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Preterm delivery (PTD) is the leading cause of infant morbidity and mortality in the United States. An epidemiological association between PTD and various bacteria that are part of the vaginal microflora has been reported. No single bacterial species has been identified as being causally associated with PTD, suggesting a multifactorial etiology. Quantitative microbiologic cultures have been used previously to define normal vaginal microflora in a predictive model. These techniques have been applied to vaginal swab cultures from pregnant women in an effort to develop predictive microbiologic models for PTD. Logistic regression analysis with microbiologic information was performed for various risk groups, and the probability of a PTD was calculated for each subject. Four predictive models were generated by using the quantitative microbiologic data. The area under the curve (AUC) for the receiver operating curves ranged from 0.74 to 0.94, with confidence intervals (CI) ranging from 0.62 to 1. The model for the previous PTD risk group with the highest percentage of PTDs had an AUC of 0.91 (CI, 0.79 to 1). It may be possible to predict PTD by using microbiologic risk factors measured once the gestation period has reached the 20-week time point.

The epidemiology of early onset neonatal group B streptococcal (GBS) disease has changed appreciably, but there are no recent assessments of the in-hospital resource utilization it incurs.We performed a retrospective cohort study of infants delivered from 1987 through 1995 at Massachusetts' largest obstetrics hospital. A matched cohort design was used to assess care occurring after transfer to another acute care hospital.There were 135 cases of early onset neonatal GBS infection complicating 85,062 deliveries (1.6/1,000 births) in 9 years, with a substantial decline beginning in 1994, when maternal intrapartum chemoprophylaxis was widely introduced. Most (73%) infants had birth weights of 2500 g or more; 93% survived. Overall both the median and mean lengths of stay were 8 days longer for infants with GBS disease than for those without this infection (P0.001). Total hospital charges for neonates with GBS disease also were higher, with the difference in medians of $5323 and in means of $10,004 (P0.001). Differences were greatest among2500-g birth weight infants; no excess was evident for infants with birth weights of1500 g.There was a substantial excess length of stay and charges associated with early onset neonatal GBS disease, although this was less than previously reported.

This study investigated the similarities and differences in perception of Cantonese tones and English stress patterns by Cantonese-English bilingual children, adults, and English monolingual adults. All three groups were asked to discriminate pairs of syllables that minimally differed in either Cantonese tone or in English stress. Bilingual children's performance on tone perception was comparable to their performance on stress perception. By contrast, bilingual adults' performance on tone perception was lower than their performance on stress perception, and there was a similar pattern in English monolingual adults. Bilingual adults tended to perform better than English monolingual adults on both the tone and stress perception tests. A significant correlation between tone perception and stress perception performance was found in bilingual children but not in bilingual adults. All three groups showed lower accuracy in the high rising-low rising contrast than any of the other 14 Cantonese tone contrasts. The acoustic analyses revealed that average F0, F0 onset, and F0 major slope were the critical acoustic correlates of Cantonese tones, whereas multiple acoustic correlates were salient in English stress, including average F0, spectral balance, duration and intensity. We argue that participants' difficulty in perceiving high rising-low rising contrasts originated from the contrasts' similarities in F0 onset and average F0; indeed the difference between their major slopes was the only cue with which to distinguish them. Acoustic-perceptual correlation analyses showed that although the average F0 and F0 onset were associated with tone perception performance in all three groups, F0 major slope was only associated with tone perception in the bilingual adult group. These results support a dynamic interactive account of suprasegmental speech perception by emphasizing the positive prosodic transfer between Cantonese tone and English stress, and the role that level of bilingual language experience and age play in shaping suprasegmental speech perception.

K x-ray fluorescence (KXRF) systems are being used in a growing number of epidemiologic studies to measure bone lead levels as a biological marker of accumulated lead exposure. Although validation of the KXRF technique in lead-doped phantoms and bare bone specimens has been repeatedly demonstrated, few studies have compared KXRF to chemical measurements of actual intact cadaver limbs (with skin and soft tissues). In this study, lead levels in eight amputated human legs were measured by KXRF; after dissection, levels in the bare bones were again measured by KXRF and then by inductively coupled plasma mass spectrometry (ICP-MS). We observed close agreement between the KXRF and ICP-MS measurements with correlation coefficients for both the tibia and patella greater than 0.9. In this study we provide further support for the validity of KXRF measurements, particularly with respect to the patella.

Serum cortisol levels were determined in 40 normal Chinese and dopamine beta-hydroxylase activities were measured in 22 normal subjects before and after acupuncture treatment. All subjects were studied twice with an interval of one week or more. In the self-control study, the subjects were needled at 5 non-acupuncture loci. in the experimental study, they were needled at the following 5 traditional acupuncture loci - right side GB-20, both sides EH-6, and both sides St-36. Blood samples were withdrawn before acupuncture and 15 and 45 min. after acupuncture. No change of serum dopamine beta-hydroxylase activity was observed. Serum cortisol levels increased significantly after needling on the traditional acupuncture loci. After acupuncture for 15 and 45 min., the cortisol increase was 28 and 50%, respectively, as compared to the self-control studies. The beneficial effect of acupuncture in the treatment of functional disorders, therefore, may be mediated by cortisol or other hormones and neurohormones.