Macrosomia - maternal and fetal risk factors

Risk factors associated with fetal macrosomia were studied in 348 pregnancies resulting in the delivery of an infant weighing 4 000 g or more in a black population. Identifiable maternal risk factors included a mother in her 3rd decade of life, multiparity, maternal weight of 70 kg or more at the end of pregnancy, prolonged or post-term pregnancy, abnormal glucose tolerance and previous history of a macrosomic infant. Male infants had a higher risk of being macrosomic. Macrosomic infants accounted for 3,4% of all singleton deliveries, with their caesarean section rate of 33,9% being almost three times that of control infants. The importance of antenatal prediction of fetal weight is emphasised and suggestions for reduction of the high perinatal mortality and morbidity rates, as well as maternal morbidity, are discussed

Ideas to Design an in situ Diamond Drilling Core Splitter within Soft Rocks

Diamond drilled cylindrical rock (core) from the earth is usually extracted using a drill rig. This is followed by splitting, at the surface with the aid of diamond impregnated saw blade, for good visual examination before sampling for analysis. The challenges in core splitting are imperfect division, time consuming, labour intensive and dust generation. This paper studied the wireline system of core barrel assembly and the device used in splitting of core (core splitting machine) at the surface, to provide ideas which would help design a mechanism that would take care of the splitting of the core in situ (i.e. at depth during the drilling process). Modifications of the core barrel assembly of the wireline system are such that the outer tube assembly is designed to have two ball bearings moulded with it. The back end assembly is designed to have a latching system which could operate independently. Also a static diamond cutting blade is inserted in the core lifter to split soft rocks or saprolite (with hardness of less than 5 on the Mohr’s scale) when a resultant feed force is applied. The stop ring in the inner tube should effectively grab the split core to prevent it from dropping and also protect the split core from washing away. Drilling at short intervals with controlled drill fluid usage is recommended in saprolite zone. Following the ideas provided, an in situ core splitter could be designed to eliminate hazards associated with conventional core splitting on the surface, save time and reduce dust generation.Keywords: Design, In situ, Diamond drilling, Core splitter, Wireline syste

Re-screening for syphilis at the time of delivery in areas ofhigh prevalence

Two hundred women who were screened for syphilis at their initial antenatal visit were rescreened at the time of delivery. Umbilical cord blood specimens as well as maternal sera were tested. Twenty-two (11%) women were rapid plasma reagin (RPR)-positive at booking, while a total of 23 (12%) were RPR-positive at the time of delivery, including an additional 5 (3%) who seroconverted. Four women who were RPR-positive at initial testing had become negative by the time of delivery following treatment. Of all neonates born to seropositive women, only 1 demonstrated clinical evidence of congenital syphilis. In view of the high seroconversion rate, we recommend screening for syphilis at the initial antenatal visit and rescreening at the time ofdelivery in areas such as ours

Natural history of endometriosis in pregnancy: ultrasound study of morphology of deep endometriosis and ovarian endometrioma

Objective: To assess the morphological appearance of deep endometriosis and ovarian endometrioma in pregnancy using pelvic ultrasound examination. Methods: This was a prospective observational cohort study conducted over 3 years at University College London Hospital, which is a tertiary level referral unit for early pregnancy complications and an accredited endometriosis center. All women who participated provided written consent and were invited for surveillance ultrasound examination at the time of their routine scans in pregnancy. All scans were performed by a single operator to eliminate interobserver variability. The change in size of ovarian endometrioma and nodules was reported as change in their mean diameter. Ovarian endometrioma with irregular thick inner walls, hyperechoic papillary projections and/or high vascularity and hyperechoic nodules with moderate to high vascularity were reported as decidualized. Results: Sixty-five women with a live, normally sited pregnancy and concomitant ultrasound features of deep and/or ovarian endometriosis were included in the study. The median age of the study population was 34 (range, 23–44) years, and the median gestational age at presentation was 7 + 6 (range, 3 + 6 to 18 + 0) weeks. From the cohort, 47/65 (72%) were nulliparous, 48/65 (74%) had a previous diagnosis of endometriosis and 19/65 (29%) conceived via in-vitro fertilization. There were 10/65 (15% (95% CI, 7–24%)) women with ovarian endometrioma alone, 28/65 (43% (95% CI, 31–55%)) with endometriotic nodules alone and the remaining 27/65 (42% (95% CI, 30–54%)) had both. Of the women with ovarian endometrioma who underwent follow-up, 29/34 (85% (95% CI, 73–97%)) experienced cyst regression, 2/34 (6% (95% CI, 0–14%)) experienced cyst growth, and in 3/34 (9% (95% CI, 0.0–18%)) women, cyst size was unchanged. In 10/34 (29% (95% CI, 14–45%)), there was complete resolution of all cysts. Of the women with nodules who underwent follow-up, 43/51 (84% (95% CI, 74–94%)) experienced nodule regression, 2/51 (4% (95% CI, 0–9%)) experienced nodule growth and, in 6/51 (12% (95% CI, 3–21%)) women, nodule size was unchanged. In 4/51 (8% (95% CI, 0–15%)) women, there was complete resolution of all nodules. In 5/37 (14% (95% CI, 3–25%)) women who attended postnatal follow-up, complete resolution of all endometriotic lesions occurred during pregnancy. In 10/34 (29% (95% CI, 14–45%)) women with ovarian endometrioma and 27/51 (53% (95% CI, 39–67%)) women with nodules, a pattern of growth was observed in the first and second trimesters, followed by regression later in pregnancy. Features of decidualization were observed in 17/34 (50% (95% CI, 33–67%)) women with ovarian endometrioma, most commonly in the first trimester, and in 25/51 (49% (95% CI, 35–63%)) women with nodules, most commonly in the second trimester. Conclusions: For the majority of women, despite features of decidualization being common in the first and second trimesters, ovarian endometrioma and deep nodules regress during pregnancy. Morphological changes of endometriosis in pregnancy are difficult to differentiate from characteristics of malignant lesions. Better understanding of the appearance of endometriosis in pregnancy is vital to minimize intervention and help counsel women regarding their condition. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology

Improved prediction of clay soil expansion using machine learning algorithms and meta-heuristic dichotomous ensemble classifiers

Soil swelling-related disaster is considered as one of the most devastating geo-hazards in modern history. Hence, proper determination of a soil's ability to expand is very vital for achieving a secure and safe ground for infrastructures. Accordingly, this study has provided a novel and intelligent approach that enables an improved estimation of swelling by using kernelised machines (Bayesian linear regression (BLR) & bayes point machine (BPM) support vector machine (SVM) and deep-support vector machine (D-SVM)); (multiple linear regressor (REG), logistic regressor (LR) and artificial neural network (ANN)), tree-based algorithms such as decision forest (RDF) & boosted trees (BDT). Also, and for the first time, meta-heuristic classifiers incorporating the techniques of voting (VE) and stacking (SE) were utilised. Different independent scenarios of explanatory features’ combination that influence soil behaviour in swelling were investigated. Preliminary results indicated BLR as possessing the highest amount of deviation from the predictor variable (the actual swell-strain). REG and BLR performed slightly better than ANN while the meta-heuristic learners (VE and SE) produced the best overall performance (greatest R2 value of 0.94 and RMSE of 0.06% exhibited by VE). CEC, plasticity index and moisture content were the features considered to have the highest level of importance. Kernelized binary classifiers (SVM, D-SVM and BPM) gave better accuracy (average accuracy and recall rate of 0.93 and 0.60) compared to ANN, LR and RDF. Sensitivity-driven diagnostic test indicated that the meta-heuristic models’ best performance occurred when ML training was conducted using k-fold validation technique. Finally, it is recommended that the concepts developed herein be deployed during the preliminary phases of a geotechnical or geological site characterisation by using the best performing meta-heuristic models via their background coding resource

Production of Activated Carbon in a Multi-Functional Platform Pilot Plant

Activated carbons were produced from coconut shells as  raw materials in a Multi-Functional Platform (MFP) pilot plant using the chemical activation method.. Derived activated carbon named, C1, C2, C3, C4, C5, and C6, based on the activation agent used and the heating rate employed, were compared to a commercial activated carbon based on acceptable parameters. C1, C2, C3, C4, C5 and C6 had relative hardness of 95.67%, 92.67%, 89.67, 91.6%, 90.67% and 93.33% respectively, averaging 92.26%, as compared to 95.6% relative hardness for the commercial activated carbon used. C6 the best performing activated carbon produced (using KOH and heating rate of 7.67 ºC/min) , had an adsorption rate of 188.68 mg Au/ h g, which was higher than the adsorption rate of the commercial activated carbon, which is 185.19 mg Au/ h g. This validates the possibility of activated carbon production commercially in Ghana

Methylation enrichment pyrosequencing: combining the specificity of MSP with validation by pyrosequencing

It has been suggested that detection of aberrant DNA methylation in clinical specimens such as sputum or saliva may be a valuable tumour biomarker. Any clinically applicable detection technique must combine high sensitivity with high specificity. In this study we describe methylation enrichment pyrosequencing (MEP), which benefits from the high sensitivity and specificity of methylation-specific PCR (MSP) but has a second, confirmatory, pyrosequencing step. The pyrosequencing reaction is rapid, relatively inexpensive and offers significant logistical advantages over previously described validation methods. As proof of principle, we illustrate MEP using assays of p16 and cyclin A1 promoters in a methylated DNA dilution matrix and also in a clinical setting using paired saliva and oral tumour specimens. Our results confirm that mis-priming of MSP, with subsequent false positive results, can occur frequently (perhaps 10%) in assays combining high numbers of PCR cycles and low concentrations of starting DNA. In our clinical example, MEP of saliva-derived DNA was more sensitive than standard non-methylation-specific pyrosequencing as illustrated using p16 and cyclin A1 promoter methylation assays

Contraceptive discontinuation among women of reproductive age in Papua New Guinea.

BACKGROUND: Papua New Guinea has one of the lowest contraceptive prevalence rates among women of reproductive age in the Western Pacific Region and this makes contraceptive discontinuation in this country a critical public health issue worth studying. This study sought to assess the factors associated with contraceptive discontinuation among women of reproductive age in Papua New Guinea. METHODS: The data used for the analysis were obtained from the Papua New Guinea Demographic and Health Survey which was conducted in 2016-2018. The outcome variable for this study was contraceptive discontinuation among women of reproductive age. Crude odds ratios and adjusted odds ratios with 95% confidence intervals were estimated using binary logistic regression. RESULTS: About 33.26% of the women discontinued injectables, 19.15% discontinued pills and 3.77% discontinued other contraception methods. Women aged 20-24 [aOR = 2.12, CI = [= [1.04,4.31] through to those aged 30-34 [aOR = 1.98, CI = 1.03,3.79] had higher odds to discontinue contraceptive usage compared to those aged 45-49. Women with no information on choice of contraception [aOR = 2.85, CI = 2.31,3.51], those with two or more births in the last five years [aOR = 2.35, CI = 1.65,3.35] and those living in the Highland region [aOR = 1.71, CI = 1.28,2.29] were more likely to discontinue contraceptive usage compared with those with information on contraceptive choices, those with no births and those living in the Island region respectively. However, women in the rural areas [aOR = 0.78, CI = 0.61,0.99], women using LARC [aOR = 0.10, CI = 0.06,0.15], injectables [aOR = 0.43, CI = 0.30,0.63] and other modern contraception methods including condom [aOR = 0.22, CI = 0.15,0.34] were less likely to discontinue contraceptive usage. CONCLUSION: A nationwide mass education on the benefits of contraception is recommended for the Papua New Guinea National Department of Health to tackle the key findings of this study which were high contraceptive discontinuation prevalence with lack of information on choice, disproportionately high contraceptive discontinuation rate in the Highland Region and the desire to give birth to more than two children as some factors associated with contraceptive discontinuation in Papua New Guinea

Biosignatures of Exposure/Transmission and Immunity.

A blood test that captures cumulative exposure over time and assesses levels of naturally acquired immunity (NAI) would provide a critical tool to monitor the impact of interventions to reduce malaria transmission and broaden our understanding of how NAI develops around the world as a function of age and exposure. This article describes a collaborative effort in multiple International Centers of Excellence in Malaria Research (ICEMRs) to develop such tests using malaria-specific antibody responses as biosignatures of transmission and immunity. The focus is on the use of Plasmodium falciparum and Plasmodium vivax protein microarrays to identify a panel of the most informative antibody responses in diverse malaria-endemic settings representing an unparalleled spectrum of malaria transmission and malaria species mixes before and after interventions to reduce malaria transmission