The origin, development, and decline of Boston's adult entertainment district : the Combat Zone

Thesis (M.C.P.)--Massachusetts Institute of Technology, Dept. of Urban Studies and Planning, 1986.MICROFICHE COPY AVAILABLE IN ARCHIVES AND ROTCHBibliography: leaves 85-89.by Salvatore M. Giorlandino.M.C.P

Antenatal automatic diagnosis of cleft lip via unsupervised clustering method relying on 3D facial soft tissue landmarks

Objectives Ultrasound (US) is the first-choice device to detect different types of facial dysmorphisms. Anyway, at present no standard protocol has been defined for automatic nor semi-automatic diagnosis. Even though the practitioner's contribution is core, steps towards automatism are to be undertaken. We propose a methodology for diagnosing cleft lip on 3D US scans. Methods A bounded Depth Minimum Steiner Trees (D-MST) clustering algorithm is proposed for discriminating groups of 3D US faces relying on the presence/absence of a cleft lip. The analysis of 3D facial surfaces via Differential Geometry is adopted to extract landmarks. Thus, the extracted geometrical information is elaborated to feed the unsupervised clustering algorithm and produce the classification. The clustering returns the probability of being affected by the pathology, allowing physicians to focus their attention on risky individuals for further analysis. Results The feasibility is tested upon the available 3D US scans data and then deeply investigated for a large dataset of adult individuals. 3D facial Bosphorus database is chosen for the testing, which seven cleft lip-affected individuals are added to, by artificially creating the defect. The algorithm correctly separates left and right-sided cleft lips, while healthy individuals create a unique cluster; thus, the method shows accurate diagnosis results. Conclusions Even if further testing is to be performed on tailored datasets made exclusively of fetal images, this techniques gives hefty hints for a future tailored algorithm. This method also fosters the investigation of the scientific formalisation of the "normotype", which is the representative face of a class of individuals, collecting all the principal anthropometric facial measurements, in order to recognise a normal or syndromic fetus

The APPLe Study: A Randomized, Community-Based, Placebo-Controlled Trial of Azithromycin for the Prevention of Preterm Birth, with Meta-Analysis

In a randomized trial in Malawi of azithromycin versus placebo in over 2,000 pregnant women, Jim Neilson and colleagues show no benefit of azithromycin for a number of outcomes including preterm birth and prenatal death

Reference charts for fetal corpus callosum length: a prospective cross-sectional study of 2950 fetuses.

Objectives-The purpose of this study was to establish reference charts for fetal corpus callosum length in a convenience sample. Methods-A prospective cross-sectional study was conducted at the Artemisia Fetal-Maternal Medical Center between December 2008 and January 2012. Among 16,975 fetal biometric measurements between 19 weeks and 37 weeks 6 days' gestation, 3438 measurements of the corpus callosum (20.3%) were available. After excluding 488 measurements (14.2%), a total of 2950 fetuses (85.8%) were considered and analyzed only once. Parametric and nonparametric quantile regression models were used for the statistical analysis. To evaluate the robustness of the proposed reference charts with respect to various distributional assumptions on the sonographic measurements at hand, we compared the gestational age (GA)-specific reference curves produced by the statistical methods used. Results-The mean corpus callosum length was 26.18 mm (SD, 4.5 mm; 95% confidence interval, 26.01-26.34 mm). The linear regression equation expressing the length of the corpus callosum as a function of GA was length (mm) = 11.17 + 1.62 x GA. The correlation between the dimension and gestation was expressed by the coefficient r = 0.83. Normal mean lengths according the parametric and nonparametric methods were defined for each week of gestation. Conclusions-This work provides new quantile-based reference charts for corpus callosum length measurements that maybe useful for diagnosis of congenital corpus callosum anomalies in fetal life

Ultrasonographic evaluation of placental cord insertion at different gestational ages in low-risk singleton pregnancies: a predictive algorithm

Objective: To evaluate the accuracy of ultrasound in visualizing placental cord insertion (PCI) at different gestational ages in order to recommend the most feasible period during pregnancy to identify it. Secondary aim was to propose a predictive algorithm for PCI visualization. Methods: We performed a single-center, prospective cohort study. We enrolled patients with singleton low-risk pregnancies who underwent fetal ultrasound scan at different gestational ages. We excluded patients with body mass index of 30 Kg/m2 or more, uterine fibroids larger than 5 cm, high-risk pregnancies, fetal weight lower than 10° percentile or higher than 90° percentile, increased (“deep pocket” > 80 mm) or decreased (“deep pocket” < 20 mm) amniotic fluid. Results: Among the 468 recruited patients, the visualization of PCI was not possible in 5.77% of the cases. Furthermore, we showed that PCI visualization was lower as the gestational age increased (p = 0.049) and more difficult in case of posterior placenta (p = 0.001). Conclusions: PCI should be evaluated in the first trimester or as early as possible during the second trimester. Moreover, we propose a feasible model to predict the possibility of PCI visualization according to gestational age and uterine site of implantation

Proteomic analysis for the study of amniotic fluid protein composition.

Abstract Amniotic fluid (AF), routinely used for prenatal diagnosis, contains large amounts of proteins produced by the amnion epithelial cells, fetal tissues, fetal excretions and placental tissuesAlthough many amniotic fluid proteins have been identified and are currently used to detect potential fetal anomalies, little is known about the functions of these proteins and how they interact with one another. Identification of changes in the protein content of amniotic fluid, therefore, may be used to detect a particular type of pathology, or to ascertain a specific genetic disorder. In the present work we used a proteomic approach, combining 2DE and MS, in order to study the protein composition of AFS

Prenatal measurement of testicular diameter by ultrasonography: development of fetal male gender and evaluation of testicular descent.

Prenatal ultrasonography has evolved through advancements in imaging technology and observer experience. The purpose of the present study was to evaluate fetal testicular descent and diameter in relation to gestational age. A prospective cross-sectional study on 331 fetuses from an unselected population underwent a detailed assessment of testicular descent and diameter at 20-40 weeks' gestation by means of transabdominal sonography (91.2%) and transvaginal sonography (8.8%) when necessary. Fetal gender was identified in the transverse and sagittal planes and maximum testicular diameter was measured. The mean testicular diameter (in millimeters) per week and the 95% confidence interval (CI) were defined. Testicular descent was not observed prior to 23 weeks' gestation, with 6.6% of the fetuses having one testis descended at 23 weeks and 98.2% after 32 weeks. A linear relationship between testicular diameter and gestational age was observed. The present results chart the time course for testicular descent and provide a centile chart for fetal testicular diameter from 25 to 40 weeks' gestation. These findings may aid prenatal diagnosis of associated abnormal conditions as well as investigations into the clinical finding of abnormal testicular size

Prenatal diagnosis and clinical outcome of ovarian cysts

Technical refinements of ultrasound (US) have greatly affected the antenatal diagnosis and treatment of ovarian cysts. From 1985 to 1990 25 consecutive fetuses with ovarian cysts were followed-up by US both during pregnancy and postnatally. All cases were diagnosed between the 28th and 39th weeks of gestation. Deliveries were all at term; cesarean section was required only for obstetric complications. Eight fetuses (32%) showed US patterns of cyst torsion, a finding confirmed at surgery in all. In five patients US patterns suggested complications postnatally that were also confirmed at operation. In six cases cysts increased or remained unchanged in size after 15 days of life: in 50% of these surgery showed ovarian torsion. In the remaining six cases spontaneous resolution occurred within 1 to 4 months. One patient required intrauterine needle aspiration. There were two cases of intestinal obstruction. To date, more than 60% of newborns with ovarian cysts require oophorectomy; however, different treatments (cystectomy, needle aspiration, uncapping) combined with a close US follow-up are likely to reduce this percentage

Validation of Extensive Next-Generation Sequencing Method for Monogenic Disorder Analysis on Cell-Free Fetal DNA: Noninvasive Prenatal Diagnosis

During pregnancy, a percentage of the cell-free DNA circulating in the maternal blood is represented by the cell-free fetal DNA (cffDNA), constituting an accessible source for noninvasive prenatal genetic screening. The coexistence of the maternal DNA, the dominant fraction of cell-free DNA, together with the cffDNA component and the scarcity of the cffDNA itself make applying traditional methods of genetics and molecular biology impossible. Next-generation sequencing methods are widely used to study fetal aneuploidies. However, in monogenic disorders, there have been relatively few studies that analyzed single mutations. We present a method for the analysis of an extended group of gene variants associated with recessive and dominant autosomal disorders using next-generation sequencing. The proposed test should allow a complete analysis of common genetic disorders and pathogen-associated variants for diagnostic use. The analysis of cffDNA for single gene disorders may replace invasive prenatal diagnosis methods, associated with the risk of spontaneous abortion and psychological stress for patients. The proposed test should assess reproductive risk for both genetic family disorders and de novo occurrences of the disease. The application of this method to a case of beta-thalassemia is also discussed