Search

Your search keyword '"Noble, Julia A"' showing total 91 results
Start Over Author "Noble, Julia A"
91 results on '"Noble, Julia A"'

2. Association between maternal haemoglobin concentrations and maternal and neonatal outcomes: the prospective, observational, multinational, INTERBIO-21st fetal study

Author

Kennedy, Stephen H, Victora, Cesar G, Craik, Rachel, Ash, Stephen, Barros, Fernando C, Barsosio, Hellen C, Berkley, James A, Carvalho, Maria, Fernandes, Michelle, Cheikh Ismail, Leila, Lambert, Ann, Lindgren, Cecilia M, McGready, Rose, Munim, Shama, Nellåker, Christoffer, Noble, Julia A, Norris, Shane A, Nosten, Francois, Ohuma, Eric, Papageorghiou, Aris T, Stein, Alan, Stones, William, Tshivuila-Matala, Chrystelle O O, Staines Urias, Eleonora, Vatish, Manu, Wulff, Katharina, Zainab, Ghulam, Zondervan, Krina T, Uauy, Ricardo, Bhutta, Zulfiqar A, Villar, José, Ohuma, Eric O, Jabin, Nusrat, Young, Melissa F, Epie, Terrence, Martorell, Reynaldo, Peña-Rosas, Juan Pablo, Garcia-Casal, Maria Nieves, and Villar, Jose

Published
2023
Full Text
View/download PDF

3. The satisfactory growth and development at 2 years of age of the INTERGROWTH-21st Fetal Growth Standards cohort support its appropriateness for constructing international standards

Author

Villar, José, Ismail, Leila Cheikh, Urias, Eleonora Staines, Giuliani, Francesca, Ohuma, Eric O, Victora, Cesar G, Papageorghiou, Aris T, Altman, Douglas G, Garza, Cutberto, Barros, Fernando C, Puglia, Fabien, Ochieng, Roseline, Jaffer, Yasmin A, Noble, Julia A, Bertino, Enrico, Purwar, Manorama, Pang, Ruyan, Lambert, Ann, Chumlea, Cameron, Stein, Alan, Fernandes, Michelle, Bhutta, Zulfiqar A, Kennedy, Stephen H, Katz, M, Bhan, MK, Garza, C, Zaidi, S, Langer, A, Rothwell, PM, Weatherall, D, Bhutta, ZA, Villar, J, Kennedy, S, Altman, DG, Barros, FC, Bertino, E, Burton, F, Carvalho, M, Ismail, L Cheikh, Chumlea, WC, Gravett, MG, Jaffer, YA, Lambert, A, Lumbiganon, P, Noble, JA, Pang, RY, Papageorghiou, AT, Purwar, M, Rivera, J, Victora, C, Shorten, M, Hoch, L, Knight, HE, Ohuma, EO, Cosgrove, C, Blakey, I, Urias, E Staines, Roseman, F, Kunnawar, N, Gu, SH, Wang, JH, Wu, MH, Domingues, M, Gilli, P, Juodvirsiene, L, Musee, N, Al-Jabri, H, Waller, S, Muninzwa, D, Yellappan, D, Carter, A, Reade, D, Miller, R, Salomon, L, Leston, A, Mitidieri, A, Al-Aamri, F, Paulsene, W, Sande, J, Al-Zadjali, WKS, Batiuk, C, Bornemeier, S, Dighe, M, Gaglioti, P, Jacinta, N, Jaiswal, S, Oas, K, Oberto, M, Olearo, E, Owende, MG, Shah, J, Sohoni, S, Todros, T, Venkataraman, M, Vinayak, S, Wang, L, Wilson, D, Wu, QQ, Zhang, Y, and Chamberlain, P

Subjects
Pediatric, Conditions Affecting the Embryonic and Fetal Periods, Infant Mortality, Clinical Research, Preterm, Low Birth Weight and Health of the Newborn, Nutrition, Prevention, Perinatal Period - Conditions Originating in Perinatal Period, 2.4 Surveillance and distribution, Aetiology, Reproductive health and childbirth, Good Health and Well Being, Brazil, Cephalometry, Child Development, China, Female, Fetal Development, Growth Charts, Health Status, Humans, India, Infant, Infant, Newborn, Italy, Kenya, Longitudinal Studies, Male, Motor Skills, Nutritional Status, Oman, Pregnancy, United Kingdom, United States, World Health Organization, International Fetal and Newborn Growth Consortium for the 21(st) Century (INTERGROWTH-21(st)), INTERGROWTH-21(st) fetal growth standards, development, postnatal growth, Paediatrics and Reproductive Medicine, Obstetrics & Reproductive Medicine
Abstract

BackgroundThe World Health Organization recommends that human growth should be monitored with the use of international standards. However, in obstetric practice, we continue to monitor fetal growth using numerous local charts or equations that are based on different populations for each body structure. Consistent with World Health Organization recommendations, the INTERGROWTH-21st Project has produced the first set of international standards to date pregnancies; to monitor fetal growth, estimated fetal weight, Doppler measures, and brain structures; to measure uterine growth, maternal nutrition, newborn infant size, and body composition; and to assess the postnatal growth of preterm babies. All these standards are based on the same healthy pregnancy cohort. Recognizing the importance of demonstrating that, postnatally, this cohort still adhered to the World Health Organization prescriptive approach, we followed their growth and development to the key milestone of 2 years of age.ObjectiveThe purpose of this study was to determine whether the babies in the INTERGROWTH-21st Project maintained optimal growth and development in childhood.Study designIn the Infant Follow-up Study of the INTERGROWTH-21st Project, we evaluated postnatal growth, nutrition, morbidity, and motor development up to 2 years of age in the children who contributed data to the construction of the international fetal growth, newborn infant size and body composition at birth, and preterm postnatal growth standards. Clinical care, feeding practices, anthropometric measures, and assessment of morbidity were standardized across study sites and documented at 1 and 2 years of age. Weight, length, and head circumference age- and sex-specific z-scores and percentiles and motor development milestones were estimated with the use of the World Health Organization Child Growth Standards and World Health Organization milestone distributions, respectively. For the preterm infants, corrected age was used. Variance components analysis was used to estimate the percentage variability among individuals within a study site compared with that among study sites.ResultsThere were 3711 eligible singleton live births; 3042 children (82%) were evaluated at 2 years of age. There were no substantive differences between the included group and the lost-to-follow up group. Infant mortality rate was 3 per 1000; neonatal mortality rate was 1.6 per 1000. At the 2-year visit, the children included in the INTERGROWTH-21st Fetal Growth Standards were at the 49th percentile for length, 50th percentile for head circumference, and 58th percentile for weight of the World Health Organization Child Growth Standards. Similar results were seen for the preterm subgroup that was included in the INTERGROWTH-21st Preterm Postnatal Growth Standards. The cohort overlapped between the 3rd and 97th percentiles of the World Health Organization motor development milestones. We estimated that the variance among study sites explains only 5.5% of the total variability in the length of the children between birth and 2 years of age, although the variance among individuals within a study site explains 42.9% (ie, 8 times the amount explained by the variation among sites). An increase of 8.9 cm in adult height over mean parental height is estimated to occur in the cohort from low-middle income countries, provided that children continue to have adequate health, environmental, and nutritional conditions.ConclusionThe cohort enrolled in the INTERGROWTH-21st standards remained healthy with adequate growth and motor development up to 2 years of age, which supports its appropriateness for the construction of international fetal and preterm postnatal growth standards.

Published
2018

4. Validation of a host blood transcriptomic biomarker for pulmonary tuberculosis in people living with HIV: a prospective diagnostic and prognostic accuracy study

Author

Abrahams, Charmaine, Africa, Hadn, Ahlers, Petri, Arendsen, Denis, Badimo, Tebogo, Baepanye, Kagiso, Baepanye, Kesenogile Edna, Bande, Bianca, Batyi, Nomfuneko Cynthia, Beukes, Roslyn, Bontsi, Laudicia Tshenolo, Booi, Obakeng Peter, Botha, Mari Cathrin, Braaf, Samentra, Buhlungu, Sivuyile, Carstens, Alida, Chauke, Kgomotso Violet, Chinappa, Thilagavathy, Chung, Eva, Chung, Michelle, Clarke, Ken, Cloete, Yolundi, Coetzee, Lorraine, Collignon, Marelize, Companie, Alessandro, Corris, Cara-mia, Cwaile, Mooketsi Theophillius, Cwele, Thobelani, Davids, Ilse, Davies, Isabella Johanna, De Klerk, Emilia, de Kock, Marwou, Dhlamini, Audrey Lebohang, Diamond, Bongani, Didloff, Maria, Dlamini, Celaphiwe, Dolo, Palesa, Eyre, Candice, Feni, Tebogo, Ferreira, Juanita, Ferus, Christal, Fisher, Michelle, Flinn, Marika, Fransman, Bernadine, Galane, Welseh Phindile, Geldenhuys, Hennie, Gempies, Diann, Goliath, Thelma, Govender, Dhineshree, Gregg, Yolande, Gumede, Goodness, Gwamada, Zanele, Halti, Senzo, Hassiem, Rieyaat, Herling, Roxane, Herselman, Yulandi, Hughes, Ellis, Issel, Henry, Iyemosolo, Blanchard Mbay, Jali, Zandile, Janse Van Rensburg, Bonita, Jansen, Ruwiyda, Jeleni, James Michael, Jonkane, Olebogeng, Julies, Fabio, Kafaar, Fazlin, Kasongo, Christian Mabika, Keffers, Sophie, Kekana, Boitumelo Sophy, Kekana, Sebaetseng Jeanette, Kelepu, Xoliswa, Khanyile, Lungile, Khobedi, Gomotsegang Virginia, Khomba, Gloria, Khoza, Lucky Sipho, King, Marietjie, Kolobe, Gloria Keitumetse, Kruger, Sandra, Kruger, Jaftha, Kunene, Ndlela Israel, Lakay, Sunelza, Lakhi, Aneesa, Langa, Nondumiso, Ledwaba, Hildah, Lekagane, Lerato Julia, Lekotloane, Sheiley Christina, Leopeng, Thelma, Louw, Ilze Jeanette, Luabeya, Angelique Kany Kany, Lusale, Sarah Teboso, Maatjie, Perfect Tiisetso, Mabasa, Immaculate, Mabe, Tshegofatso Dorah, Mabena, Kamogelo Fortunate, Mabuza, Nkosinathi Charles, Mabwe, Simbarashe, Madikwe, Johanna Thapelo, Madikwe, Octavia Mahkosazana, Maebana, Rapontwana Letlhogonolo, Magwasha, Malobisa Sylvester, Majola, Molly, Makhetha, Mantai, Makhethe, Lebohang, Malay, Vernon, Manzini, Vutlhari-I-Vunhenha Fairlord, Maphanga, Jabu, Maphanga, Nonhle, Market, Juanita, Maroele, Isholedi Samuel, Masibi, Omphile Petunia, Mathabanzini, July Rocky, Mathode, Tendamudzimu Ivan, Matsane, Ellen Ditaba, Mbata, Lungile, Meyer, Faheema, Mhandire, Nyasha Karen, Miga, Thembisiwe, Mkhize, Nosisa Charity Thandeka, Mkhokho, Caroline, Mkwalase, Neo Hilda, Mnqonywa, Nondzakazi, Moche, Karabo, Modisaotsile, Brenda Matshidiso, Mokgetsengoane, Patricia Pakiso, Mokone, Selemeng Matseliso Carol, Molatlhegi, Kegomoditswe Magdeline, Molefe, Thuso Andrew, Moloko, Joseph Panie, Molosi, Kabelo, Molotsi, Motlatsi Evelyn, Montwedi, Tebogo Edwin, Monyemangene, Boikanyo Dinah, Mooketsi, Hellen Mokopi, Moses, Miriam, Mosito, Boitumelo, Mosito, Tshplpfelo Mapula, Mosweu, Ireen Lesebang, Mothaga, Primrose, Motlagomang, Banyana Olga, Mouton, Angelique, Mpofu, Onesisa, Mthembu, Funeka Nomvula, Mtlali, Mpho, Ndlovu, Nhlamulo, Ngcobo, Nompumelelo, Noble, Julia, Ntamo, Bantubonke Bertrum, Ntanjana, Gloria, Ntshauba, Tedrius, Opperman, Fajwa, Padayatchi, Nesri, Papalagae, Thandiwe, Petersen, Christel, Phakathi, Themba, Phatshwane, Mapule Ozma, Plaatjie, Patiswa, Pretorius, Abe, Rameetse, Victor Kgothatso, Ramjit, Dirhona, Ratangee, Frances, Ratangee, Maigan, Sanyaka, Pearl Nomsa, Sato, Alicia, Schoeman, Elisma, Schreuder, Constance, Seabela, Letlhogonolo, Segaetsho, Kelebogile Magdeline, Sein, Ni Ni, Selepe, Raesibe Agnes Pearl, Senne, Melissa Neo, September, Alison, September, Cashwin, Serake, Moeti, Shenje, Justin, Shezi, Thandiwe, Shezi, Sifiso Cornelius, Sing, Phindile, Singh, Chandrapharbha, Sithetho, Zona, Solomons, Dorothy, Stanley, Kim, Steyn, Marcia, Stofile, Bongiwe, Stryers, Sonia, Swanepoel, Liticia, Swarts, Anne, Thaba, Mando Mmakhora, Theko, Lethabo Collen, Thembela, Philile, Thompo, Mugwena, Toefy, Asma, Toto, Khayalethu, Tsagae, Dimakatso Sylvia, Tsamane, Ayanda, Tshikovhi, Vincent, Tswaile, Lebogang Isaac, Tyambetyu, Petrus, Tönsing, Susanne, Valley, Habibullah, van der Merwe, Linda, van Rooyen, Elma, Veldsman, Ashley, Veldtsman, Helen, Vollenhoven, Kelvin, Zaca, Londiwe, Zimri, Elaine, Zulu, Mbali, Mendelsohn, Simon C, Fiore-Gartland, Andrew, Penn-Nicholson, Adam, Mulenga, Humphrey, Mbandi, Stanley Kimbung, Borate, Bhavesh, Hadley, Katie, Hikuam, Chris, Musvosvi, Munyaradzi, Bilek, Nicole, Erasmus, Mzwandile, Jaxa, Lungisa, Raphela, Rodney, Nombida, Onke, Kaskar, Masooda, Sumner, Tom, White, Richard G, Innes, Craig, Brumskine, William, Hiemstra, Andriëtte, Malherbe, Stephanus T, Hassan-Moosa, Razia, Tameris, Michèle, Walzl, Gerhard, Naidoo, Kogieleum, Churchyard, Gavin, Scriba, Thomas J, and Hatherill, Mark

Published
2021
Full Text
View/download PDF

5. Safety and immunogenicity of the adjunct therapeutic vaccine ID93 + GLA-SE in adults who have completed treatment for tuberculosis: a randomised, double-blind, placebo-controlled, phase 2a trial

Author

Beckmann, Anna Marie, Hsu, Fan-Chi, Albertson, Sarah, Veldsman, Ashley, Schreuder, Constance, Smit, Erica, Cloete, Yolundi, Ontong, Cynthia, Filander, Elisabeth, Jacobs, Gail, Keyser, Alana, Africa, Hadn, Mulenga, Humphrey, Noble, Julia, Makhethe, Lebohang, Steyn, Marcia, de Kock, Marwou, Quaqua, Nambitha, Lu, Yiwen, Gutschmidt, Andrea, Thienemann, Friedrich, Kahn, Stuart, Mouton, Angelique, Van Rooyen, Elma, Opperman, Fajwa, Swarts, Ann, Van Schalkwyk, Amaryl, Herselman, Yolandi, Hofmeester, Devona, Amsterdam, Julia, Hassanally, Leya, van der Merwe, Linda, Companie, Alessandro, Rossouw, Susan, Jones, Carolyn, Botes, Natasja, van der Riet, Elize, Goliath, Sandra, Kruger, Sandra, Sinandile, Eunice, Day, Tracey A, Penn-Nicholson, Adam, Luabeya, Angelique Kany Kany, Fiore-Gartland, Andrew, Du Plessis, Nelita, Loxton, Andre G, Vergara, Julie, Rolf, Tom A, Reid, Tim D, Toefy, Asma, Shenje, Justin, Geldenhuys, Hendrik, Tameris, Michele, Mabwe, Simbarashe, Bilek, Nicole, Bekker, Linda-Gail, Diacon, Andreas, Walzl, Gerhard, Ashman, Jill, Frevol, Aude, Sagawa, Zachary K, Lindestam Arlehamn, Cecilia, Sette, Alessandro, Reed, Steven G, Coler, Rhea N, Scriba, Thomas J, and Hatherill, Mark

Published
2021
Full Text
View/download PDF

6. How do individuals who self-identify as having Borderline Personality Disorder (BPD) symptomatology perceive interventions to prevent self-harm?

Author

Noble, Julia and Hanley, Terry

Subjects
616.85, qualitative, counselling psychology, self-harm, borderline personality disorder, grounded theory
Abstract

Background: Individuals with Borderline Personality Disorder [BPD] symptomatology have high rates of self-harm (50-80%). Limited information exists on the most appropriate interventions to prevent recurrent self-harm in this population. Recent reviews on BPD interventions have suggested more research needs to be conducted looking at how individuals experience interventions with the aim of identifying the effective components of interventions. Objectives: The aim of the present study was to examine how individuals with BPD symptomatology experience interventions to prevent self-harm using a qualitative methodology. Methodology: Twelve individuals with BPD symptomatology and past or current self-harm were recruited through therapeutic services, and took part in a semi-structured interview. The interviews were analysed using a grounded theory approach. Findings: The grounded theory identified a core category, an alternative path to self-harm, and two sub-categories, established beliefs and causal factors, and the time course of self-harm. The results were presented using a process model which was indicative of the participants' experiences of interventions. Conclusions: The findings suggest individuals with BPD symptomatology perceive interventions as helping to reduce self-harm when interventions are long-term, consistent, and instant, and the intervention's outcome matches the purpose for the self-harm. The use of interventions appears to be context dependent, specifically being affected by the individual's level of emotional tension, and their cognitive processing during the decision to seek help. For long-term self-harm prevention, multiple interventions are required, and individuals need to be actively maintaining and evaluating these alternative strategies. It is suggested adoption of such a holistic approach could be one avenue for developing collaborative and effective self-harm interventions in clinical practice.

Published
2016

7. Live-attenuated Mycobacterium tuberculosis vaccine MTBVAC versus BCG in adults and neonates: a randomised controlled, double-blind dose-escalation trial

Author

Africa, Hadn, Arendsen, Denis, Botes, Natasja, Cloete, Yolundi, De Kock, Marwou, Erasmus, Margaret, Jack, Lungisa, Kafaar, Fazlin, Kalepu, Xoliswa, Khomba, Nondumiso Gloria, Kruger, Sandra, Leopeng, Thelma, Makhethe, Lebohang, Mouton, Angelique, Mulenga, Humphrey, Musvosvi, Munyaradzi, Noble, Julia, Opperman, Fajwa, Reid, Tim, Rossouw, Susan, Schreuder, Constance, Smit, Erica, Steyn, Marcia, Tyambethu, Petrus, Van Rooyen, Elma, Veldsman, Ashley, Tameris, Michele, Mearns, Helen, Penn-Nicholson, Adam, Gregg, Yolande, Bilek, Nicole, Mabwe, Simbarashe, Geldenhuys, Hennie, Shenje, Justin, Luabeya, Angelique Kany Kany, Murillo, Ingrid, Doce, Juana, Aguilo, Nacho, Marinova, Dessislava, Puentes, Eugenia, Rodríguez, Esteban, Gonzalo-Asensio, Jesús, Fritzell, Bernard, Thole, Jelle, Martin, Carlos, Scriba, Thomas J, and Hatherill, Mark

Published
2019
Full Text
View/download PDF

9. Association between maternal haemoglobin concentrations and maternal and neonatal outcomes: the prospective, observational, multinational, INTERBIO-21st fetal study

Author

Ohuma, Eric O, primary, Jabin, Nusrat, additional, Young, Melissa F, additional, Epie, Terrence, additional, Martorell, Reynaldo, additional, Peña-Rosas, Juan Pablo, additional, Garcia-Casal, Maria Nieves, additional, Papageorghiou, Aris T, additional, Kennedy, Stephen H, additional, Villar, Jose, additional, Victora, Cesar G, additional, Craik, Rachel, additional, Ash, Stephen, additional, Barros, Fernando C, additional, Barsosio, Hellen C, additional, Berkley, James A, additional, Carvalho, Maria, additional, Fernandes, Michelle, additional, Cheikh Ismail, Leila, additional, Lambert, Ann, additional, Lindgren, Cecilia M, additional, McGready, Rose, additional, Munim, Shama, additional, Nellåker, Christoffer, additional, Noble, Julia A, additional, Norris, Shane A, additional, Nosten, Francois, additional, Ohuma, Eric, additional, Stein, Alan, additional, Stones, William, additional, Tshivuila-Matala, Chrystelle O O, additional, Staines Urias, Eleonora, additional, Vatish, Manu, additional, Wulff, Katharina, additional, Zainab, Ghulam, additional, Zondervan, Krina T, additional, Uauy, Ricardo, additional, Bhutta, Zulfiqar A, additional, and Villar, José, additional

Published
2023
Full Text
View/download PDF

10. Postnatal growth standards for preterm infants: the Preterm Postnatal Follow-up Study of the INTERGROWTH-21st Project

Author

Villar, José, Giuliani, Francesca, Bhutta, Zulfiqar A, Bertino, Enrico, Ohuma, Eric O, Ismail, Leila Cheikh, Barros, Fernando C, Altman, Douglas G, Victora, Cesar, Noble, Julia A, Gravett, Michael G, Purwar, Manorama, Pang, Ruyan, Lambert, Ann, Papageorghiou, Aris T, Ochieng, Roseline, Jaffer, Yasmin A, and Kennedy, Stephen H

Published
2015
Full Text
View/download PDF

11. The likeness of fetal growth and newborn size across non-isolated populations in the INTERGROWTH-21st Project: the Fetal Growth Longitudinal Study and Newborn Cross-Sectional Study

Author

Villar, José, Papageorghiou, Aris T, Pang, Ruyan, Ohuma, Eric O, Ismail, Leila Cheikh, Barros, Fernando C, Lambert, Ann, Carvalho, Maria, Jaffer, Yasmin A, Bertino, Enrico, Gravett, Michael G, Altman, Doug G, Purwar, Manorama, Frederick, Ihunnaya O, Noble, Julia A, Victora, Cesar G, Bhutta, Zulfiqar A, and Kennedy, Stephen H

Published
2014
Full Text
View/download PDF

13. International Standards for Symphysis-Fundal Height Based on Serial Measurements From the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: Prospective Cohort Study in Eight Countries

Author

Papageorghiou, Aris T., Ohuma, Eric O., Gravett, Michael G., Hirst, Jane, da Silveira, Mariangela F., Lambert, Ann, Carvalho, Maria, Jaffer, Yasmin A., Altman, Douglas G., Noble, Julia A., Bertino, Enrico, Purwar, Manorama, Pang, Ruyan, Ismail, Leila Cheikh, Victora, Cesar, Bhutta, Zulfiqar A., Kennedy, Stephen H., and Villar, José

Published
2017
Full Text
View/download PDF

14. Validation of a host blood transcriptomic biomarker for pulmonary tuberculosis in people living with HIV: a prospective diagnostic and prognostic accuracy study

Author

Mendelsohn, Simon C, primary, Fiore-Gartland, Andrew, additional, Penn-Nicholson, Adam, additional, Mulenga, Humphrey, additional, Mbandi, Stanley Kimbung, additional, Borate, Bhavesh, additional, Hadley, Katie, additional, Hikuam, Chris, additional, Musvosvi, Munyaradzi, additional, Bilek, Nicole, additional, Erasmus, Mzwandile, additional, Jaxa, Lungisa, additional, Raphela, Rodney, additional, Nombida, Onke, additional, Kaskar, Masooda, additional, Sumner, Tom, additional, White, Richard G, additional, Innes, Craig, additional, Brumskine, William, additional, Hiemstra, Andriëtte, additional, Malherbe, Stephanus T, additional, Hassan-Moosa, Razia, additional, Tameris, Michèle, additional, Walzl, Gerhard, additional, Naidoo, Kogieleum, additional, Churchyard, Gavin, additional, Scriba, Thomas J, additional, Hatherill, Mark, additional, Abrahams, Charmaine, additional, Africa, Hadn, additional, Ahlers, Petri, additional, Arendsen, Denis, additional, Badimo, Tebogo, additional, Baepanye, Kagiso, additional, Baepanye, Kesenogile Edna, additional, Bande, Bianca, additional, Batyi, Nomfuneko Cynthia, additional, Beukes, Roslyn, additional, Bontsi, Laudicia Tshenolo, additional, Booi, Obakeng Peter, additional, Botha, Mari Cathrin, additional, Braaf, Samentra, additional, Buhlungu, Sivuyile, additional, Carstens, Alida, additional, Chauke, Kgomotso Violet, additional, Chinappa, Thilagavathy, additional, Chung, Eva, additional, Chung, Michelle, additional, Clarke, Ken, additional, Cloete, Yolundi, additional, Coetzee, Lorraine, additional, Collignon, Marelize, additional, Companie, Alessandro, additional, Corris, Cara-mia, additional, Cwaile, Mooketsi Theophillius, additional, Cwele, Thobelani, additional, Davids, Ilse, additional, Davies, Isabella Johanna, additional, De Klerk, Emilia, additional, de Kock, Marwou, additional, Dhlamini, Audrey Lebohang, additional, Diamond, Bongani, additional, Didloff, Maria, additional, Dlamini, Celaphiwe, additional, Dolo, Palesa, additional, Eyre, Candice, additional, Feni, Tebogo, additional, Ferreira, Juanita, additional, Ferus, Christal, additional, Fisher, Michelle, additional, Flinn, Marika, additional, Fransman, Bernadine, additional, Galane, Welseh Phindile, additional, Geldenhuys, Hennie, additional, Gempies, Diann, additional, Goliath, Thelma, additional, Govender, Dhineshree, additional, Gregg, Yolande, additional, Gumede, Goodness, additional, Gwamada, Zanele, additional, Halti, Senzo, additional, Hassiem, Rieyaat, additional, Herling, Roxane, additional, Herselman, Yulandi, additional, Hughes, Ellis, additional, Issel, Henry, additional, Iyemosolo, Blanchard Mbay, additional, Jali, Zandile, additional, Janse Van Rensburg, Bonita, additional, Jansen, Ruwiyda, additional, Jeleni, James Michael, additional, Jonkane, Olebogeng, additional, Julies, Fabio, additional, Kafaar, Fazlin, additional, Kasongo, Christian Mabika, additional, Keffers, Sophie, additional, Kekana, Boitumelo Sophy, additional, Kekana, Sebaetseng Jeanette, additional, Kelepu, Xoliswa, additional, Khanyile, Lungile, additional, Khobedi, Gomotsegang Virginia, additional, Khomba, Gloria, additional, Khoza, Lucky Sipho, additional, King, Marietjie, additional, Kolobe, Gloria Keitumetse, additional, Kruger, Sandra, additional, Kruger, Jaftha, additional, Kunene, Ndlela Israel, additional, Lakay, Sunelza, additional, Lakhi, Aneesa, additional, Langa, Nondumiso, additional, Ledwaba, Hildah, additional, Lekagane, Lerato Julia, additional, Lekotloane, Sheiley Christina, additional, Leopeng, Thelma, additional, Louw, Ilze Jeanette, additional, Luabeya, Angelique Kany Kany, additional, Lusale, Sarah Teboso, additional, Maatjie, Perfect Tiisetso, additional, Mabasa, Immaculate, additional, Mabe, Tshegofatso Dorah, additional, Mabena, Kamogelo Fortunate, additional, Mabuza, Nkosinathi Charles, additional, Mabwe, Simbarashe, additional, Madikwe, Johanna Thapelo, additional, Madikwe, Octavia Mahkosazana, additional, Maebana, Rapontwana Letlhogonolo, additional, Magwasha, Malobisa Sylvester, additional, Majola, Molly, additional, Makhetha, Mantai, additional, Makhethe, Lebohang, additional, Malay, Vernon, additional, Manzini, Vutlhari-I-Vunhenha Fairlord, additional, Maphanga, Jabu, additional, Maphanga, Nonhle, additional, Market, Juanita, additional, Maroele, Isholedi Samuel, additional, Masibi, Omphile Petunia, additional, Mathabanzini, July Rocky, additional, Mathode, Tendamudzimu Ivan, additional, Matsane, Ellen Ditaba, additional, Mbata, Lungile, additional, Meyer, Faheema, additional, Mhandire, Nyasha Karen, additional, Miga, Thembisiwe, additional, Mkhize, Nosisa Charity Thandeka, additional, Mkhokho, Caroline, additional, Mkwalase, Neo Hilda, additional, Mnqonywa, Nondzakazi, additional, Moche, Karabo, additional, Modisaotsile, Brenda Matshidiso, additional, Mokgetsengoane, Patricia Pakiso, additional, Mokone, Selemeng Matseliso Carol, additional, Molatlhegi, Kegomoditswe Magdeline, additional, Molefe, Thuso Andrew, additional, Moloko, Joseph Panie, additional, Molosi, Kabelo, additional, Molotsi, Motlatsi Evelyn, additional, Montwedi, Tebogo Edwin, additional, Monyemangene, Boikanyo Dinah, additional, Mooketsi, Hellen Mokopi, additional, Moses, Miriam, additional, Mosito, Boitumelo, additional, Mosito, Tshplpfelo Mapula, additional, Mosweu, Ireen Lesebang, additional, Mothaga, Primrose, additional, Motlagomang, Banyana Olga, additional, Mouton, Angelique, additional, Mpofu, Onesisa, additional, Mthembu, Funeka Nomvula, additional, Mtlali, Mpho, additional, Ndlovu, Nhlamulo, additional, Ngcobo, Nompumelelo, additional, Noble, Julia, additional, Ntamo, Bantubonke Bertrum, additional, Ntanjana, Gloria, additional, Ntshauba, Tedrius, additional, Opperman, Fajwa, additional, Padayatchi, Nesri, additional, Papalagae, Thandiwe, additional, Petersen, Christel, additional, Phakathi, Themba, additional, Phatshwane, Mapule Ozma, additional, Plaatjie, Patiswa, additional, Pretorius, Abe, additional, Rameetse, Victor Kgothatso, additional, Ramjit, Dirhona, additional, Ratangee, Frances, additional, Ratangee, Maigan, additional, Sanyaka, Pearl Nomsa, additional, Sato, Alicia, additional, Schoeman, Elisma, additional, Schreuder, Constance, additional, Seabela, Letlhogonolo, additional, Segaetsho, Kelebogile Magdeline, additional, Sein, Ni Ni, additional, Selepe, Raesibe Agnes Pearl, additional, Senne, Melissa Neo, additional, September, Alison, additional, September, Cashwin, additional, Serake, Moeti, additional, Shenje, Justin, additional, Shezi, Thandiwe, additional, Shezi, Sifiso Cornelius, additional, Sing, Phindile, additional, Singh, Chandrapharbha, additional, Sithetho, Zona, additional, Solomons, Dorothy, additional, Stanley, Kim, additional, Steyn, Marcia, additional, Stofile, Bongiwe, additional, Stryers, Sonia, additional, Swanepoel, Liticia, additional, Swarts, Anne, additional, Thaba, Mando Mmakhora, additional, Theko, Lethabo Collen, additional, Thembela, Philile, additional, Thompo, Mugwena, additional, Toefy, Asma, additional, Toto, Khayalethu, additional, Tsagae, Dimakatso Sylvia, additional, Tsamane, Ayanda, additional, Tshikovhi, Vincent, additional, Tswaile, Lebogang Isaac, additional, Tyambetyu, Petrus, additional, Tönsing, Susanne, additional, Valley, Habibullah, additional, van der Merwe, Linda, additional, van Rooyen, Elma, additional, Veldsman, Ashley, additional, Veldtsman, Helen, additional, Vollenhoven, Kelvin, additional, Zaca, Londiwe, additional, Zimri, Elaine, additional, and Zulu, Mbali, additional

Published
2021
Full Text
View/download PDF

15. Safety and immunogenicity of the adjunct therapeutic vaccine ID93 + GLA-SE in adults who have completed treatment for tuberculosis: a randomised, double-blind, placebo-controlled, phase 2a trial

Author

Day, Tracey A, primary, Penn-Nicholson, Adam, additional, Luabeya, Angelique Kany Kany, additional, Fiore-Gartland, Andrew, additional, Du Plessis, Nelita, additional, Loxton, Andre G, additional, Vergara, Julie, additional, Rolf, Tom A, additional, Reid, Tim D, additional, Toefy, Asma, additional, Shenje, Justin, additional, Geldenhuys, Hendrik, additional, Tameris, Michele, additional, Mabwe, Simbarashe, additional, Bilek, Nicole, additional, Bekker, Linda-Gail, additional, Diacon, Andreas, additional, Walzl, Gerhard, additional, Ashman, Jill, additional, Frevol, Aude, additional, Sagawa, Zachary K, additional, Lindestam Arlehamn, Cecilia, additional, Sette, Alessandro, additional, Reed, Steven G, additional, Coler, Rhea N, additional, Scriba, Thomas J, additional, Hatherill, Mark, additional, Beckmann, Anna Marie, additional, Hsu, Fan-Chi, additional, Albertson, Sarah, additional, Veldsman, Ashley, additional, Schreuder, Constance, additional, Smit, Erica, additional, Cloete, Yolundi, additional, Ontong, Cynthia, additional, Filander, Elisabeth, additional, Jacobs, Gail, additional, Keyser, Alana, additional, Africa, Hadn, additional, Mulenga, Humphrey, additional, Noble, Julia, additional, Makhethe, Lebohang, additional, Steyn, Marcia, additional, de Kock, Marwou, additional, Quaqua, Nambitha, additional, Lu, Yiwen, additional, Gutschmidt, Andrea, additional, Thienemann, Friedrich, additional, Kahn, Stuart, additional, Mouton, Angelique, additional, Van Rooyen, Elma, additional, Opperman, Fajwa, additional, Swarts, Ann, additional, Van Schalkwyk, Amaryl, additional, Herselman, Yolandi, additional, Hofmeester, Devona, additional, Amsterdam, Julia, additional, Hassanally, Leya, additional, van der Merwe, Linda, additional, Companie, Alessandro, additional, Rossouw, Susan, additional, Jones, Carolyn, additional, Botes, Natasja, additional, van der Riet, Elize, additional, Goliath, Sandra, additional, Kruger, Sandra, additional, and Sinandile, Eunice, additional

Published
2021
Full Text
View/download PDF

16. Live-attenuated Mycobacterium tuberculosis vaccine MTBVAC versus BCG in adults and neonates: a randomised controlled, double-blind dose-escalation trial

Author

Tameris, Michele, Mearns, Helen, Penn-Nicholson, Adam, Gregg, Yolande, Bilek, Nicole, Mabwe, Simbarashe, Geldenhuys, Hennie, Shenje, Justin, Luabeya, Angelique Kany K., Murillo, Ingrid, Doce, Juana, Aguilo, Nacho, Marinova, Dessislava, Puentes, Eugenia, Rodríguez, Esteban, Gonzalo-Asensiom, Jesús, Fritzell, Bernard, Thole, Jelle, Martin, Carlos, Scriba, Thomas J., Hatherill, Mark, Africa, Hadn, Arendsen, Denis, Botes, Natasja, Cloete, Yolundi, De Kock, Marwou, Erasmus, Margaret, Jack, Lungisa, Kafaar, Fazlin, Kalepu, Xoliswa, Khomba, Nondumiso Gloria, Kruger, Sandra, Leopeng, Thelma, Makhethe, Lebohang, Mouton, Angelique, Mulenga, Humphrey, Musvosvi, Munyaradzi, Noble, Julia, Opperman, Fajwa, Reid, Tim, Rossouw, Susan, Schreuder, Constance, Smit, Erica, Steyn, Marcia, Tyambethu, Petrus, Van Rooyen, Elma, Veldsman, Ashley, and MTBVAC Clinical Trial Team

Abstract

Background: Infants are a key target population for new tuberculosis vaccines. We assessed the safety and immunogenicity of the live-attenuated Mycobacterium tuberculosis vaccine candidate MTBVAC in adults and infants in a region where transmission of tuberculosis is very high. Methods: We did a randomised, double-blind, BCG-controlled, dose-escalation trial at the South African Tuberculosis Vaccine Initiative site near Cape Town, South Africa. Healthy adult community volunteers who were aged 18–50 years, had received BCG vaccination as infants, were HIV negative, had negative interferon-¿ release assay (IGRA) results, and had no personal history of tuberculosis or current household contact with someone with tuberculosis were enrolled in a safety cohort. Infants born to HIV-negative women with no personal history of tuberculosis or current household contact with a person with tuberculosis and who were 96 h old or younger, generally healthy, and had not yet received routine BCG vaccination were enrolled in a separate infant cohort. Eligible adults were randomly assigned (1:1) to receive either BCG Vaccine SSI (5 × 105 colony forming units [CFU] of Danish strain 1331 in 0·1 mL diluent) or MTBVAC (5 × 105 CFU in 0·1 mL) intradermally in the deltoid region of the arm. After favourable review of 28-day reactogenicity and safety data in the adult cohort, infants were randomly assigned (1:3) to receive either BCG Vaccine SSI (2·5 × 105 CFU in 0·05 mL diluent) or MTBVAC in three sequential cohorts of increasing MTBVAC dose (2·5 × 103 CFU, 2·5 × 104 CFU, and 2·5 × 105 CFU in 0·05 mL) intradermally in the deltoid region of the arm. QuantiFERON-TB Gold In-Tube IGRA was done on days 180 and 360. For both randomisations, a pre-prepared block randomisation schedule was used. Participants (and their parents or guardians in the case of infant participants), investigators, and other clinical and laboratory staff were masked to intervention allocation. The primary outcomes, which were all measured in the infant cohort, were solicited and unsolicited local adverse events and serious adverse events until day 360; non-serious systemic adverse events until day 28 and vaccine-specific CD4 and CD8 T-cell responses on days 7, 28, 70, 180, and 360. Secondary outcomes measured in adults were local injection-site and systemic reactions and haematology and biochemistry at study day 7 and 28. Safety analyses and immunogenicity analyses were done in all participants who received a dose of vaccine. This trial is registered with ClinicalTrials.gov, number NCT02729571. Findings: Between Sept 29, 2015, and Nov 16, 2015, 62 adults were screened and 18 were enrolled and randomly assigned, nine each to the BCG and MTBVAC groups. Between Feb 12, 2016, and Sept 21, 2016, 36 infants were randomly assigned—eight to the BCG group, nine to the 2·5 × 103 CFU MTBVAC group, nine to the 2·5 × 104 CFU group, and ten to the 2·5 × 105 CFU group. Mild injection-site reactions occurred only in infants in the BCG and the 2·5 × 105 CFU MTBVAC group, with no evidence of local or regional injection-site complications. Systemic adverse events were evenly distributed across BCG and MTBVAC dose groups, and were mostly mild in severity. Eight serious adverse events were reported in seven vaccine recipients (one adult MTBVAC recipient, one infant BCG recipient, one infant in the 2·5 × 103 CFU MTBVAC group, two in the 2·5 × 104 CFU MTBVAC group, and two in the 2·5 × 105 CFU MTBVAC group), including one infant in the 2·5 × 103 CFU MTBVAC group treated for unconfirmed tuberculosis and one in the 2·5 × 105 CFU MTBVAC group treated for unlikely tuberculosis. One infant died as a result of possible viral pneumonia. Vaccination with all MTBVAC doses induced durable antigen-specific T-helper-1 cytokine-expressing CD4 cell responses in infants that peaked 70 days after vaccination and were detectable 360 days after vaccination. For the highest MTBVAC dose (ie, 2·5 × 105 CFU), these responses exceeded responses induced by an equivalent dose of the BCG vaccine up to 360 days after vaccination. Dose-related IGRA conversion was noted in three (38%) of eight infants in the 2·5 × 103 CFU MTBVAC group, six (75%) of eight in the 2·5 × 104 CFU MTBVAC group, and seven (78%) of nine in the 2·5 × 105 CFU MTBVAC group at day 180, compared with none of seven infants in the BCG group. By day 360, IGRA reversion had occurred in all three infants (100%) in the 2·5 × 103 CFU MTBVAC group, four (67%) of the six in the 2·5 × 104 CFU MTBVAC group, and three (43%) of the seven in the 2·5 × 105 CFU MTBVAC group. Interpretation: MTBVAC had acceptable reactogenicity, and induced a durable CD4 cell response in infants. The evidence of immunogenicity supports progression of MTBVAC into larger safety and efficacy trials, but also confounds interpretation of tests for M tuberculosis infection, highlighting the need for stringent endpoint definition. Funding: Norwegian Agency for Development Cooperation, TuBerculosis Vaccine Initiative, UK Department for International Development, and Biofabri.

Published
2020

17. INTERGROWTH-21st Project international INTER-NDA standards for child development at 2 years of age : an international prospective population-based study

Author

Fernandes, Michelle, Villar, José, Stein, Alan, Staines Urias, Eleonora, Garza, Cutberto, Victora, Cesar G., Barros, Fernando C., Bertino, Enrico, Purwar, Manorama, Carvalho, Maria, Giuliani, Francesca, Wulff, Katharina, Abubakar, Amina A., Kihara, Michael, Cheikh Ismail, Leila, Aranzeta, Luis, Albernaz, Elaine, Kunnawar, Naina, Di Nicola, Paola, Ochieng, Roseline, Sandells, Tamsin, Savini, Sandy, Temple, Sophie, Murray, Elizabeth, Ohuma, Eric O., Gravett, Michael G., Pang, Ruyan, Jaffer, Yasmine A., Noble, Julia Alison, Winsey, Adele, Lambert, Ann, Papageorghiou, Aris T., Bhutta, Zulfiqar, Kennedy, Stephen, Fernandes, Michelle, Villar, José, Stein, Alan, Staines Urias, Eleonora, Garza, Cutberto, Victora, Cesar G., Barros, Fernando C., Bertino, Enrico, Purwar, Manorama, Carvalho, Maria, Giuliani, Francesca, Wulff, Katharina, Abubakar, Amina A., Kihara, Michael, Cheikh Ismail, Leila, Aranzeta, Luis, Albernaz, Elaine, Kunnawar, Naina, Di Nicola, Paola, Ochieng, Roseline, Sandells, Tamsin, Savini, Sandy, Temple, Sophie, Murray, Elizabeth, Ohuma, Eric O., Gravett, Michael G., Pang, Ruyan, Jaffer, Yasmine A., Noble, Julia Alison, Winsey, Adele, Lambert, Ann, Papageorghiou, Aris T., Bhutta, Zulfiqar, and Kennedy, Stephen

Abstract

Objectives: To describe the construction of the international INTERGROWTH-21st Neurodevelopment Assessment (INTER-NDA) standards for child development at 2 years by reporting the cognitive, language, motor and behaviour outcomes in optimally healthy and nourished children in the INTERGROWTH-21st Project. Design: Population-based cohort study, the INTERGROWTH-21st Project. Setting: Brazil, India, Italy, Kenya and the UK. Participants: 1181 children prospectively recruited from early fetal life according to the prescriptive WHO approach, and confirmed to be at low risk of adverse perinatal and postnatal outcomes. Primary measures: Scaled INTER-NDA domain scores for cognition, language, fine and gross motor skills and behaviour; vision outcomes measured on the Cardiff tests; attentional problems and emotional reactivity measured on the respective subscales of the preschool Child Behaviour Checklist; and the age of acquisition of the WHO gross motor milestones. Results: Scaled INTER-NDA domain scores are presented as centiles, which were constructed according to the prescriptive WHO approach and excluded children born preterm and those with significant postnatal/neurological morbidity. For all domains, except negative behaviour, higher scores reflect better outcomes and the threshold for normality was defined as >= 10th centile. For the INTER-NDA's cognitive, fine motor, gross motor, language and positive behaviour domains these are >= 38.5, >= 25.7, >= 51.7, >= 17.8 and >= 51.4, respectively. The threshold for normality for the INTER-NDA's negative behaviour domain is <= 50.0, that is, <= 90th centile. At 22-30 months of age, the cohort overlapped with the WHO motor milestone centiles, showed low postnatal morbidity (<10%), and vision outcomes, attentional problems and emotional reactivity scores within the respective normative ranges. Conclusions: From this large, healthy and well-nourished, international cohort, we have constructed, using t

Published
2020
Full Text
View/download PDF

18. INTERGROWTH-21st Project international INTER-NDA standards for child development at 2 years of age: an international prospective population-based study

Author

Fernandes, Michelle, primary, Villar, José, additional, Stein, Alan, additional, Staines Urias, Eleonora, additional, Garza, Cutberto, additional, Victora, Cesar G, additional, Barros, Fernando C, additional, Bertino, Enrico, additional, Purwar, Manorama, additional, Carvalho, Maria, additional, Giuliani, Francesca, additional, Wulff, Katharina, additional, Abubakar, Amina A, additional, Kihara, Michael, additional, Cheikh Ismail, Leila, additional, Aranzeta, Luis, additional, Albernaz, Elaine, additional, Kunnawar, Naina, additional, Di Nicola, Paola, additional, Ochieng, Roseline, additional, Sandells, Tamsin, additional, Savini, Sandy, additional, Temple, Sophie, additional, Murray, Elizabeth, additional, Ohuma, Eric O, additional, Gravett, Michael G, additional, Pang, Ruyan, additional, Jaffer, Yasmine A, additional, Noble, Julia Alison, additional, Winsey, Adele, additional, Lambert, Ann, additional, Papageorghiou, Aris T, additional, Bhutta, Zulfiqar, additional, and Kennedy, Stephen, additional

Published
2020
Full Text
View/download PDF

21. Live-attenuated Mycobacterium tuberculosis vaccine MTBVAC versus BCG in adults and neonates: a randomised controlled, double-blind dose-escalation trial

Author

Tameris, Michele, primary, Mearns, Helen, additional, Penn-Nicholson, Adam, additional, Gregg, Yolande, additional, Bilek, Nicole, additional, Mabwe, Simbarashe, additional, Geldenhuys, Hennie, additional, Shenje, Justin, additional, Luabeya, Angelique Kany Kany, additional, Murillo, Ingrid, additional, Doce, Juana, additional, Aguilo, Nacho, additional, Marinova, Dessislava, additional, Puentes, Eugenia, additional, Rodríguez, Esteban, additional, Gonzalo-Asensio, Jesús, additional, Fritzell, Bernard, additional, Thole, Jelle, additional, Martin, Carlos, additional, Scriba, Thomas J, additional, Hatherill, Mark, additional, Africa, Hadn, additional, Arendsen, Denis, additional, Botes, Natasja, additional, Cloete, Yolundi, additional, De Kock, Marwou, additional, Erasmus, Margaret, additional, Jack, Lungisa, additional, Kafaar, Fazlin, additional, Kalepu, Xoliswa, additional, Khomba, Nondumiso Gloria, additional, Kruger, Sandra, additional, Leopeng, Thelma, additional, Makhethe, Lebohang, additional, Mouton, Angelique, additional, Mulenga, Humphrey, additional, Musvosvi, Munyaradzi, additional, Noble, Julia, additional, Opperman, Fajwa, additional, Reid, Tim, additional, Rossouw, Susan, additional, Schreuder, Constance, additional, Smit, Erica, additional, Steyn, Marcia, additional, Tyambethu, Petrus, additional, Van Rooyen, Elma, additional, and Veldsman, Ashley, additional

Published
2019
Full Text
View/download PDF

22. Deep clinical and biological phenotyping of the preterm birth and small for gestational age syndromes: The INTERBIO-21st Newborn Case-Control Study protocol

Author

Kennedy, Stephen H., primary, Victora, Cesar G., additional, Craik, Rachel, additional, Ash, Stephen, additional, Barros, Fernando C., additional, Barsosio, Hellen C., additional, Berkley, James A., additional, Carvalho, Maria, additional, Fernandes, Michelle, additional, Cheikh Ismail, Leila, additional, Lambert, Ann, additional, Lindgren, Cecilia M., additional, McGready, Rose, additional, Munim, Shama, additional, Nellåker, Christoffer, additional, Noble, Julia A., additional, Norris, Shane A., additional, Nosten, Francois, additional, Ohuma, Eric O., additional, Papageorghiou, Aris T., additional, Stein, Alan, additional, Stones, William, additional, Tshivuila-Matala, Chrystelle O.O., additional, Staines Urias, Eleonora, additional, Vatish, Manu, additional, Wulff, Katharina, additional, Zainab, Ghulam, additional, Zondervan, Krina T., additional, Uauy, Ricardo, additional, Bhutta, Zulfiqar A., additional, and Villar, José, additional

Published
2019
Full Text
View/download PDF

23. The satisfactory growth and development at 2 years of age of the INTERGROWTH-21st Fetal Growth Standards cohort support its appropriateness for constructing international standards

Author

Villar, Jose, Ismail, Leila Cheikh, Urias, Eleonora Staines, Giuliani, Francesca, Ohuma, Eric O, Victora, Cesar G, Papageorghiou, Ails T, Altman, Douglas G, Garza, Cutberto, Barros, Fernando C, Puglia, Fabien, Ochieng, Roseline, Jaffer, Yasmin A, Noble, Julia A, Bertino, Enrico, Purwar, Manorama, Pang, Ruyan, Lambert, Ann, Chumlea, Cameron, Stein, Alan, Fernandes, Michelle, Bhutta, Zulfiqar A, and Kennedy, Stephen H

Subjects
Male, China, Oman, Cephalometry, Health Status, India, Nutritional Status, Development, INTERGROWTH-21st fetal growth standards, World Health Organization, Article, Fetal Development, Child Development, Pregnancy, Humans, Longitudinal Studies, Growth Charts, Postnatal growth, Infant, Newborn, Infant, Obstetrics and Gynecology, Kenya, United Kingdom, United States, Italy, Motor Skills, Female, Brazil
Abstract

Background The World Health Organization recommends that human growth should be monitored with the use of international standards. However, in obstetric practice, we continue tomonitor fetalgrowth using numerous local charts or equations that are based on different populations for eachbody structure. Consistent with World Health Organization recommendations, the INTERGROWTH-21stProject has produced the first set of international standards to date pregnancies; to monitor fetal growth, estimated fetal weight, Doppler measures, and brain structures; to measure uterine growth, maternal nutrition, newborn infant size, and body composition; and to assess the postnatal growth of preterm babies. All these standards are based on the same healthy pregnancy cohort. Recognizing the importance of demonstrating that, postnatally, this cohortstill adhered to the World Health Organization prescriptive approach, we followed their growth and development to the key milestone of 2 years ofage. Objective The purpose of this study was to determine whether the babies in the INTERGROWTH-21stProject maintained optimal growth and development in childhood. Study Design In the Infant Follow-up Study of the INTERGROWTH-21stProject, we evaluated postnatal growth, nutrition, morbidity, and motor development up to 2 years of age in the children who contributed data to the construction of the international fetal growth, newborn infant size and body composition at birth, and preterm postnatal growth standards. Clinical care, feeding practices, anthropometric measures, and assessment of morbidity were standardized across study sites and documented at 1 and 2 years of age. Weight, length, and head circumference age- and sex-specific z-scores and percentiles and motor development milestones were estimated with the use of the World Health Organization Child Growth Standards and World Health Organization milestone distributions, respectively. For the preterm infants, corrected age was used. Variance components analysis was used to estimate the percentage variability among individuals within a study site compared with that among study sites. Results There were 3711 eligible singleton live births; 3042 children (82%) were evaluated at 2 years of age. There were no substantive differences between the included group and the lost-to-follow up group. Infant mortality rate was 3 per 1000; neonatal mortality rate was 1.6 per 1000. At the 2-year visit, the children included in the INTERGROWTH-21stFetal Growth Standards were at the 49th percentile for length, 50th percentile for head circumference, and 58th percentile for weight of the World Health Organization Child Growth Standards. Similar results were seen for the preterm subgroup that was included in the INTERGROWTH-21stPreterm Postnatal Growth Standards. The cohort overlapped between the 3rd and 97th percentiles of the World Health Organization motor development milestones. We estimated that the variance among study sites explains only 5.5% of the total variability in the length of the children between birth and 2 years of age, although the variance among individuals within a study site explains 42.9% (ie, 8 times the amount explained by the variation among sites). An increase of 8.9 cm in adult height over mean parental height is estimated to occur in the cohort from low-middle income countries, provided that children continue to have adequate health, environmental, and nutritional conditions. Conclusion The cohort enrolled in the INTERGROWTH-21ststandards remained healthy with adequate growth and motor development up to 2 years of age, which supports its appropriateness for the construction of international fetal and preterm postnatal growth standards.

Published
2017

24. Deep clinical and biological phenotyping of the preterm birth and small for gestational age syndromes: The INTERBIO-21st Newborn Case-Control Study protocol

Author

Kennedy, Stephen H., primary, Victora, Cesar G., additional, Craik, Rachel, additional, Ash, Stephen, additional, Barros, Fernando C., additional, Barsosio, Hellen C., additional, Berkley, James A., additional, Carvalho, Maria, additional, Fernandes, Michelle, additional, Cheikh Ismail, Leila, additional, Lambert, Ann, additional, Lindgren, Cecilia M., additional, McGready, Rose, additional, Munim, Shama, additional, Nellåker, Christoffer, additional, Noble, Julia A., additional, Norris, Shane A., additional, Nosten, Francois, additional, Ohuma, Eric O., additional, Papageorghiou, Aris T., additional, Stein, Alan, additional, Stones, William, additional, Tshivuila-Matala, Chrystelle O.O., additional, Staines Urias, Eleonora, additional, Vatish, Manu, additional, Wulff, Katharina, additional, Zainab, Ghulam, additional, Zondervan, Krina T., additional, Uauy, Ricardo, additional, Bhutta, Zulfiqar A., additional, and Villar, José, additional

Published
2018
Full Text
View/download PDF

25. International standards for symphysis-fundal height based on serial measurements from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: prospective cohort study in eight countries

Author

Papageorghiou, Aris T, Ohuma, Eric O, Gravett, Michael G, Hirst, Jane, da Silveira, Mariangela F, Lambert, Ann, Carvalho, Maria, Jaffer, Yasmin A, Altman, Douglas G, Noble, Julia A, Bertino, Enrico, Purwar, Manorama, Pang, Ruyan, Cheikh Ismail, Leila, Victora, Cesar, Bhutta, Zulfiqar A, Kennedy, Stephen H, Villar, José, and International Fetal and Newborn Growth Consortium for the 21st Century INTERGROWTH-21st

Subjects
Adult, Male, Fetal Growth Retardation, Anthropometry, Research, Infant, Newborn, Infant, Pubic Symphysis, Gestational Age, Newborn, Ultrasonography, Prenatal, Fetal Development, Pregnancy, Abdomen, Prenatal, Humans, Female, Longitudinal Studies, Prospective Studies, Ultrasonography
Abstract

Objective To create international symphysis-fundal height standards derived from pregnancies of healthy women with good maternal and perinatal outcomes. Design Prospective longitudinal observational study. Setting Eight geographically diverse urban regions in Brazil, China, India, Italy, Kenya, Oman, United Kingdom, and United States. Participants Healthy, well nourished pregnant women enrolled into the Fetal Growth Longitudinal Study component of the INTERGROWTH-21st Project at 9-14 weeks’ gestation, and followed up until birth. Main outcome measures Symphysis-fundal height was measured every five weeks from 14 weeks’ gestation until birth using standardised methods and dedicated research staff who were blinded to the symphysis-fundal height measurements by turning the tape measure so that numbers were not visible during examination. The best fitting curve was selected using second degree fractional polynomials and further modelled in a multilevel framework to account for the longitudinal design of the study. Results Of 13 108 women screened in the first trimester, 4607 (35.1%) met the study entry criteria. Of the eligible women, 4321 (93.8%) had pregnancies without major complications and delivered live singletons without congenital malformations. The median number of symphysis-fundal height measurements was 5.0 (range 1-7); 3976 (92.0%) women had four or more measurements. Symphysis-fundal height measurements increased almost linearly with gestational age; data were used to determine fitted 3rd, 50th, and 97th centile curves, which showed excellent agreement with observed values. Conclusions This study presents international standards to measure symphysis-fundal height as a first level screening tool for fetal growth disturbances.

Published
2016

26. How do individuals who self-identify as having Borderline Personality Disorder [BPD] symptomatology perceive interventions to prevent self-harm?

Author

Noble, Julia Natasha, WINTER, LAURA LA, Hanley, Terry, and Winter, Laura

Subjects
counselling psychology, qualitative, self-harm, borderline personality disorder, grounded theory
Abstract

Background: Individuals with Borderline Personality Disorder [BPD] symptomatology have high rates of self-harm (50-80%). Limited information exists on the most appropriate interventions to prevent recurrent self-harm in this population. Recent reviews on BPD interventions have suggested more research needs to be conducted looking at how individuals experience interventions with the aim of identifying the effective components of interventions. Objectives: The aim of the present study was to examine how individuals with BPD symptomatology experience interventions to prevent self-harm using a qualitative methodology. Methodology: Twelve individuals with BPD symptomatology and past or current self-harm were recruited through therapeutic services, and took part in a semi-structured interview. The interviews were analysed using a grounded theory approach. Findings: The grounded theory identified a core category, an alternative path to self-harm, and two sub-categories, established beliefs and causal factors, and the time course of self-harm. The results were presented using a process model which was indicative of the participants’ experiences of interventions. Conclusions: The findings suggest individuals with BPD symptomatology perceive interventions as helping to reduce self-harm when interventions are long-term, consistent, and instant, and the intervention’s outcome matches the purpose for the self-harm. The use of interventions appears to be context dependent, specifically being affected by the individual’s level of emotional tension, and their cognitive processing during the decision to seek help. For long-term self-harm prevention, multiple interventions are required, and individuals need to be actively maintaining and evaluating these alternative strategies. It is suggested adoption of such a holistic approach could be one avenue for developing collaborative and effective self-harm interventions in clinical practice.

Published
2016

27. Optimization and Interpretation of Serial QuantiFERON Testing to Measure Acquisition of Mycobacterium tuberculosis Infection

Author

Nemes, Elisa, primary, Rozot, Virginie, additional, Geldenhuys, Hennie, additional, Bilek, Nicole, additional, Mabwe, Simbarashe, additional, Abrahams, Deborah, additional, Makhethe, Lebohang, additional, Erasmus, Mzwandile, additional, Keyser, Alana, additional, Toefy, Asma, additional, Cloete, Yolundi, additional, Ratangee, Frances, additional, Blauenfeldt, Thomas, additional, Ruhwald, Morten, additional, Walzl, Gerhard, additional, Smith, Bronwyn, additional, Loxton, Andre G., additional, Hanekom, Willem A., additional, Andrews, Jason R., additional, Lempicki, Maria D., additional, Ellis, Ruth, additional, Ginsberg, Ann M., additional, Hatherill, Mark, additional, Scriba, Thomas J., additional, Rossouw, Susan, additional, Jones, Carolyn, additional, Schoeman, Elisma, additional, Gregg, Yolande, additional, Beyers, Elizabeth, additional, Kruger, Sandra, additional, Veltdsman, Helen, additional, Keffers, Sophie, additional, Goliath, Sandra, additional, Mullins, Mariana, additional, Tameris, Michele, additional, Luabeya, Angelique, additional, Veldsman, Ashley, additional, Mulenga, Humphrey, additional, Hendricks, Angelique, additional, Opperman, Fajwa, additional, Van Rooyen, Elma, additional, Noble, Julia, additional, Braaf, Samentra, additional, Ockhuis, Rose, additional, Vermeulen, Emerencia, additional, Companie, Alessandro, additional, Kelepu, Xoliswa, additional, Ratangee, Maigan, additional, Pretorius, Abraham, additional, Issel, Henry, additional, Langata, Phumzile, additional, Davids, Ilse, additional, Herling, Roxanne, additional, Africa, Hadn, additional, Steyn, Marcia, additional, Nkantso, Lungisa, additional, Xoyana, Noncedo, additional, Diamond, Bongani, additional, Erasmus, Margareth, additional, Hughes, Jane, additional, van der Westhuizen, Denise, additional, Makunzi, Lydia, additional, Botes, Natasja, additional, Amsterdam, Julia, additional, Maqubela, Clive, additional, Dlakavu, Portia, additional, Mangala, Pamela, additional, Abrahams, Charmaine, additional, Tyambetyu, Petrus, additional, Gempies, Diann, additional, Elbring, Cindy, additional, Hamilton, Elizabeth, additional, Alexander, Fadia, additional, Matiwane, Sindile Wiseman, additional, September, Cashwin, additional, Petersen, Christel, additional, Herselman, Yulande, additional, Hector, Johanna, additional, Esterhuizen, Terence, additional, Mactavie, Lauren, additional, van der Riet, Elize, additional, Pretorius, Debbie, additional, Shenje, Justin, additional, Swarts, Anne, additional, Sinandile, Eunice, additional, Botes, Janelle, additional, Schreuder, Constance, additional, Kassiem, Jateel, additional, Xasa, Onke, additional, Mosito, Boitumelo, additional, Raphela, Rodney, additional, Arendsen, Denis, additional, Dolo, Palesa, additional, Filander, Elizabeth, additional, Mahomed, Hassan, additional, Kafaar, Fazlin, additional, Workman, Leslie, additional, Ehrlich, Rodney, additional, Moyo, Sizulu, additional, Gelderbloem, Sebastian, additional, and Hussey, Gregory, additional

Published
2017
Full Text
View/download PDF

28. International standards for symphysis-fundal height based on serial measurements from the Fetal Growth Longitudinal Study of the INTERGROWTH-21stProject: prospective cohort study in eight countries

Author

Papageorghiou, Aris T, primary, Ohuma, Eric O, additional, Gravett, Michael G, additional, Hirst, Jane, additional, da Silveira, Mariangela F, additional, Lambert, Ann, additional, Carvalho, Maria, additional, Jaffer, Yasmin A, additional, Altman, Douglas G, additional, Noble, Julia A, additional, Bertino, Enrico, additional, Purwar, Manorama, additional, Pang, Ruyan, additional, Cheikh Ismail, Leila, additional, Victora, Cesar, additional, Bhutta, Zulfiqar A, additional, Kennedy, Stephen H, additional, and Villar, José, additional

Published
2016
Full Text
View/download PDF

30. The INTERGROWTH-21st fetal growth standards: toward the global integration of pregnancy and pediatric care.

Author

Papageorghiou, Aris T, Kennedy, Stephen H, Salomon, Laurent J, Altman, Douglas G, Ohuma, Eric O, Stones, William, Gravett, Michael G, Barros, Fernando C, Victora, Cesar, Purwar, Manorama, Jaffer, Yasmin, Noble, Julia A, Bertino, Enrico, Pang, Ruyan, Cheikh Ismail, Leila, Lambert, Ann, Bhutta, Zulfiqar A, Villar, José, and International Fetal and Newborn Growth Consortium for the 21(st) Century (INTERGROWTH-21(st))

Abstract

The purpose of the INTERGROWTH-21st project was to develop international, prescriptive standards for fetal growth assessed by ultrasound and fundal height, preterm postnatal growth, newborn size and body composition, maternal weight gain, and infant development at the age of 2 years. Hence, we have produced, based on World Health Organization recommendations, the first comprehensive set of international standards of optimal fetal and newborn growth that perfectly match the existing World Health Organization child growth standards. Uniquely, the same population was followed up longitudinally from 9 weeks of fetal life to 2 years of age, with growth, health, and nutritional status assessment at 2 years supporting the appropriateness of the population for construction of growth standards. The resulting package of clinical tools allows, for the first time, growth and development to be monitored from early pregnancy to infancy. The INTERGROWTH-21st fetal growth standards, which are based on observing >4500 healthy pregnancies, nested in a study of >59,000 pregnancies from populations with low rates of adverse perinatal outcomes, show how fetuses should grow-rather than the more limited objective of past references, which describe how they have grown at specific times and locations. Our work has confirmed the fundamental biological principle that variation in human growth across different populations is mostly dependent on environmental, nutritional, and socioeconomic factors. We found that when mothers' nutritional and health needs are met and there are few environmental constraints on growth, <3.5% of the total variability of skeletal growth was due to differences between populations. We propose that not recognizing the concept of optimal growth could deprive the most vulnerable mothers and their babies of optimal care, because local growth charts normalize those at highest risk for growth restriction and overweight, and can be valuable for policymakers to ensure rigorous evaluation and effective resource allocation. We strongly encourage colleagues to join efforts to provide integrated, evidence-based growth monitoring to pregnant women and their infants worldwide. Presently, there are 23.3 million infants born small for gestational age in low- to middle-income countries according to the INTERGROWTH-21st newborn size standards. We suggest that misclassification of these infants by using local charts could affect the delivery of optimal health care. [ABSTRACT FROM AUTHOR]

Published
2018
Full Text
View/download PDF

31. Live-attenuated Mycobacterium tuberculosisvaccine MTBVAC versus BCG in adults and neonates: a randomised controlled, double-blind dose-escalation trial

Author

Tameris, Michele, Mearns, Helen, Penn-Nicholson, Adam, Gregg, Yolande, Bilek, Nicole, Mabwe, Simbarashe, Geldenhuys, Hennie, Shenje, Justin, Luabeya, Angelique Kany Kany, Murillo, Ingrid, Doce, Juana, Aguilo, Nacho, Marinova, Dessislava, Puentes, Eugenia, Rodríguez, Esteban, Gonzalo-Asensio, Jesús, Fritzell, Bernard, Thole, Jelle, Martin, Carlos, Scriba, Thomas J, Hatherill, Mark, Africa, Hadn, Arendsen, Denis, Botes, Natasja, Cloete, Yolundi, De Kock, Marwou, Erasmus, Margaret, Jack, Lungisa, Kafaar, Fazlin, Kalepu, Xoliswa, Khomba, Nondumiso Gloria, Kruger, Sandra, Leopeng, Thelma, Makhethe, Lebohang, Mouton, Angelique, Mulenga, Humphrey, Musvosvi, Munyaradzi, Noble, Julia, Opperman, Fajwa, Reid, Tim, Rossouw, Susan, Schreuder, Constance, Smit, Erica, Steyn, Marcia, Tyambethu, Petrus, Van Rooyen, Elma, and Veldsman, Ashley

Abstract

Infants are a key target population for new tuberculosis vaccines. We assessed the safety and immunogenicity of the live-attenuated Mycobacterium tuberculosisvaccine candidate MTBVAC in adults and infants in a region where transmission of tuberculosis is very high.

Published
2019
Full Text
View/download PDF

33. Postnatal growth standards for preterm infants: the Preterm Postnatal Follow-up Study of the INTERGROWTH-21 st Project

Author

Villar, José, primary, Giuliani, Francesca, additional, Bhutta, Zulfiqar A, additional, Bertino, Enrico, additional, Ohuma, Eric O, additional, Ismail, Leila Cheikh, additional, Barros, Fernando C, additional, Altman, Douglas G, additional, Victora, Cesar, additional, Noble, Julia A, additional, Gravett, Michael G, additional, Purwar, Manorama, additional, Pang, Ruyan, additional, Lambert, Ann, additional, Papageorghiou, Aris T, additional, Ochieng, Roseline, additional, Jaffer, Yasmin A, additional, and Kennedy, Stephen H, additional

Published
2015
Full Text
View/download PDF

34. Anthropometric Characterization of Impaired Fetal Growth

Author

Victora, Cesar G., primary, Villar, José, additional, Barros, Fernando C., additional, Ismail, Leila Cheikh, additional, Chumlea, Cameron, additional, Papageorghiou, Aris T., additional, Bertino, Enrico, additional, Ohuma, Eric O., additional, Lambert, Ann, additional, Carvalho, Maria, additional, Jaffer, Yasmin A., additional, Altman, Douglas G., additional, Noble, Julia A., additional, Gravett, Michael G., additional, Purwar, Manorama, additional, Frederick, Ihunnaya O., additional, Pang, Ruyan, additional, Bhutta, Zulfiqar A., additional, and Kennedy, Stephen H., additional

Published
2015
Full Text
View/download PDF

35. The Distribution of Clinical Phenotypes of Preterm Birth Syndrome

Author

Barros, Fernando C., primary, Papageorghiou, Aris T., additional, Victora, Cesar G., additional, Noble, Julia A., additional, Pang, Ruyan, additional, Iams, Jay, additional, Cheikh Ismail, Leila, additional, Goldenberg, Robert L., additional, Lambert, Ann, additional, Kramer, Michael S., additional, Carvalho, Maria, additional, Conde-Agudelo, Agustin, additional, Jaffer, Yasmin A., additional, Bertino, Enrico, additional, Gravett, Michael G., additional, Altman, Doug G., additional, Ohuma, Eric O., additional, Purwar, Manorama, additional, Frederick, Ihunnaya O., additional, Bhutta, Zulfiqar A., additional, Kennedy, Stephen H., additional, and Villar, José, additional

Published
2015
Full Text
View/download PDF

36. International standards for symphysis-fundal height based on serial measurements from the Fetal Growth Longitudinal Study of the INTERGROWTH-21st Project: prospective cohort study in eight countries.

Author

Papageorghiou, Aris T., Ohuma, Eric O., Gravett, Michael G., Hirst, Jane, da Silveira, Mariangela F., Lambert, Ann, Carvalho, Maria, Jaffer, Yasmin A., Altman, Douglas G., Noble, Julia A., Bertino, Enrico, Purwar, Manorama, Ruyan Pang, Ismail, Leila Cheikh, Victora, Cesar, Bhutta, Zulfiqar A., Kennedy, Stephen H., and Villar, José

Published
2016
Full Text
View/download PDF

37. LETTERS

Author

Williams, Bill, Word, David, Johnson, Ronald D., Fraser, Jim, Meredith, Brandon, Noble, Julia, Robinson, David, Lee, David, James, Bill, Heywood, Thelma, Rushing, Carole, Bashuk, Jeff, Kotyuk, Jerry, Pryor, Glenn, Leach, Caroline, Manheim, Moshe, and Tigges, Stefan

Subjects
General interest, News, opinion and commentary
Abstract

Perdue's tax break: Responses to '3 minutes, 1 tax bill, $100,000 for Perdue,' Page One, Oct. 1 Land deal signals greed, stupidity First, I want to say that I am [...]

Published
2006

39. READERS WRITE

Author

Erickson, Jerry, Richardson, Tom, Noble, Julia, Green, David, Benator, Josiah V., Shealy, Catherine Boone, Paterson, Dale, Nachman, Paul, Goodman, Michael, Terry, David, and Rhett, Toni

Subjects
General interest, News, opinion and commentary
Abstract

Zacarias Moussaoui: Responses to '9/11 conspirator gets life,' Page One, May 4 Life term best in this case A life sentence is actually better than the death penalty, because if [...]

Published
2006

40. Exploring the effective length of therapy in a healthcare organisation.

Author

Noble, Julia

Subjects
*TREATMENT effectiveness, *TREATMENT duration, *COUNSELING psychology, *COUNSELING psychologists, *MENTAL health policy
Abstract

Content & Focus: The effective length of therapy is a current professional issue affecting counselling psychologists worldwide as the demand on resources increases and the availability of resources decreases. A priority of the World Health Organisation (WHO) Mental Health Gap Action Programme (mhGAP) is to identify strategies to scale up coverage of key interventions in resource constrained settings, promoting the involvement of service users in their own care and treatment. One often neglected area of therapy which may contribute to achieving these objectives is the length of treatment. This paper examines the evidence evaluating the effectiveness of therapeutic interventions of different lengths, and considers the problems associated with clients being prescribed a set number of sessions according to a presenting problem. A relatively recent individualised approach with client input is evaluated, with considerations of how this might fit within counselling psychology philosophy and global mental health policy. [ABSTRACT FROM AUTHOR]

Published
2015
Full Text
View/download PDF

42. The likeness of fetal growth and newborn size across non-isolated populations in the INTERGROWTH-21stProject: the Fetal Growth Longitudinal Study and Newborn Cross-Sectional Study

Author

Villar, José, Papageorghiou, Aris T, Pang, Ruyan, Ohuma, Eric O, Ismail, Leila Cheikh, Barros, Fernando C, Lambert, Ann, Carvalho, Maria, Jaffer, Yasmin A, Bertino, Enrico, Gravett, Michael G, Altman, Doug G, Purwar, Manorama, Frederick, Ihunnaya O, Noble, Julia A, Victora, Cesar G, Bhutta, Zulfiqar A, and Kennedy, Stephen H

Abstract

Large differences exist in size at birth and in rates of impaired fetal growth worldwide. The relative effects of nutrition, disease, the environment, and genetics on these differences are often debated. In clinical practice, various references are often used to assess fetal growth and newborn size across populations and ethnic origins, whereas international standards for assessing growth in infants and children have been established. In the INTERGROWTH-21stProject, our aim was to assess fetal growth and newborn size in eight geographically defined urban populations in which the health and nutrition needs of mothers were met and adequate antenatal care was provided.

Published
2014
Full Text
View/download PDF

44. The satisfactory growth and development at 2 years of age of the INTERGROWTH-21st Fetal Growth Standards cohort support its appropriateness for constructing international standards.

Author

Villar, José, Cheikh Ismail, Leila, Staines Urias, Eleonora, Giuliani, Francesca, Ohuma, Eric O., Victora, Cesar G., Papageorghiou, Aris T., Altman, Douglas G., Garza, Cutberto, Barros, Fernando C., Puglia, Fabien, Ochieng, Roseline, Jaffer, Yasmin A., Noble, Julia A., Bertino, Enrico, Purwar, Manorama, Pang, Ruyan, Lambert, Ann, Chumlea, Cameron, and Stein, Alan

Subjects
FETAL development, PREVENTION of pregnancy complications, PERINATAL growth, FETAL death
Abstract

Background: The World Health Organization recommends that human growth should be monitored with the use of international standards. However, in obstetric practice, we continue to monitor fetal growth using numerous local charts or equations that are based on different populations for each body structure. Consistent with World Health Organization recommendations, the INTERGROWTH-21st Project has produced the first set of international standards to date pregnancies; to monitor fetal growth, estimated fetal weight, Doppler measures, and brain structures; to measure uterine growth, maternal nutrition, newborn infant size, and body composition; and to assess the postnatal growth of preterm babies. All these standards are based on the same healthy pregnancy cohort. Recognizing the importance of demonstrating that, postnatally, this cohort still adhered to the World Health Organization prescriptive approach, we followed their growth and development to the key milestone of 2 years of age.Objective: The purpose of this study was to determine whether the babies in the INTERGROWTH-21st Project maintained optimal growth and development in childhood.Study Design: In the Infant Follow-up Study of the INTERGROWTH-21st Project, we evaluated postnatal growth, nutrition, morbidity, and motor development up to 2 years of age in the children who contributed data to the construction of the international fetal growth, newborn infant size and body composition at birth, and preterm postnatal growth standards. Clinical care, feeding practices, anthropometric measures, and assessment of morbidity were standardized across study sites and documented at 1 and 2 years of age. Weight, length, and head circumference age- and sex-specific z-scores and percentiles and motor development milestones were estimated with the use of the World Health Organization Child Growth Standards and World Health Organization milestone distributions, respectively. For the preterm infants, corrected age was used. Variance components analysis was used to estimate the percentage variability among individuals within a study site compared with that among study sites.Results: There were 3711 eligible singleton live births; 3042 children (82%) were evaluated at 2 years of age. There were no substantive differences between the included group and the lost-to-follow up group. Infant mortality rate was 3 per 1000; neonatal mortality rate was 1.6 per 1000. At the 2-year visit, the children included in the INTERGROWTH-21st Fetal Growth Standards were at the 49th percentile for length, 50th percentile for head circumference, and 58th percentile for weight of the World Health Organization Child Growth Standards. Similar results were seen for the preterm subgroup that was included in the INTERGROWTH-21st Preterm Postnatal Growth Standards. The cohort overlapped between the 3rd and 97th percentiles of the World Health Organization motor development milestones. We estimated that the variance among study sites explains only 5.5% of the total variability in the length of the children between birth and 2 years of age, although the variance among individuals within a study site explains 42.9% (ie, 8 times the amount explained by the variation among sites). An increase of 8.9 cm in adult height over mean parental height is estimated to occur in the cohort from low-middle income countries, provided that children continue to have adequate health, environmental, and nutritional conditions.Conclusion: The cohort enrolled in the INTERGROWTH-21st standards remained healthy with adequate growth and motor development up to 2 years of age, which supports its appropriateness for the construction of international fetal and preterm postnatal growth standards. [ABSTRACT FROM AUTHOR]

Published
2018
Full Text
View/download PDF

45. Deep learning techniques to bridge the gap between 2D and 3D ultrasound imaging

Author

Yeung, Pak Hei, Namburete, Ana Ineyda, Xie, Weidi, and Noble, Julia

Subjects
Three-dimensional imaging in medicine, Image analysis, Diagnostic ultrasonic imaging, Deep learning (Machine learning), Biomedical engineering
Abstract

Three-dimensional (3D) ultrasound imaging has contributed to our understanding of fetal developmental processes in the womb by providing rich contextual information of the inherently 3D anatomies. However, its use is limited in clinical settings, due to the high purchasing costs and limited diagnostic practicality. Freehand two-dimensional (2D) ultrasound imaging, in contrast, is routinely used in standard obstetric exams. The low cost and portability of 2D ultrasound render it uniquely suitable for use in low- and middle-income settings. However, high level of expertise is always involved and it inherently lacks a 3D representation of the anatomies, which limit its potential for more accessible and advanced assessment. Capitalizing on the flexibility offered by freehand 2D ultrasound acquisition, this thesis presents a deep learning-based framework for optimizing the utilization and diagnostic power of 2D freehand ultrasound in fetal brain imaging. First, a localization model is presented to predict the location of 2D ultrasound fetal brain scans in the 3D brain atlas. It is trained by sampling 2D slices from aligned 3D fetal brain volumes, such that heavy annotations for each 2D scan are not required. This can be used for scanning guidance and standard plane localization. An unsupervised methodology is further proposed to adapt a trained localization model to freehand 2D ultrasound images acquired from arbitrary domains, for example sonographers, manufacturers and acquisition protocols. This enables the model to be used at the bedside in practice, where it can be fine-tuned with just the images acquired in any arbitrary domains before inference. Building upon the ability to localize 2D scans in the 3D brain atlas, a framework is further presented to reconstruct 3D volumes from non-sensor-tracked 2D ultrasound images using implicit representation. With this slice-to-volume reconstruction framework, additional 3D information can be extracted from the 2D freehand scans. Finally, a semi-automatic model, trained only on raw 3D volumes without any manual annotation, is presented to segment any arbitrary structures of interest in 3D medical volumes, while only requiring manual annotation of a single slice during inference. The model is tested on wide variety of medical imaging datasets and anatomical structures, verifying its generalizability. In the design of the framework presented in this thesis, three fundamental principles, namely minimal human annotation, generalizability and sensorless operation, are followed to optimize its seamless integration into the clinical workflow. This may modernize freehand routine scanning and enhance its accessibility, while maximizing the clinical information gained from routine scans acquired as part of the continuum of pregnancy care.

Published
2022

46. Fetal gestational age estimation without clinical measurement using deep learning

Author

Lee, Lok Hin and Noble, Julia

Subjects
Machine learning
Abstract

Gestational age estimation is a key marker in obstetric care for determination of fetal growth and health. Current clinical estimation of gestational age is based on regression using clinical fetal growth charts and biometry measurements by an experienced sonographer. However, estimation of gestational age using biometry is difficult especially in late pregnancy, and there may be additional salient anatomical information in images to assist gestational age estimation in standard planes which is discarded by clinical biometry measurement. This thesis therefore attempts to use deep neural network to directly regress gestational age from fetal standard planes without pixel size information, thus relying on anatomical appearance alone without fetal biometry. In this thesis, we first investigate the data augmentation methods commonly used for medical image analysis and implement an data augmentation selection strategy. We find that this optimized augmentation strategy leads to increased performance on the proxy task of standard plane classification compared to conventional hand-crafted data augmentation methods. We then use this data augmentation strategy selection framework to train a deep convolutional neural network for gestational age estimation from the head, abdomen and femur standard planes, and investigate the performance of different loss functions for deep regression. We demonstrate gestational age estimation across the second and third trimester on the head standard plane with a mean absolute error of 0.6 weeks with the optimized data augmentation policy, and use the trained neural network to visualize anatomically salient areas of the input image. We then extend the deep learning framework by introducing priors to trainable weights, making a Bayesian neural network. The Bayesian neural network separately estimates aleatoric and epistemic uncertainty during gestational age inference. This allows for calibrated uncertainties during gestational age estimation. This is the first work to estimate fetal gestational age from ultrasound standard plane images without pixel size or biometry information, and may be potentially of use in low- and medium- income countries where accurate gestational age dating in late pregnancy is important as women present to obstetric care in all stages of pregnancy.

Published
2021

47. Improving deep-learning segmentation performance in 3D neuroimaging with minimal manual annotations

Author

Venturini, Lorenzo, Papageorghiou, Aris, Noble, Julia, and Namburete, Ana Ineyda

Subjects
Engineering, Image analysis, Machine learning, Biomedical engineering
Abstract

One of the current challenges in applying machine learning to medical images is the difficulty in obtaining labelled training data. While medical images themselves are often available, generating high-quality training labels for them is time-consuming and often requires a trained clinician. This problem is particularly acute in 3D segmentation, which generally requires detailed voxel-by-voxel segmentation maps. This thesis proposes a series of image analysis methods to leverage additional available information to improve image segmentation quality when there are limited manual labels available. Using a dataset of 3D fetal ultrasound scans with only a small number of initial segmentation labels, we demonstrate a benefit from different information sources. The approaches used in this thesis are: • Generating segmentation labels automatically from a publicly available spatio-temporal atlas, making use of prior anatomical information. We use anatomical keypoints to guide registration of atlases across different imaging modalities. We then propagate these segmentations to individual ultrasound volumes, automatically generating a set of multi-label segmentations with an average Dice coefficient of 0.818 across the chosen anatomical structures in the range of 20-25 gestational weeks. This set of labels is used to train a segmentation CNN. We find that this produces high-quality segmentations, and that training a single network with the full multi-label training set improves segmentation quality (average Dice coefficient of 0.726 across structures for a multi-task network, versus 0.659 for individual single-task networks). • Leveraging additional, unlabelled data to improve performance for a cerebellar segmentation task. Unlabelled data does not have a ground-truth label by which segmentation quality may be compared, but measures of output uncertainty can be derived using test-time augmentation and dropout measures. We use these estimates of uncertainty to inform an iterative omni-supervised framework, using the highest-quality segmentations from the unlabelled dataset as additional training data for a segmentation CNN. We show that the use of these labels as part of a training dataset improves segmentation performance, and that this is improved further when measures of uncertainty are used in data selection (an overall improvement in Dice coefficient for a cerebellar segmentation task from 0.673 to 0.727). • Passing additional, scalar information to a neural network's input. We propose an original method by which scalar data such as gestational age, readily available as part of clinical data acquisition, may be appended to the input of a fully-convolutional neural network. We show that including this information as part of the training dataset can lead to significant improvements in segmentation quality on the same cerebellar segmentation task, in the reported experiments improving test Dice coefficient from 0.673 to 0.723. We find that this improvement is not sensitive to imperfect information passed at test time. The computational methods developed in this thesis may reduce the reliance on large manually-labelled datasets for medical image analysis and save time in generating expert annotations.

Published
2021

48. Towards engineering ultrasound image analysis solutions for resource constrained environments

Author

Maraci, Mohammad Ali and Noble, Julia Alison

Subjects
618.2
Abstract

Obstetric ultrasound has proven an integral part of prenatal care for many applications including detecting pregnancy risk factors and fetal abnormalities. Although ultrasound imaging is widely used in developed countries, its availability in limited-resource settings has been dependent on device portability, associated costs, and trained healthcare workers. In recent years, as ultrasound equipment has become cheaper and portable its availability in limited-resource settings has expanded with promising trends. Yet a major constraint of ultrasound imaging is the steep learning curve to reach scanning proficiency, rendering the process challenging for inexperienced users. This thesis presents methods towards addressing the fundamental task of empowering novice sonographers to perform targeted diagnostic screening to the same level as experienced ultrasonographers. This is of particular relevance to low-resource settings where pregnant women may not be able to attend specialist obstetric care centres during their pregnancy. We address this task by introducing simplified scanning protocols and using computer vision and machine learning techniques. While aimed at low-income country healthcare needs, the research is also equally applicable to needs of developed world. Firstly, an original framework for automatic detection of frames of interest in ultrasound videos is presented. Furthermore, the merits of pre-processing images on classification accuracy, on datasets of variable size, is investigated. To this end, a classification framework for 2D ultrasound frames based on the improved Fisher vector encoding of SIFT and LP-SIFT features has been introduced. Additionally a Structured Random Forests edge detection framework is introduced for an accurate structure representation in 2D ultrasound data. Secondly, a novel framework based on video dynamics and motion patterns is presented for automatic detection of sequences of interest in real world ultrasound videos. To illustrate clinical applicability, this approach is applied to automatically identify the fetal presentation in the womb, during the third trimester of pregnancy from a predefined freehand ultrasound video sweep. A kernel dynamical textures model is utilised to model the dynamics of video sub-sequences that contain a fetal skull and those sequences that do not. A similarity kernel is then constructed between the model parameters to train a classifier. A classification accuracy of 93% was achieved using this framework. Thirdly, for the first time, the real world application of automatic analysis of predefined ultrasound videos to detect the fetal presentation and heartbeat is considered. For this application, the frames of interest are initially identified using a frame-by-frame classification framework. Moreover, a linear-chain structured graphical model is used to take into account the temporal information in the 2D predefined sweeps and to regularise the classification results. Consecutive frames of the fetal heart are further investigated for the presence of the heartbeat activity. Classification accuracy achieved using our method was about 88%. Finally, potential future directions are investigated and initial findings have been reported. These include results on a small pilot study specifically designed to perform a statistical comparison between images obtained from a standard mid-range ultrasound probe and a low-end portable ultrasound probe. Moreover, the efficacy of using a deep convolutional neural network with transfer learning is investigated and initial findings are reported.

Published
2016

49. A computer-aided tracking and motion analysis with ultrasound system for describing hip joint kinematics

Author

Jia, Rui, Noble, Julia Alison, and Mellon, Stephen

Subjects
616.7
Abstract

Joint kinematics has been suggested to play an important role in the initiation and progression of a number of musculoskeletal pathologies. Thus, investigation of joint kinematics can help clinicians and researchers to better understand musculoskeletal conditions such as osteoarthritis and trochanteric bursitis. Existing motion capture technologies used in clinical settings suffer from various limitations, including soft tissue artefact. These limitations result in a lengthy examination process, an incomplete movement description, or an inaccurate representation of the real bony landmarks. The recent introduction of a motion analysis with ultrasound (MAUS) system aimed to provide a less constrained approach to detect actual bony structures and describe joint kinematics in three dimensional (3D) space. However, the accuracy of the original MAUS system was highly dependent on the operator's experience. In this doctoral thesis, a computer-aided tracking and motion analysis with ultrasound (CAT & MAUS) system is developed to track underlying bony landmarks and describe hip joint kinematics during gait. The key contribution of this thesis is to combine state-of-the-art computer vision approaches with the original MAUS system to improve the speed, accuracy and repeatability of joint kinematics examination for clinical measurement and diagnosis. Firstly, a comprehensive review of gait analysis and relevant clinical diagnostic modalities is presented. Then, an augmented MAUS system architecture is presented, which is more flexible than the previous MAUS system of the data acquisition. It combines an optoelectronic motion analysis (MA) system with a 2D ultrasound (US) device to build up a 3D representation of the bony structure of interest. A novel calibration box with multiple functions for the augmented MAUS system is designed to spatially and temporally match US images to the motion analysis data. The average Euclidean distance error of the spatial calibration is found to be 0.34 mm and the accuracy of the temporal calibration is found to be within half of the frame acquisition interval. The augmented MAUS system with its more accurate calibration procedures can accurately present the bone of interest in 3D space. Secondly, a computer-aided post-processing pipeline is presented to automatically track the bone of interest in 3D space. A globally optimal registration method is employed to align the 3D surfaces of the target bony structure reconstructed from the manual segmentation in US images at different positions to locate the target bony landmark from one position to another. The globally optimal registration overcomes the issue of getting trapped into local minima for the conventional iterative closest point registration. The accuracy of the globally optimal registration is validated with a proximal femur phantom. The average rotation error is found to be 0.38° and the average translation error is found to be 0.33 mm, both of which are within the clinical tolerance of computer-aided orthopaedics surgery ±3° and ± 1 mm). The 3D globally optimal registration guarantees an accurate track of the same target bony structure at different positions instead of estimating the similar bony structure at each position by eyeball with previous MAUS system. However, in practice, it takes around 20 minutes to manually segment the bone structure for a single surface reconstruction, which is extremely laborious and time consuming. In order to automate the CAT & MAUS system, a novel automatic segmentation of the bone structure in a 2D US image is then developed as a precursor for an accurate globally optimal registration. The automatic bone segmentation introduces the local phase features and acoustic characteristics to enhance the bone probability for detection. The result of the automatic segmentation is validated with a pilot phantom study before applying to the in-vivo experiment and achieves an accuracy of 0.13 mm. After fully developing the CAT & MAUS system, hip joint kinematics of healthy subjects are quantified in six degrees of freedom using the CAT & MAUS system and compared to the results from the optoelectronic motion analysis system. It is shown that CAT & MAUS results describe a greater rotation range than MA results by up to 4.03° in the sagittal plane because the optoelectronic motion analysis system alone suffers from severe soft tissue artefact as the skin markers shift away from the underlying bony structures during movement. The deformation of body segments captured by MA during movements caused by soft tissue artefact is explained using Procrustes analysis to indicate the accuracy and repeatability of the CAT & MAUS system. Finally, possible future directions are proposed based on preliminary investigations using the developed CAT & MAUS system with particular reference to both the technical and clinical perspectives.

Published
2016

50. Novel embolic particles for cancer therapy

Author

Morrison, Rachel Anne, Townley, Helen, Dobson, Peter, and Noble, Julia Alison

Subjects
616.99
Abstract

The aim of this thesis was to develop novel embolic particles for cancer therapy using a combination of nano and microparticles. The particles have been designed and synthesised to have a polystyrene core, be radiopaque, act as a radiosensitiser and have a high capacity for loading of chemotherapy drugs. The polystyrene core has been designed so it effectively blocks the tumour vasculature thereby limiting oxygen and nutrient delivery to the tumour thus causing tumour necrosis. The core of the polystyrene particle incorporates tantalum oxide nanoparticles to provide X-ray contrast to the embolic microparticles. The surface of the polystyrene particle has been coated with rare earth doped titanium dioxide (TiO2) nanoparticles which produce reactive oxygen species upon X-ray activation. This allows the embolic particle to act as a radiosensitising agent and has been shown to reduce cell proliferation in the presence of X-rays. The surface of the polystyrene particles has also been coated with mesoporous SiO2 nanoparticles which allow for the high loading capacity of chemotherapeutic drugs. This permits chemotherapy to be delivered directly to the tumour location, thereby reducing the toxic side effects of systemic treatment. As a proof of concept, the chemoembolization particles have been loaded with a novel fungal derived chemotherapeutic Ophiobolin A and the controlled release has been demonstrated. The OphA chemoembolization particles reduced cell viability by approximately 70% compared to the blank chemoembolization particles. The mechanism of cell death of OphA on eight cancer cell lines and one control cell line has also been studied and its effect on cellular organelles elucidated. OphA shows great promise as a novel chemotherapeutic which could be taken forward to animal trials.

Published
2016

Catalog

Books, media, physical & digital resources
See catalog results