Effect of vitamin D replacement on maternal and neonatal outcomes: a randomised controlled trial in pregnant women with hypovitaminosis D. A protocol

Introduction: The vitamin D recommended doses during pregnancy differ between societies. The WHO guidelines do not recommend routine prenatal supplementation, but they underscore the fact that women with the lowest levels may benefit most. The effects of routine supplementation during pregnancy on maternal and neonatal clinical outcomes have not been investigated in the Middle East, where hypovitaminosis D is prevalent. Our hypothesis is that in Middle Eastern pregnant women, a vitamin D dose of 3000?IU/day is required to reach a desirable maternal 25-hydroxyvitamin D [25(OH)D] level, and to positively impact infant bone mineral content (BMC).Methods and analysis: This is a multicentre blinded randomised controlled trial. Pregnant women presenting to the Obstetrics and Gynaecology clinics will be approached. Eligible women will be randomised to daily equivalent doses of cholecalciferol, 600?IU or 3000?IU, from 15 to 18?weeks gestation until delivery. Maternal 25(OH)D and chemistries will be assessed at study entry, during the third trimester and at delivery. Neonatal anthropometric variables and 25(OH)D level will be measured at birth, and bone and fat mass assessment by dual-energy X-ray absorptiometry scan at 1?month. A sample size of 280 pregnant women is needed to demonstrate a statistically significant difference in the proportion of women reaching a 25(OH)D level ?50?nmol/L at delivery, and a difference in infant BMC of 6 (10)g, for a 90% power and a 2.5% level of significance. The proportions of women achieving a target 25(OH)D level will be compared between the two arms, using ?2. An independent t test will be used to compare mean infant BMC between the two arms. The primary analysis is an intention-to-treat analysis of unadjusted results.Ethics and dissemination: The protocol has been approved by the Institutional Review Board at the American University of Beirut-Lebanon (IM.GEHF.22). The trial results will be published in peer-reviewed medical journals and presented at scientific conferences.Trial registration number: NCT02434380.<br/

Rendimiento estático y cíclico de compuestos cementantes reforzados con fibras de vidrio

This paper concerns an experimental study of the influence of short glass-fibres randomly oriented of a reinforced cement-based composite on the mechanical behaviour. The matrix material parameters used are: cement/sand ratio and water/cement ratio fixed at 0.5; the glass-fibre content (0%, 0.5%, 1.0%, 1.5%, 2% and 2.5%) and fibre lengths (3, 6 and 12 mm). Composites mechanical characterisation under static behaviour at flexural and compression tests, shows that the reinforcement effect is beneficial only in flexural case. A synergy (matrix-reinforcement) was observed when fibre length of 12 mm is used with application rate of 2% in flexural. The fatigue behaviour determined by Wöhler plots (stress-number of cycles to rupture), derived from experimental results; showed a large results dispersion which is attributed to many causes initiating this damage. The cyclic tests illustrate brittle character of these materials; even with low-amplitude cycles of loading no adaptation of these materials can be reported.Este trabajo aborda el estudio experimental de la influencia de fibras de vidrio cortas orientadas al azar sobre el comportamiento mecánico de un composite reforzado de base cemento. Los parámetros de la matriz utilizados son: relación cemento/arena y relación agua/cemento fijada en 0,5; el contenido de fibra de vidrio (0%, 0,5%, 1,0%, 1,5%, 2% y 2,5%) y longitudes de fibra (3, 6 y 12 mm). Los resultados mecánicos de estos compuestos bajo comportamiento estático (flexión y compresión), muestran que el efecto de refuerzo es beneficioso unicamente a flexión. Se observó una sinergia (refuerzo de la matriz) cuando se usó la fibra de 12 mm con una tasa de aplicación del 2% en flexión. El comportamiento a fatiga determinado por las curvas de Wöhler (número de ciclos hasta la rotura), derivado de los resultados experimentales; mostró una gran dispersión de resultados que se atribuye a las muchas causas que pueden iniciar este daño. Las pruebas cíclicas ilustran el carácter quebradizo de estos materiales; y no se pude indicar que exista adaptación de estos materiales, incluso con ciclos de carga de baja amplitud

Towards a Non-Intrusive Pulse Oximetry System with Long-Term Mobile Monitoring

The percentage of arterial oxygen in the blood is a vital physiological sign used by clinicians and doctors to monitor the health of patients under critical conditions in the hospital; the technology used universally to monitor this is known as pulse oximetry. The sensors most commonly used in the hospitals are of reflection type such that the LEDs and the photodetector (PD) are placed on opposite ends of short distance body tissue, e.g. finger. There has been an increased demand for monitoring patients who have suffered a stroke and are recovering in their homes, and simply the elderly. For such persons, staying in the hospital is unnecessary and undesirable psychologically. As such, a system is to be designed such that patients can monitor their physiological signals, and only contact the doctor when it is imperative to do so. With the comfort of the patient in mind, the system must be unobtrusive in nature such that it does not impede any of their simply daily activities. The sensor used in the system is of reflectance type, i.e. LEDs and PD placed on the same side, and is to be placed on the pectoral region. The pectoral region is chosen for the ease of measuring electrocardiogram (ECG) signals, another vital physiological signal. Due to lesser blood perfusion in that anatomical region, the question remains as to whether signals could be acquired faithfully there. Results have shown that although signals can be obtained, they vary greatly mainly due to motion artifacts. The system could be improved if complex digital signal processing algorithms are used.</p

Static and cyclic performance of cementitious composites reinforced with glass-fibres

This paper concerns an experimental study of the influence of short glass-fibres randomly oriented of a reinforced cement-based composite on the mechanical behaviour. The matrix material parameters used are: cement/sand ratio and water/cement ratio fixed at 0.5; the glass-fibre content (0%, 0.5%, 1.0%, 1.5%, 2% and 2.5%) and fibre lengths (3, 6 and 12 mm). Composites mechanical characterisation under static behaviour at flexural and compression tests, shows that the reinforcement effect is beneficial only in flexural case. A synergy (matrix-reinforcement) was observed when fibre length of 12 mm is used with application rate of 2% in flexural. The fatigue behaviour determined by Wöhler plots (stress-number of cycles to rupture), derived from experimental results; showed a large results dispersion which is attributed to many causes initiating this damage. The cyclic tests illustrate brittle character of these materials; even with low-amplitude cycles of loading no adaptation of these materials can be reported

Weekends affect mortality risk and chance of discharge in critically ill patients: a retrospective study in the Austrian registry for intensive care.

BACKGROUND: In this study, we primarily investigated whether ICU admission or ICU stay at weekends (Saturday and Sunday) is associated with a different risk of ICU mortality or chance of ICU discharge than ICU admission or ICU stay on weekdays (Monday to Friday). Secondarily, we analysed whether weekend ICU admission or ICU stay influences risk of hospital mortality or chance of hospital discharge. METHODS: A retrospective study was performed for all adult patients admitted to 119 ICUs participating in the benchmarking project of the Austrian Centre for Documentation and Quality Assurance in Intensive Care (ASDI) between 2012 and 2015. Readmissions to the ICU during the same hospital stay were excluded. RESULTS: In a multivariable competing risk analysis, a strong weekend effect was observed. Patients admitted to ICUs on Saturday or Sunday had a higher mortality risk after adjustment for severity of illness by Simplified Acute Physiology Score (SAPS) 3, year, month of the year, type of admission, ICU, and weekday of death or discharge. Hazard ratios (95% confidence interval) for death in the ICU following admission on a Saturday or Sunday compared with Wednesday were 1.15 (1.08-1.23) and 1.11 (1.03-1.18), respectively. Lower hazard ratios were observed for dying on a Saturday (0.93 (0.87-1.00)) or Sunday (0.85 (0.80-0.91)) compared with Wednesday. This is probably related to the reduced chance of being discharged from the ICU at the weekend (0.63 (0.62-064) for Saturday and 0.56 (0.55-0.57) for Sunday). Similar results were found for hospital mortality and hospital discharge following ICU admission. CONCLUSIONS: Patients admitted to ICUs at weekends are at increased risk of death in both the ICU and the hospital even after rigorous adjustment for severity of illness. Conversely, death in the ICU and discharge from the ICU are significantly less likely at weekends

A facile and green synthetic approach toward fabrication of alcea- and thyme-stabilized tio2 nanoparticles for photocatalytic applications

A facile and green synthetic approach was considered for the synthesis of stabilized titanium dioxide (TiO2) nanoparticles. Extracts of Alcea and Thyme plants were used to synthesis TiO2 nanoparticles for photocatalytic applications. Evaluation of the structural and phase formation via X-ray diffraction (XRD) indicated the formation of the anatase phase of TiO2 along with the rutile phase. A desired single phase of anatase was obtained upon heating the as-synthesized samples at 500 °C for 3 h. Using the information provided by the XRD analyzer and the Debye Scherer relationship, the average crystallite size was found to be around 6 and 10 nm for the samples synthesized using Alcea and Thyme plants, respectively. To determine the elemental analysis and chemical structure, the energy dispersive X-ray (EDX) analyzer and Fourier Transform Infrared (FTIR) spectroscopy were employed. Field emission scanning electron microscopy (FESEM) indicated batches of ultrafine agglomerated particles for both samples, which their sizes grew by the heating process. The UV–visible analysis of photocatalytic properties confirmed the priority of TiO2 nanoparticles prepared with Thyme extracts

Mode-locking induced by coherent driving in fiber lasers

Mode-locking is a broad concept that encompasses different processes enabling short optical pulse formation in lasers. It typically requires an intracavity mechanism that discriminates between single and collective mode lasing, which can be complex and sometimes adds noise. Moreover, known mode-locking schemes do not guarantee phase stability of the carrier wave. Here, we theoretically propose that injecting a detuned signal seamlessly leads to mode-locking in fiber lasers. We show that phase-locked pulses, akin to cavity solitons, exist in a wide range of parameters. In that regime the laser behaves as a passive resonator due to the non-instantaneous gain saturation