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Aim. To evaluate the influence of selected maternal and neonatal characteristics on aorta walls in term, appropriately grown-for-gestational age newborns. Methods. Age, parity, previous abortions, weight, height, body mass index before and after delivery, smoking, and history of hypertension, of diabetes, of cardiovascular diseases, and of dyslipidemia were all assessed in seventy mothers. They delivered 34 males and 36 females healthy term newborns who underwent ultrasound evaluation of the anteroposterior infrarenal abdominal aorta diameter (APAO), biochemical profile (glucose, insulin, total cholesterol, HDL and LDL cholesterol, triglycerides, fibrinogen, and D-dimers homeostasis model assessment [HOMAIR]index), and biometric parameters. Results. APAO was related to newborn length (r = +0.36; P = 0.001), head circumference (r = +0.37; P = 0.001), gestational age (r = +0.40, P = 0.0005), HOMA index (r = +0.24; P = 0.04), and D-dimers (r = +0.33, P = 0.004). Smoke influenced APAO values (odds ratio: 1.80; confidence interval 95%: 1.05–3.30), as well as diabetes during pregnancy (r = +0.42, P = 0.0002). Maternal height influenced neonatal APAO (r = +0.47, P = 0.00003). Multiple regression analysis outlined neonatal D-dimers as still significantly related to neonatal APAO values. Conclusions. Many maternal and neonatal characteristics could influence aorta structures. Neonatal D-dimers are independently related to APAO.
Cardiovascular diseases (CVD) are still the major cause of death in developing countries, including China and India [1]. Primary prevention programs, instrumental evolution, pharmacological treatments, and lifestyle changes reduce CVD mortality compared to the 1960s data [2]. Nevertheless, CVD start since childhood. Since 1990s, the attention of physicians moved on the early stages of life [3]. The Cardiovascular Risk in Young Finns [3] was one of the first studies systematically evaluating the role of different conditions (i.e., family dietary habits and standard of education and diet of mothers) on the future cardiovascular risk profile of 3,596 children.
Dalziel et al. [4] demonstrated that adult patients born moderately preterm have increased blood pressure and insulin resistance at 30 years of age. Preterm birth rather than poor fetal growth seemed to be the major determinant of this association, although many epidemiological studies showed that low birth weight was independently associated with subsequent cardiovascular disease risk factors and increased incidence of cardiovascular disease in adulthood [5, 6]. The "fetal programming" during critical phases of development in utero could be responsible for metabolic disturbances in adult life and long-term structural changes of the vascular system [7–9].
Neonatal and maternal characteristics could early influence atherosclerosis development. Anteroposterior diameter of infrarenal abdominal aorta (APAO) is a reliable and well-established ultrasound parameter to detect early impairment of vascular structure since childhood [10, 11].
The aim of this study was to evaluate the influence of some selected maternal and neonatal characteristics on aorta walls (evaluated by mean of APAO) in term, appropriately grown-for-gestational age (AGA) newborns.
Seventy mother-newborn pairs admitted, respectively, to the Obstetric Section and Neonatology and Neonatal Intensive Care of the Department of Gynecology, Obstetrics and Neonatology of the University of Bari were enrolled in the study.
The study was approved by the Institutional Review Board of Bari University General Hospital and carried out in accordance with the principles of the Helsinki Declaration.
There were 34 males and 36 females healthy newborns, born at term (after 37 completed weeks of gestation), 38 by vaginal delivery, and 32 by C-section. Mean gestational age was 39.2 ± 1.2 weeks, mean birth weight 3, 289.3 ± 341.2g (between 10th and 90th percentile as established by gender and gestational age-specific national charts [12], AGA), mean length 49.5 ± 2.2cm, and head circumference 34.0 ± 1.2cm. They all had normal transition (Apgar 5′ ≥ 7). Newborns with any congenital malformations were excluded.
After informed consent, all newborns had ultrasound evaluation of the APAO, and biochemical profile was obtained on the blood taken at birth from umbilical cord. Blood samples had been performed early at morning (between 8:00a.m. and 9:00a.m.) after an overnight fast on the same day of the ultrasound.
APAO evaluations were done, within 24 hours after delivery, with the newborn in supine position, during a routine daytime rest period, in a warm environment (20-21°C). It was performed by a single operator using a single high-resolution vascular ultrasound Philips 5500 equipped with a 3MHz electronic probe. To improve the image acquisition, neonates were examined at least 4–6 hours after breastfeeding to reduce intestinal bloating. The electronic probe was placed one centimeter left of the umbilicus. Then the best image in long-axis projection of the abdominal aorta was obtained. The APAO was defined as the maximal external cross-sectional diameter measurement of the infrarenal abdominal aorta. It was calculated as the distance between the near and the far walls of the abdominal aorta. Measurements were performed 1cm above and distal to the umbilicus and expressed in centimeters [10, 11]. Repeatability and intraobserver variability of all ultrasound scan measurements were evaluated by means of intraclass correlation coefficient of >0.90. In particular, anteroposterior diameter showed good reproducibility with an intraclass correlation coefficient of 0.92.
Biochemical profile included glucose, insulin, total cholesterol, high-density lipoprotein (HDL) and low-density lipoprotein (LDL) cholesterol, triglycerides, fibrinogen, and D-dimers determinations. Insulin resistance was calculated by the homeostasis model assessment (HOMAIR) [13, 14].
For each mother, data on age, parity, previous abortions, weight, height, and body mass index [weight (kg)]/[height (m)]2 before and after delivery were collected. Using a combination of clinical interviews and obstetric records, information about familiar history for hypertensive, diabetic, cardiovascular diseases, and dyslipidemic conditions were also obtained. Mothers were considered as smoker if they smoked at least five cigarettes/day within 3 months before delivery or if they stopped smoking <1 year before delivery. There were no inclusion criteria for the mothers, except to have delivered an AGA term newborn. 111 mothers and related newborns were consecutively enrolled, but 70 delivered AGA term newborn.
The continuous variables were expressed as mean and standard deviation.
Categorical data had been evaluated by means of odds estimation and CI 95 had been used in order to assess statistical significance. The Pearson's linear correlation coefficient was used to study the relationship between the continuous variables. Multiple regression analysis had been adopted in order to evaluate the influence of confounding factors on APAO evaluation. A P < 0.05 was considered statistically significant.
Maternal mean age was 32 ± 5 years. Body mass index before delivery was within normal limits (22.75 ± 4.46Kg/m2). There were 19 smokers (27%). Nine (13%) had gestational diabetes, and 6 (9%) and 3 (4%) haddyslipidemia. 22 (31%) had one or more previous abortions and 5 (7%) had 2 or more previous pregnancies. Familiarity for hypertension, cardiovascular diseases, dyslipidemic conditions, and diabetes are shown in Table 1.
Neonatal data are shown in Table 2. Mean APAO value was 4.76 ± 0.98cm.
Pearson's linear regression has been used to assess any relationships between APAO values and maternal characteristics (Table 3). Furthermore, odds ratio and their relatives confidential intervals had been calculated for main dichotomous maternal variables considered (Table 4). Pearson's linear regression has been used to assess any relationships between APAO values and neonatal characteristics (Table 5).
APAO is directly related both to newborn length (r = +0.36; P = 0.001) and head circumference (r = +0.37; P = 0.001) at birth but not to birth weight (Table 5), and it is also strongly related to gestational age (r = +0.40, P = 0.0005).
Interestingly, APAO is positively related to HOMA index (r = +0.24; P = 0.04), that is, an early marker of atherosclerosis (Table 5), while no correlation between APAO and insulin (r = +0.22; P = 0.056) was found. No correlations have been found between lipids blood levels and coagulation parameters (fibrinogen and prothrombin time-international normalized ratio [PT-INR]) with APAO values, but D-dimers (r = +0.33, P = 0.004) (Figure 1).
Important data come from the analysis of correlations between maternal characteristics and APAO. Smoking habit is a strong predictor of greater APAO values [Odds Ratio (OR): 1.80 (CI 95%: 1.05–3.30)]; thus, smoking could already exert a deleterious effect on the cardiovascular system of newborns. Even dyslipidemia familiarity seems to be slightly related to APAO increase [OR: 1.18 (CI 95%: 0.70–1.92)]. The same effect resulted for diabetes during pregnancy (r = +0.42, P = 0.0002).
Maternal height influences neonatal APAO (r = +0.47, P = 0.00003) while BMI before delivery and/or weight before delivery do not.
Because of multiple associations between maternal and neonatal characteristics with neonatal APAO, we performed a multivariate regression (Table 6). Only neonatal D-dimers were still significantly related to neonatal APAO values.
In the last two decades, the scientific international community investigated the early phases of life as the moment from which atherosclerosis process could be outlined and, maybe, forced to reduce its development [3, 6]. The efforts to discover early markers of atherosclerosis since childhood lead to a new era of noninvasive technologies able to find the first moments of such a disabling process such as echocardiographic-Doppler evaluations [15], carotid intima-media thickness, flow-mediated vasodilatation, and APAO [10, 11, 16]. Our study aim was to evaluate the influence of maternal and neonatal characteristics on APAO in order to evaluate possible early factors of abdominal aorta walls alterations, that is, the beginning of atherosclerotic disease. APAO is an indicator of an earlier vascular remodeling and a high aortic stiffness, and it is therefore associated with a widespread vascular disease. It can be used to monitor patients at risk, even children [10, 11]. At the best of our knowledge, few studies have evaluated APAO in newborns.
Shankaran et al. [17] demonstrated a tight relationship between some maternal (smoke habits during pregnancy, alcohol intake, drug-addiction, etc.) and neonatal (birth weight, gender, etc.) characteristics with the cardiovascular risk profile evaluated at a 6-years followup. They were all term newborns, but the study showed the increase of blood pressure at 6 years of age only in those with intrauterine growth restriction (IUGR). Our study included only AGA infants and different maternal and neonatal characteristics, because it is already known that preterm delivery and/or IUGR are both factors able to increase the future cardiovascular risk [18, 19].
Some authors [20, 21] pointed out that maternal weight is a predictive factor for coronary heart diseases in adulthood and Poston [22] showed that gestational weight gain could influence long-term health of the neonate. Our study did not demonstrate a relationship between APAO and maternal weight and body mass index before delivery. We further showed a relationship between APAO and maternal height.
Our finding of a relationship between neonatal APAO and maternal smoking habits suggests that maternal smoking can cause an increased cardiovascular risk, already since birth [23–25]. Anna-Karin et al. [23] have found that maternal smoking is related to reduced descending aorta diameter in preterm newborns. Nevertheless, Anna-Karin et al. considered preterm newborns who had different physiological conditions than term neonates. Furthermore, their regression analysis did not consider all the confounding factors able to influence the predictability of the results, except gender and smoking. Differently from Anna-Karin et al., we have only evaluated term newborns, by considering all the parameter able to influence the relationship. At a linear analysis, smoking increased abdominal aorta intima-media thickness [24], probably through endocrine modifications, involving serum insulin-like growth factor-I (IGF-I) and insulin-like growth factor binding protein-3 (IGFBP-3) levels and actions [23] or by inducing a long-lasting "reprogramming" of the blood pressure control mechanisms [25], but the evaluation was not confirmed after adjustment for confounding variables. Nevertheless, as the hypothesis of Anna-Karin et al. about a reduced flow in placental circulation due to smoke could have influenced the reduced diameter found at abdominal aortic level, the same vascular alterations induced by smoke could enlarge the aortic diameter. For this reason further studies are needed in order to make such a matter clearer.
The relationship between APAO and coagulation parameters shows a statistically significant relationship between abdominal aorta diameter and D-dimers, the end product of stabilized fibrin degradation, whose values are higher in newborns compared to children and adults. D-dimers derive from the fibrin degradation through fibrinolysis process activation. It is encountered among those haemostatic tests able to improve the detection of coagulation process activation. Giannitsis et al. [26] already demonstrated the relationship between haemostatic factors and coronary artery diseases. Krupinski et al. [27] found an increased value of D-dimers in patients undergoing carotid endarterectomy: unstable plaques, in fact, seemed to show a higher fibrin intraplaque turnover able to induce an augmentation of D-dimers products, thus making D-dimers a surrogate marker of plaque instability. Clinical data recently indicated an association between elevated levels of D-dimers and the risk of subsequent clinical manifestations of cardiovascular disease [28]. The relationship between APAO and D-dimers in neonates is similar to the data from Empana et al. [28] in adults, and it has been confirmed by multivariate regression analysis. Thus, D-dimers could really become a marker of vessels walls instability and modification of their inner morphological structure since first days of life. At the best of our knowledge, no study have showed these results, but further studies are needed.
Furthermore, our data outlined a direct relationship between other neonatal parameters and APAO.
In particular, gestational age (r = +0.40; P = 0.0005), length (r = +0.36; P = 0.001), head circumference (r = +0.37; P = 0.001), and HOMA index (r = +0.24; P = 0.004) are all related to APAO.
Late gestational age is related to increased cardiovascular risk [29]. Our data seem to corroborate the literature findings: late gestational age is associated with increased cardiovascular risk. Nevertheless, biometrics in newborns' development is an important factor linked to cardiovascular risk. Touwslager et al. [30] demonstrated that birth weight, length, and head circumference of the infants were associated with impaired endothelial vasodilatation, that is, an early marker of atherosclerosis. Our findings seem to complete those of Touwslager et al.: we demonstrated that birth weight, length, and head circumference were all related to morphological alterations of the newborns' vasculature. This means that such neonatal parameters when altered could be considered as expression of morphological and functional early alterations of cardiovascular system; thus, they really increase cardiovascular risk profile of each individual.
In contrast with other studies [30, 31], we have not found that birth weight influences APAO.
APAO in our study population (term AGA newborns) is related to HOMAIR-index, similarly to what Simental-Mendía et al. [32] have demonstrated in small-for-gestational age (SGA) and large-for-gestational age (LGA). HOMAIR index is a fundamental parameter calculated in order to evaluate one's insulin resistance condition. According to Gesteiro et al. data [33], our newborns showed normal values of HOMAIR index in agreement with their age. Insulin resistance is already known to damage vessels walls by accelerating atherosclerotic process. Iannuzzi et al. [34] demonstrated an increased aortic stiffness related to HOMAIR values. Nevertheless, these data involved obese children, while no data concerned newborns. At the best of our knowledge, this is the first study showing a direct relationship between insulin resistance increase and damages to aortic walls since the first moments of individuals' life. This means that physicians should better control pancreatic function of newborns in order to prevent further damages to cardiovascular system.
Despite the small sample size, we obtained a preliminary evaluation of the relationship between maternal and neonatal characteristics and the cardiovascular system of the newborn, evaluated as APAO, an excellent, noninvasive and reproducible tool able to evaluate the cardiovascular risk profile in newborns. Further researches are needed in order to improve our findings.
The authors declare that there is no conflict of interests.
PubMed Central Canada is a service of the Canadian Institutes of Health Research (CIHR) working in partnership with the National Research Council's national science library in cooperation with the National Center for Biotechnology Information at the U.S. National Library of Medicine(NCBI/NLM). It includes content provided to the PubMed Central International archive by participating publishers.


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Insightful history of Middle Earth,
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This review is from: Unfinished Tales (Kindle Edition)
To a person who was already a big fan of anything Tolkien, this extra portion of Middle Earth's history was indeed enjoyable and very informative. Granted, it is crucial that the reader required an already heavy knowledge of information of both 'The Lord of the Rings', 'The Silmarillion' and even 'The Children of Hurin', as mentioned in the forward by Christopher Tolkien, but each section will answer many questions which many fans have sought the answers for.
While reading however, I sometimes found it difficult to read, but this is to expected in a Tolkien book. Overall, it was a very good read and I will enjoy reading it once more some time in the future.
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U.S. Election Program and Seventh Global Elections Organization (GEO-7) Conference
November 6-10, 2016
What's Going on at IFES?
Following the historic 2015 elections in Myanmar, the International Foundation for Electoral Systems (IFES) published five reports that provide important data on the accomplishments of the 2015 elections and outline recommendations for the 2020 electoral cycle. These documents are a result of continued collaboration between IFES, the Union Election Commission (UEC), civil society organizations, political parties, voters, domestic and international observers and implementers.
The International Foundation for Electoral Systems (IFES) and the United Nations Development Programme (UNDP) have signed a Memorandum of Understanding to advance electoral practices around the world. The enhanced collaboration will promote inclusive, credible electoral processes across borders while fostering good and accountable governance institutions.
On July 26, 1990, the United States passed the Americans with Disabilities Act (ADA), a landmark law increasing access to basic rights for persons with disabilities in the country. The ADA's passage was the result of decades of advocacy by citizens with disabilities, following other successful legal reforms such as Section 504 of the 1973 Rehabilitation Act, which established nondiscrimination of persons with disabilities in federally-funded programs as a right.
IFES Champions #HerVoteHerVoice
There are currently four separate and different reserved seat systems for women at three levels of government in Bangladesh, and they produce different gender equality outcomes. This paper, authored by IFES Bangladesh Chief of Party Silja Paasilinna, examines these systems in detail, provides an overview of gender-based challenges women elected representatives face in both general and reserved seats, and provides a summary of suggested improvements to the current systems as well as options for alternative systems.
Fatoumata Camara, a Guinean with a physical disability, is the Deputy Coordinator for the Association of Persons Living with a Disability of Mamou, Guinea. In this Q&A, Camara discusses barriers to electoral and political participation that Guineans with disabilities face, the role of civic education in reducing those barriers and major accomplishments of the disability rights movement in Guinea.
In an effort to address this growing concern, the International Foundation for Electoral Systems (IFES) plans to conduct an in-depth analysis of election management body (EMB) digital security practices and develop a diagnostic tool to help EMBs practice better digital security.


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Cookie Monster Vs. The Power Rangers
When it comes to TV shows, movies, or anything related to sports, we are always comparing, who is better than who.
When it comes to TV shows, movies, or anything related to sports, we are always comparing, who is better than who.
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You know you have done something right when people make fun of you.
As you know that is the ultimate form of flattery.
So after a long day yesterday, of helping a friend move into a new house, visiting my mother, and hanging out with my little brother, I tried to do what most people would normally do, relax.
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He can play just about any role, from a crackhead, slave to a big time drug dealer and to a man being eating by a shark.
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Some people will make things look a whole lot easier than they really are.
If you're a fan of Family Guy or ever seen an episode, you know Peter Griffin is a riot. A real life impersonator showed that the character really exist outside of television. Thank me later.


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Beyonce admits to lip sync
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- Classic Army Grenadier Custom FPS-380 Electric Airsoft Rifle
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From Flames to Fish: Resurrection of the Cuyahoga
Abstract:In 1969, debris on the Cuyahoga River in Cleveland, Ohio caught fire, helping to raise the country's awareness of the need for improvements in water quality nationwide and eventually leading to passage of the legislation that became known as the Clean Water Act. At that time, the biological community in the river had been severely impacted by pollution and consisted mostly of pollution-tolerant organisms. Over the last forty years, however, consolidation of wastewater collection, wastewater treatment upgrades, wet-weather overflow control, industrial pretreatment implementation, and other remedial actions undertaken by numerous agencies and organizations have resulted in ecological recovery of the Cuyahoga River. Sampling conducted by the Northeast Ohio Regional Sewer District and Ohio EPA in recent years has indicated that the fish and macroinvertebrates communities in many segments of the lower Cuyahoga River are currently attaining the Warmwater Habitat aquatic life use designated by Ohio EPA.
Keywords: Cuyahoga River; Index of Biotic Integrity; Invertebrate Community Index; Modified Index of Well-Being; Northeast Ohio Regional Sewer District; biological assessment
Document Type: Research Article
DOI: http://dx.doi.org/10.2175/193864709793956455
Publication date: January 1, 2009
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- Proceedings of the Water Environment Federation is an archive of papers published in the proceedings of the annual Water Environment Federation® Technical Exhibition and Conference (WEFTEC® ) and specialty conferences held since the year 2000. These proceedings are not peer reviewed. WEF Members: Sign in (right panel) with your IngentaConnect user name and password to receive complimentary access.
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NY cops get over $20K for license plate readers
By Ashley Hupfl
The Journal News
ALBANY, N.Y. — Greenburgh police will receive a $22,500 state grant for a license plate reader package that will be used toward its efforts to target burglaries, Gov. Andrew Cuomo announced Tuesday.
The department is one 31 law enforcement agencies that will share nearly $1 million in grants to boost a crime-prevention efforts in upstate New York.
The grants go to law enforcement agencies in counties not participating in the state's new Gun Involved Violence Elimination initiative. As part of the state budget, Cuomo ended Operation IMPACT, a crime-fighting program started in 2004 for 17 upstate counties with high crime rates.
Full Story: Greenburgh gets state grants for license plate readers
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There's an important distinction between attention and recognition, though I think we easily confuse them in speech and in practice. We seek attention when we want recognition, some sense of our worth or integrity to others. Attention is a necessary prerequisite for recognition, but doesn't always lead to a feeling of having been recognized. My main fear about social media is that is becoming harder to translate attention into recognition without their aid. Increasingly, attention that isn't in some way mediated seems inert, if not unsettling and creepy.
I have this feeling that people are going to become more and more wary of direct face-to-face attention because it will seem like it's wasted on them if it's not mediated, not captured somehow in social networks where it has measurable value. I imagine this playing out as a kind of fear of intimacy as it was once experienced—private unsharable moments that will seem creepier and creepier because no one else can bear witness to their significance, translate them into social distinction. Recognition within private unmediated spaces will be unsought after, the "real you" won't be there but elsewhere, in the networks.
I have an essay up at the New Inquiry about artist Laurel Nakadate, whose work is, I think, about this emerging condition—about becoming increasingly unavailable to attention in the moment, wholly ensconced by self-consciousness. Receiving attention in real time can't confirm anything about how you want to feel about yourself; it becomes a portal to a deeper loneliness—the way out seems to be to mediate the experience, watch it later, transmute it into something else. In short, we are losing the ability to feel recognized in the moment, which strands us further and further away from fully inhabiting our bodies in the present. We are always elsewhere, in the cloud.
Michael Blume 'When I Get It Right' (EP stream) (premiere) // Music
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Big Top Heartbreak "My Breath Killed the Roses" (video) (premiere) // Music
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It's Not Easy Being Yellow
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"In which we consider the challenges of and the reasons for making the "wrong" color choice in Pokemon Go.READ the article


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It'll be interesting to see what such a substantial victory in margin and venue as this one over Phoenix will do for a Lakers team that needs to mesh completely as a team to have any chance at salvaging the season. I asked Phil Jackson afterward what he thought it did, and he went the oblique route, smiling and saying: "Puts us at .500 ... 1-1."
Then he added -- in a sentiment Kobe Bryant also offered: "We'd better know that this is one game out of 82. So we just have to accept it and be gracious. Gratitude abounds."
Road victories are just a little bit more to be thankful for and appreciate than home victories. It's partly the challenge of winning on another team's floor; it's more about the communal spirit of being a team together away from home.This was the Lakers' lone trip in more than two weeks to start the season. And to have won on it -- especially in the place where they wanted to win more than anywhere -- is really noteworthy. On the road is where teams can come together apart from their separate home lives. That's the potential beauty in the travel for NBA teams.
For sports writers, there isn't that (although there is certainly bonding time with other writers -- and our crew covering the Lakers gets along better than most, I'd say). I most appreciate the greater opportunities to be introspective or catch up on reading while killing quiet time in airports or on planes or in hotel rooms. I know most of you are probably diehard sports people, but here are two non-sports recommendations: My magazine staples include the hugely undervalued "Best Life" and the consistently enlightening "Psychology Today." Believe me, everything you pick up when a reader lends context when you're trying as a writer to understand the people you're covering.
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Ehlers-Danlos syndrome, arthrochalasia type
Other Names for this Disease
- Arthrochalasis multiplex congenita
- Ehlers-Danlos syndrome type 7A (formerly)
- EDS7A (formerly)
Related Diseases
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.
connective tissue disorder that is caused by defects in a protein called collagen. Common symptoms include severe joint hypermobility; congenital hip dislocation; fragile, hyperextensible skin; hypotonia; and kyphoscoliosis (kyphosis and scoliosis).[1][2] EDS, arthrochalasia type is caused by changes (mutations) in the COL1A1 gene or the COL1A2 gene and is inherited in an autosomal dominant manner.[3] Treatment and management is focused on preventing serious complications and relieving associated signs and symptoms.[4]Ehlers-Danlos syndrome (EDS), arthrochalasia type is an inherited
Last updated: 6/2/2015
- Pauker SP & Stoler J. Clinical manifestations and diagnosis of Ehlers-Danlos syndromes. UpToDate. February 22, 2016; http://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-ehlers-danlos-syndromes.
- Klaassens M1, Reinstein E, Hilhorst-Hofstee Y, Schrander JJ, Malfait F, Staal H, ten Have LC, Blaauw J, Roggeveen HC, Krakow D, De Paepe A, van Steensel MA, Pals G, Graham JM Jr, Schrander-Stumpel CT. Ehlers-Danlos arthrochalasia type (VIIA-B)--expanding the phenotype: from prenatal life through adulthood. Clin Genet. August 2012; 82(2):121-130.
- Defendi GL. Genetics of Ehlers-Danlos Syndrome. Medscape Reference. August, 2015; http://emedicine.medscape.com/article/943567-overview.
- Susan P Pauker, MD, FACMG; Joan Stoler, MD. Overview of the management of Ehlers-Danlos syndromes. UpToDate. March 2014; Accessed 5/22/2015.
GARD Video TutorialsLearn how to find information on treatment, research, specialists, and more.
Contact GARDContact a GARD Information Specialist with your questions about this condition.
On this page
Basic Information
- Genetics Home Reference (GHR) contains information on Ehlers-Danlos syndrome, arthrochalasia type. This website is maintained by the National Library of Medicine.
- MedlinePlus was designed by the National Library of Medicine to help you research your health questions, and it provides more information about this topic.
- The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.
In Depth Information
- Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
Ehlers-Danlos Syndrome
Genetics of Ehlers-Danlos Syndrome
- MeSH® (Medical Subject Headings) is a terminology tool used by the National Library of Medicine. Click on the link to view information on this topic.
- The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch's tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
- Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine.
- Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
- PubMed is a searchable database of medical literature and lists journal articles that discuss Ehlers-Danlos syndrome, arthrochalasia type. Click on the link to view a sample search on this topic.
Other Names for this Disease
- Arthrochalasis multiplex congenita
- Ehlers-Danlos syndrome type 7A (formerly)
- EDS7A (formerly)
Related Diseases
See Disclaimer regarding information on this site. Some links on this page may take you to organizations outside of the National Institutes of Health.


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Ubisoft Celebrates 20 Years of Rayman with Massive Infographic0 Comments
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Our attempt to answer issues which most commonly occur on IGN's wikis.
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The legendary first Rayman adventure is now available from the Nintendo DSiWare service. Play as Rayman and try to save his amazing world from the evil Mr. Dark. Discover a charming universe with colorful landscapes and meet funny characters who'll help Rayman through his quest. Experiment with his abilities as you punch, hang or fly in the air and choose between two difficulty levels. Take advantage of new features in the Nintendo DSi version, such as the Nintendo DSi Camera, map selection on the touch screen and the ability to play against time to win bonuses.
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Mountain View News
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The New York Times D - Day Coin and Stamp Collection
Item # WX2-294450
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The New York Times D - Day Coin and Stamp Collection. Celebrating American heroes.
Collection includes coins, stamps and a reproduction of the front page of The New York Times June 7, 1944 edition, so you can "read all about it"... meaning D-Day, the battle of combined American, British and Canadian forces which marked the beginning of the end of the war in Europe. Official reproduction is displayed in a classy black vinyl portfolio, which also includes 2 genuine U.S. coins from the era, as well as 2 mint U.S. stamps. Includes certificate of authenticity.A piece of history:
- One 1944 Lincoln copper wheat ear cent
- One 1944 Jefferson silver wartime nickel
- One 3-cent stamp celebrating the colorful General George S. Patton for victories as commander of the U.S. Third Army, issued in 1953
- One 1-cent stamp of Franklin D. Roosevelt Hyde Park Residence, issued in 1945 after the President's death
- Measures 8 x 6 5/16 x 3/8", 10 ozs.
A beautiful, keepsake tribute.


text:
Rural Nursing: Concepts, Theory and Practice, Third Edition / Edition 3by Charlene A. Winters
View All Available Formats & Editions
Pub. Date: 10/05/2009
Publisher: Springer Publishing Company
[T]his extended text on rural nursing is a significant contribution to the knowledge base on a phenomenon that is of significant importance to nurse educators, researchers, policy makers, and clinicians."
--Dr. Angeline Bushy, PhD, RN, FAAN
University of Central Florida
College of Nursing (From/b>
Designated a Doody's Core Title!
[T]his extended text on rural nursing is a significant contribution to the knowledge base on a phenomenon that is of significant importance to nurse educators, researchers, policy makers, and clinicians."
--Dr. Angeline Bushy, PhD, RN, FAAN
University of Central Florida
College of Nursing (From the Foreword)
Thoroughly updated and revised, this new edition of Rural Nursing provides the knowledge, skills, and insight nurses must acquire to meet the unique needs of rural populations. Winters and Lee present a broad overview of the perspectives of rural persons, the characteristics of health care in rural settings, and the requirements for effective nursing practice.
With contributors from the United States, Canada, and Australia, this new edition presents an expanded view of how nurses can help make large-scale health care improvements in rural settings. Nurses will learn how to encourage changes in the health behaviors of rural people, pursue evidence-based practice and research, and create initiatives for improved education, practice, and policy.
New and expanded topics include:
- Rural male caregivers
- Perinatal experiences of rural women
- Complementary therapy and health literacy in rural dwellers
- Childhood obesity and environmental risk reduction for rural children
- Rural public health in Native American communities
Product Details
- 9780826104564
- Publisher:
- Springer Publishing Company
- Publication date:
- 10/05/2009
- Edition description:
- Third Edition
- Pages:
- 504
- Product dimensions:
- 5.90(w) x 8.90(h) x 1.30(d)
Table of Contents
Part I - The Rural Nursing Theory Base
Ch 1 - Rural Nursing: Developing the Theory Base
Ch 2 - Examining the Rural Nursing Theory Base
Ch 3 - Exploring Rural Nursing Theory Across Borders
Part II - Perspectives of Rural Persons
Ch 4 - Health Needs and Perceptions of Rural Persons
Ch 5 - Strategizing Safety: Perinatal Experiences of Rural Women
Ch 6 - Health Perceptions, Needs, and Behaviors of Remote Rural Women of Childbearing and Childrearing Age
Ch 7 - Rural and Remote Women and Resilience: Grounded Theory and Photovoice Variations on a Theme
Ch 8 - Rural Family Health: Enduring Acts of Balancing
Part III - The Rural Dweller and Response to Illness
Ch 9 - Patterns of Responses to Symptoms in Rural Residents: The Symptom-Action-Time-Line Process
Ch 10 - Updating the Symptom-Action-Time-Line Process
Ch 11 - The Chronic Illness Experience of Isolated Rural Women: Use of an Online Support Group Intervention
Ch 12 - Negotiation of Constructed Gender Among Rural Male Caregivers
Ch 13 - Complementary Therapy and Health Literacy in Rural Dwellers
Ch 14 - Acceptability: One Component in Choice of Health Care Provider
Part IV - Rural Nursing Practice
Ch 15 - The Distinctive Nature and Scope of Rural Nursing Practice: Philosophical Bases
Ch 16 - The Rural Nursing Generalist in the Acute Care Setting: Flowing Like a River
Ch 17 - The Rural Nursing Generalist in Community Health
Ch 18 - Men Working as Rural Nurses: Land of Opportunity
Ch 19 - Continuing Education and Rural Nurses
Ch 20 - Rural Nurses' Attitudes and Beliefs Towards Evidence-Base Practice
Part V - Rural Public Health
Ch 21 - Public Health Emergency Preparedness in Rural or Frontier Areas
Ch 22 - Environmental Risk Reduction for Rural Children
Ch 23 - The Culture of Rural Communities: An Examination of Rural Nursing Concepts at the Community Level
Ch 24 - Community Resiliency and Rural Nursing: Canadian and Australian Perspectives
Ch 25 -The Influence of the Rural Environment on Children's Physical Activity and Eating Behaviors
Part VI - Looking Ahead
Ch 26 - Implications for Education, Practice, and Policy
Ch 27 - An Analysis of Key Concepts for Rural Nursing
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700 acres of farmland to be conservedOctober 16,2013Farmland to
be conserved
The Vermont Housing & Conservation Board has awarded over $1.6 million in state and federal funding to conserve six farms totaling nearly 700 acres in Washington, Windham and Orange counties.
The board matched $740,000 in state funds with $864,000 in federal funding for farmland protection from the Natural Resources Conservation Service. The Vermont Land Trust is raising approximately $170,000 to match the funding.
The farmers will sell conservation easements, limiting any future development to the terms of the easement. As a result of these funding commitments, the Vermont Land Trust will conserve farms in Barre Town, Washington, Thetford, Randolph, Westminster and Dummerston.MORE IN This Just In
Police say a too-quick reaction to a GPS system's directions sent a Toyota Corolla... Full Story To our readers: This morning we had an issue that has prevented timely delivery of... Full Story
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IEEE membership options for an individual and IEEE Xplore subscriptions for an organization offer the most affordable access to essential journal articles, conference papers, standards,
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It is widely recognized that the debugging processes are usually imperfect. Software faults are not completely removed because of the difficulty in locating them or because new faults might be introduced. Hence, it is of great importance to investigate the effect of the imperfect debugging on software development cost, which, in turn, might affect the optimal software release time or operational budget. In this paper, a commonly used cost model is extended to the case of imperfect debugging. Based on this, the effect of imperfect debugging is studied. As the probability of perfect debugging, termed testing level here, is expensive to be increased, but manageable to a certain extent with additional resources, a model incorporating this situation is presented. Moreover, the problem of determining the optimal testing level is considered. This is useful when the decisions regarding the test team composition, testing strategy, etc., are to be made for more effective testing.
A not-for-profit organization, IEEE is the world's largest technical professional organization dedicated to advancing technology for the benefit of humanity.© Copyright 2016 IEEE - All rights reserved. Use of this web site signifies your agreement to the terms and conditions.


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Lithuanian Budget Deficit to Widen Under New Coalition, SEB Says
Lithuania's budget deficit is set to widen next year, even as the Baltic nation's new coalition pledges to trim it to less than 3 percent of economic output, SEB AB said.
The shortfall will probably reach 3.5 percent of gross domestic product in 2013 and 2014 after shrinking to about 3 percent this year, the Swedish bank's Lithuanian unit said today in a report. The four-party coalition plans to adopt a 2013 budget this week with a 2.5 percent deficit.
Prime Minister Algirdas Butkevicius's government, which took office last week, "still needs to disprove the skeptics, showing with deeds and not just words that it intends to maintain fiscal discipline," SEB said. Pressure to implement pre-election spending pledges will make that difficult, it said.
Lithuanian GDP will advance 3.2 percent in 2013 and 3.5 percent in 2014, SEB forecast, lowering previous estimates of 4 percent growth for both years. It left this year's forecast unchanged at 3.5 percent.


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Reviewed By John S (Chandler, AZ) Reviewed for a 2000 Honda CR-V —2/20/2016 8:34 PM
These struts are awesome, better than stock, and the service I experienced I would call world-class. And, at a price unmatched anywhere else.
Reviewed By Mike R (CASPER, WY) —7/25/2016 9:20 AM
I am quite happy with these shocks so far. Most of us know how to install shocks, but the instruction sheets are pretty vague and made no mention of the metal sleeve inside the O.E. shock bushings. These Bilstein shocks have no metal sleeve inside the bushings, but appear to be designed for use without any sort of metal sleeve...
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The Cooking Momby Amy Hanten
Secrets, Stories and Recipes from a Real Mom. Get your family back to the table with more than 250 recipes designed with real moms in mind from Cooking and Lifestyle show host Amy Hanten.
Secrets, Stories and Recipes from a Real Mom. Get your family back to the table with more than 250 recipes designed with real moms in mind from Cooking and Lifestyle show host Amy Hanten.
Product Details
- 9780983035602
- Publisher:
- Cooking Mom LLC, The
- Publication date:
- 12/28/2010
- Pages:
- 362
- Product dimensions:
- 10.00(w) x 8.00(h) x 0.75(d)
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The Cooking Mom based on 0 ratings. 7 reviews.
Most of the recipes in the cookbook is exactly how I cook. It's not quite from scratch but almost. (close enough for me!) She does use a few convenience ingredients (cream soups and jarred pasta sauce for example) but not overly so. I've tried several of the recipes and we have liked all of them this far. The reason for the 4 star review is the lack of pictures. In fact, there are no pictures of the recipes at all. A few black and white pictures of her family and that's it. Barnes and Noble says the book is a hardcover but it isn't. Actually, I don't think this book comes in hardcover.
Great cookbook but disappointed when it arrived as a paperback and not hardcover as noted in the description. Good recipes with easy to access ingredients. I'm anxious to try them out on my family!!
I have made about 30 recipes from this book and my family just loves them. I have 3 children with very different tastes and they all have loved everything. We put rating stars in the book next to the recipes and so far everything has been 5 stars. Thanks Amy, for making it easy for us working moms!
Love this cookbook! It has so many great, simple recipes for the busy mom who wants to put a healthy dinner on the table after a day of running! A must have!
This is a must-have cook book that takes the thought out of cooking for a group of sometimes picky eaters. The Cooking Mom gets that simple and easy is critical to me (the cook), and adds in such creative ideas that score time after time! My kids especially love the Breakfast Burritos, Rasberry 'n cream baked french toast, and the Champagne Chicken.
I am on the go always and time is short ,so when I discovered this cookbook my mom suggested highly, I was pleased. Its quick easy and very tasteful! Yummmy! Its alot of things you commonly have in the house so thats a big plus. Simple to follow and you can create a dish different every day with ease. I highly suggest it.
This cookbook rocks! I can actually afford to make the recipes in this book and they don't take all day to make. Love all the great casserole recipes, especially the cheesy chicken spaghetti! Great slow cooker recipes too. I've told alot of other "Cooking Moms" about the book and they all love it too! More than just recipes. There are some great, funny stories and tips in the book too.


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QAA The Alternative Providers Liaison Forum July 2016 Update
21st July 2016
21st July 2016
31st March 2016
From 6 April a new concession has been made regarding the Secure English Language Test (SELT) for Tier 4 (General) students. Learn more
16th February 2016
AASAP/UK is 25 years old in 2016 and in celebration of the fact, a reception is being held at Wychwood House, Kensington, the home of the Deputy Chief of Mission at the US Embassy in London, Ms. Elizabeth Dibble. Ms Dibble will be hosting the event and AASAP/UK members are invited Learn more
5th February 2016
Please reserve Thursday, 19 May from 6.00-7.30 pm. Further details will follow around the end of February. Learn more
20th January 2016
The Migration Advisory Committee report on Tier 2 and Tier 2 ICT has been published Learn more
20th January 2016
Petra Rantanen, the 2015/16 Lord Acton Memorial Scholarship winner, has written a retrospective essay for AASAP/UK about her time in the United Kingdom. Learn more
12th January 2016
Voting information for US citizens currently living abroad Learn more
5th November 2015
The minutes from the meeting on 29 September 2015 are now available Learn more
23rd September 2015
AASAP/UK have submitted the attached comprehensive response to the Migration Advisory Committee (MAC) Call for Evidence. Learn more
17th July 2015
UKBA has published a Statement of Changes to the Immigration Rules Learn more


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Satisfied 5/5
I'm very satisfied with this product. It's small, quiet, and performs just fine. I have a 15" MacBook Pro and I needed something to keep my laptop cool. I have been somewhat monitoring the temperatures of my laptop with a widget called iStat Pro. When I use the ChillHub, there is a definite decrease in temp. I am confident I will never have to worry about my laptop overheating with the ChillHub. It has 4 extra USB 2.0 ports built-in which is nice. 5/5 :)
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New Orleans police found a man stabbed to death late Wednesday at an apartment complex in Central City.
Daytime heating will bring scattered showers and thunderstorms for the remainder of the week and weekend.
Vice President Joe Biden, Attorney General Loretta Lynch and Gov. John Bel Edwards are scheduled to deliver remarks at memorial service for the three law enforcement officers killed in an ambush-style shooting July 17 in Baton Rouge.
Live: Morning news, weather and traffic updates from WDSU
The Catholic Cemeteries in New Orleans date all the way back to 1789. More than 200 years later, directors are asking families to not have any stagnant water outside tombs in order to prevent mosquitoes and Zika from spreading.
Jefferson Parish Sheriff Newell Normand said an armed teenager shot and killed by one of his deputies is not a victim. The teen's parents said they realize their son put himself in harms way, but they question why that deputy shot him six times.
Surveillance video from inside the Times-Picayune warehouse in Metairie shows the moment a Jefferson Parish deputy fatally shot a suspect who officials said pointed a gun at him.
Five years after his death from leukemia, little Kendall Springman continues to inspire blood donations.
Calling his office's financial situation dire, Orleans Parish Public Defender Derwyn Bunton pleaded with the City Council for more money.In the last year, several indigent, criminal defendants have gone weeks and sometimes months before being assigned lawyers.
Jefferson Parish Sheriff Newell Normand is visibly upset as he discusses a deputy-involved shooting that left 17-year-old Devon Martes dead. "Devon Martes pulled the trigger on a gun and tried to kill one of my deputies," Normand said."But for the fact that the gun malfunctioned, I might have a dead officer. Let us set the record straight, right here, right now Devon Martes is not the victim," Normand said.Jefferson Parish deputies were called to the area near Cleary and Ford St. about suspicious activity. Police said two suspects spotted rolling what appeared to be tire rims in the street. Deputies arrived on the scene and chased one of the suspects to a newspaper warehouse on the I-10 service road.Police said that's when Martes pointed his weapon at Deputy David Dalton. Dalton opened fire and fatally wounded Martes.Investigators say the 17-year-old had a loaded weapon with more than 20 rounds in the magazine. It's another scenario where officers used deadly force. It comes at a time when there has been heightened scrutiny over police relations with the community. The Sheriff's Department released video of the incident that appears to show Martes point a gun at the deputy."They were feet away, gun-to-gun, eyeball-to-eyeball, staring each other down. If you look long enough you might see the thin blue line. Over freaking tire rims," Normand said.
President Barack Obama on Wednesday harnessed the rhetorical skills that catapulted him to White House with an address to the Democratic National Convention dismissing Donald Trump in withering terms and establishing Hillary Clinton as his political ...
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Junk Mail Origami (Spiral bound)Duy Nguyen, Tramy Nguyen
Spiral bound Published: 04/12/2008
- Can be ordered from our supplier
They fill up the mailbox...and then, they fill up the recycling bin. But now Duy and Tramy Nguyen have come up with a way to make snail-mail spam appetizing - and even exotic: turn it into fantastic origami art. Their beautiful projects are specifically tailored to the dimensions of those flyers, ads and other unsolicited offers you'd normally throw away. Even beginners will be able to transform junk mail into extraordinary creations. The Nguyens start with an introduction explaining how to interpret the symbols and lines in their instructions and to make basic origami folds. Paper crafters can then put their skills to the test with 18 designs, including a bow, heart on a stand and a cool Halloween skull.
Publisher: Sterling Publishing Co Inc
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