Moran Model of Spatial Alignment in Microbial Colonies.

We describe a spatial Moran model that captures mechanical interactions and directional growth in spatially extended populations. The model is analytically tractable and completely solvable under a mean-field approximation and can elucidate the mechanisms that drive the formation of population-level patterns. As an example we model a population of E. coli growing in a rectangular microfluidic trap. We show that spatial patterns can arise as a result of a tug-of-war between boundary effects and growth rate modulations due to cell-cell interactions: Cells align parallel to the long side of the trap when boundary effects dominate. However, when cell-cell interactions exceed a critical value, cells align orthogonally to the trap's long side. This modeling approach and analysis can be extended to directionally-growing cells in a variety of domains to provide insight into how local and global interactions shape collective behavior.

Fine and ultrafine particle exposures on 73 trips by car to 65 non-smoking restaurants in the San Francisco Bay Area.

A number of studies indicate cooking is a major source of exposure to particulate matter, but few studies have measured indoor air pollution in restaurants, where cooking predominates. We made 73 visits by car to 65 different non-smoking restaurants in 10 Northern California towns while carrying portable continuous monitors that unobtrusively measured ultrafine (down to 10 nm) and fine (PM2.5 ) particles to characterize indoor restaurant exposures, comparing them with exposures in the car. The mean ultrafine number concentrations in the restaurants on dinner visits averaging 1.4 h was 71 600 particles/cm3 , or 4.3 times the mean concentration on car trips, and 12.3 times the mean background concentration in the residence. Restaurants that cooked dinner in the same room as the patrons had higher ultrafine concentrations than restaurants with separate kitchens. Restaurant PM2.5 mass concentrations averaged 36.3 µg/m3 , ranging from 1.5 to 454 µg/m3 , but were relatively low on most visits: 43% of the indoor means were below 10 µg/m3 and 66% were below 20 µg/m3 , with 5.5% above 100 µg/m3 . Exposure to fine and ultrafine particles when visiting a restaurant exceeded the exposure a person received while traveling by car to and from the restaurant.

Ultrafine particles from electric appliances and cooking pans: experiments suggesting desorption/nucleation of sorbed organics as the primary source.

Ultrafine particles are observed when metal surfaces, such as heating elements in electric appliances, or even empty cooking pans, are heated. The source of the particles has not been identified. We present evidence that particles >10 nm are not emitted directly from the heating elements or the metal surfaces. Using repeated heating of an electric burner, several types of cooking pans, and a steam iron, the increase in the number of particles (>10 nm) can be reduced to 0. After the devices are exposed to indoor air for several hours or days, subsequent heating results in renewed particle production, suggesting that organic matter has sorbed on their surfaces. Also, after a pan has been heated to the point that no increase in particles is observed, washing with detergent results in copious production of particles the next time the pan is heated. These observations suggest that detergent residue and organics sorbed from indoor air are the sources of the particles. We hypothesize that organic compounds are thermally desorbed from the hot surface as gaseous molecules; as they diffuse from the hot air near the pan into cooler air, selected compounds exceed their saturation concentration and nucleation occurs.

First observation of the unbound nucleus 15Ne.

We report on the first observation of the unbound proton-rich nucleus 15Ne. Its ground state and first excited state were populated in two-neutron knockout reactions from a beam of 500 MeV/u 17Ne. The 15Ne ground state is found to be unbound by 2.522(66) MeV. The decay proceeds directly to 13O with simultaneous two-proton emission. No evidence for sequential decay via the energetically allowed 2- and 1- states in 14F is observed. The 15Ne ground state is shown to have a strong configuration with two protons in the (sd) shell around 13O with a 63(5)% (1s1/2)2 component.

Identifying and quantifying secondhand smoke in source and receptor rooms: logistic regression and chemical mass balance approaches.

Identifying and quantifying secondhand tobacco smoke (SHS) that drifts between multiunit homes is critical to assessing exposure. Twenty-three different gaseous and particulate measurements were taken during controlled emissions from smoked cigarettes and six other common indoor source types in 60 single-room and 13 two-room experiments. We used measurements from the 60 single-room experiments for (i) the fitting of logistic regression models to predict the likelihood of SHS and (ii) the creation of source profiles for chemical mass balance (CMB) analysis to estimate source apportionment. We then applied these regression models and source profiles to the independent data set of 13 two-room experiments. Several logistic regression models correctly predicted the presence of cigarette smoke more than 80% of the time in both source and receptor rooms, with one model correct in 100% of applicable cases. CMB analysis of the source room provided significant PM2.5 concentration estimates of all true sources in 9 of 13 experiments and was half-correct (i.e., included an erroneous source or missed a true source) in the remaining four. In the receptor room, CMB provided significant estimates of all true sources in 9 of 13 experiments and was half-correct in another two.

Controlled experiments measuring personal exposure to PM2.5 in close proximity to cigarette smoking.

Few measurements of exposure to secondhand smoke (SHS) in close proximity to a smoker are available. Recent health studies have demonstrated an association between acute (<2 h) exposures to high concentrations of SHS and increased risk of cardiovascular and respiratory disease. We performed 15 experiments inside naturally ventilated homes and 16 in outdoor locations, each with 2-4 non-smokers sitting near a cigarette smoker. The smoker's and non-smokers' real-time exposures to PM2.5 from SHS were measured by using TSI SidePak monitors to sample their breathing zones. In 87% of the residential indoor experiments, the smoker received the highest average exposure to SHS, with PM2.5 concentrations ranging from 50-630 µg/m(3) . During the active smoking period, individual non-smokers sitting within approximately 1 m of a smoker had average SHS exposures ranging from negligible up to >160 µg/m(3) of PM2.5 . The average incremental exposure of the non-smokers was higher indoors (42 µg/m(3) , n = 35) than outdoors (29 µg/m(3) , n = 47), but the overall indoor and outdoor frequency distributions were similar. The 10-s PM2.5 averages during the smoking periods showed great variability, with multiple high concentrations of short duration (microplumes) both indoors and outdoors.

Observation of two-proton radioactivity of 19Mg by tracking the decay products.

We have observed the two-proton radioactivity of the previously unknown (19)Mg ground state by tracking the decay products in-flight. For the first time, the trajectories of the 2p-decay products, (17)Ne+p+p, have been measured by using tracking microstrip detectors which allowed us to reconstruct the 2p-decay vertices and fragment correlations. The half-life of (19)Mg deduced from the measured vertex distribution is 4.0(15) ps in the system of (19)Mg. The Q value of the 2p decay of the (19)Mg ground state inferred from the measured p-p-(17)Ne correlations is 0.75(5) MeV.

Radioactive materials in biosolids: dose modeling.

The Interagency Steering Committee on Radiation Standards (ISCORS) has recently completed a study of the occurrence within the United States of radioactive materials in sewage sludge and sewage incineration ash. One component of that effort was an examination of the possible transport of radioactivity from sludge into the local environment and the subsequent exposure of humans. A stochastic environmental pathway model was applied separately to seven hypothetical, generic sludge-release scenarios, leading to the creation of seven tables of Dose-to-Source Ratios (DSR), which can be used in translating from specific activity in sludge into dose to an individual. These DSR values were then combined with the results of an ISCORS survey of sludge and ash at more than 300 publicly owned treatment works, to explore the potential for radiation exposure of sludge workers and members of the public. This paper provides a brief overview of the pathway modeling methodology employed in the exposure and dose assessments and discusses technical aspects of the results obtained.

Middle cerebral artery blood flow in the fetus and central nervous system complications in the neonate.

OBJECTIVE: To evaluate the ability of blood flow (S/D) ratios in the fetal middle cerebral artery (MCA) to predict the occurrence of central nervous system (CNS) complications (bleeding and/or ischemia) in the neonate, and compare MCA flow to other tests of fetal well-being. STUDY DESIGN: This was a retrospective, observational, cross-sectional clinical outcome study of high-risk patients, evaluated in the Perinatal Center of the author's institution, who underwent antenatal testing with non-stress test (NST) and Doppler studies (including studies of the fetal umbilical artery and MCA) within 1 week of delivery. MCA flow was converted to multiples of the mean, and appropriate parametric and non-parametric statistics were used to compare MCA flow to the presence or absence of CNS complications. Comparisons were also made for the other tests of fetal well-being. RESULTS: CNS complications occurred only in infants who were delivered at less than 37 weeks of gestation (n = 14/131) and the analysis was limited to these 131 patients. Univariant analysis showed that only the NST correlated with CNS complications (OR = 5.46 (1.48-22.16)) and logistic regression confirmed the association. Neither increased diastolic flow in the MCA nor the presence of shunting correlated with CNS complications. CONCLUSIONS: This study confirms previous reports that fetal shunting, with decreased resistance and increased flow in the CNS, is a benign adaptive mechanism for the fetus under stress and not an increased risk for CNS complications. A non-reactive NST, however, is a very late sign of fetal compromise and is significantly associated with the risk of developing CNS complications.

The National Human Activity Pattern Survey (NHAPS): a resource for assessing exposure to environmental pollutants.

Because human activities impact the timing, location, and degree of pollutant exposure, they play a key role in explaining exposure variation. This fact has motivated the collection of activity pattern data for their specific use in exposure assessments. The largest of these recent efforts is the National Human Activity Pattern Survey (NHAPS), a 2-year probability-based telephone survey (n=9386) of exposure-related human activities in the United States (U.S.) sponsored by the U.S. Environmental Protection Agency (EPA). The primary purpose of NHAPS was to provide comprehensive and current exposure information over broad geographical and temporal scales, particularly for use in probabilistic population exposure models. NHAPS was conducted on a virtually daily basis from late September 1992 through September 1994 by the University of Maryland's Survey Research Center using a computer-assisted telephone interview instrument (CATI) to collect 24-h retrospective diaries and answers to a number of personal and exposure-related questions from each respondent. The resulting diary records contain beginning and ending times for each distinct combination of location and activity occurring on the diary day (i.e., each microenvironment). Between 340 and 1713 respondents of all ages were interviewed in each of the 10 EPA regions across the 48 contiguous states. Interviews were completed in 63% of the households contacted. NHAPS respondents reported spending an average of 87% of their time in enclosed buildings and about 6% of their time in enclosed vehicles. These proportions are fairly constant across the various regions of the U.S. and Canada and for the California population between the late 1980s, when the California Air Resources Board (CARB) sponsored a state-wide activity pattern study, and the mid-1990s, when NHAPS was conducted. However, the number of people exposed to environmental tobacco smoke (ETS) in California seems to have decreased over the same time period, where exposure is determined by the reported time spent with a smoker. In both California and the entire nation, the most time spent exposed to ETS was reported to take place in residential locations.

Obstetric ultrasonographic findings and fetal chromosomal abnormalities: refining the association.

OBJECTIVE: In an attempt to refine the role of ultrasonography in screening and identifying fetuses at risk for chromosomal abnormalities, a retrospective review of patients undergoing genetic amniocentesis was undertaken. STUDY DESIGN: Computer databases from the perinatal biology laboratory and cytogenetics laboratory of our institution were correlated to compare the results of the fetus' ultrasonographic examination with the cytogenetic results from amniocentesis. Univariate and multivariate analysis were used to determine the best correlations between ultrasonographic findings and chromosomal abnormalities (study 1). The results were used to construct regression analysis formulas and a Neural Network program to predict the presence or absence of chromosomal abnormalities in a second set of patients (study 2) undergoing genetic amniocentesis. RESULTS: One hundred twenty-five chromosomal abnormalities were found in 3775 fetuses in study 1 (3.3%). Multivariate analysis showed significant correlations between anomalies of the central nervous system, heart, face and neck, and extremities and increased nuchal fold, increased bowel echogenicity, abnormal biparietal diameter-to-femur ratio, and the presence of chromosomal abnormalities. Regression equations and a Neural Network program successfully predicted the presence or absence of fetal chromosomal abnormalities in a second set of 901 at-risk fetuses. CONCLUSION: A normal ultrasonographic examination result in patients who are at increased risk for fetal chromosomal abnormalities reduces the risk 2- to 3-fold, whereas the presence of any major ultrasonographic abnormality or certain minor abnormalities significantly increases the risk. The application of these results to low-risk patients is still premature.

Reoperative coronary bypass surgery using normothermic cardiopulmonary bypass: comparison with first-time procedures.

Redo coronary artery bypass grafting (CABG) is characterized by increased patient risk compared with first-time CABG. The reason for higher risk is not completely understood but it is logically related to inadequate myocardial preservation evidenced by the higher incidence of postoperative low-output syndrome. We compared normothermic cardiopulmonary bypass with cold blood maintenance cardioplegia in both first-time and redo CABGs to determine whether this single approach is appropriate for both instances. Five hundred seventeen consecutive CABG patients were retrospectively reviewed. Four hundred fifty-four first-time CABG procedures were compared with 44 redo procedures. All aspects of the operation were identical including myocardial preservation. Retrospective univariant analysis of both groups followed. Three clinical features distinguished first-time versus redo CABG. These were previous percutaneous transluminal coronary angioplasty (first-time 19% vs redo 71%; P < 0.001), preoperative intra-aortic balloon pump (first-time 38% vs redo 71%; P < 0.001), and Parsonnet risk score (first-time 11.7+/-8.2 vs redo 19.2+/-8.8; P < 0.001). Operative mortality for redo CABG was higher than in first-time procedures (3.4% vs 6.4%; P = not significant), although small sample size limited statistical significance. The length of stay was statistically longer in redo patients (8.7+/-10.8 vs 6.0+/-5.1 days; P < 0.01) and is related to a higher Parsonnet score, increased postoperative pneumonia, and failed percutaneous transluminal coronary angioplasty before redo CABG. We conclude that redo CABG is a different operation from first-time procedures and requires enhanced myocardial preservation. Normothermic cardiopulmonary bypass with cold blood maintenance cardioplegia does not appear to achieve this goal.

Intrauterine growth restriction and Doppler ultrasonography.

To clarify the difference between the fetus that is small for gestational age and the fetus with true intrauterine growth restriction, we undertook a retrospective study of singleton fetuses who had fetal weight estimation and umbilical artery Doppler velocity studies within 2 weeks of their delivery. Fetuses were divided into four categories on the basis of sonographic results from their last examination. Statistical comparisons of neonatal outcome were made for the four groups, which totaled 578 fetuses. Increased cesarean section for fetal distress, stays in the neonatal intensive care unit, and increased neonatal morbidity were seen in both small for gestational age and average for gestational age neonates with abnormal Doppler blood flow. The small for gestational age fetuses with normal Doppler studies showed no increased morbidity when compared with their average for gestational age cohorts. Umbilical artery Doppler blood flow studies were a better predictor of neonatal outcome than estimated fetal weight. Small for gestational age fetuses with normal Doppler studies most likely represent constitutionally small, not pathologically growth restricted, fetuses.

Predicting particulate (PM10) personal exposure distributions using a random component superposition statistical model.

This paper presents a new statistical model designed to extend our understanding from prior personal exposure field measurements of urban populations to other cities where ambient monitoring data, but no personal exposure measurements, exist. The model partitions personal exposure into two distinct components: ambient concentration and nonambient concentration. It is assumed the ambient and nonambient concentration components are uncorrelated and add together; therefore, the model is called a random component superposition (RCS) model. The 24-hr ambient outdoor concentration is multiplied by a dimensionless "attenuation factor" between 0 and 1 to account for deposition of particles as the ambient air infiltrates indoors. The RCS model is applied to field PM10 measurement data from three large-scale personal exposure field studies: THEES (Total Human Environmental Exposure Study) in Phillipsburg, NJ; PTEAM (Particle Total Exposure Assessment Methodology) in Riverside, CA; and the Ethyl Corporation study in Toronto, Canada. Because indoor sources and activities (smoking, cooking, cleaning, the personal cloud, etc.) may be similar in similar populations, it was hypothesized that the statistical distribution of nonambient personal exposure is invariant across cities. Using a fixed 24-hr attenuation factor as a first approximation derived from regression analysis for the respondents, the distributions of nonambient PM10 personal exposures were obtained for each city. Although the mean ambient PM10 concentrations in the three cities varied from 27.9 micrograms/m3 in Toronto to 60.9 micrograms/m3 in Phillipsburg to 94.1 micrograms/m3 in Riverside, the mean nonambient components of personal exposures were found to be closer: 52.6 micrograms/m3 in Toronto; 52.4 micrograms/m3 in Phillipsburg; and 59.2 micrograms/m3 in Riverside. The three frequency distributions of the nonambient components of exposure also were similar in shape, giving support to the hypothesis that nonambient concentrations are similar across different cities and populations. These results indicate that, if the ambient concentrations were completely controlled and set to zero in all three cities, the median of the remaining personal exposures to PM10 would range from 32.0 micrograms/m3 (Toronto) to 34.4 micrograms/m3 (Phillipsburg) to 48.8 micrograms/m3 (Riverside). The highest-exposed 30% of the population in the three cities would still be exposed to 24-hr average PM10 concentrations of 47-74 micrograms/m3; the highest 20% would be exposed to concentrations of 56-92 micrograms/m3; the highest 10% to concentrations of 88-131 micrograms/m3; and the highest 5% to 133-175 micrograms/m3, due only to indoor sources and activities. The distribution for the difference between personal exposures and indoor concentrations, or the "personal cloud," also was similar in the three cities, with a mean of 30-35 micrograms/m3, suggesting that the personal cloud accounts for more than half of the nonambient component of PM10 personal exposure in the three cities. Using only the ambient measurements in Toronto, the nonambient data from THEES in Phillipsburg was used to predict the entire personal exposure distribution in Toronto. The PM10 exposure distribution predicted by the model showed reasonable agreement with the PM10 personal exposure distribution measured in Toronto. These initial results suggest that the RCS model may be a powerful tool for predicting personal exposure distributions and statistics in other cities where only ambient particle data are available.

Assessment of indoor fine aerosol contributions from environmental tobacco smoke and cooking with a portable nephelometer.

Personal monitoring studies have indicated that environmental tobacco smoke (ETS) and cooking are major indoor particulate sources in residential and nonindustrial environments. Continuous monitoring of fine particles improves exposure assessment by characterizing the effect of time-varying indoor sources. We evaluated a portable nephelometer as a continuous monitor of indoor particulate levels. Simultaneous sampling with the nephelometer and PM2.5 impactors was undertaken to determine the relationship between particle light scattering extinction coefficient (sigma(sp)) and particle mass concentration in field and environmental chamber settings. Chamber studies evaluated nephelometer measurements of ETS and particles produced from toasting bread and frying foods. Field measurements were conducted in 20 restaurants and bars with different smoking restrictions, and in five residential kitchens. Additional measurements compared the nephelometer to a different mass measurement method, a piezobalance, in a well-characterized residence where various foods were cooked and ETS was produced. Since the piezobalance provides 2-min average mass concentration measurements, these comparisons tested the ability of the nephelometer to measure transient particle concentration peaks and decay rate curves. We found that sigma(sp) and particle mass were highly correlated (R2 values of 0.63-0.98) over a large concentration range (5-1600 microg/m3) and for different particle sources. Piezobalance and gravimetric comparisons with the nephelometer indicated similar sigma(sp) vs. mass slopes (5.6 and 4.7 m2/g for piezobalance and gravimetric comparisons of ETS, respectively). Somewhat different sigma(sp) vs. particle mass slopes (1.9-5.6 m2/g) were observed for the different particle sources, reflecting the influence of particle composition on light scattering. However, in similar indoor environments, the relationship between particle light scattering and mass concentration was consistent enough to use independent nephelometer measurements as estimates of short-term mass concentrations. A method to use nephelometer measurements to determine particulate source strengths is derived and an example application is described.

Simplified Parsonnet risk scale identifies limits to early patient discharge.

BACKGROUND: Fast-track recovery after coronary artery bypass surgery has influenced patient care positively. Predicting patients who fall off track and require prolonged (> or =7 days) hospitalization remains uncertain. The Parsonnet risk assessment score is effective in predicting length of stay, but is limited by inaccurate subdivision of risk categories. We simplified the Parsonnet risk scale to better identify patients eligible for fast-track recovery. METHOD: The cases of 604 consecutive patients who underwent isolated coronary artery bypass grafting (CABG) using cardiopulmonary bypass (CPB) were reviewed retrospectively. A rapid recovery protocol emphasizing reduced CPB time, preoperative intra-aortic balloon pump (IABP) criteria, and atrial fibrillation prophylaxis was applied to all patients. The five original divisions of the Parsonnet risk scale were reduced to three risk categories: Low (0-10; Group A), Intermediate (11-20; Group B), High (> 20; Group C). Comparisons of progressive risk categories were analyzed to identify predictive factors associated with fast-track outcomes. RESULTS: The thirty-day operative mortality for the entire group was 3.6%. Three clinical features were identified that distinguished risk progression-female gender, reoperative CABG, and increased age. Additionally, the presence of diabetes (p < 0.05), congestive heart failure (p < 0.01), and peripheral vascular disease (p < 0.001) distinguished Groups A and B, while acute myocardial infarction (p < 0.05) influenced outcomes in Group C. Group A (48%) mean risk score 5.9+/-3.2 was compared to Group B (34%) 14.8+/-2.6, which was further compared to Group C (18%) 26.4+/-2.8. The mean length of stay for Group A (5.3+/-4.1 days) was notably less than Group B (6.1+/-4.7 days; p < 0.05); however, both groups responded favorably to fast-track techniques. Group C did not respond comparably (9.2+/-9.2 vs 6.1+/-4.7 days; p < 0.001) and experienced prolonged recovery. The simplified Parsonnet risk scale did not identify differences in operative mortality and revealed only pneumonia (p < 0.05) and atrial fibrillation (p < 0.01) to be greater in Group C. As risk increased, significantly less revascularization was performed (Group A 3.6+/-1.2 grafts/patient vs Group B 3.3+/-1.2 [p < 0.01]; Group B 3.3+/-1.2 vs Group C 2.5+/-1.0 [p < 0.001]). CONCLUSION: A simplified Parsonnet risk scale (three categories) is an effective tool in identifying factors limiting fast-track recovery. Low- and intermediate-risk patients represent the majority (82%) and respond well to fast-track methods. High-risk patients (18%) are limited by a greater percentage of female patients, reoperative CABG, and the very elderly, resulting in fast-track failure. Strategies to improve recovery in high-risk patients may include evolving off-pump techniques.

Comparison of the non-stress test with the evaluation of centralization of blood flow for the prediction of neonatal compromise.

OBJECTIVE: To determine whether the middle cerebral to umbilical artery systolic/diastolic velocity waveform ratio (MC/UA) was a more sensitive indicator of fetal compromise than the non-stress test (NST). STUDY DESIGN: An outcome study of high-risk patients undergoing NST testing and MC/UA studies within 10 days of delivery. Patients were divided into four groups based on their test results, and neonatal outcome parameters were compared. RESULTS: There were significant differences between all four test result groups with respect to length of stay in the neonatal intensive care unit (NICU). Patients in whom both the NST and MC/UA ratio were normal had significantly lower utilization of Cesarean section for delivery, admission and length of stay in the NICU and occurrence of significant neonatal complications. Logistic regression analysis indicated that the combination of the NST and MC/UA ratio was an excellent predictor of perinatal outcome. CONCLUSIONS: The MC/UA ratio improves the sensitivity for the prediction of poor perinatal outcome when it is combined with the NST.

Mathematical models for predicting indoor air quality from smoking activity.

Much progress has been made over four decades in developing, testing, and evaluating the performance of mathematical models for predicting pollutant concentrations from smoking in indoor settings. Although largely overlooked by the regulatory community, these models provide regulators and risk assessors with practical tools for quantitatively estimating the exposure level that people receive indoors for a given level of smoking activity. This article reviews the development of the mass balance model and its application to predicting indoor pollutant concentrations from cigarette smoke and derives the time-averaged version of the model from the basic laws of conservation of mass. A simple table is provided of computed respirable particulate concentrations for any indoor location for which the active smoking count, volume, and concentration decay rate (deposition rate combined with air exchange rate) are known. Using the indoor ventilatory air exchange rate causes slightly higher indoor concentrations and therefore errs on the side of protecting health, since it excludes particle deposition effects, whereas using the observed particle decay rate gives a more accurate prediction of indoor concentrations. This table permits easy comparisons of indoor concentrations with air quality guidelines and indoor standards for different combinations of active smoking counts and air exchange rates. The published literature on mathematical models of environmental tobacco smoke also is reviewed and indicates that these models generally give good agreement between predicted concentrations and actual indoor measurements.

Value of inferior vena cava Doppler waveform analysis for prediction of neonatal outcome.

The objective of this article is to determine the value of the inferior vena cava preload index (IVC) to predict neonatal outcome and compare it to other biophysical methods of antenatal surveillance. A clinical outcome study of patients referred to the author's institution for Doppler velocity blood flow studies was undertaken by comparing the ability of three antenatal surveillance tests: the nonstress test (NST); umbilical artery S/D ratio (UA); and the ratio of the middle cerebral artery to umbilical artery S/D ratios (MCUA) to predict poor neonatal outcome to the ability of the IVC to predict poor outcome. Patients were followed serially and neonatal outcome data was tabulated. Those patients that delivered within 10 days of their last study were included in the analysis. Seventy patients met the inclusion criterion. Neonatal outcome based on the results of the IVC as compared with outcome based on the results of the NST, UA, and MCUA tests. Odds ratios (with 95% confidence limits) for significant neonatal morbidity predicted by each test were: NST: 2.6 (0.14-14.6); UA: 5.7 (1.7-18.8); MCUA: 3.6 (1.1-13.1); and IVC: 4.1 (1.3-13.2). Logistic regression analysis indicated that the combination of MCUA and IVC was the best method of predicting poor neonatal outcome. This study of the utility of fetal IVC suggests that this noninvasive method of antenatal surveillance may provide an additional sensitive method of evaluating the status of the high-risk fetus.