Antenatal screening for Down's syndrome: Revised nuchal translucency upper truncation limit due to improved precision of measurement

OBJECTIVE: To determine whether the improved precision of nuchal translucency (NT) measurement used in antenatal screening for Down’s syndrome observed over time as evidenced by a decrease in the multiple of the median (MoM) standard deviation requires a modification to the NT MoM truncation limits to maintain accurate risk estimation. METHODS: Probability plots were derived from the measurements of NT MoM values used in a 2018 audit of 22,362 unaffected pregnancies. The plots were used to determine whether the NT MoM upper truncation limit should be lowered. Validation plots were used to assess the screening accuracy of Down’s syndrome risk estimates calculated from observed NT MoM values in the 22,362 unaffected pregnancies and 69 Down’s syndrome pregnancies for original and revised NT MoM truncation limits. RESULTS: Probability plots indicated that with improved precision of NT measurements, there was deviation from a Gaussian distribution at less high MoM values than with less precise measurements. Validation plots showed that using the current NT MoM upper truncation limit of 2.5 MoM with improved precision NT measurements overestimates the Down’s syndrome risk (median risk in highest risk category expressed as an odds was 53.3:1 and observed prevalence was 1:1.1). The large discrepancy was corrected by changing the NT upper truncation limit to 2.0 MoM (median risk in highest risk category expressed as an odds was 1:1.78 and observed prevalence 1:2.7). CONCLUSION: The NT MoM upper truncation limit should be reduced from 2.5 to 2.0 MoM

A non-autonomous stochastic discrete time system with uniform disturbances

The main objective of this article is to present Bayesian optimal control over a class of non-autonomous linear stochastic discrete time systems with disturbances belonging to a family of the one parameter uniform distributions. It is proved that the Bayes control for the Pareto priors is the solution of a linear system of algebraic equations. For the case that this linear system is singular, we apply optimization techniques to gain the Bayesian optimal control. These results are extended to generalized linear stochastic systems of difference equations and provide the Bayesian optimal control for the case where the coefficients of these type of systems are non-square matrices. The paper extends the results of the authors developed for system with disturbances belonging to the exponential family

Some Properties of Noether Charge and a Proposal for Dynamical Black Hole Entropy

We consider a general, classical theory of gravity with arbitrary matter fields in $n$ dimensions, arising from a diffeomorphism invariant Lagrangian, \bL. We first show that \bL always can be written in a ``manifestly covariant" form. We then show that the symplectic potential current $(n-1)$-form, $\th$, and the symplectic current $(n-1)$-form, \om, for the theory always can be globally defined in a covariant manner. Associated with any infinitesimal diffeomorphism is a Noether current $(n-1)$-form, \bJ, and corresponding Noether charge $(n-2)$-form, \bQ. We derive a general ``decomposition formula" for \bQ. Using this formula for the Noether charge, we prove that the first law of black hole mechanics holds for arbitrary perturbations of a stationary black hole. (For higher derivative theories, previous arguments had established this law only for stationary perturbations.) Finally, we propose a local, geometrical prescription for the entropy, $S_{dyn}$, of a dynamical black hole. This prescription agrees with the Noether charge formula for stationary black holes and their perturbations, and is independent of all ambiguities associated with the choices of \bL, $\th$, and \bQ. However, the issue of whether this dynamical entropy in general obeys a ``second law" of black hole mechanics remains open. In an appendix, we apply some of our results to theories with a nondynamical metric and also briefly develop the theory of stress-energy pseudotensors.Comment: 30 pages, LaTe

Prevention of Neural Tube Defects: A Cross-Sectional Study of the Uptake of Folic Acid Supplementation in Nearly Half a Million Women

BACKGROUND: Taking folic acid supplements before pregnancy to reduce the risk of a neural tube defect (NTD) is especially important in countries without universal folic acid fortification. The extent of folic acid supplementation among women who had antenatal screening for Down's syndrome and NTDs at the Wolfson Institute of Preventive Medicine, London between 1999 and 2012 was assessed. METHODS AND FINDINGS: 466,860 women screened provided details on folic acid supplementation. The proportion of women who took folic acid supplements before pregnancy was determined according to year and characteristics of the women. The proportion of women taking folic acid supplements before pregnancy declined from 35% (95% CI 34%-35%) in 1999-2001 to 31% (30%-31%) in 2011-2012. 6% (5%-6%) of women aged under 20 took folic acid supplements before pregnancy compared with 40% of women aged between 35 and 39. Non-Caucasian women were less likely to take folic acid supplements before pregnancy than Caucasian women; Afro-Caribbean 17% (16%-17%), Oriental 25% (24%-25%) and South Asian 20% (20%-21%) compared with 35% (35%-35%) for Caucasian women. 51% (48%-55%) of women who previously had an NTD pregnancy took folic acid supplements before the current pregnancy. CONCLUSIONS: The policy of folic acid supplementation is failing and has led to health inequalities. This study demonstrates the need to fortify flour and other cereal grain with folic acid in all countries of the world

Prenatal screening for Down syndrome in twin pregnancies: Estimates of screening performance based on 61 affected and 7302 unaffected twin pregnancies

This article has been accepted for publication and undergone full peer review but has not been through the copyediting, typesetting, pagination and proofreading process, which may lead to differences between this version and the Version of Record. Please cite this article as doi: 10.1002/pd.538

Some remarks on a new exotic spacetime for time travel by free fall

This work is essentially a review of a new spacetime model with closed causal curves, recently presented in another paper (Class. Quantum Grav. \textbf{35}(16) (2018), 165003). The spacetime at issue is topologically trivial, free of curvature singularities, and even time and space orientable. Besides summarizing previous results on causal geodesics, tidal accelerations and violations of the energy conditions, here redshift/blueshift effects and the Hawking-Ellis classification of the stress-energy tensor are examined.Comment: 17 pages, 9 figures. Submitted as a contribution to the proceedings of "DOMOSCHOOL - International Alpine School of Mathematics and Physics, Domodossola 2018". Possible text overlaps with my previous work arXiv:1803.08214, of which this is essentially a review. Additional results concerning redshift/blueshift effects and the classification of the stress-energy tensor are presented her

A large geometric distortion in the first photointermediate of rhodopsin, determined by double-quantum solid-state NMR

Double-quantum magic-angle-spinning NMR experiments were performed on 11,12-C-13(2)-retinylidene-rhodopsin under illumination at low temperature, in order to characterize torsional angle changes at the C11-C12 photoisomerization site. The sample was illuminated in the NMR rotor at low temperature (similar to 120 K) in order to trap the primary photointermediate, bathorhodopsin. The NMR data are consistent with a strong torsional twist of the HCCH moiety at the isomerization site. Although the HCCH torsional twist was determined to be at least 40A degrees, it was not possible to quantify it more closely. The presence of a strong twist is in agreement with previous Raman observations. The energetic implications of this geometric distortion are discussed

A Comprehensive Association Analysis of Homocysteine Metabolic Pathway Genes in Singaporean Chinese with Ischemic Stroke

10.1371/journal.pone.0024757PLoS ONE69

Laxative effects of partially defatted flaxseed meal on normal and experimental constipated mice

<p>Abstract</p> <p>Background</p> <p>Constipation is a very common health problem in the world. Intake of sufficient amount of dietary fibers is a cornerstone in the prevention and treatment of constipation. As a traditional medicine, flaxseed has been used to treat constipation for centuries, but the controlled trials are rare. The purpose of the present study was to assess that whether partially defatted flaxseed meal (PDFM) has the potential role to facilitate fecal output in normal and experimental constipated mice.</p> <p>Methods</p> <p>After supplemented with 2.5%, 5% and 10% (w/w) PDFM (L-, M- and H -PDFM) for 14 days, the constipation models of mice were induced by atropine-diphenoxylate. The small intestinal transit rates, start time of defecation, amount of defecation and wet weight of feces were researched in normal and constipation model mice.</p> <p>Results</p> <p>M- and H-PDFM significantly increase small intestinal transit rates in constipation model mice. All dose of PDFM markedly shortened the start time of defecation and M- and H-PDFM significantly increase stool frequency and weight in both normal and constipation model mice.</p> <p>Conclusions</p> <p>PDFM may be a useful laxative to facilitate fecal output in normal and constipation conditions.</p

f(R) theories

Over the past decade, f(R) theories have been extensively studied as one of the simplest modifications to General Relativity. In this article we review various applications of f(R) theories to cosmology and gravity - such as inflation, dark energy, local gravity constraints, cosmological perturbations, and spherically symmetric solutions in weak and strong gravitational backgrounds. We present a number of ways to distinguish those theories from General Relativity observationally and experimentally. We also discuss the extension to other modified gravity theories such as Brans-Dicke theory and Gauss-Bonnet gravity, and address models that can satisfy both cosmological and local gravity constraints.Comment: 156 pages, 14 figures, Invited review article in Living Reviews in Relativity, Published version, Comments are welcom