Without the benefit of paralinguistic cues such as gesture, emphasis, and intonation, it can be difficult to convey emotion and tone over electronic mail (e-mail). Five experiments suggest that this limitation is often underappreciated, such that people tend to believe that they can communicate over e-mail more effectively than they actually can. Studies 4 and 5 further suggest that this overconfidence is born of egocentrism, the inherent difficulty of detaching oneself from one's own perspective when evaluating the perspective of someone else. Because e-mail communicators "hear" a statement differently depending on whether they intend to be, say, sarcastic or funny, it can be difficult to appreciate that their electronic audience may not.
ABSTRACf: In this research, the effectivenessof various blending and sonication techniques were investigated for extracting particle-associated coliforms from secondary effluent samples. The amount of shielding from ultraviolet disinfection afforded these coliforms by the particulates was then assessed. It was found that blending samples for 1.5 minutes at 19000 rpm at 4°C in a mixture of chemicals (resulting in concentrations of 10-6 M Zwittergent 3-12, 10-3 M EGTA, 0.0 I M Tris buffer, 0.1 % peptone, and pH 7) resulted in the greatest recovery of particleassociated coliform, as detected by the multiple tube fermentation (MTF) test. Fragmentation of large floes during homogenization, as evidenced by the change in particle size distribution, was most likely the responsible mechanism. Sonication proved ineffective. It was found that particle association and shielding of coliforms significantly affect accurate measurements of coliform density in secondary effluent using the standard MTF test and that significantly more coliforms may be present in disinfected secondary effluents than is indicated by the standard enumeration procedure.
Objective
To examine the association between gestational age (GA) at the time of treatment initiation for gestational diabetes (GDM) and maternal and perinatal outcomes.
Study Design
A secondary analysis of a multicenter randomized treatment trial of mild GDM in which women with mild GDM were randomized to treatment versus usual care. The primary outcome of the original trial, as well as this analysis, was a composite perinatal adverse outcome that included neonatal hypoglycemia, hyperbilirubinemia, hyperinsulinemia, and perinatal mortality. Other outcomes examined included the frequency of large for gestational age (LGA), birth weight, neonatal intensive care unit admission (NICU), gestational hypertension / preeclampsia and cesarean delivery. The interaction between GA at treatment initiation (stratified as 24-26 weeks, 27 weeks, 28 weeks, 29 weeks, ≥30 weeks) and treatment group (treated vs. routine care), with the outcomes of interest, was used to determine whether GA at treatment initiation was associated with outcome differences.
Results
Of 958 women analyzed, those who initiated treatment at an earlier GA did not gain an additional treatment benefit compared to those who initiated treatment at a later GA (p-value for interaction with the primary outcome is 0.44). Similarly, there was no evidence that other outcomes were significantly improved by earlier initiation of GDM treatment (LGA p=0.76; NICU admission p=0.8; cesarean delivery p=0.82). The only outcome that had a significant interaction between GA and treatment was gestational hypertension/preeclampsia (p=0.04), although there was not a clear cut GA trend where this outcome improved with treatment.
Conclusion
Earlier initiation of treatment of mild GDM was not associated with stronger effect of treatment on perinatal outcomes.
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