Age-specific reference ranges of serum anti-müllerian hormone in healthy women and its application in diagnosis of polycystic ovary syndrome: a population study.

OBJECTIVE: To establish the age-specific centiles of serum anti-müllerian hormone (AMH) levels in Chinese women, and to explore the use of multiples of median (MoM) AMH levels for the diagnosis of polycystic ovary syndrome (PCOS). DESIGN: An observational study. SETTING: University-affiliated hospitals and community clinics. POPULATION: We included 3137 healthy women aged 20-44 years recruited prospectively or who had archived serum samples from previous research projects. Another validation cohort of 751 women with PCOS as well as ovulatory controls, which was a convenient sample of women attending for infertility or menstrual disorders, was also studied. METHODS: The serum samples were assayed for AMH by the automated Access AMH assay. MAIN OUTCOME MEASURES: Age-specific reference ranges were constructed on the primary cohort with the Lambda-Mu-Sigma method. The MoM AMH of each subject in the validation cohort was calculated. RESULTS: Centile curves of serum AMH level against age were established. MoM AMH was significantly higher in women with PCOS than in controls (P < 0.05). The area under the ROC curve was 0.852 (95% confidence interval [CI] 0.825-0.877) (P < 0.0001) for discriminating women with PCOS from ovulatory controls by MoM AMH. CONCLUSIONS: We established a set of year-by-year age-specific reference ranges of serum AMH levels in Chinese women. The MoM AMH derived from this set of reference ranges is a promising tool to replace antral follicle count in the diagnosis of PCOS. TWEETABLE ABSTRACT: A set of age-specific reference ranges of AMH levels was established in Chinese women. Multiples of median AMH may be used to diagnose PCOS.

Identification of a natural intergenotypic recombinant hepatitis delta virus genotype 1 and 2 in Vietnamese HBsAg-positive patients.

Hepatitis D virus (HDV) infection is acquired as a co- /superinfection of Hepatitis B virus (HBV) and can modulate the pathophysiology of chronic hepatitis B and related liver diseases including hepatocellular carcinoma. Among the eight distinct HDV genotypes reported, relatively few studies have attempted to investigate the prevalence of HDV mixed genotypes and RNA recombination of HDV. With a recorded prevalence of 10-20% HBV infection in Vietnam, this study investigated the HDV variability, HDV genotypes and HDV recombination among twenty-one HDV isolates in Vietnamese HBsAg-positive patients. HDV subgenomic and full-length genome sequences were obtained using newly established HDV-specific RT-PCR techniques. The nucleotide homology was observed from 74.6% to 99.4% among the investigated full-length genome of the HDV isolates. We observed HDV genotype 1 and HDV genotype 2 in the investigated Vietnamese patients. Although no HDV genotype mixtures were observed, we report here a newly identified recombinant of HDV genotypes (HDV 1 and HDV 2). The identified recombinant HDV isolate C03 revealed sequence homology to both HDV genotype 1 (nt1 to nt907) and HDV genotype 2 (nt908 to nt1675; HDAg coding region) with a breakpoint at nt908. Our findings demonstrate the prevalence of intergenotypic recombination between HDV genotypes 1 and 2 in a Vietnamese HBsAg-positive patient. Extended investigation on the distribution and prevalence of HDV, HDV mixed genotypes and recombinant HDV genotypes in a larger Vietnamese population offers vital insights into understanding of the micro-epidemiology of HDV and subsequent pathophysiology in chronic HBV- /HDV-related liver diseases.

African coastal camera network efforts at monitoring ocean, climate, and human impacts.

Regular and long-term monitoring of coastal areas is a prerequisite to avoiding or mitigating the impacts of climate and human-driven hazards. In Africa, where populations and infrastructures are particularly exposed to risk, there is an urgent need to establish coastal monitoring, as observations are generally scarce. Measurement campaigns and very high-resolution satellite imagery are costly, while freely available satellite observations have temporal and spatial resolutions that are not suited to capture the event scale. To address the gap, a network of low-cost, multi-variable, shore-based video camera systems has been installed along the African coasts. Here, we present this network and its principle of sharing data, methods, and results obtained, building toward the implementation of a common integrated coastal management policy between countries. Further, we list new contributions to the understanding of still poorly documented African beaches' evolution, waves, and sea level impacts. This network is a solid platform for the development of inter-disciplinary observations for resources and ecology (such as fisheries, and sargassum landing), erosion and flooding, early warning systems during extreme events, and science-based coastal infrastructure management for sustainable future coasts.

A statistical causal model for the assessment of dysarthric speech and the utility of computer-based speech recognition.

The evaluation of the degree of speech impairment and the utility of computer recognition of impaired speech are separately and independently performed. Particular attention is paid to the question concerning whether or not there is a relationship between naive listeners' subjective judgements of impaired speech and the performance of a laboratory version of a speech recognition system. It is a difficult task to relate a speech impairment rating with speech recognition accuracy. Towards this end, a statistical causal model is proposed. This model is very appealing in its structure to support inference, and thus can be applied to perform various assessments such as the success of automatic recognition of dysarthric speech. The application of this model is illustrated with a case study of a dysarthric speaker compared against a normal speaker serving as a control.

An AI-based communication system for motor and speech disabled persons: design methodology and prototype testing.

An intelligent communication device is developed to assist the nonverbal, motor disabled in the generation of written and spoken messages. The device is centered on a knowledge base of the grammatical rules and message elements. A "belief" reasoning scheme based on both the information from external sources and the embedded knowledge is used to optimize the process of message search. The search for the message elements is conceptualized as a path search in the language graph, and a special frame architecture is used to construct and to partition the graph. Bayesian "belief" reasoning from the Dempster-Shafer theory of evidence is augmented to cope with time-varying evidence. An "information fusion" strategy is also introduced to integrate various forms of external information. Experimental testing of the prototype system is discussed.

[Prescription and use of benzodiazepins in Saint-Louis in Senegal: patient survey]. / Evaluation de la prescription et de l'utilisation des benzodiazépines dans la commune de Saint-Louis du Sénégal: enquête auprès des patients.

Prescription and use of benzodiazepins were evaluated with a patients survey. Direct interview were conducted with 150 patients in ten pharmacies in the city of Saint-Louis, Senegal from January to June 2002. Ten of the 15 retail pharmacies in this city agreed to participate in the survey. All patients gave their agreement to participate to the study; the questionnaire contained essentially closed questions. Writers of prescriptions were general practitioners (38.67%), specialists (34.67%), nurses (18%) and midwifes (8.66%). The most prescribed benzodiazepins were prazepam, dipotassic clorazepate, lorazepam and diazepam. Use of these drugs during night is most recommended. Nevertheless, 26.67% of the prescriptions indicated the drug should be use during the day. The period of use was between one and three Months for 33.99% of patients and three Months or more in 42%. Benzodiazepins were used by 66.67% for insomnia, alone or associated with another condition, for anxiety by 14.6% and for epilepsy by 10%. Prescriptions were for benzodiazepins alone in 47.37% of the patients and in combination with other psychotropic drugs for 19.33%. Somnolence and dependence were the most reported side effects.