratio can serve as a predictor of IUGR during pregnancy with high diagnostic accuracy. Keywords: Abdominal Circumference, Head Circumference and Birth Weight.
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Alorini, Ayesha, Aymen Ben Amira, Mohammad Alzohairi, and Moncef Bouaziz. "Prime Graph Generation through Single Edge Addition: Characterizing a Class of Graphs." European Journal of Pure and Applied Mathematics 16, no. 4 (2023): 2786–97. http://dx.doi.org/10.29020/nybg.ejpam.v16i4.4829.
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A graph G consists of a finite set V (G) of vertices with a collection E(G) of unordered pairs of distinct vertices called edge set of G. Let G be a graph. A set M of vertices is a module of G if, for vertices x and y in M and each vertex z outside M, {z, x} ∈ E(G) ⇐⇒ {z, y} ∈ E(G). Thus, a module of G is a set M of vertices indistinguishable by the vertices outside M. The empty set, the singleton sets and the full set of vertices represent the trivial modules. A graph is indecomposable if all its modules are trivial, otherwise it is decomposable. Indecomposable graphs with at least four vertices are prime graphs. The introduction and the study of the construction of prime graphs obtained from a given decomposable graph by adding one edge constitue the central points of this paper.
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Torres-Velásquez, Diana. "Martínez v. State of New Mexico: The Right to a Sufficient Education." Association of Mexican American Educators Journal 11, no. 1 (2017): 106. http://dx.doi.org/10.24974/amae.11.334.
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Plaintiffs in the Martínez v. State of New Mexico lawsuit are 51 students, parents, and guardians from seven public school districts across New Mexico. This is a school finance case that goes beyond seeking more funds for public education to arguing that providing a sufficient education for New Mexico’s 338,307 students enrolled during the 2016-2017 school year (New Mexico Public Education Department, 2017) involves more than increasing the amount of money allocated for pupils across its 89 school districts. Although the plaintiffs in this case represent low-income and high-need families of many ethnic backgrounds in New Mexico, students who are English Language Learners, and students with disabilities, the outcome has the potential to affect every student, teacher, and administrator in the state. The trial will begin on June 12th of 2017. When the case was originally filed in 2014, New Mexico’s Public Education Department (NMPED)—the defendants in this case—immediately countered with a motion to dismiss. In October of 2014, as First District Court Chief Judge Sarah Singleton rejected the motion to dismiss, she also used the opportunity to declare public education a fundamental right in New Mexico. Martínez v State of New Mexico (2014a) has the potential to transform not only the definition of equal protection and educational equity under the law, but also to correct the discriminatory and punitive practices of current reform agendas. The author examines the possibilities of law as a form of social resistance using Martínez v. State of New Mexico (2014a)—a legal case on school finance—and the concept of sufficient education as guaranteed by the New Mexico State Constitution.
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Freedman, Alexa, Carol Hogue, Donald Dudley, et al. "Associations between Maternal and Fetal Inherited Thrombophilias, Placental Characteristics Associated with Vascular Malperfusion, and Fetal Growth." TH Open 01, no. 01 (2017): e43-e55. http://dx.doi.org/10.1055/s-0037-1603925.
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AbstractPregnancy results in alterations in coagulation processes, which may increase the risk of thrombosis. Inherited thrombophilia mutations may further increase this risk, possibly through alterations in the placenta, which may result in pregnancy complications such as poor fetal growth. The purpose of our study is to evaluate the association of fetal growth, approximated by birth weight for gestational age percentile, with genetic markers of thrombophilia and placental characteristics related to vascular malperfusion. We analyzed data from the Stillbirth Collaborative Research Network's population-based case–control study conducted in 2006–2008. Study recruitment occurred in five states: Rhode Island and counties in Massachusetts, Georgia, Texas, and Utah. The analysis was restricted to singleton, nonanomalous live births ≤42 weeks' gestation with a complete placental examination and successful testing for ≥1 thrombophilia marker (858 mothers, 902 infants). Data were weighted to account for oversampling, differential consent, and availability of placental examination. We evaluated five thrombophilia markers: factor V Leiden, factor II prothrombin, methylenetetrahydrofolate reductase A1298C and C677T, and plasminogen activator inhibitor type 1 in both maternal blood and placenta/cord blood. We modeled maternal and fetal thrombophilia markers separately using linear regression. Maternal factor V Leiden mutation was associated with a 13.16-point decrease in adjusted birth weight percentile (95% confidence interval: −25.50, −0.82). Adjustment for placental abnormalities related to vascular malperfusion did not affect the observed association. No other maternal or fetal thrombophilia markers were significantly associated with birth weight percentile. Maternal factor V Leiden may be associated with fetal growth independent of placental characteristics.
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Deene, Vishnukanth, Tulasigiriyappa Yashvant Mudaraddi, and Shivani S. Gaur. "A Case Study on Vacuolated Oocytes Intracytoplasmic Sperm Injection and its Outcome." International Journal of Infertility & Fetal Medicine 7, no. 1 (2016): 23–26. http://dx.doi.org/10.5005/jp-journals-10016-1122.
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ABSTRACT This is a case study showing effects of oocyte morphological abnormalities in the form of homogenous vacuoles on intracytoplasmic sperm injection (ICSI) outcomes and its implications. Characteristic vacuoles of different size were identified in all oocytes obtained after egg collection in this patient. Eighteen oocytes were retrieved, 15 were metaphase-II and three were metaphase-I. All the oocytes were injected with sperm; out of 18 oocytes, 12 oocytes had embryo quality of grade A and three were grade B. Fifteen embryos exhibited maturation on 24 to 36 hours of incubation and showed two to four-celled stages, and after 48 to 60 hours of incubation, the embryos showed six to eight-celled stage. Grade A quality of three embryos was transferred nearly in an ongoing singleton pregnancy was confirmed How to cite this article Deene V, Mudaraddi TY, Gaur SS. A Case Study on Vacuolated Oocytes Intracytoplasmic Sperm Injection and its Outcome. Int J Infertil Fetal Med 2016;7(1): 23-26.
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Fassio, Federica, Rossella Attini, Bianca Masturzo, et al. "Risk of Preeclampsia and Adverse Pregnancy Outcomes after Heterologous Egg Donation: Hypothesizing a Role for Kidney Function and Comorbidity." Journal of Clinical Medicine 8, no. 11 (2019): 1806. http://dx.doi.org/10.3390/jcm8111806.
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Background and objectives: Preeclampsia (PE) is a risk factor for kidney diseases; egg-donation (ED) increasingly used for overcoming fertility reduction, is a risk factor for PE. CKD is also a risk factor for PE. However, kidney function is not routinely assessed in ED pregnancies. Objective of the study is seeking to assess the importance of kidney function and maternal comorbidity in ED pregnancies. Design, setting, participants and measurements. Design: retrospective observational study from clinical charts. Setting: Sant’Anna Hospital, Turin, Italy (over 7000 deliveries per year). Selection: cases: 296 singleton pregnancies from ED (gestation > 24 weeks), who delivered January 2008–February 2019. Controls were selected from the TOrino Cagliari Observational Study (1407 low-risk singleton pregnancies 2009–2016). Measurements: Standard descriptive analysis. Logistic multiple regression analysis tested: PE; pregnancy-induced hypertension; preterm delivery; small for gestational age; explicatory variables: age; BMI; parity; comorbidity (kidney diseases; immunologic diseases; thyroid diseases; other). Delivery over time was analyzed according to Kaplan Meier; ROC (Relative Operating Characteristic) curves were tested for PE and pre-term delivery, employing serum creatinine and e-GFR as continuous variables. The analysis was performed with SPSS v.14.0 and MedCalc v.18. Results: In keeping with ED indications, maternal age was high (44 years). Comorbidity was common: at least one potential comorbid factor was found in about 40% of the cases (kidney disease: 3.7%, immunologic 6.4%, thyroid disease 18.9%, other-including hypertension, previous neoplasia and all other relevant diseases—10.8%). No difference in age, parity and BMI is observed in ED women with and without comorbidity. Patients with baseline renal disease or “other” comorbidity had a higher risk of developing PE or preterm delivery after ED. PE was recorded in 23% vs. 9%, OR: 2.513 (CI 1.066–5.923; p = 0.039); preterm delivery: 30.2% vs. 14%, OR 2.565 (CI: 1.198–5.488; p = 0.044). Limiting the analysis to 124 cases (41.9%) with available serum creatinine measurement, higher serum creatinine (dichotomised at the median: 0.67 mg/dL) was correlated with risk of PE (multivariate OR 17.277 (CI: 5.125–58.238)) and preterm delivery (multivariate OR 2.545 (CI: 1.100–5.892). Conclusions: Within the limits of a retrospective analysis, this study suggests that the risk of PE after ED is modulated by comorbidity. While the cause effect relationship is difficult to ascertain, the relationship between serum creatinine and outcomes suggests that more attention is needed to baseline kidney function and comorbidity.
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Wilson, Swapnil, and Subrata Das. "I. V. Oxytocin versus oral Misoprostol for augmentation of labour, associated complications and effect on neonatal wellbeing." International Journal of Reproduction, Contraception, Obstetrics and Gynecology 7, no. 8 (2018): 3338. http://dx.doi.org/10.18203/2320-1770.ijrcog20183341.
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Background: The complications of prolonged labor are well recognized and the caesarean section has been used liberally. But even then, prolonged labor continues to be a problem. This could be due to weak uterine contractions or poor cervical dilatation. The problem can be overcome with the use of oxytocic drugs. The aim of the study was to compare the efficacy, adverse effects, safety, and feto-maternal outcome of the ARM and oral misoprostol with Artificial Rupture of Membrane (ARM) and oxytocin infusion for labor augmentation.Methods: This prospective study was conducted in the labor room of NRS Medical College and Hospital Kolkata and included 100 primigravidae women carrying singleton pregnancy at term with spontaneous onset of labor.Results: The result findings of the present study show that the prolonged labor was the major indication for LSCS in both the groups. There was a significantly higher subjects (P <0.05*) had fetal distress or fetal bradycardia, meconium staining of liquor, Tachysystole in the misoprostol group, compared to oxytocin group. No significant difference was observed among the groups with respect to neonatal wellbeing.Conclusions: Both the agents i.e. oral misoprostol and I.V. oxytocin shortens the duration of labor effectively and are effective for augmentation of labor. Apart from Tachysystole and meconium staining of liquor and fetal distress the incidence of any other complication was not significantly more in the oral misoprostol group when compared with oxytocin group. Status of the neonate was almost similar in both the groups.
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SHAN, WEIWEI, YAN LIANG, and DONGMING JIN. "CMOS CIRCUIT DESIGN OF A TAKAGI-SUGENO FUZZY LOGIC CONTROLLER." Journal of Circuits, Systems and Computers 18, no. 04 (2009): 841–56. http://dx.doi.org/10.1142/s0218126609005009.
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This paper presents a low power CMOS analog integrated circuit of a Takagi–Sugeno fuzzy logic controller with voltage/voltage interface, small chip area, relatively high accuracy and medium speed, which is composed of several improved functional blocks. Z-shaped, Gaussian and S-shaped membership function circuits with compact structures are designed, performing well with low power, high speed and small areas. A current minimization circuit is provided with high accuracy and high speed. A follower-aggregation defuzzification block composed of several multipliers for center of gravity (COG) defuzzification is presented without using a division circuit. Based on these blocks, a two-input one-output singleton fuzzy controller with nine rules is designed under a CMOS 0.6 μm standard technology provided by CSMC. HSPICE simulation results show that this controller reaches an accuracy of ±3% with power consumption of only 3.5 mW (at ±2.5 V). The speed of this controller goes up to 0.625M Fuzzy Logic Inference per Second (FLIPS), which is fast enough for real-time control.
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Wallace, JM, RP Aitken, and MA Cheyne. "Effect of post-ovulation nutritional status in ewes on early conceptus survival and growth in vivo and luteotrophic protein secretion in vitro." Reproduction, Fertility and Development 6, no. 2 (1994): 253. http://dx.doi.org/10.1071/rd9940253.
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Overfeeding during early pregnancy in ewes compromises pregnancy establishment and/or embryo survival. To determine whether high feed intakes after ovulation alter the secretory dialogue between the conceptus and the endometrium, 24 embryos (8-16-cell) from ewes fed maintenance rations were synchronously transferred in singleton on Day 3 of the cycle (oestrus, Day 0) into the uterus of ewes receiving a high or low plane of nutrition from Day 0 (n = 12 ewes per group). Embryo survival and conceptus growth were assessed on Day 16. At this time, pregnancy was maintained in 11 of 12 recipient ewes per group and conceptus mass was not influenced by nutritional plane (637 +/- 48 v. 583 +/- 72 mg for high and low groups respectively). Conceptus and endometrial tissues were cultured separately for a further 24 h in vitro in the presence of [3H]leucine. There was no quantitative difference between nutritional treatments in the incorporation of radiolabel into proteins synthesized and secreted by the conceptus or endometrium. Secretion of ovine trophoblast protein-1 was also similar in both groups. Peripheral progesterone concentrations were significantly (P < 0.05) lower throughout the luteal phase in recipient ewes on high v. low intakes after ovulation. This effect was independent of ovulation rate which was 3.1 +/- 0.40 and 2.6 +/- 0.25 corpora lutea for high and low groups respectively. A high plane of nutrition after ovulation did not influence embryo survival and development in vivo or luteotrophic protein secretion in vitro despite a reduction in peripheral progesterone concentrations.(ABSTRACT TRUNCATED AT 250 WORDS)
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Eshak, Ehab S., Chika Okada, Sachiko Baba, et al. "Maternal total energy, macronutrient and vitamin intakes during pregnancy associated with the offspring’s birth size in the Japan Environment and Children’s Study." British Journal of Nutrition 124, no. 6 (2020): 558–66. http://dx.doi.org/10.1017/s0007114520001397.
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AbstractMaternal diet during pregnancy can influence fetal growth; however, the available evidence is controversial. We aimed to assess whether maternal diet of Japanese women in mid-pregnancy can affect their offspring’s birth size via collection of questionnaire and medical record data. The studied sample was a large cohort of paired mothers and their singleton offspring (n 78 793) from fifteen areas all over Japan who participated in the Japan Environment and Children’s Study. The mid-pregnancy intakes of total energy, macronutrients and vitamins were lower than the recommended intakes for pregnant Japanese women. Maternal total energy intake was positively associated with the offspring’s birth weight; there was a 10-g mean difference in the offspring’s birth weight of mothers in the lowest (3026 g) v. highest (3036 g) quartiles of energy intake. Carbohydrate intake was positively associated with the offspring’s birth length (mean difference of 0·7 cm) and inversely associated with the ponderal index (mean difference of 0·8 g/cm3). Offspring of mothers in the highest v. lowest quartiles of total dietary fibre intake were on average 9 g heavier and had 0·3 cm longer birth length and 0·2 cm longer head circumference. The highest in reference to lowest intake quartile of vitamin C was associated with 13 g and 0·7 cm mean differences in the offspring’s birth weight and length, respectively. Several other associations were evident for maternal intakes of vitamins and the offspring’s birth size. In conclusion, maternal dietary intakes of energy, dietary fibre, carbohydrate and vitamins during pregnancy were associated with the offspring’s birth size.
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Kritsotakis, George, Leda Chatzi, Maria Vassilaki, et al. "Social capital, tolerance of diversity and adherence to Mediterranean diet: the Rhea Mother–Child Cohort in Crete, Greece." Public Health Nutrition 18, no. 7 (2014): 1300–1307. http://dx.doi.org/10.1017/s136898001400144x.
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AbstractObjectiveTo estimate the associations of individual maternal social capital and social capital dimensions (Participation in the Community, Feelings of Safety, Value of Life and Social Agency, Tolerance of Diversity) with adherence to the Mediterranean diet during pregnancy.DesignThis is a cross-sectional analysis of data from a prospective mother–child cohort (Rhea Study). Participants completed a social capital questionnaire and an FFQ in mid-pregnancy. Mediterranean diet adherence was evaluated through an a priori score ranging from 0 to 8 (minimal–maximal adherence). Maternal social capital scores were categorized into three groups: the upper 10 % was the high social capital group, the middle 80 % was the medium and the lowest 10 % was the low social capital group. Multivariable log-binomial and linear regression models adjusted for confounders were performed.SettingHeraklion, Crete, Greece.SubjectsA total of 377 women with singleton pregnancies.ResultsHigh maternal Total Social Capital was associated with an increase of almost 1 point in Mediterranean diet score (highest v. lowest group: β coefficient=0·95, 95 % CI 0·23, 1·68), after adjustment for confounders. Similar dose–response effects were noted for the scale Tolerance of Diversity (highest v. lowest group: adjusted β coefficient=1·08, 95 % CI 0·39, 1·77).ConclusionsIndividual social capital and tolerance of diversity are associated with adherence to the Mediterranean diet in pregnancy. Women with higher social capital may exhibit a higher sense of obligation to themselves and to others that may lead to proactive nutrition-related activities. Less tolerant women may not provide the opportunity to new healthier, but unfamiliar, nutritional recommendations to become part of their regular diet.
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Mitchell, Linda M., John J. Robinson, Robert G. Watt, et al. "Effects of cobalt/vitamin B12 status in ewes on ovum development and lamb viability at birth." Reproduction, Fertility and Development 19, no. 4 (2007): 553. http://dx.doi.org/10.1071/rd07012.
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Scottish Blackface ewes from cobalt-deficient farmland were fed a diet containing 0.06 mg cobalt per kg dry matter from approximately 30 days before embryo recovery/transfer until lambing. Ewes remained untreated (–Co; n = 82) or were given an intraruminal cobalt-containing bolus to compensate for the dietary deficit (+Co; n = 82). Ewes used as embryo donors (–Co, n = 17; +Co, n = 16) were artificially inseminated with semen from a single Suffolk sire. Day 6 embryos obtained from –Co and +Co donors were transferred in singleton to –Co and +Co recipients in a 2 × 2 factorial-designed experiment to determine the effects of cobalt/vitamin B12 status during the periconception period (factor 1) and pregnancy (factor 2) on lamb viability at birth. Mean (± s.e.m.) circulating concentrations of vitamin B12 in –Co and +Co donors at ovum recovery were 182 ± 10 and 1288 ± 64 pmol L–1, respectively (P < 0.001), and the number of corpora lutea per ewe ovulating was 9.9 ± 1.6 and 14.4 ± 1.3, respectively (P < 0.05). Treatment did not affect the proportion of recovered ova that contained >32 cells (viable) or the median stage of development (late morula), but viable ova recovered from –Co v. +Co ewes had a better morphological grade (2.0 ± 0.1 v. 2.20 ± 0.04, respectively; P < 0.01). There was no effect of treatment on the proportion of recipient ewes that became pregnant. Circulating concentrations of vitamin B12 were lower in –Co than +Co ewes during pregnancy (P < 0.001) and at birth in lambs born to –Co ewes compared with those born to +Co ewes (P < 0.001). There was no effect of donor or recipient cobalt/vitamin B12 status on lamb birthweight, neonatal vigour or neonatal rectal temperatures, but lambs derived from +Co v. –Co embryo donors were more active in the first 3 days after birth (P < 0.05). Results show that sub-clinical cobalt/vitamin B12 deficiency reduces ovulatory response in superovulated ewes and that periconception nutrition can affect neonatal lamb behaviour.
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Pinheiro, Rosa Lomelino, Ana Luísa Areia, Anabela Mota Pinto, and Helena Donato. "Advanced Maternal Age: Adverse Outcomes of Pregnancy, A Meta-Analysis." Acta Médica Portuguesa 32, no. 3 (2019): 219. http://dx.doi.org/10.20344/amp.11057.
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Introduction: The risks of pregnancy in women of advanced maternal age are not consensual amongst studies. The aim of this metaanalysis was to determine whether women of advanced maternal age (≥ 35 years old) had worse obstetrical and perinatal outcomes than non- advanced maternal age women (20 - 34 years old) in singleton, naturally-conceived pregnancies.Material and Methods: We searched PubMed/ MEDLINE, IndexRMP and the Cochrane Database of Systematic Reviews. Ten studies were included according to the following criteria: population of > 1000 nulliparous and/or multiparous women with singleton gestations who did not undergo any type of infertility treatment. Using Review Manager v. 5.3, two meta-analysis were performed: one comparing the outcomes of 20 - 34-year-old vs 35 - 40-year-old women, and another comparing the outcomes of 35 - 40-year-old women vs > 40-year-old women.Results: Women aged 35 - 40 years old were more likely to have > 12 years of education than 20 - 34 years old and > 40 years old women. Advanced maternal age women (35 - 40 and > 40 years old) were more likely to be overweight and having gestational diabetes and gestational hypertension. They were also more likely to undergo induced labour and elective caesarean deliveries. Furthermore, they had worse perinatal outcomes such as preterm delivery, low birthweight babies, higher rates of Neonatal Intensive Care Unit admission and worse Apgar scores. Advanced maternal age women had higher rates of perinatal mortality and stillbirth.Discussion: Most authors present similar results to our study. Although the majority of adverse outcomes can be explained through the physio-pathological changes regarding the female reproductive apparatus that come with aging and its inherent comorbidities, according to the existing literature advanced maternal age can be an independent risk factor per se. In older pregnant women without comorbidities such as gestational hypertension or diabetes there are still worse obstetric and perinatal outcomes, which indicate that advanced maternal age is an independent strong risk factor alone.Conclusion: Advanced maternal age women are at a higher risk of adverse obstetrical and perinatal outcomes. In both comparisons, worse outcomes were more prevalent in the older group, suggesting that poorer outcomes are more prevalent with increasing age.
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van Eijsden, Manon, Claire M. C. Meijers, Jessica E. Jansen, Marlou L. A. de Kroon, and Tanja G. M. Vrijkotte. "Cultural variation in early feeding pattern and maternal perceptions of infant growth." British Journal of Nutrition 114, no. 3 (2015): 481–88. http://dx.doi.org/10.1017/s0007114515000951.
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The perception of healthy growth and weight may differ between cultures, which could influence feeding practises and consequently affect the development of overweight. The present study examined ethnic variation in maternal perceptions of growth and their influence on feeding practises among Turkish and Dutch infants aged 0–6 months. Data were obtained from the mothers of 143 Turkish and 143 Dutch healthy, singleton, term infants with birth weights appropriate for gestational age, using structured interviews at 1, 4 and 6 months after birth. Compared with Dutch mothers, mothers of Turkish descent perceived a chubby infant more often as pretty (43 v. 22 %), and were more often worried about their infant's growth (13 v. 4 %). Turkish mothers were more likely to give full breast-feeding (BF) until at least 6 months (adjusted OR (aOR) 2·1, 95 % CI 1·0, 4·3) and to start introducing complementary feeding, including rice flour porridge, at the age of 6 months (aOR 2·4, 95 % CI 1·1, 4·9). Infants of Turkish descent were fed on average one milk feeding more during the day and, if introduced to complementary foods before 6 months, were more often given uncommon types of foods (e.g. yogurt and cookies) (aOR 2·1, 95 % CI 1·1, 4·3). The differences in perceptions affected differences in feeding practises only to a small extent. Preventive advice offered to Turkish mothers in Child Health Care should include discussing choices of complementary foods and frequency of feeding from an early age onwards. In Dutch mothers, support for the continuation of BF remains an important issue.
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Hafeez, S., Z. Hafeez, Sana Hafeez, S. Riaz, R. R. Khan, and A. Yousaf. "Maternofetal Outcomes of Acute Hepatitis E in Pregnancy; A Cross Sectional Study." Pakistan Journal of Medical and Health Sciences 15, no. 5 (2021): 1341–43. http://dx.doi.org/10.53350/pjmhs211551341.
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Objective: To identify the maternofetal outcomes of Acute Hepatitis E in Pregnancy Methods: A cross-sectional study was conducted at the Obstetrics and Gynecology Department of Services Institute of Medical Sciences, Lahore. It included 41 women with gestational age >32 weeks, singleton pregnancy, presenting with Hepatitis E infection. Their demographic and pregnancy-related characteristics were included. Maternal and fetal outcomes were assessed. Data was entered and analyzed using SPSS v.25. Results: Mean age of the participatns was 27.12 ± 3.85 years; the mean gestational age was 31.00 ± 6.15 weeks. Thirty one patients (75.6%) were admitted through the emergency. Twenty four (58.5%) needed packed cell transfusion and 32 (78%) needed fresh frozen plasma transfusion. Eleven patients (26.8%) developed hepatic encephalopathy and all of them required intensive care admission. The maternal mortality rate was 4 (9.8%). Thirty eight (92.1%) pregnancies were viable at the time of arrival. The fetal mortality rate was 7 (17.1%). Conclusion: HEV infections significantly contribute to materno-fetal morbidity and mortality. Screening for and monitoring HEV infection earlier during the pregnancy should be of primary public health importance. Improving awareness in women of childbearing age regarding HEV transmission and its adverse fetal effects should be prioritized. Key words: Hepatitis E virus, Maternofetal Outcomes, pregnancy, Childbearing age
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Wells, E. M., A. Navas-Acien, B. J. Apelberg, et al. "Association of selenium and copper with lipids in umbilical cord blood." Journal of Developmental Origins of Health and Disease 5, no. 4 (2014): 281–87. http://dx.doi.org/10.1017/s2040174414000233.
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Altered levels of selenium and copper have been linked with altered cardiovascular disease risk factors including changes in blood triglyceride and cholesterol levels. However, it is unclear whether this can be observed prenatally. This cross-sectional study includes 274 singleton births from 2004 to 2005 in Baltimore, Maryland. We measured umbilical cord serum selenium and copper using inductively coupled plasma mass spectrometry. We evaluated exposure levels vis-à-vis umbilical cord serum triglyceride and total cholesterol concentrations in multivariable regression models adjusted for gestational age, birth weight, maternal age, race, parity, smoking, prepregnancy body mass index, n-3 fatty acids and methyl mercury. The percent difference in triglycerides comparing those in the highest v. lowest quartile of selenium was 22.3% (95% confidence interval (CI): 7.1, 39.7). For copper this was 43.8% (95% CI: 25.9, 64.3). In multivariable models including both copper and selenium as covariates, copper, but not selenium, maintained a statistically significant association with increased triglycerides (percent difference: 40.7%, 95% CI: 22.1, 62.1). There was limited evidence of a relationship of increasing selenium with increasing total cholesterol. Our findings provide evidence that higher serum copper levels are associated with higher serum triglycerides in newborns, but should be confirmed in larger studies.
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Bacha, Lensa Tamiru, Wase Benti Hailu, and Edosa Tesfaye Geta. "Clinical outcome and associated factors of respiratory distress syndrome among preterm neonates admitted to the neonatal intensive care unit of Adama Hospital and Medical College." SAGE Open Medicine 10 (January 2022): 205031212211460. http://dx.doi.org/10.1177/20503121221146068.
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Objective: Aim of the study was to assess the clinical outcome and associated factors of respiratory distress syndrome among preterm neonates admitted to the neonatal intensive care unit of Adama Hospital and Medical College. Methods: Hospital-based cross-sectional study was conducted using 242 randomly selected medical records of preterm neonates admitted to Adama comprehensive specialized hospital. Clinical outcome was categorized as poor if the neonate died or left against advice and good if discharged after improvement. Data were coded, entered into Epidata v.7.4.2 and exported to SPSS v.27 for analysis. After initial bi-variable logistic regression analysis, predictor variables with p-value of <0.2 were included in multivariable analysis. Significant association of factors with clinical outcome was claimed at p-value <0.05 and calculated 95% adjusted odds ratio. Results: Majority of admissions were male (63.2%), mean birth weight of 1440.3 g (+321.2 SD) and sepsis (82%), hypothermia (73%), and apnea (21.5%) were leading comorbidities. One hundred fifty-two (62.8%) of preterm neonates had poor outcomes. Neonates born singleton were 47% less likely to develop poor clinical outcomes (adjusted odds ratio 0.53 (0.48–0.94). The odds of poor clinical outcomes were higher during the first 3 days of admission (adjusted odds ratio 3.83 (3.28–14.77). Extremely preterm neonates (adjusted odds ratio 4.16 (4.01–12.97), extremely low birth weight preterm neonates had higher odds of poor clinical outcome. Conclusion: The study found higher poor clinical outcome among preterm neonates admitted with respiratory distress syndrome. Poor outcome was higher in lower gestational age, lower birth weight, twins and majority of it happened during 3 days of their life. Effective preventive care and initiation of low-cost, life-saving interventions including heated humidified high-flow nasal cannula and surfactant administration could significantly improve the clinical outcome of the neonates.
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Mishra, Vineet, Rohina Aggarwal, Sumesh Choudhary, and Himani Agarwal. "Selective Fetal Reduction of Conjoined Twins in Twin Pregnancy." Journal of South Asian Federation of Obstetrics and Gynaecology 9, no. 3 (2017): 277–79. http://dx.doi.org/10.5005/jp-journals-10006-1512.
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ABSTRACT Background The incidence of conjoined twins is rare. In early pregnancy, transvaginal ultrasound may facilitate diagnosis and prompt intervention can be done. Case Report A 35 years old patient with history of infertility for 17 years conceived after In vitro fertilization–embryo transfer with donor oocytes due to ovarian factor; three embryos were transferred. Transvaginal sonography was done on 21st day after transfer and it revealed three gestational sacs with fetal pole in all the sacs. Repeat TVS done on 65th day post embryo transfer revealed one gestational sac with single live embryo, second sac with two embryos joined at thorax and abdomen with a common heart, and two heads. Couple was then counseled for fetal reduction in view of expected poor outcome of conjoined twins. Selective fetal reduction was done at 12 weeks gestation with intra-cardiac potassium chloride administration. Pregnancy is now ongoing with an apparently normal live singleton fetus. Conclusion When conjoined twins are detected early, fetal reduction is a good modality of management. These pregnancies are associated with severe complications, maternal and fetal morbidity and mortality. Hence, the sooner the fetal reduction is, the better the management of conjoined twins. How to cite this article Choudhary S, Mishra V, Aggarwal R, Agarwal H. Selective Fetal Reduction of Conjoined Twins in Twin Pregnancy. J South Asian Feder Obst Gynae 2017;9(3):277-279.
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Niu, Xue-Ke, Manik Prabhu Narsing Rao, Zhou-Yan Dong, et al. "Vulcaniibacterium gelatinicum sp. nov., a moderately thermophilic bacterium isolated from a hot spring." International Journal of Systematic and Evolutionary Microbiology 70, no. 3 (2020): 1571–77. http://dx.doi.org/10.1099/ijsem.0.003934.
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The present study aimed to determine the taxonomic positions of strains designated R-5-52-3T, R-5-33-5-1-2, R-5-48-2 and R-5-51-4 isolated from hot spring water samples. Cells of these strains were Gram-stain-negative, non-motile and rod-shaped. The strains shared highest 16S rRNA gene sequence similarity with Vulcaniibacterium thermophilum KCTC 32020T (95.1%). Growth occurred at 28–55 °C, at pH 6–8 and with up to 3 % (w/v) NaCl. DNA fingerprinting, biochemical, phylogenetic and 16S rRNA gene sequence analyses suggested that R-5-52-3T, R-5-33-5-1-2, R-5-48-2 and R-5-51-4 were different strains but belonged to the same species. Hence, R-5-52-3T was chosen for further analysis and R-5-33-5-1-2, R-5-48-2 and R-5-51-4 were considered as additional strains of this species. R-5-52-3T possessed Q-8 as the only quinone and iso-C15:0, iso-C11:0, C16 : 0 and iso-C17 : 0 as major fatty acids. The polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, unidentified polar lipids and two unidentified phospholipids. The genomic G+C content was 71.6 mol%. Heat shock proteins (e.g. Hsp20, GroEL, DnaK and Clp ATPases) were noted in the R-5-52-3T genome, which could suggest its protection in the hot spring environment. Pan-genome analysis showed the number of singleton gene clusters among Vulcaniibacterium members varied. Average nucleotide identity (ANI) values between R-5-52-3T, Vulcaniibacterium tengchongense YIM 77520T and V. thermophilum KCTC 32020T were 80.1–85.8 %, which were below the cut-off level (95–96 %) recommended as the ANI criterion for interspecies identity. Thus, based on the above results, strain R-5-52-3T represents a novel species of the genus Vulcaniibacterium , for which the name Vulcaniibacterium gelatinicum sp. nov. is proposed. The type strain is R-5-52-3T (=KCTC 72061T=CGMCC 1.16678T).
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Härtel, Christoph, Sören von Otte, Julia Koch, et al. "Polymorphisms of haemostasis genes as risk factors for preterm delivery." Thrombosis and Haemostasis 94, no. 07 (2005): 88–92. http://dx.doi.org/10.1160/th04-10-0653.
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SummaryClinical trials evaluating the potential benefit of anticoagulant treatment in pregnant women with inherited thrombophilia are based on the observation that a genetic predisposition to thrombosis is associated with frequent abortions and preterm birth. It was the aim of our study to delineate the impact of genetic polymorphisms with prothrombotic and antithrombotic effects on the occurrence of preterm birth in a large cohort of very-low-birth-weight (VLBW)-infants and their mothers. We examined the factor V Leiden and the prothrombin G20210A mutation, the factor VII 121del/ins and the factor XIII Val34Leu polymorphism in preterm very-low-birth-weight (VLBW, n=593) and term-born-infants (n=278) and their mothers (n=785).The primary outcome was preterm vs. term birth. From all polymorphisms tested, the maternal factor VII-121del/ins polymorphism (26.2 vs. 17.6 %; p=0.009) and the infant’s factor VII-121del/ins polymorphism (29.0 vs. 20.0 %; p=0.009) were more frequent in singletonVLBW and their mothers compared to term infants and their mothers. Furthermore, the frequency of the factor XIII-Val34Leu polymorphism was significantly lower in singleton VLBW than in term infant controls (5.1 vs. 9.6%, p=0.025). In a multivariate regression analysis, previous preterm delivery (OR=3.8, 95% CI: 1.7–8.4), the maternal carrier status of the factor-VII-121del/ins polymorphism (OR=1.7, 95% CI: 1.12–2.5, p=0.007) and the lower frequency of infant’s factor-XIII-Val34Leu polymorphism (OR=0.53; 95% CI: 0.29–0.96; p=0.038) were found to be independently associated with preterm delivery. InVLBW mothers with pathological CTG as cause of preterm delivery, the frequency of factor V Leiden mutation was significantly increased compared to VLBW mothers without pathological CTG (14.1 vs. 6.1%, p=0.01).The investigated haemostasis gene polymorphisms have a much lower impact on subsequent preterm delivery than known risk factors such as previous preterm birth. The reported association of the factor-VII-121del/ins polymorphism on preterm delivery and its clinical relevance needs to be further elucidated.
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Gidi, Netsanet Workneh, Robert L. Goldenberg, Assaye K. Nigussie, et al. "Comparison of neonatal outcomes of small for gestational age and appropriate for gestational age preterm infants born at 28–36 weeks of gestation: a multicentre study in Ethiopia." BMJ Paediatrics Open 4, no. 1 (2020): e000740. http://dx.doi.org/10.1136/bmjpo-2020-000740.
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PurposeThe aim of this study was to assess morbidity and mortality pattern of small for gestational age (SGA) preterm infants in comparison to appropriate for gestational age (AGA) preterm infants of similar gestational age.MethodWe compared neonatal outcomes of 1336, 1:1 matched, singleton SGA and AGA preterm infants based on their gestational age using data from the study ‘Causes of Illness and Death of Preterm Infants in Ethiopia (SIP)’. Data were analysed using SPSS V.23. ORs and 95% CIs and χ2 tests were done, p value of <0.05 was considered statistically significant.ResultThe majority of the infants (1194, 89%) were moderate to late preterm (32–36 weeks of gestation), 763 (57%) were females. Male preterm infants had higher risk of being SGA than female infants (p<0.001). SGA infants had increased risk of hypoglycaemic (OR and 95% CI 1.6 (1.2 to 2.0), necrotising enterocolitis (NEC) 2.3 (1.2 to 4.1), polycythaemia 3.0 (1.6 to 5.4), late-onset neonatal sepsis (LOS) 3.6 (1.1 to 10.9)) and prolonged hospitalisation 2.9 (2.0 to 4.2). The rates of respiratory distress syndrome (RDS), apnoea and mortality were similar in the SGA and AGA groups.ConclusionNeonatal complications such as hypoglycaemic, NEC, LOS, polycythaemia and prolonged hospitalisation are more common in SGA infants, while rates of RDS and mortality are similar in SGA and AGA groups. Early recognition of SGA status, high index of suspicion and screening for complications associated and timely intervention to prevent complications need due consideration.
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Wallace, Jacqueline M., John S. Milne, Raymond P. Aitken, and William W. Hay. "Sensitivity to metabolic signals in late-gestation growth-restricted fetuses from rapidly growing adolescent sheep." American Journal of Physiology-Endocrinology and Metabolism 293, no. 5 (2007): E1233—E1241. http://dx.doi.org/10.1152/ajpendo.00294.2007.
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Fetal sensitivity to insulin and glucose was investigated during fetal hyperinsulinemic-euglycemic (HI-euG, n = 18) and hyperglycemic-euinsulinemic (HG-euI, n = 12) clamps. Singleton bearing adolescent ewes were fed high (H) or control (C) nutrient intakes to induce compromised or normal placental/fetal size, respectively. Catheters were inserted in the umbilical vein (v), fetal artery, (a) and veins, and studies were conducted between day 126 and 133 of gestation. Umbilical blood flow (UmBF) was determined by the steady-state transplacental diffusion technique using 3H2O, and glucose fluxes were quantified by the Fick principle. For the HI-euG study, fetal glucose utilization was measured at spontaneously occurring fetal insulin concentrations and two additional higher levels, whereas fetal glucose was clamped at the initial baseline level. For the HG-euI study, fetal insulin was suppressed by somatostatin infusion, and fetal glucose utilization was determined at baseline (before somatostatin) glucose concentrations, and at 150 and 200% of this value. Placentome weight (219 vs. 395 g), fetal weight (2,965 vs. 4,373 g), and UmBF (519 vs. 794 ml/min) were lower ( P < 0.001) in H than in C groups. Relative to control fetuses, glucose extraction (G[v − a]/G[v] × 100) in the nonperturbed state was higher (21.7 vs. 15.9%) in growth-restricted fetuses despite lower glucose (0.78 vs. 1.05 μmol/ml) and insulin (8.5 vs. 16.9 μU/ml) concentrations (all P < 0.001). During the HI-euG study, total fetal glucose utilization rate increased in response to higher insulin concentrations (65 and 64% in H and C groups). Similarly during the HG-euI study, a twofold increase in glucose supply increased fetal glucose utilization by 41 and 44% in H and C groups, respectively. Throughout both studies, absolute total fetal glucose utilization rates were reduced in H vs. C groups ( P < 0.01) but were similar when expressed per kilogram fetus (HI-euG: 34.7, 49.5, and 57.5 in H vs. 34.7, 51.2, and 56.1 μmol·min−1·kg−1 in C, HG-euI: 28.7, 35.7, and 40.8 in H vs. 32.9, 34.5, and 43.8 μmol·min−1·kg−1 in C). These normal body weight-specific metabolic responses to short-term experimental increases in plasma insulin and glucose in response to chronic IUGR indicate maintained mechanisms of insulin action and glucose uptake/utilization capacity, which, if persistent, might predispose such IUGR offspring to excessive energy deposition in later life.
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Chavatte-Palmer, P., P. Laigre, C. Juillien, et al. "32ULTRASOUND MEASUREMENTS OF BOVINE SOMATIC CLONES AT DAY 50 AND DAY 64 OF PREGNANCY." Reproduction, Fertility and Development 16, no. 2 (2004): 138. http://dx.doi.org/10.1071/rdv16n1ab32.
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The overall efficiency of cloning has stayed low since this technique appeared. Most of the losses in the bovine species take place in early gestation between Day 35 and Day 70, when deficient placental development has been described. Late fetal losses are associated with excessive fetal growth and placental hydrops (Large Offspring Syndrome or LOS). One study measuring crown-rump length (CRL) by ultrasound (US) did not show any difference between clones and controls (Pace et al., 2002). The objective of this work was to compare fetal and placental measurements at Days 34, 50, and 64 for bovine clones and control pregnancies to determine whether these could be predictive of a further development of LOS. Twenty-five clone and 32 control (28 AI and 4 IVF) singleton Holstein pregnancies were used for US with a 5-MHz rectal probe. Clones originated from adult skin fibroblasts (three genotypes), used after serum starvation, as previously published (Vignon et al., 1998). CRL and head length (HL), orbital diameter (OD), vesicle width (VW), and length and width of the placentome closest to the fetus were measured at each stage. CRL were also recorded from six clone, six IVF and five AI, Day 34 and Day 60 fetuses recovered at slaughter. Maternal clinical parameters, US images with increased fetal fluids, excessive weight, and clinical features at surgical removal or birth were used to diagnose LOS. Data were analysed using multiple regression analysis with SAS software. There were no differences between IVF and AI fetal and placental measurements by ultrasound and the two groups were pooled as a single control group. LOS was diagnosed in 29% of the clones. CRL and HL were significantly smaller in clones at all stages (CRL: 10.2±3.8mm, n=5 v. 13.6±2.4mm, n=7, at retrieval at Day 34; 31.8±5.6mm v. 36.0±4.6 in controls at Day 50, by US, and 48.6±11.4 v. 63.3±4.9 at Day 64, by US, P&lt;0.05, in clones and controls, respectively) but there was no difference between the clones developing LOS and those that did not. There was no difference for OD or VW at any stage. Placentome width but not length was statistically smaller in clones compared to controls (4.8±1.5 v. 7.2±1.7mm at Day 50 and 5.7±2.0 v. 9.4±4.2 at Day 64, in clones and controls, respectively, P&lt;0.05). There were only two clones retrieved at Day 64, one degenerated and the other similar to controls. Placentome development was delayed. These data clearly show that although a large proportion of clones develop LOS in late gestation, they are actually smaller than controls in early pregnancy, whether or not they will develop LOS. This is probably due to delayed or abnormal early placental development, which can be detected by US. US cannot be used, however, to predict further development of LOS, and other means such as maternal plasma PSP60 concentrations (Heyman et al., 2002) must be used.
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László, K. D., J. Li, J. Olsen, M. Vestergaard, C. Obel, and S. Cnattingius. "Maternal bereavement and the risk of preterm delivery: the importance of gestational age and of the precursor of preterm birth." Psychological Medicine 46, no. 6 (2015): 1163–73. http://dx.doi.org/10.1017/s0033291715002688.
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BackgroundMaternal stress during pregnancy may increase the risk of preterm delivery (PD), but the associations between stress and subtypes of PD are not clear. We investigated maternal loss of a close relative and risks of very and moderately PD (<32 and 32–36 weeks, respectively) and spontaneous and medically indicated PD.MethodWe studied 4 940 764 live singleton births in Denmark (1978–2008) and Sweden (1973–2006). We retrieved information on death of women's family members (children, partner, siblings, parents), birth outcomes and maternal characteristics from nationwide registries.ResultsOverall, the death of a close family member the year before pregnancy or in the first 36 weeks of pregnancy was associated with a 7% increased risk of PD [95% confidence interval (CI) 1.04–1.10]. The highest hazard ratios (HR) for PD were found for death of an older child [HR (95% CI) 1.20 (1.10–1.31)] and for death of a partner [HR (95% CI) 1.31 (1.03–1.66)]. These losses were associated with higher risks of very preterm [HR (95% CI) 1.61 (1.29–2.01) and 2.07 (1.15–3.74), respectively] than of moderately preterm [HR (95% CI) 1.14 (1.03–1.26) and 1.22 (0.94–1.58), respectively] delivery. There were no substantial differences in the association between death of a child or partner and the risk of spontaneous v. medically indicated PD.ConclusionsDeath of a close family member the year before or during pregnancy was associated with an increased risk of PD, especially very PD. Possible mechanisms include both spontaneous and medically indicated preterm birth.
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Michikawa, Takehiro, Shin Yamazaki, Masaji Ono, et al. "Fish consumption in early pregnancy and congenital gastrointestinal tract atresia in the Japan Environment and Children’s Study." British Journal of Nutrition 121, no. 1 (2018): 100–108. http://dx.doi.org/10.1017/s0007114518002842.
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AbstractCurrent evidence suggests that the aetiology of congenital gastrointestinal (GI) tract atresia is multifactorial, and not based solely on genetic factors. However, there are no established modifiable risk factors for congenital GI tract atresia. We used data from a Japanese nationwide birth cohort study launched in 2011, and examined whether fish consumption in early pregnancy was associated with congenital GI tract atresia. We analysed data of 89 495 women (mean age at delivery=31·2 years) who delivered singleton live births without chromosomal anomalies. Based on the results of the FFQ, we estimated the daily intake of fish and n-3 PUFA consumption in early pregnancy. We defined a composite outcome (oesophageal atresia, duodenal atresia, jejunoileal atresia and/or anorectal malformation) as congenital GI tract atresia. In this population, median fish intake was 31·9 g/d, and seventy-four cases of congenital GI tract atresia were identified. Fish consumption in early pregnancy was inversely associated with the composite outcome (multivariable-adjusted OR for the high v. low consumption category=0·5, 95 % CI 0·3, 1·0). For all the specific types of atresia, decreased OR were observed in the high consumption category, although not statistically significant. Reduced atresia occurrence was observed even beyond the US Food and Drug Administration’s recommended consumption of no more than 340 g/week. Also, n-3 PUFA-rich fish and n-3 PUFA consumptions tended to be inversely associated with atresia. Fish consumption in early pregnancy may be a preventive factor for congenital GI tract atresia.
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Adibi, J. J., M. K. Lee, S. Saha, W. J. Boscardin, A. Apfel, and R. J. Currier. "Fetal sex differences in human chorionic gonadotropin fluctuate by maternal race, age, weight and by gestational age." Journal of Developmental Origins of Health and Disease 6, no. 6 (2015): 493–500. http://dx.doi.org/10.1017/s2040174415001336.
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Circulating levels of the placental glycoprotein hormone human chorionic gonadotropin (hCG) are higher in women carrying female v. male fetuses; yet, the significance of this difference with respect to maternal factors, environmental exposures and neonatal outcomes is unknown. As a first step in evaluating the biologic and clinical significance of sex differences in hCG, we conducted a population-level analysis to assess its stability across subgroups. Subjects were women carrying singleton pregnancies who participated in prenatal and newborn screening programs in CA from 2009 to 2012 (1.1 million serum samples). hCG was measured in the first and second trimesters and fetal sex was determined from the neonatal record. Multivariate linear models were used to estimate hCG means in women carrying female and male fetuses. We report fluctuations in the ratios of female to male hCG by maternal factors and by gestational age. hCG was higher in the case of a female fetus by 11 and 8% in the first and second trimesters, respectively (P<0.0001). There were small (1–5%) fluctuations in the sex difference by maternal race, weight and age. The female-to-male ratio in hCG decreased from 17 to 2% in the first trimester, and then increased from 2 to 19% in the second trimester (P<0.0001). We demonstrate within a well enumerated, diverse US population that the sex difference in hCG overall is stable. Small fluctuations within population subgroups may be relevant to environmental and physiologic effects on the placenta and can be probed further using these types of data.
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Khan, Javid Ahmed, Aadil Ashraf, Waseem A. Qureshi, and Faizana Fayaz. "Comparison of serum electrolytes with preeclampsia severity: a cross sectional study." International Journal of Research in Medical Sciences 10, no. 11 (2022): 2586. http://dx.doi.org/10.18203/2320-6012.ijrms20222863.
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Background: Preeclampsia is a common complication of pregnancy that put women and their fetuses at significant risk and result in life long sequelae. The pathogenesis of this important disease is complex as such the role of different serum electrolytes is being investigated as they are considered important for blood pressure regulation.Methods: A hospital based cross-sectional study of 100 diagnosed cases of preeclampsia divided into mild and severe according to latest International Society for the Study of Hypertension in Pregnancy (ISSHP) guidelines and equal number of age, parity and gestational age matched women (n=100), that acted as control group, with singleton normal pregnancies. Data was analyzed in SPSS V:26. Statistical tests to find out mean standard deviation and One-way ANOVA test were applied to find the significance of associations.Results: In severe preeclampsia group, the mean values of Na+, K+ and Cl- were 134.50±4.24, 4.28±0.74, 106.48±3.41 meq/l respectively in comparison to control group which had 135.57±3.29, 4.12±0.53, 108.20±3.19 meq/l respectively. Results from one way ANOVA showed that there was statistically significant difference between means of the three groups for systolic blood pressure (SBP), diastolic blood pressure (DBP), potassium and chloride levels with p<0.05. A post hoc analysis was used to distinguish the differences in means of these parameters.Conclusions: Estimation of readily available serum electrolytes of sodium potassium and chloride during the course of pregnancy can help to identify and treat preeclampsia and thus reduce the burden of morbidity and mortality in pregnant women.
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., Vaishali, and Govindrajulu Rajesh Babu. "A Comparative Study of Associated Factors for Intrapartum Meconium Staining of Amniotic Fluid in a Tertiary Care Hospital." Indian Journal of Obstetrics and Gynecology 9, no. 3 (2021): 19–24. http://dx.doi.org/10.21088/ijog.2321.1636.9321.2.
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Aims and Objectives: • To study factors associated with intra-partum meconium stained liquor &feto maternal outcome. • To compare the fetal outcome in relation to MSAF and clear amniotic fluid also in thick v/s thin meconium. Material and methods: This study prospective of 100 subjects was done in a tertiary care hospital over six months. Fifty with MSAF detected at any time during the course of labour or prior to it were enrolled in the study group. The inclusion criteria were, a singleton, cephalic, term pregnancy without anomalies. For control, the next woman giving birth following the index patient who satisfied similar inclusion criteria and had clear amniotic fluid was selected. Result: Among risk factors, preeclampsia p=0.04, fetal growth restriction p=0.05, fetal distress p=0.0002 and labour dystocia p=0.0009 were found to be statically significant. Caesarean section was considerably higher in patients with MSAF, p=<0.001. 66% patients with MSAF had FHR abnormalities as compared to 2% controls. 47.6% babies with thin MSAF and 75.8% of babies with thick MSAF had nonreassuring CTG. 42% patients had thin meconium and 58% patient had thick meconium. Conclusion: Women with prelabour or early labour rupture of membranes were noted to have a higher association with MSAF. Presence of thick MSAF, necessitates intensive monitoring of labour including surveillance of fetal wellbeing to optimise the neonatal outcome. Vigilance during labour and timely referral to higher centre/ availability of trained staff for neonatal resuscitation and management is the key to reducing neonatal morbidity and mortality associated with MSAF.
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Belokrinitskaya, Tatiana E., Nataliya I. Frolova, Natal'ia N. Strambovskaya, and Kristina A. Kolmakova. "Vasoactive genes as molecular and genetic predictors of severe preeclampsia." Gynecology 21, no. 1 (2019): 10–13. http://dx.doi.org/10.26442/20795696.2019.1.190231.
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Aim. To analyze an incidence rate of polymorphisms and combinations of genes AGT-704T> C, AGT-521C> T, AGTR1-1166A> C, AGTR2-1675G> A, еNO3-786T> C, еNOS3-894G> C, ADD1-1378G> T, CYP11B2 -304C> T, GNB3-825C> T and to assess their association with a risk of severe pre-eclampsia. Materials and methods. The study included women of early fertile age (20-35 years old) with spontaneous singleton pregnancy, no bad habits (smoking, alcohol or drug use), no extragenital diseases and no family (mother or sister) or an individual history of pre-eclampsia and with body mass index in the first trimester of pregnancy less than 35 kg/m2. The study group consisted of 100 patients with severe preeclampsia and the control group included 100 women with uncomplicated pregnancy. Genotyping was carried out by method of polymerase chain reaction. Data analysis included compliance with the Hardy - Weinberg law, Cramer's V criterion, χ2 test, odds ratio (OR) and its 95% confidence interval (CI). To assess a distribution of stated polymorphisms of genes and their alleles a general (χ2 test, df=2) and multiplicative (χ2 test, df=1) inheritance models were used. Results and discussion. Patients with severe pre-eclampsia had statistically significantly higher incidence rate of mutant homozygous genotypes AGTR1-1166CC (χ2=5,54; p=0,05) and еNO3-786CC (χ2=23,05; p=1,0E-5). A significant association between a carrier of the mutant homozygous genotype eNO3-786СC (χ2=19,780; p=0,000) and severe pre-eclampsia (OR 45,07, 95% CI 2,68-759,30) was found out. Combinations of mutant alleles of potentially predictive polymorphisms of vasoactive genes in women with preeclampsia were recorded 7,7 times more often (23% vs 3%; χ2=17,683, p=0,000; average Cramer's V link) which led to a significant association link with a risk of a disease complication (OR 9,658, 95% CI 2,795-33,367). Conclusion. A synergistic interaction between polymorphic loci in severe preeclampsia was established. The mutant homozygous genotype eNO3-786СC as well as a combination of at least two mutant alleles of genes - candidates for arterial hypertension or their combination with the mutant gene ADD1-1378TT or GNB3-825TT can claim a role of molecular and genetic predictors of severe preeclampsia.
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Fatima, Syeda Sitwat, Laila Zeb, Tanveer Shafqat, and Qudsia Qazi. "ANALYSIS OF CAESAREAN SECTION RATE ACCORDING TO ROBSON CLASSIFICATION CRITERIA: A CROSS SECTIONAL STUDY IN A TERTIARY CARE HOSPITAL." American Journal of Health, Medicine and Nursing Practice 7, no. 5 (2022): 18–27. http://dx.doi.org/10.47672/ajhmn.1009.
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Purpose: The World Health Organization, recommends the Robson Ten Group Classification System (RTGCS) as a global standard for assessing, monitoring and comparing CS rates at both national and international levels. This study was aimed to analyze CS rate in Department of Obstetrics and Gynaecology MTI, LRH, Peshawar; according to RTGCS. This will help understand the major contributory groups to the overall CS rate and to formulate strategies to optimize the escalating rates.
 Methodology: A cross-sectional study for a period of 1 year from 1st January 2021 to 31st December 2021 was conducted at a tertiary care hospital located in the capital city of KPK Province, Pakistan. Women (n=7376) who delivered during the study period, fulfilling the inclusion/exclusion criteria were included. All relevant obstetric information was entered into a structured proforma. The study population was classified into Robson 10 groups and percentages were calculated for the overall CS rate, the representation of groups and contributions of the each group to the total CS rate.
 Findings: A total of 7376 deliveries were analyzed as per RTGCS. Of these 1679 (22.76%) were caesarean sections. According to the criteria used, Group I & III represented more than half (53.75%) of the obstetric population. The major contributor to the overall CS rate was group V (Previous caesarean delivery, single, cephalic > or equal to 37weeks), followed by group I (Nulliparous, single, cephalic > or equal to 37 weeks, in spontaneous labour), group X (All singleton, cephalic, < 37 weeks gestation pregnancies-including previous CS) and group III.
 Conclusion: The implementation of RTGCS at MTI, LRH, Peshawar helped to identify the contribution of each group to the overall CS rate. Group V was the leading contributor to the overall CS rate. This study also revealed a high rate of CS among low risk groups i.e. group I and III.
 Recommendations: Current study can be used to compare results among the institutions at provincial and national levels to design uniform policies throughout the Pakistan to optimize CS rate. Furthermore, education for both pregnant women and obstetricians is required to encourage and promote ECV and VBAC to avoid repeat Caesarean sections. Moreover, the instrumental vaginal delivery should be encouraged where clinically indicated and justified
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Spangmose, A. L., E. Ginström Ernstad, S. Malchau, et al. "Obstetric and perinatal risks in 4601 singletons and 884 twins conceived after fresh blastocyst transfers: a Nordic study from the CoNARTaS group." Human Reproduction 35, no. 4 (2020): 805–15. http://dx.doi.org/10.1093/humrep/deaa032.
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Abstract Study question Are obstetric and perinatal outcomes in pregnancies after fresh blastocyst transfer (BT) comparable with those born after fresh cleavage stage transfer (CT) and spontaneous conception (SC)? Summary answer Fresh BT is associated with a higher risk of placental and perinatal complications. What is known already BT optimizes the selection of top-quality embryos and increases pregnancy and live birth rates per transfer compared to CT. However, concerns have been raised as extended culture duration may increase obstetric complications and impair perinatal outcomes. Previous studies have shown a higher risk of preterm birth (PTB) among infants born after BT compared with CT. Pregnancies after BT are also prone to a higher risk of same-sex twins after single embryo transfer (SET). Study design, size, duration A retrospective register-based cohort study used data from Denmark, Norway and Sweden including three cohorts: 56 557 singletons and 16 315 twins born after fresh IVF/ICSI cycles and 2 808 323 SC singletons in Denmark (birth years 1997–2014), Norway (2010–2015) and Sweden (2002–2015). Of the fresh IVF/ICSI singletons, 4601 were born after BT and 51 956 after CT. The twin cohort consisted of 884 fresh IVF/ICSI children born after BT and 15 431 fresh IVF/ICSI children born after CT. Participants/materials, setting, methods Data were obtained from a large Nordic cohort of children born after ART and SC initiated by the Committee of Nordic ART and Safety (CoNARTaS). The CoNARTaS cohort was established by cross-linking National ART-, Medical Birth-, and National Patients Registers using the unique personal identification number, allocated to every citizen in the Nordic countries. Obstetric and perinatal outcomes after BT, CT and SC were compared using logistic regression analysis. For perinatal outcomes, we calculated gestational age based on the date of oocyte pick-up (OPU) and in sensitivity analyses on data from Denmark and Norway, we also calculated gestational age based on the second-trimester ultrasonography (US) scan. Risk of pregnancies with same-sex twins after SET was used as a proxy for risk of monozygotic twins. Adjustments were made for child’s sex, birth year, parity (0 or &gt;1), maternal age, body mass index, smoking, educational level, fertilization method (IVF/ICSI), the number of aspirated oocytes, SET and country. Information on educational level and the number of aspirated oocytes was not available for Norway. Children born after frozen embryo transfer were not included. The birth cohorts were restricted according to the year in which BT was introduced in the different countries. Main results and the role of chance A higher risk of placenta previa was found in singleton pregnancies after BT compared with CT (adjusted odds ratio [aOR] 2.11 [95% CI 1.76; 2.52]). Singletons born after BT had a higher risk of PTB (aOR 1.14 [95% CI 1.01; 1.29]) compared with CT singletons, when estimated based on OPU. Furthermore, an altered male/female ratio (aOR 1.13 [95% CI 1.06; 1.21]) with more males following BT compared with CT was seen. Risk of same-sex twins after SET was higher after single BT compared with single CT (aOR 1.94 [95% CI 1.42; 2.60]). Limitations, reasons for caution Residual confounding cannot be excluded, in particular related to duration and cause of infertility that we could not adjust for due to lack of reliable data. Wider implications of the findings Extended embryo culture to the blastocyst stage has the potential to compromise obstetric and perinatal outcomes in fresh cycles. These results are important since an increasing number of IVF/ICSI treatments are performed as BT. Study funding/competing INTEREST(S) NORDFORSK (project no: 71450). The Research Fund of Rigshospitalet, Copenhagen University Hospital. ReproUnion Collaborative study, co-financed by the European Union, Interreg V ÖKS. Grants from Swedish state under the agreement between the Swedish government and the county councils, the ALF-agreement (LUA/ALF 70940), Hjalmar Svensson Research Foundation. The Research Council of Norway through its Centres of Excellence funding scheme, project number 262700. None of the authors has any conflicts of interests to declare regarding this study. Trial registration number ISRCTN11780826.