Search

Objective: To review medical records of pregnant women with positive non-invasive prenatal testing (NIPT) results for sex chromosome abnormalities who attended Tuen Mun hospital between 2015 and 2021. Patient decision after prenatal diagnosis, confirmatory diagnostic testing results, and pregnancy/neonatal outcomes were summarised. Methods: Medical records of women with abnormal NIPT results for sex chromosome abnormalities who attended Tuen Mun Hospital between January 2015 and December 2021 were retrospectively reviewed. Results: 56 Chinese women attended our prenatal diagnostic clinic with abnormal NIPT results for sex chromosome abnormalities involving 45, X (n=17), 47, XXY (n=10), 47, XXX (n=6), 47, XYY (n=8), disproportionate level of sex chromosomes (n=9), copy number variants of sex chromosomes (n=3), and suspected maternal sex chromosome imbalance (n=3). 53 had singleton pregnancies and three had dichorionic-diamniotic twin pregnancies. 58.9% had conventional combined Down syndrome screening; 15.2% of them were at high risk for trisomy 21. 33 (58.9%) of the patients opted for invasive diagnostic test: amniocentesis (n=29), chorionic villus sampling (n=3), and chorionic villus sampling followed by amniocentesis (n=1). Confirmatory cytogenetic test results (including postnatal results) were available in 35 cases. The overall positive predictive value of NIPT to detect fetal sex chromosome aneuploidies was 71.4%; the value was 42.9% for detecting 45, X, 100% for detecting 47,XXY, 80% for detecting 47,XXX, and 83.3% for detecting 47,XYY. False positive results were observed in three cases of confined placental mosaicism and three cases of vanishing twin pregnancies. Two women with 47,XXX and one woman with mosaic 45,X/46,XX were also incidentally discovered. Conclusion: Positive NIPT results for sex chromosome abnormalities can be caused by true fetal sex chromosome abnormalities, confined placental mosaicism/placental mosaicism, vanishing twins, and maternal X chromosome abnormalities. Multidisciplinary management can help prenatal counselling and genetic diagnosis. Follow-up confirmatory cytogenetic analysis prenatally and/or postnatally is useful to characterise the numeric or structural fetal sex chromosome abnormalities and their mosaic patterns, and can maximise the benefits of prenatal genetic screening in obtaining more genetic information to support pregnancy management and clinical care of affected unborn child. [ABSTRACT FROM AUTHOR]

Introduction: To evaluate the success rate and short-term complications of single, double, and triple modalities of uterine-sparing treatment (UST) for primary postpartum haemorrhage (PPH). Methods: We retrospectively reviewed records of women who underwent UST for PPH between 2006 and 2019 in Tuen Mun Hospital. The success rates of single, double, and triple modalities of UST (derived from the number of haemostatic hysterectomies prevented) were compared, as were short-term complications between single and double modality groups. Results: Of 221 women who underwent UST for primary PPH, 174 (78.7%) received single, 44 (19.9%) received double, and 3 (1.4%) received triple modalities of UST. The three groups were comparable, except that there were more nulliparous women in the double than single modality group, more women having caesarean sections in the single than double or triple modality group, and more uterine atony in the double or triple than single modality group. The success rate of haemostasis decreased from 94.3% after single modality to 90.9% after double modalities to 0% after triple modalities (p<0.001). All three women with triple modalities of UST eventually underwent haemostatic hysterectomy. The single and double modality groups were comparable in terms of short-term complications. Conclusion: Single and double modalities of UST were effective and safe in treating primary PPH. Early resort to hysterectomy should be considered if double modalities of UST failed to achieve haemostasis. [ABSTRACT FROM AUTHOR]

Study on the emulsion formation mechanically and relate the effect of emulsions to the friction or wall shear stress ( τw ) in the pipeline flow has not yet been explored. So, this study aims to understand the emulsions formation mechanically and to discover the effects of water-in-oil emulsions to the pipeline flow transport by relating the effect of emulsions to the wall shear stress or friction of the pipe. In this study, wall shear stress is compared at water cuts from 0% to 40%, Reynolds number that covers laminar (1100 < Re < 1800) and transitional (2400 < Re < 2800) flow regime, pipeline constrictions that consists of gradual and sudden contraction with a contraction ratio of 0.50 and 0.75, respectively as well as along the pipelines. To carry out the experiments, the Ultrasonic Velocity Profiler and a lab-scale flow rig were used. The results show that the maximum wall shear stress happens at 10% water cuts, higher Reynolds number results in lower wall shear stress, pipeline constriction with contraction ratio of 0.75 results in higher wall shear stress than the contraction ratio of 0.50 and sudden constriction results in higher wall shear stress than the gradual constriction, and wall shear stress increases with the increase in the length of the pipeline downstream the pipeline constriction. In conclusion, pipeline flow with higher Reynolds number and pipeline constriction (which represents the usage of choke valve in the industries) type gradual constriction ratio 0.50 are recommended to be used in the oil and gas industries because this combination results in the lowest wall shear stress. [ABSTRACT FROM AUTHOR]

Edible bird nests (EBNs) are highly demanded globally. The industry was recently affected by an import ban to China due to high nitrite levels. Subsequently, many concerns have been raised. In this study, the microbial composition of both raw and commercial EBNs was investigated. The raw EBNs were purchased from swiftlet farms: Kuala Sanglang (Perlis), Pantai Remis (Perak), Kluang (Johor), Kajang (Selangor) and Kota Bharu (Kelantan). The commercial nests were purchased from five different Chinese traditional medicinal shops (Companies A-E) in Malaysia and one from Indonesia (Medan). A total of 123 and 34 isolates were successfully identified from unboiled raw and commercial EBNs respectively. The highest average CFU (1.77 x 104) was associated with raw EBNs obtained from Kluang, while for the commercial EBNs, those obtained from Company M1 had the highest CFU (5.50 x 104). Bacillus sp. accounted for the highest isolated species from both unboiled raw and commercial EBNs. Bacillus sp. and Brevibacillus sp. were mainly isolated from the boiled EBNs. Bacillus spp. were the dominant bacterial groups in all the raw EBNs except for those obtained from Kajang. The average number of bacteria isolated from the raw EBNs (average = 7) was higher compared with those isolated from the commercial EBNs (average = 4). The highest average number of bacterial isolates was reported in the raw EBNs obtained from Kota Bharu. Among the commercial EBNs, one EBN sample each from Companies A and M1 showed the highest number of isolates (n = 10). In general, there was a significant reduction in the number of bacteria isolated after boiling the EBNs. Raw EBNs obtained from Kajang had a distinct pool of bacterial species where the majority of the isolated species belonged to Staphylococcus species. The associated health impacts of these microorganisms to the consumers and public need to be addressed. [ABSTRACT FROM AUTHOR]

The surface EMG signal in the action of dynamic contraction has more movement interference compared to sustained static contractions. In addition, the recruitment and de-recruitment of motor units causes a faster change in the surface EMG signal's proprieties. Therefore, more complex techniques are required to extract information from the surface EMG signal. The standardized protocol for surface myoelectric signal measurement in table tennis was a case study in this research area. The Autoregressive method based on the Akaike Information Criterion, the Wavelet method based on intensity analysis, and the Hilbert-Huang transform method were used to estimate the muscle fatigue and non-fatigue condition. The result was that the Hilbert-Huang transform method was shown to be more reliable and accurate for studying the biceps brachii muscle in both conditions. However, the Wavelet method based on intensity analysis is more reliable and accurate for the pectoralis major muscle, deltoideus anterior muscle and deltoideus medialis muscle. The results suggest that different time-frequency analysis techniques influence different muscle analyses based on surface EMG signals in fatigue and non-fatigue conditions. [ABSTRACT FROM AUTHOR]

There is more regulation of franchising, licensing, and distribution sales and relationships in Asia than in any other continent. This article surveys and compares the laws and regulations that apply to franchising, licensing and distribution relationships under franchise and related laws in The People's Republic of China, Indonesia, Japan, The Republic of Korea, Malaysia and Vietnam. The authors discuss the breadth and impact of these laws on franchisors, licensors and others; the extent to which there is overregulation; and, techniques for dealing with these laws. The information and issues are presented in a thematic question and answer format for ease of comparison. [ABSTRACT FROM AUTHOR]

Introduction: Heavy metals and other contaminants in food have been a concern to food industries, consumers and governing authorities. The purpose of this study was to determine the levels of heavy metals and other elements in edible bird nests (EBNs). Methods: Raw and processed (commercial) EBNs were used in the study. Raw EBNs were collected directly from five house farms in Peninsular Malaysia - Kuala Sanglang (Kedah), Pantai Remis (Perak), Kluang 0ohor), Kota Bharu (Kelantan) and Kajang (Selangor). Processed EBNs were purchased from five Chinese traditional medicinal shops located in Peninsular Malaysia. The levels of 32 elements were determined by inductively coupled plasma-mass spectrometry and findings of the study were compared to the maximum regulatory limits set by the Standards and Industrial Research Institute of Malaysia (SIRIM) for EBNs. Results: Of the seven elements with maximum regulatory limits (As, Cd, Pb, Hg, Sn, Cu, Fe), one raw EBN was detected with mercury level of 70.180 ppb which was above the SIRIM permissible limit of 50 ppb. All the EBNs had iron levels above the SIRIM permissible limit of 30 ppb. The levels of the other 25 elements with no maximum regulatory limits (Ca, Mg, Na, K, P, Co, Cr, Mn, Mo, Se, Zn, Ag, Ba, Be, Bi, B, Li, Ni, Sb, Sr, Ti, U, V, Al, Zr) were also determined. Conclusion: The data obtained for the 25 elements with no permissible limits can serve as baseline data for further studies to establish their maximum regulatory limits. [ABSTRACT FROM AUTHOR]

Objectives: Congenital heart disease is associated with high mortality and morbidity rates, being the most life-threatening defect in the first month of postnatal life and accounting for approximately half of all childhood mortality from birth defects. Despite this, the prenatal detection rate for congenital outflow tract anomalies by ultrasound imaging is relatively low. The aim of this study was to establish a nomogram for the pulmonary artery/aorta (PA/AO) ratio measured in the three-vessel view plane. This ratio was investigated as a simple screening tool for congenital cardiac outflow tract abnormalities. Methods: The study was a prospective evaluation of 966 singleton fetuses at 16-24 weeks of gestation and 46 fetuses with congenital cardiac outflow tract abnormalities. The diameters of the pulmonary artery and aorta were measured in the three-vessel view. The PA/AO ratio was calculated and a nomogram was constructed. The mean and 95% CI for the ratio were defined and the PA/AO ratios of cases with outflow tract abnormalities were plotted against the values for normal fetuses. Results: The gestational age of the normal group ranged from 16 to 24 weeks, with a median of 19 weeks. The pulmonary artery diameter measured between 2.1 and 4.93 mm (mean, 3.3 mm) and the aorta measured between 2.1 and 5.2 mm (mean, 2.93 mm). The mean (SD) PA/AO ratio was 1.16 (0.18) (95% CI, 0.87-1.58; range 0.61-1.86; median, 1.14). For fetuses with outflow tract abnormalities, the median gestation was 19 weeks and 37/43 (86%) had a PA/AO ratio outside the 95% CI. Conclusions: The PA/AO ratio derived from measurements in the three-vessel view plane can be used as an initial screening tool for outflow tract anomalies and may have a sensitivity of up to 86%, with a 5% false-positive rate. [ABSTRACT FROM AUTHOR]

Objective: To assess the effect of glucose control on the rate of growth of fetuses in women with pregestational diabetes mellitus (Types 1 and 2). Methods: All pregestational diabetic women booked at Mater Mothers' Hospital, Brisbane, Australia, between 1 January 1994 and 31 December 2002, were included. Pregnancies with congenital fetal anomalies, multiple pregnancies, and pregnancies terminated prior to 20 weeks' gestation were excluded. Dating scans were performed before 14 weeks' gestation and serial scans were performed at 18, 24, 28, 32 and 36 weeks. Fetal parameters, including biparietal diameter, femur length and abdominal circumference, were recorded. The daily growth rates for biparietal diameter, femur length, and fetal abdominal area were calculated and compared with those in a low-risk (non-diabetic) population. The growth rates in fetuses of women with satisfactory diabetic control (HbA1c < 6.5%) and unsatisfactory control (HbA1c > or = 6.5%) in the three trimesters were compared. Results: A total of 174 diabetic pregnancies were included and a total of 997 ultrasound scans were performed. The growth rates for fetuses of mothers with diabetes mellitus were significantly higher than for those in the low-risk population. The z-scores for biparietal diameter, femur length, and fetal abdominal area were 0.18, 0.59 and 1.44, respectively. Fetuses of diabetic mothers with high HbA1c in the first trimester had significantly greater fetal abdominal area growth rate than those with normal HbA1c (fetal abdominal area z-score of 1.7 vs. 0.75, P = 0.009). Although the fetal abdominal area z-scores in fetuses of diabetic mothers with high HbA1c in the second or third trimesters were also higher than those with normal HbA1c levels, the differences did not reach statistical significance. Maternal obesity did not influence the fetal growth rate. Conclusion: The rate of growth of fetuses of diabetic mothers differs from that of the normal population. Growth acceleration persists until the late third trimester. Moreover, periconceptional glucose control appears to have a significant effect on accelerated growth of the fetal abdominal area. [ABSTRACT FROM AUTHOR]

Objective: Cardiac impairment is frequently found in babies of diabetic mothers. It is still controversial whether this is due to poor glucose control. The aim of this study is to compare the cardiac function in fetuses of well- and poorly-controlled pre-gestational diabetic pregnancy in third trimester.Methods: Women with type 1 pre-gestational diabetes were enrolled at 30-32 weeks. Cardiac size and interventricular septal wall thickness were measured by M-mode at end-diastolic phase. The right and left ventricular ejection fractions were calculated. At the mitral and tricuspid valves inflow, the ratio between early ventricular filling and active atrial filling (E/A) at both atrioventricular valves were measured by Doppler echocardiography. Peak velocities of ascending aorta and pulmonary artery were assessed. The angle of isonation was kept at <20 degrees. Women with poorly-controlled diabetes (HbA1c>6.5%) were compared with those with satisfactorily controlled diabetes (HbA1c < or = 6.5%).Results: A total of 21 women with pre-gestational diabetes were recruited for this study. Eight women with well-controlled diabetes were compared with 9 women who had poorly-controlled diabetes. HbA1c in the poorly-controlled group was 7.3% and in the well-controlled group it was 5.4% (p<0.001). There was no difference between the two groups in cardiac size, interventricular septal wall thickness, ejection fraction, aorta and pulmonary artery peak flow velocities. The right atrioventricular E/A ratio was significantly lower among the poorly-controlled diabetic pregnancies (0.71 vs. 0.54; p<0.05).Conclusion: Fetuses of poorly-controlled diabetic mothers had a lower right atrioventricular E/A ratio. This may be due to metabolic acidosis, non-hypertrophic cardiac dysfunction or fetal polycythemia. [ABSTRACT FROM AUTHOR]

This study deals with the carbonation of concrete incorporating ground granulated blast-furnace slag (GGBS), fly ash (FA), and silica fume (SF). It is observed that a decreased water-to-binder ratio and replacement level of GGBS, FA, or SF, or an increase in GGBS fineness and curing age in water, led to better carbonation resistance. However, compared to a plain concrete, the concrete incorporating mineral admixtures (except GGBS with higher fineness and SF) generally showed lower resistance to carbonation, possibly due to the dominating effect of the reduction in calcium hydroxide over pore refinement. Hence, adequate curing is recommended for enhancing the resistance of concrete containing GGBS, FA, and SF to carbonation. It is also found that both the carbonation coefficient and compressive strength served as good indicators for the carbonation rate of concrete with and without mineral admixtures. [ABSTRACT FROM AUTHOR]

Pregnancies complicated with meconium-stained liquor are regarded as at risk of fetal distress. Evidence from animal and human studies indicate that passage of meconium may be related to fetal maturity. This retrospective study attempts to quantify the relative risk of non-reassuring cardiotocography or 'fetal distress' in pregnant women complicated by meconium-stained liquor for preterm, term and post-term pregnancies. A total of 9542 singleton pregnancies, delivered in a tertiary obstetric unit in Hong Kong between 1 July 1996 and 31 June 1999, were included in the study. Of these pregnancies, 1946 (20·4%) were identified as having meconium-stained liquor, ranging from thin to thick staining. There was a strong association between incidence of meconium-stained liquor (P < 0·0005) and moderate/thick meconium-stained liquor with advanced gestational age. The incidence of non-reassuring cardiotocography in women presenting with meconiun-stained liquor was significantly higher (9·8% vs. 6·4%). The relative risk of non-reassuring cardiotocography in women with meconium-stained liquor increased with more advanced gestation. Close fetal surveillance during labour is required among these pregnancies. Premature labour is associated with higher incidence of fetal distress but the presence of meconium did not pose an additional risk. [ABSTRACT FROM AUTHOR]