One step versus two step approach for gestational diabetes screening: systematic review and meta-analysis of the randomized trials

INTRODUCTION: To compare both the prevalence of gestational diabetes mellitus (GDM) as well as maternal and neonatal outcomes by either the one-step or the two-step approaches. MATERIAL AND METHODS: Electronic databases were searched from their inception until June 2017. We included all randomized controlled trials (RCTs) comparing the one-step with the two-step approaches for the screening and diagnosis of GDM. The primary outcome was the incidence of GDM. RESULTS: Three RCTs (n = 2333 participants) were included in the meta-analysis. 910 were randomized to the one step approach (75 g, 2 hrs), and 1423 to the two step approach. No significant difference in the incidence of GDM was found comparing the one step versus the two step approaches (8.4 versus 4.3%; relative risk (RR) 1.64, 95%CI 0.77-3.48). Women screened with the one step approach had a significantly lower risk of preterm birth (PTB) (3.7 versus 7.6%; RR 0.49, 95%CI 0.27-0.88), cesarean delivery (16.3 versus 22.0%; RR 0.74, 95%CI 0.56-0.99), macrosomia (2.9 versus 6.9%; RR 0.43, 95%CI 0.22-0.82), neonatal hypoglycemia (1.7 versus 4.5%; RR 0.38, 95%CI 0.16-0.90), and admission to neonatal intensive care unit (NICU) (4.4 versus 9.0%; RR 0.49, 95%CI 0.29-0.84), compared to those randomized to screening with the two step approach. CONCLUSIONS: The one and the two step approaches were not associated with a significant difference in the incidence of GDM. However, the one step approach was associated with better maternal and perinatal outcomes

Exponential Tapered Balun with Different Sizes for UWB Elliptical Dipole Antenna

This work presents a broadband tapered balun with different sizes using nonlinear transition particularly suitable for planar and three-dimensional (3-D) dipole antennas for ultra-wideband (UWB) applications such as communication, radar systems and geolocation precision. Four baluns with wideband microstrip-to-parallel-strip transition using an elliptical structure for an elliptical dipole antenna are proposed. The initial balun structure consists of a nonlinear profile with a quarter-wavelength for both height and width. By studying the current distributions at the balun surface, it can be reduced to 25%, 50% and 75% from the original size. Measured results based on the reflection coefficients for all baluns are shown to be better than -10 dB from 1.0 GHz to 10 GHz. These baluns are integrated with an elliptical dipole which acts as a feeding circuit. Eight set of antennas with a planar and 3-D configurations with four different sizes are proposed in this work. The planar configurations are named as Planar 1, Planar 2, Planar 3 and Planar 4 while the 3-D configurations are named as 3D Dipole 1, 3D Dipole 2, 3D Dipole 3 and 3D Dipole 4, respectively. The results show that all antennas with the proposed baluns operates within the UWB frequency range

Beyond Bukhara: trade, identity and interregional exchange across Asia

This article explores the nature of inter-Asian trade dynamics through a consideration of the role played by traders from northern Afghanistan’s Central Asian borderlands. It explores the role that traders from this region have played in commercial exchanges involving China, the Arabian Peninsula and a range of settings in West Asia. In addition to documenting the inter-Asian scope of these traders’ activities, the article also addresses the shifting nature of their identity formations in relationship to successive waves of migration. The traders often identify themselves in relationship to ethno-national identity categories (Turkmen, Uzbek and Tajik) that are politically salient in Central Asia and Afghanistan today. At the same time, the traders also emphasise their being from families that migrated from the territories of the Emirate of Bukhara during the early years of communist rule in the 1920s and 1930s. In the context of the Soviet invasion of Afghanistan in 1979, many of these families moved from Afghanistan to Saudi Arabia, often staying for several years in cities and towns in Pakistan. Over the past three decades, Central Asian émigré families have increasingly established their businesses and communities in the Arabian Peninsula and Turkey; they also run offices in the trading cities of maritime China

An Inductive Link-Based Wireless Power Transfer System for Biomedical Applications

A wireless power transfer system using an inductive link has been demonstrated for implantable sensor applications. The system is composed of two primary blocks: an inductive power transfer unit and a backward data communication unit. The inductive link performs two functions: coupling the required power from a wireless power supply system enabling battery-less, long-term implant operation and providing a backward data transmission path. The backward data communication unit transmits the data to an outside reader using FSK modulation scheme via the inductive link. To demonstrate the operation of the inductive link, a board-level design has been implemented with high link efficiency. Test results from a fabricated sensor system, composed of a hybrid implementation of custom-integrated circuits and board-level discrete components, are presented demonstrating power transmission of 125 mW with a 12.5% power link transmission efficiency. Simultaneous backward data communication involving a digital pulse rate of up to 10 kbps was also observed

Risk of Branch Occlusion and Ischemic Complications with the Pipeline Embolization Device in the Treatment of Posterior Circulation Aneurysms

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Ontology-based prediction of cancer driver genes

Abstract: Identifying and distinguishing cancer driver genes among thousands of candidate mutations remains a major challenge. Accurate identification of driver genes and driver mutations is critical for advancing cancer research and personalizing treatment based on accurate stratification of patients. Due to inter-tumor genetic heterogeneity many driver mutations within a gene occur at low frequencies, which make it challenging to distinguish them from non-driver mutations. We have developed a novel method for identifying cancer driver genes. Our approach utilizes multiple complementary types of information, specifically cellular phenotypes, cellular locations, functions, and whole body physiological phenotypes as features. We demonstrate that our method can accurately identify known cancer driver genes and distinguish between their role in different types of cancer. In addition to confirming known driver genes, we identify several novel candidate driver genes. We demonstrate the utility of our method by validating its predictions in nasopharyngeal cancer and colorectal cancer using whole exome and whole genome sequencing

Peasant settlers and the ‘civilizing mission’ in Russian Turkestan, 1865-1917

This article provides an introduction to one of the lesser-known examples of European settler colonialism, the settlement of European (mainly Russian and Ukrainian) peasants in Southern Central Asia (Turkestan) in the late nineteenth and early twentieth centuries. It establishes the legal background and demographic impact of peasant settlement, and the role played by the state in organising and encouraging it. It explores official attitudes towards the settlers (which were often very negative), and their relations with the local Kazakh and Kyrgyz population. The article adopts a comparative framework, looking at Turkestan alongside Algeria and Southern Africa, and seeking to establish whether paradigms developed in the study of other settler societies (such as the ‘poor white’) are of any relevance in understanding Slavic peasant settlement in Turkestan. It concludes that there are many close parallels with European settlement in other regions with large indigenous populations, but that racial ideology played a much less important role in the Russian case compared to religious divisions and fears of cultural backsliding. This did not prevent relations between settlers and the ‘native’ population deteriorating markedly in the years before the First World War, resulting in large-scale rebellion in 1916

Normograms of ovarian volume, Uterine size and endometrial thickness in urban midlife Malaysia women

Cancers of the ovary and corpus uteri afflict 5% and 3.6% Malaysian women respectively. Ovarian cancer (OC) remained the deadliest gynaecological malignancy in perimenopausal women mainly due to the lack of symptoms until the disease had spread. Ultrasonography could provide a preliminary screening allowing the clinician to tailor subsequent management and counselling for these women. To support the basis for selective screening, a study on 517 urban disease free women aged 45 years and above, uterus-intact, non-users of HRT was undertaken. This study presented normograms of ovary, uterus and endometrium derived from entry ultrasound assessment. The sample comprised of 58.0% premenopaused and 42.0% postmenopaused women with an average age of 51.27±5.35 years old. Over two thirds were Chinese followed by Malays and Indians. The findings indicated that the average uterine size and endometrial thickness (ET) was 7.21±1.67x4.36±1.30cm and 6.36±3.73mm respectively. Premenopausal women had larger uterus compared to those postmenopaused (p70 years old. From these findings, a cut-off of <5.0mm was considered clinically acceptable in normal postmenopaused regardless of ethnicity. Nearly one fifth (18.9%) had uterine fibroids, a quarter (25%) in premenopausal women as compared to 10% postmenopaused (p<0.0005). The mean right and left ovarian volume (OV) was 5.48±7.85cm3 and 5.80±16.78cm3 respectively. There was a gradual decline in OV with age and menopause from about 7cm3 at age 45-49 years to less than 1.5cm3 at 70 years giving a clinical norm OV of <7.5cm3 and <3.5cm3 respectively in pre and postmenopausal Malaysian women. Benign ovarian cysts seen in 2.9% had a mean size of 65.14±88.22cm3. In conclusion, ET and OV normograms should be made available for the Malaysian population to facilitate screening for gynaecological malignancie