Combining beta-core fragment and total oestriol measurements to test for Down syndrome pregnancies

Recent articles by Cuckle et al., Canick et al., and Isozaki et al. have evaluated urine beta-core fragment as a screening test for Down syndrome in second-trimester pregnancies. They found over four-fold elevation of beta-core fragment levels in Down syndrome pregnancies, and between 62 and 88 per cent detection of this trisomy at a 5 per cent false-positive rate. Urine beta-core fragment may be a superior screening test for Down syndrome pregnancies. In the present study, urinary total oestriol has been evaluated as a marker to use in combination with beta-core fragment in screening for Down syndrome pregnancies. The two markers were evaluated separately in relation to the urine creatinine concentration. To amplify screening performance, we evaluated the ratio of beta-core fragment to total oestriol levels (creatinine-independent). beta-core fragment and total oestriol levels were determined (normalized to creatinine, ng/mg creatinine) in urine samples from 480 unaffected and 12 Down syndrome pregnancies, collected consecutively at a single prenatal diagnosis centre. The median beta-core fragment level in Down syndrome cases was 4.5 MOM. Fifty-eight per cent of Down syndrome cases had beta-core fragment levels exceeding the 95th centile of unaffected pregnancies. The median total oestriol level in Down syndrome cases was 0.33 MOM. Forty-two per cent of Down syndrome cases had total oestriol levels exceeding the 95th centile of unaffected pregnancies. We investigated the ratio of the two determinants (beta-core fragment, ng/ml divided by total oestriol, ng/ml) in our sample set. The median beta-core fragment:total oestriol ratio in Down syndrome cases was 13 MOM. Seventy-five per cent of Down syndrome cases had a ratio exceeding the 95th and the 99.5th centile of unaffected pregnancies. Total oestriol complements beta-core fragment in urine screening for Down syndrome pregnancies. A test measuring the ratio of the two urine determinants may be a significant improvement over current serum methods for detecting Down syndrome.     

Development of Online Ultrasound Instructional Module and Comparison to Traditional Teaching Methods

A Web‐based teaching device was constructed to deliver information on fundamentals of ultrasound imaging to approximately one‐half the students in an undergraduate medical imaging course, while the remaining students were taught the same material via traditional lectures and typed notes. The students participating in this study were separated randomly but in such a manner that prior achievement was statistically equivalent for the two groups. After approximately two weeks of instruction, an ultrasound imaging exam was administered. Results indicated no statistically significant difference in scores on homework assigned during the instructional period between the traditional and online groups. Similarly, there was no statistically significant difference in the average exam scores of students in the two groups. The traditional group required significantly more time on learning activities than did the online group. These results indicated that level of understanding was not affected by use of the online device, while efficiency of learning improved dramatically. Reasons reported by the students for the improved efficiency of the online method included flexibility in time usage and ability to cater to the individual, which came with the added responsibility of self‐discipline. The traditional teaching method, meanwhile, allowed interaction with and instant feedback from a professor and other students. In this study we have demonstrated that the nature of an online device yields a higher level of efficiency than traditional lectures, despite the inherent drawbacks of the approach. The effectiveness of this device could potentially be improved by implementing enhancements to increase the level of interaction for the user and to help with discipline and time management.     

Effects of size and orientation change on hippocampal activation during episodic recognition: a PET study

To determine whether physical match between studied and tested items influences blood flow increases in the hippocampal formation associated with recognition memory, positron emission tomography (PET) was used to measure changes in regional cerebral blood flow while healthy volunteers made old/new judgements about line drawings of objects. Some objects were tested in the same size and orientation as they had appeared earlier during the study phase of the experiment; other objects were tested in a different size or orientation than when they were studied. Blood flow increases in the vicinity of the hippocampal formation were observed in the same object condition compared with the size change and the orientation change conditions, even though recognition accuracy was affected significantly only by orientation change. Results add to previous findings suggesting that physical similarity between studied items and test cues may contribute to hippocampal activation during episodic retrieval.     

On the Direct Addition of Amine N–H to Ch≡C Triple Bonds with Late Transition Metal Catalysts

The kinetics of the transition metal-catalysed direct addition of amine NH bonds to carbon--carbon multiple bonds (hydroamination) has been explored by in situ spectroscopic techniques. From an open mass balance it was concluded that an intermediate species was formed during the cyclisation of 6-aminohex-1-yne. This species was identified as the enamine 2-methylene-piperidine, which is the primary hydroamination product.     

New compact wideband bandpass filter using three parallel-coupledlines

A new miniature bandpass filter, comprising three-conductor short-circuited spurline resonators of approximately a quarter-wavelength long, with a very wide bandwidth approaching multioctaves is reported for the first time. The chain matrix of the filter resonator is derived. The new filter has been developed using microstrip line with less than 1 dB insertion loss over a passband from 2 to 8 GHz. Reasonably good agreement between the measured and calculated results is observed     

Networks in workers' compensation medical delivery

Medical networks offer discounted fees, control of the workers' compensation case, quality monitoring, and managed care services. As channeling of workers' compensation cases to networks increases, credentialed physicians will benefit.