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Adams J, Hasan M, Thorp J. Using neurotechnology in the emergency and safety management for creating a safer work environment. J Emerg Manag 2023; 21:133-139. [PMID: 37270412 DOI: 10.5055/jem.0768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Brain-computer interfaces are emerging neurotechnology conducting specific commands or outputs based on acquiring brain signals or inputs. This study examines the common hazards present in industries, which can be managed by neurotechnology, as well as compares two types of brain-computer interfaces in the neurotechnology area. The findings from this work suggest acknowledging current safety management practices and technology that can promote a safer work environment, in addition to increasing probable applications of use of the current research findings related to neurotechnology. This study advises understanding the risks associated between noninvasive and invasive neurotechnologies, whereas noninvasive technologies are safer that exhibit lesser degrees of accuracy or applications of use compared to its counterpart, which is invasive technology. This study proposes future development of this technology, which can integrate components based on common practices by industry.
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Affiliation(s)
- James Adams
- Computer Science and Engineering Technology (CSET) Department, University of Houston-Downtown (UHD), Houston, Texas
| | - Mahmud Hasan
- Faculty Advisor, ASSP UHD Student Chapter, Computer Science and Engineering Technology (CSET) Department, University of Houston-Downtown (UHD), Houston, Texas. ORCID: https://orcid.org/0000-0001-6275-392X
| | - Jacob Thorp
- Computer Science and Engineering Technology (CSET) Department, University of Houston-Downtown (UHD), Houston, Texas
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Adams J, Hasan M, Thorp J. AI (artificial intelligence)-assisted planning within emergency management operations. J Emerg Manag 2021; 20:41-52. [PMID: 35289389 DOI: 10.5055/jem.0622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
There is a demand for future technologies to be embedded within emergency management operations. Artificial intelligence (AI) can help save lives and create more efficient systems for emergency management operators to prepare, design, develop, and execute responses to disasters and catastrophes. This study intends to provide insight into how AI can integrate with climate modeling and traffic management systems in response to natural disasters. Research with supporting evidence implies that current technology and frameworks can coexist inside the existing infrastructure and emergency management operations. A growing population with an increase in anthropogenic emissions and the inability to predict future disasters and catastrophes suggests that AI can help address these challenges.
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Affiliation(s)
- James Adams
- Sustainability Consultant, Computer Science and Engineering Technology Department, University of Houston-Downtown, Houston, Texas
| | - Mahmud Hasan
- University of Houston Downtown, Houston, Texas. ORCID: https://orcid.org/0000-0001-6275-392X
| | - Jacob Thorp
- Computer Science and Engineering Technology Department, University of Houston-Downtown, Houston, Texas
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Thorp J, Willson J. The Neck Disability Index is Not Correlated with Some Parameters of Temporomandibular Disorders: A Cross-Sectional Study. J Oral Facial Pain Headache 2019; 33:39–46. [DOI: 10.11607/ofph.1992] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Guintivano J, Sullivan PF, Stuebe AM, Penders T, Thorp J, Rubinow DR, Meltzer-Brody S. Adverse life events, psychiatric history, and biological predictors of postpartum depression in an ethnically diverse sample of postpartum women. Psychol Med 2018; 48:1190-1200. [PMID: 28950923 PMCID: PMC6792292 DOI: 10.1017/s0033291717002641] [Citation(s) in RCA: 81] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Race, psychiatric history, and adverse life events have all been independently associated with postpartum depression (PPD). However, the role these play together in Black and Latina women remains inadequately studied. Therefore, we performed a case-control study of PPD, including comprehensive assessments of symptoms and biomarkers, while examining the effects of genetic ancestry. METHODS We recruited our sample (549 cases, 968 controls) at 6 weeks postpartum from obstetrical clinics in North Carolina. PPD status was determined using the MINI-plus. Psychiatric history was extracted from medical records. Participants were administered self-report instruments to assess depression (Edinburgh Postnatal Depression Scale) and adverse life events. Levels of estradiol, progesterone, brain-derived neurotrophic factor, oxytocin, and allopregnanalone were assayed. Principal components from genotype data were used to estimate genetic ancestry and logistic regression was used to identify predictors of PPD. RESULTS This population was racially diverse (68% Black, 13% Latina, 18% European). Genetic ancestry was not a predictor of PPD. Case status was predicted by a history of major depression (p = 4.01E-14), lifetime anxiety disorder diagnosis (p = 1.25E-34), and adverse life events (p = 6.06E-06). There were no significant differences between groups in any hormones or neurosteroids. CONCLUSIONS Psychiatric history and multiple exposures to adverse life events were significant predictors of PPD in a population of minority and low-income women. Genetic ancestry and hormone levels were not predictive of case status. Increased genetic vulnerability in conjunction with risk factors may predict the onset of PPD, whereas genetic ancestry does not appear predictive.
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Affiliation(s)
- J Guintivano
- Department of Psychiatry,University of North Carolina,Chapel Hill, NC,USA
| | - P F Sullivan
- Department of Psychiatry,University of North Carolina,Chapel Hill, NC,USA
| | - A M Stuebe
- Department of Obstetrics and Gynecology,University of North Carolina,NC,USA
| | - T Penders
- Department of Psychiatry and Behavioral Medicine,East Carolina University,NC,USA
| | - J Thorp
- Department of Obstetrics and Gynecology,University of North Carolina,NC,USA
| | - D R Rubinow
- Department of Psychiatry,University of North Carolina,Chapel Hill, NC,USA
| | - S Meltzer-Brody
- Department of Psychiatry,University of North Carolina,Chapel Hill, NC,USA
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Qu F, Beukman AJA, Nadj-Perge S, Wimmer M, Nguyen BM, Yi W, Thorp J, Sokolich M, Kiselev AA, Manfra MJ, Marcus CM, Kouwenhoven LP. Electric and Magnetic Tuning Between the Trivial and Topological Phases in InAs/GaSb Double Quantum Wells. Phys Rev Lett 2015; 115:036803. [PMID: 26230816 DOI: 10.1103/physrevlett.115.036803] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2015] [Indexed: 06/04/2023]
Abstract
Among the theoretically predicted two-dimensional topological insulators, InAs/GaSb double quantum wells (DQWs) have a unique double-layered structure with electron and hole gases separated in two layers, which enables tuning of the band alignment via electric and magnetic fields. However, the rich trivial-topological phase diagram has yet to be experimentally explored. We present an in situ and continuous tuning between the trivial and topological insulating phases in InAs/GaSb DQWs through electrical dual gating. Furthermore, we show that an in-plane magnetic field shifts the electron and hole bands relatively to each other in momentum space, functioning as a powerful tool to discriminate between the topologically distinct states.
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Affiliation(s)
- Fanming Qu
- QuTech and Kavli Institute of Nanoscience, Delft University of Technology, 2600 GA Delft, The Netherlands
| | - Arjan J A Beukman
- QuTech and Kavli Institute of Nanoscience, Delft University of Technology, 2600 GA Delft, The Netherlands
| | - Stevan Nadj-Perge
- QuTech and Kavli Institute of Nanoscience, Delft University of Technology, 2600 GA Delft, The Netherlands
| | - Michael Wimmer
- QuTech and Kavli Institute of Nanoscience, Delft University of Technology, 2600 GA Delft, The Netherlands
| | - Binh-Minh Nguyen
- HRL Laboratories, 3011 Malibu Canyon Road, Malibu, California 90265, USA
| | - Wei Yi
- HRL Laboratories, 3011 Malibu Canyon Road, Malibu, California 90265, USA
| | - Jacob Thorp
- HRL Laboratories, 3011 Malibu Canyon Road, Malibu, California 90265, USA
| | - Marko Sokolich
- HRL Laboratories, 3011 Malibu Canyon Road, Malibu, California 90265, USA
| | - Andrey A Kiselev
- HRL Laboratories, 3011 Malibu Canyon Road, Malibu, California 90265, USA
| | - Michael J Manfra
- Department of Physics, Purdue University, West Lafayette, Indiana 47907, USA
| | - Charles M Marcus
- Center for Quantum Devices, Niels Bohr Institute, University of Copenhagen, 2100 Copenhagen, Denmark
| | - Leo P Kouwenhoven
- QuTech and Kavli Institute of Nanoscience, Delft University of Technology, 2600 GA Delft, The Netherlands
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Davis CE, Kyle BN, Thorp J, Wu Q, Firnhaber J. Comparison of Pain, Functioning, Coping, and Psychological Distress in Patients with Chronic Low Back Pain Evaluated for Spinal Cord Stimulator Implant or Behavioral Pain Management. Pain Med 2015; 16:753-60. [DOI: 10.1111/pme.12526] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Thorp J. Economics—questions rather than answers. BJOG 2015; 122:1225. [PMID: 25573080 DOI: 10.1111/1471-0528.13204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- J Thorp
- University of North Carolina Center for Women's Health Research, Chapel Hill, NC, USA
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Bailit JL, Grobman W, Zhao Y, Wapner RJ, Reddy UM, Varner MW, Leveno KJ, Caritis SN, Iams JD, Tita AT, Saade G, Sorokin Y, Rouse DJ, Blackwell SC, Tolosa JE, VanDorsten JP, Mercer B, Milluzzi C, Dalton W, Dotson T, McDonald P, Brezine C, McGrail A, Mallett G, Ramos-Brinson M, Roy A, Stein L, Campbell P, Collins C, Jackson N, Dinsmoor M, Senka J, Paychek K, Peaceman A, Talucci M, Zylfijaj M, Reid Z, Leed R, Benson J, Forester S, Kitto C, Davis S, Falk M, Perez C, Hill K, Sowles A, Postma J, Alexander S, Andersen G, Scott V, Morby V, Jolley K, Miller J, Berg B, Thorp J, Dorman K, Mitchell J, Kaluta E, Clark K, Spicer K, Timlin S, Wilson K, Moseley L, Santillan M, Price J, Buentipo K, Bludau V, Thomas T, Fay L, Melton C, Kingsbery J, Benezue R, Simhan H, Bickus M, Fischer D, Kamon T, DeAngelis D, Shubert P, Latimer C, Guzzo L, Johnson F, Gerwig L, Fyffe S, Loux D, Frantz S, Cline D, Wylie S, Iams J, Wallace M, Northen A, Grant J, Colquitt C, Moss J, Salazar A, Acosta A, Hankins G, Hauff N, Palmer L, Lockhart P, Driscoll D, Wynn L, Sudz C, Dengate D, Girard C, Field S, Breault P, Smith F, Annunziata N, Allard D, Silva J, Gamage M, Hunt J, Tillinghast J, Corcoran N, Jimenez M, Ortiz F, Givens P, Rech B, Moran C, Hutchinson M, Spears Z, Carreno C, Heaps B, Zamora G, Seguin J, Rincon M, Snyder J, Farrar C, Lairson E, Bonino C, Smith W, Beach K, Van Dyke S, Butcher S, Thom E, Rice M, McGee P, Momirova V, Palugod R, Reamer B, Larsen M, Williams T, Spong C, Tolivaisa S. Nonmedically indicated induction vs expectant treatment in term nulliparous women. Am J Obstet Gynecol 2015; 212:103.e1-7. [PMID: 24983681 DOI: 10.1016/j.ajog.2014.06.054] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2014] [Revised: 05/27/2014] [Accepted: 06/23/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE The purpose of this study was to compare maternal and neonatal outcomes in nulliparous women with nonmedically indicated inductions at term vs those expectantly treated. STUDY DESIGN Data were obtained from maternal and neonatal charts for all deliveries on randomly selected days across 25 US hospitals over a 3-year period. A low-risk subset of nulliparous women with vertex nonanomalous singleton gestations who delivered 38 0/7 to 41 6/7 weeks were selected. Maternal and neonatal outcomes for nonmedically indicated induction within each week were compared with women who did not undergo nonmedically indicated induction during that week. Multivariable analysis was used to adjust for hospital, maternal age, race/ethnicity, body mass index, cigarette use, and insurance status. RESULTS We found 31,169 women who met our criteria. Neonatal complications were either less frequent with nonmedically indicated induction or no different between groups. Nonmedically indicated induction was associated with less frequent peripartum infections (odds ratio [OR], 0.39; 95% confidence interval [CI], 0.16-0.98) at 38 weeks of gestation and less frequent third- and fourth-degree lacerations (OR, 0.60; 95% CI, 0.42-0.86) and less frequent peripartum infections (OR, 0.66; 95% CI, 0.49-0.90) at 39 weeks of gestation. Nonmedically indicated induction was associated with a longer admission-to-delivery time by approximately 3-4 hours and increased odds of cesarean delivery at 38 (OR, 1.50; 95% CI, 1.08-2.08) and 40 weeks (OR, 1.30; 95% CI, 1.15-1.46) of gestation. CONCLUSION At 39 weeks of gestation, nonmedically indicated induction is associated with lower maternal and neonatal morbidity than women who are expectantly treated.
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Thorp J, Palacios S, Symons J, Simon J, Barbour K. Improving prospects for treating hypoactive sexual desire disorder (HSDD): development status of flibanserin. BJOG 2014; 121:1328-31. [DOI: 10.1111/1471-0528.12878] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2014] [Indexed: 01/23/2023]
Affiliation(s)
- J Thorp
- Department of Obstetrics and Gynecology; University of North Carolina; Chapel Hill NC USA
| | | | - J Symons
- Sprout Pharmaceuticals, Inc.; Raleigh NC USA
| | - J Simon
- Sprout Pharmaceuticals, Inc.; Raleigh NC USA
- Department of Obstetrics and Gynecology; George Washington University; Women's Health & Research Consultants (r); Washington DC USA
| | - K Barbour
- Sprout Pharmaceuticals, Inc.; Raleigh NC USA
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Mercier RJ, Garrett J, Thorp J, Siega-Riz AM. Pregnancy intention and postpartum depression: secondary data analysis from a prospective cohort. BJOG 2013; 120:1116-22. [PMID: 23651010 DOI: 10.1111/1471-0528.12255] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess the relationship between unintended pregnancy and postpartum depression. DESIGN Secondary analysis of data from a prospective pregnancy cohort. SETTING The study was performed at the University of North Carolina prenatal care clinics. POPULATION/SAMPLE Pregnant women enrolled for prenatal care at the University of North Carolina Hospital Center. METHODS Participants were questioned about pregnancy intention at 15-19 weeks of gestation, and classified as having an intended, mistimed or unwanted pregnancy. They were evaluated for postpartum depression at 3 and 12 months postpartum. Log binomial regression was used to assess the relationship between unintended pregnancy and depression, controlling for confounding by demographic factors and reproductive history. MAIN OUTCOME MEASURES Depression at 3 and 12 months postpartum, defined as Edinburgh Postpartum Depression Scale score >13. RESULTS Data were analysed for 688 women at 3 months and 550 women at 12 months. Depression was more likely in women with unintended pregnancies at both 3 months (risk ratio [RR] 2.1, 95% confidence interval [95% CI] 1.2-3.6) and 12 months (RR 3.6, 95% CI 1.8-7.1). Using multivariable analysis adjusting for confounding by age, poverty and education level, women with unintended pregnancies were twice as likely to have postpartum depression at 12 months (RR 2.0, 95% CI 0.96-4.0). CONCLUSION While many elements may contribute to postpartum depression, unintended pregnancy could also be a contributing factor. Women with unintended pregnancy may have an increased risk of depression up to 1 year postpartum.
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Affiliation(s)
- R J Mercier
- Department of Obstetrics and Gynecology, UNC School of Medicine, Chapel Hill, NC 27599, USA.
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Affiliation(s)
- S Meltzer-Brody
- University of North Carolina at Chapel Hill, Obstetrics and Gynaecology, Chapel Hill, NC 27599-7570, USA
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Salafia CM, Yampolsky M, Misra DP, Shlakhter O, Haas D, Eucker B, Thorp J. Placental surface shape, function, and effects of maternal and fetal vascular pathology. Placenta 2010; 31:958-62. [PMID: 20933281 DOI: 10.1016/j.placenta.2010.09.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2010] [Revised: 08/26/2010] [Accepted: 09/07/2010] [Indexed: 10/19/2022]
Abstract
GOAL In clinical practice, variability of placental surface shape is common. We measure the average placental shape in a birth cohort and the effect deviations from the average have on placental functional efficiency. We test whether altered placental shape improves the specificity of histopathology diagnoses of maternal uteroplacental and fetoplacental vascular pathology for clinical outcomes. MATERIALS AND METHODS 1225 Placentas from a prospective cohort had chorionic plate digital photographs with perimeters marked at 1-2 cm intervals. After exclusions of pre-term (n = 202) and velamentous cord insertion (n = 44), 979 (95.7%) placentas were analyzed. Median shape and mean perimeter were estimated. The relationship of fetal and placental weight was used as an index of placental efficiency termed "β". The principal placental histopathology diagnoses of maternal uteroplacental and fetoplacental vascular pathologies were coded by review of individual lesion scores. Acute fetal inflammation was scored as a "negative control" pathology not expected to affect shape. ANOVA with Bonferroni tests for subgroup comparisons were used. RESULTS The mean placental chorionic shape at term was round with a radius estimated at 9.1 cm. Increased variability of the placental shape was associated with lower placental functional efficiency. After stratifying on placental shape, the presence of either maternal uteroplacental or fetoplacental vascular pathology was significantly associated with lower placental efficiency only when shape was abnormal. CONCLUSIONS Quantifying abnormality of placental shape is a meaningful clinical tool. Abnormal shapes are associated with reduced placental efficiency. We hypothesize that such shapes reflect deformations of placental vascular architecture, and that an abnormal placental shape serves as a marker of maternal uteroplacental and/or fetoplacental vascular pathology of sufficiently long standing to impact placental (and by extension, potentially fetal) development.
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Affiliation(s)
- C M Salafia
- Placental Analytics, LLC, 93 Colonial Avenue, Larchmont, NY 10538, USA.
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Thorp J, Jolly E, Sand M. Efficacy of flibanserin 100 mg QHS in premenopausal women with hypoactive sexual desire disorder (HSDD): sexual satisfaction. Fertil Steril 2010. [DOI: 10.1016/j.fertnstert.2010.07.865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Yampolsky M, Salafia CM, Shlakhter O, Haas D, Eucker B, Thorp J. Centrality of the umbilical cord insertion in a human placenta influences the placental efficiency. Placenta 2009; 30:1058-64. [PMID: 19879649 DOI: 10.1016/j.placenta.2009.10.001] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2009] [Revised: 09/29/2009] [Accepted: 10/01/2009] [Indexed: 11/25/2022]
Abstract
GOAL We assess the effect on placental efficiency of the non-centrality of the umbilical cord insertion and on chorionic vascular distribution to determine if cord centrality measurably affects placental function as reflected in birth weight. MATERIALS AND METHODS 1225 placentas collected from a prospective cohort had digital photographs of the chorionic plate. Of these, 1023 were term, 44 had velamentous cord insertion and 12 had missing clinical data, leaving N=967 (94.5%) cases for analysis. Mathematical tools included a dynamical stochastic growth model of placental vasculature, Fourier analysis of radial parameterization of placental perimeters, and relative chorionic vascular density (a measure of "gaps" in the vascular coverage) derived from manual tracings of the fetal chorionic surface images. Bivariate correlations used Pearson's or Spearman's rank correlation as appropriate, with p<0.05 considered significant. RESULTS The correlation of the standard deviation of the placental radius (a measure of non-roundness of the placenta) with cord displacement was negligible (r=0.01). Empirical simulations of the vascular growth model with cord displacement showed no deviation from a normal round-to-oval placental shape for cord displacement of 10-50% of placental radius. The correlation of the metabolic scaling exponent beta with cord displacement measured by Fourier analysis is 0.17 (p<0.001). Analysis of the chorionic vascular density in traced images shows a high correlation of the relative vascular distance with cord displacement: 0.59 in one set of 12 images, and 0.20 in the other set of 28 images. CONCLUSION Non-central cord insertion has little measurable correlation with placental shape in observed or simulated placentas. However, placentas with a displaced cord show a markedly reduced transport efficiency, reflected in a larger value of beta and hence in a smaller birth weight for a given placental weight. Placentas with a non-central cord insertion have a sparser chorionic vascular distribution, as measured by the relative vascular distance. Even if typically a placenta with a non-central insertion is of a normal round shape, its vasculature is less metabolically effective. These findings demonstrate another method by which altered placental structure may affect the fetal environment, influencing birth weight and potentially contributing to later health risks.
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Affiliation(s)
- M Yampolsky
- Department of Mathematics, University of Toronto, Ontario, Canada.
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Yampolsky M, Salafia CM, Shlakhter O, Haas D, Eucker B, Thorp J. Modeling the variability of shapes of a human placenta. Placenta 2008; 29:790-7. [PMID: 18674815 PMCID: PMC2570048 DOI: 10.1016/j.placenta.2008.06.005] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/28/2008] [Revised: 06/12/2008] [Accepted: 06/16/2008] [Indexed: 11/25/2022]
Abstract
BACKGROUND Placentas are generally round/oval in shape, but "irregular" shapes are common. In the Collaborative Perinatal Project data, irregular shapes were associated with lower birth weight for placental weight, suggesting variably shaped placentas have altered function. METHODS (I) Using a 3D one-parameter model of placental vascular growth based on Diffusion Limited Aggregation (an accepted model for generating highly branched fractals), models were run with a branching density growth parameter either fixed or perturbed at either 5-7% or 50% of model growth. (II) In a data set with detailed measures of 1207 placental perimeters, radial standard deviations of placental shapes were calculated from the umbilical cord insertion, and from the centroid of the shape (a biologically arbitrary point). These two were compared to the difference between the observed scaling exponent and the Kleiber scaling exponent (0.75), considered optimal for vascular fractal transport systems. Spearman's rank correlation considered p<0.05 significant. RESULTS (I) Unperturbed, random values of the growth parameter created round/oval fractal shapes. Perturbation at 5-7% of model growth created multilobate shapes, while perturbation at 50% of model growth created "star-shaped" fractals. (II) The radial standard deviation of the perimeter from the umbilical cord (but not from the centroid) was associated with differences from the Kleiber exponent (p=0.006). CONCLUSIONS A dynamical DLA model recapitulates multilobate and "star" placental shapes via changing fractal branching density. We suggest that (1) irregular placental outlines reflect deformation of the underlying placental fractal vascular network, (2) such irregularities in placental outline indicate sub-optimal branching structure of the vascular tree, and (3) this accounts for the lower birth weight observed in non-round/oval placentas in the Collaborative Perinatal Project.
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Affiliation(s)
- M Yampolsky
- Department of Mathematics, University of Toronto, 40 St. George Street, Toronto, Ontario, Canada M5S2E4.
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Viswanathan M, Hartmann K, Palmieri R, Lux L, Swinson T, Lohr KN, Gartlehner G, Thorp J. The use of episiotomy in obstetrical care: a systematic review. Evid Rep Technol Assess (Summ) 2005:1-8. [PMID: 15910014 PMCID: PMC4780926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
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Fogleman K, Thorp J, Herring A. Factors that Influence the Timing of Spontaneous Labor at Term. J Investig Med 2003. [DOI: 10.1177/108155890305100620] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Affiliation(s)
- K Fogleman
- University of North Carolina-Chapel Hill Doris Duke Clinical Research Fellowship Program, Chapel Hill, NC
| | - J Thorp
- University of North Carolina-Chapel Hill Doris Duke Clinical Research Fellowship Program, Chapel Hill, NC
| | - A Herring
- University of North Carolina-Chapel Hill Doris Duke Clinical Research Fellowship Program, Chapel Hill, NC
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Fogleman K, Thorp J, Herring A. FACTORS THAT INFLUENCE THE TIMING OF SPONTANEOUS LABOR AT TERM. J Investig Med 2003. [DOI: 10.1136/jim-51-06-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Bender DE, Harbour C, Thorp J, Morris P. Tell me what you mean by "sí": perceptions of quality of prenatal care among immigrant Latina women. Qual Health Res 2001; 11:780-94. [PMID: 11710077 DOI: 10.1177/104973230101100607] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Individual perceptions form the basis of many health research reports related to access, utilization, continuity, and quality. Many health care providers are not well equipped for designing studies or collecting data with immigrant populations. In this article, the authors examine issues in data collection on topics related to perceptions of quality of prenatal care among immigrant Latino populations. The conceptual model is Donabedian's framework for quality. Two instruments--a qualitative interview with photographs representing components of quality and a questionnaire--were used for data collection. Examples of narrative responses given by women in response to the photo-narrative prompts are presented and compared to shorter survey responses. The authors emphasize the importance of designing research instruments that reflect the perceptions of the research subjects rather than simply those of the investigators.
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Affiliation(s)
- D E Bender
- University of North Carolina School of Public Health
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Abstract
BACKGROUND Primary pulmonary hypertension is a rare and dangerous entity in pregnancy. Previous studies have found a 35-50% maternal mortality rate in the peripartum period. To date, most reports have described treatment of these patients with diuretics, digoxin, and calcium-channel blockers. CASE We describe the successful treatment of a primigravida with severe primary pulmonary hypertension. We used elective intubation before labor, inhaled nitric oxide therapy, and assisted vaginal delivery with epidural anesthesia that resulted in a viable infant and survival of the mother. CONCLUSION Nitric oxide can be used to successfully treat primary pulmonary hypertension in pregnancy.
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Affiliation(s)
- G K Lam
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of North Carolina School of Medicine, Chapel Hill, North Carolina 27599, USA.
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Bernhardt JM, Strecher VJ, Bishop KR, Potts P, Madison EM, Thorp J. Handheld computer-assisted self-interviews: user comfort level and preferences. Am J Health Behav 2001; 25:557-63. [PMID: 11720303 DOI: 10.5993/ajhb.25.6.5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES To examine the comfort level and survey preferences of participants who completed handheld computer-assisted self-interviews (H-CASI). METHODS Obstetrics patients (N=187) were surveyed about their comfort with the H-C
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Affiliation(s)
- J M Bernhardt
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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22
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Thorp J. Acute tocolysis for treatment of preterm labor: review and meta-analysis. Obstet Gynecol 2000. [DOI: 10.1016/s0029-7844(00)00770-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Royce RA, Thorp J, Granados JL, Savitz DA. Bacterial vaginosis associated with HIV infection in pregnant women from North Carolina. J Acquir Immune Defic Syndr Hum Retrovirol 1999; 20:382-6. [PMID: 10096583 DOI: 10.1097/00042560-199904010-00009] [Citation(s) in RCA: 53] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND We investigated whether bacterial vaginosis is associated with HIV infection in pregnant women in North Carolina, U.S.A. METHODS At 24 to 29 weeks' gestation, we recruited 724 women receiving prenatal care to provide interview information and vaginal swabs for Gram's stain scoring of vaginal flora. FINDINGS As vaginal flora score increased, prevalence of HIV increased (trend p = .03). HIV prevalence was 0.8% (4 of 489 patients), 1.2% (1 of 84 patients), and 3.3% (5 of 151 patients) among women with normal, intermediate, and abnormal vaginal flora, respectively. All HIV-infected women were free from AIDS and were taking antiretroviral medication. Compared with women with normal vaginal flora, the relative risk for prevalence of HIV infection with intermediate flora was 1.5 (95% confidence interval [CI], 0.2, 12.9) and with abnormal flora was 4.0 (95% CI, 1.1, 14.9). The association between abnormal vaginal flora and HIV infection could not be explained by age, ethnicity, number of sexual partners in the past 6 months, sexually transmitted diseases (STDs), or douching during pregnancy. INTERPRETATION In a population with a relatively low HIV prevalence, vaginal flora abnormalities were associated with prevalent HIV infection. We cannot determine whether vaginal flora abnormalities increase women's susceptibility to HIV infection or become more common after infection. The increased prevalence of bacterial vaginosis among HIV-infected pregnant women increases risk for preterm delivery. Incidence studies are required to discern whether control of bacterial vaginosis might reduce HIV infectivity.
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Affiliation(s)
- R A Royce
- University of North Carolina, Chapel Hill 27599, USA
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25
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Abstract
Untreated hyperthyroidism during pregnancy is associated with increased maternal and perinatal morbidity. Some features of this disease simulate preeclampsia, which may encourage delivery of the fetus. We report a case of poorly controlled hyperthyroidism associated with generalized seizures, where patient management was directed at a diagnosis of preeclampsia-eclampsia. Although the presence of eclampsia and marked hyperthyroidism is very rare, this case illustrates the importance of aggressive medical management of hyperthyroidism. A 17-year-old gravida was diagnosed with hyperthyroidism at 15 weeks' gestation. At 26 weeks' gestation, she was admitted to the hospital after noting edema of the upper and lower extremities, nausea, vomiting, shortness of breath, and a cough. At admission, she was hypertensive, tachycardic, and dyspneic. The patient was believed to have preeclampsia with pulmonary edema complicated by hyperthyroidism. We initiated magnesium sulfate therapy and administered several bolus doses of hydralazine, with little effect on blood pressure. Oliguria was noted, and a pulmonary artery catheter was inserted. Hours later, generalized seizure activity occurred, and a decision was made for abdominal delivery. Postoperatively, cardiovascular function stabilized. On postoperative day 3, we received the results of the thyroid function tests obtained at admission, which suggested a markedly hyperthyroid condition. Untreated or poorly treated hyperthyroidism may present a clinical picture similar to preeclampsia. In our case, both disease processes coexisted in their severest forms. It is possible, although completely unproven, that a relationship exists between poorly controlled hyperthyroidism and preeclampsia-eclampsia. More importantly, accurate diagnosis of hyperthyroidism should lead to prompt medical or surgical management, thereby decreasing maternal and perinatal morbidity.
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Affiliation(s)
- D C Mayer
- Department of Anesthesiology, University of North Carolina School of Medicine, Chapel Hill 27599, USA
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Thorp J. HISStory lessons. Health Serv J 1992; 102:32. [PMID: 10123550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/11/2023]
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Cohen GR, Thorp J, Yeast JD, Meyer BA, O'Kell R, Macy C. A markedly immature lecithin-sphingomyelin ratio at term and congenital hypothyroidism. Am J Dis Child 1991; 145:1227-8. [PMID: 1951210 DOI: 10.1001/archpedi.1991.02160110017011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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Cohen GR, Kramer P, Thorp J, Yeast J. Percutaneous balloon mitral valvuloplasty in a pregnant woman with mitral stenosis, sickle cell crisis and acute pulmonary edema. A case report. J Reprod Med 1991; 36:759-60. [PMID: 1956018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
A woman with acute congestive heart failure secondary to mitral stenosis and sickle cell crisis was treated successfully with a combination of an exchange transfusion and percutaneous balloon valvuloplasty. That combination provided an alternative to surgical mitral commissurotomy, with its significant risks for both the mother and fetus. The patient was able to undergo an uncomplicated pregnancy course despite the increased risk of cardiac decompensation in the intrapartum and postpartum period.
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Affiliation(s)
- G R Cohen
- St. Luke's Perinatal Center, Kansas City, MO 64111
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29
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Mittleman K, Thorp J, Haberman K, Bilanin J, Doubt T. THERMAL CHANGES DURING INTERMITTENT WORK IN COOL WATER AFTER CARBOHYDRATE LOADING. Med Sci Sports Exerc 1989. [DOI: 10.1249/00005768-198904001-00280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Maxwell VB, Crump JH, Thorp J. The measurement of risk indicators for coronary heart disease in air traffic control officers: a screening study in a healthy population. Aviat Space Environ Med 1983; 54:246-9. [PMID: 6847560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We describe an attempt to improve the predictive value of the routine annual medical examination of Air Traffic Control Officers by extending its scope. In addition to the four well-recognised coronary heart disease risk indicators--age, smoking habit, family history of coronary heart disease, and systolic blood pressure--we measured plasma fibrinogen, serum total, and high-density lipoprotein cholesterol. Relative risk of coronary heart disease was assessed for each subject using a multiple logistic equation, and then compared with a large matched control. There were no statistical differences between the risk factors in the two groups. The factors measured do not support the view that air traffic control produces an increased risk of coronary heart disease, despite the alleged connection between stress and coronary heart disease. However, the gradient of risk within the air traffic control population should be evaluated in those at highest risk.
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Thorp J. Medico-technical devices--reporting of accidents. Hosp Eng 1980; 34:20. [PMID: 10248958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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32
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Mittleman K, Thorp J, Haberman K, Bilanin J, Doubt T. THERMAL CHANGES DURING INTERMITTENT WORK IN COOL WATER AFTER CARBOHYDRATE LOADING. Med Sci Sports Exerc 1980. [DOI: 10.1249/00005768-198004001-00280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Thorp J. Economic consideration in adopting electronic equipment. World Hosp 1976; 13:192-4. [PMID: 10305870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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34
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Allgén LG, Ekelund LG, Hultman E, Kallner A, Lindstedt S, Roos K, Thorp J, De VERDIER CH. [New units of measurement in medicine]. Lakartidningen 1973; 70:4405-7. [PMID: 4787912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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