Ultrasonic biparietal diameter (BPD), femur length, abdominal circumference, femur length/abdominal circumference ratio, estimated fetal weight, ponderal index, estimated fetal length were measured within 72 h of delivery of 30 small-for-date (SFD) and 174 non-SFD newborns. Evaluation of each ultrasound variable in the antenatal diagnosis of SFD fetus was assessed. Abdominal circumference and estimated fetal weight were the best predictors in confirming SFD in 73.3 and 76.6 per cent respectively, followed by BPD (63.3%). Other variables (femur length, femur length/abdominal circumference ratio, estimated fetal length and ponderal index) were less accurate in diagnosis of SFD babies. For all variables studied negative predictive value was high (almost 90% or above). However, positive predictive value for abdominal circumference and estimated fetal weight were satisfactory. This study demonstrates the usefulness of abdominal circumference and estimated fetal weight in recognising SFD. It also shows that various growth variables could be used to rule out the diagnosis of IUGR with reasonable accuracy (negative predictive value greater than or equal to 90).

Two lab-scale Self Forming Dynamic Membrane BioReactors (SFD-MBR), equipped with 50 µm nylon meshes were set up and operated for the treatment of real municipal wastewater. Plastic carriers were added in one of the two bioreactors to generate a combination of the Integrated Fixed-film Activated Sludge (IFAS) and the SFD-MBR technologies. Overall, the two systems performed very well, achieving excellent effluent quality under steady state conditions and showing good resilience to extreme organic loading conditions. Continuous air scouring and periodical mesh cleaning by jet rinsing with tap water were effective in maintaining stable and high productivity (membrane flux around 67 L m2 h-1) over a period of 140 days. The application of the IFAS process resulted in lower production of excess sludge and improved denitrification. On the other hand, under the tested conditions the combined IFAS-SFD-MBR showed a higher tendency to mesh clogging with respect to the SFD-MBR.

OBJECTIVE

To report a methodology for 3-dimensional (3D) assessment of the stent-graft deployment accuracy after endovascular aneurysm repair (EVAR).

METHODS

A methodology was developed and validated to calculate the 3D distances between the endograft fabric and the renal arteries over the curve of the aorta. The shortest distance between one of the renal arteries and the fabric (SFD) and the distance from the contralateral renal artery to the fabric (CFD) were determined on the first postoperative computed tomography (CT) scan of 81 elective EVAR patients. The SFDs were subdivided into a target position (0-3 mm distal to the renal artery), high position (partially covering the renal artery), and low position (>3 mm distal to the renal artery). Data are reported as the median (interquartile range, IQR).

RESULTS

Intra- and interobserver agreements for automatic and manual calculation of the SFD and CFD were excellent (ICC >0.892, p<0.001). The median SFD was 1.4 mm (IQR -0.9, 3.0) and the median CFD was 8.0 mm (IQR 3.9, 14.2). The target position was achieved in 44%, high position in 30%, and low position in 26% of the patients. The median slope of the endograft toward the higher renal artery was 2.5° (IQR -5.5°, 13.9°).

CONCLUSIONS

The novel methodology using 3D CT reconstructions enables accurate evaluation of endograft position and slope within the proximal aortic neck. In this series, only 44% of endografts were placed within the target position with regard to the lowermost renal artery.

A design of cladding waveguides in Nd:YCOB nonlinear crystals is demonstrated in this work. Compact Fabry-Perot oscillation cavities are employed for waveguide laser generation at 1062 nm and self-frequency-doubling at 531 nm, under optical pump at 810 nm. The waveguide laser shows slope efficiency as high as 55% at 1062 nm. The SFD green waveguide laser emits at 531 nm with a maximum power of 100 μW.

OBJECTIVE

Different detector properties will heavily affect the results of off-axis measurements outside of radiation fields, where a different energy spectrum is encountered. While a diode detector would show a high spatial resolution, it contains high atomic number elements, which lead to perturbations and energy-dependent response. An ionization chamber, on the other hand, has a much smaller energy dependence, but shows dose averaging over its larger active volume. We suggest a way to obtain spatial energy response corrections of a detector independent of its volume effect for profiles of arbitrary fields by using a combination of two detectors.

METHODS

Measurements were performed at an Elekta Versa HD accelerator equipped with an Agility MLC. Dose profiles of fields between 10 × 4 cm² and 0.6 × 0.6 cm² were recorded several times, first with different small-field detectors (unshielded diode 60012 and stereotactic field detector SFD, microDiamond, EDGE, and PinPoint 31006) and then with a larger volume ionization chamber Semiflex 31010 for different photon beam qualities of 6, 10, and 18 MV. Correction factors for the small-field detectors were obtained from the readings of the respective detector and the ionization chamber using a convolution method. Selected profiles were also recorded on film to enable a comparison.

RESULTS

After applying the correction factors to the profiles measured with different detectors, agreement between the detectors and with profiles measured on EBT3 film was improved considerably. Differences in the full width half maximum obtained with the detectors and the film typically decreased by a factor of two. Off-axis correction factors outside of a 10 × 1 cm² field ranged from about 1.3 for the EDGE diode about 10 mm from the field edge to 0.7 for the PinPoint 31006 25 mm from the field edge. The microDiamond required corrections comparable in size to the Si-diodes and even exceeded the values in the tail region of the field. The SFD was found to require the smallest correction. The corrections typically became larger for higher energies and for smaller field sizes.

CONCLUSIONS

With a combination of two detectors, experimentally derived correction factors can be obtained. Application of those factors leads to improved agreement between the measured profiles and those recorded on EBT3 film. The results also complement so far only Monte Carlo-simulated values for the off-axis response of different detectors.

A spray freeze drying (SFD) method, using a spray nozzle, liquid N(2) and a lyophilizer, was developed to prepare composite particles of a poorly water-soluble drug. The resultant particles were found to have a porous structure. The purpose of the present research was to prepare a sustained release formulation using the SFD technique. Tolbutamide (TBM)and Eudragit S were used as model drugs and pH-dependent carrier, respectively. Eudragit S is a polymer that is soluble at or above pH 7.0. Morphological evaluation of the composite particles revealed that they had a porous structure with a significantly larger specific surface area than bulk TBM. The physicochemical properties of the particles were found to be dependent on the drug to carrier ratio, with the crystallinity of the TBM decreasing as the proportion of Eudragit S increased. Dissolution tests in solutions of pH 1.2 and pH 6.8 showed that the release profiles of TBM from the SFD composite particles were improved compared to bulk TBM, through the use of the pH-dependent carrier. On the other hand, following compression of the composite particles, sustained release was observed in a solution of pH 6.8, whereas almost no dissolution occurred in a solution of pH 1.2.

Purpose of review: Surgical flow disruptions (SFD) are deviations from the progression of a procedure which can be potentially compromising to the safety of the patient. Investigators have previously demonstrated that SFDs can increase the likelihood of error. To date, there has been no investigation into flow disruptions through the eyes of clinicians in the operating room. This study, therefore, attempted to better understand SFDs and their impact from the perspective of operating room team members.

Recent findings: After Institutional Review Board approval, a survey was sent to operating room team members including surgeons, anesthesia providers, nurses, and surgical technologists. The survey was developed to assess the perceived frequency and consequences of SFDs, and the ability to report and perceive the efficacy of reporting to management. Among 111 survey participants, 65% reported that surgical flow disruptions happen either "several times a day" or "every procedure." Forty percent ranked poor communication as the most frequent cause of SFDs. Ten percent reported equipment failure was the most frequent cause of SFDs. Respondents who identified as attending surgeons felt impacts on patient safety and staff burnout was the most likely consequence of SFDs. Scrub technicians and nurses felt that economic consequences were the most likely result. Forty-four percent did not feel reporting led to effective change. Thirty-five percent did not believe they could report issues without adverse consequences. Flow disruptions represent patterns or accumulations of disruptions which may highlight weak points in surgical systems and potential causes of staff burnout and medical error. The data in the present investigation demonstrate that OR team members recognize surgical flow disruptions are an important issue and believe poor communication and equipment problems are a significant factor. Our data additionally suggest the groups surveyed do not feel safe or productive in reporting flow disruptions.

Keywords: Anesthesiologist; Nurse; Operating room; Surgeon; Surgical flow disruptions.

BACKGROUND

The subsequent L5-S1 disc degeneration associated with long fusion arthrodesis terminating at L5 in patients with adult scoliosis has been a common concern. However, few studies paid attention to its preoperative predictors, especially in spinopelvic parameters. The purpose of the present study was to clarify the preoperative predictors of subsequent L5-S1 disc degeneration after long fusion arthrodesis terminating at L5 in patients with adult scoliosis on spinopelvic parameters.

METHODS

In this retrospective study, we enrolled 67 patients with adult scoliosis, and the patients were divided into disc degeneration group (DD) and no disc degeneration group (NDD), based on the presence or absence of subsequent L5-S1 disc degeneration. The status of L5-S1 disc was evaluated by a modified version of radiographic classification. Characteristics and spinopelvic parameters of preoperative patients were collected as potential predictors for subsequent lumbosacral disc degeneration after long fusion arthrodesis terminating at L5 in patients with adult scoliosis. Multivariate logistic regression analysis and the receiver operating characteristic curve were used to identify the preoperative predictors, with an adjusted odds ratio (OR) and 95% confidence intervals (CI).

RESULTS

Thirty-six patients (53.73%) with subsequent L5-S1 disc degeneration were divided into group DD (preoperative score 0.81 ± 0.57, last follow-up score 1.83 ± 0.60, P < 0.001), and the other 31 patients were divided into group NDD (preoperative and last follow-up score 0.87 ± 0.49). There was no statistical difference in preoperative score (P = 0.583) of lumbosacral disc between two groups; however, significant statistical difference showed in last follow-up score (P < 0.001). Multivariate logistic regression identified three preoperative predictors: pelvic incidence (PI) (P = 0.018), sagittal vertical axis (SVA) (P = 0.024), and sacrum-femoral distance (SFD) (P = 0.023). PI < 48.5° (OR = 0.911, 95% CI = 0.843-0.984), SVA>> 4.43 cm (OR = 1.308, 95% CI = 1.036-1.649), and SFD>> 5.65 cm (OR = 1.337, 95% CI = 1.041-1.718) showed satisfied accuracy for predicting subsequent L5-S1 disc degeneration.

CONCLUSIONS

The prevalence of the subsequent L5-S1 disc degeneration after long fusion arthrodesis terminating at L5 in patients with adult scoliosis was 57.3% (36 of 67 patients). PI < 48.5°, SVA>> 4.43 cm, and SFD>> 5.65 cm were preoperative predictors for the subsequent L5-S1 disc degeneration. More attention should be paid to prevent the L5-S1 disc from degeneration when these preoperative predictors exist, especially with two or more.

In 830 healthy pregnant women with delivery after the 37th week and parturation of a new-born normal for date (NFD) the Symphysis-Fundus-Measurement (SFM) was established and a standard curve was constructed. The curve is a nearly identic one with that given by the Swedish author Westin. There are significant deviations from the standard curve in patients with large for dates fetuses (LFD) and in those with small for dates fetuses (SFD). For LFD the difference is to make ensure statistically in the 24th and for SFD in the 31th week of pregnancy. Both parameters leave the +/- 1s--Standard-deviation in the 33th week of pregnancy. The +/- 2 s--Standard-deviation is not to be passed over. In twin-pregnancies the +/- 2 s--Standard-deviation is crossed after the 18th week of pregnancy. In obese pregnant women the SFM is to be seen significantly over that of pregnancies with normal body-weight. In conclusion we believe, that by consideration of the +/- 1 s--Standard-deviation and of the values for obese women in the curve of the SFM the distinctive sensitivity for detection of SFD-pregnancies is to be improved. By assessment of the registered dates of 308 Nulligravidae and 260 Multigravidae showing an undisturbed progress of pregnancy and a term--delivery the Westin--Score of the cervix uteri and its underlying single parameters have been ascertained and graphically recorded. The values concerning the Multiparae are a bit higher positioned than those of the Nulliparae. The inclination of both curves are otherwise similar.(ABSTRACT TRUNCATED AT 250 WORDS)

To study the influence of beta 2-stimulants on pregnant woman and fetus from cardiovascular and metabolic viewpoint, tests were conducted on pregnant rats and human clinical cases of threatened premature labor. 1) When terbutaline 800 micrograms was administered to groups of pregnant rats for 4 days and 8 days, body weight, and weight of liver, placenta and heart of both mother and fetus indicated the trend of decrease when compared to the control, but the difference was not statistically significant. 2) Concentration of c-AMP in the fetal serum was found to be less than the control (P less than 0.001) under the above conditions and consequently c-AMP/c-GMP indicated decrease. Concentrations of c-AMP and c-GMP in the maternal, fetal cardiac tissue were in a decreasing tendency in the terbutaline group. In the patholo-histological studies, terbutaline-induced myocardial necrosis was not observed. 3) In the past five years, of the terbutaline treated cases, specifically 15 cases of large dose and long period of administration were analyzed and the prognosis of their children were followed up. The doses were 20.6 mg (iv, im), and 1276 mg (po), arrest less than 37W was noted in four cases, but onset of SFD was not observed. During the administration term, no abnormality of mothers was noted before and after delivery, and unusual phenomenon was not recognized in the prognosis traced on newborns.

Healthcare organizations strive to deliver safe, high-quality, efficient care. These complex systems frequently harbor gaps, which if unmitigated, could result in harm. Systems-focused simulation (SFS) projects, which include systems-focused debriefing (SFD), if well designed and executed, can proactively and comprehensively identify gaps and test and improve systems, enabling institutions to improve safety and quality before patients and staff are placed at risk.The previously published systems-focused debriefing framework, Promoting Excellence and Reflective Learning in Simulation (PEARLS) for Systems Integration (PSI), describes a systematic approach to SFD. It includes an essential "pre-work" phase, encompassing evidence-informed steps that lead up to a SFD. Despite inclusion in the PSI framework, a detailed description of the pre-work phase, and how each component facilitates change management, was limited.The goal of this paper is to elucidate the PSI "Pre-work" phase, everything leading up to the systems-focused simulation and debriefing. It describes how the integration of project and change management principles ensures that a comprehensive collection of safety and quality issues are reliably identified and captured.

Keywords: Change management; Patient safety; Project management; Quality improvement; Simulation; System improvement; Systems integration; Systems simulation; Systems-focused debriefing.

Background: Late-onset retinal degeneration (L-ORD) is a rare autosomal dominant retinal dystrophy related to C1QTNF5 gene variants.Materials and methods: Twenty-six patients (21-81 years) with L-ORD due to c.562C>A p.(Pro188Thr) with a mean follow-up time of 8 years (range 1-37 years) underwent an extensive ophthalmic work-up.Results: Best-corrected visual acuity (BCVA) and visual fields were maintained up to 50 to 55 years (n = 8), with a gradual decline, but conservation of functional central vision between 55 to 65 years (n = 15), followed by a steep decrease in overall visual function beyond 65 years (n = 9). Classic anterior segment findings in L-ORD of abnormally long, anteriorly inserted lens zonules were absent in most patients (n = 24/26). In contrast, findings of iris transillumination and sphincter pupillae atrophy with poor dilation were novel. Patients presented with three completely different initial fundus phenotypes: adjoining pavingstone-like atrophic patches (type 1) (n = 6/20); tiny yellow-white subretinal dots (type 2) (n = 8/20); or larger yellow, thick, round sub-RPE drusenoid deposits (type 3) (n = 4/20). Two patients had a mixed phenotype. Although different in presentation phenotype, patients eventually all progressed to a common panretinal atrophy with diffuse intraretinal pigment migration beyond the age of 65. Progression pace, and thus visual prognosis, differed depending on presentation phenotype. Specifically, type 2 appears to have a more benign course.Conclusions: Phenotypic analysis showed three distinct presenting phenotypes with a considerable intrafamilial variability both in age of onset of clinical signs and in disease progression, with a fair visual potential (>20/40) until the seventh decade.Abbreviations: L-ORD: Late-onset retinal degeneration; C1QTNF5: complement 1Q tumor necrosis factor 5; OCT: Ocular coherence tomography; BCVA: Best-corrected visual acuity; RPE: Retinal pigment epithelium; ffERG: Full-field electroretinography; IRD: Inherited retinal dystrophy; CNV: Choroidal neovascularization; LAZ: Long anteriorly inserted zonules; AMPK: AMP-activated protein kinase; IOP: Intraocular pressure; cSLO: confocal scanning laser ophthalmoscopy; BAF: Blue light autofluorescence; NIR-AF: Near-infrared autofluorescence; NIR-R: Near-infrared reflectance; RF: Red-free; SD-OCT: Spectral domain ocular coherence tomography; HRR: Hardy-Rand-Rittler pseudo-isochromatic plates; AS: anterior segment; UBM: ultrasound biomicroscopy; PCR: Polymerase chain reaction; SNP: Single nucleotide polymorphism; VEGF: Vascular endothelial growth factor; IZ: Interdigitation zone; EZ: Ellipsoid zone; ELM: External limiting membrane; LP: Light perception; AMD: Age-related macular degeneration; SFD: Sorsby fundus dystrophy.

Keywords: C1QTNF5; L-ORD; LAZ; Late-onset retinal degeneration; long aanteriorly insertedlens zonules.

The increasing cost of landfills, and lack of natural large aggregates observing interests for using wastes to produce concrete and mortar materials. Utilizing plastic waste and crushed ceramic waste not only save the landfills cost but also reduce the cost of using natural aggregates. Secondly, tea is the second most consumed beverage at world level and resulted huge amount of waste. Thus, this article attempts to develop the appropriate characteristics of self-compacting concrete (SCC) by adding plastic waste, tea waste, and crushed ceramics. The fresh and hardened properties of the SCC were investigated to examine the addition of waste plastic, whereas the content of tea waste and crushed ceramic was kept constant. The results revealed that the addition of plastic waste caused to reduce SFD, L-Box, segregation, and fresh density, and obtained maximum values as 765 mm, 0.94, 19, and 2382 kg/m³ for PP5 and RP5, respectively, whereas T500 and V-funnel flow gradually increased with increasing waste plastic, and the maximum values were obtained as 3.44 and 16 for RP25 and PP+RP25, respectively. Further, compressive and flexural strengths were decreased with increasing content of waste plastic, and the maximum values were obtained as 55 MPa and 6.5 MPa for PP5 and PP+RP5 at 28 days, respectively. The results proved the possibility of using plastic waste, tea waste, and crushed ceramics in SCC.

Keywords: Eco-friendly material; Fresh and hardened properties; Recycled material; Self-compacting concrete; Sustainability.

In 2012, the paramedical Francophone Diabetes Society (SFD) visited Mayotte in the context of a training programme for health professionals. The training addressed diabetes prevention, self-monitoring of blood glucose and treatment management while respecting the population's cultural habits.

In the industry there is a tendency to shorten production processes of semi-dry fermented sausages (SFDS). Emerging problems then are generally related to product flavour and texture. Five batches of the same product were produced under pilot-plant conditions, following strictly standardised procedures. At pre-determined time intervals in the early ripening stage weight loss, pH and a(w) values were recorded and Uniaxial compression tests were performed on cylindrical axial product samples. Uniaxial compression was introduced as a potential new methodology for determining the consistency of fermented sausages. The compression data were used to calculate stress and strain at fracture and Young's modulus. Despite careful standardisation of both the product formulation and the manufacturing process, the various parameters showed considerable variation. As anticipated, there was significant product weight loss, and decrease in pH and a(w) during the manufacturing process. Analyses of variance showed that neither stress, strain nor Young's modulus changed significantly over the period from 2-9 days. However, the averages of the Young's modulus tended to increase with time. These results suggest that the Young's modulus may become an important production parameter, in addition to the already applied product pH, a(w) and weight loss.

To find the effect of intrauterine growth retardation on postnatal changes in body composition, we studied nine preterm small for date (SFD) and 9 gestation matched appropriate for gestational age (AGA) infants (mean +/- SD birth weight - SFD : 1431 +/- 16I g, AGA : 1904 +/- 223 g, gestational age - SFD; 237 +/- 9 days, AGA : 236 +/- 7 days). Total body water (TBW) and extracellular water (ECW) were measured at birth, on the day of maximum weight loss and on regaining of birth weight. Body solids were calculated from the difference between TBW and body weight. SFD infants had significantly less postnatal weight loss (64 +/- 19 g) than AGA infants (135 +/- 49 g; P < 0.01) and showed a significant gain in body solids (19 +/- 12 g) during this period which was not seen in AGA infants (-4 +/- 14 g; P < 0.05). The subsequent weight gain occurred at similar rates in SFD (16 +/- 4 g/day) and AGA (18 +/- 6 g/day) infants, but a significantly higher ratio of the weight gain consisted of solids in SFD as compared to AGA infants (P < 0.05). Per unit of body weight, SFD infants had significantly less body solids (213 +/- 12 g/kg) than AGA infants (228 +/- 18 g/kg; P < 0.05) at birth, but by the time birth weight was regained the two groups of infants had similar probody solids (SFD: 248 +/- 7 g/kg, AGA : 255 +/- 12 g/kg). These results suggest that in SFD infants catch-up growth starts early, during the period of apparent weight loss.

Middle cerebral artery (MCA) blood flow velocity waveforms were recorded by a pulsed Doppler system in normal and small for dates (SFD) fetuses. Eighty four normal growth fetuses and 15 SFD fetuses were studied between the 28th and 40th gestational week. The flow velocity waveforms were analysed to determine the resistance index (RI = peak systolic velocity minus end diastolic velocity/peak systolic velocity). The results obtained were as follows: 1. The mean values of RI in the MCA had a peak of 0.802 +/- 0.049 at 32-33 gestational weeks and decreased gradually to a level of 0.686 +/- 0.087 at 40 gestational weeks. 2. In 8 asymmetrical SFD fetuses, the RI values for the MCA were below the normal range (mean -1.5 SD) in 6 cases and normal in 2 cases. 3. The RI values for MCA in all 7 symmetrical SFD fetuses were in the normal range.

Sorsby's Fundus Dystrophy (SFD) is a rare autosomal dominant maculopathy that shares many clinical features with Age-Related Macular Degeneration (AMD). It is caused by a mutation in a single gene, TIMP-3, which accumulates in Bruch's membrane (BM). BM thickening and TIMP-3 accumulation can also be found in AMD. From our understanding of the pathophysiology of SFD we hypothesize that BM thickening could be responsible for making the elastic layer vulnerable to invasion by choriocapillaris, thereby leading to choroidal neovascularization in some cases of AMD, whilst in others it could deprive the retinal pigment epithelium of its blood supply, thereby causing geographic atrophy.

OBJECTIVE

To study the mean, standard deviation and centiles for anthropometry and haemoglobin in healthy term infants followed up to 12 months of age.

METHODS

Cohort study.

METHODS

Kathmandu Medical College Teaching Hospital (KMCTH) in Kathmandu.

METHODS

Consecutive healthy term newborns Method: 100 consecutive healthy term newborns were enrolled at birth.19 babies were lost in follow up. So, 81(45 male, 36 female) healthy, full term infants were followed up from birth to 12 months of age. Anthropometry (weight, length, and head circumference) and haemoglobin were measured at birth, 6 weeks, 6 months, 9 months and 12 months of age. Haemoglobin was estimated by Hemocue microcuvette method. The data so obtained was subjected to statistical analysis by using SPSS computer package.

RESULTS

Mean, centile and standard deviation score values for weight (Kgs), infant length (cms), head circumference (cms) and haemoglobin (gm/dl) at birth, 6 weeks, 6 months, 9 months and 12 months of age.

RESULTS

Out of 100 babies enrolled, data presented here is for the remaining 81 babies. Among 81 babies, 76 were appropriate for gestational age (AGA) and 3 were small for gestation (SFD). The mean, standard deviation and percentile values are presented for anthropometry (weight, length and head circumference) and haemoglobin at birth, 6 weeks, 6 months, 9 months and 12 months of age. The mean birth weight was 3.05 kg (SD 0.41). The mean infant length and head circumference at birth were 49 cm (2.28) and 33.8 cm (SD1.4) respectively. The mean haemoglobin at birth was 15.7 gm/dl (SD 2.29). At 12 months of age mean weight, length, head circumference and haemoglobin were 9 kg (SD 0.81), 73.5 cm (SD 2.9), 45 cm (SD 1.2 ) and 11.1 gm/dl (SD 1.41) respectively. Almost 50% of the babies at 6 weeks, 9 months and 12 months of age were found to be anaemic (Hb < 11 gm/dl). Among the babies, 49% were exclusively breast fed for 6 months of age. Other feeding practices seen were, mothers breast feed with water supplementation (25%), mothers breast feeding with formula feed (16%) and formula feeding only (5%). National and international comparisons of anthropometry and haemoglobin data are shown in table.

Two hundred and sixty three pregnant diabetic mothers' perinatal outcome was evaluated. Two hundred and twenty five infants were born to gestational diabetic mothers (IGDM) and 38 infants to mothers with established diabetes mellitus (IDM). In IGDM group, 34 babies (15%) were preterm and 45 (20%) were low birth weight (less than 2500 g). Thirty eight babies (17%) were large-for-dates (LFD) and 14 (6.2%) were small-for-dates (SFD). Among IDM group, 8 (21%) babies were preterm and 8 (21%) were low birth weight (less than 2500 g). Fifteen babies (39.5%) were LFD and 3 (8%) were SFD. Out of all babies, hypoglycemia occurred in 43 (16%), birth asphyxia in 24 (9%) and respiratory distress in 21 (8%). Nearly half of respiratory distress were due to hyaline membrane disease. Perinatal mortality rate was significantly higher (p less than 0.001) in IDM (237/1000 live birth) as compared to IGDM (40/1000 live birth).

The 2007 international consensus about the standardization of HbA(1c) determination and expression of results is progressively implemented in most countries. In France, a common working group of the Société française de biologie clinique (SFBC) and the Société francophone de diabétologie (SFD) has expressed the following recommendations. HbA(1c) results are expressed in percentage of total hemoglobin and in mmol HbA(1c)/mol Hb, but are not converted into estimated average glucose. A table indicating the correspondence between HbA(1c) and estimated average glucose may be given with the results, subject to precautions of interpretation at the individual level.

This paper performs integrated performance evaluation, including preamble detection in the Smart Body Area Networks (SmartBAN) physical layer (PHY). The system specifications for a PHY and media access control layer (MAC) in SmartBAN, which is a standard for medical and health care advanced by the European Telecommunications Standards Institute (ETSI), were issued in April 2015. In the PHY, the packet structure has a two-octet preamble, which is used, e.g., for timing synchronization. However, it is considered that the current preamble structure is not appropriate for handling medical and healthcare data that are required to have high reliability because of the too simple structure. Therefore, we propose adding a start frame delimiter (SFD) to correctly detect the header position. Computer simulations indicate that preambles with an SFD consisting of an orthogonal maximal length sequence (M-sequence) perform better than SmartBAN and similar approaches, particularly when transmitting over the IEEE model CM3. In addition, the packet error ratio (PER) and energy efficiency are evaluated in an integrated manner while taking preamble detection into consideration. The numerical results from computer simulations indicated the best performance with respect to PER was achieved using a preamble with orthogonal M-sequences of 4 octets. However, for energy efficiency, better results were obtained using a preamble with orthogonal M-sequences of 2 octets. Additionally, the theoretical analysis found the optimum length of the PHY packet to achieve the maximum energy efficiency with PER less than 10^-2.

OBJECTIVE

Cellular immune status in major depression (MD) patients differs from that in somatoform disorder (SFD) patients and healthy controls (HC). It is still questionable whether the patterns of immune parameters remain stable over time. Therefore, we studied lymphocyte and monocyte cell counts and neopterin levels in peripheral blood of MD and SFD patients and HC over 12 weeks and tested for correlations between biochemical and psychometric parameters.

METHODS

Thirty-nine patients with MD, 27 with SFD, and 51 HC were recruited. Peripheral blood was drawn at four visits, at 4-week intervals. We assessed the total cell count of B lymphocytes, natural killer (NK) cells, T lymphocyte subpopu-lations, and monocytes by flow cytometry, and neopterin serum levels by ELISA. Psychometric parameters were measured with questionnaires.

RESULTS

Counts of lymphocytes, monocytes, and neopterin were stable in the SFD and HC groups. In the MD group, total CD3+, CD3+CD8+, NK cells, and CD3+CD25+ T cells showed inhomogeneous variances in Friedman tests, particularly in females. Neopterin correlated with depressed mood in MD patients, and with body mass index in HC.

CONCLUSIONS

Cellular immune parameters are stable in HC and SFD. Our results may indicate influences of MD and gender on some cellular immune parameters. This may need to be considered in future immunological studies.