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BACKGROUND: Exposure to toxins during pregnancy is the main modifiable behavior that affects the placenta and, consequently, the fetus. In particular, smoking is a recognized risk factor for negative outcomes. Our study pretended to examine gross and microscopic placental features in women who reported exposure to tobacco, alcohol, or other psychoactive substances. METHODS: In this observational case-control study, we collected 706 placentas to assess precise substance exposure histological-interaction features of in the placenta. We examined gross and microscopic placental features, and then recorded maternal and newborn clinical conditions. RESULTS: We found that 4.8% of mothers admitted to consumption of some type of (harmful) substance. The most common pre-existing maternal condition was obesity (20.3%); predominant complications included amniotic infection (32.3%), urinary tract infection (14.5%) and hypertensive disorders of pregnancy (14.5%). In newborns, we discovered positive associations as respiratory distress syndrome. Macroscopically, exposed mothers had heavier placentas, more true knots, and single umbilical artery; microscopically, they were more likely to exhibit fetal vascular malperfusion (FVM). CONCLUSIONS: Until our present study, no research linked umbilical cord defects to toxic substance exposure; our study results do confirm association with adverse outcomes in neonates and alterations in the neuro-cardio-placental circuit through FVM. IMPLICATIONS: The results are confirming the importance of this modifiable risk factor and how its presence may potentially affect the course of pregnancy, as well as the health of both mother and child.
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Placenta , Complicaciones del Embarazo , Trastornos Relacionados con Sustancias , Humanos , Femenino , Embarazo , Placenta/patología , Recién Nacido , Estudios de Casos y Controles , Adulto , Complicaciones del Embarazo/epidemiología , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/complicaciones , Consumo de Bebidas Alcohólicas/efectos adversos , Consumo de Bebidas Alcohólicas/epidemiología , Fumar/efectos adversos , Fumar/epidemiología , Factores de RiesgoRESUMEN
Some hard ticks' species can act as vectors of a wide variety of pathogens of human and animal importance such as Anaplasma, Ehrlichia and Rickettsia spp. In Colombia, a total of forty-six tick species have been described, and some of them have been implicated as vectors of some infectious agents. The department of Cauca is one of the thirty-two departments of Colombia. Most of its population lives in rural areas and depends on agriculture as the main economic activity, favoring exposure to ticks and tick-borne pathogens. Thus, the present study aimed to determine the tick species and tick-borne pathogens circulating in this region. From August to November 2017, ticks were collected from dogs, horses and cattle from eight rural areas of four municipalities in the department of Cauca. All collected ticks were classified according to taxonomic keys and organized in pools. DNA was extracted from all tick pools for molecular confirmation of tick species and detection of Anaplasma, Ehrlichia and Rickettsia spp. A total of 2809 ticks were collected which were grouped in 602 pools. Ticks were morphologically identified as Amblyomma cajennense sensu lato, Dermacentor nitens, Rhipicephalus microplus and Rhipicephalus sanguineus sensu lato. The molecular identity of A. cajennense s.l. was confirmed as Amblyomma patinoi. A total of 95% of the pools scored positive for members of the Anaplasmataceae family, of which, 7.8% and 7.3% were positive to Anaplasma and Ehrlichia spp., respectively, being identified as Anaplasma marginale, Ehrlichia minasensis and Ehrlichia canis; and 16.1% were positive for Rickettsia spp. with high identity for Rickettsia asembonensis, Rickettsia felis and Candidatus Rickettsia senegalensis. This is the first report describing the natural infection of ticks with rickettsial pathogens and the occurrence of A. patinoi ticks in Cauca department, Colombia.
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Rhipicephalus sanguineus , Rickettsia , Enfermedades por Picaduras de Garrapatas , Animales , Perros , Humanos , Bovinos , Caballos , Animales Domésticos , Colombia/epidemiología , Rickettsia/genética , Anaplasma/genética , Rhipicephalus sanguineus/microbiología , Enfermedades por Picaduras de Garrapatas/microbiologíaRESUMEN
Ehrlichia minasensis is a new pathogenic bacterial species that infects cattle, and Borrelia theileri causes bovine borreliosis. We detected E. minasensis and B. theileri DNA in cattle from southwestern Colombia by using PCR. E. minasensis and B. theileri should be considered potential etiologies of febrile syndrome in cattle from Colombia.
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Infecciones por Borrelia , Enfermedades de los Bovinos , Animales , Infecciones por Borrelia/veterinaria , Bovinos , Enfermedades de los Bovinos/epidemiología , Enfermedades de los Bovinos/microbiología , Colombia/epidemiología , ADN , Reacción en Cadena de la PolimerasaRESUMEN
Introduction: In recent decades, there has been a growing increase in the diagnosis of patients with inborn errors of the immune system, formerly known as primary immunodeficiency dis-orders (PIDs). Timely diagnosis remains a challenge due to low clinical suspicion and poor edu-cation on the subject. It is estimated that between 70% and 90% of these pathologies remain underdiagnosed in our environment.Objective: The objective of this study is to characterize the demographic and clinical presen-tation of pediatric group patients with inborn errors of the immune system in a Colombian tertiary hospital.Methods: Retrospective descriptive study of 306 patients with a diagnosis of innate errors of the immune system who consulted the PID clinic between 2011 and 2018 in a high-complexity institution in Cali, Colombia.Results: Three-hundred and six patients were included. The median age was 4 years (IQR 2.37.7 years), and 59.5% of the patients were male. According to the International Union of Immunological Societies Expert Committee for Primary Immunodeficiency classification for inborn errors of the immune system, the most common group was antibody deficiency in 74.8% (n=229), especially in the age group between 1 and 5 years. The least frequent in our pop-ulation was complement deficiency. Of the warning signs stipulated for these pathologies, the most frequent were the (1) need for intravenous antibiotics (32%), (2) difficulty growing (15.7%), (3) four or more episodes of ear infection (10.8%), and (4) abscesses in organs or cuta-neous abscesses (12.7%). No patient reported two or more episodes of pneumonia or sinusitis, and only 5.8% of the patients received a bone marrow transplant (AU)
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Humanos , Masculino , Femenino , Preescolar , Niño , Enfermedades del Sistema Inmune/congénito , Atención Terciaria de Salud , Estudios Retrospectivos , ColombiaRESUMEN
BACKGROUND: The objective of this study was to assess dietary behavior among sixth- to eighth-grade students to inform the delivery and content of nutrition education. METHODS: This was a qualitative study through focus groups. Subjects were 57 adolescents 10-14 years old, 30 males and 27 females distributed in six groups. To compare group responses, transcriptions were coded using the original question guide. The information was analyzed using the content analysis technique. RESULTS: The main findings showed that adolescents knew dietary guidelines, but they consumed non-healthy food. They liked to cook but preferred fast food preparations. They increased fast food consumption on weekends and with friends. In utilization of Information Communication Technologies (ICT), all students had access to technology through mobile phones, tablets and computers and were open to have an interactive program with personal information about diet and behavior. CONCLUSIONS: Adolescents dietary behavior is not healthy and can be changed with interactive programs considering participation, personal information and utilizing ICT.
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Conducta del Adolescente/psicología , Conducta de Elección , Conductas Relacionadas con la Salud , Estudiantes/psicología , Estudiantes/estadística & datos numéricos , Adolescente , Niño , Chile , Femenino , Grupos Focales , Humanos , Masculino , Investigación Cualitativa , Instituciones Académicas/estadística & datos numéricosRESUMEN
Mixed-halide organic-inorganic hybrid perovskites are considered promising light-absorbing materials in the development of solar cells related to the obtained high-power conversion efficiency. Current efforts are focused on the study of the energy-conversion mechanisms, where the nonradiative recombination pathway is the least explored. In this work, a combination of optical and photoacoustic spectroscopies is used to determine the visible spectral light-into-heat conversion efficiency of lead-based mixed-halide organic-inorganic hybrid perovskites in a semicomplete n-i-p mesoscopic perovskite solar cell (PSC). A remarkable average conversion efficiency of about 87% has been found for the nonradiative combination in the perovskite, with the estimated composition ${{\rm FA}_{0.71}}{{\rm MA}_{0.29}}{{\rm PbI}_{2.9}}{{\rm Br}_{0.1}}$FA0.71MA0.29PbI2.9Br0.1 in the wavelength range of 400 to 800 nm. As a result, 13% of the incident light is transformed in radiative recombination processes and/or photodegradation of the material. Furthermore, the extinction coefficient and refractive index of the material are reported, and it was found that the optical constants and the optical absorption in the short-wavelength range are significantly smaller than previously reported for${{\rm MAPbI}_3}$MAPbI3.
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Rickettsia typhi and Rickettsia felis (Rickettsiales: Rickettsiaceae) are flea-transmitted pathogens. They are important causes of acute febrile illness throughout the world. We, therefore, sought to identify the rickettsial species present in the fleas of dogs and cats in the department of Cauca, Colombia. In this study, we collected 1,242 fleas from 132 dogs and 43 fleas from 11 cats. All fleas were morphologically identified as Ctenocephalides felis (Bouché) adults and organized in pools for DNA extraction (234 pools from dogs and 11 from cats). The gltA gene from rickettsiae was targeted for screening amplification using conventional PCR. In total, 144 of the 245 pools (58.7%) were positive. The positive samples were then processed for the amplification of the 17kDa antigen gene (144/144; 100% positive) and sca5 gene (140/144; 97.2% positive). In addition, restriction enzyme length polymorphism analysis using NlaIV on the amplified product of the sca5 gene demonstrated several organisms: 21/140 (15%) were R. felis, 118/140 (84.3%) were Rickettsia asemboensis, and 1/140 (0.7%) were Candidatus Rickettsia senegalensis. Subsequent sequencing confirmed Candidatus Rickettsia senegalensis in C. felis collected from dogs the first reported from Colombia.
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Enfermedades de los Gatos/microbiología , Ctenocephalides/microbiología , Enfermedades de los Perros/microbiología , Infecciones por Rickettsia/veterinaria , Rickettsia/aislamiento & purificación , Animales , Enfermedades de los Gatos/parasitología , Gatos , Colombia , Enfermedades de los Perros/parasitología , Perros , Infestaciones por Pulgas/parasitología , Infestaciones por Pulgas/veterinaria , Rickettsia/clasificación , Infecciones por Rickettsia/microbiologíaRESUMEN
Ionic liquids are being proposed for the improvement of many refinery-related applications where water and oil coexist. However, the lack of relevant thermodynamic data on equilibrium processes involving water, oil and an ionic liquid is a stumbling block. Phase diagrams of these systems are complex, with many different regions, especially when the ionic liquid is solid at room conditions. This greatly complicates modelling, which is usually neglected or carried out only partially. In this work, for the first time, the simultaneous correlation not only of liquid-liquid and liquid-liquid-liquid but also solid-liquid equilibrium data for ternary systems involving ionic liquids has been carried out. To that end, the ionic liquid 1-hexyl-3-methylpyridinium trifluoromethanesulfonate, with an alkyl chain length that favours nano-segregation, was selected. Phase diagrams with water and different representative oils (octane, toluene and cyclohexane) have been determined at various temperatures and atmospheric pressure. The great capacity of the NRTL model, a powerful tool used in all chemical process simulators, was shown by simultaneously correlating data from all the equilibrium regions. However, adequate equilibrium equations and pivotal strategies were required. Low deviations and a good representation of phase diagrams was achieved. A topological analysis based on the Gibbs common tangent criterion and a stability test allowed validation of the proposed correlation parameters.
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The focus of this study is broadly to define the physics involved in radon generation and transport through the soil and other materials using different parameter-estimation tools from the literature. The effect of moisture in the soil and radon transport via water in the pore space was accounted for with the application of a porosity correction coefficient. A 2D finite element model is created, which reproduces the diffusion and advection mechanisms resulting from specified boundary conditions. A comparison between the model and several analytical and numerical solutions obtained from the literature and field studies validates the model. Finally, the results demonstrate that the model can predict radon entry through different building boundary conditions, such as concrete slabs with or without joints, variable slab thicknesses and diffusion coefficients, and the use of several radon barrier membranes. Cracks in the concrete or the radon barrier membrane have been studied to understand how indoor concentration is affected by these issues.
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Contaminantes Radiactivos del Aire/análisis , Contaminación del Aire Interior/análisis , Análisis de Elementos Finitos , Modelos Teóricos , Contaminación del Aire Interior/estadística & datos numéricos , Materiales de Construcción , Difusión , Vivienda , Radón/análisisRESUMEN
The difficulty in achieving a good thermodynamic description of phase equilibria is finding a model that can be extended to a large variety of chemical families and conditions. This problem worsens in the case of systems containing more than two phases or involving complex compounds such as ionic liquids. However, there are interesting applications that involve multiphasic systems, and the promising features of ionic liquids suggest that they will play an important role in many future processes. In this work, for the first time, the simultaneous correlation of liquid-liquid and liquid-liquid-liquid equilibrium data for ternary systems involving ionic liquids has been carried out. To that end, the phase diagram of the water + [P6 6 6 14][DCA] + hexane system has been determined at 298.15 K and 323.15 K and atmospheric pressure. The importance of this system lies in the possibility of using the surface active ionic liquid to improve surfactant enhanced oil recovery methods. With those and previous measurements, thirteen sets of equilibrium data for water + ionic liquid + oil ternary systems have been correlated. The isoactivity equilibrium condition, using the NRTL model, and some pivotal strategies are proposed to correlate these complex systems. Good agreement has been found between experimental and calculated data in all the regions (one triphasic and two biphasic) of the diagrams. The geometric aspects related to the Gibbs energy of mixing function obtained using the model, together with the minor common tangent plane equilibrium condition, are valuable tools to check the consistency of the obtained correlation results.
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Epstein-Barr virus (EBV) is a persistent virus with oncogenic capacity that has been implicated in the development of aggressive B cell lymphomas, primarily in immunosuppressed individuals, although it can be present in immunocompetent individuals. Changes in the function and clonal diversity of T lymphocytes might be implied by viral persistence and lymphoma development. The aim of the present study was to evaluate the frequency, phenotype, function and clonotypical distribution of EBV-specific T cells after peripheral blood stimulation with a virus lysate in newly diagnosed patients with diffuse large B cell lymphoma (DLBCL) aged more than 50 years without prior histories of clinical immunosuppression compared with healthy controls. Our results showed impaired EBV-specific immune responses among DLBCL patients that were associated primarily with decreased numbers of central and effector memory CD8(+) T lymphocytes. In contrast to healthy controls, only a minority of the patients showed CD4(+)/tumour necrosis factor (TNF)-α(+) T cells expressing T cell receptor (TCR)-Vß17 and CD8(+)/TNF-α(+) T cells with TCR-Vß5·2, Vß9 and Vß18 in response to EBV. Notably, the production of TNF-α was undetectable among TCR-Vß5·3(+), Vß11(+), Vß12(+), Vß16(+) and Vß23(+) CD8(+) T cells. In addition, we observed decreased numbers of CD4(+)/TNF-α(+) and CD8(+)/TNF-α(+), CD8(+)/interleukin (IL)-2(+) and CD8(+)/TNF-α(+)/IL-2(+) T lymphocytes in the absence of T cells capable of producing TNF-α, IL-2 and IFN-γ after EBV stimulation simultaneously. Moreover, DLBCL patients displayed higher IL-10 levels both under baseline conditions and after EBV stimulation. These findings were also observed in patients with positive EBV viral loads. Prospective studies including a large number of patients are needed to confirm these findings.
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Linfocitos T CD8-positivos/inmunología , Infecciones por Virus de Epstein-Barr/inmunología , Herpesvirus Humano 4/inmunología , Linfoma de Células B Grandes Difuso/inmunología , Anciano , Anciano de 80 o más Años , Linfocitos T CD4-Positivos/inmunología , Linfocitos T CD4-Positivos/metabolismo , Linfocitos T CD8-positivos/metabolismo , Linfocitos T CD8-positivos/virología , Infecciones por Virus de Epstein-Barr/sangre , Infecciones por Virus de Epstein-Barr/virología , Femenino , Citometría de Flujo , Herpesvirus Humano 4/fisiología , Interacciones Huésped-Patógeno/inmunología , Humanos , Interferón gamma/inmunología , Interferón gamma/metabolismo , Interleucina-10/inmunología , Interleucina-10/metabolismo , Interleucina-2/inmunología , Interleucina-2/metabolismo , Recuento de Linfocitos , Linfoma de Células B Grandes Difuso/sangre , Linfoma de Células B Grandes Difuso/virología , Masculino , Persona de Mediana Edad , Receptores de Antígenos de Linfocitos T alfa-beta/inmunología , Receptores de Antígenos de Linfocitos T alfa-beta/metabolismo , Factor de Necrosis Tumoral alfa/inmunología , Factor de Necrosis Tumoral alfa/metabolismo , Carga Viral/inmunologíaRESUMEN
No disponible
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Humanos , Femenino , Lactante , Linfohistiocitosis Hemofagocítica/complicaciones , Infecciones por Virus de Epstein-Barr/complicaciones , Herpesvirus Humano 4/patogenicidad , Linfocitos T CD8-positivosAsunto(s)
Linfocitos B/patología , Trasplante de Médula Ósea , Fiebre/diagnóstico , Herpesvirus Humano 4/inmunología , Mononucleosis Infecciosa/diagnóstico , Linfohistiocitosis Hemofagocítica/diagnóstico , Profilaxis Antibiótica , Preescolar , Ciclosporina/administración & dosificación , Dexametasona/administración & dosificación , Supervivencia sin Enfermedad , Quimioterapia Combinada , Etopósido/administración & dosificación , Femenino , Fiebre/complicaciones , Fiebre/tratamiento farmacológico , Humanos , Inmunoglobulinas Intravenosas/administración & dosificación , Mononucleosis Infecciosa/complicaciones , Mononucleosis Infecciosa/tratamiento farmacológico , Linfohistiocitosis Hemofagocítica/complicaciones , Linfohistiocitosis Hemofagocítica/tratamiento farmacológico , RecurrenciaRESUMEN
Resumen La hemorragia posparto es una de las principales complicaciones maternas que genera morbimortalidad. Se asocia diversas causas, como atonía uterina, retención de restos placentarios y coagulopatías. Una poco conocida es la infección por Ascarislumbricoides. Se realiza la revisión de un caso clínico de paciente de 16 años de edad, que evolucionó a histerectomía secundaria a ascariasis y muerte materna, que ingresó al Servicio de Urgencias Obstétricas del Hospital de la Universidad del Norte. Según nuestro conocimiento, es el primer caso descrito en nuestro país en el que se sospecha la asociación de hemorragia posparto y la infección por Ascarislumbricoides.
Abstract Postpartum hemorrhage is one of the most important obstetrical complications, having a high morbidity and mortality rate. It is associated to different causes such as uterine atony, placental birth alterations, and coagulopathy. One not so well-known cause is the infestation with the parasite Ascarislumbricoides. We report a case of a 16-year-old patient who required an emergency postpartum hysterectomy until progressing to death due to ascariasis. To our current knowledge, this is the first reported case in Colombia where there is a suspected association between the infestation with Ascarislumbricoides and postpartum hemorrhage.
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The objective was to describe changes in serum ferritin (SF) in women residents in Mexico City. We evaluated prospectively, three groups of non-anemic, non-pregnant women (< 20, 21-40 y 40-58 years old). Sociodemographic variables, hemoglobin (Hb) and erythrocyte index and SF values were registered. We included 252 women in the study. There were no differences in Hb values (15.0, 14.6 and 14.7 g/dL) or erythrocyte index between the three groups of women. We found significative differences (p < 0.001) in mean values of (32 and 34 micrograms/L), for group 1 and 2, with group 3 (SF 54 micrograms/L). In global sample, we observed low SF store, a normal or higher in 76 cases (30.2%), 163 (64.6%) and 13 cases (5.2%), respectively. The women with SF lower than 20 micrograms/L were in proportion 0.54, 0.32 and 0.16. Elevated values in SF were found in a proportion 0.04, 0.18 and 0.13, for groups 1, 2 and 3, with significative differences (p < 0.001). We observed that non-anemic women in Mexico City, showed increase in SF concentrations beginning at 41 years of age, without any major variation in their erythocyte indexes. The prevalence in moderate-severe iron deficiency between 18 to 40 years of years, decreasing progressively.
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Ferritinas/sangre , Hemoglobinas/análisis , Hierro/sangre , Adolescente , Adulto , Anemia Ferropénica/sangre , Anemia Ferropénica/diagnóstico , Femenino , Hemoglobinometría , Humanos , Persona de Mediana EdadAsunto(s)
Inmunosupresores/uso terapéutico , Trasplante de Riñón/inmunología , Ácido Micofenólico/análogos & derivados , Donantes de Tejidos/estadística & datos numéricos , Corticoesteroides/uso terapéutico , Factores de Edad , Anciano , Anciano de 80 o más Años , Creatinina/sangre , Ciclosporina/uso terapéutico , Monitoreo de Drogas , Quimioterapia Combinada , Femenino , Rechazo de Injerto/epidemiología , Rechazo de Injerto/prevención & control , Humanos , Masculino , Persona de Mediana Edad , Ácido Micofenólico/uso terapéutico , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios Retrospectivos , Donantes de Tejidos/clasificaciónAsunto(s)
Aciclovir/uso terapéutico , Antivirales/uso terapéutico , Infecciones por Citomegalovirus/prevención & control , Trasplante de Riñón , Adolescente , Adulto , Anciano , Infecciones por Citomegalovirus/epidemiología , Femenino , Humanos , Incidencia , Masculino , Persona de Mediana Edad , Complicaciones Posoperatorias , Estudios RetrospectivosRESUMEN
The object of this study was to evaluate the changes in fibrinolysis and clotting inhibitors in patients with preeclampsia and to describe the connection between preeclampsia and blood pressure values. Two groups of pregnant women were prospectively studied at delivery: group 1 women without preeclampsia and group 2 patients with preeclampsia. The variables that were registered are: diastolic blood pressure (DBP), systolic blood pressure (SBP), mean blood pressure (MBP), hemoglobin (Hb), platelet count (Plt), lupus like inhibitor, anticardiolipin antibodies (ACA), antinuclear antibodies (ANA), fibronectina, D dimer, protein S (PS), protein C (PC) and vo Willebrand factor (vWF). 62 pregnant women were included. The patients of group 2 presented high values of Hb (p 0.01), fibronectin (p 0.0001), D-dimer (p 0.01) and lower PC (p 0.04). We found an association between fibronectin and higher values of SBP, DBP, MBP and Hb (p 0.0007) versus lower values of VFW and PC (p 0.002). The low values of total PS were associated with high D-dimer and SBP results (p 0.04 and 0.002 respectively). All patients were ACA/ANA negative. In preclampsia there is a increased hemoconcentration and drop in clotting inhibitors (PC), without fibrinolytic compensatory response (lower D-dimer) and remarked vasopressive effect (hig fibronectin). This changes depend on the stratification of blood pressure. Th SBP and MBP values depend on the haemodynamic changes (Hb, fibronectin), while the increase in DBP expresses a non compensated thrombophilic state.
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Preeclampsia/complicaciones , Trombofilia/complicaciones , Presión Sanguínea , Estudios Transversales , Femenino , Hemodinámica , Humanos , Recuento de Plaquetas , Preeclampsia/sangre , Embarazo , Resultado del Embarazo , Estudios Prospectivos , Trombofilia/sangreRESUMEN
Este estudio fue realizado para valorar la reacción periapical producida con el uso de formocresol diluido 1:5 por cuatro minutos en pulpotomías de premolares temporales en perros, después de 45 días. Se tomaron 32 dientes, a 16 de los cuales se les colocó formocresol diluido 1:5 por cuatro minutos y la otra mitad fue utilizado como grupo de control. Se realizaron Cortes histológicos a nivel periapical, los cuales fueron evaluados a doble ciego, encontrando una marcada reacción inflamatoria a nivel periapical en el grupo experimental.
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Formocresoles , PulpotomíaRESUMEN
For to establish the probability of the early identification of the iron deficient in the infant, we evaluate the correlation between the serum ferritin (SF) values at two and eight months of age. It included 57 infants, 30 cases with SF higher than 20 ng/mL (group I), eight cases with SF between 12-20 ng/mL (group II) and 19 infants with SF lower of 12 ng/mL (group III); the addition of two late groups result in 27 cases with SF lower of 20 ng/mL (group IV). None cases had SF lower 20 ng/mL at two months of age. The correlation between SF values and hemoglobin (Hb) at two and eight months of age, the Hb of the infants deficients had better correlation (0.602 P = 0.006). The SF not had statistic correlation. For to establish if the groups had the same values of SF and Hb at two months on age, the SF values were in the group III vs group I were 154.1 and 274.6 ng/mL (P = 0.004) respectively. This data indicate that the infants that development severe iron deficiency to eight months of age, may predict this quantify the SF at two months of age.