ABSTRACT
Diabetic macular edema (DME) and age-related macular degeneration (AMD) are two common eye diseases. They are often undiagnosed or diagnosed late. This can result in permanent and irreversible vision loss. Therefore, early detection and treatment of these diseases can prevent vision loss, save money, and provide a better quality of life for individuals. Optical coherence tomography (OCT) imaging is widely applied to identify eye diseases, including DME and AMD. In this work, we developed automatic deep learning-based methods to detect these pathologies using SD-OCT scans. The convolutional neural network (CNN) from scratch we developed gave the best classification score with an accuracy higher than 99% on Duke dataset of OCT images.
ABSTRACT
BACKGROUND: Physical activity (PA) during pregnancy is associated with healthy gestational weight gain (GWG) and a reduced risk of developing gestational diabetes (GD), gestational hypertension (GHT) and fetal macrosomia. However, in Canada, less than 20% of pregnant women meet PA recommendations. This study assessed associations between an intervention including PA education by prenatal nurses and a PA prescription delivered by physicians and fetal and maternal outcomes. METHODS: This is a quasi-experimental study. Two groups of women who received their prenatal care at the obstetrics clinic of a university hospital were created. In the first group, 394 pregnant women followed at the clinic received standard care. In the second group, 422 women followed at the clinic received standard care supplemented with education on the relevance of PA during pregnancy and a prescription for PA. Data for both study groups were obtained from the medical records of the mothers and their newborns. Logistic regressions were used to compare the odds of developing excessive GWG, GD, GHT, and fetal macrosomia between the two study groups. RESULTS: The addition of PA education and PA prescription to prenatal care was associated with 29% lower odds of developing excessive GWG (adjusted odds ratios (OR) 0.71, 95% confidence intervals (CI) 0.51-0.99), 73% lower odds of developing GHT (0.27, 0.14-0.53), 44% lower odds of fetal macrosomia (> 4 kg) (0.56, 0.34-0.93), and 40% lower odds of being large for gestational age (0.60, 0.36-0.99). The intervention was not associated with a difference in odds of developing GD (0.48, 0.12-1.94). CONCLUSIONS: The inclusion of education and prescription of PA as part of routine prenatal care was associated with improvements in maternal and fetal health outcomes, including significantly lower odds of GWG, GHT and macrosomia.
Subject(s)
Diabetes, Gestational , Prenatal Care , Pregnancy , Female , Infant, Newborn , Humans , Fetal Macrosomia/prevention & control , Weight Gain , Diabetes, Gestational/prevention & control , Exercise , Body Mass Index , Pregnancy OutcomeABSTRACT
The problems with setting up breastfeading are common and are associated with a heightened risk of weening. The main motives brought up by the mothers for early weening were fatigue and the suboptimal infant breastfeeding behaviour (SIBB). The goal of this study is to describe the fatigue levels of breastfeading women who gave birth to healthy full term babies in a hospital setting and the SIBB. This study also examines the relation between these two variables. This descriptive correlational and cross-sectional study was conducted with breasfeeding women who gave birth to healthy, full term, single babies at the CHU in Moncton between June and September 2013. Fatigue Continuum Form and Infant Breastfeeding Assesement Tool were each used to measure fatigue and SIBB. Analysis was done using Spearman's correlation coefficient (r) and bivariate associations where measured using the chi-square test (χ2). Sixty-four mother child dyads were included in this study. 64.1 % of mothers experienced moderate fatigue. Maternal fatigue was associated with parity (p=0,003), the mothers' level of education (p=0,043), the child's birth weight (p=0,035), the delay before introducing the breast (p=0,001) and the frequency of feedings on D0 (p=0,037). The prevalence of SIBB was 57.8 % on day 0 (D0) and 25 % on day 1 (D1). SIBB is associated with a frequency of less than eight feedings in the first 24 hours (D0 (p=0,001) and D1(p=0,003)), to the primiparity (D1) (p=0,046), nipple types (D1) (p=0,010), previous breastfeeding experience (D1) (p=0,046). Skin on skin contact in the delivery room (D1) (p=0,041) and the delay before the first introduction to the breast (D1) (p=0,027). À significant correlation was noted between maternal fatigue and SIBB on D0 (r=0,196 ; p=0,029) and between SIBB on D0 and on D1 (r=0,661 ; p<0.001). A special supervision of mother-child dyads that are at risk is necessary in order to benefit from extra support during hospital stays and following their discharge from the hospital.
