Accuracy of Transvaginal Ultrasound in Prediction of Latency Period in Women with Preterm Premature Rupture of Membranes

Background: Preterm prelabor rupture of membranes (PPROM) is a major cause of Pretem Birth (PTB), Pretem Birth (PTB) is the most significant cause of perinatal morbidity and mortality worldwide. Cervical length (CL), posterior uterocervical angle (PUCA) and anterior uterocervical angle (AUCA) have been postulated in several studies to have an important role in prediction of PTB. Up to our knowledge, this is the first study that combines the three cervical parameters in prediction of latency period in women with PPROM. Aim of the Work: To assess the accuracy of cervical length, posterior uterocervical angle and anterior uterocervical angle in prediction of latency period in women with Preterm prelabor rupture of membranes. Subjects and Methods: A Prospective cohort study on 205 women with PPROM was held at Ain Shams University Maternity Hospital, a transvaginal ultrasound was performed to measure cervical length, posterior uterocervical angle, anterior uterocervical angle. Results: A total of 205 pregnant women with PPROM were included in this study, the latency grade was within 2 days in 57 (27.8%) of cases while was after 2 days in 148 (72.2%) of cases. As regards cervical length cut-off value 25.0 mm, sensitivity was 78.9%, specificity was 65.5%, posterior uterocervical angle cut-off value 108.0°, sensitivity was 93.0%, specificity was 60.1%, and anterior uterocervical angle cut-off value 106.0°, sensitivity was 93.0%, specificity was 71.6%. Conclusion: The combination of cervical length (CL), posterior uterocervical angle (PUCA) and anterior uterocervical angle (AUCA) measurements greatly predicts the latency period in women with PPROM, and Anterior uterocervical angle (AUCA) ≥ 106.0° had the highest diagnostic value in predicting latency period within two days.

An Emergency Plan Selection Method for Emergency Latency

Drawing upon a characteristic analysis of the latency period in emergencies,this paper proposes an emergency plan selection method based on interval language variables and information entropy to address the challenge of acquiring critical information during this crucial stage.Initially,decision-makers employ interval language variables to express the preference information regarding emergency plans,while also introducing an enhanced information entropy theory to derive the weight coefficients of key indicators.Subsequently,the weighted arithmetic average operator of interval language is applied twice to aggregate the preference information alongside the relative importance of decision-makers and the weight coefficients of key indicators.Finally,the ranking coefficients of each emergency plan are sorted to determine the optimal scheme.The feasibility and effectiveness of this method are demonstrated through a case study involving the selection of an emergency plan for a flood disaster in a specific location.

Cardiac Neurons Firing Preceding Cortical Neurons Firing by Variable Time Equivalent to RP before Conscious Act

The signals and the neuronal mechanisms that underlying the behavior, actions, and action-directed goals in man and animals during conscious state are not fully understood, and the neuro-dynamic mechanisms and the source of these neuronal signals are not authenticated. Temporal judgment alone can neither account for neural signaling necessary for emergence of conscious act nor explain RP （Readiness Potential, the accepted neural correlate time needed for the neurons to fire） that precedes the onset of action or the latency time of 0.5 ms that precedes the conscious act found by Libet. Neuronal feedback mechanisms between the heart and the brain seem feasible and logical suggestions to be considered, so clearly, I would suggest that the onset of a conscious-directed goal, conscious action, freewill, intension, and the neural signals and mechanisms that control them may depend upon the interaction between two sources： （1） the brain and （2） the heart. The temporal-cardiac （neural system） interaction has been well established in heart-brain interaction studies by many workers who found that the work of the heart precedes that of the brain in EEG （electroencephalography） findings in conscious stimulation, which may explain and account for RP time and the 0.5 ms latency period of Libet＇s important findings. According to my hypothesis （AlFaki 2009） and views, the temporal neurons in the soma to-sensory cortex will respond to conscious stimulation only after receiving neuronal signals from the cardiac neurons in the neural plexus of the heart; after variable millisecond equivalent to RP or Libet＇s latency period prior to temporal neuronal firinging in response to conscious act, this time is the time needed by cardiac neurons to process and signal information to the brain through feedback mechanism and heart-brain interaction.