Search

Objectives Pre-eclampsia (PE) is associated with both postpartum endothelial dysfunction and asymptomatic structural heart alterations consistent with heart failure stage B (HF-B). In this study we assessed the relation between endothelial function, by means of flow-mediated dilation (FMD), and HF-B at 4 years postpartum. Methods In 67 formerly PE women and 37 healthy parous controls, we ultrasonographically assessed cardiac function, geometry and FMD. HF-B was diagnosed as left ventricular hypertrophy (left ventricular mass index (LVMi) >95 g/m2), concentric remodelling (relative wall thickness (RWT) >0.42 and LVMi ≤95 g/m2), mild systolic dysfunction (left ventricular ejection fraction (LVEF) >40 and

Assessment of ocular irritation is a regulatory requirement in safety evaluation of industrial and consumer products. Although a number of in vitro ocular irritation assays exist, none are capable of fully categorizing chemicals as stand-alone assays. Therefore, the CEFIC-LRI-AIMT6-VITO CON4EI (CONsortium for in vitro Eye Irritation testing strategy) project was developed to assess the reliability of eight in vitro test methods and computational models as well as establishing an optimal tiered-testing strategy. For three computational models (Toxtree, and Case Ultra EYE_DRAIZE and EYE_IRR) performance parameters were calculated. Coverage ranged from 15 to 58%. Coverage was 2 to 3.4 times higher for liquids than for solids. The lowest number of false positives (5%) was reached with EYE_IRR; this model however also gave a high number of false negatives (46%). The lowest number of false negatives (25%) was seen with Toxtree; for liquids Toxtree predicted the lowest number of false negatives (11%), for solids EYE_DRAIZE did (17%). It can be concluded that the training sets should be enlarged with high quality data. The tested models are not yet sufficiently powerful for stand-alone evaluations, but that they can surely become of value in an integrated weight-of-evidence approach in hazard assessment.

Infection during pregnancy is common and the developing fetal brain is vulnerable to vertical transmission due to immaturity of the fetal immune system. Infection is a major cause of multiple organ abnormalities, including the neuraxis, due to the neurotropism of the infectious agents. This review sets out to give an overview of fetal infection, review the general principles of the nature and timing of the infectious insult with respect to outcomes, review the neuroimaging of infection by ultrasound and magnetic resonance imaging (MRI), and review the various pathogens involved, including the two most common, cytomegalovirus (CMV) and Toxoplasma, and also other common viral and nonviral infections.

The term “Big Data” refers to massive volumes of data that grow at an increasing rate and encompass complex data types such as audio and video. While the applications of Big Data and analytic techniques for business purposes have received considerable attention, it is less clear how external sources of Big Data relate to the transaction processing-oriented world of accounting information systems. This paper uses the Resource-Event-Agent Enterprise Ontology (REA) (McCarthy 1982; International Standards Organization [ISO] 2007) to model the implications of external Big Data sources on business transactions. The five-phase REA-based specification of a business transaction as defined in ISO (2007) is used to formally define associations between specific Big Data elements and business transactions. Using Big Data technologies such as Apache Hadoop and MapReduce, a number of information extraction patterns are specified for extracting business transaction-related information from Big Data. We also present a number of analytics patterns to demonstrate how decision making in accounting can benefit from integrating specific external Big Data sources and conventional transactional data. The model and techniques presented in this paper can be used by organizations to formalize the associations between external Big Data elements in their environment and their accounting information artifacts, to build architectures that extract information from external Big Data sources for use in an accounting context, and to leverage the power of analytics for more effective decision making.

Background Women who have experienced childhood trauma may be at risk for postpartum depression, increasing the likelihood of negative outcomes among their children. Predictive pathways from maternal childhood trauma to child outcomes, as mediated by postpartum depression, require investigation. Methods A longitudinal sample of South African women (N=150) was followed through pregnancy and postpartum. Measures included maternal trauma history reported during pregnancy; postpartum depression through six months; and maternal-infant bonding, infant development, and infant physical growth at one year. Structural equation models tested postpartum depression as a mediator between maternal experiences of childhood trauma and children’s outcomes. A subset of women (N=33) also participated in a lab-based emotional Stroop paradigm, and their responses to fearful stimuli at six weeks were explored as a potential mechanism linking maternal childhood trauma, postpartum depression, and child outcomes. Results Women with childhood trauma experienced greater depressive symptoms through six months postpartum, which then predicted negative child outcomes at one year. Mediating effects of postpartum depression were significant, and persisted for maternal-infant bonding and infant growth after controlling for covariates and antenatal distress. Maternal avoidance of fearful stimuli emerged as a potential affective mechanism. Limitations Limitations included modest sample size, self-report measures, and unmeasured potential confounders. Conclusions Findings suggest a mediating role of postpartum depression in the intergenerational transmission of negative outcomes. Perinatal interventions that address maternal trauma histories and depression, as well as underlying affective mechanisms, may help interrupt cycles of disadvantage, particularly in high-trauma settings such as South Africa.

Objectives Pre-eclampsia (PE) is associated with both postpartum endothelial dysfunction and asymptomatic structural heart alterations consistent with heart failure Stage B (HF-B). In this study, we assessed the relationship between endothelial function, measured by flow-mediated dilation (FMD), and HF-B in women with a history of PE. Methods This was an observational study in which 67 formerly pre-eclamptic women (>= 4 years postpartum) and 37 healthy parous controls were assessed ultrasonographically for cardiac function and geometry, as well as for endothelial function by means of brachial artery FMD. HF-B was diagnosed as left ventricular hypertrophy (left ventricular mass index (LVMi) > 95 g/m(2)), concentric remodeling (relative wall thickness> 0.42 and LVMi 40% and < 55%) or asymptomatic valvular disease. Cardiovascular and metabolic syndrome variables were compared between women with history of PE and controls, as well as between those in the formerly pre-eclamptic group who had HF Stage A, HF-B or no HF. Logistic regression analysis was performed to assess the associations of FMD with PE, metabolic syndrome risk factors and obstetric parameters. Results The prevalence of HF-B amongst formerly pre-eclamptic women was three-fold higher than that observed for controls (25% vs 8%, P < 0.05), while FMD was lower in formerly pre-eclamptic women compared with controls (6.12% vs 8.22%, P < 0.01); history of PE remained associated independently with lower FMD after adjusting for metabolic syndrome risk factors and obstetric parameters (beta, -1.88; 95% CI, -3.59 to -0.18). However, HF-B did not relate to low FMD in formerly pre-eclamptic women. Conclusions Years after pregnancy, formerly preeclamptic women have lower FMD and have HF-B more often compared with healthy parous controls. Nonetheless, HF-B was not related to reduced FMD. Copyright c (C) 2017 ISUOG. Published by John Wiley & Sons Ltd.

OBJECTIVE: To examine the effects of cigarette, marihuana and methamphetamine smoking and consumption of alcohol during pregnancy on maternal serum alpha-fetoprotein (MSAFP) levels at 20-24 weeks. STUDY DESIGN: In the Safe Passage Study (SPS) more than 12,000 pregnant women were prospectively followed up during pregnancy and until the infant was one year old to examine the effects of exposure to alcohol during pregnancy on stillbirth and sudden infant death syndrome. The present study is a cross-sectional secondary analysis of MSAFP analyses done at 20-24 weeks gestation in 1,679 SPS participants, recruited at the Bishop Lavis Community Health Centre, Cape Town, South Arica. RESULTS: Low or moderate alcohol consumption with or without smoking, nor methamphetamine or marihuana use affected mean MSAFP levels. High MSAFP levels were associated with high alcohol consumption, young age, low body mass index (BMI) (

This paper presents an architecture for integrating cloud computing and enterprise systems based on the Resource-Event-Agent (REA) model. The public/private approach used in RosettaNet provides the conceptual basis to capture information used in the cloud and by users of the cloud locally in their own systems. The architecture is then examined using information in the context of REA and the cloud-based software developed by Workday to illustrate different characteristics of the approach.

Objective To examine the effects of cigarette, marihuana and methamphetamine smoking and consumption of alcohol during pregnancy on maternal serum alpha-fetoprotein (MSAFP) levels at 20-24 weeks. Study design In the Safe Passage Study (SPS) more than 12,000 pregnant women were prospectively followed up during pregnancy and until the infant was one year old to examine the effects of exposure to alcohol during pregnancy on stillbirth and sudden infant death syndrome. The present study is a cross-sectional secondary analysis of MSAFP analyses done at 20-24 weeks gestation in 1,679 SPS participants, recruited at the Bishop Lavis Community Health Centre, Cape Town, South Arica. Results Low or moderate alcohol consumption with or without smoking, nor methamphetamine or marihuana use affected mean MSAFP levels. High MSAFP levels were associated with high alcohol consumption, young age, low body mass index (BMI) (

Pre-eclampsia (PE) is associated with both postpartum endothelial dysfunction and asymptomatic structural heart alterations consistent with heart failure Stage B (HF-B). In this study, we assessed the relationship between endothelial function, measured by flow-mediated dilation (FMD), and HF-B in women with a history of PE.This was an observational study in which 67 formerly pre-eclamptic women (≥ 4 years postpartum) and 37 healthy parous controls were assessed ultrasonographically for cardiac function and geometry, as well as for endothelial function by means of brachial artery FMD. HF-B was diagnosed as left ventricular hypertrophy (left ventricular mass index (LVMi) 95 g/mThe prevalence of HF-B amongst formerly pre-eclamptic women was three-fold higher than that observed for controls (25% vs 8%, P 0.05), while FMD was lower in formerly pre-eclamptic women compared with controls (6.12% vs 8.22%, P 0.01); history of PE remained associated independently with lower FMD after adjusting for metabolic syndrome risk factors and obstetric parameters (β, -1.88; 95% CI, -3.59 to -0.18). However, HF-B did not relate to low FMD in formerly pre-eclamptic women.Years after pregnancy, formerly pre- eclamptic women have lower FMD and have HF-B more often compared with healthy parous controls. Nonetheless, HF-B was not related to reduced FMD. Copyright © 2017 ISUOG. Published by John WileySons Ltd.

Background. Neural tube defects (NTDs) are an important category of birth defect, but surveillance remains inadequate in South Africa. Objectives. To assess the identification of NTDs at a tertiary hospital using a range of prenatal, perinatal and postnatal data sources, and to estimate the impact of prenatal diagnosis and birth prevalence for the referral area. Methods. Cases of anencephaly, encephalocele and spina bifida (SB) in a 6-year period were retrospectively identified from 5 data sources covering prenatal, perinatal and postnatal care. These were cross-correlated to avoid duplicate entries and to determine the contribution of different data sources. Details of prenatal diagnosis and termination of pregnancy (TOP) were obtained for 10 years, and birth prevalence over 2 years. Results. During a 6-year period 195 NTDs were identified at a Western Cape Province tertiary hospital. These included 59 (30%) cases of anencephaly, 28 (14%) of encephalocele and 108 (55%) of SB. The majority of NTDs (71%) were detected prenatally, although SB was less commonly diagnosed prenatally than cranial defects (56% v. 88%; p

SYNOPSIS As information and communication technologies (IT) become more deeply ingrained and inextricably woven into the fabric of organizations, more perplexing research and practice questions emerge. This commentary applies an organizing information systems research framework to accounting. The framework explicitly recognizes that complexities of the accounting value chain define relevant practice issues for research. We demonstrate application of the framework with examples that integrate different accounting disciplines and different research methodologies. Using a select number of prior research studies, we emphasize how design science, archival, and behavioral research paradigms work together to advance theory and inform practice. We also demonstrate how the framework directs future research for both well-established and emerging practice issues. JEL Classifications: M15; M41.

Contains fulltext : 182443.pdf (Publisher’s version ) (Closed access) OBJECTIVE: The aim of this systematic review and meta-analysis was to describe comprehensively the pattern of cardiac remodeling during normotensive human singleton pregnancy and to compare it with that of pregnancy complicated by hypertension. METHODS: We performed a meta-analysis of the current literature on cardiac remodeling during normotensive and complicated pregnancies. Literature was retrieved from PubMed (NCBI) and EMBASE (Ovid) databases. Included studies needed to report a reference measurement (matched non-pregnant control group, prepregnancy or postpartum) and measurements made during predetermined gestational-age intervals. Mean differences between reference and pregnancy data were calculated using the random-effects model described by DerSimonian and Laird. RESULTS: Forty-eight studies were included in the meta-analysis, with publication dates ranging from 1977 to 2016. During normotensive pregnancy, most geometric indices started to increase in the second trimester. Left ventricular mass (LVM) increased by 28.36 (95% CI, 19.73-37.00) g (24%), and relative wall thickness (RWT) increased by 0.03 (95% CI, 0.02-0.05) (10%) compared with those in the reference group. During hypertensive pregnancy, LVM and RWT increased more than during normotensive pregnancy (92 (95% CI, 75.46-108.54) g (95%) and 0.14 (95% CI, 0.09-0.19) (56%), respectively). CONCLUSIONS: During normotensive pregnancy, most cardiac geometric indices change from the second trimester onwards. Both LVM and RWT increase, by 20% and 10%, respectively, consistent with concentric rather than eccentric remodeling. Cardiac adaptation in hypertensive pregnancy deviates from that in healthy pregnancy by a greater change in LVM (95% increase from reference) and RWT (56% increase from reference). Copyright (c) 2017 ISUOG. Published by John Wiley & Sons Ltd.

The expansion of oxygen minimum zones (OMZ's) in estuaries can be harmful for ecology and economy, prompting the demand for expensive measures. Here we look at the oxygen dynamics in two northern temperate European estuaries, the Schelde (The Netherlands/Belgium) and the Elbe (Germany) and analysed data from the period of 2004e2009. The Schelde is characterized by two zones of increased oxygen consumption; the Elbe shows one zone of increased oxygen consumption. Despite reduction in biochemical oxygen demand in both estuaries, oxygen conditions improved in the Schelde estuary, while the oxygen minimum zone persisted in the Elbe estuary. To understand these different oxygen dynamics, we applied a one-dimensional reactive transport model to both estuaries. In the Schelde we found low oxygen concentrations to be related to organic matter and ammonium input from the major tributaries. In the Elbe, additionally to a high input of organic matter from upstream, oxygen dynamics were influenced by abrupt changes in estuarine morphology. Next, the origin of the organic matter substrate differs between the two estuaries. In the Elbe, the organic matter imported is mostly composed of algal die-off produced in the Elbe River upstream. In the Schelde the organic matter and ammonium input is mostly related to sewage input of anthropogenic origin. This implies that waste water treatment will be more effective to remediate hypoxia related problems in the Schelde than in the Elbe.

Doppler examination of the fetal middle cerebral artery (MCA) is considered highly reliable in detecting severe fetal anaemia. We present a case of a mother with severe pre-eclampsia at 32 weeks’ gestation and non-immune fetal hydrops without obvious cause. Since the MCA peak systolic velocity (PSV) was normal, severe anaemia was not considered as a possible cause, but after delivery the infant was found to be severely anaemic and died. Histological examination of the placenta revealed multiple extensive haemorrhages (subchorionic, intraparenchymal and intravillous), and autopsy indicated that the most likely cause of death was severe anaemia and hypoxia due to multiple and extensive placental haemorrhages, which had developed over the course of several days. We postulate that the MCA PSV failed to indicate severe anaemia because of the combination of subacute anaemia with severe profound hypoxia due to placental insufficiency.

To identify the most accurate formula to estimate fetal weight (EFW) from ultrasound parameters in severe preterm preeclampsia.In a prospective study, serial ultrasound assessments were performed in 123 women with severe preterm preeclampsia. The EFW, calculated for 111 live born, normal, singleton fetuses within 7 days of delivery using 38 published formulae, was compared to the actual birth weight (ABW). Accuracy was assessed by correlations, mean (absolute and signed) (%) errors, % correct predictions within 5-20% of ABW and limits of agreement.Accuracy was highly variable. Most formulae systematically overestimated ABW. Five Hadlock formulae utilizing three or four variables and Woo 3 formula had the highest accuracy and did not differ significantly (mean absolute % errors 6.8-7.2%, SDs 5.3-5.8%,75% of estimations within 10% of ABW and 95% limits of agreement between -18/20% and +14/15%). They were not negatively affected by clinical variables but had some inconsistency in bias over the ABW range. All other formulae, including those targeted for small, preterm or growth restricted fetuses, were inferior and/or affected by multiple clinical variables.In this GA window, Hadlock formulae using three or four variables or Woo 3 formula can be recommended.

The main purpose of this paper is to provide design and implementation guidance to those interested in utilizing blogs as a collaborative learning tool in any given field of study. We created the Sarbanes-Oxley Blog (SoxBlog), a web-based forum for asynchronous student-instructor-expert collaboration. Given the recent scandals and publication of the Sarbanes-Oxley Act of 2002 (SOX), we increased our emphasis on integrating corporate governance and ethics issues into the financial accounting curriculum. Students new to financial accounting were asked to research a number of targeted issues related to the accounting environment and corporate governance and to discuss them with their peers, instructor, and experts. Some of the items to be discussed include: the relationship between task and learning objectives, students’ engagement in the collaboration process, the structuring of the collaboration process, and the technological simplicity of creating and using blogs. Overall, students perceived the SoxBlog collaboration as a positive learning experience.

In a continuously changing business environment, the need for more flexible enterprise systems has been recognized by many. Different solutions are being suggested to improve the adaptability of enterprise systems, including model-driven architectures and reflective systems. A model-driven architecture starts from an enterprise schema that formally defines the business activities of a company. This schema is then progressively transformed into more implementation-specific models until source code is generated [1, 2]. Changes in business practices are accommodated by enterprise schema updates that are then automatically propagated into software code. Reflective systems record enterprise schemas explicitly so that they can be manipulated at run time [3, 4]. A reflective system is more flexible since the definition of the enterprise schema and its integrity rules can be configured external to the execution of the program [5]. The expected benefits of reflective systems include improved adaptability, semantics, and reusability. On the other hand, their design is substantially more complex, and the execution of applications built with such systems is slower since the definition of the enterprise schema needs to be interpreted. A timeless REA enterprise system integrates ontological specifications as part of its reflective architecture. The Resource-Event-Agent (REA) enterprise ontology [6, 7] is strongly rooted in accounting and economic theory and addresses the issue of what phenomena should be captured in an enterprise system. In addition, it provides structuring guidelines on how economic phenomena should be assembled into business process and value chain specifications [8]. This paper explores the reflective architecture, design, and operation of timeless REA enterprise systems. We first describe the integration of ontological specifications as part of reflective enterprise systems. Next, we use claim management and cost calculation examples to illustrate how the ontological specifications can be employed for the design of reusable, ontology-driven applications.

The Resource-Event-Agent (REA) enterprise model is a widely accepted framework for the design of the accountability infrastructure of enterprise information systems. Policy-level specifications define constraints and guidelines under which an enterprise operates, and they are an extension to the REA enterprise model, adding the “what should, could, or must be” to the “what is.” This paper aims both at comprehensive understanding of policy-level definitions as part of REA enterprise systems and at understanding of the semantic constructs that enable such definitions. We first explore two distinctive semantic abstractions essential to policy-level specifications: typification and grouping. The typification abstraction links instances of an object class to concepts for which they are concrete realizations, while the grouping abstraction aggregates objects into collections. We next present a number of patterns for the semantic modeling of policies. Following, we look at policy-level applications for REA enterprise information systems. We explore type and grouping definitions for the REA primitives (resource, event, agent) and discuss enterprise applications for three different kinds of policy definitions: knowledge-intensive descriptions, validation rules, and target descriptions. Our discussion of specific enterprise applications includes internal control applications (e.g., limit checks), variance analysis based on standard specifi-cations (e.g., bills of materials), and budgeting applications.

Objectives To predict when delivery will occur, within 48 h and 7 days of presentation and before 35 weeks’ gestation in women presenting with threatened preterm labor. Methods Sonographic measurement of cervical length was carried out in 510 women with singleton pregnancies presenting with threatened preterm labor and intact membranes at 24 to 33 + 6 weeks of gestation. The measurement was not taken into account in the subsequent management of the pregnancies. The outcome measures were delivery within 48 h and 7 days of presentation and delivery before 35 weeks. Results The median gestation at presentation was 30 + 1 (range, 24 to 33 + 6) weeks and the median cervical length was 25 (range, 1–51) mm. Delivery within 48 h of presentation occurred in 21 (4.1%) cases, delivery within 7 days occurred in 43 (8.4%) and delivery before 35 weeks occurred in 76 (14.9%). Logistic regression analysis demonstrated that the only significant independent predictor of delivery within 48 h was cervical length (odds ratio (OR), 0.73; 95% CI, 0.65–0.81) and for delivery within 7 days the independent predictors were cervical length (OR, 0.69; 95% CI, 0.63–0.76) and vaginal bleeding (OR, 19.42; 95% CI, 3.87–97.4). In the subgroup of women who did not deliver within 7 days of presentation, the incidence of delivery before 35 weeks was 7.1% (33 of 467) and the only significant independent predictor of such delivery was cervical length (OR, 0.92; 95% CI, 0.88–0.96, P < 0.0001). There was no significant independent contribution to any of the outcome measures from ethnic group, maternal age, gestational age, body mass index, parity, cigarette smoking or use of tocolytics.

Congenital rubella infection has been associated with a number of abnormalities including cardiac, central nervous system and placental complications. We present a case with multiple fetal abnormalities detected on prenatal ultrasound, and confirmed postnatally, that included a single umbilical artery, severe tricuspid regurgitation, micrognathia and agenesis of the inferior cerebellar vermis. Postnatal echocardiography additionally revealed unobstructed total anomalous pulmonary venous drainage (TAPVD) into the coronary sinus. Placental examination showed signs of placentitis, and polymerase chain reaction on neonatal serum was positive for rubella. Following a multidisciplinary team review, it was decided to provide only supportive care, and the infant died at 6 months of age owing to a respiratory tract infection. To our knowledge, TAPVD and agenesis of the inferior cerebellar vermis have not been reported previously in association with congenital rubella infection. This case illustrates how congenital infection may present in atypical ways and stresses the importance of considering congenital infection in the differential diagnosis of fetal anomalies when multiple features are present.