A preliminary study on the pattern of weight change from pregnancy to 6 months postpartum: a latent growth model approach.

OBJECTIVE: There is a lack of comprehensive understanding about patterns of weight change from pregnancy to childbirth and beyond. We describe the trajectory of weight change pattern from pre-pregnancy to 6 months postpartum and examine demographical and perinatal variables that predict the weight change using the latent growth model (LGM). DESIGN AND SUBJECTS: This study used a longitudinal design. The study participants were 120 women whose body weights were measured at eight time points. RESULTS: The adjusted mean pre-pregnancy weight was 52.57 kg. When the weight growth rate for 10-13 weeks of pregnancy and pre-pregnancy weight was set to 1, the body-weight change rate was 2.20 during the second trimester, 2.14 during the third trimester, -2.90 during the period from the third trimester to 2-3 weeks postpartum, -0.08 during the period from 2-3 weeks to 4-5 weeks postpartum, -0.37 during the period from 4-5 weeks to 11-12 weeks postpartum, and -0.65 during the period from 11-12 weeks to 24-25 weeks postpartum. On average, body weight increased 26.54% (13.95 kg) from pre-pregnancy to 36-39 weeks of pregnancy and body weight remained 6.26% (3.29 kg) higher at 24-25 weeks postpartum compare with pre-pregnancy. In terms of factors related to body weight, age was positively associated with pre-pregnancy body weight. Parity had a negative effect on the change of body weight. Women who had an increased change rate in body weight had higher newborn birth weights. CONCLUSIONS: We found that weight change from pregnancy to postpartum followed a pattern that could be specified using the LGM approach. The women retained more than 6% of weight at 6 months postpartum compared with their pre-pregnancy weight.

A Comparison of Food Portion Size Estimation by Older Adults, Young Adults and Nutritionists.

OBJECTIVES: To investigate the ability of older adults, younger adults and nutritionists to assess portion size using traditional methods versus a computer-based method. This was to inform the development of a novel dietary assessment method for older adults "The NANA system". DESIGN: Older and younger adults assessed the portion size of self-served portions of foods from a buffet style set up using traditional and computerised portion size assessment aids. Nutritionists assessed the portion size of foods from digital photographs using computerised portion size aids. These estimates were compared to known weights of foods using univariate analyses of covariance (ANCOVA). SETTING: The University of Sheffield, United Kingdom. SUBJECTS: Forty older adults (aged 65 years and over), 41 younger adults (aged between 18 and 40 years) and 25 nutritionists. RESULTS: There was little difference in the abilities of older and younger adults to assess portion size using both assessment aids with the exception of small pieces morphology. Even though the methods were not directly comparable among the test groups, there was less variability in portion size estimates made by the nutritionists. CONCLUSION: Older adults and younger adults are similar in their ability to assess food portion size and demonstrate wide variability of estimation compared to the ability of nutritionists to estimate portion size from photographs. The results suggest that the use of photographs of meals consumed for portion size assessment by a nutritionist may improve the accuracy of dietary assessment. Improved portion size assessment aids are required for all age groups.

The Steiner ratio conjecture of Gilbert and Pollak is true.

Let P be a set of n points on the euclidean plane. Let Ls(P) and Lm(P) denote the lengths of the Steiner minimum tree and the minimum spanning tree on P, respectively. In 1968, Gilbert and Pollak conjectured that for any P, Ls(P) >/= (radical3/2)Lm(P). We provide an abridged proof for their conjecture in this paper.

Using the NANA toolkit at home to predict older adults' future depression.

BACKGROUND: Depression is currently underdiagnosed among older adults. As part of the Novel Assessment of Nutrition and Aging (NANA) validation study, 40 older adults self-reported their mood using a touchscreen computer over three, one-week periods. Here, we demonstrate the potential of these data to predict future depression status. METHODS: We analysed data from the NANA validation study using a machine learning approach. We applied the least absolute shrinkage and selection operator with a logistic model to averages of six measures of mood, with depression status according to the Geriatric Depression Scale 10 weeks later as the outcome variable. We tested multiple values of the selection parameter in order to produce a model with low deviance. We used a cross-validation framework to avoid overspecialisation, and receiver operating characteristic (ROC) curve analysis to determine the quality of the fitted model. RESULTS: The model we report contained coefficients for two variables: sadness and tiredness, as well as a constant. The cross-validated area under the ROC curve for this model was 0.88 (CI: 0.69-0.97). LIMITATIONS: While results are based on a small sample, the methodology for the selection of variables appears suitable for the problem at hand, suggesting promise for a wider study and ultimate deployment with older adults at increased risk of depression. CONCLUSIONS: We have identified self-reported scales of sadness and tiredness as sensitive measures which have the potential to predict future depression status in older adults, partially addressing the problem of underdiagnosis.

New construction for transversal design.

The study of gene functions requires the development of a DNA library of high quality through much of testing and screening. Pooling design is a mathematical tool to reduce the number of tests for DNA library screening. The transversal design is a special type of pooling design, which is good in implementation. In this paper, we present a new construction for transversal designs. We will also extend our construction to the error-tolerant case.

Anisodamine induces the hexagonal phase in phospholipid liposomes.

The effects of anisodamine on the polymorphic phase behaviour of cardiolipin and dioleoylphosphatidylcholine liposomes have been investigated by freeze-fracture electron microscopy. Anisodamine induces the formation of lipidic particles in cardiolipin liposomes at pH 7.0 and hexagonal HII tubes at pH 8.8. When the molar ratio of anisodamine and dioleoylphosphatidylcholine is 4 to 1, lipidic particles can be observed in the fracture faces.

The disordering effect of hyoscyamine drugs on phospholipid membranes.

The effect of hyoscyamine drugs on the fluidity of dipalmitoylphosphatidylcholine liposomes has been studied by differential scanning calorimetry (DSC), electron spin resonance spectroscopy (ESR), fluorescence polarization and freeze-fracture electron microscopic techniques. DSC results indicate that anisodamine, anisodine, atropine and scopolamine all increase the fluidity of dipalmitoylphosphatidylcholine liposomes but with different degrees of efficiency. The increasing of fluidity of dipalmitoylphosphatidylcholine liposomes by hyoscyamine drugs is in a dose-dependent way. Increase of the fluidity of phosphatidylcholine liposomes by anisodamine was also shown by the other three methods. The possible mechanism of hyoscyamine-membrane interaction is discussed.

Phase transitions of Acholeplasma laidlawii membranes. The involvement of Mg(2+)-ATPase in the C transition.

Highly sensitive differential scanning calorimetry has been employed to study the phase transitions of A. laidlawii membrane. The DSC curves obtained show five distinct transitions between 20 and 80 degrees C which contain a reversible lipid thermotropic transition at about 37 degrees C and four irreversible denaturation transitions of the membrane proteins occurred at about 44 degrees C, 52 degrees C, 62 degrees C, and 67 degrees C, respectively. Total enthalpy of the thermal denaturation of membrane proteins is 3.4 +/- 0.5 cal/g. Further study of A. laidlawii membrane preparations by means of thermal gel analysis and enzyme activity measurements at various temperatures provided information that the third peak (C transition) of the DSC curve involved primarily with Mg(2+)-ATPase on A. laidlawii membranes.

Anisodamine causes acyl chain interdigitation in phosphatidylglycerol.

The effect of anisodamine on the structure of the gel phase and the properties of the acyl chain disordering transition of dipalmitoylphosphatidylglycerol (DPPG) has been studied through high-sensitivity differential scanning calorimetry (DSC) and fluorescence polarization measurements of 16-(9-anthroyloxyl)-palmitic acid (16AP) and 3-(9-anthroyloxyl)-stearic acid (3AS), labeling, respectively, the ends and the third carbon of the acyl chains. The non-interdigitated DPPG multilamellar vesicles formed in HEPES buffer show clear fluidity gradient in their acyl chains, whereas the fluidity gradients are completely abolished in the presence of anisodamine. The DSC results showed that the phase transition temperature (Tm) of DPPG is decreased and the enthalpy (delta H) is increased by anisodamine, while the pre-transition vanishes. At 3 mM anisodamine, the delta H of DPPG reaches 9.6 kcal/mol. It can be concluded that DPPG forms an interdigitated gel phase in the presence of anisodamine. A molecular scheme for the interaction of anisodamine with DPPG is proposed.

Studies on the phospholipid composition of pathogenic cell membranes of Mycoplasma hyopneumoniae.

The membrane phospholipid and fatty acid compositions of Mycoplasma hyopneumoniae, a pathogen of porcine enzootic pneumoniae isolated in China, was studied by thin-layer chromatography and gas chromatography. The results showed that membrane phospholipids consisted predominantly of diphosphatidylglycerol. The percentage of C16 - C18 fatty acids comprised 79% of the total fatty acids, of which oleic acid as well as palmitic acid are the major fatty acids. Some differences were shown in fatty acid composition as compared with membranes of other species of Mycoplasma.

Error-tolerant pooling designs with inhibitors.

Pooling designs are used in clone library screening to efficiently distinguish positive clones from negative clones. Mathematically, a pooling design is just a nonadaptive group testing scheme which has been extensively studied in the literature. In some applications, there is a third category of clones called "inhibitors" whose effect is to neutralize positives. Specifically, the presence of an inhibitor in a pool dictates a negative outcome even though positives are present. Sequential group testing schemes, which can be modified to three-stage schemes, have been proposed for the inhibitor model, but it is unknown whether a pooling design (a one-stage scheme) exists. Another open question raised in the literature is whether the inhibitor model can treat unreliable pool outcomes. In this paper, we answer both open problems by giving a pooling design, as well as a two-stage scheme, for the inhibitor model with unreliable outcomes. The number of pools required by our schemes are quite comparable to the three-stage scheme.

Efficacy of plasmin-treated intravenous gamma-globulin for therapy of Kawasaki syndrome.

In order to delineate the efficacy of plasmin-treated intravenous gamma-globulin (IVGG) in the treatment of Kawasaki syndrome, we compared the frequency of coronary artery abnormalities in children treated or not with IVGG for Kawasaki syndrome. Among 291 cases of Kawasaki syndrome diagnosed during the period of 1987 to 1991 without coronary abnormalities within 10 days of the onset of illness, 128 were treated with IVGG and aspirin and were compared with 163 treated with aspirin alone. IVGG was given in a dosage of 400 mg/kg/day for 4 consecutive days. The detection of coronary abnormalities was monitored by two dimensional echocardiography. Two weeks after enrollment coronary artery abnormalities were present in 37 (22.7%) of 163 children in the aspirin group and in 9 (9%) of 128 in the gamma-globulin group (P < 0.05). Seven weeks after enrollment, abnormalities were present in 20 (12.3%) of 163 children in the aspirin group and in 6 (4.6%) of 128 in the IVGG group (P < 0.05). We conclude that plasmin-treated IVGG is effective in reducing the prevalence of coronary artery abnormalities in Kawasaki syndrome and suggest a predominant role of the Fc gamma fragment of IgG in the therapeutic effect.

Interaction of the interdigitated DPPG or DPPG/DMPC bilayer with human erythrocyte band 3: differential scanning calorimetry and fluorescence studies.

Human erythrocyte band 3 reconstituted into phospholipid vesicles has been used for studying the interaction of interdigitated lipid bilayer with an integral membrane protein. The interdigitated gel phase in DPPG/band 3 or DPPG/DMPC/band 3 systems was induced with polymyxin B (PMB) or Tris+. The phase transitions of the vesicles were detected with high-sensitivity differential scanning calorimetry (DSC). The results indicated that band 3 does not cause significant alterations in the interdigitated phase of phospholipids, with only a little decrease of the phase transition enthalpies. Fluorescence measurements showed that the transition of phospholipid/band 3 systems from the non-interdigitated to interdigitated phase is accompanied by marked intrinsic fluorescence changes of band 3. The interdigitated phase of DPPG or DPPG/DMPC vesicles increases the intrinsic fluorescence intensity of band 3 and significantly decreases the accessibility of certain tryptophan residues on the protein to Cs+.

Effect of lanthanide ions on the phase behavior of dipalmitoylphosphatidylcholine multilamellar liposomes.

The effect of lanthanide ions (Ln3+) and their coordination compounds of diethylenetriamine pentaacetic acid (DTPA) on the phase behavior of dipalmitoylphosphatidylcholine (DPPC) multi-lamellar liposomes has been studied by differential scanning calorimetry (DSC), Raman spectroscopy, and freeze-fracture electron microscopic techniques. The displacement of Ca2+ binding on DPPC liposomes by lanthanide ions was also studied. The results show that the binding degree of four kinds of chloride salts with DPPC liposomes is: YbCl3 > GdCl3 > LaCl3 > CaCl2. Lanthanide ions increase the phase transition temperature of DPPC liposomes and decrease the membrane fluidity. Freeze-fracture electron microscopic results show that La3+ enhances the order of DPPC membrane. The effect of coordination compounds of lanthanides with DTPA on the phase behavior of DPPC liposomes is smaller than that of their chlorides. La3+, Gd3+, and Yb3+, can displace Ca2+ binding on DPPC liposomes, but there coordination compounds of DTPA can hardly displace Ca2+. Raman spectroscopic results show that a very slight effect in lateral packing order of DPPC liposomes was observed at various concentrations of lanthanides.

Emergency separation of omphaloischiopagus tetrapus conjoined twins in the newborn period.

This article reports an experience on subemergent separation of xyphoomphaloischiopagus tetrapus conjoined twins in the newborn period when survival of one of the twins was threatened by a severely malformed counterpart.

The Structural Ceramics Database: Technical Foundations.

The development of a computerized database on advanced structural ceramics can play a critical role in fostering the widespread use of ceramics in industry and in advanced technologies. A computerized database may be the most effective means of accelerating technology development by enabling new materials to be incorporated into designs far more rapidly than would have been possible with traditional information transfer processes. Faster, more efficient access to critical data is the basis for creating this technological advantage. Further, a computerized database provides the means for a more consistent treatment of data, greater quality control and product reliability, and improved continuity of research and development programs. A preliminary system has been completed as phase one of an ongoing program to establish the Structural Ceramics Database system. The system is designed to be used on personal computers. Developed in a modular design, the preliminary system is focused on the thermal properties of monolithic ceramics. The initial modules consist of materials specification, thermal expansion, thermal conductivity, thermal diffusivity, specific heat, thermal shock resistance, and a bibliography of data references. Query and output programs also have been developed for use with these modules. The latter program elements, along with the database modules, will be subjected to several stages of testing and refinement in the second phase of this effort. The goal of the refinement process will be the establishment of this system as a user-friendly prototype. Three primary considerations provide the guidelines to the system's development: (1) The user's needs; (2) The nature of materials properties; and (3) The requirements of the programming language. The present report discusses the manner and rationale by which each of these considerations leads to specific features in the design of the system.

Sequelae and complications related to dental extractions in patients with hematologic malignancies and the impact on medical outcome.

OBJECTIVE: The purpose of this retrospective study was to evaluate sequelae and complications after dental extractions and to analyze their impact on medical treatment in patients with myelodysplastic syndrome, acute and chronic leukemia, and multiple myeloma during a 3-year period. STUDY DESIGN: The study population included 388 patients with hematologic malignancies. All medical and dental charts were reviewed in a retrospective fashion to identify patients who received dental extractions. Preexisting dental disease and intervention (extraction) were evaluated, and parameters such as days of hospitalization and survival rate were compared with those of the remainder population who did not receive dental extractions. RESULTS: Of the 388 patients, 69 underwent dental extractions and 9 had sequelae and complications after the intervention. The resulting complication rate of 13% was reported. Although some patients did experience delay of chemotherapy or bone marrow transplant (BMT), or both, no significant difference was found in the number of days in the hospital for BMT and the survival rate for the patients with sequelae and complications (n = 9) and for the remainder population (n = 319) ( >.05). CONCLUSION: Dental extraction intervention provided in the prechemotherapy and pre-BMT time frame did not have a negative bearing on medical outcome.

Effects of fibrin glue on hemostasis.

In order to decrease complications following incomplete hemostasis, we tried to make a safe, efficient and highly concentrated fibrin glue by thawing single-donor fresh frozen plasma. Using a unique animal model, in which arterial bleeding was created, fibrin glue and some related hemostatic agents were tested to evaluate their hemostatic effectiveness. The results demonstrated that: 1) the concomitant use of cryoprecipitate-thrombin tissue glue with adjuvant (aprotinin or calcium chloride) had a better hemostatic effect than the use of cryoprecipitate-thrombin tissue glue alone (p < 0.05); 2) impregnation of fibrin glue with a suitable vehicle was advisable to accelerate the coagulation plug formation and to enhance the mechanical strength of the adhesive plug; 3) Gelform, used as a vehicle to hold the fibrin glue, had a more efficient hemostatic effect than gauze, collagen fleece and Surgicel (p < 0.05); 4) systemic heparinization attenuated the effectiveness of the hemostatic agents and aggravated the bleeding problem, but a low hematocrit level did not; 5) fibrin glue had its own limitations, especially under systemic heparinization, on hemostatic effectiveness in a high-pressure system. Understanding the characteristics of fibrin glue, as mentioned above, definitely improved the hemostatic effectiveness of the glue, especially after failure of the usual methods of controlling bleeding.

Hyperamylasemia following cardiopulmonary bypass.

In order to study the occurrence of postbypass hyperamylasemia, 75 patients undergoing cardiopulmonary bypass (CPB) were studied from March 1989 to January 1990. There were 49 males and 26 females. Among them, 27 had congenital heart disease, 30 had valvular disease, and 18 had coronary artery disease. There were 27 patients with at least one elevated serum amylase sample after operation. Thus, the overall incidence of hyperamylasemia was 36%. As compared with the preoperative data (1.3%), there was a statistically significant difference in the occurrence of hyperamylasemia (p less than 0.05). Three patients had overt clinical pancreatitis postoperatively. There was no positive correlation between the serum amylase level and the occurrence of pancreatitis (p greater than 0.05). Forty-two cases had a significant elevation of the amylase creatinine clearance ratio (ACCR) after CPB. However, there was no significant difference between the groups with pulsatile and nonpulsatile CPB (p greater than 0.05). Three patients (4%) died in our series. The causes of death were heart failure in two and fulminant pancreatitis associated with low cardiac output in one. Although our experience in dealing with pancreatitis improved survival, mortality was still high (33.3%) in our series. Nevertheless, there was no apparent correlation between mortality and postbypass hyperamylasemia (p greater than 0.05). Logistic regression analysis was used to analyze the risk factors of the occurrence of hyperamylasemia, and the analysis revealed that patients with coronary artery disease were susceptible to postbypass hyperamylasemia. Our studies indicate that the use of total serum amylase or ACCR to monitor for the occurrence of pancreatitis in postbypass patients is inadequate.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of laparoscopically assisted vaginal hysterectomy and abdominal hysterectomy in taiwan.

In order to clarify the feasibility of laparoscopically assisted vaginal hysterectomy (LAVH) using a not-for-extra charge instrument and to determine its cost-effectiveness in the Taiwan national health care system, we designed a prospective comparison which recruited candidates with nonmalignant uterine tumors prepared for hysterectomy to assess treatment by the laparoscopic versus the laparotomic approach. There were 144 patients in the laparoscopic group and 157 patients in the laparotomic group. The two groups were similar in characteristics. A total of 138 LAVHs were completed with six conversions (4.2%) to abdominal hysterectomy. Intraoperatively, the mean operating time in the LAVH group was longer than in the laparotomic group (134 vs 112 minutes, p < 0.001). No statistically significant differences were found between the two groups in mean estimated blood loss (260 vs 259 mL) and complications (5.8 vs 4.5%). Postoperatively, mean flatulence-relief time (27.4 vs 31.3 hours) and intramuscular meperidine requirements (1.6 vs 2.5 ampoules, 1 ampoule = 50 mg) were significantly less with LAVH. There were no differences in mean hemoglobin levels (10.7 vs 10.9 g/dL), complications (9.4 vs 13.4%, p = 0.288), or hospital stay (4.9 vs 5.2 days, p = 0.058). The mean total hospital charges (NT$48,390 vs 41,649) and insurance-paid costs (NT$43,992 vs 38,389) were significantly greater in the LAVH group. In conclusion, LAVH when performed by an experienced laparoscopist and for adequately selected patients, permits a better short-term convalescence, but is more expensive compared with conventional abdominal hysterectomy.