Study rationale The incidence, location, morphology and size characteristics of cerebral aneurysms in patients presenting to Groote Schuur hospital with either subarachnoid haemorrhage or 3 rd nerve palsy have not been established by a formal audit. Objectives To determine the patient demographics, frequency of CT angiographic detection of cerebral aneurysms and aneurysmal characteristics in patients presenting to Groote Schuur Hospital with sub-arachnoid haemorrhage and /or 3 rd nerve palsy Materials and methods Computed tomographic angiographic reports of cerebral vessels of patients who presented either with subarachnoid haemorrhage or 3 rd nerve palsy to Groote Schuur hospital were reviewed over a 19-month period from January 2018 – July 2019. The data obtained were coded, entered and analysed using IBM SPSS version 25 software. Descriptive statistics was used to report the means, modes and frequencies. Demographic and aneurysmal data were compared with a similar period 5 years previously. Results One hundred and twenty-one aneurysms (121) were analysed in 2018 -2019 and 124 in 2013-2014. The large majority were solitary (92% in both groups), small (94% and 90%) and saccular (96% and 87%) respectively. Significantly more fusiform aneurysms (13% vs 6%) were seen in the earlier group. 8 % of patients had multiple aneurysms. Less than 1% were ‘giant' ( >20mm). The mean age of the patients was the same for both periods (47 years). The mean aneurysm body size was 5.7mm and 7.1mm and the mean body: neck ratio was 6 2.1 vs 1.8b). Themost frequent locations were the posterior communicating artery (31.4% [2018/2019], 35% [2013- 2014]), anterior communicating artery (29% [2018/2019], 18.5% [2013/2014]) and the middle Cerebral Arteries (13.2% [2018/2019], 13.7% [2013/2014]). The least common sites were the Superior Cerebellar artery (SCA) [2018/2019] and the Vertebral artery (0.8%) [2013/2014]. Conclusion This study has compared the demographics of patients presenting to Groote Schuur Hospital with CT angiographically confirmed symptomatic intracranial aneurysms over two periods (January to July) 5 years apart. Both the patient demographics and the aneurysmal architecture were consistent over these time periods. Further our findings conform to that described previously both in Southern Africa and abroad i.e aneurysms which have bled are most commonly related to the posterior communicating, anterior communicating and the middle cerebral arteries and most aneurysms are small and saccular in shape. Over the periods studied, there was no change in the number of patients presenting to Groote Schuur Hospital for CT cerebral angiography and Interventional treatment post aneurysm rupture. These data represent a baseline for future statistical comparison and the information extrapolated from this study will be useful for interventive planning and resource mobilization at our institution and within the Western Cape Department of Health.

archives@tulane.edu / Zika virus (ZIKV), a member of the Flaviviridae family, was the cause of a large viral outbreak reaching across the Americas during 2015 and 2016. Discovered in 1947, it has historically been a neglected disease, due to its emergence in humans on a large scale being recent. At the time of the outbreak, no FDA approved ZIKV diagnostics existed, and those that were able to detect the virus were unable to distinguish it from related viruses such as Dengue virus (DENV), and at this time, no approved therapeutics or vaccines are available. We investigated the ability of diagnostics targeted toward both anti-NS1 antibodies and NS1 antigen circulating during infection to detect current or past ZIKV disease, as well as the capability of NS1 to produce a protective response. Our studies suggest anti-NS1diagnostics are feasible, though some populations may display an immune response reminiscent of a prior infection. Levels of circulating NS1 were lower than those produced during DENV infection, though were still detectable with our assay. Additionally, intraperitoneal immunization with NS1 produced an anti-ZIKV NS1 response that coincided with a decrease in viremia, though further work was needed to discern life-prolonging effects. Together, this work furthers the development of the tools necessary to combat future outbreaks of ZIKV in vulnerable populations. / 1 / Brandon Beddingfield

La maladie d'Alzheimer (MA) et les troubles neurocognitifs associés représentent l'un des plus grands défis de santé publique de notre époque. Le développement de tests de dépistage cognitifs et de différents outils diagnostics tels que l'imagerie structurelle ont permis d'améliorer le dépistage et le diagnostic de la MA. Néanmoins, il est maintenant bien reconnu que la MA peut se présenter de façon atypique, par des déficits initialement isolés aux sphères langagières, visuospatiales ou comportementales, avec préservation relative de la mémoire. Le diagnostic différentiel des troubles neurocognitifs s'est aussi élargi pour inclure les différentes variantes cliniques de la démence frontotemporale (DFT), des syndromes parkinsoniens atypiques, etc. La reconnaissance et le diagnostic de ces troubles neurocognitifs sont actuellement sous-optimaux, entraînant des délais de diagnostic et de traitement. Différents outils diagnostics ont été développés pour améliorer le dépistage de ces troubles neurocognitifs atypiques en clinique de mémoire académique. Les objectifs de ce travail doctoral sont d' : 1. Améliorer notre compréhension et caractérisation des variantes non amnésiques de la MA. 2. Optimiser l'utilisation et l'interprétation d'outils diagnostiques pour améliorer le diagnostic des troubles neurocognitifs atypiques. Ce travail doctoral s'articule autour de deux objectifs, six études principales et dix publications additionnelles. Objectif 1 : Améliorer notre compréhension et la caractérisation des variantes non amnésiques de la MA. - Étude 1 : Revue systématique de la littérature sur les variantes non amnésiques de la MA et des causes de sa variabilité clinique anatomique. - Étude 2 : Étude rétrospective sur le profil clinique anatomique de la MA frontale. - Étude 3 : Étude multicentrique sur la caractérisation de l'aphasie primaire progressive liée à la MA. Objectif 2 : Optimiser l'utilisation et l'interprétation d'outils diagnostics pour améliorer le diagnostic des troubles neurocognitifs atypiques. - Étude 4 : Interprétation d'un hypométabolisme du gyrus cingulaire postérieur à la TEP-FDG dans les variantes non mnésiques de la MA. - Étude 5 : Méta-analyse sur la valeur prédictive positive et la valeur prédictive négative de la TEP amyloïde. - Étude 6 : Impact de l'analyse des biomarqueurs Alzheimer dans le LCR sur le diagnostic des troubles neurocognitifs en clinique de mémoire.

Montréal Trigonix inc. 2018

Myxomatous mitral valve degeneration (MMVD) is the most common canine cardiac disease. In the studies presented in this dissertation, we used advanced echocardiographic techniques to elucidate several aspects of MMVD in dogs. Our hypothesis was that the mitral valve (MV) morphology could have a role in the development of MMVD. First, we tested whether we could use real time three-dimensional transthoracic echocardiography (RT-3DTTE), and an offline software for MV analysis to evaluate canine MV. We described that the technique was feasible and repeatable, we evaluated the morphology of the MV in healthy dogs, and we provided reference values for MV morphologic variables in this species. Then, we used the same technique to compare healthy dogs to dogs affected by MMVD. We found that dogs affected by MMVD have more circular and flatter valve. We then analyzed the MV of healthy Cavalier King Charles Spaniels (CKCSs), given the high predisposition of this breed for MMVD. Our findings indicate that compared to healthy dogs of other breeds, the MV of healthy CKCSs is flatter and has less leaflet tenting, corroborating our hypothesis that an altered MV morphology could represent a predisposing factor for disease development. We also used RT–3DTTE to characterize the area of the regurgitant MV orifice of dogs affected with MMVD, finding that the technique requires further standardization in order to become clinically useful. The elevation of pulmonary venous pressure caused by MMVD can, in some dogs, cause pulmonary arterial hypertension (PH), which is a risk factor associated with worse outcome in dogs with MMVD. Diagnosis of PH in dogs with MMVD is usually made by estimating pulmonary pressure using Doppler echocardiography. We are currently evaluating the accuracy of this technique, compared to invasive measurement of pulmonary pressure. Only preliminary data are presented regarding this study, as the disclosure of the blinding would have infringed the power of the study. Our preliminary results demonstrate that there is only moderate agreement between the two techniques, indicating that caution should be used when deriving the non-invasive estimation of systolic pulmonary pressure in order to make clinical decisions. / Ph. D.

No

Background: The amount of time that it takes to get a breast cancer diagnosis is very important to patients. The Ontario diagnostic assessment unit (DAU) is designed to improve the quality and timeliness of care during a breast cancer diagnosis. This study described and examined the association between the length of the diagnostic interval and DAU use in Ontario, Canada. Methods: This was a retrospective cohort study among all breast cancer patients diagnosed between Jan 1st, 2011 and Dec 31st, 2011 in Ontario, Canada. DAU use and diagnostic intervals were described. The association between DAU use and the diagnostic interval was examined separately in a cohort of 2499 screen-detected patients and a cohort of 4381 symptomatic patients. Study data sources included administrative databases available at the Institute for Clinical Evaluative Sciences (ICES) and Cancer Care Ontario (CCO). The diagnostic interval was defined as the time from the index contact to the cancer diagnosis. DAU use was determined based on the payment record within the organized screening program as well as the hospital where patients were diagnosed. Multivariate median regressions were used to control for possible confounders. Results: On average, Ontario breast cancer patients waited 4.6 weeks to be diagnosed. Forty-eight percent were diagnosed in a DAU and 52% were diagnosed in the usual care route. In screen-detected patients, DAUs had a higher rate in meeting national timeliness targets compared to usual care (79.1% vs. 70.2%, p<0.001). DAU use was significantly associated with an 8.3-day decrease in the time to diagnosis (95% CI: 6.5-10.2) after controlling for potential confounders. In symptomatic patients, DAUs also had a higher rate in achieving the Canadian timeliness targets compare to usual care (71.7% vs. 58.1%, p<0.001). DAUs significantly reduced the time to diagnosis by 10 days (95% CI: 7.8-11.9) after controlling for possible confounders. Conclusions: We observed considerable variation in breast cancer diagnostic intervals and DAU use in Ontario. Use of Ontario DAUs was associated with improved diagnostic timeliness for breast cancer patients. / Thesis (Master, Community Health & Epidemiology) -- Queen's University, 2013-11-18 13:19:03.231

submitted by Chair Siu Fan. / Thesis (M.Sc.)--Chinese University of Hong Kong, 1998. / Includes bibliographical references (leaves 75-83). / Chapter 1 --- INTRODUCTION --- p.1 / Chapter 2 --- LITERATIRE REVIEW --- p.3 / Chapter 2.1 --- Causes and clinical syndromes in MPS --- p.3 / Chapter 2.1.1 --- MPS --- p.4 / Chapter 2.1.2 --- Classification of MPS --- p.4 / Chapter 2.1.2.1 --- MPS I (Hurler's syndrome) --- p.5 / Chapter 2.1.2.2 --- MPS IS (Scheie syndrome) --- p.5 / Chapter 2 .1.2.3 --- MPS II (Hunter's disease) --- p.6 / Chapter 2.1.2.4 --- MPS Type III (The Sanfilippo diseases) --- p.6 / Chapter 2.1.2.5 --- MPS Type IV (Morquio's disease) --- p.6 / Chapter 2.1.2.6 --- MPS Type VI (Maroteaux 一 Lamy syndrome) --- p.7 / Chapter 2.1.2.7 --- MPS Type VII (Sly syndrome) --- p.8 / Chapter 2.1.3 --- Treatment and prospects for MPS --- p.8 / Chapter 2.1.3.1 --- To manage the handicaps and disabilities --- p.8 / Chapter 2.1.3.2 --- Enzyme replacement --- p.9 / Chapter 2.1.3.3 --- Bone marrow transplantation --- p.10 / Chapter 2.2 --- Basic aspects of GAG --- p.10 / Chapter 2.2.1 --- Distributions of GAG --- p.12 / Chapter 2.2.2 --- Functions and Roles of GAG --- p.12 / Chapter 2.2.3 --- Stepwise degradation of GAGs --- p.12 / Chapter 2.2.4 --- Source of urinary GAG --- p.13 / Chapter 2.2.5 --- Common features of GAGS --- p.14 / Chapter 2.2.6 --- Factors affecting the excretion pattern ot GAG --- p.16 / Chapter 2.3 --- Methods for MPS Diagnosis --- p.16 / Chapter 2.3.1 --- Qualitative urine methods for screening and typing --- p.16 / Chapter 2.3.1.1 --- Spot tests --- p.16 / Chapter 2.3.1.2 --- Precipitation methods --- p.16 / Chapter 2.3.1.3 --- One-dimensional electrophoresis --- p.17 / Chapter 2.3.1.4 --- Two-dimensional electrophoresis --- p.17 / Chapter 2.3.1.5 --- Thin layer chromatography --- p.17 / Chapter 2.3.2 --- Quantitative methods for urinary GAG --- p.17 / Chapter 2.3.2.1 --- Measurement of hexuronic acid --- p.18 / Chapter 2.3.2.2 --- HPLC or Column chromatography --- p.18 / Chapter 2.3.2.3 --- Dye-binding methods --- p.19 / Chapter 2.3.3 --- Cytological studies --- p.19 / Chapter 2.3.4 --- Tissue culture --- p.20 / Chapter 2.3.5 --- Tissue biopsy --- p.20 / Chapter 2.3.6 --- Prenatal diagnosis of the MPS --- p.21 / Chapter 2.4 --- Bacterial GAG hydrolytic enzymes --- p.23 / Chapter 2.5 --- Summary of Literature Review --- p.25 / Chapter 3. --- AIMS OF STUDY --- p.26 / Chapter 4. --- MATERIALS AND METHODS --- p.26 / Chapter 4.1 --- Sample collection --- p.26 / Chapter 4.2 --- Materials &-Equipment --- p.26 / Chapter 4.3 --- Preparation of Reagents and Standards --- p.27 / Chapter 4.3.1 --- Stock DMB reagent solutions --- p.27 / Chapter 4.3.2 --- Working DMB solution --- p.27 / Chapter 4.3.3 --- GAG standards --- p.27 / Chapter 4.3.4 --- Reagents for electrophoresis --- p.27 / Chapter 4.3.4.1 --- 0.1M barium acetate solution --- p.27 / Chapter 4.3.4.2 --- 15% ethanolic barium acetate --- p.28 / Chapter 4.3.4.3 --- 50% ethanolic barium acetate --- p.28 / Chapter 4.3.4.4 --- Alcian blue working solution --- p.28 / Chapter 4.3.4.5 --- 0.1M Tris Buffer --- p.28 / Chapter 4.3.4.6 --- CTB Tris solution --- p.28 / Chapter 4.3.4.7 --- 2.0M lithium chloride --- p.28 / Chapter 4.3.5 --- Reagents for enzymatic degradation --- p.28 / Chapter 4.3.5.1 --- Reconstitution of CSE enzyme --- p.28 / Chapter 4.3.5.2 --- Reconstitution of DSE enzyme --- p.29 / Chapter 4.3.5.3 --- Reconstitution ofHSE I enzyme --- p.29 / Chapter 4.4 --- Methods --- p.31 / Chapter 4.4.1 --- Cobas Bio DMB method --- p.31 / Chapter 4.4.2 --- Cobas Fara DMB method --- p.31 / Chapter 4.4.3 --- Evaluation of methods --- p.31 / Chapter 4.4.3.1 --- To study the matrix effect --- p.31 / Chapter 4.4.3.2 --- Calibration --- p.31 / Chapter 4.4.3.3 --- Precision performance --- p.34 / Chapter 4.4.3.4 --- Linearity check --- p.34 / Chapter 4.4.3.5 --- Detection Limit --- p.34 / Chapter 4.4.3.6 --- Recovery study --- p.35 / Chapter 4.4.3.7 --- Correlation with Cobas Bio to develop the reference range --- p.35 / Chapter 4.4.4 --- Electrophoresis method --- p.36 / Chapter 4.4.4.1 --- Sample preparation --- p.36 / Chapter 4.4.4.2 --- Electrophoresis procedure --- p.36 / Chapter 4.4.5 --- Enzymatic degradation method --- p.37 / Chapter 4.4.5.1 --- Digestion of GAG in aqueous and urine matrix --- p.37 / Chapter 4.4.5.2 --- To optimize the amount of enzyme used to degrade GAG --- p.38 / Chapter 4.4.5.3 --- To study the specificity of GAG degrading enzyme --- p.39 / Chapter 4.4.5.4 --- To study the interaction of GAG --- p.40 / Chapter 4.4.5.5 --- To study the stability of enzyme CSE and DSE --- p.40 / Chapter 4.4.5.6 --- Study MPS patient sample --- p.41 / Chapter 5 --- Results --- p.42 / Chapter 5.1 --- Performance characteristics of the DMB method --- p.42 / Chapter 5.1.1 --- Matrix effect --- p.42 / Chapter 5.1.2 --- Calibration --- p.42 / Chapter 5.1.3 --- Precision performance --- p.42 / Chapter 5.1.4 --- Linearity Range --- p.42 / Chapter 5.1.5 --- Detection limit --- p.42 / Chapter 5.1.6 --- Recovery --- p.47 / Chapter 5.1.7 --- Correlation of Cobas Fara with Cobas Bio --- p.47 / Chapter 5.2 --- Results of GAG enzymatic degradation --- p.50 / Chapter 5.2.2 --- To optimise the amount of enzyme for GAG degradation --- p.57 / Chapter 5.2.3 --- The specificity of GAG degrading enzymes --- p.57 / Chapter 5.2.4 --- The interaction of GAG --- p.57 / Chapter 5.2.5 --- The stability of enzymes --- p.57 / Chapter 5.2.6 --- MPS patient study --- p.57 / Chapter 5.2.6.1 --- Type I/II/VI/VII --- p.57 / Chapter 5.2.6.2 --- MPS Type III patient 1 --- p.64 / Chapter 5.2.6.3 --- MPS Type IIIC patient 2 --- p.64 / Chapter 6. --- DISCUSSION --- p.67 / Chapter 6.1 --- Automated DMB method on Cobas Fara --- p.67 / Chapter 6 2 --- GAG specific degradation enzymes --- p.70 / Chapter 7. --- CONCLUSION & SUGGESTION FOR FUTURE STUDIES --- p.73 / Chapter 8. --- REFERENCES --- p.75

Les systèmes photovoltaïques (PV) peuvent être exploités dans différents lieux. L'exposition extérieure des panneaux PV mets en jeu une combinaison complexe de facteurs (le vent, la pluie, la neige, la chaleur, la foudre, ombrage, …) qui provoquent leurs dégradations au cours du temps et réduit leurs rendement. Le diagnostic est parmi les solutions intéressantes en vue de faire fonctionner des panneaux PV à leur puissance optimale et afin de maximiser l'efficacité de la conversion PV dans le but de réduire les coûts de maintenance. Dans ce travail de thèse, nous nous intéressons uniquement au diagnostic des générateurs PV. L'objectif de cette thèse est de proposer des outils de traitement de signal permettant de détecter et de localiser des défauts conduisant à une baisse de rendement. Pour mener ce travail, nous faisons tout d'abord un état de l'art sur les panneaux photovoltaïques de l'aspect microscopique (cellule) à l'aspect macroscopique (champs). Pour commencer, nous présentons le principe de fonctionnement d'une cellule photovoltaïque. Parallèlement à cela, nous décrivons les différents types de défauts et présentons un panorama des méthodes de leur détection. La seconde partie, consacrée aux outils théoriques. On rappelle la définition de la cyclostationnarité et des outils associés à la cyclostationnarité à l'ordre 1 (moyenne synchrone) et l'ordre 2 (corrélation spectrale). Les performances des panneaux PV dépendant principalement des conditions météorologiques (irradiance, température), ces conditions présentent des propriétés cyclostationnaires (CS) et permettent de décomposer les signaux en un motif cyclique (CSI) et un motif aléatoire cyclostationnaire à l'ordre 2 (CS2). La CS2 est associée à des phénomènes météorologiques comme les passages nuageux. À l'aide d'exemples, nous montrons que les outils classiques (Moyenne Synchrone,Cepstre) utilisés dans le domaine de la CS ne permettent pas une bonne séparation de la composante cyclique et la partie aléatoire pour le signal d'ensoleillement à cause de la variation d'amplitude d'un cycle à un autre engendré par l'effet de la saisonnalité. C'est pourquoi nous introduisons dans ce travail une méthode originale appelée ATSA adapté à ce type de signaux. Une troisième partie traitant de la modélisation de défauts indique comment construire une base de données de signaux électriques par simulation. De nombreux modèles électriques sont utilisés dans la littérature pour comprendre le fonctionnement des panneaux PV. Le modèle de Bishop a été retenu dans cette étude, car il représente bien la caractéristique courant tension (1-V) du fonctionnement des cellules PV dans régime direct ainsi que dans le régime inverse dans le cas où une cellule est occultée. Les signaux électriques des indicateurs (puissance maximale, courant court circuit et tension circuit ouvert) sont ensuite calculés à partir de la caractéristique I-V du panneau PV obtenue pour des conditions spécifiques (irradiance, température, défaut de mismatch, défaut de diode de bypass) L'originalité de notre travail est de simuler les signaux en utilisant des caractéristiques d'ensoleillement réelles obtenu par mesure satellite. Nous introduisons ainsi la notion de saisonnalité dans la caractéristique I-V qui dépend alors du temps. La fonction d'autocorrélation cyclique est appliquée sur les parties aléatoires des signaux afin de travailler sur la CS à l'ordre2 (CS2). Dans la quatrième partie, on montre comment combiner les outils tels que l'ATSA pour faire du diagnostic sur les signaux que nous avons simulés. Dans cette étude, la CS2 des signaux a donné de bons résultats pour faire du diagnostic en comparant par l'analyse temporelle et fréquentielle / Photovoltaic (PV) systems can be operated in different locations. The exhibition (Wind, rain, snow, heat, lightning, shading, etc.) which cause their degradation over time and reduc their efficiency. Diagnosis is one of the interesting solutions to make PV panels work at their optimum power and in order to maximize the efficiency of PV conversion in order to reduce maintenance costs. In this thesis work, we are interested only in the diagnosis of PV generators. The aim of this thesis is to propose signal processing tools to detect and locate faults leading to a drop in efficiency. To carry out this work, we first make a stateof the art on the panels. Photovoltaic cells of microscopic appearance (cell) with macroscopic appearance (fields). To begin, we present the principle of operation of a photovoltaic cell as well as the various parameters affecting its performance. The combination of cells to create a photovoltaic panel, panels to create fields, are the studied. It is then shown how to connect these elements to a Load and network. At the same time, we describe the different types of defects and present an overview of the methods of their detection. A third part dealing with the modeling of defects shows how to build a database of electrical signals by simulation. Many electrical models are used in the literature to understand the functioning of PV panels. The Bishop model has been chosen in this study because it represents the current voltage characteristic (I-V) of the functioning of the PV cells in direct regime as well as in the inverse regime in the case where a cell is occulted. We explain how the different types of defects affect the I-V characteristic of solar panels. The electrical signals of the indicators (maximum power, short circuit current and open circuit voltage) are then calculated from the characteristic [V of the PV panel obtained for specific conditions (irradiance, temperature, mismatch defect, bypass diode fault). .). The originality of our work is to simulate the signals using real sunlight characteristics obtained by satellite measurements. We introduce the notion of seasonality into the characteristic I-V which then depends on time. We then analyze the first signals obtained by simulation. The time evolution of these indicators shows a CS aspect and the ATSA method is applied for these signals to have a good separation of the cyclic pattern and the random pattern of the time signals. The separation of these two components. To work on different CS commands. The cyclic autocorrelation function is applied to the random parts of the signals to work on the CS to order2 (CS2). In the fourth part, we show how to combine tools such as ATSA to diagnose the signals we simulated. We first present our choice of types of defects and severity used to build our database. Next, we describe and illustrate the various indicator in detail for a shading defect. A larger study is then carried out on all the simulated defects. In this study, the CS2 of the signals gave good results to make the diagnosis by comparing by the time and frequency analysis

by Shen Tai. / Thesis (M.Phil.)--Chinese University of Hong Kong, 1997. / Includes bibliographical references (leaves 84-92). / Chapter CHAPTER1 --- INTRODUCTION --- p.2 / Chapter CHAPTER2 --- LITERATURE REVIEW / Chapter 2.1 --- Fibronectin --- p.4 / Chapter 2.1a --- Functions and basic molecular structure --- p.4 / Chapter 2.1b --- Polymorphism and alternative splicing --- p.5 / Chapter 2.1c --- Primary classification --- p.6 / Chapter 2.2 --- Oncofetal fibronectin --- p.7 / Chapter 2.2a --- Introduction --- p.7 / Chapter 2.2b --- Recognition by FDC-6 monoclonal antibody --- p.7 / Chapter 2.2c --- Specificity of FDC-6 antibody --- p.8 / Chapter 2.2d --- Glycosylation of fetal fibronectin molecule --- p.9 / Chapter 2.2e --- Fibronectin and human pregnancy --- p.9 / Chapter 2.2f --- Regulation of fetal fibronectin synthesis --- p.11 / Chapter 2.2g. --- Possible mechanism of fetal fibronectin release --- p.12 / Chapter 2.3 --- The uterine cervix in human labour --- p.13 / Chapter 2.3a --- Introduction --- p.14 / Chapter 2.3b --- Physiological cervical ripening --- p.14 / Chapter 2.3c --- Role of prostaglandins --- p.16 / Chapter 2.3d --- Fibronectin and degradation of cervical matrix --- p.16 / Chapter 2.4 --- Evaluation of cervical status --- p.17 / Chapter 2.4a --- Bishop score --- p.17 / Chapter 2.4b --- Intravaginal ultrasound evaluation of cervix --- p.18 / Chapter 2.4c --- Fibronectin as a tool for evaluation of cervical status --- p.19 / Chapter 2.5 --- Pre-induction cervical ripening with PGE2 --- p.20 / Chapter 2.5a --- Introduction --- p.20 / Chapter 2.5b --- Route of delivery --- p.21 / Chapter 2.5c --- Indications for cervical ripening with prostaglandins --- p.21 / Chapter 2.5d --- Possible Mechanism --- p.22 / Chapter 2.5e --- PGE2 effectiveness and potential risks --- p.23 / Chapter 2.5f --- Other cervical ripening techniques and agents --- p.25 / Chapter 2.5g --- Prediction for outcomes of induction and pre- induction cervical ripening with PGE2 --- p.26 / Chapter 2.6 --- Application of fibronectin in Obstetrics --- p.29 / Chapter 2.6a --- Prediction of preterm delivery --- p.29 / Chapter 2.6b --- Evaluation of cervical status --- p.31 / Chapter 2.6c --- Prediction of prolonged pregnancy --- p.32 / Chapter 2.6d --- Prediction for outcomes of induced labor --- p.32 / Chapter CHAPTER3 --- METHODOLOGY / Chapter 3.1 --- Introduction --- p.36 / Chapter 3.2. --- Study population and recruitment --- p.36 / Chapter 3.2a --- Inclusive criterion --- p.36 / Chapter 3.2b --- Exclusive criterion --- p.36 / Chapter 3 3 --- Measurement of Fetal Fibronectin --- p.38 / Chapter 3.3.1 --- Fetal Fibronectin Membrane Immunoassay --- p.39 / Chapter 3.3.1a --- Principle of the test --- p.39 / Chapter 3.3.1b --- Reagent and materials --- p.39 / Chapter 3.3.1c --- Specimen collection --- p.40 / Chapter 3.3.1d --- Assay procedure and interpretation of results --- p.40 / Chapter 3.3.2 --- Fetal Fibronectin Enzyme Immunoassay --- p.40 / Chapter 3.3.2a --- Principle of the test --- p.40 / Chapter 3.3.2b --- Materials --- p.41 / Chapter 3.3.2c --- Specimen collection --- p.42 / Chapter 3.3.2d --- Assay procedure and interpretation of results --- p.43 / Chapter 3.4 --- Cervical status determination --- p.44 / Chapter Chapter4 --- RESULT --- p.47 / Chapter Chapter5 --- DISCUSSION --- p.80 / REFERENCES --- p.83