Clinical outcomes after external cephalic version with spinal anesthesia after failure of a first attempt without anesthesia.

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Massalha, Manal; Garmi, Gali; Zafran, Noah; Carmeli, Julia; Gimburg, Genady; Salim, Raed

2017-12-01

To determine whether repeat external cephalic version (ECV) with spinal anesthesia affects clinical outcomes and cesarean delivery rates. A retrospective study was conducted using data collected at one hospital in Israel between January 1, 2009, and December 31, 2015. Women with non-vertex singleton pregnancies (≥37 weeks) who had a failed ECV attempt without spinal anesthesia were included in the analysis. All women were offered a repeat ECV with spinal anesthesia. Outcomes assessed were rates of vertex presentation at delivery, successful repeat ECV, and cesarean delivery. Overall, 145 of 213 ECV attempts without spinal anesthesia were successful. Of the 68 women with a failed attempt, 5 (7%) experienced spontaneous version and 18 (26%) delivered at another institution or went into spontaneous labor. Among the remaining 45 women, 28 (62%) agreed to a repeat ECV with spinal anesthesia; 11 (39%) of these procedures were successful. All 11 women experienced vertex presentation at delivery versus none of the 17 women who refused repeat ECV (P=0.003). The cesarean delivery rate was 64% (18/28) versus 100% (17/17), respectively (P=0.007). Repeat ECV with spinal anesthesia after a failed first attempt without spinal anesthesia increased vertex presentation at birth and decreased the rate of cesarean delivery. © 2017 International Federation of Gynecology and Obstetrics.

Probability of cesarean delivery after successful external cephalic version.

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Burgos, Jorge; Iglesias, María; Pijoan, José I; Rodriguez, Leire; Fernández-Llebrez, Luis; Martínez-Astorquiza, Txantón

2015-11-01

To identify factors associated with cesarean delivery following successful external cephalic version (ECV). In a prospective study, data were obtained for ECV procedures performed at Cruces University Hospital, Spain, between March 2002 and June 2012. Women with a singleton pregnancy who had a successful, uncomplicated ECV and whose delivery was assisted at the study hospital, with the fetus in cephalic presentation, were included. A multivariate model of risk factors of cesarean delivery was developed. Among 627 women included, 92 (14.7%) delivered by cesarean. A cesarean was performed among 33 (8.5%) of 387 women with spontaneous labor versus 59 (24.6%) of 240 who were induced (P < 0.001). Multivariate analysis showed that higher BMI (P = 0.006), labor induction (P = 0.001), and prior cesarean (P < 0.001) were associated with cesarean. Time between ECV and delivery was inversely associated with probability of cesarean during the first 2 weeks. Thus, the probabilities of cesarean delivery on the first day were 0.53 (95% CI 0.35-0.71) and 0.34 (95% CI 0.18-0.51) following induced and spontaneous labor, respectively. On the seventh day, the probabilities were 0.23 (95% CI 0.15-0.32) and 0.12 (95% CI 0.07-0.18), respectively. Following ECV, induction of labor, an interval of less than 2 weeks to delivery, BMI, and previous cesarean were associated with an increased risk of cesarean. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Rising cesarean deliveries among apparently low-risk mothers at university teaching hospitals in Jordan: analysis of population survey data, 2002–2012

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Rifai, Rami Al

2014-01-01

Background: Cesarean delivery conducted without medical indication places mothers and infants at risk for adverse outcomes. This study assessed changes in trends of, and factors associated with, cesarean deliveries in Jordan, from 2002 to 2012. Methods: Data for ever-married women ages 15–49 years from the 2002, 2007, and 2012 Jordan Population and Family Health Surveys were used. Analyses were restricted to mothers who responded to a question regarding the hospital-based mode of delivery for their last birth occurring within the 5 years preceding each survey (2002, N = 3,450; 2007, N = 6,307; 2012, N = 6,365). Normal birth weight infants and singleton births were used as markers for births that were potentially low risk for cesarean delivery, because low/high birth weight and multiple births are among the main obstetric variables that have been documented to increase risk of cesareans. Weighted descriptive and multivariate analyses were conducted using 4 logistic regression models: (1) among all mothers; and among mothers stratified (2) by place of delivery; (3) by birth weight of infants; and (4) by singleton vs. multiple births. Results: The cesarean delivery rate increased significantly over time, from 18.2% in 2002, to 20.1% in 2007, to 30.3% in 2012. Place of delivery, birth weight, and birth multiplicity were significantly associated with cesarean delivery after adjusting for confounding factors. Between 2002 and 2012, the rate increased by 99% in public hospitals vs. 70% in private hospitals; by 93% among normal birth weight infants vs. 73% among low/high birth weight infants; and by 92% among singleton births vs. 29% among multiple births. The changes were significant across all categories except among multiple births. Further stratification revealed that the cesarean delivery rate was 2.29 times higher in university teaching hospitals (UTHs) than in private hospitals (Pcesarean delivery rate among births that may have been at low risk for

Postdates induction with an unfavorable cervix and risk of cesarean.

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McCoy, Jennifer; Downes, Katheryne L; Srinivas, Sindhu K; Levine, Lisa D

2018-03-21

To determine the risk of cesarean delivery associated with postdates induction (≥41 weeks) compared to term induction (37-40w6d) among women with an unfavorable cervix, and to examine the risk factors associated with cesarean among women undergoing postdates induction. A planned secondary analysis of a large prospective cohort study on induction (n = 854) was performed. Women with a singleton gestation, intact membranes, and an unfavorable cervix (Bishop score of ≤6 and dilation ≤2 cm) who were undergoing a term (≥37 weeks) induction for any indication were included. Women with a prior cesarean were excluded. The primary outcome was cesarean delivery. Relative risk of cesarean was estimated using a modified Poisson's regression model. There was a significantly increased risk of cesarean for women undergoing postdates induction (n = 154) compared to women 37-40w6d (n = 700), (46.8 versus 26.0%, p cesarean remained after adjustment for race, parity, and pregnancy-related hypertension (aRR 1.70 [1.39-2.09], p cesarean among women ≥41 weeks included nulliparity (aRR 3.38 95%CI (2.42-4.74)), BMI ≥30 (aRR 1.72 95%CI (1.34-2.21)), and starting cervical dilation cesarean compared to women 37-40w6d, with nulliparity, obesity, and cervical dilation <1 cm being independent risk factors. These data can be used to augment patient counseling and support the ongoing discussion regarding the risk of post dates induction.

Risk factors for incomplete healing of the uterine incision after cesarean section.

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Chen, Yan; Han, Ping; Wang, Yi-Jia; Li, Yan-Xia

2017-08-01

To analyze related risk factors of post-cesarean scar defects (PCSDs). A retrospective study of full-term women delivered by cesarean with singleton infants at our hospital from April 2014 to December 2015 was performed. 69 cases of diagnosed PCSDs and 107 cases with no PCSD who accepted cesarean were recruited for analysis. Individual medical case and operative report review were retrieved for maternal clinical characteristics analysis. There was no difference in age, gestational age, BMI and baby's weight between the two groups. PCSD group has more cases of anemia, higher neutrophil percentage and more cases of elected cesarean and emergency cesarean than controls (all p cesarean, there were more cases with cervix dilated larger than 3 cm in operation and more cases received cesarean at least one time before. In addition, women with cesarean interval of at least 5 years, women with ultrasonic measured echo longer than 3 cm, women with poor healing in uterine incision, women with retroposition of uterus and women who had intrauterine separation are more prone to develop PCSDs. The occurrence of a defective uterine scar after cesarean section is primarily a by-product of the combination of multiple factors: age ≥30 years, BMI ≥27.30, premature rupture of membranes, elective cesarean section, post-operative anemia, WBC count ≥12.5 × 10 9  g/L and retroposition of uterus. These are high risk factors of PCSDs.

Peripartum Morbidity after Cesarean Delivery for Arrest of Dilation at 4 to 5 cm Compared with 6 to 10 cm.

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Dahlke, Joshua D; Sperling, Jeffrey D; Has, Phinnara; Lovgren, Todd R; Connealy, Brendan D; Rouse, Dwight J

2018-04-24

 Given that recent consensus guidelines established to decrease cesarean delivery (CD) rates use 6 cm to define the onset of the active phase of labor, our objective was to evaluate maternal and neonatal outcomes after CD for the indication of arrest of dilation at 4 to 5 cm compared with ≥ 6 cm.  We performed a secondary analysis using data from the Maternal Fetal-Medicine Units Network Cesarean Registry. We included nulliparous women with term, singleton, vertex gestations who underwent primary CD for arrest of dilation. We compared those who reached a maximum cervical dilation of 4 to 5 cm with those of ≥6 cm. Our primary outcome was composite maternal morbidity that included chorioamnionitis, endometritis, transfusion, wound complication, operative injury, intensive care unit admission, or death.  Of the 73,257 women in the dataset, 5,681 met the inclusion criteria. After adjusting for confounders, there was no difference in composite maternal (adjusted odds ratio [aOR]: 1.19; 95% confidence interval [CI]: 0.94-1.52) or neonatal morbidity (aOR: 0.94; 95% CI: 0.79-1.10) between the groups.  In this historical cohort, maternal and neonatal outcomes after CD for arrest of dilation ≥ 6 cm were comparable to those performed at 4 to 5 cm and support recent labor management guidelines. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Midpregnancy Cervical Length in Nulliparous Women and its Association with Postterm Delivery and Intrapartum Cesarean Delivery

NARCIS (Netherlands)

van der Ven, A. J.; van Os, M. A.; Kleinrouweler, C. E.; Verhoeven, C. J. M.; de Miranda, E.; Bossuyt, P. M.; de Groot, C. J. M.; Haak, M. C.; Pajkrt, E.; Mol, B. W. J.; Kazemier, B. M.

2016-01-01

To evaluate the association between midpregnancy cervical length and postterm delivery and cesarean delivery during labor. In a multicenter cohort study, cervical length was measured in low-risk singleton pregnancies between 16 and 22 weeks of gestation. From this cohort, we identified nulliparous

Risk factors for cesarean delivery in primigravida during spontaneous labor

International Nuclear Information System (INIS)

Hc, C.; Yahya, M.S.; Mooi, C.S.

2015-01-01

Objective: To identify the risk factors for cesarean delivery among primigravida at Hospital Serdang. Methodology: This was a case control study which involved total 260 of 130 primigravida patients that underwent cesarean section (cases) and 130 primigravida patients that underwent vaginal delivery (control) at obstetrics and gynaecology department of Hospital Serdang, Malaysia from January until June 2013. A standardized proforma was used to collect the data of each primigravida patient presenting in spontaneous labour at term with singleton pregnancy with either caesarean or vaginal delivery. Results: Majority of the cases were Malaysian (86.9%) and mostly were from Malay ethnic group (75.4%). In multivariate logistic regression analysis, presence of hypertension status (odds ratio (OR) 5.7, 95% CI; 1.56-20.84) and gestational age less than 40 weeks (OR 2.60, 95% CI 1.34-5.02), fetal weight more than 3000 gm (OR 1.8, 95% CI 1.1-2.95), were associated with higher odds of cesarean delivery. Conclusion: Primigravida with presence of hypertension, having gestational age less than 40 weeks and heavier fetus were associated with higher odds of cesarean delivery. (author)

Diagnosis of dystocia and management with cesarean section among primiparous women in Ottawa-Carleton.

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Stewart, P J; Dulberg, C; Arnill, A C; Elmslie, T; Hall, P F

1990-01-01

We carried out a chart review study to determine the rate of diagnosis of dystocia (abnormal progress) and the use of cesarean section to treat dystocia among 3887 primiparous women who gave birth to a single baby in the vertex presentation at four hospitals in Ottawa-Carleton in 1984. Of the 3740 women who had some labour 1127 (30.1%) were given a diagnosis of dystocia. Cesarean section for dystocia was done during all phases of labour (41% of procedures in the latent phase, 38% in the active phase and 21% in the second stage). The cesarean section rate varied among the hospitals from 11.8% to 19.6%. A total of 75% of the cesarean sections were for dystocia, disproportion or failed induction. The findings suggest that cesarean section is being done for disproportion without a trial of labour beyond the latent phase and for dystocia in the absence of fetal distress. If these practices were modified the cesarean section rate could be reduced from 16% to about 8%, the rate found in some other centres and that observed in Canada in the early 1970s. PMID:2302643

The U.S. Twin Delivery Volume and Association with Cesarean Delivery Rates: A Hospital-Level Analysis.

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Easter, Sarah Rae; Robinson, Julian N; Carusi, Daniela; Little, Sarah E

2018-03-01

 The objective of this study was to test whether hospitals experienced in twin delivery have lower rates of cesarean delivery for twins.  We divided obstetric hospitals in the 2011 National Inpatient Sample by quartile of annual twin deliveries and compared twin cesarean delivery rates between hospitals with weighted linear regression. We used Pearson's coefficients to correlate a hospital's twin cesarean delivery rate to its overall cesarean delivery and vaginal birth after cesarean (VBAC) rates.  Annual twin delivery volume ranged from 1 to 506 across the 547 analyzed hospitals with a median of 10 and mode of 3. Adjusted rates of cesarean delivery were independent of delivery volume with a rate of 75.5 versus 74.8% in the lowest and highest volume hospitals ( p  = 0.09 across quartiles). A hospital's cesarean delivery rate for twins moderately correlated with the overall cesarean rate ( r  = 0.52, p  < 0.01) and inversely correlated with VBAC rate ( r  =  - 0.42, p  < 0.01).  Most U.S. obstetrical units perform a low volume of twin deliveries with no decrease in cesarean delivery rates at higher volume hospitals. Twin cesarean delivery rates correlate with other obstetric parameters such as singleton cesarean delivery and VBAC rates suggesting twin cesarean delivery rate is more closely related to a hospital's general obstetric practice than its twin delivery volume. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Variation in Primary Cesarean Delivery Rates by Individual Physician within a Single Hospital Laborist Model

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METZ, Torri D.; ALLSHOUSE, Amanda A.; GILBERT, Sara A Babcock; DOYLE, Reina; TONG, Angie; CAREY, J. Christopher

2016-01-01

Background Laborist practice models are associated with lower cesarean delivery rates than individual private practice models in several studies; however, this effect is not uniform. Further exploration of laborist models may help us better understand the observed reduction in cesarean delivery rates in some hospitals with implementation of a laborist model. Objective Our objective was to evaluate the degree of variation in primary cesarean delivery rates by individual laborists within a single institution employing a laborist model. In addition, we sought to evaluate whether differences in cesarean delivery rates resulted in different maternal or short-term neonatal outcomes. Study Design At this teaching institution, one laborist (either a generalist or maternal-fetal medicine attending physician) is directly responsible for labor and delivery management during each shift. No patients are followed in a private practice model nor are physicians incentivized to perform deliveries. We retrospectively identified all laborists who delivered nulliparous, term women with cephalic singletons at this institution from 2007-14. Overall and individual primary cesarean delivery rates were reported as percentages with exact Pearson 95% CI. Laborists were grouped by tertile as having low, medium or high cesarean delivery rates. Characteristics of the women delivered, indications for cesarean delivery, and short-term neonatal outcomes were compared between these groups. A binomial regression model of cesarean delivery was estimated, where the relative rates of each laborist compared to the lowest-unadjusted laborist rate were calculated; a second model was estimated to adjust for patient-level maternal characteristics. Results Twenty laborists delivered 2,224 nulliparous, term women with cephalic singletons. The overall cesarean delivery rate was 24.1% (95% CI 21.4-26.8). In an unadjusted binomial model, the overall effect of individual laborist was significant (pcesarean

The Brazilian preference: cesarean delivery among immigrants in Portugal.

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Cristina Teixeira

Full Text Available OBJECTIVE: To evaluate how the country of origin affects the probability of being delivered by cesarean section when giving birth at public Portuguese hospitals. STUDY DESIGN: Women delivered of a singleton birth (n = 8228, recruited from five public level III maternities (April 2005-August 2006 during the procedure of assembling a birth cohort, were classified according to the country of origin and her migration status as Portuguese (n = 7908, non-Portuguese European (n = 84, African (n = 77 and Brazilian (n = 159. A Poisson model was used to evaluate the association between country of birth and cesarean section that was measured by adjusted prevalence ratio (PR and respective 95% confidence intervals (95%CI. RESULTS: The cesarean section rate varied from 32.1% in non-Portuguese European to 48.4% in Brazilian women (p = 0.008. After adjustment for potential confounders and compared to Portuguese women as a reference, Brazilian women presented significantly higher prevalence of cesarean section (PR = 1.26; 95%CI: 1.08-1.47. The effect was more evident among multiparous women (PR = 1.39; 95%CI: 1.12-1.73 and it was observed when cesarean section was performed either before labor (PR = 1.43; 95%CI: 0.99-2.06 or during labor (PR = 1.30; 95%CI: 1.07-1.58. CONCLUSIONS: The rate of cesarean section was significantly higher among Brazilian women and it was independent of the presence of any known risk factors or usual clinical indications, suggesting that cultural background influences the mode of delivery overcoming the expected standard of care and outcomes in public health services.

Cervical dilation at the time of cesarean section for dystocia -- effect on subsequent trial of labor.

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Abildgaard, Helle; Ingerslev, Marie Diness; Nickelsen, Carsten; Secher, Niels Joergen

2013-02-01

To investigate the effect of cervical dilation at the time of cesarean section due to dystocia and success in a subsequent pregnancy of attempted vaginal delivery. Retrospective study. University hospital in Copenhagen capital area. All women with a prior cesarean section due to dystocia who had undergone a subsequent pregnancy with a singleton delivery during 2006-2010. Medical records were reviewed for prior vaginal birth, cervical dilation reached before cesarean section and induction of labor, gestational age, use of oxytocin, epidural anesthesia and mode of birth was collected. A total of 889 women were included; 373 had had a trial of labor. The success rate for vaginal birth among women with prior cesarean section for dystocia at 4-8 cm dilation was 39%, but 59% for women in whom prior cesarean section had been done at a fully or almost fully dilated cervix (9-10 cm) (p dystocia done late in labor and women with a vaginal delivery prior to their cesarean section had a greater chance of a successful vaginal birth during a subsequent delivery. © 2012 The Authors Acta Obstetricia et Gynecologica Scandinavica© 2012 Nordic Federation of Societies of Obstetrics and Gynecology.

Singleton pregnancy outcomes after assisted and non-assisted reproductive technology in infertile patients.

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Tsutsumi, Ryo; Fujimoto, Akihisa; Osuga, Yutaka; Ooi, Nagisa; Takemura, Yuri; Koizumi, Minako; Yano, Tetsu; Taketani, Yuji

2012-07-01

Singleton pregnancy after assisted reproductive technology (ART) has been associated with higher risks of adverse pregnancy outcome than naturally conceived singleton pregnancy. This study was to elucidate whether the ART procedure is responsible for abnormal pregnancy outcome comparing those after ART and non-ART in infertile patients. We compare the singleton pregnancy outcome of infertile patients in our university hospital between 2000 and 2008 following ART (351 pregnancies) and non-ART (213 pregnancies) procedures. Pregnancy outcome parameters were incidence of pregnancy induced hypertension, placenta previa, placental abruption, cesarean delivery, preterm birth, very preterm birth, stillbirth, low birth weight and very low birth weight. Most of the pregnancy outcome parameters were not significantly different between the ART group and the non-ART group. Only placenta previa was significantly higher in the ART group than in the non-ART group (odds ratio 4.0; 95 % CI 1.2-13.7). ART procedure may itself be a risk factor for the development of placenta previa. Some of the abnormal perinatal outcomes that had been previously attributed to ART, however, may be due to the baseline characteristics of infertile patients.

Risk Factors for Cesarean Delivery following Labor Induction in Multiparous Women

Directory of Open Access Journals (Sweden)

Corine J. Verhoeven

2013-01-01

Full Text Available Objective. To identify potential risk factors for cesarean delivery following labor induction in multiparous women at term. Methods. We conducted a retrospective case-control study. Cases were parous women in whom the induction of labor had resulted in a cesarean delivery. For each case, we used the data of two successful inductions as controls. Successful induction was defined as a vaginal delivery after the induction of labor. The study was limited to term singleton pregnancies with a child in cephalic position. Results. Between 1995 and 2010, labor was induced in 2548 parous women, of whom 80 had a cesarean delivery (3%. These 80 cases were compared to the data of 160 parous women with a successful induction of labor. In the multivariate analysis history of preterm delivery (odds ratio (OR 5.3 (95% CI 1.1 to 25, maternal height (OR 0.87 (95% CI 0.80 to 0.95 and dilatation at the start of induction (OR 0.43 (95% CI 0.19 to 0.98 were associated with failed induction. Conclusion. In multiparous women, the risk of cesarean delivery following labor induction increases with previous preterm delivery, short maternal height, and limited dilatation at the start of induction.

Risk of cesarean delivery among pregnant women with class III obesity.

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Borghesi, Yves; Labreuche, Julien; Duhamel, Alain; Pigeyre, Marie; Deruelle, Philippe

2017-02-01

To identify factors associated with cesarean delivery among women with class III obesity attempting vaginal delivery. In a retrospective study, medical charts were reviewed for women aged 18 years or older with a singleton pregnancy of at least 37 weeks and a body mass index (calculated as weight in kilograms divided by the square of height in meters) of 40 or higher who were eligible to attempt vaginal delivery at a maternity hospital in Lille, France, between 1999 and 2012. Among 345 eligible women, 301 (87.2%) attempted vaginal delivery; 211 (70.1%) were successful and 90 (29.9%) delivered by cesarean. The frequency of nulliparity was higher among those undergoing cesarean after a trial of labor (64 [71.1%]) than among those who delivered vaginally (57 [27.0%]; Pcesarean (61 [67.8%] vs 96 [45.5%]; Pcesarean among women attempting vaginal delivery (odds ratio [OR] 2.30, 95% confidence interval [CI] 1.25-4.22), whereas history of vaginal delivery was protective (OR 0.08, 95% CI 0.04-0.17). Nulliparous women with class III obesity attempting a vaginal delivery should be warned of the high risk of cesarean delivery, especially if they require induction. © 2016 International Federation of Gynecology and Obstetrics.

Labor induction and cesarean delivery: A prospective cohort study of first births in Pennsylvania, USA.

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Kjerulff, Kristen H; Attanasio, Laura B; Edmonds, Joyce K; Kozhimannil, Katy B; Repke, John T

2017-09-01

Mode of delivery at first childbirth largely determines mode of delivery at subsequent births, so it is particularly important to understand risk factors for cesarean delivery at first childbirth. In this study, we investigated risk factors for cesarean delivery among nulliparous women, with focus on the association between labor induction and cesarean delivery. A prospective cohort study of 2851 nulliparous women with singleton pregnancies who attempted vaginal delivery at hospitals in Pennsylvania, 2009-2011, was conducted. We used nested logistic regression models and multiple mediational analyses to investigate the role of three groups of variables in explaining the association between labor induction and unplanned cesarean delivery-the confounders of maternal characteristics and indications for induction, and the mediating (intrapartum) factors-including cervical dilatation, labor augmentation, epidural analgesia, dysfunctional labor, dystocia, fetal intolerance of labor, and maternal request of cesarean during labor. More than a third of the women were induced (34.3%) and 24.8% underwent cesarean delivery. Induced women were more likely to deliver by cesarean (35.9%) than women in spontaneous labor (18.9%), unadjusted OR 2.35 (95% CI 1.97-2.79). The intrapartum factors significantly mediated the association between labor induction and cesarean delivery (explaining 76.7% of this association), particularly cervical dilatation <3 cm at hospital admission, fetal intolerance of labor, and dystocia. The indications for labor induction only explained 6.2%. Increased risk of cesarean delivery after labor induction among nulliparous women is attributable mainly to lower cervical dilatation at hospital admission and higher rates of labor complications. © 2017 Wiley Periodicals, Inc.

Trends and predictors of cesarean birth in Singapore, 2005-2014: A population-based cohort study.

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Chi, Claudia; Pang, Deanette; Aris, Izzuddin M; Teo, Wei Ting; Li, Sarah Weiling; Biswas, Arijit; Yong, Eu Leong; Chong, Yap Seng; Tan, Kelvin; Kramer, Michael S

2018-02-17

Rates of cesarean birth have continued to rise in many high-income countries. We examined the temporal trends and predictors of cesarean birth in Singapore. Linked hospitalization and Birth Registry data were used to examine all live births to Singaporean citizens and permanent residents between January 1, 2005 and December 31, 2014 (n = 342 932 births). We calculated cesarean rates and age-adjusted average annual percent change (AAPC) in those rates and used sequential multivariable regression modeling to assess the contribution of changes in predictors to the change in cesarean rates over time. The overall cesarean rate in Singapore rose from 32.2% in 2005 to 37.4% in 2014. Among singleton, cephalic, term pregnancies, the two major predictions of cesarean were nulliparity and previous cesarean, each accounting for just over one-third of all cesareans. Higher AAPC was observed in nulliparous women of Indian ethnicity (0.74% [95% confidence interval 0.68-0.80]) compared with Chinese (0.62% [0.60-0.65]) or Malay women (0.63% [0.59-0.68]), and in women who delivered in private hospitals (0.62% [0.60-0.64]) compared with those delivered under subsidized care in public hospitals (0.58% [0.52-0.63]). Parity and education had the largest influences on cesarean birth trend (attenuation of AAPC from 0.62% [0.59-0.66] to 0.39% [0.38-0.40] after adjustment). Cesarean birth has continued to rise at a steady rate in Singapore. Strategies to curb this temporal increase include avoidance of medically unnecessary primary cesarean and attempts at trial of labor and vaginal delivery among women with a history of prior cesarean. © 2018 Wiley Periodicals, Inc.

How singleton breech babies at term are born in France: a survey of data from the AUDIPOG network.

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Lansac, J; Crenn-Hebert, C; Rivière, O; Vendittelli, F

2015-05-01

Based on data from the AUDIPOG sentinel network between 1994 and 2010, we can say that the rate of singleton breech presentation at term is 3% and remains unchanged despite an external cephalic version rate of 35%. The total cesarean section rate is currently 75%. This rate increased by nearly 20% after the Hannah publication in 2000, regardless of the type of breech and type of maternity unit. The rate of planned cesarean sections increased in particular, going from 40% to 60%, and even reaching 67% for footling breech presentations. The rate is higher in type I maternity units than in type II or III. This cesarean section rate has been stable since 2005 and has even decreased for the Frank breech. The average rate of external cephalic version remains stable at around 23%. The episiotomy rate is 28%. The rate of babies transferred to neonatology units is higher for breech babies at term than for babies presenting cephalically (3.9% compared to 2.9%), but the newborns most often transferred are those born by cesarean section (4.1% compared to 3.4%). Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Twin versus singleton pregnancies: the incidence, pregnancy complications, and obstetric outcomes in a Nigerian tertiary hospital.

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Obiechina, Nj; Okolie, Ve; Eleje, Gu; Okechukwu, Zc; Anemeje, Oa

2011-01-01

Twin pregnancy is associated with more pregnancy complications and poorer pregnancy outcome than singleton pregnancy. Hence periodic review is necessary to improve on the pregnancy outcome. To determine the incidence and compare pregnancy complications and obstetric outcomes of twin pregnancies and singleton pregnancies. The twin pregnancies (study group) that were delivered at Nnamdi Azikiwe University Teaching Hospital (NAUTH), Nnewi, South-East Nigeria from 1st February 2005 to 31st January 2010 were compared with singleton deliveries (control group) that occurred in the same hospital during the same period. A total of 3351 deliveries were conducted during the study period, of which 113 were twin deliveries, giving an incidence of 1:29.6 deliveries. Only 100 case files could be retrieved for analysis. The mean parities for the twins and singletons were 2.7 ± 2.33 weeks and 1.96 ± 1.87 weeks whereas the mean gestational age at delivery for twin and singleton deliveries were 34 ± 5.2 weeks and 38.7 ± 2.4 weeks respectively (P < 0.05). The mean birth weights were 3.14 ± 0.73 kg and 2.3 ± 1.0 kg for singletons and twins respectively (P < 0.05). Hypertensive disorders of pregnancy, cord prolapse, malpresentation, premature rupture of membranes, low Apgar scores, cesarean section rate, and perinatal death were significantly higher in twin pregnancies than in singleton. The incidence of twin pregnancy over the study period was high and was significantly associated with more pregnancy complications and poorer obstetric outcomes. Close antenatal and intrapartum care are needed in order to improve outcome and decrease complications.

Late preterm birth and previous cesarean section: a population-based cohort study.

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Yasseen Iii, Abdool S; Bassil, Kate; Sprague, Ann; Urquia, Marcelo; Maguire, Jonathon L

2018-02-21

Late preterm birth (LPB) is increasingly common and associated with higher morbidity and mortality than term birth. Yet, little is known about the influence of previous cesarean section (PCS) and the occurrence of LPB in subsequent pregnancies. We aim to evaluate this association along with the potential mediation by cesarean sections in the current pregnancy. We use population-based birth registry data (2005-2012) to establish a cohort of live born singleton infants born between 34 and 41 gestational weeks to multiparous mothers. PCS was the primary exposure, LPB (34-36 weeks) was the primary outcome, and an unplanned or emergency cesarean section in the current pregnancy was the potential mediator. Associations were quantified using propensity weighted multivariable Poisson regression, and mediating associations were explored using the Baron-Kenny approach. The cohort included 481,531 births, 21,893 (4.5%) were LPB, and 119,983 (24.9%) were predated by at least one PCS. Among mothers with at least one PCS, 6307 (5.26%) were LPB. There was increased risk of LPB among women with at least one PCS (adjusted Relative Risk (aRR): 1.20 (95%CI [1.16, 1.23]). Unplanned or emergency cesarean section in the current pregnancy was identified as a strong mediator to this relationship (mediation ratio = 97%). PCS was associated with higher risk of LPB in subsequent pregnancies. This may be due to an increased risk of subsequent unplanned or emergency preterm cesarean sections. Efforts to minimize index cesarean sections may reduce the risk of LPB in subsequent pregnancies.

Remifentanil at induction of general anesthesia for cesarean section: Double blind,randomized clinical trial

OpenAIRE

Behdad, Shekoufeh; Ayatollahi, Vida; Harrazi, Hamid; Nazemian, Naderali; Heiranizadeh, Najmeh; Baghianimoghadam, Behnam

2013-01-01

Introduction: Remifentanil, with its rapid activity onset and short duration of action, may be more effective than other opioids for providing hemodynamic stability during obstetric anesthesia. However, there is some evidence of adverse effects on neonatal respiratory function. We investigated maternal and fetal effects of Remifentanil during cesarean section surgery. Methods: Eighteen women with singleton term pregnancies, and physical class status of I or II as defined by the American Socie...

Cesarean Delivery in the United States 2005 - 2014: A Population-Based Analysis Using the Robson Ten Group Classification System.

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Hehir, Mark P; Ananth, Cande V; Siddiq, Zainab; Flood, Karen; Friedman, Alexander M; D'Alton, Mary E

2018-04-12

Cesarean delivery has increased steadily in the United States over recent decades with significant downstream health consequences. The World Health Organization has endorsed the Robson Ten Group Classification System (TGCS) as a global standard to facilitate analysis and comparison of cesarean delivery rates. Our objective was to apply the TGCS to a nationwide cohort in the United States over a 10-year period. This population-based analysis applied the TGCS to all births in the United States from 2005-2014, recorded in the 2003-revised birth certificate format. Over the study 10-year period 27,044,217 deliveries met inclusion criteria. Five parameters (parity including previous cesarean, gestational age, labor onset, fetal presentation and plurality), identifiable on presentation for delivery, were used to classify all women included into one of ten groups. The overall cesarean rate was 31.6%. Group 3 births (singleton, term, cephalic multiparas in spontaneous labor) were most common, while Group 5 births (those with a previous cesarean) accounted for the most cesarean deliveries increasing from 27% of all cesareans in 2005-06 to over 34% in 2013-14. Breech pregnancies (Groups 6 and 7) had cesarean rates above 90%. Primiparous and multiparous women who had a prelabor cesarean [Groups 2(b) and 4(b)] accounted for over one quarter of all cesarean deliveries. Women with a previous cesarean delivery represent an increasing proportion of cesarean deliveries. Use of the Robson criteria allows standardised comparisons of data and identifies clinical scenarios driving changes in cesarean rates. Hospitals and health organisations can use the TGCS to evaluate quality and processes associated with cesarean delivery. Copyright © 2018 Elsevier Inc. All rights reserved.

Risks of adverse outcomes in the next birth after a first cesarean delivery.

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Kennare, Robyn; Tucker, Graeme; Heard, Adrian; Chan, Annabelle

2007-02-01

To estimate the risks of cesarean first birth, compared with vaginal first birth, for adverse obstetric and perinatal outcomes in the second birth. Population-based retrospective cohort study of all singleton, second births in the South Australian perinatal data collection 1998 to 2003 comparing outcomes for 8,725 women who underwent a cesarean delivery for their first birth with 27,313 women who underwent a vaginal first birth. Predictor variables include age, indigenous status, smoking, pregnancy interval, medical and obstetric complications, gestation, patient type, hospital category, and history of ectopic pregnancy, miscarriage, stillbirth or termination of pregnancy. The cesarean delivery cohort had increased risks for malpresentation (odds ratio [OR] 1.84, 95% confidence interval [CI] 1.65-2.06), placenta previa (OR 1.66, 95% CI 1.30-2.11), antepartum hemorrhage (OR 1.23, 95% CI 1.08-1.41), placenta accreta (OR 18.79, 95% CI 2.28-864.6), prolonged labor (OR 5.89, 95% CI 3.91-8.89), emergency cesarean (relative risk 9.37, 95% CI 8.98-9.76) and uterine rupture (OR 84.42, 95% CI 14.64-infinity), preterm birth (OR 1.17, 95% CI 1.04-1.31), low birth weight (OR 1.30, 95% CI 1.14-1.48), small for gestational age (OR 1.12, 95% CI 1.02-1.23), stillbirth (OR 1.56, 95% CI 1.04-2.32), and unexplained stillbirth (OR 2.34, 95% CI 1.26-4.37). The range of the number of primary cesarean deliveries needed to harm included 134 for one additional preterm birth, up to 1,536 for one additional placenta accreta. Cesarean delivery is associated with increased risks for adverse obstetric and perinatal outcomes in the subsequent birth. However, some risks may be due to confounding factors related to the indication for the first cesarean. II.

Sonographic large fetal head circumference and risk of cesarean delivery.

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Lipschuetz, Michal; Cohen, Sarah M; Israel, Ariel; Baron, Joel; Porat, Shay; Valsky, Dan V; Yagel, Oren; Amsalem, Hagai; Kabiri, Doron; Gilboa, Yinon; Sivan, Eyal; Unger, Ron; Schiff, Eyal; Hershkovitz, Reli; Yagel, Simcha

2018-03-01

Persistently high rates of cesarean deliveries are cause for concern for physicians, patients, and health systems. Prelabor assessment might be refined by identifying factors that help predict an individual patient's risk of cesarean delivery. Such factors may contribute to patient safety and satisfaction as well as health system planning and resource allocation. In an earlier study, neonatal head circumference was shown to be more strongly associated with delivery mode and other outcome measures than neonatal birthweight. In the present study we aimed to evaluate the association of sonographically measured fetal head circumference measured within 1 week of delivery with delivery mode. This was a multicenter electronic medical record-based study of birth outcomes of primiparous women with term (37-42 weeks) singleton fetuses presenting for ultrasound with fetal biometry within 1 week of delivery. Fetal head circumference and estimated fetal weight were correlated with maternal background, obstetric, and neonatal outcome parameters. Elective cesarean deliveries were excluded. Multinomial regression analysis provided adjusted odds ratios for instrumental delivery and unplanned cesarean delivery when the fetal head circumference was ≥35 cm or estimated fetal weight ≥3900 g, while controlling for possible confounders. In all, 11,500 cases were collected; 906 elective cesarean deliveries were excluded. A fetal head circumference ≥35 cm increased the risk for unplanned cesarean delivery: 174 fetuses with fetal head circumference ≥35 cm (32%) were delivered by cesarean, vs 1712 (17%) when fetal head circumference cesarean delivery by an adjusted odds ratio of 1.75 (95% confidence interval, 1.4-2.18) controlling for gestational age, fetal gender, and epidural anesthesia. The rate of prolonged second stage of labor was significantly increased when either the fetal head circumference was ≥35 cm or the estimated fetal weight ≥3900 g, from 22.7% in the total

Cesarean Birth

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... QUESTIONS LABOR, DELIVERY, AND POSTPARTUM CARE FAQ006 Cesarean Birth (C-section) • What is cesarean birth? • What are the reasons for cesarean birth? • Is a cesarean birth necessary if I have ...

Can oxytocin augmentation modify the risk of epidural analgesia by maternal age in cesarean sections?

Science.gov (United States)

Rossen, Janne; Klungsøyr, Kari; Albrechtsen, Susanne; Løkkegård, Ellen; Rasmussen, Steen; Bergholt, Thomas; Skjeldestad, Finn E

2018-03-07

Maternal age is an established risk factor for cesarean section; epidural analgesia and oxytocin augmentation may modify this association. We investigated the effects and interactions of oxytocin augmentation, epidural analgesia and maternal age on the risk of cesarean section. In all, 416 386 nulliparous women with spontaneous onset of labor, ≥37 weeks of gestation and singleton infants with a cephalic presentation during 2000-2011 from Norway and Denmark were included [Ten-group classification system (Robson) group 1]. In this case-control study the main exposure was maternal age; epidural analgesia, oxytocin augmentation, birthweight and time period were explanatory variables. Chi-square test and logistic regression were used to estimate associations and interactions. The cesarean section rate increased consistently with advancing maternal age, both overall and in strata of epidural analgesia and oxytocin augmentation. We observed strong interactions between maternal age, oxytocin augmentation and epidural analgesia for the risk of cesarean section. Women with epidural analgesia generally had a reduced adjusted odds ratio when oxytocin was used compared with when it was not used. In Norway, this applied to all maternal age groups but in Denmark only for women ≥30 years. Among women without epidural, oxytocin augmentation was associated with an increased odds ratio for cesarean section in Denmark, whereas no difference was observed in Norway. Oxytocin augmentation in nulliparous women with epidural analgesia is associated with a reduced risk of cesarean section in labor with spontaneous onset. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

Antibiotic prophylaxis at elective cesarean section: a randomized controlled trial in a low resource setting.

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Kandil, Mohamed; Sanad, Zakaria; Gaber, Wael

2014-04-01

To determine the best time to administer prophylactic antibiotics at Cesarean delivery in order to reduce the postoperative maternal infectious morbidity in a low resource setting. One hundred term primigravidae with singleton pregnancy were recruited and randomly allocated to two equal groups. Each woman received 2 g intravenous Cefazoline. Women in Group I received it prior to skin incision while those in Group II had it immediately after cord clamping. We measured the following outcome parameters: (1) Surgical site wound infection; (2) Endometritis and (3) Urinary tract infection. There was no significant difference in any of the patients' characteristics between both groups. In Group I, three cases developed surgical site infections but four in Group II (p > 0.05). In Group I, the infected cases had Cesarean because of malpresentations while in Group II, two cases had Cesarean because of patients' request, one because of maternal heart disease and one due to intra-uterine growth restriction. Seven and nine cases had urinary tract infection in Groups I and II, respectively, (p > 0.05). Prophylactic antibiotic administration either prior to surgery or after cord clamping is probably equally effective in reducing the postoperative infectious morbidity after Cesarean in low resource settings.

Prophylactic transcervical amnioinfusion in laboring women with oligohydramnios.

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Amin, A F; Mohammed, M S; Sayed, G H; Abdel-Razik, S

2003-05-01

Evaluation of prophylactic intrapartum amnioinfusion in women with oligohydramnios. Assiut University Hospital during the period from February 2000 to September 2001, 160 laboring women with oligohydramnios [amniotic fluid index (AFI) amnioinfusion and control groups. Inclusion criteria were: term singleton gestation, vertex presentation, cervical dilatation amnioinfusion was done with warmed normal saline. there was a significant increase in AFI after amnioinfusion (Pamnioinfusion group showed lower cesarean section rate for fetal distress (P=0.003), lower incidence of abnormal FHR (P=0.006), fewer neonates with Apgar score amnioinfusion is a simple, safe and effective procedure.

Remote prognosis after primary cesarean delivery: the association of VBACs and recurrent cesarean deliveries with maternal morbidity

Directory of Open Access Journals (Sweden)

Erez O

2012-03-01

Full Text Available Offer Erez1, Lena Novack2, Vered Kleitman-Meir1, Doron Dukler1, Idit Erez-Weiss3, Francesca Gotsch4, Moshe Mazor11Department of Obstetrics and Gynecology, Soroka University Medical Center, 2Department of Epidemiology, 3Department of Family Medicine, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; 4Obstetrics and Gynecology Departement, Policlinico GB Rossi Azienda Ospedaliera Universitaria Integrata Verona, ItalyPurpose: To determine the effects of vaginal birth after cesarean (VBAC versus repeated cesarean sections (RCS after a primary cesarean section (CS, on the rate of intraoperative and postpartum maternal morbidity.Patients and methods: This is a retrospective population-based cohort study. During the study period (1988–2005 there were 200,012 deliveries by 76,985 women at our medical center; 16,365 of them had a primary CS, of which 7429 women delivered a singleton infant after the primary CS, met the inclusion criteria, were included in our study, and were followed for four consecutive deliveries. Patients were divided into three study groups according to the outcome of their consecutive delivery after the primary CS: VBAC (n = 3622, elective CS (n = 1910, or an urgent CS (n = 1897. Survival analysis models were used to investigate the effect of the urgency of CS and the numbers of pregnancy predating the primary CS on peripartum complications.Results: Women who failed a trial of labor had a higher rate of uterine rupture than those who had a VBAC. Patients who delivered by CS had a higher rate of endometritis than those giving birth vaginally. The rate of cesarean hysterectomy and transfer to other departments increased significantly at the fourth consecutive surgery (P = 0.02 and P = 0.003, respectively. VBAC was associated with a 55% reduction in the risk of intrapartum complications in comparison to a planned CS (hazard ratio [HR] 0.45; 95% confidence interval [CI]: 0.22–0.89. A greater

Patient-Perceived Pressure from Clinicians for Labor Induction and Cesarean Delivery: A Population-Based Survey of U.S. Women

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Jou, Judy; Kozhimannil, Katy B; Johnson, Pamela Jo; Sakala, Carol

2015-01-01

Objective To determine whether patient-perceived pressure from clinicians for labor induction or cesarean delivery is significantly associated with having these procedures. Data Sources/Study Setting Listening to Mothers III, a nationally representative survey of women 18–45 years who delivered a singleton infant in a U.S. hospital July 2011–June 2012 (N = 2,400). Study Design Multivariate logistic regression analysis of factors associated with perceived pressure and estimation of odds of induction and cesarean given perceived pressure. Principal Findings Overall, 14.8 percent of respondents perceived pressure from a clinician for labor induction and 13.3 percent for cesarean delivery. Women who perceived pressure for labor induction had higher odds of induction overall (adjusted odds ratio [aOR]: 3.51; 95 percent confidence interval [CI]: 2.5–5.0) and without medical reason (aOR: 2.13; 95 percent CI: 1.3–3.4) compared with women who did not perceive pressure. Those perceiving pressure for cesarean delivery had higher odds of cesarean overall (aOR: 5.17; 95 percent CI: 3.2–8.4), without medical reason (aOR: 6.13; 95 percent CI: 3.4–11.1), and unplanned cesarean (aOR: 6.70; 95 percent CI: 4.0–11.3). Conclusions Patient-perceived pressure from clinicians significantly predicts labor induction and cesarean delivery. Efforts to reduce provider–patient miscommunication and minimize potentially unnecessary procedures may be warranted. PMID:25250981

Interdelivery weight gain and risk of cesarean delivery following a prior vaginal delivery.

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Dude, Annie M; Lane-Cordova, Abbi D; Grobman, William A

2017-09-01

Approximately one third of all deliveries in the United States are via cesarean. Previous research indicates weight gain during pregnancy is associated with an increased risk of cesarean delivery. It remains unclear, however, whether and to what degree weight gain between deliveries (ie, interdelivery weight gain) is associated with cesarean delivery in a subsequent pregnancy following a vaginal delivery. The objective of the study was to determine whether interdelivery weight gain is associated with an increased risk of intrapartum cesarean delivery following a vaginal delivery. This was a case-control study of women who had 2 consecutive singleton births of at least 36 weeks' gestation between 2005 and 2016, with a vaginal delivery in the index pregnancy. Women were excluded if they had a contraindication to a trial of labor (eg, fetal malpresentation or placenta previa) in the subsequent pregnancy. Maternal characteristics and delivery outcomes for both pregnancies were abstracted from the medical record. Maternal weight gain between deliveries was measured as the change in body mass index at delivery. Women who underwent a subsequent cesarean delivery were compared with those who had a repeat vaginal delivery using χ 2 statistics for categorical variables and Student t tests or analysis of variance for continuous variables. Multivariable logistic regression was used to determine whether interdelivery weight gain remained independently associated with intrapartum cesarean delivery after adjusting for potential confounders. Of 10,396 women who met eligibility criteria and had complete data, 218 (2.1%) had a cesarean delivery in the subsequent pregnancy. Interdelivery weight gain was significantly associated with cesarean delivery and remained significant in multivariable analysis for women with a body mass index increase of at least 2 kg/m 2 (adjusted odds ratio, 1.53, 95% confidence interval, 1.03-2.27 for a body mass index increase of 2 kg/m 2 to gained 2 kg

Can oxytocin augmentation modify the risk of epidural analgesia by maternal age in cesarean sections?

DEFF Research Database (Denmark)

Rossen, Janne; Klungsøyr, Kari; Albrechtsen, Susanne

2018-01-01

was used compared with when it was not used. In Norway, this applied to all maternal age groups but in Denmark only for women ≥30 years. Among women without epidural, oxytocin augmentation was associated with an increased odds ratio for cesarean section in Denmark, whereas no difference was observed....... MATERIAL AND METHODS: In all, 416 386 nulliparous women with spontaneous onset of labor, ≥37 weeks of gestation and singleton infants with a cephalic presentation during 2000-2011 from Norway and Denmark were included [Ten-group classification system (Robson) group 1]. In this case-control study the main...... exposure was maternal age; epidural analgesia, oxytocin augmentation, birthweight and time period were explanatory variables. Chi-square test and logistic regression were used to estimate associations and interactions. RESULTS: The cesarean section rate increased consistently with advancing maternal age...

Planned Cesarean Delivery at Term and Adverse Outcomes in Childhood Health

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Black, Mairead; Bhattacharya, Siladitya; Philip, Sam; Norman, Jane E.; McLernon, David J.

2016-01-01

Importance Planned cesarean delivery comprises a significant proportion of births globally, with combined rates of planned and unscheduled cesarean delivery in a number of regions approaching 50%. Observational studies have shown that offspring born by cesarean delivery are at increased risk of ill health in childhood, but these studies have been unable to adjust for some key confounding variables. Additionally, risk of death beyond the neonatal period has not yet been reported for offspring born by planned cesarean delivery. Objective To investigate the relationship between planned cesarean delivery and offspring health problems or death in childhood. Design, Setting, and Participants Population-based data-linkage study of 321 287 term singleton first-born offspring born in Scotland, United Kingdom, between 1993 and 2007, with follow-up until February 2015. Exposures Offspring born by planned cesarean delivery in a first pregnancy were compared with offspring born by unscheduled cesarean delivery and with offspring delivered vaginally. Main Outcomes and Measures The primary outcome was asthma requiring hospital admission; secondary outcomes were salbutamol inhaler prescription at age 5 years, obesity at age 5 years, inflammatory bowel disease, type 1 diabetes, cancer, and death. Results Compared with offspring born by unscheduled cesarean delivery (n = 56 015 [17.4%]), those born by planned cesarean delivery (12 355 [3.8%]) were at no significantly different risk of asthma requiring hospital admission, salbutamol inhaler prescription at age 5 years, obesity at age 5 years, inflammatory bowel disease, cancer, or death but were at increased risk of type 1 diabetes (0.66% vs 0.44%; difference, 0.22% [95% CI, 0.13%-0.31%]; adjusted hazard ratio [HR], 1.35 [95% CI, 1.05-1.75]). In comparison with children born vaginally (n = 252 917 [78.7%]), offspring born by planned cesarean delivery were at increased risk of asthma requiring hospital admission (3.73% vs 3

Route of delivery following successful external cephalic version.

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Policiano, Catarina; Costa, Ana; Valentim-Lourenço, Alexandre; Clode, Nuno; Graça, Luís M

2014-09-01

To evaluate the delivery route and the indications for cesarean delivery after successful external cephalic version (ECV). A retrospective matched case-control study was conducted at a hospital in Lisbon, Portugal, between 2002 and 2012. Each woman who underwent successful ECV (n = 44) was compared with the previous and next women who presented for labor management and who had the same parity and a singleton vertex pregnancy at term (n = 88). The outcome measures were route of delivery, indications for cesarean delivery, and incidence of nonreassuring fetal status. Attempts at ECV were successful in 62 (46%) of 134 women, and 44 women whose fetuses remained in a cephalic presentation until delivery were included in the study. The rates of intrapartum cesarean delivery and operative vaginal delivery did not differ significantly between cases and controls (intrapartum cesarean delivery, 9 [20%] vs 16 [18%], P = 0.75; operative vaginal delivery, 14 [32%] vs 19 [22%], P = 0.20). The indications for cesarean delivery after successful ECV did not differ; in both groups, cesarean delivery was mainly performed for labor arrest disorders (cases, 6 [67%] vs controls, 13 [81%]; P = 0.63). Successful ECV was not associated with increased rates of intrapartum cesarean delivery or operative vaginal delivery. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

The Cesarean Decision Survey

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Puia, Denise M.

2013-01-01

A descriptive study design was used to describe the decision of women having a cesarean surgery. The Cesarean Birth Decision Survey was used to collect data from 101 postpartum women who underwent a cesarean. Most of the surgeries were to primipara women who reported doctor recommendation and increased safety for the baby as the main reasons for the cesarean. Those women who had repeat cesarean surgery all cited their previous cesarean as the main reason for the current surgery. Women’s knowledge of cesarean surgery needs to be assessed early in pregnancy so that appropriate education may be provided. Accurate and ongoing information may decrease the number of women choosing a cesarean surgery. PMID:24868134

Cerebroplacental ratio thresholds measured within two weeks of birth and the risk of Cesarean section for intrapartum fetal compromise and adverse neonatal outcome.

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N Bligh, Larissa; Alsolai, Amal A; Greer, Ristan M; Kumar, Sailesh

2017-06-08

Prediction of intrapartum fetal compromise in uncomplicated, term pregnancies is a global obstetric challenge. Currently, no widely accepted screening test for this condition exists, although the cerebroplacental ratio (CPR) shows promise. We aimed to prospectively evaluate the screening performance of the CPR 10 th centile for detection of Cesarean section for intrapartum fetal compromise (IFC) and composite adverse neonatal outcome (ANO) in low-risk women from 36 weeks and to determine the best CPR threshold from three previously described in the literature. In a blinded, prospective, observational, cohort study, 483 women with uncomplicated singleton pregnancies underwent fortnightly CPR measurement from 36 weeks to delivery and intrapartum and neonatal outcomes were recorded. The CPR 10 th centile threshold screening test performance was calculated for emergency Cesarean section for IFC and composite ANO, incorporating acidosis at birth, Apgar Cesarean section for IFC and 17.9% had a composite ANO. Sensitivity and specificity for CPR Cesarean section IFC and composite ANO, respectively. Comparing the three CPR thresholds, CPR Cesarean section for IFC area under the receiver operating characteristic curve = 0.72, composite ANO area under the receiver operating characteristic curve = 0.58), although its predictive utility was only fair for Cesarean section for IFC and poor for composite ANO. The CPR 10 th centile may be useful as a component of a risk assessment tool for Cesarean section for IFC in low risk pregnancies at term. This article is protected by copyright. All rights reserved.

Neonatal and maternal outcomes comparing women undergoing two in vitro fertilization (IVF) singleton pregnancies and women undergoing one IVF twin pregnancy.

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Sazonova, Antonina; Källen, Karin; Thurin-Kjellberg, Ann; Wennerholm, Ulla-Britt; Bergh, Christina

2013-03-01

To compare outcomes for women undergoing two in vitro fertilization (IVF) pregnancies with singletons and women undergoing one IVF twin pregnancy. The concept of single-embryo transfer in IVF has reduced the risks of both maternal and neonatal complications, but there is still a discussion of whether or not twins are a desired outcome of IVF. Registry study. Not applicable. All reported twins after IVF with double-embryo transfer (n = 1,982) and their mothers (n = 991) and all mothers (n = 921) who gave birth to two IVF singletons (n = 1,842). None. Maternal and neonatal outcomes including severe neonatal morbidity. Preterm birth, very preterm birth, low birth weight, very low birth weight, and small for gestational age were dramatically increased for IVF twins compared with two IVF singletons with the same mother, with adjusted odds ratios from 4 to 16. Significantly higher rates of respiratory complications, sepsis, and jaundice were detected among the IVF twins. Significantly higher rates of preeclampsia, preterm premature rupture of the membranes, and cesarean section were observed for IVF twin pregnancies. The neonatal and maternal outcomes were dramatically better for women undergoing two IVF singleton pregnancies compared with one IVF twin pregnancy after double-embryo transfer. These results support single-embryo transfer to minimize the risks associated with twin pregnancies. Copyright © 2013 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Adding Sufentanil to TAP Block Hyperbaric Bupivacaine Decreases Post-Cesarean Delivery Morphine Consumption

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Laleh Eslamian

2016-04-01

Full Text Available Pain management is crucially important in the postoperative period as it increases patient comfort and satisfaction. The primary outcome of present study was to evaluate the effect of sufentanil added to hyperbaric bupivacaine solution 0.25% in transversus abdominis plane (TAP block, on postoperative analgesic consumption. Fifty ASA physical status I–II term primiparous single-tone pregnant women aged 20–40 years scheduled for elective cesarean delivery with Pfannenstiel incision under general anaesthesia were enrolled in this randomized, double-blind, placebo-controlled trial. Ultrasound guided TAP block was performed at the end of surgery. Patients were randomly enrolled into two groups. Patients in the study group received 20 ml of hyperbaric bupivacaine 0.25% plus 1mL of sufentanil on either side while patients in the placebo group were administered 20 ml of hyperbaric bupivacaine 0.25% along with 1mL of placebo. Post-cesarean delivery visual analogue scale (VAS for pain and morphine usage were measured and recorded. The morphine consumption was significantly less in the study group (37.2 ± 16.1 mg than the control group (52.8 ± 16.7 mg, P =0.002.The VAS for pain both in rest and coughing were same in groups. Sufentanil added to 0.25% hyperbaric bupivacaine in TAP block decreases post cesarean delivery morphine consumption.

The risk of emergency cesarean section after failure of vaginal delivery according to prepregnancy body mass index or gestational weight gain by the 2009 Institute of Medicine guidelines

Science.gov (United States)

Kwon, Ha Yan; Kwon, Ja-Young; Park, Yong Won

2016-01-01

Objective To evaluate the risk of emergency cesarean section according to the prepregnancy body mass index (BMI) and gestational weight gain per the 2009 Institute of Medicine guidelines. Methods A retrospective analysis of data from 2,765 women with singleton full-term births (2009 to 2012) who attempted a vaginal delivery was conducted. Pregnancies with preeclampsia, chronic hypertension, diabetes, planned cesarean section, placenta previa, or cesarean section due to fetal anomalies or intrauterine growth restriction were excluded. Odds ratios (ORs) and confidence intervals (CIs) for emergency cesarean section were calculated after adjusting for prepregnancy BMI or gestational weight gain. Results Three-hundred and fifty nine (13.0%) women underwent emergency cesarean section. The adjusted OR for overweight, obese, and extremely obese women indicated a significantly increased risk of cesarean delivery. Gestational weight gain by Institute of Medicine guidelines was not associated with an increased risk of cesarean delivery. However, inadequate and excessive weight gain in obese women was highly associated with an increased risk of emergency cesarean section, compared to these in normal BMI (OR, 5.56; 95% CI, 1.36 to 22.72; OR, 3.63; 95% CI, 1.05 to 12.54; respectively), while there was no significant difference between normal BMI and obese women with adequate weight gain. Conclusion Obese women should be provided special advice before and during pregnancy for controlling weight and careful consideration should be needed at the time of vaginal delivery to avoid emergency cesarean section. PMID:27200306

Vertex reconstruction in CMS

International Nuclear Information System (INIS)

Chabanat, E.; D'Hondt, J.; Estre, N.; Fruehwirth, R.; Prokofiev, K.; Speer, T.; Vanlaer, P.; Waltenberger, W.

2005-01-01

Due to the high track multiplicity in the final states expected in proton collisions at the LHC experiments, novel vertex reconstruction algorithms are required. The vertex reconstruction problem can be decomposed into a pattern recognition problem ('vertex finding') and an estimation problem ('vertex fitting'). Starting from least-squares methods, robustifications of the classical algorithms are discussed and the statistical properties of the novel methods are shown. A whole set of different approaches for the vertex finding problem is presented and compared in relevant physics channels

Vertex Reconstruction in CMS

CERN Document Server

Chabanat, E; D'Hondt, J; Vanlaer, P; Prokofiev, K; Speer, T; Frühwirth, R; Waltenberger, W

2005-01-01

Because of the high track multiplicity in the final states expected in proton collisions at the LHC experiments, novel vertex reconstruction algorithms are required. The vertex reconstruction problem can be decomposed into a pattern recognition problem ("vertex finding") and an estimation problem ("vertex fitting"). Starting from least-square methods, ways to render the classical algorithms more robust are discussed and the statistical properties of the novel methods are shown. A whole set of different approaches for the vertex finding problem is presented and compared in relevant physics channels.

Attentional capture by masked colour singletons.

Science.gov (United States)

Ansorge, Ulrich; Horstmann, Gernot; Worschech, Franziska

2010-09-15

We tested under which conditions a colour singleton of which an observer is unaware captures attention. To prevent visual awareness of the colour singleton, we used backward masking. We find that a masked colour singleton cue captures attention if it matches the observer's goal to search for target colours but not if it is task-irrelevant. This is also reflected in event-related potentials to the visible target: the masked goal-matching cue elicits an attentional potential (N2pc) in a target search task. By contrast, a non-matching but equally strong masked colour singleton cue failed to elicit a capture effect and an N2pc. Results are discussed with regard to currently pertaining conceptions of attentional capture by colour singletons. Copyright 2010 Elsevier Ltd. All rights reserved.

Cord around neck in singleton term pregnancies and its outcome

International Nuclear Information System (INIS)

Sajjad, R.; Mustafa, N.

2014-01-01

stained labour. Cord length was measured, 60 cm in 28%, 53 cm in 21%, 74 cm in 51% of patients. Longer length of cord (74 cm) was seen in patients ended up into emergency cesarean. Conclusion: Cord around neck can be delivered vaginally if monitored carefully. Immediate action is required in case of any complication to get good maternal and fetal outcome and to avoid morbidity and mortality with cord around neck. To enlist the complications with nuchal cord in singleton term pregnancies and to determine maternal and fetal outcome in singleton term pregnancies. Design: Descriptive study. Place and duration of study: The study was carried out at Gynaecology and Obstetric department Combined Military Hospital Quetta from Nov 2007 to May 2008. Patients and methods: One hundred women irrespective of parity with healthy, singleton term pregnancy and cephalic presentation, labouring or not labouring, were selected from outpatient department. A total of 41 patients were booked with Doppler ultrasound done in antenatal period. Other 59 were poorly booked and diagnosed with cord around neck by clinical criteria e.g. high head at term, fetal distress, meconium discharge, slow progress in labour leading to prolonged labour. All patients signed well informed written proforma regarding study and its outcome. Vigilant feto maternal monitoring was done during labour. All events during labour were mentioned in proformas which were attached with patients case notes. Data was interperated in term of frequency and percentages. Results: Complications with cord around neck found were still birth 3%, fetal distress 15%, intrauterine death 1%. Prolonged labour was seen in 14%, Meconium discharge in 5%, and high presenting part was found in 11% of cases. Maternal outcome were elective caesarean section in 6%, emergency caesarean-section in 32%, spontaneous vaginal delivery in 54% and instrumental vaginal delivery in 8% of the cases. Different fetal outcomes seen were intrauterine death

Cesarean Section - Multiple Languages

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... Your Recovery After Cesarean Birth (Part 1) - English MP3 Your Recovery After Cesarean Birth (Part 1) - 简体中文 (Chinese, Simplified (Mandarin dialect)) MP3 Your Recovery After Cesarean Birth (Part 1) - English ...

Decreased risk of prematurity after elective repeat cesarean delivery in Hispanics.

Science.gov (United States)

Vilchez, Gustavo; Chelliah, Anushka; Bratley, Elaine; Bahado-Singh, Ray; Sokol, Robert

2015-01-01

The current recommendation is to delay elective repeat cesarean deliveries (ERCD) until 39 weeks to decrease prematurity risks. Prior reports suggest accelerated maturity of fetuses according to race (African-Americans and Asians). To analyze the effect of the Hispanic ethnicity on the prematurity risk after ERCD. The US Natality Database from 2004 to 2008 was reviewed. Inclusion criteria were singleton delivery, no trial of labor, repeat cesarean. Exclusion criteria were fetal anomalies, history of diabetes/hypertension related disorders. Outcomes analyzed were Apgar score, assisted ventilation, intensive care admission, surfactant/antibiotic use and seizures. Two groups were identified: non-Hispanic Whites (NHW) and Hispanic Whites (HW). Regression analysis was performed to calculate adjusted odds ratios. Deliveries at 36-40 weeks were studied with 40 weeks as the reference group. A total of 930421 ERCDs were identified, 396823 NHW and 236733 HW. For NHW, the risk of prematurity was lower at 39 weeks. For HW, there was no difference in the risks of prematurity at/beyond 38 weeks. There appears to be accelerated maturity with no increase in prematurity risk at 38 weeks in HW delivered by ERCD. Ethnicity can be considered for patient counseling and decision making regarding optimal timing of elective interventions.

Review of the Recent Literature on the Mode of Delivery for Singleton Vertex Preterm Babies

Directory of Open Access Journals (Sweden)

Smriti Ray Chaudhuri Bhatta

2011-01-01

Full Text Available Choosing the safest method of delivery and preventing preterm labour are obstetric challenges in reducing the number of preterm births and improving outcomes for mother and baby. Optimal route of delivery for preterm vertex neonates has been a controversial topic in the obstetric and neonatal community for decades and continues to be debated. We reviewed 22 studies, most of which have been published over the last five years with an aim to find answers to the clinical questions relevant to deciding the mode of delivery. Findings suggested that the neonatal outcome does not depend on the mode of delivery. Though Caesarean section rates are increasing for preterm births, it does not prevent neurodisability and cannot be recommended unless there are other obstetric indications to justify it. Therefore, clinical judgement of the obstetrician depending on the individual case still remains important in deciding the mode of delivery.

Feature singletons attract spatial attention independently of feature priming.

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Yashar, Amit; White, Alex L; Fang, Wanghaoming; Carrasco, Marisa

2017-08-01

People perform better in visual search when the target feature repeats across trials (intertrial feature priming [IFP]). Here, we investigated whether repetition of a feature singleton's color modulates stimulus-driven shifts of spatial attention by presenting a probe stimulus immediately after each singleton display. The task alternated every two trials between a probe discrimination task and a singleton search task. We measured both stimulus-driven spatial attention (via the distance between the probe and singleton) and IFP (via repetition of the singleton's color). Color repetition facilitated search performance (IFP effect) when the set size was small. When the probe appeared at the singleton's location, performance was better than at the opposite location (stimulus-driven attention effect). The magnitude of this attention effect increased with the singleton's set size (which increases its saliency) but did not depend on whether the singleton's color repeated across trials, even when the previous singleton had been attended as a search target. Thus, our findings show that repetition of a salient singleton's color affects performance when the singleton is task relevant and voluntarily attended (as in search trials). However, color repetition does not affect performance when the singleton becomes irrelevant to the current task, even though the singleton does capture attention (as in probe trials). Therefore, color repetition per se does not make a singleton more salient for stimulus-driven attention. Rather, we suggest that IFP requires voluntary selection of color singletons in each consecutive trial.

Ethical issues in cesarean delivery.

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Chervenak, Frank A; McCullough, Laurence B

2017-08-01

Cesarean delivery is the most common and important surgical intervention in obstetric practice. Ethics provides essential guidance to obstetricians for offering, recommending, recommending against, and performing cesarean delivery. This chapter provides an ethical framework based on the professional responsibility model of obstetric ethics. This framework is then used to address two especially ethically challenging clinical topics in cesarean delivery: patient-choice cesarean delivery and trial of labor after cesarean delivery. This chapter emphasizes a preventive ethics approach, designed to prevent ethical conflict in clinical practice. To achieve this goal, a preventive ethics approach uses the informed consent process to offer cesarean delivery as a medically reasonable alternative to vaginal delivery, to recommend cesarean delivery, and to recommend against cesarean delivery. The limited role of shared decision making is also described. The professional responsibility model of obstetric ethics guides this multi-faceted preventive ethics approach. Copyright © 2017. Published by Elsevier Ltd.

Obstetrical correlates of the first time cesarean section, compared with the repeated cesarean section

International Nuclear Information System (INIS)

Rukh, G.; Akhtar, S.

2007-01-01

To determine the clinical and epidemiological characteristics in patients having their first cesarean section (FCS) and compare it with findings in patients with repeated cesarean section (RCS). This study included all the women who gave birth by cesarean sections, 817 of the total 5992 deliveries, at this unit during the study period. Data on potential risk factors for the first cesarean section (FCS) and repeated cesarean section (RCS were extracted from medical records, which were reviewed and compared between these two groups of women. Data were statistically analyzed with student t-test for comparison between means and Chi-square test for comparison between percentages. Crude odds ratio (OR) with 95% confidence interval (95% CI) were calculated. Significance was taken at p 0.05). The frequency of first cesarean section and repeat cesarean section is high in our setup. Adequate following of the programs to diminish the percentage of FCS by curtailing its predisposing factors is needed. (author)

A nonperturbative fermion-boson vertex

International Nuclear Information System (INIS)

Bashir, A.; Raya, A.

2002-01-01

We calculate the massive fermion propagator at one-loop order in QED3. The Ward-Takahashi identity (WTI) relates the propagator to the vertex. This allows us to split the vertex into its longitudinal and transverse parts. The former is fixed by the WTI. Following the scheme of Ball and Chiu later modified by Kizilersue et. al., we calculate the full vertex at one-loop order. A mere subtraction of the longitudinal part of the vertex gives us the transverse part. The α dependence in the transverse vertex can be eliminated by making use of the perturbative expressions for the wavefunction renormalization function and the mass function of complicated arguments of the incoming and outgoing fermion momenta. This leads us to a vertex which is nonperturbative in nature. We also calculate an effective vertex for which the arguments of the unknown functions have no angular dependence, making it particularly suitable for numerical studies of dynamical symmetry breaking

[Shortened hospital stay for elective cesarean section after initiation of a fast-track program and midwifery home-care].

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Gunnarsdottir, Johanna; Bjornsdottir, Thorbjörg Edda; Halldorsson, Thorhallur Ingi; Halldorsdottir, Gudrun; Geirsson, Reynir Tomas

2011-07-01

To audit whether hospital stay shortened without increasing readmissions after implementation of fast-track methodology for elective cesarean section and characterize what influences length of stay. A fast-track program was initiated in November 2008, with a one year clinical audit and satisfaction survey. Discharge criteria were predefined and midwife home visits included if discharge was within 48 hours. Hospital stay by parity for women with elective section for singleton pregnancy between 1.11. 2008 - 31.10. 2009 (n=213, fast-track 182) was compared to 2003 (n=199) and 2007 (n=183). Readmissions and outpatient visits 2007 and 2008-9 were counted. Reasons for longer stay were recorded in fast-track, and body mass index. Median hospital stay decreased significantly from 81 to 52 hours between 2007 and 2008-9. Readmissions were four in each period and outpatient visit rates similar. In 2008-9, 66% of all women were discharged within 48 hours. Women in the fast-track program were satisfied with early discharge. Hospital stay for parous women was shorter in 2007 compared to 2003, but unchanged for nulliparas. Parity had a minimal influence on length of stay in 2008-9, although nulliparous women ≤ 25 years were more likely to stay >48 hours. Body mass index did not correlate with length of stay. Pain was rarely the reason for a longer stay in the fast-track program and 90% were satisfied with pain-medication after discharge. Most healthy women can be discharged early after singleton birth by elective cesarean, without increasing readmissions.

The Green Bay cesarean section study. III. Falling cesarean birth rates without a formal curtailment program.

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Sandmire, H F; DeMott, R K

1994-06-01

We observed decreases in cesarean birth rates at two Green Bay hospitals after the 1990 publication of our first cesarean section study. The purpose of this study was to determine the causes of those decreases and to see whether any outcome changes occurred with lower rates. An additional objective was to determine the perceptions of the 10 physicians regarding the determinants of cesarean birth rates. We compared recent cesarean birth rates (1990 to 1992) to former rates (1986 to 1988) for 10 of the 11 physicians analyzed in our previous studies. Newborn outcomes were analyzed to determine whether variations occur in comparing low to high cesarean rate physician groups. The total, primary, and repeat cesarean birth rates declined from 13.3% to 10.2%, 8.6% to 6.8%, and 4.7% to 3.4%, respectively, between 1986 to 1988 and 1990 to 1992. Variations in cesarean rates occurred among physicians and groups of physicians. Higher cesarean rates did not result in better perinatal outcome. Literature reports, residency training, continuing medical education attendance, and liability risks were the major determinants of cesarean birth as perceived by the 10 physicians in the study. The least important determinant, rated fifteenth of 15, was the national cesarean birth rate.

Vertex algebras and algebraic curves

CERN Document Server

Frenkel, Edward

2004-01-01

Vertex algebras are algebraic objects that encapsulate the concept of operator product expansion from two-dimensional conformal field theory. Vertex algebras are fast becoming ubiquitous in many areas of modern mathematics, with applications to representation theory, algebraic geometry, the theory of finite groups, modular functions, topology, integrable systems, and combinatorics. This book is an introduction to the theory of vertex algebras with a particular emphasis on the relationship with the geometry of algebraic curves. The notion of a vertex algebra is introduced in a coordinate-independent way, so that vertex operators become well defined on arbitrary smooth algebraic curves, possibly equipped with additional data, such as a vector bundle. Vertex algebras then appear as the algebraic objects encoding the geometric structure of various moduli spaces associated with algebraic curves. Therefore they may be used to give a geometric interpretation of various questions of representation theory. The book co...

What Is a Cesarean Delivery?

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... Twitter Pinterest Email Print What is a cesarean delivery? A cesarean delivery is a surgical procedure in which a fetus ... 32.2% of U.S. births were by cesarean delivery. 2 The CDC also found that the number ...

Vanishing twin syndrome among ART singletons and pregnancy outcomes.

Science.gov (United States)

Magnus, Maria C; Ghaderi, Sara; Morken, Nils-Halvdan; Magnus, Per; Bente Romundstad, Liv; Skjærven, Rolv; Wilcox, Allen J; Eldevik Håberg, Siri

2017-11-01

Among babies born by ART, do singleton survivors of a vanishing twin have lower birth weight than other singletons? Vanishing twin syndrome (VTS) was associated with lower birth weight among ART singletons; a sibship analysis indicated that the association was not confounded by maternal characteristics that remain stable between deliveries. Previous studies indicate that ART singletons with VTS have increased risk of adverse pregnancy outcomes, compared with other ART singletons. The potential contribution of unmeasured maternal background characteristics has been unclear. This was a Norwegian population-based registry study, including 17 368 mothers with 20 410 ART singleton deliveries between January 1984 and December 2013. The study population included 17 291 ART singletons without VTS, 638 ART singletons with VTS and 2418 ART singletons with uncertain vanishing twin status. We estimated differences in birth weight and gestational age comparing ART singletons with VTS first to all ART singletons without VTS, and subsequently to their ART siblings without VTS, using random- and fixed-effects linear regression, respectively. The corresponding comparisons for the associations with preterm birth and small for gestational age (SGA) were conducted using random-and fixed-effects logistic regression. The sibling analysis of preterm birth included 587 discordant siblings, while the sibling analysis of SGA included 674 discordant siblings. ART singletons with VTS had lower birth weight when compared to all ART singletons without VTS, with an adjusted mean difference (95% CI) of -116 g (-165, -67). When we compared ART singletons with VTS to their ART singletons sibling without VTS, the adjusted mean difference was -112 g (-209, -15). ART singletons with VTS also had increased risk of being born SGA, with an adjusted odds ratio (OR) (95% CI) of 1.48 (1.07, 2.03) compared to all ART singletons without VTS, and 2.79 (1.12, 6.91) in the sibship analyses. ART singletons with

Vertex detectors

International Nuclear Information System (INIS)

Lueth, V.

1992-07-01

The purpose of a vertex detector is to measure position and angles of charged particle tracks to sufficient precision so as to be able to separate tracks originating from decay vertices from those produced at the interaction vertex. Such measurements are interesting because they permit the detection of weakly decaying particles with lifetimes down to 10 -13 s, among them the τ lepton and charm and beauty hadrons. These two lectures are intended to introduce the reader to the different techniques for the detection of secondary vertices that have been developed over the past decades. The first lecture includes a brief introduction to the methods used to detect secondary vertices and to estimate particle lifetimes. It describes the traditional technologies, based on photographic recording in emulsions and on film of bubble chambers, and introduces fast electronic registration of signals derived from scintillating fibers, drift chambers and gaseous micro-strip chambers. The second lecture is devoted to solid state detectors. It begins with a brief introduction into semiconductor devices, and then describes the application of large arrays of strip and pixel diodes for charged particle tracking. These lectures can only serve as an introduction the topic of vertex detectors. Time and space do not allow for an in-depth coverage of many of the interesting aspects of vertex detector design and operation

Impact of the mode of delivery on maternal and neonatal outcome in spontaneous-onset breech labor at 32+0-36+6 weeks of gestation: A retrospective cohort study.

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Toivonen, Elli; Palomäki, Outi; Korhonen, Päivi; Huhtala, Heini; Uotila, Jukka

2018-03-30

To compare neonatal and maternal outcomes in spontaneously onset preterm breech deliveries after trial of labor (BTOL) and intended cesarean section (BCS), and between BTOL and vertex control deliveries, in singleton fetuses at 32 +0 -36 +6  weeks of gestation. Retrospective single center cohort study in a Finnish University Hospital including all spontaneous-onset preterm breech deliveries with 32 completed gestational weeks in 2003-2015. The study population comprised a total of 176 preterm breech and 103 vertex control deliveries, matched by gestational age and whether the mother had given birth vaginally before or not. Infants with severe malformations and antepartum fetal distress were excluded. Subgroup analyses were made in two cohorts according to gestational age. Main outcome measures were maternal and neonatal mortality and morbidity, low cord pH and Apgar score. No mortality was observed, and severe morbidity was rare. No difference in incidence of low cord pH or five-minute Apgar score was observed between the groups. Apgar scores at the age of one minute were comparable in the breech groups but more often low in the BTOL group compared to the vertex control group. 16.5% of neonates in the BTOL group, 23.3% in the BCS group and 7.8% in the vertex group needed intensive care. In logistic regression analysis, lower gestational age and being small for gestational age were associated with the need for neonatal intensive care. Being allowed a trial of labor was not associated with the need for neonatal intensive care. Maternal morbidity was similar across the groups, but median blood loss was more pronounced in the BCS group compared to the BTOL group. In breech deliveries at 32 +0 -36 +6 gestational weeks, trial of labor did not increase neonatal morbidity compared to intended cesarean delivery. Infants born after a trial of labor in breech presentation display low one-minute Apgar score and need intensive care more often compared to vertex controls

Legal Briefing: Unwanted Cesareans and Obstetric Violence.

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Pope, Thaddeus Mason

2017-01-01

A capacitated pregnant woman has a nearly unqualified right to refuse a cesarean section. Her right to say "no" takes precedence over clinicians' preferences and even over clinicians' concerns about fetal health. Leading medical societies, human rights organizations, and appellate courts have all endorsed this principle. Nevertheless, clinicians continue to limit reproductive liberty by forcing and coercing women to have unwanted cesareans. This "Legal Briefing" reviews recent court cases involving this type of obstetric violence. I have organized these court cases into the following six categories: 1. Epidemic of Unwanted Cesareans 2. Court-Ordered Cesareans 3. Physician-Coerced Cesareans 4. Physician-Ordered Cesareans 5. Cesareans for Incapacitated Patients 6. Cesareans for Patients in a Vegetative State or Who Are Brain Dead. Copyright 2017 The Journal of Clinical Ethics. All rights reserved.

The effect of a sonographic estimated fetal weight on the risk of cesarean delivery in macrosomic and small for gestational-age infants.

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Matthews, Kathy C; Williamson, John; Gupta, Simi; Lam-Rachlin, Jennifer; Saltzman, Daniel H; Rebarber, Andrei; Fox, Nathan S

2017-05-01

To assess the association of a sonographic estimated fetal weight (sonoEFW) with the risk of cesarean delivery in women with macrosomic or small for gestational age (SGA) infants. Retrospective cohort of singleton deliveries >24 weeks by one MFM practice from 2005 to 2014. We included all patients who delivered an infant with macrosomia (birth weight ≥4000 g) or SGA (birth weight cesarean delivery between patients who did and did not have a sonoEFW within four weeks of delivery. Regression analysis was performed to control for any differences in baseline characteristics. In patients with macrosomic infants (n = 352), the risk of cesarean delivery was significantly higher in the sonoEFW group (45.3% versus 17.6%, aOR 2.144, 95% CI: 1.06-4.34). When we restricted the analysis to the subgroup of 265 patients who attempted vaginal delivery, our results were similar (22.3% versus 9.1%, aOR 2.73, 95% CI: 1.15-6.48). In patients with an SGA infant (n = 614), the risk of cesarean delivery was not higher in the sonoEFW group (37.4% versus 24.1%, aOR 1.23, 95% CI: 0.80-2.07), nor in those who attempted vaginal delivery (19.8% versus 13.7%, aOR 1.17, 95% CI: 0.62-2.21). A sonoEFW prior to delivery is independently associated with cesarean delivery in women with macrosomic infants, but not those with SGA infants. This should be considered when deciding to obtain a sonoEFW at the end of pregnancy, particularly if not for an accepted indication.

Comparison of maternal and fetal outcomes among patients undergoing cesarean section under general and spinal anesthesia: a randomized clinical trial

Directory of Open Access Journals (Sweden)

Anıl İçel Saygı

Full Text Available CONTEXT AND OBJECTIVE: As the rates of cesarean births have increased, the type of cesarean anesthesia has gained importance. Here, we aimed to compare the effects of general and spinal anesthesia on maternal and fetal outcomes in term singleton cases undergoing elective cesarean section.DESIGN AND SETTING: Prospective randomized controlled clinical trial in a tertiary-level public hospital.METHODS: Our study was conducted on 100 patients who underwent cesarean section due to elective indications. The patients were randomly divided into general anesthesia (n = 50 and spinal anesthesia (n = 50 groups. The maternal pre and postoperative hematological results, intra and postoperative hemodynamic parameters and perinatal results were compared between the groups.RESULTS: Mean bowel sounds (P = 0.036 and gas discharge time (P = 0.049 were significantly greater and 24th hour hemoglobin difference values (P = 0.001 were higher in the general anesthesia group. The mean hematocrit and hemoglobin values at the 24th hour (P = 0.004 and P < 0.001, respectively, urine volume at the first postoperative hour (P < 0.001 and median Apgar score at the first minute (P < 0.0005 were significantly higher, and the time that elapsed until the first requirement for analgesia was significantly longer (P = 0.042, in the spinal anesthesia group.CONCLUSION: In elective cases, spinal anesthesia is superior to general anesthesia in terms of postoperative comfort. In pregnancies with a risk of fetal distress, it would be appropriate to prefer spinal anesthesia by taking the first minute Apgar score into account.

False Labor at Term in Singleton Pregnancies: Discharge After a Standardized Assessment and Perinatal Outcomes.

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Nelson, David B; McIntire, Donald D; Leveno, Kenneth J

2017-07-01

To evaluate perinatal outcomes in women sent home with a diagnosis of false labor at term and assess the time interval to return for delivery. This was a prospective observational cohort study of women at 37 0/7 to 41 6/7 weeks of gestation without pre-existing medical complications who presented to our hospital-based triage unit with symptoms of labor and underwent a standardized evaluation. Women diagnosed as having false labor with a live singleton fetus in cephalic presentation without a prior cesarean delivery and sent home were compared with a group of similar women diagnosed to be in spontaneous labor. Women with hypertension, diabetes, and known fetal malformations were excluded. Using a perinatal composite outcome of respiratory insufficiency, intraventricular hemorrhage, culture-proven sepsis, Apgar score 3 or less at 5 minutes, phototherapy, and perinatal death, we tested the noninferiority of being sent home compared with being admitted for labor. The relationship of cervical dilatation to the time interval from discharge home to delivery was also analyzed. Between October 2012 and March 2016, a total of 3,949 women met inclusion criteria and were diagnosed with false labor, discharged, and returned to deliver, whereas 2,592 similar women were admitted in early labor. The mean interval from discharge to return was 4.9 days. Cesarean delivery rates were not different between the study groups-11% for both (P=.69), and the perinatal composite outcome rates were not significantly different between those sent home and those admitted-3.2% compared with 3.1% (P=.79). Women with more advanced cervical dilatation at discharge returned and delivered significantly earlier than those with less dilatation regardless of parity. Discharge with false labor at term after a standardized assessment in a triage unit was not associated with increased rates of adverse perinatal composite outcomes or cesarean delivery. The time interval to return for delivery was

[Relationship between the risk of emergency cesarean section for nullipara with the prepregnancy body mass index or gestational weight gain].

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Zhao, R F; Zhang, W Y; Zhou, L

2017-11-25

Objective: To investigate the risk of emergency cesarean section during labor with the pre-pregnancy body mass index or gestational weight gain. Methods: A total of 6 908 healthy nullipara with singleton pregnancy and cephalic presentation who was in term labor in Beijing Obstetrics and Gynecology Hospital from August 1(st), 2014 to September 30(th), 2015 were recruited. They were divided into two groups, the vaginal delivery group (92.88%, 6 416/6 908) and the emergency cesarean section group (7.12%, 492/6 908). According to WHO body mass index (BMI) classification criteria and the pre-pregnancy BMI, the 6 908 women were divided into three groups, the underweight group(BMIgain (GWG) group (16.72%, 1 155/6 908), the appropriate GWG group (43.11%, 2 978/6 908), the excessive GWG group (40.17%, 2 775/6 908). Unadjusted and adjusted odds ratio ( OR ) and confidence interval ( CI ) of the risk of emergency cesarean section were calculated by bivariate logistic regression. Results: (1) Comparing to the vaginal delivery group, women in the emergency cesarean section group were older, with a lower education level. Their prepregnancy BMI was higer and had more gestational weight gain. They had higher morbidity of pregnancy induced hypertension and gestational diabetes mellitus. Comparing to the vaginal delivery group, the neonates in the emergency cesarean section group were elder in gestational week, with higher birth weight. More male infants and large for gestation age infants were seen in the emergency cesarean section group (all P gain was associated with the increased risk of emergency cesarean section, (a OR= 1.03, 95% CI : 1.01-1.05). GWG above IOM giudelines did not independently affect the risk of emergency cesarean section ( OR= 1.30, 95% CI : 1.07-1.58; a OR= 1.01, 95% CI : 0.82-1.24). In the underweight group, the normal weight group and the overweight or obese group, the excessive GWG women and the appropriate GWG women had no significant difference in the

Complication of cesarean section: pregnancy on the cicatrix of a previous cesarean section.

Science.gov (United States)

Wang, Weimin; Long, Wenqing; Yu, Qunhuan

2002-02-01

To probe into the clinical manifestation, diagnosis, as well as treatment of pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester. Analysis of 14 patients with pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester was made after conservative treatment by drugs from January 1996 to December 1999. The 14 patients with a pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester were painless, had slight vaginal bleeding, and concurrently had increased serum beta-subunit human chorionic gonadotropin (beta-HCG). Doppler ultrasonic examination revealed an obvious enlargement of the previous cesarean section cicatrix in the uterine isthmus, and found a gestational sac or mixed mass attached to the cicatrice, with a very thin myometrium between the gestational sac and bladder walls. Among the 14 patients, 12 patients had crystalline trichosanthes injected into the cervix, mifepristone taken orally, or methotrexate in the form of intramuscular injection. Following this procedure, their serum beta-HCG dropped to normal. The other 2 patients had a total hysterectomy. Pregnancy on the cicatrix of a previous cesarean section at the uterine isthmus in the first trimester is a complication of cesarean section. Early diagnosis and effective conservative treatment by drugs are instrumental in decreasing the potential occurrence of uterine rupture, which is also conducive to preserving the patient's future fertility.

String bits and the spin vertex

OpenAIRE

Jiang, YunfengInstitut de Physique Théorique, DSM, CEA, URA2306 CNRS Saclay, F-91191 Gif-sur-Yvette, France; Kostov, Ivan(Institut de Physique Théorique, DSM, CEA, URA2306 CNRS Saclay, F-91191 Gif-sur-Yvette, France); Petrovskii, Andrei(Institut de Physique Théorique, DSM, CEA, URA2306 CNRS Saclay, F-91191 Gif-sur-Yvette, France); Serban, Didina(Institut de Physique Théorique, DSM, CEA, URA2306 CNRS Saclay, F-91191 Gif-sur-Yvette, France)

2015-01-01

We initiate a novel formalism for computing correlation functions of trace operators in the planar N=4 SYM theory. The central object in our formalism is the spin vertex, which is the weak coupling analogy of the string vertex in string field theory. We construct the spin vertex explicitly for all sectors at the leading order using a set of bosonic and fermionic oscillators. We prove that the vertex has trivial monodromy, or put in other words, it is a Yangian invariant. Since the monodromy o...

Effect of stage of initial labor dystocia on vaginal birth after cesarean success.

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Lewkowitz, Adam Korrick; Nakagawa, Sanae; Thiet, Mari-Paule; Rosenstein, Melissa Greer

2015-12-01

The objective of the study was to examine whether the stage of labor dystocia causing a primary cesarean delivery (CD) affects a trial of labor after cesarean (TOLAC) success. This was a retrospective cohort study of women who had primary CD of singleton pregnancies for first- or second-stage labor dystocia and attempted TOLAC at a single hospital between 2002 and 2014. We compared TOLAC success rates between women whose primary CD was for first- vs second-stage labor dystocia and investigated whether the effect of prior dystocia stage on TOLAC success was modified by previous vaginal delivery (VD). A total of 238 women were included; nearly half (49%) achieved vaginal birth after cesarean (VBAC). Women with a history of second-stage labor dystocia were more likely to have VBAC compared with those with first-stage dystocia, although this trend was not statistically significant among the general population (55% vs 45%, adjusted odds ratio, 1.4, 95% confidence interval, 0.8-2.5]). However, among women without a prior VD, those with a history of second-stage dystocia did have statistically higher odds of achieving VBAC than those with prior first-stage dystocia (54% vs 38%, adjusted odds ratio, 1.8 [95% confidence interval, 1.0-3.3], P for interaction = .043). Nearly half of women with a history of primary CD for labor dystocia will achieve VBAC. Women with a history of second-stage labor dystocia have a slightly higher VBAC rate, seen to a statistically significant degree in those without a history of prior VD. TOLAC should be offered to all eligible women and should not be discouraged in women with a prior second-stage arrest. Copyright © 2015 Elsevier Inc. All rights reserved.

Cesarean deliveries and maternal weight retention.

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Kapinos, Kandice A; Yakusheva, Olga; Weiss, Marianne

2017-10-04

Cesarean delivery accounts for nearly one-third of all births in the U.S. and contributes to an additional $38 billion in healthcare costs each year. Although Cesarean delivery has a long record of improving maternal and neonatal mortality and morbidity, increased utilization over time has yielded public health concerns and calls for reductions. Observational evidence suggests Cesarean delivery is associated with increased maternal postpartum weight, which may have significant implications for the obesity epidemic. Previous literature, however, typically does not address selection biases stemming from correlations of pre-pregnancy weight and reproductive health with Cesarean delivery. We used fetal malpresentation as a natural experiment as it predicts Cesarean delivery but is uncorrelated with pre-pregnancy weight or maternal health. We used hospital administrative data (including fields used in vital birth record) from the state of Wisconsin from 2006 to 2013 to create a sample of mothers with at least two births. Using propensity score methods, we compared maternal weight prior to the second pregnancy of mothers who delivered via Cesarean due to fetal malpresentation to mothers who deliver vaginally. We found no evidence that Cesarean delivery in the first pregnancy causally leads to greater maternal weight, BMI, or movement to a higher BMI classification prior to the second pregnancy. After accounting for correlations between pre-pregnancy weight, gestational weight gain, and mode of delivery, there is no evidence of a causal link between Cesarean delivery and maternal weight retention.

A systematic review and meta-analysis of velamentous cord insertion among singleton pregnancies and the risk of preterm delivery.

Science.gov (United States)

de Los Reyes, Samantha; Henderson, Janice; Eke, Ahizechukwu C

2018-03-23

Observational studies have reported varying results about the association of velamentous cord insertion (VCI) with adverse pregnancy outcomes. To evaluate the risk of preterm delivery among singleton pregnancies complicated by VCI. Various databases were searched for English-language articles published up to February, 28, 2017, using keywords including VCI; abnormal placentation; abnormal cord insertions; adverse perinatal outcomes; and preterm birth. Outcome measures included preterm delivery; pre-eclampsia; cesarean delivery; fetal demise in utero (FDIU); and small for gestational age (SGA). Only studies involving VCI were included in the meta-analysis. Analyses were performed using RevMan version 5.3.5 (The Nordic Cochrane Centre, Copenhagen, Denmark). There were six studies included in the analysis. The VCI and control groups comprised 16 295 and 1 366 485 women, respectively. An increased incidence of preterm delivery was found for the VCI group compared with the control group (11.8% vs 7.0%; adjusted odds ratio [aOR] 1.95, 95% confidence interval [CI] 1.85-2.04). A diagnosis of VCI was also associated with cesarean delivery (aOR 1.17, 95% CI 1.12-1.23), SGA (aOR 1.93, 95% CI 1.83-2.04), and FDIU (aOR 3.96, 95% CI 3.21-4.89). The presence of VCI was associated with adverse pregnancy outcomes. © 2018 International Federation of Gynecology and Obstetrics.

Flat-space singletons

International Nuclear Information System (INIS)

Fronsdal, C.

1987-01-01

Singletons exist, as particles and as local fields, only in 3+2 de Sitter space. Their kinematical properties make them natural candidates for constituents of massless fields, and perhaps for quarks. It is interesting to find out how to describe this type of compositeness in flat space. A theory of interacting singleton fields in de Sitter space is now available, and in this paper we study the flat-space limit of the Green's functions of that theory. The flat-space limit is an autonomous theory of Green's functions, but is not an operator field theory. The three-point function is calculated and its flat-space limit is found to reveal glimpses of a physical interpretation. Causal and spectral properties are in accord with the tenets of axiomatic field theory. The theory is a generalization of local field theory, in which photons appear as composite objects although the physical S matrix is the same as in conventional QED

The Relationship between Rostral Retraction of the Pannus and Outcomes at Cesarean Section.

Science.gov (United States)

Turan, Ozhan M; Rosenbloom, Joshua; Galey, Jessica L; Kahntroff, Stephanie L; Bharadwaj, Shobana; Turner, Shafonya M; Malinow, Andrew M

2016-08-01

Objective Maternal obesity presents several challenges at cesarean section. In an effort to routinely employ a transverse suprapubic skin incision, we often retract the pannus in a rostral direction using adhesive tape placed after induction of anesthesia and before surgical preparation of the skin. We sought to understand the association between taping and neonatal cord blood gases, Apgar scores, and time from skin incision to delivery of the neonate. Study Design This is a retrospective study, performed using prospectively collected anesthesiology records with data supplemented from the patients' medical records. Singleton pregnancies with morbid obesity (body mass index [BMI] > 40 kg/m(2)) between 37 and 42 weeks of gestation who delivered via nonurgent, scheduled cesarean delivery under regional (spinal, combined spinal-epidural, or epidural) anesthesia between March 2007 and March 2013 were identified. Maternal demographics including BMI, comorbidities, type of anesthesia, time intervals during the surgery, cord gas results, and Apgar scores were collected. The relationship between taping and blood acid-base status, Apgar scores, and interval from skin incision to delivery was investigated using appropriate statistical tests. Results There were 2,525 (27.5%) cesarean deliveries out of 9,189 total deliveries. Applying the described inclusion/exclusion criteria, 141 patients were identified (33 taped and 108 nontaped). There was no significant difference in BMI between the taped (51.9 kg/m(2)) and nontaped groups (47.4 kg/m(2)), p > 0.05. There was no difference in type of anesthesia (p > 0.05). The only significant difference between the taped and not-taped groups was the presence of chronic hypertension in the taped group (p = 0.03). There were no significant differences in cord blood gas values, Apgar scores, or skin incision to delivery interval (p > 0.05 for all outcomes). Conclusions Taping of the pannus at cesarean section is a

A Novel Vertex Affinity for Community Detection

Energy Technology Data Exchange (ETDEWEB)

Yoo, Andy [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Sanders, Geoffrey [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Henson, Van [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States); Vassilevski, Panayot [Lawrence Livermore National Lab. (LLNL), Livermore, CA (United States)

2015-10-05

We propose a novel vertex affinity measure in this paper. The new vertex affinity quantifies the proximity between two vertices in terms of their clustering strength and is ideal for such graph analytics applications as community detection. We also developed a framework that combines simple graph searches and resistance circuit formulas to compute the vertex affinity efficiently. We study the properties of the new affinity measure empirically in comparison to those of other popular vertex proximity metrics. Our results show that the existing metrics are ill-suited for community detection due to their lack of fundamental properties that are essential for correctly capturing inter- and intra-cluster vertex proximity.

A validated calculator to estimate risk of cesarean after an induction of labor with an unfavorable cervix.

Science.gov (United States)

Levine, Lisa D; Downes, Katheryne L; Parry, Samuel; Elovitz, Michal A; Sammel, Mary D; Srinivas, Sindhu K

2018-02-01

Induction of labor occurs in >20% of pregnancies, which equates to approximately 1 million women undergoing an induction in the United States annually. Regardless of how common inductions are, our ability to predict induction success is limited. Although multiple risk factors for a failed induction have been identified, risk factors alone are not enough to quantify an actual risk of cesarean for an individual woman undergoing a cesarean. The objective of this study was to derive and validate a prediction model for cesarean after induction with an unfavorable cervix and to create a Web-based calculator to assist in patient counseling. Derivation and validation of a prediction model for cesarean delivery after induction was performed as part of a planned secondary analysis of a large randomized trial. A predictive model for cesarean delivery was derived using multivariable logistic regression from a large randomized trial on induction methods (n = 491) that took place from 2013 through 2015 at an academic institution. Full-term (≥37 weeks) women carrying a singleton gestation with intact membranes and an unfavorable cervix (Bishop score ≤6 and dilation ≤2 cm) undergoing an induction were included in this trial. Both nulliparous and multiparous women were included. Women with a prior cesarean were excluded. Refinement of the prediction model was performed using an observational cohort of women from the same institution who underwent an induction (n = 364) during the trial period. An external validation was performed utilizing a publicly available database (Consortium for Safe Labor) that includes information for >200,000 deliveries from 19 hospitals across the United States from 2002 through 2008. After applying the same inclusion and exclusion criteria utilized in the derivation cohort, a total of 8466 women remained for analysis. The discriminative power of each model was assessed using a bootstrap, bias-corrected area under the curve. The cesarean delivery

The three-photon vertex

International Nuclear Information System (INIS)

Delbourgo, R.

1976-01-01

Owing to weak interactions, the three-photon vertex is non-zero. From gauge invariance and symmetry requirements, it is proved that the C = -1P = - 1 vertex amplitudes are at least of order q 7 in the limit of soft photon momentum q and that if any two photons are placed on mass shell the form factors vanish identically. (author)

Maternal and Fetal Outcome in Elective versus Emergency Cesarean Section

Directory of Open Access Journals (Sweden)

Anupama Suwal

2013-12-01

Results: The incidence of cesarean section was 254 (22.30% out of which emergency cesarean section accounted for 167 (65.7% and elective cesarean section for 87 (34.3%. The usual indications of emergency cesarean section were fetal distress, previous cesarean section in labour, non progress of labour and prolonged second stage of labour. The usual indications of elective cesarean section were previous cesarean section, breech, cephalopelvic disproportion and cesarean section on demand. There was found to be no significant difference in age, period of gestation, blood loss and blood transfusion in emergency vs. elective cesarean section. There was significant difference seen in the length of hospital stay, fever, urinary tract infection, wound infection and low APGAR in five minutes indicating that these were more common in emergency cesarean section. Significant difference was also seen in the incidence of postpartum haemorrhage indicating that it was seen more in elective cesarean section. Conclusions: The incidence of cesarean section in Nepal Medical College Teaching Hospital is high and the overall complication rate is higher in emergency cesarean section than in elective cesarean section. Keywords: cesarean section; fetal and maternal outcome.

Proposal for a CLEO precision vertex detector

International Nuclear Information System (INIS)

1991-01-01

Fermilab experiment E691 and CERN experiment NA32 have demonstrated the enormous power of precision vertexing for studying heavy quark physics. Nearly all collider experiments now have or are installing precision vertex detectors. This is a proposal for a precision vertex detector for CLEO, which will be the pre-eminent heavy quark experiment for at least the next 5 years. The purpose of a precision vertex detector for CLEO is to enhance the capabilities for isolating B, charm, and tau decays and to make it possible to measure the decay time. The precision vertex detector will also significantly improve strange particle identification and help with the tracking. The installation and use of this detector at CLEO is an important step in developing a vertex detector for an asymmetric B factory and therefore in observing CP violation in B decays. The CLEO environment imposes a number of unique conditions and challenges. The machine will be operating near the γ (4S) in energy. This means that B's are produced with a very small velocity and travel a distance about 1/2 that of the expected vertex position resolution. As a consequence B decay time information will not be useful for most physics. On the other hand, the charm products of B decays have a higher velocity. For the long lived D + in particular, vertex information can be used to isolate the charm particle on an event-by-event basis. This helps significantly in reconstructing B's. The vertex resolution for D's from B's is limited by multiple Coulomb scattering of the necessarily rather low momentum tracks. As a consequence it is essential to minimize the material, as measured in radiation lengths, in the beam pip and the vertex detector itself. It is also essential to build the beam pipe and detector with the smallest possible radius

Transversus Abdominis Plane Block Versus Wound Infiltration for Analgesia After Cesarean Delivery: A Randomized Controlled Trial.

Science.gov (United States)

Tawfik, Mohamed Mohamed; Mohamed, Yaser Mohamed; Elbadrawi, Rania Elmohamadi; Abdelkhalek, Mostafa; Mogahed, Maiseloon Mostafa; Ezz, Hanaa Mohamed

2017-04-01

Transversus abdominis plane (TAP) block and local anesthetic wound infiltration provide analgesia after cesarean delivery. Studies comparing the 2 techniques are scarce, with conflicting results. This double-blind, randomized controlled trial aimed to compare bilateral ultrasound-guided TAP block with single-shot local anesthetic wound infiltration for analgesia after cesarean delivery performed under spinal anesthesia. We hypothesized that the TAP block would decrease postoperative cumulative fentanyl consumption at 24 hours. Eligible subjects were American Society of Anesthesiologists physical status II parturients with full-term singleton pregnancies undergoing elective cesarean delivery under spinal anesthesia. Exclusion criteria were: 40 years of age; height consumption at 24 hours. Secondary outcomes were the time to the first postoperative fentanyl dose, cumulative fentanyl consumption at 2, 4, 6, and 12 hours, pain scores at rest and on movement at 2, 4, 6, 12, and 24 hours, the deepest level of sedation, the incidence of side effects (nausea and vomiting and pruritis), and patient satisfaction. Data from 78 patients (39 patients in each group) were analyzed. The mean ± SD of cumulative fentanyl consumption at 24 hours was 157.4 ± 63.4 μg in the infiltration group and 153.3 ± 68.3 μg in the TAP group (difference in means [95% confidence interval] is 4.1 [-25.6 to 33.8] μg; P = .8). There were no significant differences between the 2 groups in the time to the first postoperative fentanyl dose, cumulative fentanyl consumption at 2, 4, 6, and 12 hours, pain scores at rest and on movement at 2, 4, 6, 12, and 24 hours, the deepest level of sedation, and patient satisfaction. The incidence of side effects (nausea and vomiting and pruritis) was low in the 2 groups. TAP block and wound infiltration did not significantly differ regarding postoperative fentanyl consumption, pain scores, and patient satisfaction in parturients undergoing cesarean delivery under

The STAR Vertex Position Detector

Energy Technology Data Exchange (ETDEWEB)

Llope, W.J., E-mail: llope@rice.edu [Rice University, Houston, TX 77005 (United States); Zhou, J.; Nussbaum, T. [Rice University, Houston, TX 77005 (United States); Hoffmann, G.W. [University of Texas, Austin, TX 78712 (United States); Asselta, K. [Brookhaven National Laboratory, Upton, NY 11973 (United States); Brandenburg, J.D.; Butterworth, J. [Rice University, Houston, TX 77005 (United States); Camarda, T.; Christie, W. [Brookhaven National Laboratory, Upton, NY 11973 (United States); Crawford, H.J. [University of California, Berkeley, CA 94720 (United States); Dong, X. [Lawrence Berkeley National Laboratory, Berkeley, CA 94720 (United States); Engelage, J. [University of California, Berkeley, CA 94720 (United States); Eppley, G.; Geurts, F. [Rice University, Houston, TX 77005 (United States); Hammond, J. [Brookhaven National Laboratory, Upton, NY 11973 (United States); Judd, E. [University of California, Berkeley, CA 94720 (United States); McDonald, D.L. [Rice University, Houston, TX 77005 (United States); Perkins, C. [University of California, Berkeley, CA 94720 (United States); Ruan, L.; Scheblein, J. [Brookhaven National Laboratory, Upton, NY 11973 (United States); and others

2014-09-21

The 2×3 channel pseudo Vertex Position Detector (pVPD) in the STAR experiment at RHIC has been upgraded to a 2×19 channel detector in the same acceptance, called the Vertex Position Detector (VPD). This detector is fully integrated into the STAR trigger system and provides the primary input to the minimum-bias trigger in Au+Au collisions. The information from the detector is used both in the STAR Level-0 trigger and offline to measure the location of the primary collision vertex along the beam pipe and the event “start time” needed by other fast-timing detectors in STAR. The offline timing resolution of single detector channels in full-energy Au+Au collisions is ∼100 ps, resulting in a start time resolution of a few tens of picoseconds and a resolution on the primary vertex location of ∼1 cm.

Congenital Malformations in Singleton Infants Conceived by Assisted Reproductive Technologies and Singleton Infants by Natural Conception in Tehran, Iran

Directory of Open Access Journals (Sweden)

Ramin Mozafari Kermani

2017-10-01

Full Text Available Background: Multiple pregnancies occur more frequently in assisted reproductive technology (ART compared to normal conception (NC. It is known that the risk of congenital malformations in a multiple pregnancy are higher than single pregnancy. The aim of this study is to compare congenital malformations in singleton infants conceived by ART to singleton infants conceived naturally. Materials and Methods: In this historical cohort study, we performed a historical cohort study of major congenital malformations (MCM in 820 singleton births from January 2012 to December 2014. The data for this analysis were derived from Tehran’s ART linked data file. The risk of congenital malformations was compared in 164 ART infants and 656 NC infants. We performed multiple logistic regression analyses for the independent association of ART on each outcome. Results: We found 40 infants with MCM 29 (4.4% NC infants and 14 (8.3% ART infants. In comparison with NC infants, ART infants had a significant 2-fold increased risk of MCM (P=0.046. After adjusting individually for maternal age, infant gender, prior stillbirth, mother’s history of spontaneous abortion, and type of delivery, we did not find any difference in risk. In this study the majority (95.1% of all infants were normal but 4.9% of infants had at least one MCM. We found a difference in risk of MCMs between in vitro fertilization (IVF and intracytoplasmic sperm injection (ICSI. We excluded the possible role of genotype and other unknown factors in causing more malformations in ART infants. Conclusion: This study reported a higher risk of MCMs in ART singleton infants than in NC singleton infants. Congenital heart disease, developmental dysplasia of the hip (DDH, and urogenital malformations were the most reported major malformations in singleton ART infants according to organ and system classification.

Maternal Super Obesity and Neonatal Morbidity after Term Cesarean Delivery.

Science.gov (United States)

Smid, Marcela C; Vladutiu, Catherine J; Dotters-Katz, Sarah K; Manuck, Tracy A; Boggess, Kim A; Stamilio, David M

2016-10-01

Objective To estimate the association between maternal super obesity (body mass index [BMI] ≥ 50 kg/m(2)) and neonatal morbidity among neonates born via cesarean delivery (CD). Methods Retrospective cohort of singleton neonates delivered via CD ≥ 37 weeks in the Maternal-Fetal Medicine Unit Cesarean Registry. Maternal BMI at delivery was stratified as 18.5 to 29.9 kg/m(2), 30 to 39.9 kg/m(2), 40 to 49.9 kg/m(2), and ≥ 50 kg/m(2). Primary outcomes included acute (5-minute Apgar score neonatal injury, and/or transient tachypnea of the newborn) and severe (grade 3 or 4 intraventricular hemorrhage, necrotizing enterocolitis, seizure, respiratory distress syndrome, hypoxic ischemic encephalopathy, meconium aspiration, ventilator support ≥ 2 days, sepsis and/or neonatal death) neonatal morbidity. Odds of neonatal morbidity were estimated for each BMI category adjusting for clinical and operative characteristics. Results Of 41,262 maternal-neonatal dyads, 36% of women were nonobese, 49% had BMI of 30 to 39.9 kg/m(2), 12% had BMI of 40 to 49.9 kg/m(2), and 3% were super obese. Compared with nonobese women, super obese women had twofold odds of acute (5 vs. 10%; adjusted odds ratio [aOR]: 1.81, 95% confidence interval [CI]: 1.59-2.73) and severe (3 vs. 6%; aOR: 2.08; 95% CI: 1.59-2.73) neonatal morbidity. Conclusion Among term infants delivered via CD, maternal super obesity is associated with increased risk of neonatal morbidity. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Biricodar. Vertex Pharmaceuticals.

Science.gov (United States)

Dey, Saibal

2002-05-01

Vertex is developing biricodar as a chemosensitizing agent designed to restore the effectiveness of chemotherapeutic agents in tumor multidrug resistance. By November 1998, phase II trials had commenced for biricodar, in combination with chemotherapy, for five common cancer indications: breast, ovarian, soft-tissue sarcomas, small cell lung cancer and prostate cancer. Phase II trials were ongoing in January 2002. By March 2000, Vertex was the sole developer of biricodar, as an agreement made in 1996 with BioChem Pharma (now Shire Pharmaceuticals), for the development and marketing of biricodar in Canada was terminated. Biricodar is the free base compound, which also has a citrate salt analog known as VX-710-3. Vertex has published three patents, WO-09615101, WO-09636630 and WO-09736869, disclosing derivatives of biricodar that are claimed for the treatment of multidrug resistant protein and P-glycoprotein-mediated multidrug resistant tumors. In January 2002, a Banc of America analyst report forecast that biricodar had a 30% chance of reaching the market with a launch date in the second half of 2005, with peak sales estimated at $250 million.

Contributing Indications to the Rising Cesarean Delivery Rate

Science.gov (United States)

BARBER, Emma L.; LUNDSBERG, Lisbet; BELANGER, Kathleen; PETTKER, Christian M.; FUNAI, Edmund F.; ILLUZZI, Jessica L.

2013-01-01

OBJECTIVE To examine physician-documented indications for cesarean delivery in order to investigate the specific indications contributing to this increase. METHODS We analyzed rates of primary and repeat cesarean delivery, including indications for the procedure, among 32,443 live births at a major academic hospital between 2003–2009. Time trends for each indication were modeled to estimate the absolute and cumulative annualized relative risk of cesarean by indication over time and the relative contribution of each indication to the overall increase in primary cesarean delivery rate. RESULTS The cesarean delivery rate increased from 26% to 36.5% between 2003 and 2009; 50.0% of the increase was attributable to an increase in primary cesarean delivery. Among the documented indications, nonreassuring fetal status, arrest of dilation, multiple gestation, pre-eclampsia, suspected macrosomia, and maternal request increased over time, while arrest of descent, malpresentation, maternal-fetal indications, and other obstetric indications (eg, cord prolapse, placenta previa) did not increase. The relative contributions of each indication to the total increase in primary cesarean rate were: Non-reassuring fetal status (32%), labor arrest disorders (18%), multiple gestation (16%), suspected macrosomia (10%), pre-eclampsia (10%), maternal request (8%), maternal-fetal conditions (5%), and other obstetric conditions (1%). CONCLUSION Primary cesarean births accounted for 50% of the increasing cesarean rate. Among primary cesareans, more subjective indications (nonreassuring fetal status and arrest of dilation) contributed larger proportions than more objective indications (malpresentation, maternal-fetal, and obstetric conditions). PMID:21646928

Cesarean scar pregnancy

DEFF Research Database (Denmark)

Petersen, Kathrine Birch; Hoffmann, Elise; Rifbjerg Larsen, Christian

2016-01-01

OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE, and Coch......OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE...

Cesarean Section: MedlinePlus Health Topic

Science.gov (United States)

... Foundation) Cesarean Section: The Operation (March of Dimes Birth Defects Foundation) Statistics and Research Changes in Cesarean Delivery Rates by Gestational Age: United States, 1996-2011 (National ...

Vaginal Birth After Cesarean Delivery: Deciding on a Trial of Labor After a Cesarean Delivery (TOLAC)

Science.gov (United States)

f AQ FREQUENTLY ASKED QUESTIONS FAQ070 LABOR, DELIVERY, AND POSTPARTUM CARE Vaginal Birth After Cesarean Delivery • What is a vaginal birth after cesarean delivery (VBAC)? • What is a trial of labor ...

Promotion of family-centered birth with gentle cesarean delivery.

Science.gov (United States)

Magee, Susanna R; Battle, Cynthia; Morton, John; Nothnagle, Melissa

2014-01-01

In this commentary we describe our experience developing a "gentle cesarean" program at a community hospital housing a family medicine residency program. The gentle cesarean technique has been popularized in recent obstetrics literature as a viable option to enhance the experience and outcomes of women and families undergoing cesarean delivery. Skin-to-skin placement of the infant in the operating room with no separation of mother and infant, reduction of extraneous noise, and initiation of breastfeeding in the operating room distinguish this technique from traditional cesarean delivery. Collaboration among family physicians, obstetricians, midwives, pediatricians, neonatologists, anesthesiologists, nurses, and operating room personnel facilitated the provision of gentle cesarean delivery to families requiring an operative birth. Among 144 gentle cesarean births performed from 2009 to 2012, complication rates were similar to or lower than those for traditional cesarean births. Gentle cesarean delivery is now standard of care at our institution. By sharing our experience, we hope to help other hospitals develop gentle cesarean programs. Family physicians should play an integral role in this process. © Copyright 2014 by the American Board of Family Medicine.

A Macdonald refined topological vertex

Science.gov (United States)

Foda, Omar; Wu, Jian-Feng

2017-07-01

We consider the refined topological vertex of Iqbal et al (2009 J. High Energy Phys. JHEP10(2009)069), as a function of two parameters ≤ft\\lgroup x, y \\right\\rgroup , and deform it by introducing the Macdonald parameters ≤ft\\lgroup q, t \\right\\rgroup , as in the work of Vuletić on plane partitions (Vuletić M 2009 Trans. Am. Math. Soc. 361 2789-804), to obtain ‘a Macdonald refined topological vertex’. In the limit q → t , we recover the refined topological vertex of Iqbal et al and in the limit x → y , we obtain a qt-deformation of the original topological vertex of Aganagic et al (2005 Commun. Math. Phys. 25 425-78). Copies of the vertex can be glued to obtain qt-deformed 5D instanton partition functions that have well-defined 4D limits and, for generic values of ≤ft\\lgroup q, t\\right\\rgroup , contain infinite-towers of poles for every pole present in the limit q → t .

Vertex algebras and mirror symmetry

International Nuclear Information System (INIS)

Borisov, L.A.

2001-01-01

Mirror Symmetry for Calabi-Yau hypersurfaces in toric varieties is by now well established. However, previous approaches to it did not uncover the underlying reason for mirror varieties to be mirror. We are able to calculate explicitly vertex algebras that correspond to holomorphic parts of A and B models of Calabi-Yau hypersurfaces and complete intersections in toric varieties. We establish the relation between these vertex algebras for mirror Calabi-Yau manifolds. This should eventually allow us to rewrite the whole story of toric mirror symmetry in the language of sheaves of vertex algebras. Our approach is purely algebraic and involves simple techniques from toric geometry and homological algebra, as well as some basic results of the theory of vertex algebras. Ideas of this paper may also be useful in other problems related to maps from curves to algebraic varieties.This paper could also be of interest to physicists, because it contains explicit description of holomorphic parts of A and B models of Calabi-Yau hypersurfaces and complete intersections in terms of free bosons and fermions. (orig.)

Cesarean birth - What's in a name?

Science.gov (United States)

Ni, L; Elsaharty, A; McConachie, I

2018-05-01

Cesarean birth is known as both cesarean section (CS) and cesarean delivery (CD). The International Journal of Obstetric Anesthesia (IJOA) is the leading obstetric anesthesia journal, and a barometer of attitudes within the profession. The journal recently published the hundredth issue, spanning 25 years (to December 2016). It is an opportune time to examine the evolution of surgical birth terminology (CS versus CD) during that period. We examined 1583 articles in IJOA, subdividing them into editorials, papers, review articles, debates and case reports. We searched for the terms CS, CD, neither or both; and examined the geographical origin of the articles, dividing them into "North America", Europe" and "Rest of the World". There has been a change in terminology from CS towards CD - mainly from the mid-2000s onwards. Cesarean delivery was predominantly used in North American publications, while CS was predominantly favoured in European publications. It is possible that some of these trends represent policies of journal reviewers, although this does not explain all geographical differences. The term CS may represent tautology as the Latin roots of "cesarean" and "section" both refer to cutting. This would suggest CD to be the preferred terminology. Cesarean delivery also aligns with other terminology, for example vaginal and forceps delivery. A consistent approach would improve clarity. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparison of academic performance of twins and singletons in adolescence

DEFF Research Database (Denmark)

Christensen, Kaare; Petersen, Inge; Skytthe, Axel

2006-01-01

deviations for twins and singletons (8.02 v 8.02 and 1.05 v 1.06) despite the twins weighing on average 908 g (95% confidence interval 886 to 930 g) less than the singletons at birth. Controlling for birth weight, gestational age at birth, age at test, and parents' age and education confirmed the similarity......OBJECTIVES: To determine whether twins in recent cohorts show similar academic performance in adolescence to singletons and to test the effect of birth weight on academic performance in twins and singletons. DESIGN: Follow-up study. SETTING: Denmark. PARTICIPANTS: All twins (n=3411) and a 5% random...... sample of singletons (n=7796) born in Denmark during 1986-8. MAIN OUTCOME MEASURES: Test scores in ninth grade (age 15 or 16), birth weight, gestational age at birth, parents' age, and parents' education. RESULTS: Ninth grade test scores were normally distributed, with almost identical mean and standard...

Incidence of Incisional Hernia after Cesarean Delivery

DEFF Research Database (Denmark)

Aabakke, Anna J M; Krebs, Lone; Ladelund, Steen

2014-01-01

OBJECTIVE: To estimate the incidence of incisional hernias requiring surgical repair after cesarean delivery over a 10-year period. METHODS: This population- and register-based cohort study identified all women in Denmark with no history of previous abdominal surgery who had a cesarean delivery...... the inclusion period. The cumulated incidence of a hernia repair within 10 years after a cesarean delivery was 0.197% (95% CI 0.164-0.234%). The risk of a hernia repair was higher during the first 3 years after a cesarean delivery, with an incidence after 3 years of 0.157% (95% CI 0.127-0.187%). CONCLUSIONS...

Cesarean myomectomy in modern obstetrics: More light and fewer shadows.

Science.gov (United States)

Sparić, Radmila; Kadija, Saša; Stefanović, Aleksandar; Spremović Radjenović, Svetlana; Likić Ladjević, Ivana; Popović, Jela; Tinelli, Andrea

2017-05-01

The study aim was to evaluate management of myomas during cesarean section, the pro and cons and the outcomes of cesarean myomectomy. Moreover, we tried to investigate the long-term outcomes of cesarean myomectomy. The authors conducted a literature review using scientific databases, focusing on the benefits and outcomes of cesarean myomectomy and the recent trends regarding this topic, and identified relevant articles, related references and other papers citing them. Despite the demonstrated advantages of cesarean myomectomy, postponed myomectomy after cesarean section was recommended in some instances. Apart from recent reports on the safety and feasibility of cesarean myomectomy, the current literature also describes serious complications of cesarean myomectomy, including even maternal death. This poses a question about the reported rate of complications: whether it is underestimated in common practice. Although some studies strongly suggest the safety of cesarean myomectomy, data on the long-term outcomes of cesarean myomectomy in women are lacking. The risk-benefit ratio of cesarean myomectomy should be re-evaluated in the new century, given the increasing patient age, incidence of myoma in pregnancy, and the wide use of assisted reproductive techniques. © 2017 Japan Society of Obstetrics and Gynecology.

Case mix adjusted variation in cesarean section rate in Sweden.

Science.gov (United States)

Mesterton, Johan; Ladfors, Lars; Ekenberg Abreu, Anna; Lindgren, Peter; Saltvedt, Sissel; Weichselbraun, Marianne; Amer-Wåhlin, Isis

2017-05-01

Cesarean section (CS) rate is a well-established indicator of performance in maternity care and is also related to resource use. Case mix adjustment of CS rates when performing comparisons between hospitals is important. The objective of this study was to estimate case mix adjusted variation in CS rate between hospitals in Sweden. In total, 139 756 deliveries in 2011 and 2012 were identified in administrative systems in seven regions covering 67% of all deliveries in Sweden. Data were linked to the Medical birth register and population data. Twenty-three different sociodemographic and clinical characteristics were used for adjustment. Analyses were performed for the entire study population as well as for two subgroups. Logistic regression was used to analyze differences between hospitals. The overall CS rate was 16.9% (hospital minimum-maximum 12.1-22.6%). Significant variations in CS rate between hospitals were observed after case mix adjustment: hospital odds ratios for CS varied from 0.62 (95% CI 0.53-0.73) to 1.45 (95% CI 1.37-1.52). In nulliparous, cephalic, full-term, singletons the overall CS rate was 14.3% (hospital minimum-maximum: 9.0-19.0%), whereas it was 4.7% for multiparous, cephalic, full-term, singletons with no previous CS (hospital minimum-maximum: 3.2-6.7%). In both subgroups significant variations were observed in case mix adjusted CS rates. Significant differences in CS rate between Swedish hospitals were found after adjusting for differences in case mix. This indicates a potential for fewer interventions and lower resource use in Swedish childbirth care. Best practice sharing and continuous monitoring are important tools for improving childbirth care. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Singleton strings

International Nuclear Information System (INIS)

Engquist, J.; Sundell, P.; Tamassia, L.

2007-01-01

The group theoretical structure underlying physics in anti de Sitter (AdS) spacetime is intrinsically different with respect to the flat case, due to the presence of special ultra-short representations, named singletons, that do not admit a flat space limit. The purpose of this collaboration is to exploit this feature in the study of string and brane dynamics in AdS spacetime, in particular while trying to establish a connection between String Theory in AdS backgrounds (in the tensionless limit) and Higher-Spin Gauge Theory. (orig.)

Vertex Reconstruction in ATLAS Run II

CERN Document Server

Zhang, Matt; The ATLAS collaboration

2016-01-01

Vertex reconstruction is the process of taking reconstructed tracks and using them to determine the locations of proton collisions. In this poster we present the performance of our current vertex reconstruction algorithm, and look at investigations into potential improvements from a new seed finding method.

The vertex Zagreb indices of some graph operations

Directory of Open Access Journals (Sweden)

N. De

2016-12-01

Full Text Available Recently, Tavakoli et al. introduced a new version of Zagreb indices, named as vertex Zagreb indices. In this paper explicit expressions of different graphs operations of vertex Zagreb indices are presented and also as an application, explicit formulas for vertex Zagreb indices of some chemical graphs are obtained.

Language Development of Three- to Twelve-Year-Old Twins Compared to Singletons.

Science.gov (United States)

Dʼhaeseleer, Evelien; Geenens, Eline; Parmentier, Sarah; Corthals, Paul; Van Lierde, Kristiane

2016-01-01

The language development of twins tends to lag behind in comparison to that of singletons. The purpose of this study was to compare expressive and receptive language skills of 3- to 12-year-old twins with singletons. Secondly, correlations between language differences between twins and singletons and age were investigated. Twenty-four twins with a mean age of 5.1 years participated in the study. The control group consisted of 24 singletons who were matched for gender and age. Language development was investigated using the Clinical Evaluation of Language Fundamentals. Twins scored significantly lower for expressive and receptive language skills compared to singletons. Even when excluding preterm-born children, twins still scored significantly lower for expressive language skills. There was no correlation between age and language differences between twins and their matched singletons. Twins score lower for expressive and receptive language skills compared to singletons, and preterm birth cannot be regarded as the main cause for the language delay. The language delay in twins is rather mild but does not seem to decrease with increasing age. © 2016 S. Karger AG, Basel.

Neonatal clavicle fracture in cesarean delivery: incidence and risk factors.

Science.gov (United States)

Choi, Hyun Ah; Lee, Yeon Kyung; Ko, Sun Young; Shin, Son Moon

2017-07-01

Neonatal clavicle fracture in cesarean delivery is rare and has not been extensively studied. We performed a retrospective review of cesarean deliveries with neonatal clavicle fracture during a 12-year period. Maternal and neonatal factors as well as surgical factors related to cesarean delivery for the fracture were determined and compared to the control group to analyze their significance. Among a total 89 367 deliveries during the study period, 36 286 babies were born via cesarean section. Nineteen cases of clavicle fractures in cesarean section were identified (0.05% of total live births via cesarean section). In the analysis of maternal and neonatal risk factors, birthweight, birthweight ≥ 4000  g and maternal age were significantly associated with clavicle fracture in cesarean section. However, clavicle fractures were not correlated with the selected surgical factors such as indication for cesarean section, skin incision to delivery time and incision type of skin and uterus. Logistic regression analysis showed that birthweight was the major risk factor for clavicle fracture. Clavicle fractures complicated 0.05% of cesarean deliveries. The main risk factor related to a clavicle fracture in cesarean section was the birthweight of an infant. As reported in previous studies associated with vaginal delivery, clavicle fracture is considered to be an unavoidable event and may not be eliminated, even in cesarean delivery.

Fluctuations in two-dimensional six-vertex systems

International Nuclear Information System (INIS)

Youngblood, R.W.; Axe, J.D.; McCoy, B.M.

1979-01-01

The character of polarization correlations in six-vertex systems is discussed. With the aid of a connection between the 1-d Heisenberg--Ising chain and the six-vertex problem, existing results for the chain correlations are used to obtain information about long-wavelength polarization correlations in six-vertex models. These results are compared with a neutron scattering study of 2-d polarization correlations in the layered compound copper formate tetrahydrate. Because the six-vertex model is equivalent to a particular roughening model, these results also explicitly predict the critical behavior of that roughening model just above its roughening temperature. The results correspond to the predictions of Kosterlitz and Thouless for the phase transition in the 2-d Coulomb gas. 5 figures

Cesarean section in Ethiopia: prevalence and sociodemographic characteristics.

Science.gov (United States)

Yisma, Engida; Smithers, Lisa G; Lynch, John W; Mol, Ben W

2017-11-20

The objective of this study was to assess the prevalence and sociodemographic characteristics of cesarean section in Ethiopia. We used data collected for Ethiopia Demographic and Health Surveys (DHS) conducted in 2000, 2005, 2011, and 2016. A two-stage, stratified, clustered random sampling design was used to gather information from women who gave birth within the 5-year period before each of the surveys. We analyzed the data to identify sociodemographic characteristics associated with cesarean section using log-Poisson regression models. The national cesarean section rate increased from 0.7% in 2000 to 1.9% in 2016, with increases across seven of the eleven administrative regions of Ethiopia. Addis Ababa had the highest cesarean section rate (21.4%) in 2016 and the greatest increase since 2000. In the adjusted analysis, women who gave birth in private health facility had a 78.0% higher risk of cesarean section (adjusted prevalence ratio (aPR) (95% CI) 1.78 (1.22, 2.58)) compared with women who gave birth in public health facility. Having four or more births was associated with a lower risk of cesarean section compared with first births (aPR (95% CI) 0.36 (0.16, 0.79)). The Ethiopian national cesarean section rate is about 2%, but the rate varies widely among administrative regions, suggesting unequal access. Cesarean sections were highest among urban mothers, first births, births to women with higher education, and births to women from the richest quintile of household wealth.

Loop vertex expansion for higher-order interactions

Science.gov (United States)

Rivasseau, Vincent

2018-05-01

This note provides an extension of the constructive loop vertex expansion to stable interactions of arbitrarily high order, opening the way to many applications. We treat in detail the example of the (\\bar{φ } φ )^p field theory in zero dimension. We find that the important feature to extend the loop vertex expansion is not to use an intermediate field representation, but rather to force integration of exactly one particular field per vertex of the initial action.

Secondary vertex detection at the SLC

International Nuclear Information System (INIS)

Anon.

1982-01-01

The vertex topology of a high energy e + e - interaction contains a wealth of information. These interactions copiously produce the tau lepton and hadrons containing the c and b quarks; all these particles decay within a millimeter or so of the primary interaction point, giving these interactions a rich secondary vertex structure. With suitable detectors, one can hope to reconstruct these vertices and so tag events with tau's, c's and b's; measure lifetimes and mixing angles; and perhaps directly measure the flavor of c and b jets. The spatial resolution and track-pair resolution required of such detectors demand detector development, but several techniques, including solid state microstrip and CCD detectors, pressurized drift chambers, and holographic bubbble chambers look promising. Vertex detection in the colliding beam environment has already yielded a measurement of the tau lifetime. The SLC, with its micron-sized beam and one-centimeter sized beam pipe is uniquely suited for these studies. Compared to conventional storage rings, it offers a well-defined and minute primary interaction point, the possibility of locating a detector within a centimeter of the interaction (an order of magnitude improvement over LEP), negligibly thin beam pipes, and a repetition rate low enough to permit novel detectors and readout schemes. This report discusses the physics accessible with vertex detectors, depicts the physics environment at 100 GeV - particle multiplicities, momenta, angular correlations, and topologies of charm decays, sketches the elements of a vertex detector, and, through some model studies evaluates the spatial resolution and track-pair resolution requirements, and summarizes the detector technologies which seem most promising for vertex detection

[Risk factors for bladder injuries during cesarean section].

Science.gov (United States)

Alcocer Urueta, Jaime; Bonilla Mares, Marcela; Gorbea Chávez, Viridiana; Velázquez Valassi, Beatriz

2009-01-01

To identify risk factors for bladder injury during cesarean delivery, to let patients and doctors know them and their importance. We conducted a case-control study of women undergoing cesarean delivery at the Instituto Nacional de PerinatologíaIsidro Espinosa de los Reyes between January 2001 and December 2007. Cases were women with bladder injuries at the time of cesarean section. Two controls per case were selected randomly. Medical records were reviewed for clinical and demographic data to compare them. Twenty-one bladder injuries were identified among 24, 057 cesarean sections, (incidence 0.087%), only 19 were analized. Prior cesarean section was more prevalent among cases than controls (63% vs 42% p 0.134), with an OR of 2.35 (95% CI 0.759-7.319), when we take only patients with one cesarea in contrast with no cesarea the OR is 3.75 (95% CI 1.002- 14.07). Statistically significant differences (P values < .05) between cases and controls were found in gestacional age (38.16 vs 37.35 weeks), prior cesareans (42% vs 18%), adhesions (79% vs 5%), Odds ratio of 67.5 (95% CI 11.14- 408), VBAC (31.5 vs 3%), median skin incisión (16% vs 68%), Pfannenstiel (84% vs 32%), blood loss (744cc vs 509cc) and length of surgery 135 vs 58 minutes). No differences were found among age, BMI, prior surgery, labor, premature rupture of membranes, station, chorioamnioitis, induction, uterine incision, timing of delivery, uterine rupture. Prior cesarean section and adhesions are risk factors for bladder injury at the time of repeat cesarean delivery. Elective cesarean delivery is valid but it is duty of physicians to inform patients the risks of it.

Locking mechanisms in degree-4 vertex origami structures

Science.gov (United States)

Fang, Hongbin; Li, Suyi; Xu, Jian; Wang, K. W.

2016-04-01

Origami has emerged as a potential tool for the design of mechanical metamaterials and metastructures whose novel properties originate from their crease patterns. Most of the attention in origami engineering has focused on the wellknown Miura-Ori, a folded tessellation that is flat-foldable for folded sheet and stacked blocks. This study advances the state of the art and expands the research field to investigate generic degree-4 vertex (4-vertex) origami, with a focus on facet-binding. In order to understand how facet-binding attributes to the mechanical properties of 4-vertex origami structures, geometries of the 4-vertex origami cells are analyzed and analytically expressed. Through repeating and stacking 4-vertex cells, origami sheets and stacked origami blocks can be constructed. Geometry analyses discover four mechanisms that will lead to the self-locking of 4-vertex origami cells, sheets, and stacked blocks: in-cell facet-binding, inlayer facet-binding, inter-layer facet binding, and in-layer and inter-layer facet-bindings. These mechanisms and the predicted self-locking phenomena are verified through 3D simulations and prototype experiments. Finally, this paper briefly introduces the unusual mechanical properties caused by the locking of 4-vertex origami structures. The research reported in this paper could foster a new breed of self-locking structures with various engineering applications.

Cesarean section on request at 39 weeks: impact on shoulder dystocia, fetal trauma, neonatal encephalopathy, and intrauterine fetal demise.

Science.gov (United States)

Hankins, Gary D V; Clark, Shannon M; Munn, Mary B

2006-10-01

.15% for vaginal deliveries and applying it to the 3 million deliveries>or=39 weeks EGA, approximately 4500 cases of brachial plexus palsy would occur. If only 15% of these injuries were permanent, 675 permanent brachial plexus palsies would occur annually. If the risk of permanent injury is 1 in 10,000 as reported by Chauhan, 300 permanent brachial plexus palsies would occur annually in the United States. The range then for permanent brachial plexus injury that could be avoided with cesarean section on request would appear to vary between 1 in 5000 and 1 in 10,000 vaginal births. Fetal trauma: The incidence of significant birth trauma varies from 0.2 to 1 to 2 per 1000 births. The use of sequential instruments, for example, vacuum followed by forceps or vice versa, is specifically associated with an unacceptably high injury rate. Intrapartum-related neonatal deaths of vertex singleton fetuses with birthweights>2500 g from traumatic cranial or cervical spine injury secondary to vacuum- or forceps-assisted vaginal delivery are still occurring. Overall, the frequency of significant fetal injury is significantly greater with vaginal delivery, especially operative vaginal delivery, than with cesarean section for the nonlaboring woman at 39 weeks EGA or near term when early labor has been established. Neonatal encephalopathy: The prevalence of moderate to severe neonatal encephalopathy is 3.8/1000 term live births with a neonatal fatality rate of 9.1%. In 4% to 10% of cases, the etiology appears to be pure intrapartum hypoxia. Intrapartum hypoxia superimposed on antepartum risk factors may account for up to 25% of the moderate to severe encephalopathies, according to one cohort. A paradox in the data thus far is that infants born to nonlaboring women delivered by cesarean section had an 83% reduction in the occurrence of moderate or severe encephalopathy. Considering a prevalence of moderate or severe neonatal encephalopathy of 0.38% and applying it to the 3 million deliveries

On fermionic representation of the framed topological vertex

International Nuclear Information System (INIS)

Deng, Fusheng; Zhou, Jian

2015-01-01

The Gromov-Witten invariants of ℂ"3 with branes is encoded in the topological vertex which has a very complicated combinatorial expression. A simple formula for the topological vertex was proposed by Aganagic et al. in the fermionic picture. We will propose a similar formula for the framed topological vertex and prove it in the case when there are one or two branes.

Determining the Effect of Early Feeding after Cesarean section Compared with Regular Diet on the Gastrointestinal Function of Women Referred to Tajrish Hospital, Iran

Directory of Open Access Journals (Sweden)

M Amiri-Siavoshani

2016-10-01

Full Text Available Background & aim: Early feeding after cesarean section can have beneficial effects, however, no sufficient study has been conducted in this area. The aim of this study was to determine the effects of early feeding on the gastrointestinal complications in women after cesarean section and comparing it with a regular diet.   Methods: The present randomized-clinical-trial study was conducted on 160 women who admitted to Shohada hospital and underwent cesarean section in 2011-2012. The inclusion criteria included women with gestational age more than 37 weeks, singleton pregnancy, having at least 8 hours of fasting, and regional anesthesia (spinal cord, respectively. After registration of demographic characteristics and pregnancy, women were randomly divided into two groups: Early feeding (2 hours after completion of the operation, 250 ml filtered juice, tea and biscuits style regime in the next 2 hours and 2 hours after the usual diet and the usual power (8 hours of operation clear liquid diet the day after the usual diet groups. Presence of gastrointestinal symptoms in 2, 4, 8 and 12 hours after surgery, time to the bowel sounds auscultation, passage of flatus and stool were recorded. Data were analyzed by SPSS software version13.The significance level of p-value was considered 0.05.   Conclusion: Early feeding caused the acceleration of gastrointestinal symptoms, earlier bowel sounds auscultation and earlier utilization of gas. It is recommended to investigate the different diets and examined the level of compliance and satisfaction.  

[Vaginal birth after cesarean section in light of international opinions].

Science.gov (United States)

Németh, Gábor; Molnár, András

2017-07-01

The tendency of increasing cesarean section rate has drawn worldwide attention. The vaginal birth after cesarean section is a useful method to decrease cesarean section rate at defined cases. Retrospective overview of factors resulting successful vaginal birth, labor/induction's condition, criterias, short and long term benefits and consequences. Overview recommendations of international guidelines and publications' results concerned vaginal birth after cesarean section in "PubMed", "MEDLINE", "Cochrane" databases from 1996 to 2016. Reviewing results of recommendations and publications we can declare that statements are inconsistent, however the option of vaginal birth after cesarean section is appropriate for decrease complications and trend of increasing cesarean section rate. It would be important in our country to define a uniform recommendation regarding vaginal birth after cesarean section, with supporting evidence in obstetrical and gynecological practice. Orv Hetil. 2017; 158(30): 1168-1174.

Vertex Reconstruction at STAR: Overview and Performance Evaluation

Science.gov (United States)

Smirnov, D.; Lauret, J.; Perevoztchikov, V.; Van Buren, G.; Webb, J.

2017-10-01

The STAR experiment at the Relativistic Heavy Ion Collider (RHIC) has a rich physics program ranging from studies of the Quark Gluon Plasma to the exploration of the spin structure of the proton. Many measurements carried out by the STAR collaboration rely on the efficient reconstruction and precise knowledge of the position of the primary-interaction vertex. Throughout the years two main vertex finders have been predominantly utilized in event reconstruction by the experiment: MinutVF and PPV with their application domains focusing on heavy ion and proton-proton events respectively. In this work we give a brief overview and discuss recent improvements to the vertex finding algorithms implemented in the STAR software library. In our studies we focus on the finding efficiency and the quality of the reconstructed primary vertex. We examine the effect of an additional constraint, imposed by an independent measurement of the beam line position, when it is applied during the fit. We evaluate the significance of the improved primary vertex resolution on identification of the secondary decay vertices occurring inside the beam pipe. Finally, we present a method and its software implementation developed to measure the performance of the primary vertex reconstruction algorithms.

Maternal Risk Factors for Singleton Preterm Births and Survival at ...

African Journals Online (AJOL)

Context: Risk factors for and survival of singleton preterm births may vary ... factors and survival‑to‑discharge rate for singleton preterm births at the University of ... Statistical analysis involved descriptive and inferential statistics at 95% level of ...

Applying Lean Six Sigma methodology to reduce cesarean section rate.

Science.gov (United States)

Chai, Ze-Ying; Hu, Hua-Min; Ren, Xiu-Ling; Zeng, Bao-Jin; Zheng, Ling-Zhi; Qi, Feng

2017-06-01

This study aims to reduce cesarean section rate and increase rate of vaginal delivery. By using Lean Six Sigma (LSS) methodology, the cesarean section rate was investigated and analyzed through a 5-phase roadmap consisting of Define, Measure, Analyze, Improve, and Control. The principal causes of cesarean section were identified, improvement measures were implemented, and the rate of cesarean section before and after intervention was compared. After patients with a valid medical reason for cesarean were excluded, the main causes of cesarean section were maternal request, labor pain, parturient women assessment, and labor observation. A series of measures was implemented, including an improved parturient women assessment system, strengthened pregnancy nutrition guidance, implementation of painless labor techniques, enhanced midwifery team building, and promotion of childbirth-assist skills. Ten months after introduction of the improvement measures, the cesarean section rate decreased from 41.83% to 32.00%, and the Six Sigma score (ie, Z value) increased from 1.706 to 1.967 (P < .001). LSS is an effective way to reduce the rate of cesarean section. © 2016 John Wiley & Sons, Ltd.

What is vaginal birth after cesarean (VBAC)?

Science.gov (United States)

... Pinterest Email Print What is vaginal birth after cesarean (VBAC)? VBAC refers to vaginal delivery of a baby after a previous pregnancy was delivered by cesarean delivery. In the past, pregnant women who had ...

Pulmonary function in advanced uncomplicated singleton and twin pregnancy.

Science.gov (United States)

Siddiqui, Anwar Hasan; Tauheed, Nazia; Ahmad, Aquil; Mohsin, Zehra

2014-01-01

Pregnancy brings about significant changes in respiratory function, as evidenced by alterations in lung volumes and capacities, which are attributable to the mechanical impediment caused by the growing foetus. This study was undertaken in order to identify changes in respiratory function during normal pregnancy and to determine whether such changes are more pronounced in twin pregnancy than in singleton pregnancy. Respiratory function was assessed in 50 women with twin pregnancies and in 50 women with singleton pregnancies (during the third trimester in both groups), as well as in 50 non-pregnant women. We measured the following pulmonary function test parameters: FVC; FEV1; PEF rate; FEV1/FVC ratio; FEF25-75%; and maximal voluntary ventilation. All respiratory parameters except the FEV1/FVC ratio were found to be lower in the pregnant women than in the non-pregnant women. We found no significant differences between women with twin pregnancies and those with singleton pregnancies, in terms of respiratory function. Despite its higher physiological demands, twin pregnancy does not appear to impair respiratory function to any greater degree than does singleton pregnancy.

New vertex reconstruction algorithms for CMS

CERN Document Server

Frühwirth, R; Prokofiev, Kirill; Speer, T.; Vanlaer, P.; Chabanat, E.; Estre, N.

2003-01-01

The reconstruction of interaction vertices can be decomposed into a pattern recognition problem (``vertex finding'') and a statistical problem (``vertex fitting''). We briefly review classical methods. We introduce novel approaches and motivate them in the framework of high-luminosity experiments like at the LHC. We then show comparisons with the classical methods in relevant physics channels

Smarandachely Adjacent-Vertex-Distinguishing Proper Edge Chromatic Number of Cm∨Kn

OpenAIRE

Shunqin Liu

2016-01-01

According to different conditions, researchers have defined a great deal of coloring problems and the corresponding chromatic numbers. Such as, adjacent-vertex-distinguishing total chromatic number, adjacent-vertex-distinguishing proper edge chromatic number, smarandachely-adjacent-vertex-distinguishing proper edge chromatic number, smarandachely-adjacent-vertex-distinguishing proper total chromatic number. And we focus on the smarandachely adjacent-vertex-distinguishing proper edge chromatic...

Vertex routing models

International Nuclear Information System (INIS)

Markovic, D; Gros, C

2009-01-01

A class of models describing the flow of information within networks via routing processes is proposed and investigated, concentrating on the effects of memory traces on the global properties. The long-term flow of information is governed by cyclic attractors, allowing to define a measure for the information centrality of a vertex given by the number of attractors passing through this vertex. We find the number of vertices having a nonzero information centrality to be extensive/subextensive for models with/without a memory trace in the thermodynamic limit. We evaluate the distribution of the number of cycles, of the cycle length and of the maximal basins of attraction, finding a complete scaling collapse in the thermodynamic limit for the latter. Possible implications of our results for the information flow in social networks are discussed.

Outcome of Cesarean Myomectomy: Is it a Safe Procedure?

Science.gov (United States)

Senturk, Mehmet Baki; Polat, Mesut; Doğan, Ozan; Pulatoğlu, Çiğdem; Yardımcı, Oğuz Devrim; Karakuş, Resul; Tayyar, Ahter Tanay

2017-11-01

Myomectomy performed during cesarean section is still controversial because of the potential for associated complications, especially with large myomas. Many obstetricians avoid performing cesarean myomectomy procedures because of the risk of uncontrollable hemorrhage. However, the prevalence of pregnant women with myomas is increasing, leading to an increase in the likelihood that physicians will encounter this issue. The aim of this study was to compare outcomes and complications of patients who either had or did not have cesarean myomectomy. A total of 361 patients were evaluated in this retrospective study. Patients who had cesarean section with myomectomy and patients had cesarean section without myomectomy were compared with regard to demographics, drop in hemoglobin levels, complications, blood transfusion rates and duration of operation. These parameters were also compared when the diameter of the myoma was larger than 5 cm. Values of p  0.05), the mean myoma diameter was smaller and the duration of operation was longer in the group who underwent cesarean myomectomy (p  0.05). This study shows that myomectomy during cesarean section does not increase complications or transfusion rates and appears to be a safe procedure.

Prenatal care and socioeconomic status: effect on cesarean delivery.

Science.gov (United States)

Milcent, Carine; Zbiri, Saad

2018-03-10

Cesarean deliveries are widely used in many high- and middle-income countries. This overuse both increases costs and lowers quality of care and is thus a major concern in the healthcare industry. The study first examines the impact of prenatal care utilization on cesarean delivery rates. It then determines whether socioeconomic status affects the use of prenatal care and thereby influences the cesarean delivery decision. Using exclusive French delivery data over the 2008-2014 period, with multilevel logit models, and controlling for relevant patient and hospital characteristics, we show that women who do not participate in prenatal education have an increased probability of a cesarean delivery compared to those who do. The study further indicates that attendance at prenatal education varies according to socioeconomic status. Low socioeconomic women are more likely to have cesarean deliveries and less likely to participate in prenatal education. This result emphasizes the importance of focusing on pregnancy health education, particularly for low-income women, as a potential way to limit unnecessary cesarean deliveries. Future studies would ideally investigate the effect of interventions promoting such as care participation on cesarean delivery rates.

Genus Ranges of 4-Regular Rigid Vertex Graphs.

Science.gov (United States)

Buck, Dorothy; Dolzhenko, Egor; Jonoska, Nataša; Saito, Masahico; Valencia, Karin

2015-01-01

A rigid vertex of a graph is one that has a prescribed cyclic order of its incident edges. We study orientable genus ranges of 4-regular rigid vertex graphs. The (orientable) genus range is a set of genera values over all orientable surfaces into which a graph is embedded cellularly, and the embeddings of rigid vertex graphs are required to preserve the prescribed cyclic order of incident edges at every vertex. The genus ranges of 4-regular rigid vertex graphs are sets of consecutive integers, and we address two questions: which intervals of integers appear as genus ranges of such graphs, and what types of graphs realize a given genus range. For graphs with 2 n vertices ( n > 1), we prove that all intervals [ a, b ] for all a genus ranges. For graphs with 2 n - 1 vertices ( n ≥ 1), we prove that all intervals [ a, b ] for all a genus ranges. We also provide constructions of graphs that realize these ranges.

Cesarean delivery rates and obstetric culture - an Italian register-based study.

Science.gov (United States)

Plevani, Cristina; Incerti, Maddalena; Del Sorbo, Davide; Pintucci, Armando; Vergani, Patrizia; Merlino, Luca; Locatelli, Anna

2017-03-01

Cesarean delivery rates are rising due to multiple factors, including less use of operative vaginal delivery and vaginal birth after cesarean delivery, which often reflect local obstetric practices. Objectives of the study were to analyze the relations between cesarean delivery, these practices, and perinatal outcomes. We included all deliveries in the 72 hospitals of Lombardia, a region in northern Italy, during the year 2013. The delivery certificate was used as data source. Pearson's correlation coefficient and logistic regression were used for statistical analysis. We included 87 896 deliveries. The number of deliveries per hospital ranged from 140 to 6123. The rate of cesarean delivery was 28.3% (range 9.9-86.4%), operative vaginal delivery 4.7% (range 0.2-10.0%), and vaginal birth after cesarean 17.3% (range 0-79.2%). We found a significant inverse correlation between rates of overall cesarean delivery and operative vaginal delivery (r = -0.25, p = 0.04). The correlation between rate of overall cesarean delivery and vaginal birth after cesarean was also inverse and significant (r = -0.57, p cesarean delivery rate and the rates of Apgar score at 5 min cesarean delivery, could reduce the rising cesarean delivery rate. This will require a change in obstetric culture, continuing education of healthcare providers, and leadership. © 2016 Nordic Federation of Societies of Obstetrics and Gynecology.

Attentional control during visual search: The effect of irrelevant singletons

NARCIS (Netherlands)

Theeuwes, J.; Burger, R.

1998-01-01

Four experiments investigated whether a highly salient color singleton can be ignored during serial search. Observers searched for a target letter among nontarget letters and were instructed to ignore an irrelevant, highly salient color singleton that was either compatible or incompatible with the

Capture by colour: evidence for dimension-specific singleton capture.

Science.gov (United States)

Harris, Anthony M; Becker, Stefanie I; Remington, Roger W

2015-10-01

Previous work on attentional capture has shown the attentional system to be quite flexible in the stimulus properties it can be set to respond to. Several different attentional "modes" have been identified. Feature search mode allows attention to be set for specific features of a target (e.g., red). Singleton detection mode sets attention to respond to any discrepant item ("singleton") in the display. Relational search sets attention for the relative properties of the target in relation to the distractors (e.g., redder, larger). Recently, a new attentional mode was proposed that sets attention to respond to any singleton within a particular feature dimension (e.g., colour; Folk & Anderson, 2010). We tested this proposal against the predictions of previously established attentional modes. In a spatial cueing paradigm, participants searched for a colour target that was randomly either red or green. The nature of the attentional control setting was probed by presenting an irrelevant singleton cue prior to the target display and assessing whether it attracted attention. In all experiments, the cues were red, green, blue, or a white stimulus rapidly rotated (motion cue). The results of three experiments support the existence of a "colour singleton set," finding that all colour cues captured attention strongly, while motion cues captured attention only weakly or not at all. Notably, we also found that capture by motion cues in search for colour targets was moderated by their frequency; rare motion cues captured attention (weakly), while frequent motion cues did not.

Vertex Accentuation in Female Pattern Hair Loss in Asians

Directory of Open Access Journals (Sweden)

Chavalit Supsrisunjai

2016-05-01

Full Text Available Background: The most common cause of hair loss seen in women is female pattern hair loss (FPHL, also known as female androgenetic alopecia. It affects the central part of the scalp, but spares the frontal hairline. Frontal accentuation was also described by Olsen. In Asian women, vertex thinning patterns are frequently developed, but there has been no report about vertex thinning pattern in female pattern hair loss. Objective: To find prevalence of vertex accentuation in female pattern hair loss (FPHL in Asian women. Methods: Scalp hair counting (n/cm2 were measured at 3 different areas; vertex, mid scalp and frontal area respectively by digital dermoscope (Dino digital AM-413T. Visual counting and photography were performed. Outcomes were evaluated by gross appearance of vertex thinning and/or hair density <120 /cm2 in any of 3 areas. Results: 143 patients were evaluated. Mean age was 45.54 years. Of the hair loss type, 36.4% were mid-scalp, 33.6% were vertex accentuation and 30.1% were frontal accentuation, respectively. Age was not significantly different among the 3 types of hair loss (P- value 0.859. Conclusion: Although the most common female pattern hair loss type is diffuse type (Ludwig type, vertex accentuation pattern is the second most common pattern in this study. This study is the first to mention “Vertex accentuation” to be another pattern for FPHL.

Delivery of double singleton pregnancies in a woman with a double uterus, double cervix, and complete septate vagina

Directory of Open Access Journals (Sweden)

Ming-Jie Yang

2015-12-01

Full Text Available Uterine anomalies involving a double uterus, double cervix, also known as didelphys uterus, and complete septate vagina are rarely seen and have an associated fertility problem. However, artificial reproductive technology with embryo transfers can help solve this fertility challenge. Conception in the uterus in just one side is commonly seen for embryos, which are always transferred through the usually used (dilated vagina. We here present a patient with the above uterine anomaly who conceived with the aid of in vitro fertilization and embryo transfer to both uterine cavities under general anesthesia, which resulted in successful double singleton pregnancies with one fetus in each uterus. With intensive prenatal care, the pregnancy course for each fetus was rather uneventful. Although both fetuses were in cephalic presentation, cesarean section was performed at the 39th week of gestation with good outcomes in order to preclude anticipated difficulties if the baby had been delivered through the rarely dilated vagina. However, order of birth between the two fetuses was a crucial decision during the operation.

Cesarean Section and Chronic Immune Disorders

DEFF Research Database (Denmark)

Sevelsted, Astrid; Stokholm, Jakob; Bønnelykke, Klaus

2015-01-01

OBJECTIVES: Immune diseases such as asthma, allergy, inflammatory bowel disease, and type 1 diabetes have shown a parallel increase in prevalence during recent decades in westernized countries. The rate of cesarean delivery has also increased in this period and has been associated with the develo......OBJECTIVES: Immune diseases such as asthma, allergy, inflammatory bowel disease, and type 1 diabetes have shown a parallel increase in prevalence during recent decades in westernized countries. The rate of cesarean delivery has also increased in this period and has been associated...... with the development of some of these diseases. METHODS: Mature children born by cesarean delivery were analyzed for risk of hospital contact for chronic immune diseases recorded in the Danish national registries in the 35-year period 1977-2012. Two million term children participated in the primary analysis. We...... studied childhood diseases with a suspected relation to a deviant immune-maturation and a debut at young age. The effect of cesarean delivery on childhood disease incidences were estimated by means of confounder-adjusted incidence rate ratios with 95% confidence intervals obtained in Poisson regression...

Lectures on the Topological Vertex

CERN Document Server

Mariño, M

2008-01-01

In this lectures, I will summarize the approach to Gromov–Witten invariants on toric Calabi–Yau threefolds based on large N dualities. Since the large N duality/topological vertex approach computes Gromov–Witten invariants in terms of Chern–Simons knot and link invariants, Sect. 2 is devoted to a review of these. Section 3 reviews topological strings and Gromov–Witten invariants, and gives some information about the open string case. Section 4 introduces the class of geometries we will deal with, namely toric (noncompact) Calabi–Yau manifolds, and we present a useful graphical way to represent these manifolds which constitutes the geometric core of the theory of the topological vertex. Finally, in Sect. 5, we define the vertex and present some explicit formulae for it and some simple applications. A brief Appendix contains useful information about symmetric polynomials. It has not been possible to present all the relevant background and physical derivations in this set of lectures. However, these...

Dissociating Compatibility Effects and Distractor Costs in the Additional Singleton Paradigm

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Charles eFolk

2013-07-01

Full Text Available The interpretation of identity compatibility effects associated with irrelevant items outside the nominal focus of attention has fueled much of the debate over early versus late selection and perceptual load theory. However, compatibility effects have also played a role in the debate over the extent to which the involuntary allocation of spatial attention (i.e., attentional capture is completely stimulus-driven or whether it is contingent on top-down control settings. For example, in the context of the additional singleton paradigm, irrelevant color singletons have been found to produce not only an overall cost in search performance but also significant compatibility effects. This combination of search costs and compatibility effects has been taken as evidence that spatial attention is indeed allocated in a bottom-up fashion to the salient but irrelevant singletons. However, it is possible that compatibility effects in the additional singleton paradigm reflect parallel processing of identity associated with low perceptual load rather than an involuntary shift of spatial attention. In the present experiments, manipulations of load were incorporated into the traditional additional singleton paradigm. Under low load conditions, both search costs and compatibility effects were obtained, replicating previous studies. Under high load conditions, search costs were still present, but compatibility effects were eliminated. This dissociation suggests that the costs associated with irrelevant singletons may reflect filtering processes rather than the allocation of spatial attention.

Rare complications of cesarean scar

International Nuclear Information System (INIS)

Mahajan, Divyesh; Kang, Mandeep; Sandhu, Manavjit Singh; Jain, Vanita; Kalra, Naveen; Khandelwal, Niranjan

2013-01-01

Cesarean scar pregnancy (CSP) and cesarean scar dehiscence (CSD) are the most dreaded complications of cesarean scar (CS). As the incidence of CS is increasing worldwide, so is the incidence of CSP, especially in cases with assisted reproduction techniques. It is of utmost importance to diagnose CSP in the early first trimester, as it can lead to myometrial rupture with fatal outcome. On the other hand, CSD may be encountered during pregnancy or in the postpartum period. CSD in the postpartum period is very rare and can cause secondary postpartum hemorrhage (PPH) leading to increased maternal morbidity or even death if not diagnosed and managed promptly. Both complications can be diagnosed on ultrasonography (USG) and confirmed on magnetic resonance imaging (MRI). These two conditions carry high morbidity and mortality. In this article, we highlight the role of imaging in the early diagnosis and management of these conditions

Rare complications of cesarean scar

Directory of Open Access Journals (Sweden)

Divyesh Mahajan

2013-01-01

Full Text Available Cesarean scar pregnancy (CSP and cesarean scar dehiscence (CSD are the most dreaded complications of cesarean scar (CS. As the incidence of CS is increasing worldwide, so is the incidence of CSP, especially in cases with assisted reproduction techniques. It is of utmost importance to diagnose CSP in the early first trimester, as it can lead to myometrial rupture with fatal outcome. On the other hand, CSD may be encountered during pregnancy or in the postpartum period. CSD in the postpartum period is very rare and can cause secondary postpartum hemorrhage (PPH leading to increased maternal morbidity or even death if not diagnosed and managed promptly. Both complications can be diagnosed on ultrasonography (USG and confirmed on magnetic resonance imaging (MRI. These two conditions carry high morbidity and mortality. In this article, we highlight the role of imaging in the early diagnosis and management of these conditions.

Pulmonary function in advanced uncomplicated singleton and twin pregnancy

Directory of Open Access Journals (Sweden)

Anwar Hasan Siddiqui

2014-06-01

Full Text Available Objective: Pregnancy brings about significant changes in respiratory function, as evidenced by alterations in lung volumes and capacities, which are attributable to the mechanical impediment caused by the growing foetus. This study was undertaken in order to identify changes in respiratory function during normal pregnancy and to determine whether such changes are more pronounced in twin pregnancy than in singleton pregnancy. Methods: Respiratory function was assessed in 50 women with twin pregnancies and in 50 women with singleton pregnancies (during the third trimester in both groups, as well as in 50 non-pregnant women. We measured the following pulmonary function test parameters: FVC; FEV1; PEF rate; FEV1/FVC ratio; FEF25-75%; and maximal voluntary ventilation. Results: All respiratory parameters except the FEV1/FVC ratio were found to be lower in the pregnant women than in the non-pregnant women. We found no significant differences between women with twin pregnancies and those with singleton pregnancies, in terms of respiratory function. Conclusions: Despite its higher physiological demands, twin pregnancy does not appear to impair respiratory function to any greater degree than does singleton pregnancy.

Random matrices and the six-vertex model

CERN Document Server

Bleher, Pavel

2013-01-01

This book provides a detailed description of the Riemann-Hilbert approach (RH approach) to the asymptotic analysis of both continuous and discrete orthogonal polynomials, and applications to random matrix models as well as to the six-vertex model. The RH approach was an important ingredient in the proofs of universality in unitary matrix models. This book gives an introduction to the unitary matrix models and discusses bulk and edge universality. The six-vertex model is an exactly solvable two-dimensional model in statistical physics, and thanks to the Izergin-Korepin formula for the model with domain wall boundary conditions, its partition function matches that of a unitary matrix model with nonpolynomial interaction. The authors introduce in this book the six-vertex model and include a proof of the Izergin-Korepin formula. Using the RH approach, they explicitly calculate the leading and subleading terms in the thermodynamic asymptotic behavior of the partition function of the six-vertex model with domain wa...

Primary Vertex Reconstruction at the ATLAS Experiment

CERN Document Server

Grimm, Kathryn; The ATLAS collaboration

2016-01-01

Efficient and precise reconstruction of the primary vertex in an LHC collision is essential in both the reconstruction of the full kinematic properties of a hard-scatter event and of soft interactions as a measure of the amount of pile-up. The reconstruction of primary vertices in the busy, high pile-up environment of Run-2 of the LHC is a challenging task. New methods have been developed by the ATLAS experiment to reconstruct vertices in such environments. Advances in vertex seeding include methods taken from medical imaging, which allow for reconstruction of multiple vertices with small spatial separation. The adoption of this new seeding algorithm within the ATLAS adaptive vertex finding and fitting procedure will be discussed, and the first results of the new techniques from Run-2 data will be presented. Additionally, data-driven methods to evaluate vertex resolution will be presented with special focus on correct methods to evaluate the effect of the beam spot constraint; results from these methods in Ru...

Trial of Labor After One Cesarean: Role of the Order and Number of Prior Vaginal Births on the Risk of Emergency Cesarean Delivery and Neonatal Admission

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Peng Chiong Tan

2008-09-01

Conclusion: In women who have had prior vaginal birth attempting a trial of labor after cesarean, a vaginal delivery before cesarean delivery is an independent risk factor for repeat cesarean. Women with two or more prior vaginal births have a similar risk for repeat cesarean and neonatal admission to women with only one prior vaginal birth.

Cost-effectiveness of external cephalic version for term breech presentation.

Science.gov (United States)

Tan, Jonathan M; Macario, Alex; Carvalho, Brendan; Druzin, Maurice L; El-Sayed, Yasser Y

2010-01-21

External cephalic version (ECV) is recommended by the American College of Obstetricians and Gynecologists to convert a breech fetus to vertex position and reduce the need for cesarean delivery. The goal of this study was to determine the incremental cost-effectiveness ratio, from society's perspective, of ECV compared to scheduled cesarean for term breech presentation. A computer-based decision model (TreeAge Pro 2008, Tree Age Software, Inc.) was developed for a hypothetical base case parturient presenting with a term singleton breech fetus with no contraindications for vaginal delivery. The model incorporated actual hospital costs (e.g., $8,023 for cesarean and $5,581 for vaginal delivery), utilities to quantify health-related quality of life, and probabilities based on analysis of published literature of successful ECV trial, spontaneous reversion, mode of delivery, and need for unanticipated emergency cesarean delivery. The primary endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted year of life gained. A threshold of $50,000 per quality-adjusted life-years (QALY) was used to determine cost-effectiveness. The incremental cost-effectiveness of ECV, assuming a baseline 58% success rate, equaled $7,900/QALY. If the estimated probability of successful ECV is less than 32%, then ECV costs more to society and has poorer QALYs for the patient. However, as the probability of successful ECV was between 32% and 63%, ECV cost more than cesarean delivery but with greater associated QALY such that the cost-effectiveness ratio was less than $50,000/QALY. If the probability of successful ECV was greater than 63%, the computer modeling indicated that a trial of ECV is less costly and with better QALYs than a scheduled cesarean. The cost-effectiveness of a trial of ECV is most sensitive to its probability of success, and not to the probabilities of a cesarean after ECV, spontaneous reversion to breech, successful second ECV trial, or adverse

Cost-effectiveness of external cephalic version for term breech presentation

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Carvalho Brendan

2010-01-01

Full Text Available Abstract Background External cephalic version (ECV is recommended by the American College of Obstetricians and Gynecologists to convert a breech fetus to vertex position and reduce the need for cesarean delivery. The goal of this study was to determine the incremental cost-effectiveness ratio, from society's perspective, of ECV compared to scheduled cesarean for term breech presentation. Methods A computer-based decision model (TreeAge Pro 2008, Tree Age Software, Inc. was developed for a hypothetical base case parturient presenting with a term singleton breech fetus with no contraindications for vaginal delivery. The model incorporated actual hospital costs (e.g., $8,023 for cesarean and $5,581 for vaginal delivery, utilities to quantify health-related quality of life, and probabilities based on analysis of published literature of successful ECV trial, spontaneous reversion, mode of delivery, and need for unanticipated emergency cesarean delivery. The primary endpoint was the incremental cost-effectiveness ratio in dollars per quality-adjusted year of life gained. A threshold of $50,000 per quality-adjusted life-years (QALY was used to determine cost-effectiveness. Results The incremental cost-effectiveness of ECV, assuming a baseline 58% success rate, equaled $7,900/QALY. If the estimated probability of successful ECV is less than 32%, then ECV costs more to society and has poorer QALYs for the patient. However, as the probability of successful ECV was between 32% and 63%, ECV cost more than cesarean delivery but with greater associated QALY such that the cost-effectiveness ratio was less than $50,000/QALY. If the probability of successful ECV was greater than 63%, the computer modeling indicated that a trial of ECV is less costly and with better QALYs than a scheduled cesarean. The cost-effectiveness of a trial of ECV is most sensitive to its probability of success, and not to the probabilities of a cesarean after ECV, spontaneous reversion

Certain extensions of vertex operator algebras of affine type

International Nuclear Information System (INIS)

Li Haisheng

2001-01-01

We generalize Feigin and Miwa's construction of extended vertex operator (super)algebras A k (sl(2)) for other types of simple Lie algebras. For all the constructed extended vertex operator (super)algebras, irreducible modules are classified, complete reducibility of every module is proved and fusion rules are determined modulo the fusion rules for vertex operator algebras of affine type. (orig.)

Indications for primary cesarean delivery relative to body mass index

Science.gov (United States)

Kawakita, Tetsuya; Reddy, Uma M.; Landy, Helain J.; Iqbal, Sara N.; Huang, Chun-Chih; Grantz, Katherine L.

2016-01-01

Background Obesity is a known risk factor for cesarean delivery. Limited data are available regarding the reasons for the increased rate of primary cesarean in obese women. It is important to identify the factors leading to an increased risk of cesarean to identify opportunities to reduce the primary cesarean rate. Objective We evaluated indications for primary cesarean across body mass index kg/m2 classes to identify the factors contributing to the increase rate of cesarean among obese women. Study design In the Consortium of Safe Labor study between 2002 and 2008, we calculated indications for primary cesarean including failure to progress or cephalopelvic disproportion, non-reassuring fetal heart tracing, malpresentation, elective, hypertensive disease, multiple gestation, placenta previa or vasa previa, failed induction, human immunodeficiency virus or active herpes simplex virus, history of uterine scar, fetal indication, placental abruption, chorioamnionitis, macrosomia, and failed operative delivery. For women with primary cesarean for failure to progress or cephalopelvic disproportion, dilation at the last recorded cervical examination was evaluated. Women were categorized according to body mass index on admission: normal weight (18.5-24.9), overweight (25.0-29.9), obese class I (30.0-34.9), II (35.0-39.9), and III (≥40). Cochran-Armitage Trend Test and Chi-square tests were performed. Results Of 66,502 nulliparous and 76,961 multiparous women in the study population, 19,431 nulliparous (29.2%) and 7,329 multiparous women (9.5%) underwent primary cesarean. Regardless of parity, malpresentation, failure to progress or cephalopelvic disproportion, and non-reassuring fetal heart tracing were the common indications for primary cesarean. Regardless of parity, the rates of primary cesarean for failure to progress or cephalopelvic disproportion increased with increasing body mass index (normal weight, class I, II and III obesity in nulliparous: 33.2%, 41.6%, 46

Drift chamber vertex detectors for SLC/LEP

Energy Technology Data Exchange (ETDEWEB)

Hayes, K G

1988-03-01

Factors influencing the design of drift chamber vertex detectors for SLC and LEP are discussed including global strategy, chamber gas, cell design, and signal processing. The designs of the vertex chambers for the L3 and OPAL experiments at LEP and the Mark II experiment at the SLC are described.

Design of a secondary-vertex trigger system

International Nuclear Information System (INIS)

Husby, D.; Chew, P.; Sterner, K.; Selove, W.

1995-06-01

For the selection of beauty and charm events with high efficiency at the Tevatron, a secondary-vertex trigger system is under design. It would operate on forward-geometry events. The system would use on-line tracking of all tracks in the vertex detector, to identify events with clearly detached secondary vertices

Graph Theory. 2. Vertex Descriptors and Graph Coloring

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Lorentz JÄNTSCHI

2002-12-01

Full Text Available This original work presents the construction of a set of ten sequence matrices and their applications for ordering vertices in graphs. For every sequence matrix three ordering criteria are applied: lexicographic ordering, based on strings of numbers, corresponding to every vertex, extracted as rows from sequence matrices; ordering by the sum of path lengths from a given vertex; and ordering by the sum of paths, starting from a given vertex. We also examine a graph that has different orderings for the above criteria. We then proceed to demonstrate that every criterion induced its own partition of graph vertex. We propose the following theoretical result: both LAVS and LVDS criteria generate identical partitioning of vertices in any graph. Finally, a coloring of graph vertices according to introduced ordering criteria was proposed.

Pregnancy outcomes associated with Cesarean deliveries in Peruvian public health facilities

Science.gov (United States)

Gonzales, Gustavo F; Tapia, Vilma L; Fort, Alfredo L; Betran, Ana Pilar

2013-01-01

A continuous rise in the rate of cesarean deliveries has been reported in many countries over recent decades. This trend has prompted the emergence of a debate on the risks and benefits associated with cesarean section. The present study was designed to estimate cesarean section rates over time during the period between 2000 and 2010 in Peru and to present outcomes for each mode of delivery. This is a secondary analysis of a large database obtained from the Perinatal Information System, which includes 570,997 pregnant women and their babies from 43 Peruvian public health facilities in three geographical regions: coast, highlands, and jungle. Over 10 years, 558,901 women delivered 563,668 infants weighing at least 500 g. The cesarean section rate increased from 25.5% in 2000 to 29.9% in 2010 (26.9% average; P cesarean than vaginal deliveries (P cesarean section (P cesarean section group than in the vaginal delivery group. Data suggest that cesarean sections are associated with adverse pregnancy outcomes. PMID:24124393

The evaluation of myomectomies performed during cesarean ...

African Journals Online (AJOL)

Background: We evaluated the data of patients who had applied myomectomy during cesarean section operation in our clinic between April, 2008 and December, 2010. Objective: In this period, 3689 cesarean sections were done in our clinic, we analyzed their data retrospectively and determined 27 myomectomy cases ...

Varying gestational age patterns in cesarean delivery: An international comparison

NARCIS (Netherlands)

Delnord, M.; Blondel, B.; Drewniak, N.; Klungsøyr, K.; Bolumar, F.; Mohangoo, A.; Gissler, M.; Szamotulska, K.; Lack, N.; Nijhuis, J.; Velebil, P.; Sakkeus, L.; Chalmers, J.; Zeitlin, J.; Haidinger, G.; XMartens, G.; Misselwitz, B.; Wenzlaff, P.; Bonham, S.; Jaselioniene, J.; Gatt, M.; Klungsøyr, K.; Barros, H.; Novak, Z.; Gottvall, K.

2014-01-01

Background: While international variations in overall cesarean delivery rates are well documented, less information is available for clinical sub-groups. Cesarean data presented by subgroups can be used to evaluate uptake of cesarean reduction policies or to monitor delivery practices for high and

Cesarean section rates and indications at our clinic between 2001 and 2005

Directory of Open Access Journals (Sweden)

Ertan Uzun

2006-12-01

Full Text Available OBJECTIVE: Cesarean section has increased risks for maternal mortality and morbidity, and perinatal morbidity. The purpose of this study was to analyze the annual distribution of indications and rates of cesarean sections in all deliveries that happened between 2001 and 2005.\tMATERIAL-METHODS: We evaluated retrospectively the hospital records of 1806 patients who underwent cesarean section among 2416 deliveries at Suleyman Demirel University, School of Medicine, Department of Obstetrics and Gynecology, between 2001- 2005. The annual distribution of patients with cesarean section were analyzed with respect to age, parity, vaginal birth rate and cesarean section indications.\tRESULTS: The rate of cesarean section is between 58.1% and 85.2%. This rate increased by years. The most increased indications of cesarean section were previous cesarean, cephalo-pelvic disproportion, and fetal distress. While the rate of previous cesarean\twas 18.3 % in 2001, it increased to 29.6 % in 2005. In a same manner, the rates of cephalo-pelvic disproportion was raised from 2.8% to 21.4%.. The indications of fetal distress and desire of contraception were decreased during this period (p CONCLUSION: The cesarean rate has increased by years in our clinic. This increase was attributed to the increased rate of previous cesarean section, the increased number of primigravid women over 35 year old, and the management of breech presentations. The widespread use of antenatal diagnostic techniques also caused an increase in the rate of cesarean section.

Repeat cesarean delivery: what indications are recorded in the medical chart?

Science.gov (United States)

Lydon-Rochelle, Mona T; Gardella, Carolyn; Cárdenas, Vicky; Easterling, Thomas R

2006-03-01

National surveillance estimates reported a troubling 63 percent decline in the rate of vaginal birth after cesarean delivery (VBAC) from 1996 (28.3%) to 2003 (10.6%), with subsequent rising rates of repeat cesarean delivery. The study objective was to examine patterns of documented indications for repeat cesarean delivery in women with and without labor. We conducted a population-based validation study of 19 nonfederal short-stay hospitals in Washington state. Of the 4,541 women who had live births in 2000, 11 percent (n = 493) had repeat cesarean without labor and 3 percent (n = 138) had repeat cesarean with labor. Incidence of medical conditions and pregnancy complications, patterns of documented indications for repeat cesarean delivery, and perioperative complications in relation to repeat cesarean delivery with and without labor were calculated. Of the 493 women who underwent a repeat cesarean delivery without labor, "elective"(36%) and "maternal request"(18%) were the most common indications. Indications for maternal medical conditions (3.0%) were uncommon. Among the 138 women with repeat cesarean delivery with labor, 60.1 percent had failure to progress, 24.6 percent a non-reassuring fetal heart rate, 8.0 percent cephalopelvic disproportion, and 7.2 percent maternal request during labor. Fetal indications were less common (5.8%). Breech, failed vacuum, abruptio placentae, maternal complications, and failed forceps were all indicated less than 5.0 percent. Women's perioperative complications did not vary significantly between women without and with labor. Regardless of a woman's labor status, nearly 10 percent of women with repeat cesarean delivery had no documented indication as to why a cesarean delivery was performed. "Elective" and "maternal request" were common indications among women undergoing repeat cesarean delivery without labor, and nearly 10 percent of women had undocumented indications for repeat cesarean delivery in their medical record

Dystocia as a cause of untimely cesarean section.

Science.gov (United States)

Djurić, Janko; Arsenijević, Slobodan; Banković, Dragic; Protrka, Zoran; Sorak, Marija; Dimitrijević, Aleksandra; Tanasković, Irena

2012-07-01

One of the most frequent indications for cesarean section is dystocia. It is impossible to predict, difficult to identify and coincident with the rapid expiry of the expected time, so it is important to point out some mistakes in expecting vaginal delivery. The aim of this study was to examine the frequency and the length of dystocia-related cesarean delivery, as well as the vitality of the newborn immediately after birth. A prospective 3-year study was conducted including a total number of 6470 deliveries regardless of whether they were completed using cesarean section after an unsuccessful attempt of spontaneous vaginal delivery or not. The Apgar score, a proved useful tool for the assessment of the vitality of newborn children in the first minute, was used. On the basis of the established indications, 653 (10.10%) of deliveries were completed using cesarean section. Dystocia was the third most common indication for cesarean section (16.38%). Deliveries in which dystocia was established as a diagnosis lasted much longer (p = 0.030) which resulted in weaker vitality of newborn children (p = 0.000) compared to the deliveries ended by spontaneous vaginal delivery. This study shows that deliveries caused by dystocia last much longer and newborn children are of weaker vitality compared to other deliveries caused not by dystocia. Decisions concerning cesarean section must be made in a timely fashion.

Drift chamber vertex detectors for SLC/LEP

International Nuclear Information System (INIS)

Hayes, K.G.

1987-03-01

The short but measurable lifetimes of the b and c quarks and the tau lepton have motivated the development of high precision tracking detectors capable of providing information on the decay vertex topology of events containing these particles. This paper reviews the OPAL, L3, and MARK II experiments vertex drift chambers

Fetomaternal hemorrhage in women undergoing elective cesarean section

DEFF Research Database (Denmark)

Perslev, Anette; Jørgensen, Finn Stener; Nielsen, Leif Kofoed

2010-01-01

Objective. To investigate the degree of fetomaternal hemorrhage (FMH) caused by elective cesarean section. Design. Descriptive study. Settings. University Hospitals in Copenhagen, Denmark. Population. Women scheduled for elective cesarean section, in the period September 2007 to January 2009......, at the Department of Gynecology and Obstetrics, Hvidovre Hospital, University of Copenhagen, Denmark. Methods. Two maternal blood samples were taken, the first before cesarean section and the second immediately after. Both samples were analyzed at the Blood Bank, Rigshospitalet, Copenhagen, for the presence...

Fetal outcome in emergency versus elective cesarean sections at Souissi Maternity Hospital, Rabat, Morocco

Science.gov (United States)

Benzouina, Soukayna; Boubkraoui, Mohamed El-mahdi; Mrabet, Mustapha; Chahid, Naima; Kharbach, Aicha; El-hassani, Amine; Barkat, Amina

2016-01-01

Introduction Perinatal mortality rates have come down in cesarean sections, but fetal morbidity is still high in comparison to vaginal delivery and the complications are more commonly seen in emergency than in elective cesarean sections. The objective of the study was to compare the fetal outcome and the indications in elective versus emergency cesarean section performed in a tertiary maternity hospital. Methods This comparative cross-sectional prospective study of all the cases undergoing elective and emergency cesarean section for any indication at Souissi maternity hospital of Rabat, Morocco, was carried from January 1, to February 28, 2014. Data were analyzed with emphasis on fetal outcome and cesarean sections indications. Mothers who had definite antenatal complications that would adversely affect fetal outcome were excluded from the study. Results There was 588 (17.83%) cesarean sections among 3297 births of which emergency cesarean section accounted for 446 (75.85%) and elective cesarean section for 142 cases (24.15%). Of the various factors analyzed in relation to the two types of cesarean sections, statistically significant associations were found between emergency cesarean section and younger mothers (P cesarean section performed under general anesthesia (P cesarean section was fetal distress (30.49%), while the most frequent indication in elective cesarean section was previous cesarean delivery (47.18%). Conclusion The overall fetal complications rate was higher in emergency cesarean section than in elective cesarean section. Early recognition and referral of mothers who are likely to undergo cesarean section may reduce the incidence of emergency cesarean sections and thus decrease fetal complications. PMID:27347286

Timing of elective repeated cesarean delivery in patients with previous two or more cesarean section.

Science.gov (United States)

Mohammed, Abdel-Baset F; Bayo, Arabo I; Abu-Jubara, Mahmoud F

2013-01-01

To assess the maternal and neonatal consequences of scheduling elective repeated cesarean section (ERCS) at 39 weeks rather than 38 weeks and to assess the impacts of delivering by emergency cesarean section (CS) before the planned date. Retrospective Cohort study. Patients with previous two or more CS planned for ERCS at term during the period from January to June 2011. Medical records were reviewed for demographic and clinical data, planned timing of CS, emergency cesarean and any adverse maternal or neonatal outcome. Adverse maternal or neonatal outcome. Four hundred and twenty women were included, 71.4% of cases were posted <39 weeks and 28.6% were posted at ≥39 weeks. Patients posted ≥ 39 weeks were more prone to deliver by emergency CS (16.6 vs. 10.6%) and the neonates were less prone to RDS and NICU admission (p < 0.05). Our data support the justification to book patients for ERCS at ≥39 weeks.

Role of Frontal Cortex in Attentional Capture by Singleton Distractors

Science.gov (United States)

de Fockert, Jan W.; Theeuwes, Jan

2012-01-01

The role of frontal cortex in selective attention to visual distractors was examined in an attentional capture task in which participants searched for a unique shape in the presence or absence of an additional colour singleton distractor. The presence of the additional singleton was associated with slower behavioural responses to the shape target,…

The Outcome Analysis of Cesarean Section Cases in One-Year Period

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Osman Balcı

2007-04-01

CONCLUSIONS: The rates of cesarean deliveries are increasing day by day. The increased rates of prior cesarean deliveries is a critical factor for the risks of recurrent surgeries and cost-effectiveness. We concluded that to determine the real indications for primary cesarean deliveries and to be more selective and careful are assumed to decrease the cesarean delivery rates.

Recommendations for routine reporting on indications for cesarean delivery in developing countries.

Science.gov (United States)

Stanton, Cynthia; Ronsmans, Carine

2008-09-01

Cesarean delivery rates are increasing rapidly in many developing countries, particularly among wealthy women. Poor women have lower rates, often so low that they do not reach the minimum rate of 1 percent. Little data are available on clinical indications for cesarean section, information that could assist in understanding why cesarean delivery rates have changed. This paper presents recommendations for routine reporting on indications for cesarean delivery in developing countries. These recommendations resulted from an international consultation of researchers held in February 2006 to promote the collection of comparable data to understand change in, or composition of, the cesarean delivery rate in developing countries. Data are presented from selected countries, categorizing cesareans by three classification systems. A single classification system was recommended for use in both high and low cesarean delivery rate settings, given that underuse and overuse of cesarean section are evident within many populations. The group recommended a hierarchical categorization, prioritizing cesareans performed for absolute maternal indications. Categorization among the remaining nonabsolute indications is based on the primary indication for the procedure and include maternal and fetal indications and psychosocial indications, required for high cesarean delivery rate settings. Data on indications for cesarean sections are available everywhere the procedure is performed. All that is required is compilation and review at facility and at higher levels. Advocacy within ministries of health and medical professional organizations is required to advance these recommendations since researchers have inadequately communicated the health effects of both underuse and overuse of cesarean delivery.

Jet Vertex Charge Reconstruction

CERN Document Server

Nektarijevic, Snezana; The ATLAS collaboration

2015-01-01

A newly developed algorithm called the jet vertex charge tagger, aimed at identifying the sign of the charge of jets containing $b$-hadrons, referred to as $b$-jets, is presented. In addition to the well established track-based jet charge determination, this algorithm introduces the so-called \\emph{jet vertex charge} reconstruction, which exploits the charge information associated to the displaced vertices within the jet. Furthermore, the charge of a soft muon contained in the jet is taken into account when available. All available information is combined into a multivariate discriminator. The algorithm has been developed on jets matched to generator level $b$-hadrons provided by $t\\bar{t}$ events simulated at $\\sqrt{s}$=13~TeV using the full ATLAS detector simulation and reconstruction.

Twisted vertex algebras, bicharacter construction and boson-fermion correspondences

International Nuclear Information System (INIS)

Anguelova, Iana I.

2013-01-01

The boson-fermion correspondences are an important phenomena on the intersection of several areas in mathematical physics: representation theory, vertex algebras and conformal field theory, integrable systems, number theory, cohomology. Two such correspondences are well known: the types A and B (and their super extensions). As a main result of this paper we present a new boson-fermion correspondence of type D-A. Further, we define a new concept of twisted vertex algebra of order N, which generalizes super vertex algebra. We develop the bicharacter construction which we use for constructing classes of examples of twisted vertex algebras, as well as for deriving formulas for the operator product expansions, analytic continuations, and normal ordered products. By using the underlying Hopf algebra structure we prove general bicharacter formulas for the vacuum expectation values for two important groups of examples. We show that the correspondences of types B, C, and D-A are isomorphisms of twisted vertex algebras

The Mark III vertex chamber

International Nuclear Information System (INIS)

Adler, J.; Bolton, T.; Bunnell, K.

1987-07-01

The design and construction of the new Mark III vertex chamber is described. Initial tests with cosmic rays prove the ability of track reconstruction and yield triplet resolutions below 50 μm at 3 atm using argon/ethane (50:50). Also performed are studies using a prototype of a pressurized wire vertex chamber with 8 mm diameter straw geometry. Spatial resolution of 35mm was obtained using dimethyl ether (DME) at 1 atm and 30 μm using argon/ethane (50/50 mixture) at 4 atm. Preliminary studies indicate the DME to adversely affect such materials as aluminized Mylar and Delrin

On the local vertex antimagic total coloring of some families tree

Science.gov (United States)

Febriani Putri, Desi; Dafik; Hesti Agustin, Ika; Alfarisi, Ridho

2018-04-01

Let G(V, E) be a graph of vertex set V and edge set E. Local vertex antimagic total coloring developed from local edge and local vertex antimagic coloring of graph. Local vertex antimagic total coloring is defined f:V(G)\\cup E(G)\\to \\{1,2,3,\\ldots,|V(G)|+|E(G)|\\} if for any two adjacent vertices v 1 and v 2, w({v}1)\

Intraoperative adverse events associated with extremely preterm cesarean deliveries.

Science.gov (United States)

Bertholdt, Charline; Menard, Sophie; Delorme, Pierre; Lamau, Marie-Charlotte; Goffinet, François; Le Ray, Camille

2018-05-01

At the same time as survival is increasing among premature babies born before 26 weeks of gestation, the rates of cesarean deliveries before 26 weeks is also rising. Our purpose was to compare the frequency of intraoperative adverse events during cesarean deliveries in two gestational age groups: 24-25 weeks and 26-27 weeks. This single-center retrospective cohort study included all women with cesarean deliveries performed before 28 +0 weeks from 2007 through 2015. It compared the frequency of intraoperative adverse events between two groups: those at 24-25 weeks of gestation and at 26-27 weeks. Intraoperative adverse events were a classical incision, transplacental incision, difficulty in fetal extraction (explicitly mentioned in the surgical report), postpartum hemorrhage (≥500 mL of blood loss), and injury to internal organs. A composite outcome including at least one of these events enabled us to analyze the risk factors for intraoperative adverse events with univariate and multivariable analysis. Stratified analyses by the indication for the cesarean were performed. We compared 74 cesarean deliveries at 24-25 weeks of gestation and 214 at 26-27 weeks. Intraoperative adverse events occurred at higher rates in the 24-25-week group (63.5 vs. 30.8%, p cesarean. These results should help obstetricians and women making decisions about cesarean deliveries at these extremely low gestational ages. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

Pregnancy outcomes associated with Cesarean deliveries in Peruvian public health facilities

Directory of Open Access Journals (Sweden)

Gonzales GF

2013-10-01

Full Text Available Gustavo F Gonzales,1–2 Vilma L Tapia,2 Alfredo L Fort,3 Ana Pilar Betran31Department of Biological and Physiological Sciences, Faculty of Sciences and Philosophy, 2Instituto de Investigaciones de la Altura, Universidad Peruana Cayetano Heredia, Lima, Peru; 3Department of Reproductive Health and Research, World Health Organization, Geneva, SwitzerlandAbstract: A continuous rise in the rate of cesarean deliveries has been reported in many countries over recent decades. This trend has prompted the emergence of a debate on the risks and benefits associated with cesarean section. The present study was designed to estimate cesarean section rates over time during the period between 2000 and 2010 in Peru and to present outcomes for each mode of delivery. This is a secondary analysis of a large database obtained from the Perinatal Information System, which includes 570,997 pregnant women and their babies from 43 Peruvian public health facilities in three geographical regions: coast, highlands, and jungle. Over 10 years, 558,901 women delivered 563,668 infants weighing at least 500 g. The cesarean section rate increased from 25.5% in 2000 to 29.9% in 2010 (26.9% average; P < 0.01. The rate of stillbirths was lower with cesarean than vaginal deliveries (P < 0.01. On the other hand, and as expected, the rates for preterm births, twin pregnancies, and preeclampsia were higher in women who delivered by cesarean section (P < 0.01. More importantly, the rate of maternal mortality was 5.5 times higher in the cesarean section group than in the vaginal delivery group. Data suggest that cesarean sections are associated with adverse pregnancy outcomes.Keywords: elective cesarean, emergency cesarean, geographical regions, cesarean rates over time, adverse outcomes, developing country

The LHCb VERTEX LOCATOR performance and VERTEX LOCATOR upgrade

International Nuclear Information System (INIS)

Rodríguez Pérez, P

2012-01-01

LHCb is an experiment dedicated to the study of new physics in the decays of beauty and charm hadrons at the Large Hadron Collider (LHC) at CERN. The Vertex Locator (VELO) is the silicon detector surrounding the LHCb interaction point. The detector operates in a severe and highly non-uniform radiation environment. The small pitch and analogue readout result in a best single hit precision of 4 μm. The upgrade of the LHCb experiment, planned for 2018, will transform the entire readout to a trigger-less system operating at 40 MHz event rate. The vertex detector will have to cope with radiation levels up to 10 16 1 MeVn eq /cm 2 , more than an order of magnitude higher than those expected at the current experiment. A solution is under development with a pixel detector, based on the Timepix/Medipix family of chips with 55 x 55 μm pixels. In addition a micro-strip solution is also under development, with finer pitch, higher granularity and lower mass than the current detector. The current status of the VELO will be described together with recent testbeam results.

The BaBar silicon vertex tracker

International Nuclear Information System (INIS)

Bozzi, C.; Carassiti, V.; Ramusino, A. Cotta; Dittongo, S.; Folegani, M.; Piemontese, L.; Abbott, B.K.; Breon, A.B.; Clark, A.R.; Dow, S.; Fan, Q.; Goozen, F.; Hernikl, C.; Karcher, A.; Kerth, L.T.; Kipnis, I.; Kluth, S.; Lynch, G.; Levi, M.; Luft, P.; Luo, L.; Nyman, M.; Pedrali-Noy, M.; Roe, N.A.; Zizka, G.; Roberts, D.; Barni, D.; Brenna, E.; Defendi, I.; Forti, A.; Giugni, D.; Lanni, F.; Palombo, F.; Vaniev, V.; Leona, A.; Mandelli, E.; Manfredi, P.F.; Perazzo, A.; Re, V.; Angelini, C.; Batignani, G.; Bettarini, S.; Bondioli, M.; Bosi, F.; Calderini, G.; Carpinelli, M.; Dutra, F.; Forti, F.; Gagliardi, D.; Giorgi, M.A.; Lusiani, A.; Mammini, P.; Morganti, M.; Morsani, F.; Paoloni, E.; Profeti, A.; Rama, M.; Rampino, G.; Rizzo, G.; Sandrelli, F.; Simi, G.; Triggiani, G.; Tritto, S.; Vitale, R.; Burchat, P.; Cheng, C.; Kirkby, D.; Meyer, T.; Roat, C.; Bona, M.; Bianchi, F.; Daudo, F.; Girolamo, B. Di; Gamba, D.; Giraudo, G.; Grosso, P.; Romero, A.; Smol, A.; Trapani, P.; Zanin, D.; Bosisio, L.; Ricca, G. Della; Lanceri, L.; Pompili, A.; Poropat, P.; Prest, M.; Rastelli, C.; Vallazza, E.; Vuagnin, G.; Hast, C.; Potter, E.P.; Sharma, V.; Burke, S.; Callahan, D.; Campagnari, C.; Dahmes, B.; Eppich, A.; Hale, D.; Hall, K.; Hart, P.; Kuznetsova, N.; Kyre, S.; Levy, S.; Long, O.; May, J.; Richman, J.; Verkerke, W.; Witherell, M.; Beringer, J.; Eisner, A.M.; Frey, A.; Grillo, A.; Grothe, M.; Johnson, R.; Kroeger, W.; Lockman, W.; Pulliam, T.; Rowe, W.; Schmitz, R.; Seiden, A.; Spencer, E.; Turri, M.; Wilder, M.; Charles, E.; Elmer, P.; Nielsen, J.; Orejudos, W.; Scott, I.; Walsh, J.; Zobernig, H.

2000-01-01

The BaBar Silicon Vertex Tracker (SVT) is designed to provide the high-precision vertexing necessary for making measurements of CP violation at the SLAC B-Factory PEP-II. The instrument consists of five layers of double-sided silicon strip detectors and has been installed in the BaBar experiment and taking colliding beam data since May 1999. An overview of the design as well as performance and experience from the initial running will be presented

Fetomaternal hemorrhage in women undergoing elective cesarean section

DEFF Research Database (Denmark)

Perslev, Anette; Jørgensen, Finn Stener; Nielsen, Leif Kofoed

2011-01-01

OBJECTIVE: To investigate the degree of fetomaternal hemorrhage (FMH) caused by elective cesarean section. DESIGN: Descriptive study. SETTINGS: University Hospitals in Copenhagen, Denmark. POPULATION: Women scheduled for elective cesarean section, in the period September 2007 to January 2009, at ...

Assessing the role of case mix in cesarean delivery rates.

Science.gov (United States)

Lieberman, E; Lang, J M; Heffner, L J; Cohen, A

1998-07-01

Implicit in comparisons of unadjusted cesarean rates for hospitals and providers is the assumption that differences result from management practices rather than differences in case mix. This study proposes a method for comparison of cesarean rates that takes the effect of case mix into account. All women delivered of infants at our institution from December 1, 1994, through July 31, 1995, were classified according to whether they received care from community-based practitioners (N=3913) or from the hospital-based practice that serves a higher-risk population (N=1556). Women were categorized according to both obstetric history (nulliparas, multiparas without a previous cesarean, multiparas with a previous cesarean) and the presence of obstetric conditions influencing the risk of cesarean delivery (multiple birth, breech presentation or transverse lie, preterm, no trial of labor for a medical indication). We determined the percent of women in each parity-obstetric condition subgroup and calculated a standardized cesarean rate for the hospital-based practice using the case mix of the community-based practitioners as the standard. The crude cesarean rate was higher for the hospital-based practice (24.4%) than for the community-based practitioners (21.5%), a rate difference of 2.9% (95% confidence interval=0.4%, 5.4%; P=.02). However, the proportion of women falling into categories conferring a high risk of cesarean delivery (multiple pregnancy, breech presentation or transverse lie, preterm, no trial of labor permitted) was twice as high for the hospital-based practice (24.4% hospital, 12.1% community). The standardization indicates that if the hospital-based practitioners had the same case mix as community-based practitioners, their overall cesarean rate would be 20.1%, similar to the 21.5% rate of community providers (rate difference=-1.4%, 95% confidence interval =-3.1%, 0.3%; P=.11). Standardization for case mix provides a mechanism for distinguishing differences

Twin-singleton differences in cognitive abilities in a sample of Africans in Nigeria.

Science.gov (United States)

Hur, Yoon-Mi; Lynn, Richard

2013-08-01

Recent studies comparing cognitive abilities between contemporary twins and singletons in developed countries have suggested that twin deficits in cognitive abilities no longer exist. We examined cognitive abilities in a sample of twins and singletons born recently in Nigeria to determine whether recent findings can be replicated in developing countries. Our sample consisted of 413 pairs of twins and 280 singletons collected from over 45 public schools in Abuja and its neighboring states in Nigeria. The ages of twins and singletons ranged from 9 to 20 years with a mean (SD) of 14.6 years (2.2 years) for twins and 16.1 years (1.8 years) for singletons. Zygosity of the same-sex twins was determined by analysis of 16 deoxyribonucleic acid markers. We asked participants to complete a questionnaire booklet that included Standard Progressive Matrices-Plus Version (SPM+), Mill-Hill Vocabulary Scale (MHV), Family Assets Questionnaire, and demographic questions. The data were corrected for sex and age and then analyzed using maximum likelihood model-fitting analysis. Although twins and singletons were comparable in family social class indicators, singletons did better than twins across all the tests (d = 0.10 to 0.35). The average of d for SPM+ total [0.32; equivalent to 4.8 Intelligence Quotient (IQ) points] and d for MHV (0.24; equivalent to 3.6 IQ points) was 0.28 (equivalent to 4.2 IQ points), similar to the twin-singleton gap found in old cohorts in developed countries. We speculate that malnutrition, poor health, and educational systems in Nigeria may explain the persistence of twin deficits in cognitive abilities found in our sample.

Plethystic vertex operators and boson-fermion correspondences

International Nuclear Information System (INIS)

Fauser, Bertfried; Jarvis, Peter D; King, Ronald C

2016-01-01

We study the algebraic properties of plethystic vertex operators, introduced in (2010 J. Phys. A: Math. Theor. 43 405202), underlying the structure of symmetric functions associated with certain generalized universal character rings of subgroups of the general linear group, defined to stabilize tensors of Young symmetry type characterized by a partition of arbitrary shape π . Here we establish an extension of the well-known boson-fermion correspondence involving Schur functions and their associated (Bernstein) vertex operators: for each π , the modes generated by the plethystic vertex operators and their suitably constructed duals, satisfy the anticommutation relations of a complex Clifford algebra. The combinatorial manipulations underlying the results involve exchange identities exploiting the Hopf-algebraic structure of certain symmetric function series and their plethysms. (paper)

Plethystic vertex operators and boson-fermion correspondences

Science.gov (United States)

Fauser, Bertfried; Jarvis, Peter D.; King, Ronald C.

2016-10-01

We study the algebraic properties of plethystic vertex operators, introduced in (2010 J. Phys. A: Math. Theor. 43 405202), underlying the structure of symmetric functions associated with certain generalized universal character rings of subgroups of the general linear group, defined to stabilize tensors of Young symmetry type characterized by a partition of arbitrary shape π. Here we establish an extension of the well-known boson-fermion correspondence involving Schur functions and their associated (Bernstein) vertex operators: for each π, the modes generated by the plethystic vertex operators and their suitably constructed duals, satisfy the anticommutation relations of a complex Clifford algebra. The combinatorial manipulations underlying the results involve exchange identities exploiting the Hopf-algebraic structure of certain symmetric function series and their plethysms.

Trial of labor compared to repeat cesarean section in women with no other risk factors than a prior cesarean delivery

DEFF Research Database (Denmark)

Studsgaard, Anne; Skorstengaard, Malene; Glavind, Julie

2013-01-01

OBJECTIVE: To compare outcomes with trial of labor after cesarean (TOLAC) or elective repeat cesarean delivery on maternal request (ERCD-MR). DESIGN: Prospective cohort study. SETTING: Danish university hospital. POPULATION: Women with TOLAC (n = 1161) and women with ERCD-MR (n = 622) between 2003...... registration of the deliveries. MAIN OUTCOME MEASURES: Adverse neonatal outcomes, risk factors for emergency cesarean, and uterine rupture in case of TOLAC. RESULTS: TOLAC was associated with an increased risk of neonatal depression [odds ratio (OR) 3.6, 95% confidence interval (CI) 1.1-19.1] and neonatal...... vaginal delivery (adjusted OR 1.8, 95% CI 1.1-3.0), index emergency cesarean during labor (adjusted OR 3.0, 95% CI 2.3-4.1), maternal age ≥35 years (adjusted OR 1.9, 95% CI 1.3-2.8), pre-pregnancy body mass index ≥30 (adjusted OR 2.1, 95% CI 1.3-3.3), and birthweight 4000-4499 g (adjusted OR 1.5, 95% CI 1...

Vertex-Detector R&D for CLIC

OpenAIRE

Dannheim, Dominik

2013-01-01

A detector concept based on hybrid planar pixel-detector technology is under development for the CLIC vertex detector. It comprises fast, low-power and small-pitch readout ASICs implemented in 65 nm CMOS technology (CLICpix) coupled to ultra-thin sensors via low-mass interconnects. The power dissipation of the readout chips is reduced by means of power pulsing, allowing for a cooling system based on forced gas flow. In this paper the CLIC vertex-detector requirements are reviewed and the curr...

Toward an ethically responsible approach to vaginal birth after cesarean.

Science.gov (United States)

Lyerly, Anne Drapkin; Little, Margaret Olivia

2010-10-01

Determining approach to delivery after a previous cesarean is among the most contentious areas of obstetrics. We present a framework for ethically responsible guidelines and practice regarding vaginal birth after cesarean. We describe ethical complexities of 3 key issues that mark the debate: the cesarean delivery rate, safety, and patient autonomy. We then describe a taxonomy of considerations that should inform a responsible framework for guideline development and highlight critical distinctions between types of guidelines that have been blurred in the past. We then forward 2 central claims. First, in otherwise uncomplicated birth after a single previous cesarean, both vaginal birth after cesarean and repeat cesarean should be regarded as reasonable options; women, rather than policymakers, providers, insurance carriers, or hospitals, should determine delivery approach. Second, in complicated cases, providers and policymakers should carefully calibrate the strength of evidence to ensure differential risk and cost are adequate to justify directive guidelines given important variations in values women bring to childbirth. Copyright © 2010 Elsevier Inc. All rights reserved.

"Suffering twice": the gender politics of cesarean sections in Taiwan.

Science.gov (United States)

Kuan, Chen-I

2014-09-01

Women's pursuit of medical interventions in childbirth has been a challenging issue in feminist and medical anthropological research on the medicalization of reproduction. This article addresses the gender politics surrounding maternal requests for cesarean sections in Taiwan. Since the 1990s, Taiwanese cesarean rates have been reported as among the highest in the world. That is not the case now, yet they are still perceived as such, and the current rate of 37% is indeed high by any standards. The government and public discourses attribute the high cesarean rate to women's demand for this intervention. However, my ethnographic research indicates that the Taiwanese hospital birthing system leads to the prevalence of cesareans, and that women's requests for them constitute strategic responses to the system and its existing high cesarean rates. Using women's attempt to avoid "suffering twice" as an example, I argue that maternal requests for cesareans often lie at the intersection between their restricted control over childbirth and their agency within the medical system. © 2014 by the American Anthropological Association.

Pion-nucleon vertex function with one nucleon off shell

International Nuclear Information System (INIS)

Mizutani, T.; Rochus, P.

1979-01-01

The pion-nucleon vertex function with an off-mass-shell nucleon is obtained through sideways dispersion relations with the P 11 and S 11 pion-nucleon phase shifts as only input. Contrary to the recent calculation of Nutt and Shakin, we find that the proper and improper vertex functions behave quite differently, indicating the importance of the nucleon propagator dressing. In particular the proper vertex function is found to have two poles in the unphysical region

Misrecognition of need: women's experiences of and explanations for undergoing cesarean delivery.

Science.gov (United States)

Tully, Kristin P; Ball, Helen L

2013-05-01

International rates of operative delivery are consistently higher than the World Health Organization determined is appropriate. This suggests that factors other than clinical indications contribute to cesarean section. Data presented here are from interviews with 115 mothers on the postnatal ward of a hospital in Northeast England during February 2006 to March 2009 after the women underwent either unscheduled or scheduled cesarean childbirth. Using thematic content analysis, we found women's accounts of their experiences largely portrayed cesarean section as everything that they had wanted to avoid, but necessary given their situations. Contrary to popular suggestion, the data did not indicate impersonalized medical practice, or that cesareans were being performed 'on request.' The categorization of cesareans into 'emergency' and 'elective' did not reflect maternal experiences. Rather, many unscheduled cesareans were conducted without indications of fetal distress and most scheduled cesareans were not booked because of 'choice.' The authoritative knowledge that influenced maternal perceptions of the need to undergo operative delivery included moving forward from 'prolonged' labor and scheduling cesarean as a prophylactic to avoid anticipated psychological or physical harm. In spontaneously defending themselves against stigma from the 'too posh to push' label that is currently common in the media, women portrayed debate on the appropriateness of cesarean childbirth as a social critique instead of a health issue. The findings suggest the 'need' for some cesareans is due to misrecognition of indications by all involved. The factors underlying many cesareans may actually be modifiable, but informed choice and healthful outcomes are impeded by lack of awareness regarding the benefits of labor on the fetal transition to extrauterine life, the maternal desire for predictability in their parturition and recovery experiences, and possibly lack of sufficient experience for

Perturbative quantum field theory via vertex algebras

International Nuclear Information System (INIS)

Hollands, Stefan; Olbermann, Heiner

2009-01-01

In this paper, we explain how perturbative quantum field theory can be formulated in terms of (a version of) vertex algebras. Our starting point is the Wilson-Zimmermann operator product expansion (OPE). Following ideas of a previous paper (S. Hollands, e-print arXiv:0802.2198), we consider a consistency (essentially associativity) condition satisfied by the coefficients in this expansion. We observe that the information in the OPE coefficients can be repackaged straightforwardly into 'vertex operators' and that the consistency condition then has essentially the same form as the key condition in the theory of vertex algebras. We develop a general theory of perturbations of the algebras that we encounter, similar in nature to the Hochschild cohomology describing the deformation theory of ordinary algebras. The main part of the paper is devoted to the question how one can calculate the perturbations corresponding to a given interaction Lagrangian (such as λφ 4 ) in practice, using the consistency condition and the corresponding nonlinear field equation. We derive graphical rules, which display the vertex operators (i.e., OPE coefficients) in terms of certain multiple series of hypergeometric type.

Belle II silicon vertex detector

Energy Technology Data Exchange (ETDEWEB)

Adamczyk, K. [H. Niewodniczanski Institute of Nuclear Physics, Krakow 31-342 (Poland); Aihara, H. [Department of Physics, University of Tokyo, Tokyo 113-0033 (Japan); Angelini, C. [Dipartimento di Fisica, Università di Pisa, I-56127 Pisa (Italy); INFN Sezione di Pisa, I-56127 Pisa (Italy); Aziz, T.; Babu, V. [Tata Institute of Fundamental Research, Mumbai 400005 (India); Bacher, S. [H. Niewodniczanski Institute of Nuclear Physics, Krakow 31-342 (Poland); Bahinipati, S. [Indian Institute of Technology Bhubaneswar, Satya Nagar (India); Barberio, E.; Baroncelli, Ti.; Baroncelli, To. [School of Physics, University of Melbourne, Melbourne, Victoria 3010 (Australia); Basith, A.K. [Indian Institute of Technology Madras, Chennai 600036 (India); Batignani, G. [Dipartimento di Fisica, Università di Pisa, I-56127 Pisa (Italy); INFN Sezione di Pisa, I-56127 Pisa (Italy); Bauer, A. [Institute of High Energy Physics, Austrian Academy of Sciences, 1050 Vienna (Austria); Behera, P.K. [Indian Institute of Technology Madras, Chennai 600036 (India); Bergauer, T. [Institute of High Energy Physics, Austrian Academy of Sciences, 1050 Vienna (Austria); Bettarini, S. [Dipartimento di Fisica, Università di Pisa, I-56127 Pisa (Italy); INFN Sezione di Pisa, I-56127 Pisa (Italy); Bhuyan, B. [Indian Institute of Technology Guwahati, Assam 781039 (India); Bilka, T. [Faculty of Mathematics and Physics, Charles University, 121 16 Prague (Czech Republic); Bosi, F. [INFN Sezione di Pisa, I-56127 Pisa (Italy); Bosisio, L. [Dipartimento di Fisica, Università di Trieste, I-34127 Trieste (Italy); INFN Sezione di Trieste, I-34127 Trieste (Italy); and others

2016-09-21

The Belle II experiment at the SuperKEKB collider in Japan is designed to indirectly probe new physics using approximately 50 times the data recorded by its predecessor. An accurate determination of the decay-point position of subatomic particles such as beauty and charm hadrons as well as a precise measurement of low-momentum charged particles will play a key role in this pursuit. These will be accomplished by an inner tracking device comprising two layers of pixelated silicon detector and four layers of silicon vertex detector based on double-sided microstrip sensors. We describe herein the design, prototyping and construction efforts of the Belle-II silicon vertex detector.

Operator Product Formulas in the Algebraic Approach of the Refined Topological Vertex

International Nuclear Information System (INIS)

Cai Li-Qiang; Wang Li-Fang; Wu Ke; Yang Jie

2013-01-01

The refined topological vertex of Iqbal—Kozçaz—Vafa has been investigated from the viewpoint of the quantum algebra of type W 1+∞ by Awata, Feigin, and Shiraishi. They introduced the trivalent intertwining operator Φ which is normal ordered along with some prefactors. We manage to establish formulas from the infinite operator product of the vertex operators and the generalized ones to restore this prefactor, and obtain an explicit formula for the vertex realization of the topological vertex as well as the refined topological vertex

Vaginal birth after cesarean: new insights on maternal and neonatal outcomes.

Science.gov (United States)

Guise, Jeanne-Marie; Denman, Mary Anna; Emeis, Cathy; Marshall, Nicole; Walker, Miranda; Fu, Rongwei; Janik, Rosalind; Nygren, Peggy; Eden, Karen B; McDonagh, Marian

2010-06-01

To systematically review the evidence about maternal and neonatal outcomes relating to vaginal birth after cesarean (VBAC). Relevant studies were identified from multiple searches of MEDLINE, DARE, and the Cochrane databases (1980 to September 2009) and from recent systematic reviews, reference lists, reviews, editorials, Web sites, and experts. Inclusion criteria limited studies to the English-language and human studies conducted in the United States and developed countries specifically evaluating birth after previous cesarean delivery. Studies focusing on high-risk maternal or neonatal conditions, including breech vaginal delivery, or fewer than 10 patients were excluded. Poor-quality studies were not included in analyses. We identified 3,134 citations and reviewed 963 articles for inclusion; 203 articles met the inclusion criteria and were quality rated. Overall rates of maternal harms were low for both trial of labor and elective repeat cesarean delivery. Although rare in both elective repeat cesarean delivery and trial of labor, maternal mortality was significantly increased for elective repeat cesarean delivery at 0.013% compared with 0.004% for trial of labor. The rates of maternal hysterectomy, hemorrhage, and transfusions did not differ significantly between trial of labor and elective repeat cesarean delivery. The rate of uterine rupture for all women with prior cesarean was 0.30%, and the risk was significantly increased for trial of labor (0.47% compared with 0.03% for elective repeat cesarean delivery). Perinatal mortality was also significantly increased for trial of labor (0.13% compared with 0.05% for elective repeat cesarean delivery). Overall the best evidence suggests that VBAC is a reasonable choice for the majority of women. Adverse outcomes were rare for both elective repeat cesarean delivery and trial of labor. Definitive studies are lacking to identify patients who are at greatest risk for adverse outcomes.

Vertex epidural haematoma manifesting with bilateral upper limb ...

African Journals Online (AJOL)

Vertex epidural haematomas (VEDH) are rare and difficulties are encountered in diagnosis and management. This is a case report of a patient with a vertex epidural haematoma who presented with signs of severe head injury with upper limb decerebrate posture. We discuss the challenges of radiological investigation and ...

Vertex Reconstruction for AEGIS’ FACT Detector

CERN Document Server

Themistokleous, Neofytos

2017-01-01

My project dealt with the development of a vertex reconstruction technique to discriminate antihydrogen from background signals in the AEGIS apparatus. It involved the creation of a Toy Monte-Carlo to simulate particle annihilation events, and a vertex reconstruction utility based on the Bayesian theory of probability. The first results based on 107 generated events with single track in the detector are encouraging. For such events, the algorithm can reconstruct the z-coordinate accurately , while for the r-coordinate the result is less accurate.

Prevention of urinary and anal incontinence: role of elective cesarean delivery.

Science.gov (United States)

Lal, Mira

2003-10-01

Currently, prophylactic elective cesarean to prevent incontinence is being promoted without robust evidence supporting it, this has created confusion among health personnel [corrected]. Past research centered on defining the damaging effect of vaginal birth on continence whilst the limited research on elective cesarean considered it protective. Cesarean delivery has economic, obstetric, gynecological and psychosocial consequences, but incontinence is not uncommon with a persistent morbidity. There is confusion among health personnel about advocating elective cesarean delivery to prevent incontinence. Reviewing current research would facilitate obstetric thinking. Multiplanar endosonography and three-dimensional magnetic resonance imaging scanning are reportedly better in delineating structural alterations in the continence mechanism following vaginal birth and could be applied to postcesarean incontinence. Incontinence can follow vaginal or elective cesarean delivery and the severity following either mode is comparable. Urinary incontinence can resolve, persist or start de novo and the primiparous prevalence is similar following cesarean or vaginal birth. Transient anal incontinence can manifest during pregnancy. Paradoxically, pelvic floor strengthening exercises are beneficial for pregnancy-related incontinence, yet urinary incontinence occurs in nulliparas notwithstanding a strong pelvic floor. Improved imaging techniques should promote a better understanding of postcesarean incontinence. Since severe incontinence can occur after elective cesarean, its reportedly preventative role deserves more scrutiny. When incontinence occurs without labor, it is transient or shows exercise-related improvement; the role of elective cesarean delivery seems tenuous and needs careful evaluation. Current evidence does not support the routine use of elective cesarean to prevent incontinence so the delivery mode should continue to be dictated by obstetric considerations.

Male fetuses are associated with increased risk for cesarean delivery in Malaysian nulliparae.

Science.gov (United States)

Viegas, Osborn A C; Lee, Pei Sue; Lim, Keng Joo; Ravichandran, Jeganathan

2008-01-01

The association between fetal sex and outcome of pregnancy and labor has been well documented in western populations. However, no studies in Malaysia or other developing countries have examined the effect of fetal sex on such outcomes.The main objective of this study was to determine the influence of fetal sex on the outcome of labor at term in a cohort of Malaysian nulliparae.A retrospective observational study was designed using data from 4644 Malaysian nulliparae who gave birth consecutively to singleton male babies at Hospital Sultanah Aminah, Johor Bahru, after normal full-term pregnancies.The results of this study indicate that mothers giving birth to male infants have a greater risk of requiring cesarean delivery because male babies are heavier and have statistically significantly greater head circumference (P < .001). These findings concur with those obtained in western populations and suggest that the differences in outcome observed are biological, not dictated by race, ethnicity, or environmental conditions. Such information could help in the antenatal assessment of Malaysian patients and stimulate more comprehensive studies of the mechanisms involved in this sex-based difference in outcomes. Reasons for such differences are proposed.

Attentional Capture to a Singleton Distractor Degrades Visual Marking in Visual Search

Directory of Open Access Journals (Sweden)

Kenji Yamauchi

2017-05-01

Full Text Available Visual search is easier after observing some distractors in advance; it is as if the previewed distractors were excluded from the search. This effect is referred to as the preview benefit, and a memory template that visually marks the old locations of the distractors is thought to help in prioritizing the locations of newly presented items. One remaining question is whether the presence of a conspicuous item during the sequential shift of attention within the new items reduces this preview benefit. To address this issue, we combined the above preview search and a conventional visual search paradigm using a singleton distractor and examined whether the search performance was affected by the presence of the singleton. The results showed that the slope of reaction time as a function of set size became steeper in the presence of a singleton, indicating that the singleton distractor reduced the preview benefit. Furthermore, this degradation effect was positively correlated with the degree of conventional attentional capture to a singleton measured in a separate experiment with simultaneous search. These findings suggest that the mechanism of visual marking shares common attentional resources with the search process.

Quark-gluon vertex dressing and meson masses beyond ladder-rainbow truncation

International Nuclear Information System (INIS)

Matevosyan, Hrayr H.; Thomas, Anthony W.; Tandy, Peter C.

2007-01-01

We include a generalized infinite class of quark-gluon vertex dressing diagrams in a study of how dynamics beyond the ladder-rainbow truncation influences the Bethe-Salpeter description of light-quark pseudoscalar and vector mesons. The diagrammatic specification of the vertex is mapped into a corresponding specification of the Bethe-Salpeter kernel, which preserves chiral symmetry. This study adopts the algebraic format afforded by the simple interaction kernel used in previous work on this topic. The new feature of the present work is that in every diagram summed for the vertex and the corresponding Bethe-Salpeter kernel, each quark-gluon vertex is required to be the self-consistent vertex solution. We also adopt from previous work the effective accounting for the role of the explicitly non-Abelian three-gluon coupling in a global manner through one parameter determined from recent lattice-QCD data for the vertex. Within the current model, the more consistent dressed vertex limits the ladder-rainbow truncation error for vector mesons to be never more than 10% as the current quark mass is varied from the u/d region to the b region

Irrelevant Singletons in Pop-Out Search: Attentional Capture or Filtering Costs?

Science.gov (United States)

Becker, Stefanie I.

2007-01-01

The aim of the present study was to investigate whether costs invoked by the presence of an irrelevant singleton distractor in a visual search task are due to attentional capture by the irrelevant singleton or spatially unrelated filtering costs. Measures of spatial effects were based on distance effects, compatibility effects, and differences…

Attentional Capture by an Unannounced Color Singleton Depends on Expectation Discrepancy

Science.gov (United States)

Horstmann, Gernot

2005-01-01

Eight experiments examined the conditions under which a color singleton that is presented for the 1st time without prior announcement captures attention. The main hypothesis is that an unannounced singleton captures attention to the extent that it deviates from expectations. This hypothesis was tested within a visual-search paradigm in which…

Uterine rupture after previous low segment transverse cesarean is rarely catastrophic.

Science.gov (United States)

Soltsman, Sofia; Perlitz, Yuri; Ben Ami, Moshe; Ben Shlomo, Izhar

2018-03-01

The cornerstone of concerns over trial of labor after cesarean (TOLAC) is the risk of uterine rupture. The purpose of this study was to document the rate of uterine rupture during TOLAC and to delineate its severity and consequences. We retrospectively collected the data on vaginal and cesarean deliveries after a previous cesarean section with specific emphasis on uterine rupture and dehiscence in our center from 2006 through 2013. 22,670 deliveries were registered, with 18.2% rate of cesarean section. 2890 women had a single cesarean scar; of them 1206 delivered vaginally and 194 were re-operated during unsuccessful TOLAC. Seven cases of uterine rupture and 16 cases of dehiscence were recorded. There were no maternal, intrapartum or neonatal deaths, and no cesarean hysterectomy. There was one re-laparotomy, one ICU admission, and one blood transfusion; one neonate was admitted to NICU. TOLAC was successful in 86.1% of cases. Cautious selection and close monitoring of candidates are the cornerstones of successful management of TOLAC. Readily available facilities for emergency cesarean delivery and concerted obstetrical team can save the mother and child from catastrophic complications.

Association between prior vaginal birth after cesarean and subsequent labor outcome.

Science.gov (United States)

Krispin, Eyal; Hiersch, Liran; Wilk Goldsher, Yulia; Wiznitzer, Arnon; Yogev, Yariv; Ashwal, Eran

2018-04-01

To estimate the effect of prior successful vaginal birth after cesarean (VBAC) on the rate of uterine rupture and delivery outcome in women undergoing labor after cesarean. A retrospective cohort study of all women attempting labor after cesarean delivery in a university-affiliated tertiary-hospital (2007-2014) was conducted. Study group included women attempting vaginal delivery with a history of cesarean delivery and at least one prior VBAC. Control group included women attempting first vaginal delivery following cesarean delivery. Primary outcome was defined as the rate of uterine rupture. Secondary outcomes were delivery and maternal outcomes. Of 62,463 deliveries during the study period, 3256 met inclusion criteria. One thousand two hundred and eleven women had VBAC prior to the index labor and 2045 underwent their first labor after cesarean. Women in the study group had a significantly lower rate of uterine rupture 9 (0.7%) in respect to control 33 (1.6%), p = .036, and had a higher rate of successful vaginal birth (96 vs. 84.9%, p cesarean, prior VBAC appears to be associated with lower rate of uterine rupture and higher rate of successful vaginal birth.

Conformity expectations: Differential effects on IVF twins and singletons' parent-child relationships and adjustment.

Science.gov (United States)

Anderson, Kayla N; Rueter, Martha A; Connor, Jennifer J; Chen, Muzi; Damario, Mark

2015-08-01

Increased utilization of in vitro fertilization (IVF) to treat infertility has resulted in a growing twin birthrate. Despite early childhood risks, twins have fewer psychosocial problems in middle childhood than singleton children. This study proposes that parents' conformity expectations for children have differential effects on parent-child relationships for twin and singleton children, which indirectly explains twins' more optimum psychosocial adjustment. Parental conformity expectations, parent-child relationship satisfaction, and children's emotional, behavioral, and attention problems were assessed in a sample of 288 6- to 12-year-old IVF-conceived twins and singletons. Overall, parents of twins had higher expectations for child conformity to parent rules than singleton parents. Path models demonstrate that twin status and parental expectations for child conformity interact to influence parent-child relationships, and this interaction indirectly accounted for differences in twins' and singletons' psychosocial adjustment. Findings suggest parenting constructs have differential influences on the association between twin status and parent-child relationships. Parenting research, predominantly conducted with singletons, should be reexamined before applying existing research to twin children and their families. (c) 2015 APA, all rights reserved).

Propagation of the trip behavior in the VENUS vertex chamber

International Nuclear Information System (INIS)

Ohama, Taro; Yamada, Yoshikazu.

1995-03-01

The high voltage system of the VENUS vertex chamber occasionally trips by a discharge somewhere among cathode electrodes during data taking. This trip behavior induces often additional trips at other electrodes such as the skin and the grid electrodes in the vertex chamber. This propagation mechanism of trips is so complicated in this system related with multi-electrodes. Although the vertex chamber is already installed inside the VENUS detector and consequently the discharge is not able to observe directly, a trial to estimate the propagation has been done using only the information which appears around the trip circuits and the power supply of the vertex chamber. (author)

Effects of Music during Multiple Cesarean Section Delivery.

Science.gov (United States)

Handan, Eren; Sahiner, Nejla Canbulat; Bal, Meltem Demirgoz; Dissiz, Melike

2018-03-01

This experimental study was conducted to determine the level of anxiety in women undergoing multiple cesarean section. Sixty multiple cesarean section referrals were randomly assigned to either the experimental or control groups. Data was collected at the Karaman Public Health Hospital in Turkey, from June 2015 to June 2016. Songs chosen earlier by the patients were played during the cesarean section procedure for the experimental group. The control group was studied without music. Data was collected using a questionnaire form, and Visual Analogue Scale (VAS) was used to determine the anxiety levels. The t-test and chi-square test were used to analyse statistically significant differences between the groups. The VAS scores before and during the procedure showed significantly lower scores for the experimental group, compared to the control group (p<0.05). Music therapy reduces the physiological and cognitive responses of anxiety in patients undergoing multiple cesarean section, and can be used in the clinical practice.

Mechanical design of the CDF SVX II silicon vertex detector

International Nuclear Information System (INIS)

Skarha, J.E.

1994-08-01

A next generation silicon vertex detector is planned at CDF for the 1998 Tevatron collider run with the Main Injector. The SVX II silicon vertex detector will allow high luminosity data-taking, enable online triggering of secondary vertex production, and greatly increase the acceptance for heavy flavor physics at CDF. The design specifications, geometric layout, and early mechanical prototyping work for this detector are discussed

A covariant representation of the Ball–Chiu vertex

International Nuclear Information System (INIS)

Ahmadiniaz, Naser; Schubert, Christian

2013-01-01

In nonabelian gauge theory the three-gluon vertex function contains important structural information, in particular on infrared divergences, and is also an essential ingredient in the Schwinger–Dyson equations. Much effort has gone into analyzing its general structure, and at the one-loop level also a number of explicit computations have been done, using various approaches. Here we use the string-inspired formalism to unify the calculations of the scalar, spinor and gluon loop contributions to the one-loop vertex, leading to an extremely compact representation in all cases. The vertex is computed fully off-shell and in dimensionally continued form, so that it can be used as a building block for higher-loop calculations. We find that the Bern–Kosower loop replacement rules, originally derived for the on-shell case, hold off-shell as well. We explain the relation of the structure of this representation to the low-energy effective action, and establish the precise connection with the standard Ball–Chiu decomposition of the vertex. This allows us also to predict that the vanishing of the completely antisymmetric coefficient function S of this decomposition is not a one-loop accident, but persists at higher-loop orders. The sum rule found by Binger and Brodsky, which leads to the vanishing of the one-loop vertex in N=4 SYM theory, in the present approach relates to worldline supersymmetry

A covariant representation of the Ball–Chiu vertex

Energy Technology Data Exchange (ETDEWEB)

Ahmadiniaz, Naser, E-mail: naser@ifm.umich.mx [Instituto de Física y Matemáticas, Universidad Michoacana de San Nicolás de Hidalgo, Edificio C-3, Apdo. Postal 2-82, C.P. 58040, Morelia, Michoacán (Mexico); Dipartimento di Fisica, Università di Bologna and INFN, Sezione di Bologna, Via Irnerio 46, I-40126 Bologna (Italy); Schubert, Christian, E-mail: schubert@ifm.umich.mx [Instituto de Física y Matemáticas, Universidad Michoacana de San Nicolás de Hidalgo, Edificio C-3, Apdo. Postal 2-82, C.P. 58040, Morelia, Michoacán (Mexico); Dipartimento di Fisica, Università di Bologna and INFN, Sezione di Bologna, Via Irnerio 46, I-40126 Bologna (Italy); Max-Planck-Institut für Gravitationsphysik, Albert-Einstein-Institut, Mühlenberg 1, D-14476 Potsdam (Germany)

2013-04-21

In nonabelian gauge theory the three-gluon vertex function contains important structural information, in particular on infrared divergences, and is also an essential ingredient in the Schwinger–Dyson equations. Much effort has gone into analyzing its general structure, and at the one-loop level also a number of explicit computations have been done, using various approaches. Here we use the string-inspired formalism to unify the calculations of the scalar, spinor and gluon loop contributions to the one-loop vertex, leading to an extremely compact representation in all cases. The vertex is computed fully off-shell and in dimensionally continued form, so that it can be used as a building block for higher-loop calculations. We find that the Bern–Kosower loop replacement rules, originally derived for the on-shell case, hold off-shell as well. We explain the relation of the structure of this representation to the low-energy effective action, and establish the precise connection with the standard Ball–Chiu decomposition of the vertex. This allows us also to predict that the vanishing of the completely antisymmetric coefficient function S of this decomposition is not a one-loop accident, but persists at higher-loop orders. The sum rule found by Binger and Brodsky, which leads to the vanishing of the one-loop vertex in N=4 SYM theory, in the present approach relates to worldline supersymmetry.

Performance of the LHCb Vertex Locator

CERN Document Server

Bjørnstad, Pal Marius

2011-01-01

The Vertex Locator is a silicon microstrip detector which provides the LHCb experiment with high precision measurements of tracks and decay vertices. The VELO sensors are exposed to a radiation dose of (2.5-6.5) x 10$^{13}n_{eq}$/cm$^2$ per fb$^{-1}$ in the area which is most irradiated. A best hit resolution of 4$mu$ is obtained for angled tracks, in agreement with expectations. The VELO has a vertex position resolution down to 11$mu$m in the transverse direction and an excellent momentum dependent performance.

Improving vertex position determination by using a kinematic fit

International Nuclear Information System (INIS)

Forden, G.E.; Saxon, D.H.

1985-05-01

A method is developed for improving decay vertex reconstruction by using kinematic fits. This is applied to generated charm meson decays. An improvement of 16% in the vertex position measurement along the flight path is achieved. (author)

The scalar-photon 3-point vertex in massless quenched scalar QED

International Nuclear Information System (INIS)

Concha-Sánchez, Y; Gutiérrez-Guerrero, L X; Fernández-Rangel, L A

2016-01-01

Non perturbative studies of Schwinger-Dyson equations (SDEs) require their infinite, coupled tower to be truncated in order to reduce them to a practically solvable set. In this connection, a physically acceptable ansatz for the three point vertex is the most favorite choice. Scalar quantum electrodynamics (sQED) provides a simple and neat platform to address this problem. The most general form of the scalar-photon three point vertex can be expressed in terms of only two independent form factors, longitudinal and transverse. Ball and Chiu have demonstrated that the longitudinal vertex is fixed by requiring the Ward-Fradkin-Green- Takahashi identity (WFGTI), while the transverse vertex remains undetermined. In massless quenched sQED, we propose the transverse part of the non perturbative scalar-photon vertex. (paper)

Cesarean section imprints cord blood immune cell distributions

DEFF Research Database (Denmark)

Thysen, Anna Hammerich; Larsen, Jeppe Madura; Rasmussen, Mette Annelie

2014-01-01

Immune programming in early life may affect the risk of developing immune-related diseases later in life. Children born by cesarean section seem to be at higher risk of asthma, allergic rhinitis, and type-1 diabetes. We hypothesized that delivery by cesarean section may affect immune maturation i...

Subgraphs in vertex neighborhoods of K-free graphs

DEFF Research Database (Denmark)

Bang-Jensen, J.; Brandt, Stephan

2004-01-01

In a K-free graph, the neighborhood of every vertex induces a K-free subgraph. The K-free graphs with the converse property that every induced K-free subgraph is contained in the neighborhood of a vertex are characterized, based on the characterization in the case r = 3 due to Pach [8]....

Vaginal preparation with antiseptic solution before cesarean section for preventing postoperative infections.

Science.gov (United States)

Haas, David M; Morgan, Sarah; Contreras, Karenrose

2014-09-09

Cesarean delivery is one of the most common surgical procedures performed by obstetricians. Infectious morbidity after cesarean delivery can have a tremendous impact on the postpartum woman's return to normal function and her ability to care for her baby. Despite the widespread use of prophylactic antibiotics, postoperative infectious morbidity still complicates cesarean deliveries. To determine if cleansing the vagina with an antiseptic solution before a cesarean delivery decreases the risk of maternal infectious morbidities, including endometritis and wound complications. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (21 July 2014). We included randomized and quasi-randomized trials assessing the impact of vaginal cleansing immediately before cesarean delivery with any type of antiseptic solution versus a placebo solution/standard of care on post-cesarean infectious morbidity. We independently assessed eligibility and quality of the studies. Five trials randomizing 1946 women (1766 analyzed) evaluated the effects of vaginal cleansing (all with povidone-iodine) on post-cesarean infectious morbidity. The risk of bias was generally low, with the quality of most of the studies being high. Vaginal preparation immediately before cesarean delivery significantly reduced the incidence of post-cesarean endometritis from 7.2% in control groups to 3.6% in vaginal cleansing groups (average risk ratio (RR) 0.39, 95% confidence interval (CI) 0.16 to 0.97, five trials, 1766 women). The risk reduction was particularly strong for women with ruptured membranes (1.4% in the vaginal cleansing group versus 15.4% in the control group; RR 0.13, 95% CI 0.02 to 0.66, two trials, 148 women). No other outcomes realized statistically significant differences between the vaginal cleansing and control groups. No adverse effects were reported with the povidone-iodine vaginal cleansing.The quality of the evidence using GRADE was low for post-cesarean endometritis

Breech at term--mode of delivery? A register-based study

DEFF Research Database (Denmark)

Krebs, L; Langhoff-Roos, J; Weber, Tom

1995-01-01

. Register-based cohort study of all (n = 15718) singleton term breech deliveries of non-malformed infants in Denmark 1982-1990. Process and outcome measures: mode of delivery, gestational age, birth weight, congenital malformations, intrapartum death, Apgar scores and early neonatal death. RESULTS. A total...... of 3247 (20.7%) term infants were delivered vaginally, 7106 (45.3%) by elective and 5356 (34.1%) by emergency cesarean section. Infants delivered vaginally and by emergency cesarean section had significantly higher rates of mortality (intrapartum and early neonatal death) and morbidity (low Apgar scores......) when compared to those delivered by elective cesarean section. In vaginal deliveries, parity was not correlated with outcome, but infants with a birth weight above 4000 grams had significantly higher rates of low Apgar scores. CONCLUSIONS. Register data on singleton term breech deliveries imply...

Youssef’s Syndrome following Cesarean Section

Directory of Open Access Journals (Sweden)

Ozer Birge

2015-01-01

Full Text Available Youssef’s syndrome is characterized by cyclic hematuria (menouria, absence of vaginal bleeding (amenorrhea, and urinary incontinence due to vesicouterine fistula (VUF, the least common of the urogynecological fistulas. Youssef’s syndrome has a variable clinical presentation. A vesicouterine fistula is an abnormal pathway between the bladder and the uterus. The most common cause is lower segment Cesarean section. Conservative treatment may be appropriate in some cases, but surgery is the definitive treatment. Vesicouterine fistula should be suspected in cases presenting with urinary incontinence even years after Cesarean section. Diagnostic tests as well as necessary appropriate surgery should be performed on cases with suspected vesicouterine fistula. We present a 40-year-old multiparous woman with vesicouterine fistula after primary Cesarean section; she presented with urinary incontinence, hematuria, and amenorrhea 1 year after the birth. Here, we discuss our case with the help of previously published studies found in the literature.

A new method for computing the quark-gluon vertex

International Nuclear Information System (INIS)

Aguilar, A C

2015-01-01

In this talk we present a new method for determining the nonperturbative quark-gluon vertex, which constitutes a crucial ingredient for a variety of theoretical and phenomenological studies. This new method relies heavily on the exact all-order relation connecting the conventional quark-gluon vertex with the corresponding vertex of the background field method, which is Abelian-like. The longitudinal part of this latter quantity is fixed using the standard gauge technique, whereas the transverse is estimated with the help of the so-called transverse Ward identities. This method allows the approximate determination of the nonperturbative behavior of all twelve form factors comprising the quark-gluon vertex, for arbitrary values of the momenta. Numerical results are presented for the form factors in three special kinematical configurations (soft gluon and quark symmetric limit, zero quark momentum), and compared with the corresponding lattice data. (paper)

Numerical indications on the semiclassical limit of the flipped vertex

Energy Technology Data Exchange (ETDEWEB)

Magliaro, Elena; Perini, Claudio; Rovelli, Carlo [Centre de Physique Theorique de Luminy , Case 907, F-13288 Marseille (France)

2008-05-07

We introduce a technique for testing the semiclassical limit of a quantum gravity vertex amplitude. The technique is based on the propagation of a semiclassical wave packet. We apply this technique to the newly introduced 'flipped' vertex in loop quantum gravity, in order to test the intertwiner dependence of the vertex. Under some drastic simplifications, we find very preliminary, but surprisingly good numerical evidence for the correct classical limit.

A note on arbitrarily vertex decomposable graphs

Directory of Open Access Journals (Sweden)

Antoni Marczyk

2006-01-01

Full Text Available A graph \\(G\\ of order \\(n\\ is said to be arbitrarily vertex decomposable if for each sequence \\((n_{1},\\ldots,n_k\\ of positive integers such that \\(n_{1}+\\ldots+n_{k}=n\\ there exists a partition \\((V_{1},\\ldots,V_{k}\\ of the vertex set of \\(G\\ such that for each \\(i \\in \\{1,\\ldots,k\\}\\, \\(V_{i}\\ induces a connected subgraph of \\(G\\ on \\(n_i\\ vertices. In this paper we show that if \\(G\\ is a two-connected graph on \\(n\\ vertices with the independence number at most \\(\\lceil n/2\\rceil\\ and such that the degree sum of any pair of non-adjacent vertices is at least \\(n-3\\, then \\(G\\ is arbitrarily vertex decomposable. We present another result for connected graphs satisfying a similar condition, where the bound \\(n-3\\ is replaced by \\(n-2\\.

Performance-Optimization Studies for the CLIC Vertex Detector

CERN Document Server

AUTHOR|(CDS)2085406; Roloff, Philipp

The Compact Linear Collider (CLIC) is a mutli-TeV linear e+e- collider currently under development at CERN. In the post-LHC era, CLIC will allow to explore a great number of searches for New Physics such as the precise measurements of the Higgs boson. In this master thesis, we mainly focus on the development and the improvement of the vertex detector. The vertex detector requires excellent spatial resolution, low mass, geometrical coverage down to low polar angles, high rate readout for the sensors and new cooling technologies for heat removal. Considering such requirements, the CLIC vertex detector technology is far more advanced in comparison to the technologies currently used in particle physics. This project consists of two main parts. In the first part, we study the vertex detector and optimize its geometry for the use of airflow cooling techniques and also for flavor tagging. In the second part, we implement a decoder which can respect the timing constraints for the CLICpix chip, a silicon pixel detect...

Measurement of Rb Using a Vertex Mass Tag

International Nuclear Information System (INIS)

Steiner, R.; Benvenuti, A.C.; Coller, J.A.; Hedges, S.J.; Johnson, A.S.; Shank, J.T.; Whitaker, J.S.; Allen, N.J.; Cotton, R.; Dervan, P.J.; Hasan, A.; McKemey, A.K.; Watts, S.J.; Caldwell, D.O.; Lu, A.; Yellin, S.J.; Cavalli-Sforza, M.; Coyne, D.G.; Fernandez, J.P.; Liu, X.; Reinertsen, P.L.; Schalk, T.; Schumm, B.A.; DOliveira, A.; Johnson, R.A.; Meadows, B.T.; Nussbaum, M.; Dima, M.; Harton, J.L.; Smy, M.B.; Staengle, H.; Wilson, R.J.; Baranko, G.; Fahey, S.; Fan, C.; Krishna, N.M.; Lauber, J.A.; Nauenberg, U.; Wagner, D.L.; Bazarko, A.O.; Bolton, T.; Rowson, P.C.; Shaevitz, M.H.; Camanzi, B.; Mazzucato, E.; Piemontese, L.; Calcaterra, A.; De Sangro, R.; Peruzzi, I.; Piccolo, M.; Eisenstein, B.I.; Gladding, G.; Karliner, I.; Shapiro, G.; Steiner, H.; Bardon, O.; Burrows, P.N.; Busza, W.; Cowan, R.F.; Dong, D.N.; Fero, M.J.; Gonzalez, S.; Kendall, H.W.; Lath, A.; Lia, V.; Osborne, L.S.; Quigley, J.; Taylor, F.E.; Torrence, E.; Verdier, R.; Williams, D.C.

1998-01-01

We report a new measurement of R b =Γ Z 0 →bbar b /Γ Z 0 →hadrons using a double tag technique, where the b hemisphere selection is based on the reconstructed mass of the B hadron decay vertex. The measurement was performed using a sample of 130x10 3 hadronic Z 0 events, collected with the SLD detector at SLC. The method utilizes the 3D vertexing abilities of the CCD pixel vertex detector and the small stable SLC beams to obtain a high b -tagging efficiency and purity. We obtain R b =0.2142±0.0034(stat) ±0.0015(syst)±0.0002( R c ) . copyright 1998 The American Physical Society

Flipped spinfoam vertex and loop gravity

Energy Technology Data Exchange (ETDEWEB)

Engle, Jonathan; Pereira, Roberto [CPT, CNRS Case 907, Universite de la Mediterranee, F-13288 Marseille (France); Rovelli, Carlo [CPT, CNRS Case 907, Universite de la Mediterranee, F-13288 Marseille (France)], E-mail: rovelli@cpt.univ-mrs.fr

2008-07-21

We introduce a vertex amplitude for 4d loop quantum gravity. We derive it from a conventional quantization of a Regge discretization of euclidean general relativity. This yields a spinfoam sum that corrects some difficulties of the Barrett-Crane theory. The second class simplicity constraints are imposed weakly, and not strongly as in Barrett-Crane theory. Thanks to a flip in the quantum algebra, the boundary states turn out to match those of SO(3) loop quantum gravity-the two can be identified as eigenstates of the same physical quantities-providing a solution to the problem of connecting the covariant SO(4) spinfoam formalism with the canonical SO(3) spin-network one. The vertex amplitude is SO(3) and SO(4)-covariant. It rectifies the triviality of the intertwiner dependence of the Barrett-Crane vertex, which is responsible for its failure to yield the correct propagator tensorial structure. The construction provides also an independent derivation of the kinematics of loop quantum gravity and of the result that geometry is quantized.

Effects of epidural lidocaine analgesia on labor and delivery: A randomized, prospective, controlled trial

Directory of Open Access Journals (Sweden)

Nafisi Shahram

2006-12-01

Full Text Available Abstract Background Whether epidural analgesia for labor prolongs the active-first and second labor stages and increases the risk of vacuum-assisted delivery is a controversial topic. Our study was conducted to answer the question: does lumbar epidural analgesia with lidocaine affect the progress of labor in our obstetric population? Method 395 healthy, nulliparous women, at term, presented in spontaneous labor with a singleton vertex presentation. These patients were randomized to receive analgesia either, epidural with bolus doses of 1% lidocaine or intravenous, with meperidine 25 to 50 mg when their cervix was dilated to 4 centimeters. The duration of the active-first and second stages of labor and the neonatal apgar scores were recorded, in each patient. The total number of vacuum-assisted and cesarean deliveries were also measured. Results 197 women were randomized to the epidural group. 198 women were randomized to the single-dose intravenous meperidine group. There was no statistical difference in rates of vacuum-assisted delivery rate. Cesarean deliveries, as a consequence of fetal bradycardia or dystocia, did not differ significantly between the groups. Differences in the duration of the active-first and the second stages of labor were not statistically significant. The number of newborns with 1-min and 5-min Apgar scores less than 7, did not differ significantly between both analgesia groups. Conclusion Epidural analgesia with 1% lidocaine does not prolong the active-first and second stages of labor and does not increase vacuum-assisted or cesarean delivery rate.

State variation in rates of cesarean and VBAC delivery: 1989 and 1993.

Science.gov (United States)

Clarke, S C; Taffel, S M

1996-01-01

There is wide variation among states in rates of cesarean and vaginal births after cesarean (VBAC) deliveries. In general, states in the South have the highest cesarean rates, states in the West have the lowest, and states in the Northeast and Midwest are intermediate. Louisiana had the highest overall rate in 1993 (27.7 per 100 births) while Alaska had the lowest rate (15.2). The majority of states had declines in their cesarean rate between 1989 and 1993. Patterns in primary cesarean rates are similar to those of the overall rate-states in the South generally have the highest rates while states in the West have the lowest rates. Primary cesarean rates ranged between a high of 19.6 in Louisiana to a low of 10.6 in Wisconsin. In general, states with low cesarean rates have among the highest rates of VBAC delivery. Alaska had the highest VBAC rate (40.0), which was almost quadruple the rate of Louisiana (11.2), the state with the lowest rate. Most states had substantial increases in VBAC rates between 1989 and 1993. When examining cesarean rates by maternal age and birth order, states with the highest overall rates also have among the highest age/birth order-specific rates. Cesarean rates were lowest for mothers under 25 years of age having a second or higher order birth in Alaska, 10.4, and highest for mothers 35 years of age or over having a first birth in Mississippi, 51.3. Standardized cesarean rates which were adjusted for differences between states in maternal age and birth order distributions did not diminish the variation among areas.

Physical examination-indicated cerclage in singleton and twin pregnancies: maternal-fetal outcomes.

Science.gov (United States)

Bernabeu, Andrea; Goya, Maria; Martra, Miquel; Suy, Anna; Pratcorona, Laia; Merced, Carme; Llurba, Elisa; Casellas, Manel; Carreras, Elena; Cabero, Luis

2016-01-01

To study maternal and perinatal outcomes after physical examination-indicated cerclage in both singleton and twin pregnancies and evaluate the possible risk factors associated. Retrospective review of all women undergoing physical examination-indicated cerclage at the Hospital Vall d'Hebro, Barcelona from January 2009 to December 2012 after being diagnosed with cervical incompetence and risk of premature birth. During the study period, 60 cases of women diagnosed with cervical incompetence who were carrying live and morphologically-normal fetuses (53 singleton and 7 twin pregnancies), and who had an imminent risk of premature birth were evaluated. Mean gestational age until birth was 35 weeks in singleton and 32 weeks in twin pregnancies. Four cases (7.5%) of immature births and one case (2.0%) of neonatal death were recorded in singleton pregnancies. No cases of immature births or neonatal deaths were recorded in twin pregnancies. Diagnostic amniocentesis was performed IN all cases to rule out possible chorioamnionitis. Physical examination-indicated cerclage for cervical incompetence in women at risk for immature or preterm birth demonstrates good perinatal prognosis without increasing maternal morbidity in either singleton or twin pregnancies. The increase in gestation time in our study may also have been due to the fact that patients with subclinical chorioamnionitis were excluded by diagnostic amniocentesis.

Value of computed tomography pelvimetry in patients with a previous cesarean section

International Nuclear Information System (INIS)

Yamani, Tarik Y.; Rouzi, Abdulrahim A.

1998-01-01

A case-control study was conducted at the Department of Obstetrics and Gynaecology, King Abdulaziz University Hospital, Jeddah, Saudi Arabia to determine the value of computed tomography pelivimetry in patients with a previous cesarean section. Between January 1993 and December 1995, 219 pregnant women with one previous cesarean had antenatal CT pelvimetry for assessment of the pelvis. One hundred and nineteen women did not have CT pelvimetry and served as control. Fifty-one women (51%) in the CT pelvimetry group were delivered by cesarean section. Twenty-three women (23%) underwent elective cesarean section for contracted pelvis based upon the findings of CT pelvimetry and 28 women (28%) underwent emergency cesarean section after trial of labor. In the group who did not have CT pelvimetry, 26 women (21.8%) underwent emergency cesarean section. This was a statistically significant difference (P=0.02). There were no statistically significant differences in birthweight and Apgar scores either group. There was no prenatal or maternal mortality in this study. Computed tomography pelvimetry increased the rate of cesarean delivery without any benefit in the immediate delivery outcomes. Therefore, the practice of documenting the adequacy of the pelvis by CT pelvimetry before vaginal birth after cesarean should be abandoned. (author)

Obstetrician perceptions of the causes of high cesarean delivery rates in Turkey.

Science.gov (United States)

Küçük, Mert

2017-07-01

To assess obstetricians' perceptions surrounding cesarean delivery rates in Turkey. The present cross-sectional descriptive study was performed between May 1 and June 30, 2016. Practicing obstetricians with contact details known by the researchers and those attending a conference in Turkey were asked to complete a self-administered questionnaire that collected demographic data and information on participants' opinions, beliefs, knowledge, attitudes, and practices related to cesarean delivery. There were 100 obstetricians who responded to the survey. Awareness of high cesarean delivery rates was reported by 96 (96%) participants and 95 (95%) respondents said they were supportive of efforts to reduce it. There were 60 (60%), 83 (83%), and 100 (100%) participants aware of associations between high cesarean delivery rates and increased maternal and infant mortality; increased risk of uterine rupture; and increased risk of placenta previa, placenta accreta, and emergency cesarean hysterectomy, respectively. The most commonly reported reason for high cesarean delivery rates was high compensation costs during medical litigation legal proceedings, reported by all 100 (100%) participants. Participants were generally aware of the risks associated with high cesarean delivery rates. The results suggest that the greatest concern among obstetricians who perform cesarean deliveries was malpractice litigation. © 2017 International Federation of Gynecology and Obstetrics.

Cesarean section trends in the Nordic Countries - a comparative analysis with the Robson classification.

Science.gov (United States)

Pyykönen, Aura; Gissler, Mika; Løkkegaard, Ellen; Bergholt, Thomas; Rasmussen, Steen C; Smárason, Alexander; Bjarnadóttir, Ragnheiður I; Másdóttir, Birna B; Källén, Karin; Klungsoyr, Kari; Albrechtsen, Susanne; Skjeldestad, Finn E; Tapper, Anna-Maija

2017-05-01

The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. Retrospective population-based registry study including all deliveries (3 398 586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four 3-year time periods. For each country, we analyzed which groups contributed to the change in the total cesarean rate. Between the first and the last time period studied, the total cesarean rates increased in Denmark (16.4 to 20.7%), Norway (14.4 to 16.5%) and Sweden (15.5 to 17.1%), but towards the end of our study, the cesarean rates stabilized or even decreased. The increase was explained mainly by increases in the absolute contribution from R5 (women with previous cesarean) and R2a (induced labor on nulliparous). In Finland, the cesarean rate decreased slightly (16.5 to 16.2%) mainly due to decrease among R5 and R6-R7 (breech presentation, nulliparous/multiparous). In Iceland, the cesarean rate decreased in all parturient groups (17.6 to 15.3%), most essentially among nulliparous women despite the increased induction rates. The increased total cesarean rates in the Nordic countries are explained by increased cesarean rates among nulliparous women, and by an increased percentage of women with previous cesarean. Meanwhile, induction rates on nulliparous increased significantly, but the impact on the total cesarean rate was unclear. The Robson classification facilitates benchmarking and targeting efforts for lowering the cesarean rates. © 2017 Nordic Federation of Societies of Obstetrics and Gynecology.

Cesarean section among immigrants in Norway.

Science.gov (United States)

Vangen, S; Stoltenberg, C; Skrondal, A; Magnus, P; Stray-Pedersen, B

2000-07-01

We studied prevalences and risk factors for cesarean section among different groups of immigrants from countries outside Western Europe and North America in comparison to ethnic Norwegians. The study is population based using data from the Medical Birth Registry of Norway. A total of 553,491 live births during the period 1986-1995 were studied, including 17,891 births to immigrant mothers. The prevalences of cesarean section ranged from 10.1% among women from Vietnam to 25.8% in the group of Filipino origin. The use of abdominal delivery was also high in the groups from Sri Lanka/India (21.3%), Somalia/Eritrea/Ethiopia (20.5%) and Chile/Brazil (24.3%), while the frequency among women from Turkey/Morocco (12.6%) and Pakistan (13.2%) was approximately the same as among ethnic Norwegians (12.4%). Feto-pelvic disproportion, fetal distress and prolonged labor were the most important diagnoses associated with the high prevalences, but the significance of these diagnoses differed among the groups. Other unknown factors come into play, particularly among women from Somalia/Eritrea/Ethiopia and Chile/Brazil. There was substantial variation in the use of cesarean section among ethnic groups in Norway. The diagnoses feto-pelvic disproportion, fetal distress and prolonged labor may be confounded by a number of factors including maternal request for cesarean section and difficulties in handling the delivery. Further research is needed to explain the observed differences.

The NA50 segmented target and vertex recognition system

International Nuclear Information System (INIS)

Bellaiche, F.; Cheynis, B.; Contardo, D.; Drapier, O.; Grossiord, J.Y.; Guichard, A.; Haroutunian, R.; Jacquin, M.; Ohlsson-Malek, F.; Pizzi, J.R.

1997-01-01

The NA50 segmented target and vertex recognition system is described. The segmented target consists of 7 sub-targets of 1-2 mm thickness. The vertex recognition system used to determine the sub-target where an interaction has occured is based upon quartz elements which produce Cerenkov light when traversed by charged particles from the interaction. The geometrical arrangement of the quartz elements has been optimized for vertex recognition in 208 Pb-Pb collisions at 158 GeV/nucleon. A simple algorithm provides a vertex recognition efficiency of better than 85% for dimuon trigger events collected with a 1 mm sub-target set-up. A method for recognizing interactions of projectile fragments (nuclei and/or groups of nucleons) is presented. The segmented target allows a large target thickness which together with a high beam intensity (∼10 7 ions/s) enables high statistics measurements. (orig.)

Matched cohort study of external cephalic version in women with previous cesarean delivery.

Science.gov (United States)

Keepanasseril, Anish; Anand, Keerthana; Soundara Raghavan, Subrahmanian

2017-07-01

To evaluate the efficacy and safety of external cephalic version (ECV) among women with previous cesarean delivery. A retrospective study was conducted using data for women with previous cesarean delivery and breech presentation who underwent ECV at or after 36 weeks of pregnancy during 2011-2016. For every case, two multiparous women without previous cesarean delivery who underwent ECV and were matched for age and pregnancy duration were included. Characteristics and outcomes were compared between groups. ECV was successful for 32 (84.2%) of 38 women with previous cesarean delivery and 62 (81.6%) in the control group (P=0.728). Multivariate regression analysis confirmed that previous cesarean was not associated with ECV success (odds ratio 1.89, 95% confidence interval 0.19-18.47; P=0.244). Successful vaginal delivery after successful ECV was reported for 19 (59.4%) women in the previous cesarean delivery group and 52 (83.9%) in the control group (P<0.001). No ECV-associated complications occurred in women with previous cesarean delivery. To avoid a repeat cesarean delivery, ECV can be offered to women with breech presentation and previous cesarean delivery who are otherwise eligible for a trial of labor. © 2017 International Federation of Gynecology and Obstetrics.

Elective induction of labor at 39 weeks among nulliparous women: The impact on maternal and neonatal risk.

Science.gov (United States)

Sinkey, Rachel G; Lacevic, Jasmin; Reljic, Tea; Hozo, Iztok; Gibson, Kelly S; Odibo, Anthony O; Djulbegovic, Benjamin; Lockwood, Charles J

2018-01-01

Optimal management of pregnancies at 39 weeks gestational age is unknown. Therefore, we sought to perform a comparative effectiveness analysis of elective induction of labor (eIOL) at 39 weeks among nulliparous women with non-anomalous singleton, vertex fetuses as compared to expectant management (EM) which included IOL for medical or obstetric indications or at 41 weeks in undelivered mothers. A Monte Carlo micro-simulation model was constructed modeling two mutually exclusive health states: eIOL at 39 weeks, or EM with IOL for standard medical or obstetrical indications or at 41 weeks if undelivered. Health state distribution probabilities included maternal and perinatal outcomes and were informed by a review of the literature and data derived from the Consortium of Safe Labor. Analyses investigating preferences for maternal versus infant health were performed using weighted utilities. Primary outcome was determining which management strategy posed less maternal and neonatal risk. Secondary outcomes were rates of cesarean deliveries, maternal morbidity and mortality, stillbirth, neonatal morbidity and mortality, and preferences regarding the importance of maternal and perinatal health. A management strategy of eIOL at 39 weeks resulted in less maternal and neonatal risk as compared to EM with IOL at 41 weeks among undelivered patients. Cesarean section rates were higher in the EM arm (35.9% versus 13.9%, p39 week eIOL still resulted in fewer cesarean deliveries as compared to EM (8.0% versus 26.1%, p39 week eIOL was favored over EM. Mathematical modeling revealed that eIOL at 39 weeks resulted in lower population risks as compared to EM with induction of labor at 41 weeks. Specifically, eIOL at 39 weeks resulted in a lower cesarean section rate, lower rates of maternal morbidity, fewer stillbirths and neonatal deaths, and lower rates of neonatal morbidity.

Term Elective Induction of Labor and Perinatal Outcomes in Obese Women: Retrospective Cohort Study

Science.gov (United States)

Lee, Vanessa R.; Darney, Blair G.; Snowden, Jonathan M.; Main, Elliott K.; Gilbert, William; Chung, Judith; Caughey, Aaron B.

2015-01-01

Objective To compare perinatal outcomes between elective induction of labor (eIOL) and expectant management in obese women. Design Retrospective cohort study. Setting Deliveries in California in 2007. Population Term, singleton, vertex, nonanomalous deliveries among obese women (n=74,725). Methods Women who underwent eIOL at 37 weeks were compared with women who were expectantly managed at that gestational age. Similar comparisons were made at 38, 39, and 40 weeks. Results were stratified by parity. Chi-square tests and multivariable logistic regression were used for statistical comparison. Main Outcome Measures Method of delivery, severe perineal lacerations, postpartum hemorrhage, chorioamnionitis, macrosomia, shoulder dystocia, brachial plexus injury, respiratory distress syndrome. Results The odds of cesarean delivery were lower among nulliparous women with eIOL at 37 weeks (odds ratio [OR] 0.55, 95% confidence interval [CI] 0.34–0.90) and 39 weeks (OR 0.77, 95% CI 0.63–0.95) compared to expectant management. Among multiparous women with a prior vaginal delivery, eIOL at 37 (OR 0.39, 95% CI 0.24–0.64), 38 (OR 0.65, 95% CI 0.51–0.82), and 39 weeks (OR 0.67, 95% CI 0.56–0.81) was associated with lower odds of cesarean. Additionally, eIOL at 38, 39, and 40 weeks was associated with lower odds of macrosomia. There were no differences in the odds of operative vaginal delivery, lacerations, brachial plexus injury, or respiratory distress syndrome. Conclusions In obese women, term eIOL may decrease the risk of cesarean delivery, particularly in multiparas, without increasing the risks of other adverse outcomes when compared with expectant management. Tweetable Abstract Elective induction of labor in obese women does not increase risk of cesarean or other perinatal morbidities. PMID:26840780

Impact of clinical audits on cesarean section rate.

Science.gov (United States)

Peng, Fu-Shiang; Lin, Hsien-Ming; Lin, Ho-Hsiung; Tu, Fung-Chao; Hsiao, Chin-Fen; Hsiao, Sheng-Mou

2016-08-01

Many countries have noted a substantial increase in the cesarean section rate (CSR). Several methods for lowering the CSR have been described. Understanding the impact of clinical audits on the CSR may aid in lowering CSR. Thus, our aim is to elucidate the effect of clinical audits on the CSR. We retrospectively analyzed 3781 pregnant women who gave birth in a medical center between January 2008 and January 2011. Pregnant women who delivered between January 2008 and July 2009 were enrolled as the pre-audit group (n = 1592). After August 2009, all cesarean section cases that were audited were enrolled in the audit group (n = 2189). The CSR was compared between groups. The overall CSR (34.5% vs. 31.1%, adjusted odds ratio [OR] = 0.83, p = 0.008) and the cesarean section rate due to dystocia (9.6% vs. 6.2%, p strategy for reducing the CSR. Therefore, we recommend strict monitoring of the indications in dystocia for cesarean section to reduce the CSR. Copyright © 2016. Published by Elsevier B.V.

Cesarean section changes neonatal gut colonization

DEFF Research Database (Denmark)

Stokholm, Jakob; Thorsen, Jonathan; Chawes, Bo L

2016-01-01

BACKGROUND: Delivery by means of cesarean section has been associated with increased risk of childhood immune-mediated diseases, suggesting a role of early bacterial colonization patterns for immune maturation. OBJECTIVE: We sought to describe the influence of delivery method on gut and airway......-driven partial least squares analyses. The initial airway microbiota was unaffected by birth method. CONCLUSION: Delivery by means of cesarean section was associated with early colonization patterns of the neonatal gut but not of the airways. The differences normalized within the first year of life. We speculate...

Quantum vertex model for reversible classical computing.

Science.gov (United States)

Chamon, C; Mucciolo, E R; Ruckenstein, A E; Yang, Z-C

2017-05-12

Mappings of classical computation onto statistical mechanics models have led to remarkable successes in addressing some complex computational problems. However, such mappings display thermodynamic phase transitions that may prevent reaching solution even for easy problems known to be solvable in polynomial time. Here we map universal reversible classical computations onto a planar vertex model that exhibits no bulk classical thermodynamic phase transition, independent of the computational circuit. Within our approach the solution of the computation is encoded in the ground state of the vertex model and its complexity is reflected in the dynamics of the relaxation of the system to its ground state. We use thermal annealing with and without 'learning' to explore typical computational problems. We also construct a mapping of the vertex model into the Chimera architecture of the D-Wave machine, initiating an approach to reversible classical computation based on state-of-the-art implementations of quantum annealing.

Multipole expansion of vertex functions with two final particles

International Nuclear Information System (INIS)

Daumens, Michel

1977-01-01

The expansions of the usual vertex functions are generalized to the vertex functions with two final particles. For four vector functions, expressions are similar to those of Chew, Goldberger, Low and Nambu, and of Adler and the consequences of the isobaric model are studied [fr

Fermionic construction of vertex operators for twisted affine algebras

International Nuclear Information System (INIS)

Frappat, L.; Sorba, P.; Sciarrino, A.

1988-03-01

We construct vertex operator representations of the twisted affine algebras in terms of fermionic (or parafermionic in some cases) elementary fields. The folding method applied to the extended Dynkin diagrams of the affine algebras allows us to determine explicitly these fermionic fields as vertex operators

Tracking and vertexing for B physics at hadron accelerators

International Nuclear Information System (INIS)

Johnson, R.; Purohit, M.; Weidemann, A.W.

1993-01-01

In this note, the authors report on some of the activities of the Tracking and Vertexing Working Group of this Workshop. Track and vertex finding is essential to exploit the high production rate of B-mesons at hadron accelerators, both for triggering and analysis. Here, they review the tracking and vertex-finding systems of some of the major existing and proposed collider and fixed-target experiments at existing and future hadron accelerators, with a view towards their usefulness for B-physics. The capabilities of both general-purpose detectors and those of dedicated B-physics experiments are considered

Cesarean Delivery Changes the Natural Position of the Uterus on Transvaginal Ultrasonography.

Science.gov (United States)

Kaelin Agten, Andrea; Honart, Anne; Monteagudo, Ana; McClelland, Spencer; Basher, Basmy; Timor-Tritsch, Ilan E

2018-05-01

To assess whether cesarean delivery changes the natural position of the uterus. In this retrospective Institutional Review Board-approved cohort study, we conducted a search of our university gynecologic ultrasonography (US) database. Patients with transvaginal US images before and after either vaginal or cesarean delivery between 2012 and 2015 were included. Women with prior cesarean delivery were excluded. Two readers independently measured antepartum and postpartum flexion angles between the longitudinal axis of the uterine body and the cervix. We calculated intraclass correlation coefficients to measure inter-reader agreement. Antepartum and postpartum uterine flexion angles were compared between patients with vaginal and cesarean delivery. We included 173 patients (107 vaginal and 66 cesarean delivery). The mean interval between scans ± SD was 18 ± 10 months. Inter-reader agreement for flexion angles was almost perfect (intraclass correlation coefficients: antepartum, 0.939; postpartum, 0.969; both P cesarean delivery (154.8° ± 45.7°) versus vaginal delivery (145.8° ± 43.7°; P = .216). Mean postpartum flexion angles were higher after cesarean delivery (180.4° ± 51.2°) versus vaginal delivery (152.8° ± 47.7°; P = .001. Differences in antepartum and postpartum flexion angles between cesarean and vaginal delivery were statistically significant (25.6° versus 7.0°; P = .027). Cesarean delivery can change the uterine flexion angle to a more retroflexed position. Therefore, all women with a history of cesarean delivery should undergo a transvaginal US examination before any gynecologic surgery or intrauterine device placement to reduce the possibility of surgical complications. © 2017 by the American Institute of Ultrasound in Medicine.

The quintic interaction vertex in light-cone gravity

International Nuclear Information System (INIS)

Ananth, Sudarshan

2008-01-01

We consider pure gravity in light-cone gauge and derive the complete quintic interaction vertex. Up to quartic order, the Kawai-Lewellen-Tye (KLT) relations can be made manifest at the level of the Einstein-Hilbert Lagrangian. The quintic interaction vertex represents an essential first step in further extending the off-shell validity of the KLT relations to higher order vertices

Cesarean Delivery for a Life‑threatening Preterm Placental Abruption

African Journals Online (AJOL)

Following a failed induction of labor with a deteriorating maternal condition despite resuscitation, emergency cesarean delivery was offered with good maternal outcome. Cesarean delivery could avert further disease progression and possible maternal death in cases of severe preterm placental abruption where vaginal ...

Track and vertex reconstruction in the ATLAS experiment

International Nuclear Information System (INIS)

Lacuesta, V

2013-01-01

The track and vertex reconstruction algorithms of the ATLAS Inner Detector have demonstrated excellent performance in the early data from the LHC. However, the rapidly increasing number of interactions per bunch crossing introduces new challenges both in computational aspects and physics performance. The combination of both silicon and gas based detectors provides high precision impact parameter and momentum measurement of charged particles, with high efficiency and small fake rate. Vertex reconstruction is used to identify with high efficiency the hard scattering process and to measure the amount of pile-up interactions, both aspects are crucial for many physics analyses. The performance of track and vertex reconstruction efficiency and resolution achieved in the 2011 and 2012 data-taking period are presented.

Track and Vertex Reconstruction in the ATLAS Experiment

CERN Document Server

Lacuesta, V; The ATLAS collaboration

2012-01-01

The track and vertex reconstruction algorithms of the ATLAS Inner Detector have demonstrated excellent performance in the early data from the LHC. However, the rapidly increas- ing number of interactions per bunch crossing introduces new challenges both in computational aspects and physics performance. The combination of both silicon and gas based detectors provides high precision impact parameter and momentum measurement of charged particles, with high efficiency and small fake rate. Vertex reconstruction is used to identify with high efficiency the hard scattering process and to measure the amount of pile-up interactions, both aspects are cru- cial for many physics analyses. The performance of track and vertex reconstruction efficiency and resolution achieved in the 2011 and 2012 data-taking period are presented.

Track and Vertex Reconstruction in the ATLAS Experiment

CERN Document Server

Lacuesta, V; The ATLAS collaboration

2012-01-01

The track and vertex reconstruction algorithms of the ATLAS Inner Detector have demonstrated excellent performance in the early data from the LHC. However, the rapidly increas- ing number of interactions per bunch crossing introduces new challenges both in computational aspects and physics performance. The combination of both silicon and gas based detectors pro- vides high precision impact parameter and momentum measurement of charged particles, with high efficiency and small fake rate. Vertex reconstruction is used to identify with high efficiency the hard scattering process and to measure the amount of pile-up interactions, both aspects are cru- cial for many physics analyses. The performance of track and vertex reconstruction efficiency and resolution achieved in the 2011 and 2012 data-taking period are presented.

Cesarean scar pregnancy treated by curettage and aspiration guided by laparoscopy

Directory of Open Access Journals (Sweden)

Shu S

2015-08-01

Full Text Available Shan-rong Shu, Xin Luo, Zhi-xin Wang, Yu-hong Yao Department of Obstetrics and Gynecology, The First Affiliated Hospital of JiNan University, HuangPu Road West, Guangzhou, People’s Republic of China Abstract: Pregnancy in a cesarean scar is the rarest form of an ectopic pregnancy. The treatment for cesarean scar pregnancy mainly includes systemic methotrexate and uterine artery embolization. Here, we reported a case of cesarean scar pregnancy treated by curettage and aspiration guided by laparoscopy. The treatment plan included two phases. Three days after a combination of methotrexate and mifepristone was administered, the gestational sac was removed under laparoscopy, which enabled a successful treatment for the unruptured ectopic pregnancy in a previous cesarean scar and made it possible to preserve the reproductive capability of the patient. Keywords: cesarean scar pregnancy, laparoscopy, curettage and aspiration 

Intrathecal Ropivacaine in Cesarean Delivery

African Journals Online (AJOL)

2017-12-05

Dec 5, 2017 ... Conclusion: Ropivacaine administration produced rapid induction of ... KEYWORDS: Ropivacaine, spinal anesthesia, intrathecal, cesarean section. Intrathecal .... expressed as mean standard deviation (SD). One-way.

The effect of delaying childbirth on primary cesarean section rates.

Science.gov (United States)

Smith, Gordon C S; Cordeaux, Yolande; White, Ian R; Pasupathy, Dharmintra; Missfelder-Lobos, Hannah; Pell, Jill P; Charnock-Jones, D Stephen; Fleming, Michael

2008-07-01

The relationship between population trends in delaying childbirth and rising rates of primary cesarean delivery is unclear. The aims of the present study were (1) to characterize the association between maternal age and the outcome of labor, (2) to determine the proportion of the increase in primary cesarean rates that could be attributed to changes in maternal age distribution, and (3) to determine whether the contractility of uterine smooth muscle (myometrium) varied with maternal age. We utilized nationally collected data from Scotland, from 1980 to 2005, and modeled the risk of emergency cesarean section among women delivering a liveborn infant in a cephalic presentation at term. We also studied isolated myometrial strips obtained from 62 women attending for planned cesarean delivery in Cambridge, England, from 2005 to 2007. Among 583,843 eligible nulliparous women, there was a linear increase in the log odds of cesarean delivery with advancing maternal age from 16 y upwards, and this increase was unaffected by adjustment for a range of maternal characteristics (adjusted odds ratio for a 5-y increase 1.49, 95% confidence interval [CI] 1.48-1.51). Increasing maternal age was also associated with a longer duration of labor (0.49 h longer for a 5-y increase in age, 95% CI 0.46-0.51) and an increased risk of operative vaginal birth (adjusted odds ratio for a 5-y increase 1.49, 95% CI 1.48-1.50). Over the period from 1980 to 2005, the cesarean delivery rate among nulliparous women more than doubled and the proportion of women aged 30-34 y increased 3-fold, the proportion aged 35-39 y increased 7-fold, and the proportion aged > or =40 y increased 10-fold. Modeling indicated that if the age distribution had stayed the same over the period of study, 38% of the additional cesarean deliveries would have been avoided. Similar associations were observed in multiparous women. When studied in vitro, increasing maternal age was associated with reduced spontaneous activity and

Cesarean sections in Brazil: will they ever stop increasing?

Directory of Open Access Journals (Sweden)

Fernando C. Barros

Full Text Available OBJECTIVE: To describe trends, geographic distribution, and risk factors for cesarean deliveries in Brazil in 2000-2011, and to determine if efforts to curtail rates have had a measurable impact. METHODS: This was an observational study using nationwide information from the Department of Informatics of the Unified Health System (DATASUS. Individual level analyses were based on data regarding maternal education, age, parity, and skin color. Ecological analyses at the level of 431 health districts investigated the relationships with health facility density and poverty level. RESULTS: Cesarean rates increased markedly, from 37.9% in 2000 to 53.9% in 2011. Preliminary results from 2012 showed a rate of 55.8%, with the richest geographic areas showing the highest rates. Rates at the municipal level varied from 9%-96%. Cesareans were more common in women with higher education, white skin color, older age, and in primi- paras. In the ecological analyses, the number of health facilities per 1 000 population was strongly and positively correlated with cesarean rates, with an increase of 16.1 percentage points (95% Confidence Interval [95%CI] = 4.3-17.8 for each facility. An increase of 1 percentage point in the poverty rate was associated with a decline of 0.5 percentage point in cesarean rates (95%CI = 0.5-0.6. CONCLUSIONS: The strong associations with maternal education and health facility density suggest that the vast majority of cesareans are not medically indicated. A number of policies and programs have been launched to counteract this trend, but have had virtually no impact.

Vertex Reconstruction in the ATLAS Experiment at the LHC

CERN Document Server

Bouhova-Thacker, E; The ATLAS collaboration; Kostyukhin, V; Liebig, W; Limper, M; Piacquadio, G; Lichard, P; Weiser, C; Wildauer, A

2009-01-01

In the harsh environment of the Large Hadron Collider at CERN (design luminosity of $10^{34}$ cm$^{-2}$ s$^{-1}$) efficient reconstruction of vertices is crucial for many physics analyses. Described in this paper are the strategies for vertex reconstruction used in the ATLAS experiment and their implementation in the software framework Athena. The algorithms for the reconstruction of primary and secondary vertices as well as for finding of photon conversions and vertex reconstruction in jets are described. A special emphasis is made on the vertex fitting with application of additional constraints. The implementation of mentioned algorithms follows a very modular design based on object-oriented C++ and use of abstract interfaces. The user-friendly concept allows event reconstruction and physics analyses to compare and optimize their choice among different vertex reconstruction strategies. The performance of implemented algorithms has been studied on a variety of Monte Carlo samples and results are presented.

Less-Restrictive Food Intake During Labor in Low-Risk Singleton Pregnancies: A Systematic Review and Meta-analysis.

Science.gov (United States)

Ciardulli, Andrea; Saccone, Gabriele; Anastasio, Hannah; Berghella, Vincenzo

2017-03-01

To evaluate benefits and harms of food intake during labor. Electronic databases such as MEDLINE and ClinicalTrials.gov were searched from their inception until October 2016. We included randomized trials comparing a policy of less-restrictive food intake with a policy of more restrictive food intake during labor. The primary outcome was the mean duration of labor. Meta-analysis was performed using the random-effects model of DerSimonian and Laird to produce summary treatment effects in terms of either a relative risk or a mean difference with 95% confidence interval (CI). Ten trials, including 3,982 laboring women, were included. All the studies involved laboring singletons considered at low risk because they had no obstetric or medical complications that would increase the likelihood of cesarean delivery. In three studies, women were allowed to select from a low-residue diet throughout the course of labor. One study had honey date syrup as the allowed food intake. Five studies had carbohydrate drinks as food intake in labor. The last one was the only trial that allowed unrestrictive food intake. In the included studies, all women in the intervention group were allowed the assigned food intake until delivery, whereas women in a control group were allowed only ice chips, water, or sips of water until delivery. A policy of less-restrictive food intake was associated with a significantly shorter duration of labor (mean difference -16 minutes, 95% CI -25 to -7). No other benefits or harms in obstetric or neonatal outcome were noticed. Regurgitation during general anesthesia and Mendelson syndrome did not occur in either group. Women with low-risk singleton pregnancies who were allowed to eat more freely during labor had a shorter duration of labor. A policy of less-restrictive food intake during labor did not influence other obstetric or neonatal outcomes nor did it increase the incidence of vomiting. Operative delivery rates were similar.

CCD-based vertex detectors

CERN Document Server

Damerell, C J S

2005-01-01

Over the past 20 years, CCD-based vertex detectors have been used to construct some of the most precise 'tracking microscopes' in particle physics. They were initially used by the ACCMOR collaboration for fixed target experiments in CERN, where they enabled the lifetimes of some of the shortest-lived charm particles to be measured precisely. The migration to collider experiments was accomplished in the SLD experiment, where the original 120 Mpixel detector was later upgraded to one with 307 Mpixels. This detector was used in a range of physics studies which exceeded the capability of the LEP detectors, including the most precise limit to date on the Bs mixing parameter. This success, and the high background hit densities that will inevitably be encountered at the future TeV-scale linear collider, have established the need for a silicon pixel-based vertex detector at this machine. The technical options have now been broadened to include a wide range of possible silicon imaging technologies as well as CCDs (mon...

Comparison of Obstetric Outcome in Terms of the Risk of Low Birth Weight, Preterm Delivery, Cesarean Section Rate and Anemia in Primigravid Adolescents and Older Primigravida

International Nuclear Information System (INIS)

Naz, U.

2014-01-01

Objective: To compare the obstetric outcome in terms of risk of low birth weight, preterm delivery, cesarean section rate and anemia in primigravid adolescents and older primigravida. Study Design: Cohort study. Place and Duration of Study: Department of Obstetrics and Gynaecology, Sir Ganga Ram Hospital, Lahore, from July to December 2012. Methodology: Three hundred primigravid women presenting to department of obstetrics and gynecology of Sir Ganga Ram Hospital, Lahore, having live singleton pregnancy, including 150 adolescents (A/sup 2/ 19 years) and 150 adults (A/sup 3/ 20 years) were studied. Obstetric outcome in terms of gestational age at delivery, infant's birth weight, presence of anemia and cesarean section rate was compared between two groups. Results were analyzed using Statistical Package for Social Sciences (SPSS) version 16. Chi-square test was applied with 0.05 as level of significance. Results: The mean age of adolescent subjects was 17.3 + 1.5 years and of adults 25.6 + 3.4 years. Mean gestational age at delivery was similar in two groups (39.2 weeks and 39.4 weeks, p = 0.37). Adolescents were more likely to have a preterm delivery (11.2% vs. 4.9%, p = 0.04) and low birth weight infants (19.3% vs. 8.2%, p = 0.005) than adults. Adolescents were more likely to be anemic (46% vs. 32%, p = 0.01) than adults. However, cesarean section rate was not statistically different between two groups. Conclusion: This study showed that primiparous adolescents have significantly higher risk of adverse pregnancy outcomes such as preterm delivery, low birth weight infants and anemia as compared to adult primiparas. (author)

Adhesion barriers at cesarean delivery: advertising compared with the evidence.

Science.gov (United States)

Albright, Catherine M; Rouse, Dwight J

2011-07-01

Cesarean delivery, the most common surgery performed in the United States, is complicated by adhesion formation in 24-73% of cases. Because adhesions have potential sequelae, different synthetic adhesion barriers are currently heavily marketed as a means of reducing adhesion formation resultant from cesarean delivery. However, their use for this purpose has been studied in only two small, nonblinded and nonrandomized trials, both of which were underpowered and subject to bias. Neither demonstrated improvement in meaningful clinical outcomes. In the only cost-effectiveness analysis of adhesion barriers to date, the use of synthetic adhesion barriers was cost-effective only when the subsequent rate of small bowel obstruction was at least 2.4%, a rate far higher than that associated with cesarean delivery. In fact, intra-abdominal adhesions from prior cesarean delivery rarely cause maternal harm and have not been demonstrated to adversely affect perinatal outcome. Based on our review of the available literature, we think the use of adhesion barriers at the time of cesarean delivery would be ill-advised at the present time.

Sagittal venous sinus thrombosis after cesarean section: a case report

Directory of Open Access Journals (Sweden)

Farideh Keypour

2013-07-01

Full Text Available Background: Cerebral venous thrombosis (CVT is uncommon after cesarean section. Although it can be a leading cause of maternal mortality. CVT may occur during pregnancy because of hypercoagulable states such as preeclampsia, thrombophilias, antiphospholipid antibody syndrome and sepsis.Case presentation: A 31 years old woman G2 Ab1 at 37 weeks gestational age with  premature rupture of membrane underwent cesarean section because breech presentation and preeclampsia. Spinal anesthesia was done for emergent cesarean section. On the second day after cesarean section, she developed headache, vomiting, focal neurologic deficits, paresthesia, blurred vision. Brain magnetic resonance imaging (MRI showed thrombosis in anterior half of superior sagittal sinus. Treatment consisted of anticoagulation.  Conclusion: Thrombophilias, pregnancy-related hypertension and cesarean section are the predisposing factors for thromboembolism. Unfractionated heparin and low molecular weight heparin (LMWs are effective drugs for thromboprophylaxis. It is vital to prevent venous thrombosis to reduce mortality during both intrapartum and postpartum periods. Consideration of cerebral venous thrombosis in similar cases is recommended.

Vertex function of an electron in a constant electromagnetic field

International Nuclear Information System (INIS)

Morozov, D.A.; Narozhnyj, N.B.; Ritus, V.I.

1981-01-01

The third order with respect to radiation field vertex function for an electron located in a constant crossed field of arbitrary intensity is determined. It is shown that radiative interaction smears out the Airy function which describes the intensity of the interaction between electrons and photons in an external field as a function of the nonconserving momentum component. The qualitative relation Vsup((3)) approximately αchisup(2/3)Vsup((1)) between the third and first order vertex functions is found for large values of the dynamic parameter chi=((eFp)sup(2))sup(1/2)msup(-2). It is also shown that radiative interaction does not alter the order of magnitude of the squared mass of the system transferred at the vertex. The vertex function satisfies the Ward identity modified by the external field [ru

Time trends in births and cesarean deliveries among women with disabilities.

Science.gov (United States)

Horner-Johnson, Willi; Biel, Frances M; Darney, Blair G; Caughey, Aaron B

2017-07-01

Although it is likely that childbearing among women with disabilities is increasing, no empirical data have been published on changes over time in the numbers of women with disabilities giving birth. Further, while it is known that women with disabilities are at increased risk of cesarean delivery, temporal trends in cesarean deliveries among women with disabilities have not been examined. To assess time trends in births by any mode and in primary cesarean deliveries among women with physical, sensory, or intellectual/developmental disabilities. We conducted a retrospective cohort study using linked vital records and hospital discharge data from all deliveries in California, 2000-2010 (n = 4,605,061). We identified women with potential disabilities using ICD-9 codes. We used descriptive statistics and visualizations to examine time patterns. Logistic regression analyses assessed the association between disability and primary cesarean delivery, stratified by year. Among all women giving birth, the proportion with a disability increased from 0.27% in 2000 to 0.80% in 2010. Women with disabilities had significantly elevated odds of primary cesarean delivery in each year, but the magnitude of the odds ratio decreased over time from 2.60 (95% CI = 2.25 = 2.99) in 2000 to 1.66 (95% CI = 1.51-1.81) in 2010. Adequate clinician training is needed to address the perinatal care needs of the increasing numbers of women with disabilities giving birth. Continued efforts to understand cesarean delivery patterns and reasons for cesarean deliveries may help guide further reductions in proportions of cesarean deliveries among women with disabilities relative to women without disabilities. Copyright © 2017 Elsevier Inc. All rights reserved.

Misrecognition of need: Women’s experiences of and explanations for undergoing cesarean delivery

Science.gov (United States)

Tully, Kristin P.; Ball, Helen L.

2013-01-01

International rates of operative delivery are consistently higher than the World Health Organization determined is appropriate. This suggests that factors other than clinical indications contribute to cesarean section. Data presented here are from interviews with 115 mothers on the postnatal ward of a hospital in Northeast England during February 2006 to March 2009 after the women underwent either unscheduled or scheduled cesarean childbirth. Using thematic content analysis, we found women’s accounts of their experiences largely portrayed cesarean section as everything that they had wanted to avoid, but necessary given their situations. Contrary to popular suggestion, the data did not indicate impersonalized medical practice, or that cesareans were being performed ‘on request.’ The categorization of cesareans into ‘emergency’ and ‘elective’ did not reflect maternal experiences. Rather, many unscheduled cesareans were conducted without indications of fetal distress and most scheduled cesareans were not booked because of ‘choice.’ The authoritative knowledge that influenced maternal perceptions of the need to undergo operative delivery included moving forward from ‘prolonged’ labor and scheduling cesarean as a prophylactic to avoid anticipated psychological or physical harm. In spontaneously defending themselves against stigma from the ‘too posh to push’ label that is currently common in the media, women portrayed debate on the appropriateness of cesarean childbirth as a social critique instead of a health issue. The findings suggest the ‘need’ for some cesareans is due to misrecognition of indications by all involved. The factors underlying many cesareans may actually be modifiable, but informed choice and healthful outcomes are impeded by lack of awareness regarding the benefits of labor on the fetal transition to extrauterine life, the maternal desire for predictability in their parturition and recovery experiences, and possibly lack

Spin wave Feynman diagram vertex computation package

Science.gov (United States)

Price, Alexander; Javernick, Philip; Datta, Trinanjan

Spin wave theory is a well-established theoretical technique that can correctly predict the physical behavior of ordered magnetic states. However, computing the effects of an interacting spin wave theory incorporating magnons involve a laborious by hand derivation of Feynman diagram vertices. The process is tedious and time consuming. Hence, to improve productivity and have another means to check the analytical calculations, we have devised a Feynman Diagram Vertex Computation package. In this talk, we will describe our research group's effort to implement a Mathematica based symbolic Feynman diagram vertex computation package that computes spin wave vertices. Utilizing the non-commutative algebra package NCAlgebra as an add-on to Mathematica, symbolic expressions for the Feynman diagram vertices of a Heisenberg quantum antiferromagnet are obtained. Our existing code reproduces the well-known expressions of a nearest neighbor square lattice Heisenberg model. We also discuss the case of a triangular lattice Heisenberg model where non collinear terms contribute to the vertex interactions.

Acute parotiditis after cesarean section; case report

OpenAIRE

Cristina Moisei; Romina M. Sima; Liana Pleş

2017-01-01

The enlargement of the parotid gland develops in inflammatory or stenotic conditions but after Cesarean section the symptomatology is unusual. A 38 year old patient with no obstetrical history referred to our clinic for pregnancy, which followed our national program of prenatal care. The outcome of the pregnancy was favorable for both mother and fetus. During labor the fetus developed bradycardia and the patient delivered by Cesarean section a 3400 g baby-boy with 8 Apgar Score; the anesthesi...

Graphs with No Induced Five-Vertex Path or Antipath

DEFF Research Database (Denmark)

Chudnovsky, Maria; Esperet, Louis; Lemoine, Laetitia

2017-01-01

We prove that a graph G contains no induced five-vertex path and no induced complement of a five-vertex path if and only if G is obtained from 5-cycles and split graphs by repeatedly applying the following operations: substitution, split unification, and split unification in the complement, where...

Primary vertex reconstruction at the ATLAS experiment

CERN Document Server

AUTHOR|(INSPIRE)INSPIRE-00301388; The ATLAS collaboration; Casper, D.; Hooberman, B.; Gui, B.; Lee, G.; Maurer, J.; Morley, A.; Pagan Griso, S.; Petersen, B.; Prokofiev, K.; Shan, L.; Shope, D.; Wharton, A.; Whitmore, B.; Zhang, M.

2017-01-01

These proceedings present the method and performance of primary vertex reconstruction at the ATLAS experiment during Runs 1 and 2 at the LHC. The studies presented focus on data taken during 2012 at a centre-of-mass energy of $\\sqrt{s} = 8$ TeV, and during 2015-2016 at $\\sqrt{s} = 13$ TeV. Some predictions toward future runs are also presented. The measurement of the position and size of the luminous region and its use as a constraint to improve the primary vertex resolution are discussed.

Association of placenta praevia with repeat cesarean section in ...

African Journals Online (AJOL)

Background: Several risk factors for placenta praevia exist, including previous cesarean section(C/S). This association has been investigated long time ago, however in this hospital there is no documented evidence. This study was done to assess the risk of placenta praevia based on number of previous cesarean sections.

Effects of Cesarean Delivery on Breastfeeding Practices and Duration: A Prospective Cohort Study.

Science.gov (United States)

Chen, Cheng; Yan, Yan; Gao, Xiao; Xiang, Shiting; He, Qiong; Zeng, Guangyu; Liu, Shiping; Sha, Tingting; Li, Ling

2018-01-01

Mothers are encouraged to exclusively breastfeed for the first 6 months. However, cesarean delivery rates have increased worldwide, which may affect breastfeeding. Research aim: This study aimed to determine the potential effects of cesarean delivery on breastfeeding practices and breastfeeding duration. This was a 6-month cohort study extracted from a 24-month prospective cohort study of mother-infant pairs in three communities in Hunan, China. Data about participants' characteristics, delivery methods, breastfeeding initiation, use of formula in the hospital, exclusive breastfeeding, and any breastfeeding were collected at 1, 3, and 6 months following each infant's birth. The chi-square test, logistic regression model, and Cox proportional hazard regression model were used to examine the relationship between breastfeeding practices and cesarean delivery. The number of women who had a cesarean delivery was 387 (40.6%), and 567 (59.4%) women had a vaginal delivery. The exclusive breastfeeding rates at 1, 3, and 6 months were 80.2%, 67.4%, and 21.5%, respectively. Women who had a cesarean delivery showed a lower rate of exclusive breastfeeding and any breastfeeding than those who had a vaginal delivery ( p cesarean delivery was related with using formula in the hospital and delayed breastfeeding initiation. Cesarean delivery also shortened the breastfeeding duration (hazard ratio = 1.40, 95% confidence interval [1.06, 1.84]). Healthcare professionals should provide more breastfeeding skills to women who have a cesarean delivery and warn mothers about the dangers of elective cesarean section for breastfeeding practices.

The use of quality control performance charts to analyze cesarean delivery rates nationally.

LENUS (Irish Health Repository)

Turner, Michael J

2012-02-01

OBJECTIVE: To examine the use of quality control performance charts to analyze cesarean rates nationally. METHODS: Information on cesarean rates was obtained for all 19 Irish maternity hospitals receiving state funding in 2009. All women who underwent cesarean delivery of a live or stillborn infant weighing 500 g or more between January 1 and December 31 were included. Deliveries were classified as elective or emergency. Individual hospitals were not identified in the analysis. RESULTS: The mean rates per hospital of elective and emergency cesarean were 12.9+\\/-2.6% (n=9337) and 13.8+\\/-3.0% (n=9989), respectively-giving an overall mean rate of 26.7+\\/-4.2% (n=19326) per hospital. Cesarean rates were normally distributed. Using a quality control performance chart with a cutoff 2 standard deviations from the mean, 1 hospital was above the normal range for both total and elective cesareans, indicating that its pre-labor obstetric practices warrant clinical review. Another hospital had a mean emergency cesarean rate above the normal range, indicating that its labor ward practices warrant review. CONCLUSION: Quality control performance charts can be used to analyze cesarean rates nationally and, thus, to identify hospitals at which obstetric practices should be reviewed.

BRST invariant mixed string vertex for the bosonic string

International Nuclear Information System (INIS)

Clarizia, A.; Pezzella, F.

1987-09-01

We construct a BRST invariant (N+M)-string vertex including both open and closed string states. When we saturate it with N open string and M closed string physical states it reproduces their corresponding scattering amplitude. As a particular case we obtain BRST invariant vertex for the open-closed string transition. (orig.)

Vertex functions at finite momentum: Application to antiferromagnetic quantum criticality

Science.gov (United States)

Wölfle, Peter; Abrahams, Elihu

2016-02-01

We analyze the three-point vertex function that describes the coupling of fermionic particle-hole pairs in a metal to spin or charge fluctuations at nonzero momentum. We consider Ward identities, which connect two-particle vertex functions to the self-energy, in the framework of a Hubbard model. These are derived using conservation laws following from local symmetries. The generators considered are the spin density and particle density. It is shown that at certain antiferromagnetic critical points, where the quasiparticle effective mass is diverging, the vertex function describing the coupling of particle-hole pairs to the spin density Fourier component at the antiferromagnetic wave vector is also divergent. Then we give an explicit calculation of the irreducible vertex function for the case of three-dimensional antiferromagnetic fluctuations, and show that it is proportional to the diverging quasiparticle effective mass.

Decreased rates of shoulder dystocia and brachial plexus injury via an evidence-based practice bundle.

Science.gov (United States)

Sienas, Laura E; Hedriana, Herman L; Wiesner, Suzanne; Pelletreau, Barbara; Wilson, Machelle D; Shields, Laurence E

2017-02-01

To evaluate whether a standardized approach to identify pregnant women at risk for shoulder dystocia (SD) is associated with reduced incidence of SD and brachial plexus injury (BPI). Between 2011 and 2015, prospective data were collected from 29 community-based hospitals in the USA during implementation of an evidence-based practice bundle, including an admission risk assessment, required "timeout" before operative vaginal delivery (OVD), and low-fidelity SD drills. All women with singleton vertex pregnancies admitted for vaginal delivery were included. Rates of SD, BPI, OVD, and cesarean delivery were compared between a baseline period (January 2011-September 2013) and an intervention period (October 2013-June 2015), during which there was a system-wide average bundle compliance of 90%. There was a significant reduction in the incidence of SD (17.6%; P=0.028), BPI (28.6%; P=0.018), and OVD (18.0%; P<0.001) after implementation of the evidence-based practice bundle. There was a nonsignificant reduction in primary (P=0.823) and total (P=0.396) cesarean rates, but no association between SD drills and incidence of BPI. Implementation of a standard evidence-based practice bundle was found to be associated with a significant reduction in the incidence of SD and BPI. Utilization of low-fidelity drills was not associated with a reduction in BPI. © 2016 International Federation of Gynecology and Obstetrics.

Self-locking degree-4 vertex origami structures.

Science.gov (United States)

Fang, Hongbin; Li, Suyi; Wang, K W

2016-11-01

A generic degree-4 vertex (4-vertex) origami possesses one continuous degree-of-freedom for rigid folding, and this folding process can be stopped when two of its facets bind together. Such facet-binding will induce self-locking so that the overall structure stays at a pre-specified configuration without additional locking elements or actuators. Self-locking offers many promising properties, such as programmable deformation ranges and piecewise stiffness jumps, that could significantly advance many adaptive structural systems. However, despite its excellent potential, the origami self-locking features have not been well studied, understood, and used. To advance the state of the art, this research conducts a comprehensive investigation on the principles of achieving and harnessing self-locking in 4-vertex origami structures. Especially, for the first time, this study expands the 4-vertex structure construction from single-component to dual-component designs and investigates their self-locking behaviours. By exploiting various tessellation designs, this research discovers that the dual-component designs offer the origami structures with extraordinary attributes that the single-component structures do not have, which include the existence of flat-folded locking planes, programmable locking points and deformability. Finally, proof-of-concept experiments investigate how self-locking can effectively induce piecewise stiffness jumps. The results of this research provide new scientific knowledge and a systematic framework for the design, analysis and utilization of self-locking origami structures for many potential engineering applications.

CT of the pelvis after cesarean section

International Nuclear Information System (INIS)

Twickler, D.; Setiawan, H.; Harrell, R.; Brown, C.E.L.

1989-01-01

Febrile morbidity following cesarean section is often evaluated with CT, although the CT appearance of the normal uterus has not been evaluated. This study was undertaken to learn the normal uterine appearance after cesarean section. To date, 15 women who also underwent bilateral tubal ligation have been studied. Six had a vertical uterine incision; nine had a low transverse incision. Contrast-enhanced pelvic CT was performed 1--5 days after surgery. All women were asymptomatic, with a normal postpartum course

Fetal outcome in emergency versus elective cesarean sections at ...

African Journals Online (AJOL)

Introduction: Perinatal mortality rates have come down in cesarean sections, but fetal morbidity is still high in comparison to vaginal delivery and the complications are more commonly seen in emergency than in elective cesarean sections. The objective of the study was to compare the fetal outcome and the indications in ...

The effect of delaying childbirth on primary cesarean section rates.

Directory of Open Access Journals (Sweden)

Gordon C S Smith

2008-07-01

Full Text Available The relationship between population trends in delaying childbirth and rising rates of primary cesarean delivery is unclear. The aims of the present study were (1 to characterize the association between maternal age and the outcome of labor, (2 to determine the proportion of the increase in primary cesarean rates that could be attributed to changes in maternal age distribution, and (3 to determine whether the contractility of uterine smooth muscle (myometrium varied with maternal age.We utilized nationally collected data from Scotland, from 1980 to 2005, and modeled the risk of emergency cesarean section among women delivering a liveborn infant in a cephalic presentation at term. We also studied isolated myometrial strips obtained from 62 women attending for planned cesarean delivery in Cambridge, England, from 2005 to 2007. Among 583,843 eligible nulliparous women, there was a linear increase in the log odds of cesarean delivery with advancing maternal age from 16 y upwards, and this increase was unaffected by adjustment for a range of maternal characteristics (adjusted odds ratio for a 5-y increase 1.49, 95% confidence interval [CI] 1.48-1.51. Increasing maternal age was also associated with a longer duration of labor (0.49 h longer for a 5-y increase in age, 95% CI 0.46-0.51 and an increased risk of operative vaginal birth (adjusted odds ratio for a 5-y increase 1.49, 95% CI 1.48-1.50. Over the period from 1980 to 2005, the cesarean delivery rate among nulliparous women more than doubled and the proportion of women aged 30-34 y increased 3-fold, the proportion aged 35-39 y increased 7-fold, and the proportion aged > or =40 y increased 10-fold. Modeling indicated that if the age distribution had stayed the same over the period of study, 38% of the additional cesarean deliveries would have been avoided. Similar associations were observed in multiparous women. When studied in vitro, increasing maternal age was associated with reduced spontaneous

Increased rates of cesarean sections and large families: a potentially dangerous combination.

Science.gov (United States)

Saleh, Ahmed M; Dudenhausen, Joachim W; Ahmed, Badreldeen

2017-07-26

Rates of cesarean sections have been on the rise over the past three decades all over the world, despite the ideal rate of 10-15% that had been set by the World Health Organization (WHO) in 1985, in Fortaleza, Brazil. This epidemic increase in the rate of cesarean delivery is due to many factors which include, cesarean delivery on request, advanced maternal age at first pregnancy, decrease in number of patients who are willing to try vaginal birth after cesarean delivery, virtual disappearance of vaginal breech delivery, perceived increase in the weight of the fetus and increase in the number of women with chronic medical conditions such as Diabetes Mellitus and congenital heart disease in the reproductive age. There is no doubt that cesarean delivery is a safe procedure and it is getting safer and safer for many reasons. However, like all other surgical procedures it is not without risks both to the mother and the new born. There is a substantial increase in the incidence of morbidly adherent placenta and the risk of scar pregnancy. In the Middle East and many African and Asian countries women tend to have large families. The number of previous cesarean section deliveries is directly proportional to the risk of developing morbidly adherent placenta. Morbidly adherent placenta is the most common cause of emergency postpartum hysterectomy, which is often associated with multiple surgical complications, severe maternal morbidity and mortality. The increased rates of cesarean sections lead to increased rates of scar pregnancies, which can have lethal consequences. Cesarean delivery has a negative impact on the infant immune system. This effect on the infant led to the introduction of a new concept called "Vaginal seeding". This refers to the practice of transferring some maternal vaginal fluid to the infant born via cesarean section in an effort to enhance its immune system.

Sonographic evaluation of surgical repair of uterine cesarean scar defects.

Science.gov (United States)

Pomorski, Michal; Fuchs, Tomasz; Rosner-Tenerowicz, Anna; Zimmer, Mariusz

2017-10-01

The aim of the study was to assess the clinical outcomes of surgical repair of uterine cesarean scar defects with sonography (US). Seven nonpregnant women with history of cesarean section and a large uterine scar defect were enrolled. The surgical repair was performed by minilaparotomy. The US assessment of the uterine scar was performed using a standardized approach at baseline, then at a first visit 2-3 days following the surgical intervention (V1) and at a follow-up visit 3 months later (V2). Residual myometrial thickness (RMT), width, and depth of the scar defect were measured. The mean RMT increased significantly from 1.9 mm at baseline to 8.8 mm at V1 and 8.0 mm at V2. No intraoperative complications were observed. Postmenstrual spotting and abdominal pain reported preoperatively resolved after the operation. A surgical repair procedure for an incompletely healed uterine cesarean scar is effective in increasing RMT thickness, decreasing the depth of the scar, and reducing symptoms related to the cesarean section scar defect. Further studies on post-repair pregnancy outcomes are required to evaluate whether the procedure affects the rate of cesarean scar pregnancy, morbidly adherent placenta, and/or uterine scar dehiscence and rupture. The repair of a cesarean scar defect is recommended only for symptomatic women. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:455-460, 2017. © 2017 Wiley Periodicals, Inc.

The Mark III vertex chamber and prototype test results

International Nuclear Information System (INIS)

Grab, C.

1987-07-01

A vertex chamber has been constructed for use in the Mark III experiment. The chamber is positioned inside the current main drift chamber and will be used to trigger data collection, to aid in vertex reconstruction, and to improve the momentum resolution. This paper discusses the chamber's construction and performance and tests of the prototype

RAVE-a Detector-independent vertex reconstruction toolkit

Energy Technology Data Exchange (ETDEWEB)

Waltenberger, Wolfgang [Institute of High Energy Physics, Austrian Academy of Sciences A-1050 Vienna (Austria)], E-mail: walten@hephy.oeaw.ac.at; Mitaroff, Winfried; Moser, Fabian [Institute of High Energy Physics, Austrian Academy of Sciences A-1050 Vienna (Austria)

2007-10-21

A detector-independent toolkit for vertex reconstruction (RAVE) is being developed, along with a standalone framework (VERTIGO) for testing, analyzing and debugging. The core algorithms represent state of the art for geometric vertex finding and fitting by both linear (Kalman filter) and robust estimation methods. Main design goals are ease of use, flexibility for embedding into existing software frameworks, extensibility, and openness. The implementation is based on modern object-oriented techniques, is coded in C++ with interfaces for Java and Python, and follows an open-source approach. A beta release is available.

RAVE-a Detector-independent vertex reconstruction toolkit

International Nuclear Information System (INIS)

Waltenberger, Wolfgang; Mitaroff, Winfried; Moser, Fabian

2007-01-01

A detector-independent toolkit for vertex reconstruction (RAVE) is being developed, along with a standalone framework (VERTIGO) for testing, analyzing and debugging. The core algorithms represent state of the art for geometric vertex finding and fitting by both linear (Kalman filter) and robust estimation methods. Main design goals are ease of use, flexibility for embedding into existing software frameworks, extensibility, and openness. The implementation is based on modern object-oriented techniques, is coded in C++ with interfaces for Java and Python, and follows an open-source approach. A beta release is available

Large baby syndrome in singletons born after frozen embryo transfer (FET)

DEFF Research Database (Denmark)

Pinborg, Anja; Henningsen, AA; Loft, A

2013-01-01

Are singletons born after frozen embryo transfer (FET) at increased risk of being born large for gestational age (LGA) and if so, is this caused by intrinsic maternal factors or related to the freezing/thawing procedures?......Are singletons born after frozen embryo transfer (FET) at increased risk of being born large for gestational age (LGA) and if so, is this caused by intrinsic maternal factors or related to the freezing/thawing procedures?...

Maternal obesity and rate of cesarean delivery in Djibouti.

Science.gov (United States)

Minsart, Anne-Frederique; N'guyen, Thai-Son; Dimtsu, Hirut; Ratsimanresy, Rachel; Dada, Fouad; Ali Hadji, Rachid

2014-11-01

To calculate the prevalence of maternal obesity and to determine the relation between obesity and cesarean delivery in an urban hospital in Djibouti. In an observational cohort study, all women who had a live birth or stillbirth between October 2012 and November 2013 were considered for inclusion. Body mass index (BMI, calculated as weight in kilograms divided by the square of height in meters) was calculated throughout pregnancy, and women with a BMI of at least 30.0 were deemed to be obese. Multivariate logistic regression analyses were used to evaluate the relation between cesarean and obesity. Overall, 100 (24.8%) of 404 women were obese before 14 weeks of pregnancy, as were 112 (25.2%) of 445 before 22 weeks, and 200 (43.2%) of 463 at delivery. Obesity before 22 weeks was associated with a 127% excess risk of cesarean delivery (adjusted odds ratio 2.27; 95% CI 1.07-4.82; P=0.032). Similar trends were found when the analyses were limited to the subgroup of women without a previous cesarean delivery or primiparae. Prevalence of maternal obesity is high in Djibouti City and is related to an excess risk of cesarean delivery, even after controlling for a range of medical and socioeconomic variables. Copyright © 2014 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

Observed Mother- and Father-Child Interaction Differences in Families with Medically Assisted Reproduction-Conceived Twins and Singletons.

Science.gov (United States)

Anderson, Kayla N; Rueter, Martha A; Connor, Jennifer J; Koh, Bibiana D

2017-12-01

Increased medically assisted reproduction (MAR) use to treat infertility has resulted in a growing twin birth rate. Little is known about parent-child relationships for twin relative to singleton children in middle childhood. This study fills this gap by examining parent-child relationships in 57 families with eighty 6- to 12-year-old MAR twin and singleton children using observational data (warm and supportive communication, control, and hostility). Nested ANCOVAs indicate that while mothers exhibit similar interactional behaviors toward twins and singletons, fathers have less optimum behaviors toward twins relative to singletons. Twins displayed less engaged behavior with mothers and fathers relative to singletons. Given the vitality of parent-child relationships for family and child adjustment, future studies should examine determinants and outcomes of twin-singleton relationship differences to bolster twins' and their families' functioning. © 2016 Family Process Institute.

Obstetricians' choice of cesarean delivery in ambiguous cases

DEFF Research Database (Denmark)

Fuglenes, Dorthe; Oian, Pål; Kristiansen, Ivar Sønbø

2009-01-01

OBJECTIVE: The aim of this study was to test the hypothesis that obstetricians' choice of delivery method is influenced by their risk attitude and perceived risk of complaints and malpractice litigation. STUDY DESIGN: The choice of delivery method in ambiguous cases was studied in a nationwide...... survey of Norwegian obstetricians (n = 716; response rate, 71%) using clinical scenarios. The risk attitude was measured by 6 items from the Jackson Personality Inventory-Revised. RESULTS: The proportion of obstetricians consenting to the cesarean request varied both within and across the scenarios....... The perceived risk of complaints and malpractice litigation was a clear determinant of obstetricians' choice of cesarean in all of the clinical scenarios, whereas no impact was observed for risk attitude. CONCLUSION: Obstetricians' judgments about cesarean request in ambiguous clinical cases vary considerably...

Clinical indications for cesarean delivery among women living with female genital mutilation.

Science.gov (United States)

Rodriguez, Maria I; Say, Lale; Abdulcadir, Jasmine; Hindin, Michelle J

2017-10-01

To compare primary indications for cesarean delivery among patients with different female genital mutilation (FGM) status. The present secondary analysis included data from women who underwent trial of labor resulting in cesarean delivery at 28 obstetric centers in six African countries between November 1, 2001, and March 31, 2003. Associations between cesarean delivery indications and FGM status were assessed using descriptive statistics and multivariable multinomial logistic regression. Data from 1659 women (480 patients with no type of FGM and 1179 patients with FGM [any type]) were included; cesarean delivery indications were collapsed into five categories (fetal indications, maternal factors, stage 1 arrest, stage 2 arrest, and other). The incidence of a clear medical indication for cesarean delivery did not differ between the groups (P=0.320). Among patients without a clear indication for cesarean delivery, women with FGM were more likely to have undergone cesarean delivery for maternal factors (adjusted relative risk ratio [aRRR] 3.92, 95% confidence interval [CI] 1.3-11.71), stage 1 arrest (aRRR 7.74, 95% CI 1.33-45.07), stage 2 arrest (aRRR 6.63, 95% CI 3.74-11.73), or other factors (aRRR 2.41, 95% CI 1.04-5.60) rather than fetal factors compared with women who had no type of FGM. Among women with unclear medical indications, FGM was associated with cesarean delivery being performed for maternal factors or arrest disorders. © 2017 World Health Organization; licensed by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Vaginal birth after cesarean section—The world trend and local experience in Taiwan

OpenAIRE

Hsiu-Ting Tsai; Chia-Hsun Wu

2017-01-01

Objective: The trend of increasing cesarean section rates had evoked worldwide attention. Many approaches were introduced to diminish cesarean section rates. Vaginal birth after cesarean section (VBAC) is a route of delivery with diverse agreements. In this study, we try to reveal the world trend in VBAC and our experience of a 10-year period in a medical center in northern Taiwan. Materials and methods: This is a retrospective study of all women who underwent elective repeat cesarean deli...

The demand factors for cesareans in Portugal – some preliminary results

OpenAIRE

Tavares, Aida Isabel; Rocha, Tania

2012-01-01

The aim of this work is to determine the demand factors for cesareans in Portugal. This work is exploratory and preliminary. Data is aggregated in NUTSII , for the period 2002-10. The number of cesareans performed is count data which requires the estimation of this panel data by a negative binomial with fixed effects. The main result is the evidence that there may be induced demand for cesareans in Portugal. Further research is needed.

On Pathos Adjacency Cut Vertex Jump Graph of a Tree

OpenAIRE

Nagesh.H.M; R.Chandrasekhar

2014-01-01

In this paper the concept of pathos adjacency cut vertex jump graph PJC(T) of a tree T is introduced. We also present a characterization of graphs whose pathos adjacency cut vertex jump graphs are planar, outerplanar, minimally non-outerplanar, Eulerian and Hamiltonian.

Operadic formulation of topological vertex algebras and gerstenhaber or Batalin-Vilkovisky algebras

International Nuclear Information System (INIS)

Huang Yizhi

1994-01-01

We give the operadic formulation of (weak, strong) topological vertex algebras, which are variants of topological vertex operator algebras studied recently by Lian and Zuckerman. As an application, we obtain a conceptual and geometric construction of the Batalin-Vilkovisky algebraic structure (or the Gerstenhaber algebra structure) on the cohomology of a topological vertex algebra (or of a weak topological vertex algebra) by combining this operadic formulation with a theorem of Getzler (or of Cohen) which formulates Batalin-Vilkovisky algebras (or Gerstenhaber algebras) in terms of the homology of the framed little disk operad (or of the little disk operad). (orig.)

Vanishing twins: a predictor of small-for-gestational age in IVF singletons

DEFF Research Database (Denmark)

Pinborg, Anja; Lidegaard, Ojvind; Freiesleben, Nina la Cour

2007-01-01

The purpose of this study was to assess the effect of a vanishing twin on the risk of being small-for-gestational age (SGA) in in vitro fertilization (IVF) singletons.......The purpose of this study was to assess the effect of a vanishing twin on the risk of being small-for-gestational age (SGA) in in vitro fertilization (IVF) singletons....

Vertex Reconstruction and Performance in ATLAS

CERN Document Server

Whitmore, Ben William; The ATLAS collaboration

2017-01-01

Efficient and precise reconstruction of the primary vertices in LHC collisions is essential in both the reconstruction of the full kinematic properties of a hard-scatter event and of soft interactions as a measure of the amount of pile-up. The reconstruction of the primary vertices in the busy, high pile up environment of the LHC is a challenging task. The challenges and novel methods developed by the ATLAS experiment to reconstruct vertices in such environments will be presented. The performance of the current vertexing algorithms using Run-2 data will be presented and compared to results from simulation. Additionally, data-driven methods to evaluate vertex resolution, and details of upgrades to the ATLAS inner detector will be presented.

Random tree growth by vertex splitting

International Nuclear Information System (INIS)

David, F; Dukes, W M B; Jonsson, T; Stefánsson, S Ö

2009-01-01

We study a model of growing planar tree graphs where in each time step we separate the tree into two components by splitting a vertex and then connect the two pieces by inserting a new link between the daughter vertices. This model generalizes the preferential attachment model and Ford's α-model for phylogenetic trees. We develop a mean field theory for the vertex degree distribution, prove that the mean field theory is exact in some special cases and check that it agrees with numerical simulations in general. We calculate various correlation functions and show that the intrinsic Hausdorff dimension can vary from 1 to ∞, depending on the parameters of the model

Accuracy of Blood Loss Measurement during Cesarean Delivery

OpenAIRE

Doctorvaladan, Sahar V.; Jelks, Andrea T.; Hsieh, Eric W.; Thurer, Robert L.; Zakowski, Mark I.; Lagrew, David C.

2017-01-01

Objective?This study aims to compare the accuracy of visual, quantitative gravimetric, and colorimetric methods used to determine blood loss during cesarean delivery procedures employing a hemoglobin extraction assay as the reference standard. Study Design?In 50 patients having cesarean deliveries blood loss determined by assays of hemoglobin content on surgical sponges and in suction canisters was compared with obstetricians' visual estimates, a quantitative gravimetric method, and the blood...

Pion production and absorption in nuclear reactions. I. The vertex function

International Nuclear Information System (INIS)

Nutt, W.T.; Shakin, C.M.

1977-01-01

We have performed a model calculation of the pion-nucleon vertex function for the case in which one nucleon is allowed to go far off its mass shell. We discuss the relevance of this vertex function for the calculation of pion production and absorption in nuclear reactions, such as (π + ,p), (p,π + ), and for the pionic disintegration of the deuteron. The model used is based upon an approximation to an exact equation for the vertex function derived from a field-theoretic model with pseudoscalar coupling. Our calculations indicate a strong dependence of the vertex function on the invariant mass of the off-shell nucleon. The results are dominated by the presence of the 1470 MeV, P 11 resonance

Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery

NARCIS (Netherlands)

Schaaf, J. M.; Hof, M. H. P.; Mol, B. W. J.; Abu-Hanna, A.; Ravelli, A. C. J.

2012-01-01

Please cite this paper as: Schaaf J, Hof M, Mol B, Abu-Hanna A, Ravelli A. Recurrence risk of preterm birth in subsequent twin pregnancy after preterm singleton delivery.BJOG 2012;119:16241629. Objective To determine the risk of preterm birth in a subsequent twin pregnancy after previous singleton

Timing of delivery after external cephalic version and the risk for cesarean delivery.

Science.gov (United States)

Kabiri, Doron; Elram, Tamar; Aboo-Dia, Mushira; Elami-Suzin, Matan; Elchalal, Uriel; Ezra, Yossef

2011-08-01

To estimate the association between time of delivery after external cephalic version at term and the risk for cesarean delivery. This retrospective cohort study included all successful external cephalic versions performed in a tertiary center between January 1997 and January 2010. Stepwise logistic regression was used to calculate the odds ratio (OR) for cesarean delivery. We included 483 external cephalic versions in this study, representing 53.1% of all external cephalic version attempts. The incidence of cesarean delivery for 139 women (29%) who gave birth less than 96 hours from external cephalic version was 16.5%; for 344 women (71%) who gave birth greater than 96 hours from external cephalic version, the incidence of cesarean delivery was 7.8% (P = .004). The adjusted OR for cesarean delivery was 2.541 (95% confidence interval 1.36-4.72). When stratified by parity, the risk for cesarean delivery when delivery occurred less than 96 hours after external cephalic version was 2.97 and 2.28 for nulliparous and multiparous women, respectively. Delivery at less than 96 hours after successful external cephalic version was associated with an increased risk for cesarean delivery. III.

Silicon Technologies for the CLIC Vertex Detector

CERN Document Server

Spannagel, Simon

2017-01-01

CLIC is a proposed linear e$^+$e$^−$ collider designed to provide particle collisions at center-of-mass energies of up to 3 TeV. Precise measurements of the properties of the top quark and the Higgs boson, as well as searches for Beyond the Standard Model physics require a highly performant CLIC detector. In particular the vertex detector must provide a single point resolution of only a few micrometers while not exceeding the envisaged material budget of around 0.2%$~X_0$ per layer. Beam-beam interactions and beamstrahlung processes impose an additional requirement on the timestamping capabilities of the vertex detector of about 10 ns. These goals can only be met by using novel techniques in the sensor and ASIC design as well as in the detector construction. The R&D program for the CLIC vertex detector explores various technologies in order to meet these demands. The feasibility of planar sensors with a thickness of 50–150$~\\mu$m, including different active edge designs, are evaluated using Timepix3 A...

Complex growing networks with intrinsic vertex fitness

International Nuclear Information System (INIS)

Bedogne, C.; Rodgers, G. J.

2006-01-01

One of the major questions in complex network research is to identify the range of mechanisms by which a complex network can self organize into a scale-free state. In this paper we investigate the interplay between a fitness linking mechanism and both random and preferential attachment. In our models, each vertex is assigned a fitness x, drawn from a probability distribution ρ(x). In Model A, at each time step a vertex is added and joined to an existing vertex, selected at random, with probability p and an edge is introduced between vertices with fitnesses x and y, with a rate f(x,y), with probability 1-p. Model B differs from Model A in that, with probability p, edges are added with preferential attachment rather than randomly. The analysis of Model A shows that, for every fixed fitness x, the network's degree distribution decays exponentially. In Model B we recover instead a power-law degree distribution whose exponent depends only on p, and we show how this result can be generalized. The properties of a number of particular networks are examined

Connections for Small Vertex Models

Indian Academy of Sciences (India)

This paper is a first attempt at calssifying connections on small vertex models i.e., commuting squares of the form displayed in (1.2) below. ... obtain necessary conditions for two such `model connections' in (2, ) to be ... Current Issue : Vol.

Wrong vertex displacements due to Lee-Wick resonances at LHC

International Nuclear Information System (INIS)

Alvarez, E.; Schat, C.; Rold, L. da; Szynkman, A.

2009-01-01

We show how a resonance from the recently proposed Lee-Wick Standard Model could lead to wrong vertex displacements at LHCb. We study which could be the possible 'longest lived' Lee-Wick particle that could be created at LHC, and we study its possible decays and detections. We conclude that there is a region in the parameter space which would give wrong vertex displacements as a unique signature of the Lee-Wick Standard Model at LHCb. Further numerical simulation shows that LHC era could explore these wrong vertex displacements through Lee-Wick leptons below 500 GeV. (author)

Calculation of track and vertex errors for detector design studies

International Nuclear Information System (INIS)

Harr, R.

1995-01-01

The Kalman Filter technique has come into wide use for charged track reconstruction in high-energy physics experiments. It is also well suited for detector design studies, allowing for the efficient estimation of optimal track covariance matrices without the need of a hit level Monte Carlo simulation. Although much has been published about the Kalman filter equations, there is a lack of previous literature explaining how to implement the equations. In this paper, the operators necessary to implement the Kalman filter equations for two common detector configurations are worked out: a central detector in a uniform solenoidal magnetic field, and a fixed-target detector with no magnetic field in the region of the interactions. With the track covariance matrices in hand, vertex and invariant mass errors are readily calculable. These quantities are particularly interesting for evaluating experiments designed to study weakly decaying particles which give rise to displaced vertices. The optimal vertex errors are obtained via a constrained vertex fit. Solutions are presented to the constrained vertex problem with and without kinematic constraints. Invariant mass errors are obtained via propagation of errors; the use of vertex constrained track parameters is discussed. Many of the derivations are new or previously unpublished

Vertex dynamics in multi-soliton solutions of Kadomtsev–Petviashvili II equation

International Nuclear Information System (INIS)

Zarmi, Yair

2014-01-01

A functional of the solution of the Kadomtsev–Petviashvili II equation maps multi-soliton solutions onto systems of vertices—structures that are localized around soliton junctions. A solution with one junction is mapped onto a single vertex, which emulates a free, spatially extended, particle. In solutions with several junctions, each junction is mapped onto a vertex. Moving in the x–y plane, the vertices collide, coalesce upon collision and then split up. When well separated, they emulate free particles. Multi-soliton solutions, whose structure does not change under space–time inversion as |t| → ∞, are mapped onto vertex systems that undergo elastic collisions. Solutions, whose structure does change, are mapped onto systems that undergo inelastic collisions. The inelastic vertex collisions generated from the infinite family of (M,1) solutions (M external solitons, (M − 2) Y-shaped soliton junctions, M ⩾ 4) play a unique role: the only definition of vertex mass consistent with momentum conservation in these collisions is the spatial integral of the vertex profile. This definition ensures, in addition, that, in these collisions, the total mass and kinetic energy due to the motion in the y-direction are conserved. In general, the kinetic energy due to the motion in the x-direction is not conserved in these collisions. (paper)

Construction of vertex operators using operator formalism techniques

International Nuclear Information System (INIS)

Gato, B.; Massachusetts Inst. of Tech., Cambridge

1989-01-01

We derive vertex operators in oscillator form as an application of the conserved charges method developed by Vafa for the operator formalism in higher genus Riemann surfaces. This construction proves to be clear, direct and valid for the bosonic and fermionic strings as wells as for twisted strings on orbifolds. We discuss the method and construct vertex operators for the bosonic string moving on Z N orbifolds and for the fermionic string in the NSR formulation. (orig.)

The vertex detector for the Lepton/Photon collaboration

Energy Technology Data Exchange (ETDEWEB)

Sullivan, J.P.; Boissevain, J.G.; Fox, D.; Hecke, H. van; Jacak, B.V.; Kapustinsky, J.S.; Leitch, M.J.; McGaughey, P.L.; Moss, J.M.; Sondheim, W.E. [Los Alamos National Lab., NM (United States)

1991-12-31

The conceptual design of the vertex detector for the Lepton/Photon Collaboration at RHIC is described, including simulations of its expected performance. The design consists of two con- centric layers of single-sided Si strips. The expected performance as a multiplicity detector and in measuring the pseudo-rapidity ({nu}) distribution is discussed as well as the expected vertex finding efficiency and accuracy. Various options which could be used to reduce the cost of the detector are also discussed.

The vertex detector for the Lepton/Photon Collaboration

International Nuclear Information System (INIS)

Sullivan, J.P.; Boissevain, J.G.; Fox, D.; van Hecke, H.; Jacak, B.V.; Kapustinsky, J.S.; Leitch, M.J.; McGaughey, P.L.; Moss, J.M.; Sondheim, W.E.

1991-01-01

The conceptual design of the vertex detector for the Lepton/Photon Collaboration at RHIC is described, including simulations of its expected performance. The design consists of two concentric layers of single-sided Si strips. The expected performance as a multiplicity detector and in measuring the pseudo-rapidity η distribution is discussed as well as the expected vertex finding efficiency and accuracy. Various options which could be used to reduce the cost of the detector are also discussed

The placental factor in spontaneous preterm birth in twin vs. singleton pregnancies.

Science.gov (United States)

Weiner, Eran; Dekalo, Ann; Feldstein, Ohad; Barber, Elad; Schreiber, Letizia; Bar, Jacob; Kovo, Michal

2017-07-01

The association between infection and inflammatory response in singleton preterm birth (PTB) is well established, yet, less is known about PTB in twins. We aimed to compare the placental component and pregnancy outcome in pregnancies complicated with PTB of singletons vs. twin deliveries. We hypothesized that due to different underlying mechanisms, placental inflammatory lesions will be more prevalent in placentas derived from singleton pregnancies than twins. Labor characteristics, neonatal outcome and placental histopathology reports of spontaneous PTB at 24-33 6 / 7 weeks, from 1/2008-12/2015, were reviewed. were compared between dichorionic-diamniotic twin deliveries (twins group) and singleton deliveries (singleton group) matched for gestational age. Excluded from the study medically indicated deliveries, due to preeclampsia or fetal growth restriction, and monochorionic twins. Placental lesions were classified to maternal vascular supply lesions, fetal vascular supply lesions, and maternal (MIR) and fetal (FIR) inflammatory responses. Composite neonatal outcome was defined as one or more of early complications: respiratory distress, necrotizing enterocolitis, sepsis, blood transfusion, ventilation, seizures, intra-ventricular hemorrhage, hypoglycemia, phototherapy, or death. The twins group (n=72) was characterized by higher maternal BMI (p=0.009), and higher rates of assisted reproductive techniques (56.2% vs. 17.8%, pPTBs are characterized by higher rate of inflammatory and malperfusion lesions. The lack of these findings in twins PTBs suggests different factors that participate in the development of preterm birth in twins, such as over-distension of the uterus and up regulation of oxytocin receptors. Copyright © 2017 Elsevier B.V. All rights reserved.

MATERNAL ACCOUNTS OF THEIR BREASTFEEDING INTENT AND EARLY CHALLENGES AFTER CESAREAN CHILDBIRTH

Science.gov (United States)

Tully, Kristin P.; Ball, Helen L.

2013-01-01

Background Breastfeeding outcomes are often worse after cesarean section compared to vaginal childbirth. Objectives This study characterizes mothers’ breastfeeding intentions and their infant feeding experiences after cesarean childbirth. Methods Data are from 115 mothers on a postnatal unit in Northeast England during February 2006 to March 2009. Interviews were conducted an average of 1.5 days (range 1–6 days) after the women underwent unscheduled or scheduled cesarean. Results Thematic analysis of the data suggested breastfeeding was mostly considered the “right thing to do,” preferable, natural, and “supposedly healthier,” but tiring and painful. Advantages of supplementation involved more satiated infants, feeding ease, and longer sleep bouts. The need for “thinking about yourself” was part of cesarean recovery. Infrequent feeding was concerning but also enabled maternal rest. Other breastfeeding obstacles were maternal mobility limitations, positioning difficulties, and frustration at the need for assistance. Participants were confused about nocturnal infant wakings, leading many to determine that they had insufficient milk. Mothers were surprised that sub-clinically poor infant condition was common following cesarean section. Some breastfeeding difficulty stemmed from “mucus” expulsion that had to occur before the infants could be “interested” in feeding. Women who cited motivations for breastfeeding that included benefit to themselves were more likely to exclusively breastfeed on the postnatal unit after their cesareans than those who reported infant-only motivations. Conclusions For the majority of mothers, breastfeeding after a cesarean is affected by interrelated and compounding difficulties. Provision of more relational breastfeeding information may enable families to better anticipate early feeding experiences after cesarean section childbirth. PMID:24252711

Intrinsic-normal-ordered vertex operators from the multiloop N-tachyon amplitude

International Nuclear Information System (INIS)

Aldazabal, G.; Nunez, C.; Bonini, M.; Iengo, R.

1987-09-01

We construct vertex operators for arbitrary mass level states of the closed bosonic string. Starting from a generalization of the Koba-Nielsen amplitude which is suitable for an arbitrary genus Riemann surface, we read the vertex operators from the residues of the poles for the intermediate states. Since the original expression is metric independent and normal ordered without the need of inventing any regularization scheme, our vertex operators also possess these properties. We discuss their general features. (author). 17 refs

Perinatal outcome of preterm cesarean section in a resource-limited ...

African Journals Online (AJOL)

Background: The relationship between perinatal outcome and anesthetic technique for preterm cesarean sections has not been explored in South Eastern, Nigeria. Objective: The objective of the following study is to evaluate perinatal outcome in preterm cesarean sections conducted under general anesthesia (GA) and ...

Shifts of visuospatial attention to invisible (metacontrast-masked singletons: Clues from reaction times and event-related potential

Directory of Open Access Journals (Sweden)

Manfred Heumann

2006-01-01

Full Text Available In the current study, we tested whether a masked and, thus, invisible singleton-cue captures atten-tion in a stimulus-driven manner or in a top-down contingent manner. The manual RT (Reaction Time capture effect with the invisible singleton--cue decreased substantially when a match between the singleton-cue and the top-down controlled set of searched-for target features was also decreased. By contrast, with the PCN (Posterior Contralateral Negativity, an electrophysiological measure of the capture of visuospatial attention by the invisible singleton-cue, no significant decrement was observed. Taken together, the results support the assumption that an invisible singleton-cue can capture attention in a stimulus-driven manner, and that different delays in the deallocation of attention (i.e., attention is deallocated more efficiently from acue that does not match the top-down controlled set than from a cue that does match the same set account for the weaker manual RT capture effect with a set- -nonmatching invisible singleton-cue.

A quantum hybrid with a thin antenna at the vertex of a wedge

Energy Technology Data Exchange (ETDEWEB)

Carlone, Raffaele, E-mail: raffaele.carlone@unina.it [Università “Federico II” di Napoli, Dipartimento di Matematica e Applicazioni “R. Caccioppoli”, MSA, via Cinthia, I-80126, Napoli (Italy); Posilicano, Andrea, E-mail: andrea.posilicano@uninsubria.it [DiSAT, Università dell' Insubria, via Valleggio 11, I-22100, Como (Italy)

2017-03-26

We study the spectrum, resonances and scattering matrix of a quantum Hamiltonian on a “hybrid surface” consisting of a half-line attached by its endpoint to the vertex of a concave planar wedge. At the boundary of the wedge, outside the vertex, homogeneous Dirichlet conditions are imposed. The system is tunable by varying the measure of the angle at the vertex. - Highlights: • Spectral characterization of a quantum Hamiltonian on “hybrid surface” consisting of a halfline attached to the vertex of a concave planar wedge. • The system is tunable by varying the measure of the angle at the vertex. • Relation between the conduction properties inside the hybrid and formation of resonances. • Easy generalization of the results to more complicated structures.

Cesarean section in the People’s Republic of China: current perspectives

Science.gov (United States)

Feng, Xing Lin; Wang, Ying; An, Lin; Ronsmans, Carine

2014-01-01

Objective To review the current knowledge on the prevalence, reasons, and consequences of cesarean sections in the People’s Republic of China. Methods Peer-reviewed articles were systematically searched on PubMed. The following Chinese databases were comprehensively searched: the China National Knowledge Infrastructure, Wanfang, and the VIP information. The databases were searched from inception to September 1, 2013. Two reviewers independently screened the titles and abstracts for eligibility. Full texts of eligible papers were reviewed, where relevant references were hand-searched and reviewed. Findings Sixty articles were included from PubMed, 17 articles were intentionally picked out from Chinese journals, and five additional articles were added, for a total of 82 articles for the analysis. With a current national rate near 40%, the literature consistently reported a rapid rise of cesarean sections in the People’s Republic of China in the past decades, irrespective of where people lived or their socioeconomic standing. Nonclinical factors were considered as the main drivers fueling the rise of cesareans in the People’s Republic of China. There was a lively debate on whether women’s preferences or providers’ distorted financial incentives affected the rise in cesarean sections. However, recent evidence suggests that it might be the People’s Republic of China’s health development approach – focusing on specialized care and marginalizing primary care – that is playing a role. Although 30 articles were identified studying the consequences of cesareans, the methodologies are in general weak and the themes are out of focus. Conclusion The overuse of cesareans is rising alarmingly in the People’s Republic of China and has become a real public health problem. No consensus has been made on the leverage factors that drive the cesarean epidemic, particularly for those nonclinical factors. The more macro level structural factors may have played a part

Contingent orienting or contingent capture: a size singleton matching the target-distractor size relation cannot capture attention.

Science.gov (United States)

Du, Feng; Yin, Yue; Qi, Yue; Zhang, Kan

2014-08-01

In the present study, we examined whether a peripheral size-singleton distractor that matches the target-distractor size relation can capture attention and disrupt central target identification. Three experiments consistently showed that a size singleton that matches the target-distractor size relation cannot capture attention when it appears outside of the attentional window, even though the same size singleton produces a cuing effect. In addition, a color singleton that matches the target color, instead of a size singleton that matches the target-distractor size relation, captures attention when it is outside of the attentional window. Thus, a size-relation-matched distractor is much weaker than a color-matched distractor in capturing attention and cannot capture attention when the distractor appears outside of the attentional window.

The CDF online silicon vertex tracker

International Nuclear Information System (INIS)

Ashmanskas, W.

2001-01-01

The CDF Online Silicon Vertex Tracker reconstructs 2-D tracks by linking hit positions measured by the Silicon Vertex Detector to the Central Outer Chamber tracks found by the eXtremely Fast Tracker. The system has been completely built and assembled and it is now being commissioned using the first CDF run II data. The precision measurement of the track impact parameter will allow triggering on B hadron decay vertices and thus investigating important areas in the B sector, like CP violation and B s mixing. In this paper we briefly review the architecture and the tracking algorithms implemented in the SVT and we report on the performance of the system achieved in the early phase of CDF run II

The CDF online Silicon Vertex Tracker

International Nuclear Information System (INIS)

Ashmanskas, W.; Bardi, A.; Bari, M.; Belforte, S.; Berryhill, J.; Bogdan, M.; Carosi, R.; Cerri, A.; Chlachidze, G.; Culbertson, R.; Dell'Orso, M.; Donati, S.; Fiori, I.; Frisch, H.J.; Galeotti, S.; Giannetti, P.; Glagolev, V.; Moneta, L.; Morsani, F.; Nakaya, T.; Passuello, D.; Punzi, G.; Rescigno, M.; Ristori, L.; Sanders, H.; Sarkar, S.; Semenov, A.; Shochet, M.; Speer, T.; Spinella, F.; Wu, X.; Yang, U.; Zanello, L.; Zanetti, A.M.

2002-01-01

The CDF Online Silicon Vertex Tracker (SVT) reconstructs 2D tracks by linking hit positions measured by the Silicon Vertex Detector to the Central Outer Chamber tracks found by the eXtremely Fast Tracker (XFT). The system has been completely built and assembled and it is now being commissioned using the first CDF run II data. The precision measurement of the track impact parameter will allow triggering on B hadron decay vertices and thus investigating important areas in the B sector, like CP violation and B s mixing. In this paper we briefly review the architecture and the tracking algorithms implemented in the SVT and we report on the performance of the system achieved in the early phase of CDF run II

Interobserver variation in measurements of Cesarean scar defect and myometrium with 3D ultrasonography

DEFF Research Database (Denmark)

Madsen, Lene Duch; Glavind, Julie; Uldbjerg, Niels

Objectives: To evaluate the Cesarean scar defect depth and the residual myometrial thickness with 3-dimensional (3D) sonography concerning interobserver variation. Methods: Ten women were randomly selected from a larger cohort of Cesarean scar ultrasound evaluations. All women were examined 6......-16 months after their first Cesarean section with 2D transvaginal sonography and had 3D volumes recorded. Two observers independently evaluated “off-line” each of the 3D volumes stored. Residual myometrial thickness (RMT) and Cesarean scar defect depth (D) was measured in the sagittal plane with an interval...... of Cesarean section scar size and residual myometrium needs further investigation....

Performance of the ATLAS primary vertex reconstruction algorithms

CERN Document Server

Zhang, Matt

2017-01-01

The reconstruction of primary vertices in the busy, high pile up environment of the LHC is a challenging task. The challenges and novel methods developed by the ATLAS experiment to reconstruct vertices in such environments will be presented. Such advances in vertex seeding include methods taken from medical imagining, which allow for reconstruction of very nearby vertices will be highlighted. The performance of the current vertexing algorithms using early Run-2 data will be presented and compared to results from simulation.

Trial of Labor Compared With Cesarean Delivery in Superobese Women.

Science.gov (United States)

Grasch, Jennifer L; Thompson, Jennifer L; Newton, J Michael; Zhai, Amy W; Osmundson, Sarah S

2017-11-01

To examine whether labor compared with planned cesarean delivery is associated with increased maternal and neonatal morbidity. We conducted a retrospective cohort study of all women with body mass indexes (BMIs) at delivery of 50 or greater delivering a live fetus at 34 weeks of gestation of greater between January 1, 2008, and December 31, 2015. Pregnancies with multiple gestations and major fetal anomalies were excluded. The primary outcome was a composite of maternal and neonatal morbidity and was estimated to be 50% in superobese women based on institutional data. A sample size of 338 women determined the study period and was selected to show a 30% difference in the incidence of the primary outcome between the two groups. Multivariate logistic regression adjusted for potential confounders. There were 344 women with BMIs of 50 or greater who met eligibility criteria, of whom 201 (58%) labored and 143 (42%) underwent planned cesarean delivery. Women who labored were younger, more likely to be nulliparous, and less likely to have pre-existing diabetes. Among women who labored, 45% underwent a cesarean delivery, most commonly for labor arrest (61%) or nonreassuring fetal status (28%). Composite maternal and neonatal morbidity was reduced among women who labored even after adjusting for age, parity, pre-existing diabetes, and prior cesarean delivery (adjusted odds ratio 0.42, 95% CI 0.24-0.75). In the subgroup of women (n=234) who underwent a cesarean delivery, whether planned (n=143) or after labor (n=91), there were no differences in maternal and neonatal morbidity except that severe maternal morbidity was increased in women (n=12) who labored (8.8% compared with 2.1%, relative risk 4.2, 95% CI 1.14-15.4). Despite high rates of cesarean delivery in women with superobesity, labor is associated with lower composite maternal and neonatal morbidity. Severe maternal morbidity may be higher in women who require a cesarean delivery after labor.

Lower marriage and divorce rates among twins than among singletons in Danish birth cohorts 1940-1964

DEFF Research Database (Denmark)

Petersen, Inge; Martinussen, Torben; McGue, Matthew

2011-01-01

compare rates of marriage and divorce in a sample of 35,975 twins and 81,803 singletons born 1940-1964. Cox-regressions are used in order to control for potential confounders. We find that compared with singletons twins have significantly lower marriage rates: (males: 15-19 years: Hazard Ratio (HR) = 0...... twins compared with singletons (HR=0.87, 95%CI: 0.83-0.90). These differences offset each other, thus 57% of both populations remain in their first marriage until censoring. The interpretation may be that since twins have a partner from birth, they do not have the same need for marriage as singletons...

Vertex operators for a bosonic string

International Nuclear Information System (INIS)

Sasaki, Ryu; Yamanaka, Itaru.

1985-09-01

Based on the operator formalism and the Virasoro algebra, we present a simple method of constructing vertex operators describing the emission and absorption of general particles in bosonic string theories. (author)

Cervical Abscess with Vaginal Fistula After Extraperitoneal Cesarean Section

Directory of Open Access Journals (Sweden)

Ching-Yu Chou

2007-12-01

Full Text Available Extraperitoneal cesarean section was once used for the prevention of infection and postoperative adhesion. However, we report an unusual complication after this procedure. A 29-year-old woman had pus discharge from the anterior vaginal wall after extraperitoneal cesarean section. Broad-spectrum antibiotics failed to relieve her symptoms and vaginal culture yielded Morganella morganii. Magnetic resonance imaging, sagittal view, showed a cervical abscess measuring 5 × 5 cm with a tract extending to the anterior vagina. After performing dilation and abscess drainage via the cervical ostium, the symptoms gradually subsided with adequate antibiotic treatment. Cervical abscess may develop after extraperitoneal cesarean section and present initially as vaginal fistula. Detailed imaging study provides comprehensive anatomic information for effective management.

Risk factors for cesarean delivery and adverse neonatal outcome in twin pregnancies attempting vaginal delivery.

Science.gov (United States)

Schachter-Safrai, Natali; Karavani, Gilad; Haj-Yahya, Rani; Ofek Shlomai, Noa; Porat, Shay

2018-02-24

Twin vaginal delivery presents a unique clinical challenge for obstetricians. The Twin Birth Study demonstrated the safety of planned vaginal delivery regarding neonatal outcomes. However, that study lacked a description of the risk factors associated with and the outcome of unplanned cesarean section. The aim of this study is to identify potential risk factors for cesarean section and delivery related neonatal morbidity and mortality in women with twin pregnancy attempting vaginal delivery. A retrospective cohort study including 1070 women with twin pregnancy that underwent a trial of labor between 2003 and 2015. The study population was divided according to the mode of delivery: vaginal delivery, combined vaginal-cesarean and intrapartum cesarean delivery of both twins. Several risk factors and neonatal outcomes were examined by both univariate analysis and multinomial logistic regression analysis. The rate of vaginal delivery of both twins was 88.3%, whereas the rates of combined vaginal cesarean and unplanned cesarean delivery were 4.6% and 7.1%, respectively. Nulliparity and nonvertex presentation of twin B were found to be independently associated with cesarean delivery for both twins. Additionally, nonvertex presentation of twin B was independently associated with combined vaginal-cesarean delivery. The proportion of neonates with Apgar score cesarean group compared with those delivered by the vaginal route alone. Nulliparity and nonvertex presentation of twin B were found to be associated with intrapartum cesarean delivery in twin pregnancies. © 2018 Nordic Federation of Societies of Obstetrics and Gynecology.

A multistate quality improvement program to decrease elective deliveries before 39 weeks of gestation.

Science.gov (United States)

Oshiro, Bryan T; Kowalewski, Leslie; Sappenfield, William; Alter, Caroline C; Bettegowda, Vani R; Russell, Rebecca; Curran, John; Reeves, Lori; Kacica, Marilyn; Andino, Nelson; Mason-Marti, Peyton; Crouse, Dennis; Knight, Susan; Littlejohn, Karen; Malatok, Sharyn; Dudley, Donald J; Berns, Scott D

2013-05-01

Nonmedically indicated (elective) deliveries before 39 weeks of gestation result in unnecessary neonatal morbidity. We sought to determine whether implementation of a process improvement program will decrease the rate of elective scheduled singleton early-term deliveries (37 0/7-38 6/7 weeks of gestation) in a group of diverse community and academic hospitals. Policies and procedures for scheduling inductions and cesarean deliveries were implemented and patient and health care provider education was provided. Outcomes for scheduled singleton deliveries at 34 weeks of gestation or higher were submitted through a web-based data entry system. The rate of scheduled singleton elective early-term deliveries as well as the rates of early-term medically indicated and unscheduled deliveries, neonatal intensive care unit admissions, and singleton term fetal mortality rate were evaluated. A total of 29,030 scheduled singletons at 34 weeks of gestation or higher were delivered in 26 participating hospitals between January 2011 and December 2011. Elective scheduled early-term deliveries decreased from 27.8% in the first month to 4.8% in the 12th month (Pscheduled singleton early-term inductions (72%, P=.029) and cesarean deliveries (84%; Pscheduled early-term singletons decreased nonsignificantly from 1.5% to 1.2% (P=.24). There was no increase in the term fetal mortality rate. A rapid-cycle process improvement program substantially decreased elective scheduled early-term deliveries to less than 5% in a group of diverse hospitals across multiple states. III.

Algebraic Bethe ansatz for 19-vertex models with reflection conditions

International Nuclear Information System (INIS)

Utiel, Wagner

2003-01-01

In this work we solve the 19-vertex models with the use of algebraic Bethe ansatz for diagonal reflection matrices (Sklyanin K-matrices). The eigenvectors, eigenvalues and Bethe equations are given in a general form. Quantum spin chains of spin one derived from the 19-vertex models were also discussed

Scar Endometriosis Following Cesarean Section

Directory of Open Access Journals (Sweden)

Rüya Deveer

2012-04-01

CONCLUSION: Abdominal wall endometriosis frequently presents with cyclical pain during menstruation which is localised to a palpable mass in the abdominal wall especially in those who have had previous cesarean section. Complete surgical excision is curative.

Cesarean Outcomes in US Birth Centers and Collaborating Hospitals: A Cohort Comparison.

Science.gov (United States)

Thornton, Patrick; McFarlin, Barbara L; Park, Chang; Rankin, Kristin; Schorn, Mavis; Finnegan, Lorna; Stapleton, Susan

2017-01-01

High rates of cesarean birth are a significant health care quality issue, and birth centers have shown potential to reduce rates of cesarean birth. Measuring this potential is complicated by lack of randomized trials and limited observational comparisons. Cesarean rates vary by provider type, setting, and clinical and nonclinical characteristics of women, but our understanding of these dynamics is incomplete. We sought to isolate labor setting from other risk factors in order to assess the effect of birth centers on the odds of cesarean birth. We generated low-risk cohorts admitted in labor to hospitals (n = 2527) and birth centers (n = 8776) using secondary data obtained from the American Association of Birth Centers (AABC). All women received prenatal care in the birth center and midwifery care in labor, but some chose hospital admission for labor. Analysis was intent to treat according to site of admission in spontaneous labor. We used propensity score adjustment and multivariable logistic regression to control for cohort differences and measured effect sizes associated with setting. There was a 37% (adjusted odds ratio [OR], 0.63; 95% confidence interval [CI], 0.50-0.79) to 38% (adjusted OR, 0.62; 95% CI, 0.49-0.79) decreased odds of cesarean in the birth center cohort and a remarkably low overall cesarean rate of less than 5% in both cohorts. These findings suggest that low rates of cesarean in birth centers are not attributable to labor setting alone. The entire birth center care model, including prenatal preparation and relationship-based midwifery care, should be studied, promoted, and implemented by policy makers interested in achieving appropriate cesarean rates in the United States. © 2016 by the American College of Nurse-Midwives.

Meson-baryon-baryon vertex function and the Ward-Takahashi identity

International Nuclear Information System (INIS)

Wang, S.; Banerjee, M.K.

1996-01-01

Ohta proposed a solution for the well-known difficulty of satisfying the Ward-Takahashi identity for a photo-meson-baryon-baryon amplitude (γMBB) when a dressed meson-baryon-baryon (MBB) vertex function is present. He obtained a form for the γMBB amplitude which contained, in addition to the usual pole terms, longitudinal seagull terms which were determined entirely by the MBB vertex function. He arrived at his result by using a Lagrangian which yields the MBB vertex function at tree level. We show that such a Lagrangian can be neither Hermitian nor charge conjugation invariant. We have been able to reproduce Ohta close-quote s result for the γMBB amplitude using the Ward-Takahashi identity and no other assumption, dynamical or otherwise, and the most general form for the MBB and γMBB vertices. However, contrary to Ohta close-quote s finding, we find that the seagull terms are not robust. The seagull terms extracted from the γMBB vertex occur unchanged in tree graphs, such as in an exchange current amplitude. But the seagull terms which appear in a loop graph, as in the calculation of an electromagnetic form factor, are, in general, different. The whole procedure says nothing about the transverse part of the (γMBB) vertex and its contributions to the amplitudes in question. copyright 1996 The American Physical Society

Stress-tensor commutators and Schwinger terms in singleton theories

International Nuclear Information System (INIS)

Bergshoeff, E.; Sezgin, E.; Tanii, Y.

1989-06-01

We compute the commutators of the regularized quantum stress-tensor of singleton theories formulated on the boundary of a (p + 2)-dimensional anti de Sitter space (AdS p+2 ). (These are superconformal field theories on S p x S 1 ). We find that the algebra is not closed except in the case of AdS 3 . It does contain, however, the finite dimensional AdS p+2 algebra SO(p + 1,2). We also find divergent, field dependent as well as field independent Schwinger terms (i.e. the central extensions), which, however, do not lead to anomalies in the algebra of the AdS charges. We also give a simple derivation of the two-point functions for bosonic and fermionic singletons. (author). 15 refs

Introduction to vertex algebras, Borcherds algebras and the Monster Lie algebras

International Nuclear Information System (INIS)

Gebert, R.W.

1993-09-01

The theory of vertex algebras constitutes a mathematically rigorous axiomatic formulation of the algebraic origins of conformal field theory. In this context Borcherds algebras arise as certain ''physical'' subspaces of vertex algebras. The aim of this review is to give a pedagogical introduction into this rapidly-developing area of mathematics. Based on the machinery of formal calculus we present the axiomatic definition of vertex algebras. We discuss the connection with conformal field theory by deriving important implications of these axioms. In particular, many explicit calculations are presented to stress the eminent role of the Jacobi identity axiom for vertex algebras. As a class of concrete examples the vertex algebras associated with even lattices are constructed and it is shown in detail how affine Lie algebras and the fake Monster Lie algebra naturally appear. This leads us to the abstract definition of Borcherds algebras as generalized Kac-Moody algebras and their basic properties. Finally, the results about the simplest generic Borcherds algebras are analysed from the point of view of symmetry in quantum theory and the construction of the Monster Lie algebra is sketched. (orig.)

MR imaging findings in cesarean scar pregnancy

International Nuclear Information System (INIS)

Zhang Xiangqun; Xu Yikai; Luo Xiaoqin

2012-01-01

Objective: To analyze MRI findings of cesarean scar pregnancy (CSP). Methods: The MR findings in 18 patients who were diagnosed as CSP by surgery from March 2010 to November 2011 were retrospectively analyzed, and comparison was made between the MRI findings and surgical results. Results: All Gestational sacs (18) were clearly detected by MRI. Among the 18 cases,gestational sac presented as cystic mass with smooth margin located within the scar of uterine wall at the lower anterior uterus in 16 cases. In 2 of the 16 cases, gestational sac was found within the myometrium, whereas in the remaining 14 cases, gestational sac was found partially within the myometrium with extension into the uterine cavity. The anterior wall of isthmus uteri became thinner. In the remaining 2 of the 18 cases, gestational sac presented as irregular, multilobolated mass, growing deep into the myometrium as well as into the uterine cavity. On T 2 WI, the mass showed heterogeneous signal intensity. A small amount of hemorrhage within the mass and uterine cavity could be seen on T 1 WI. An enhancing solid component with a heterogeneous mass could be seen. All gestational sacs in 18 cases were located at or adjacent to the previous cesarean scar. In the area of cesarean scar,the signal of the uterine wall was disconnected, with focal indentation or thinning and the previous cesarean scar exhibited hypointensity on both T 1 WI and T 2 WI. Conclusion: CSP has its unique findings on MRI, these specific features can provide useful information in the management of CSP. (authors)

Construction of a specification from its singleton part

NARCIS (Netherlands)

Fernández, R.; Maillard, G.

2006-01-01

We state a construction theorem for specications starting from single-site conditional probabilities (singleton part). We consider general single-site spaces and kernels that are absolutely continuous with respect to a chosen product mea- sure (free measure). Under a natural order-consistency

Maternal and neonatal copeptin levels at cesarean section and vaginal delivery.

Science.gov (United States)

Foda, Ashraf A; Abdel Aal, Ibrahim A

2012-12-01

The objective of the study was to measure the copeptin levels in maternal serum and umbilical cord serum at cesarean section and vaginal delivery in normotensive pregnancy and pre-eclamptic women. This was a prospective study at Mansoura University Hospital, Egypt. Ninety cases were included. They were divided into six groups: (1) normal pregnancy near term, as a control group, (2) primiparas who had vaginal delivery, (3) primiparas who had vaginal delivery and mild preeclampsia, (4) elective repeat cesarean section, (5) intrapartum cesarean section for indications other than fetal distress, and (6) intrapartum cesarean section for fetal distress. Serum copeptin concentrations were quantified with an enzyme-linked immunosorbent assay (ELISA). Mean, standard deviation, and paired t-test were used to test for significant change in quantitative data. The vaginal delivery groups had higher levels of maternal serum copeptin than the elective cesarean section group (P<0.01). Higher maternal serum copeptin levels were found in cases with pre-eclampsia as compared with the normotensive cases. The maternal copeptin levels during intrapartum cesarean section were higher than that during elective repeat cesarean section. There was a significant correlation between maternal copeptin levels and the duration of the first stage. In the presence of fetal distress, umbilical cord serum copeptin levels were significantly higher than other groups. Vaginal delivery can be very painful and stressful, and is accompanied by a marked increase of maternal serum copeptin. Increased maternal levels of serum copeptin were found in cases with pre-eclampsia as compared with the normotensive cases, and it may be helpful in assessing the disease. Intrauterine fetal distress is a strong stimulus to the release of copeptin into the fetal circulation. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

The CDF Silicon Vertex Trigger

International Nuclear Information System (INIS)

Dell'Orso, Mauro

2006-01-01

Motivations, design, performance and ongoing upgrade of the CDF Silicon Vertex Trigger are presented. The system provides CDF with a powerful tool for online tracking with offline quality in order to enhance the reach on B-physics and large P t -physics coupled to b quarks

BTeV detached vertex trigger

International Nuclear Information System (INIS)

Gottschalk, E.E.

2001-01-01

BTeV is a collider experiment that has been approved to run in the Tevatron at Fermilab. The experiment will conduct precision studies of CP violation using a forward-geometry detector. The detector will be optimized for high-rate detection of beauty and charm particles produced in collisions between protons and anti-protons. BTeV will trigger on beauty and charm events by taking advantage of the main difference between these heavy quark events and more typical hadronic events - the presence of detached beauty and charm decay vertices. The first stage of the BTeV trigger will receive data from a pixel vertex detector at a rate of 100 gb s -1 , reconstruct tracks and vertices for every beam crossing, reject 99% of beam crossings that do not produce beauty or charm particles, and trigger on beauty events with high efficiency. An overview of the trigger design and its influence on the design of the pixel vertex detector is presented

Stochastic higher spin six vertex model and Macdonald measures

Science.gov (United States)

Borodin, Alexei

2018-02-01

We prove an identity that relates the q-Laplace transform of the height function of a (higher spin inhomogeneous) stochastic six vertex model in a quadrant on one side and a multiplicative functional of a Macdonald measure on the other. The identity is used to prove the GUE Tracy-Widom asymptotics for two instances of the stochastic six vertex model via asymptotic analysis of the corresponding Schur measures.

Pion-nucleon vertex function with an off-shell nucleon

International Nuclear Information System (INIS)

Nutt, W.T.; Shakin, C.M.

1977-01-01

A model calculation for the π-N vertex function is presented in the case in which there is a single off-mass-shell nucleon and a (nearly) on-mass-shell pion. Very strong effects due to the P 11 resonance at 1470 MeV are found. A simple parametrization of the vertex function is prvided in the case that at least one nucleon is on its mass shell. (Auth.)

Worldline calculation of the three-gluon vertex

International Nuclear Information System (INIS)

Ahmadiniaz, N.; Schubert, C.

2012-01-01

The three-gluon vertex is a basic object of interest in nonabelian gauge theory. At the one-loop level, it has been calculated and analyzed by a number of authors. Here we use the worldline formalism to unify the calculations of the scalar, spinor and gluon loop contributions to the one-loop vertex, leading to an extremely compact representation in terms of field strength tensors. We verify its equivalence with previously obtained representations, and explain the relation of its structure to the low-energy effective action. The sum rule found by Binger and Brodsky for the scalar, spinor and gluon loop contributions in the present approach relates to worldline supersymmetry.

Simulations with the PANDA micro-vertex-detector

International Nuclear Information System (INIS)

Kliemt, Ralf

2013-01-01

The PANDA experiment will be built at the upcoming FAIR facility at GSI in Darmstadt, featuring antiproton-proton reactions hadron physics in a medium energy range. Charm physics will play an important role and therefore secondary decays relatively close to the interaction zone as well. The MVD will be the detector closest to these and will provide high-quality vertex position measurements. Alongside the detector layout and hardware development a detailed detector simulation and reconstruction software is required. This work contains the detailed description and the performance studies of the software developed for the MVD. Furthermore, vertexing tools are introduced and their performance is studied for the MVD.

Simulations with the PANDA micro-vertex-detector

Energy Technology Data Exchange (ETDEWEB)

Kliemt, Ralf

2013-07-17

The PANDA experiment will be built at the upcoming FAIR facility at GSI in Darmstadt, featuring antiproton-proton reactions hadron physics in a medium energy range. Charm physics will play an important role and therefore secondary decays relatively close to the interaction zone as well. The MVD will be the detector closest to these and will provide high-quality vertex position measurements. Alongside the detector layout and hardware development a detailed detector simulation and reconstruction software is required. This work contains the detailed description and the performance studies of the software developed for the MVD. Furthermore, vertexing tools are introduced and their performance is studied for the MVD.

Six-vertex model and Schramm-Loewner evolution

Science.gov (United States)

Kenyon, Richard; Miller, Jason; Sheffield, Scott; Wilson, David B.

2017-05-01

Square ice is a statistical mechanics model for two-dimensional ice, widely believed to have a conformally invariant scaling limit. We associate a Peano (space-filling) curve to a square ice configuration, and more generally to a so-called six-vertex model configuration, and argue that its scaling limit is a space-filling version of the random fractal curve SL E κ, Schramm-Loewner evolution with parameter κ , where 4 <κ ≤12 +8 √{2 } . For square ice, κ =12 . At the "free-fermion point" of the six-vertex model, κ =8 +4 √{3 } . These unusual values lie outside the classical interval 2 ≤κ ≤8 .

Network Unfolding Map by Vertex-Edge Dynamics Modeling.

Science.gov (United States)

Verri, Filipe Alves Neto; Urio, Paulo Roberto; Zhao, Liang

2018-02-01

The emergence of collective dynamics in neural networks is a mechanism of the animal and human brain for information processing. In this paper, we develop a computational technique using distributed processing elements in a complex network, which are called particles, to solve semisupervised learning problems. Three actions govern the particles' dynamics: generation, walking, and absorption. Labeled vertices generate new particles that compete against rival particles for edge domination. Active particles randomly walk in the network until they are absorbed by either a rival vertex or an edge currently dominated by rival particles. The result from the model evolution consists of sets of edges arranged by the label dominance. Each set tends to form a connected subnetwork to represent a data class. Although the intrinsic dynamics of the model is a stochastic one, we prove that there exists a deterministic version with largely reduced computational complexity; specifically, with linear growth. Furthermore, the edge domination process corresponds to an unfolding map in such way that edges "stretch" and "shrink" according to the vertex-edge dynamics. Consequently, the unfolding effect summarizes the relevant relationships between vertices and the uncovered data classes. The proposed model captures important details of connectivity patterns over the vertex-edge dynamics evolution, in contrast to the previous approaches, which focused on only vertex or only edge dynamics. Computer simulations reveal that the new model can identify nonlinear features in both real and artificial data, including boundaries between distinct classes and overlapping structures of data.

Recurrence risk of low Apgar score among term singletons: a population-based cohort study

NARCIS (Netherlands)

Ensing, Sabine; Schaaf, Jelle M.; Abu-Hanna, Ameen; Mol, Ben W. J.; Ravelli, Anita C. J.

2014-01-01

To examine the risk of recurrence of low Apgar score in a subsequent term singleton pregnancy. Population-based cohort study. The Netherlands. A total of 190,725 women with two subsequent singleton term live births between 1999 and 2007. We calculated the recurrence risk of low Apgar score after

Intravenous fluid rate for reduction of cesarean delivery rate in nulliparous women: a systematic review and meta-analysis.

Science.gov (United States)

Ehsanipoor, Robert M; Saccone, Gabriele; Seligman, Neil S; Pierce-Williams, Rebecca A M; Ciardulli, Andrea; Berghella, Vincenzo

2017-07-01

The National Institute of Child Health and Human Development, American College of Obstetricians and Gynecologists, and Society for Maternal-Fetal Medicine have emphasized the need to promote vaginal delivery and have offered recommendations to safely prevent primary cesarean delivery. However, there has been limited discussion regarding management of intravenous fluids and other aspects of labor management that may influence mode of delivery. Therefore the aim of our study was to determine whether an intravenous fluid rate of 250 vs. 125 mL/h is associated with a difference in cesarean delivery rate. Searches were performed in MEDLINE, OVID, Scopus, ClinicalTrials.gov, the PROSPERO International Prospective Register of Systematic Reviews, Embase, Web of Science, and the Cochrane Library for randomized controlled trials. We included all randomized controlled trials comparing intravenous fluid rates of 250 vs. 125 mL/h in nulliparous women in spontaneous labor at term with singleton pregnancies at ≥36 weeks. Studies were included regardless of the type of intravenous fluids used and regardless of whether oral intake was restricted during labor. Studies including multiparous women or women whose labor was induced were excluded. The primary outcome was the incidence of cesarean delivery. We planned to assess a subgroup analysis according to type of fluids used and according to restriction of oral fluid intake. Seven trials including 1215 nulliparous women in spontaneous labor at term were analyzed; 593 (48.8%) in the 250 mL/h group, and 622 (51.2%) in the 125 mL/h group. Five studies used lactated Ringer's solution, one used normal saline in dextrose water, and in one study it was unclear which intravenous fluid was used. Women who received intravenous fluids at 250 mL/h had a significantly lower incidence of cesarean delivery for any indication (12.5 vs. 18.1%; RR 0.70, 95% CI 0.53-0.92; seven studies, 1215 participants; I 2 = 0%) and for dystocia (4.9 vs. 7.7%; RR

The RAVE/VERTIGO vertex reconstruction toolkit and framework

Science.gov (United States)

Waltenberger, W.; Mitaroff, W.; Moser, F.; Pflugfelder, B.; Riedel, H. V.

2008-07-01

A detector-independent toolkit for vertex reconstruction (RAVE1) is being developed, along with a standalone framework (VERTIGO2) for testing, analyzing and debugging. The core algorithms represent state-of-the-art for geometric vertex finding and fitting by both linear (Kalman filter) and robust estimation methods. Main design goals are ease of use, flexibility for embedding into existing software frameworks, extensibility, and openness. The implementation is based on modern object-oriented techniques, is coded in C++ with interfaces for Java and Python, and follows an open-source approach. A beta release is available.

Factors contributing to the decision to perform a cesarean section in Labrador retrievers.

Science.gov (United States)

Dolf, Gaudenz; Gaillard, Claude; Russenberger, Jane; Moseley, Lou; Schelling, Claude

2018-02-27

In the past 10 years, the frequency of unplanned cesarean sections in the Labrador Retriever breeding colony at Guiding Eyes for the Blind stayed around 10% (range 5% to 28%). To reduce the number of cesarean sections, factors influencing the occurrence of a cesarean section need to be known. The goal of this study was to identify factors that contribute to the decision to perform a cesarean section. Of the 688 Labrador Retriever litters whelped between 2003 and 2016, 667 litters had sufficient data and remained in the analysis. The target trait was ordinal with the three levels "normal whelping", "assisted whelping" and "cesarean section". A general ordinal logistic regression approach was used to analyze the data. Model selection with possible predictors resulted in a final model including weight of the dam, the weight of the heaviest puppy of a litter, the number of fetuses malpositioned and the quality of uterine contractions. Weight and size of a litter, parity, maternal inbreeding coefficient, whelping season, dam and sire were dropped from the model because they were not significant. The risk of a cesarean section was influenced by the combination of the weight of the dam and the weight of the heaviest puppy in the litter, as well as by the number of malpositioned fetuses and the quality of the contractions. Larger puppies increased the risk of cesarean section especially when the dam had a lighter weight. For dams weighing 23.6 kg and 32.8 kg the predicted probability of a cesarean section was low, with 0.06 and 0.02, respectively, when the heaviest puppy in a litter was light (0.42 kg), contractions were normal and no fetus was malpositioned. However, the probability of a cesarean section was much higher, ranging from 0.24 to 0.08, when the heaviest puppy in a litter was heavy (0.66 kg). Means to reduce the cesarean section frequency in this Labrador Retriever breeding colony should include genetic selection for ideal puppy weight. In addition, dams

Safe management of cesarean section in a patient of Eisenmenger syndrome

Directory of Open Access Journals (Sweden)

Silvia Minicucci

2012-01-01

Full Text Available We report our experience of a 29-year-old female with a complete atrio-ventricular septal defect leading to a single ventricle physiology and Eisenmenger syndrome. The patient successfully underwent spinal anesthesia for cesarean section in the 31 st week of pregnancy. A multidisciplinary approach involving cardiologist, cardiac surgeon, obstetrician, and anesthesiologist was utilized to achieve a safe pregnancy and cesarean for the delivery of the baby. A close clinical assessment is required, especially during the third trimester when the risk of acute right ventricular dysfunction increases. The use of extracorporeal membrane oxygenation (ECMO (as a bridge to recovery or bridge to salvage was planned to support oxygenation and circulation in case of acute biventricular dysfunction. The delivery/cesarean section was performed in a cardiac surgery operating room, and to reduce the time-frame for ECMO institution the femoral vessels were exposed surgically before the cesarean section.

On the Relation between Edge and Vertex Modelling in Shape Analysis

DEFF Research Database (Denmark)

Hobolth, Asger; Kent, John Thomas; Dryden, Ian L.

2002-01-01

Objects in the plane with no obvious landmarks can be described by either vertex transformation vectors or edge transformation vectors. In this paper we provide the relation between the two transformation vectors. Grenander & Miller (1994) use a multivariate normal distribution with a block...... circulant covariance matrix to model the edge transformation vector. This type of model is also feasible for the vertex transformation vector and in certain cases the free parameters of the two models match up in a simple way. A vertex model and an edge model are applied to a data set of sand particles...

Effects of Vertex Activity and Self-organized Criticality Behavior on a Weighted Evolving Network

International Nuclear Information System (INIS)

Zhang Guiqing; Yang Qiuying; Chen Tianlun

2008-01-01

Effects of vertex activity have been analyzed on a weighted evolving network. The network is characterized by the probability distribution of vertex strength, each edge weight and evolution of the strength of vertices with different vertex activities. The model exhibits self-organized criticality behavior. The probability distribution of avalanche size for different network sizes is also shown. In addition, there is a power law relation between the size and the duration of an avalanche and the average of avalanche size has been studied for different vertex activities

Opinions of women towards cesarean delivery and priority issues of care in the postpartum period.

Science.gov (United States)

Kisa, Sezer; Zeyneloğlu, Simge

2016-05-01

This study was conducted, in order to determine the opinions of women who had a cesarean delivery and the problems that they faced in the postpartum period. This descriptive study was conducted with 337 women who delivered babies by cesarean section. The data were collected using a semi-structured questionnaire. The results of the study showed that 53.4% of women underwent cesarean delivery for the first time, and 83.1% said that it was the obstetrician's decision to have a cesarean delivery. More than half of the women (61.1%) had a negative experience with cesarean delivery due to postpartum pain (44.7%) and inability to care for their infant (35.9%). The most common problems associated with cesarean delivery were postpartum pain (96.1%), back pain (68.2%), problems passing gas (62.0%), bleeding (56.1%), breastfeeding problems (49.6%) and limitation of movement (43.6%) respectively. Understanding the the opinions and problems of women towards cesarean delivery assists healthcare professionals in identifying better ways to provide appropriate care and support. Copyright © 2015 Elsevier Inc. All rights reserved.

Cesarean section trends in the Nordic Countries – a comparative analysis with the Robson classification

DEFF Research Database (Denmark)

Pyykönen, Aura; Gissler, Mika; Løkkegaard, Ellen

2017-01-01

(3 398 586) between 2000 and 2011 in Denmark, Finland, Iceland, Norway and Sweden. The Robson group distribution, cesarean rate and contribution of each Robson group were analyzed nationally for four 3-year time periods. For each country, we analyzed which groups contributed to the change......Introduction: The cesarean rates are low but increasing in most Nordic countries. Using the Robson classification, we analyzed which obstetric groups have contributed to the changes in the cesarean rates. Material and methods: Retrospective population-based registry study including all deliveries...... in the total cesarean rate. Results: Between the first and the last time period studied, the total cesarean rates increased in Denmark (16.4 to 20.7%), Norway (14.4 to 16.5%) and Sweden (15.5 to 17.1%), but towards the end of our study, the cesarean rates stabilized or even decreased. The increase...

Gauge covariant fermion-photon vertex in quenched, massless three dimensional quantum electrodynamics

International Nuclear Information System (INIS)

Tjiang, P.C.; Burden, C.J.

1998-01-01

Full text: We consider the problem of designing an Ansatz for the transverse part of the fermion-photon vertex in QED 3 . Our work is based on that of Ball and Chiu, who consider restrictions placed on the vertex by the U(1) Ward identity, and on subsequent modifications which attempt to satisfy the Landau-Khalatnikov transformation rules. A class of vertex Ansaetze including that proposed by Dong et al is tested using the gauge invariance of the vacuum polarisation scalar

Managed care market share and cesarean section rates in the United States: is there a link?

Science.gov (United States)

Hueston, W J; Sutton, A

2000-11-01

After peaking during the early 1980s, cesarean section rates in the United States have been falling for the last decade. At the same time, managed care enrollment has increased dramatically. This study examines whether managed care penetration in local markets is associated with lower cesarean section rates in those geographic area. A cross-sectional comparison of cesarean section rates and health maintenance organization (HMO) market penetration in 61 selected metropolitan areas in the United States was conducted. National birth certificate data for 1996 were used to calculate crude and race-adjusted cesarean section rates for residents in each area. No relationship between overall cesarean section rates in the metropolitan areas and managed care penetration was observed. Subanalyses of racial groups demonstrated the existence of a weak association between managed care penetration and cesarean section rates for white women (21.2% for the highest quartile of HMO penetration, compared with 19.1% for the lowest quartile; P = .03), but not for African-Americans or other minorities. Managed care penetration in a market may have an association with cesarean section rates for white women, but the strength of this relationship is small. Even if managed care delivery systems reduce cesarean section rates in their own populations, this change is likely to have only a small impact on overall cesarean rates. HMO penetration is unlikely to influence national cesarean section rates, nor does it appear to explain state variations in these rates.

Comparison of Subcuticular Suture Materials in Cesarean Skin Closure

Directory of Open Access Journals (Sweden)

Pınar Solmaz Hasdemir

2015-01-01

Full Text Available Aim. Comparison of the rate of wound complications, pain, and patient satisfaction based on used subcuticular suture material. Methods. A total of 250 consecutive women undergoing primary and repeat cesarean section with low transverse incision were prospectively included. The primary outcome was wound complication rate including infection, dehiscence, hematoma, and hypertrophic scar formation within a 6-week period after operation. Secondary outcomes were skin closure time, the need for use of additional analgesic agent, pain score on numeric rating scale, cosmetic score, and patient scar satisfaction scale. Results. Absorbable polyglactin was used in 108 patients and nonabsorbable polypropylene was used in 142 patients. Wound complication rates were similar in primary and repeat cesarean groups based on the type of suture material. Skin closure time is longer in nonabsorbable suture material group in both primary and repeat cesarean groups. There was no difference between groups in terms of postoperative pain, need for additional analgesic use, late phase pain, and itching at the scar. Although the cosmetic results tended to be better in the nonabsorbable group in primary surgery patients, there was no significant difference in the visual satisfaction of the patients. Conclusions. Absorbable and nonabsorbable suture materials are comparable in cesarean section operation skin closure.

A study of factors influencing surgical cesarean delivery times in an academic tertiary center.

Science.gov (United States)

Gonzalez Fiol, A; Meng, M-L; Danhakl, V; Kim, M; Miller, R; Smiley, R

2018-05-01

Knowledge of hospital-specific average cesarean delivery operative times, and factors influencing length of surgery, can serve as a guide for anesthesiologists when choosing the optimal anesthetic technique. The aim of this study was to determine operative times and the factors influencing those times for cesarean delivery. We conducted a retrospective review of all 1348 cesarean deliveries performed at an academic hospital in 2011. The primary outcome was mean operative time for first, second, third and fourth or more cesarean deliveries. The secondary goal was to identify factors influencing operative time. Variables included age, body mass index, previous surgery, gestational age, urgency of cesarean delivery, anesthesia type, surgeon's seniority, layers closed, and performance of tubal ligation. Mean (standard deviation) operative times for first (n=857), second (n=353), third (n=108) and fourth or more (n=30) cesarean deliveries were 56 (19), 60 (19), 69 (28) and 82 (31) minutes, respectively (P cesarean delivery or the presence of other factors that could increase operative time may warrant catheter-based anesthetic techniques or the addition of adjunctive medications to prolong spinal anesthetic block. Institutional and individual surgeon factors may play an even more important role in determining surgical time. Copyright © 2018 Elsevier Ltd. All rights reserved.

Cesarean section in the People’s Republic of China: current perspectives

Directory of Open Access Journals (Sweden)

Feng XL

2014-01-01

Full Text Available Xing Lin Feng,1 Ying Wang,1 Lin An,2 Carine Ronsmans3 1Department of Health Policy and Administration, School of Public Health, Peking University, Beijing, People’s Republic of China; 2Department of Women, Children and Adolescent Health, School of Public Health, Peking University, Beijing, People’s Republic of China; 3Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, England Objective: To review the current knowledge on the prevalence, reasons, and consequences of cesarean sections in the People’s Republic of China. Methods: Peer-reviewed articles were systematically searched on PubMed. The following Chinese databases were comprehensively searched: the China National Knowledge Infrastructure, Wanfang, and the VIP information. The databases were searched from inception to September 1, 2013. Two reviewers independently screened the titles and abstracts for eligibility. Full texts of eligible papers were reviewed, where relevant references were hand-searched and reviewed. Findings: Sixty articles were included from PubMed, 17 articles were intentionally picked out from Chinese journals, and five additional articles were added, for a total of 82 articles for the analysis. With a current national rate near 40%, the literature consistently reported a rapid rise of cesarean sections in the People’s Republic of China in the past decades, irrespective of where people lived or their socioeconomic standing. Nonclinical factors were considered as the main drivers fueling the rise of cesareans in the People’s Republic of China. There was a lively debate on whether women’s preferences or providers’ distorted financial incentives affected the rise in cesarean sections. However, recent evidence suggests that it might be the People’s Republic of China’s health development approach – focusing on specialized care and marginalizing primary care – that is playing a role. Although 30 articles

Status and prospects of the LHCb Vertex Locator

CERN Document Server

van Beuzekom, Martin

2007-01-01

The Vertex Locator of the LHCb experiment is a dedicated subdetector for the reconstruction of primary and secondary vertices in b-hadron decays. The vertex detector features two halves with 21 modules each, mounted on retractable bases. Each module consists of two half-disk silicon micro-strip sensors measuring hits in R and $\\Phi$ coordinates. The strip pitch ranges from 40 to about 100 $\\mu$m. A vacuum boy with a 300 $\\mu$m thick aluminium foil shields the sensors from the wakefields of the proton beams which are passing at a distance of 8 mm from the active area of the sensors. Because of the harsh non-uniform radiation environment we opted for n-on-n strips in diffusion oxygenated float zone silicon. The current status of the vertex detector, which has recently entered the commissioning phase, will be discussed. Given the limited lifetime of the detector due to the radiation environment, developments for a detector replacement with n-on-p type modules have already started. Possible upgrade scenarios fo...

Risk factors for wound disruption following cesarean delivery.

Science.gov (United States)

Subramaniam, Akila; Jauk, Victoria C; Figueroa, Dana; Biggio, Joseph R; Owen, John; Tita, Alan T N

2014-08-01

Risk factors for post-cesarean wound infection, but not disruption, are well-described in the literature. The primary objective of this study was to identify risk factors for non-infectious post-cesarean wound disruption. Secondary analysis was conducted using data from a single-center randomized controlled trial of staple versus suture skin closure in women ≥24 weeks' gestation undergoing cesarean delivery. Wound disruption was defined as subcutaneous skin or fascial dehiscence excluding primary wound infections. Composite wound morbidity (disruption or infection) was examined as a secondary outcome. Patient demographics, medical co-morbidities, and intrapartum characteristics were evaluated as potential risk factors using multivariable logistic regression. Of the 398 randomized patients, 340, including 26 with disruptions (7.6%) met inclusion criteria and were analyzed. After multivariable adjustments, African-American race (aOR 3.9, 95% CI 1.1-13.8) and staple - as opposed to suture - wound closure (aOR 5.4, 95% CI 1.8-16.1) remained significant risk factors for disruption; non-significant increases were observed for body mass index ≥30 (aOR 2.1, 95% CI 0.6-7.5), but not for diabetes mellitus (aOR 0.9, 95% CI 0.3-2.9). RESULTS for composite wound morbidity were similar. Skin closure with staples, African-American race, and considering the relatively small sample size, potentially obesity are associated with increased risk of non-infectious post-cesarean wound disruption.

Chiral vertex operators in off-conformal theory: Sine-Gordon example

International Nuclear Information System (INIS)

Chang, S.; Rajaraman, R.

1996-01-01

We study chiral vertex operators in sine-Gordon (SG) theory, viewed as an off-conformal system. We find that these operators, which would have been primary fields in the conformal limit, have interesting properties in the SG model. Some of them commute with the cosine interaction term in the Hamiltonian at a finite separation. Their Heisenberg equations of motion are local in space. An example of such vertex operators is Mandelstam close-quote s bosonic representation of the Fermi field. Another example is a set of vertex operators of topological number 2. We show how to construct conserved nonlocal currents from these operators. In the presence of the nonconformal interactions, these nonlocal currents have unique Lorentz spins. copyright 1996 The American Physical Society

Systematic review of progesterone for the prevention of preterm birth in singleton pregnancies

DEFF Research Database (Denmark)

Rode, Line; Langhoff-Roos, Jens; Andersson, Charlotte

2009-01-01

. SEARCH STRATEGY: A search in the PubMed, Embase, and Cochrane database was performed using the keywords: pregnancy, progesterone, preterm birth/preterm delivery, preterm labor, controlled trial, and randomized controlled trial. SELECTION CRITERIA: Studies on singleton pregnancies. DATA COLLECTION...... AND ANALYSIS: A meta-analysis was performed on randomized trials including singleton pregnancies with previous preterm birth. MAIN RESULTS: Two new randomized controlled trials of women with previous preterm birth were added to the four analyzed in the Cochrane review, and the meta-analysis of all six studies......BACKGROUND: A Cochrane review in 2006 concluded that further knowledge is required before recommendation can be made with regard to progesterone in the prevention of preterm birth. OBJECTIVE: To provide an update on the preventive effect of progesterone on preterm birth in singleton pregnancies...

[The effect of breast massage at different time in the early period after cesarean section].

Science.gov (United States)

Chu, J Y; Zhang, L; Zhang, Y J; Yang, M J; Li, X W; Sun, L L

2017-11-06

Objective: To evaluate the effect of breast massage at different time in the early period on maternal lactation after cesarean section. Methods: 80 women delivered by cesarean section were randomly selected from maternity ward of a hospital in Shandong province during Jan. 2013 to Jan. 2015; which were divided into four groups, with 20 patients in each. Three groups received 3 times of breast massage every 24 hoursbeginning from 2, 12 and 24 h after cesarean section, respectively. The control group didn't receive any breast massage. The starting time and status of lactation were observed and recorded after cesarean section. 5 ml venous blood sample was drawn from each patient respectively at 2 h before cesarean, 6, 12, 24, 48 and 72 h after cesarean to test the level of serum prolactin. The lactation status of each group was compared. Results: The P (50) ( P (25)- P (75)) of starting time of lactation of the three massage groups and control group were 3 (2-6) h, 4 (2-8) h, 4 (3-12) h and 4 (2-12) h, respectively, whose differences showed no statistical significance ( H =3.32, P= 0.345).The number of delivered women with adequate lactation 24 hours after cesarean was 10 in the group who received massage beginning from 2 h after cesarean; while the number was only 2 in the control group. The number of delivered women with adequate lactation 48 hours after cesarean was 18 in the group who received massage beginning from 2 h after cesarean; while the number was 8 in the control group. The differences showed statistical significances ( P values were 0.021 and 0.008, respectively). The serum prolactin level in the group of delivered women who received massage from 2 h after cesarean was separately (195.9±78.5), (176.0±96.5), (216.4±110.0), (190.0±56.8) and (184.8±69.6) μg/L at 2, 12, 24, 48 and 72 h after cesarean, which were significantly higher than those in the control group (which were (128.8±40.6), (127.3±66.8), (162.2±58.8), (145.1±64.7) and (141.7±49

The ARGUS vertex trigger

International Nuclear Information System (INIS)

Koch, N.; Kolander, M.; Kolanoski, H.; Siegmund, T.; Bergter, J.; Eckstein, P.; Schubert, K.R.; Waldi, R.; Imhof, M.; Ressing, D.; Weiss, U.; Weseler, S.

1995-09-01

A fast second level trigger has been developed for the ARGUS experiment which recognizes tracks originating from the interaction region. The processor compares the hits in the ARGUS Micro Vertex Drift Chamber to 245760 masks stored in random access memories. The masks which are fully defined in three dimensions are able to reject tracks originating in the wall of the narrow beampipe of 10.5 mm radius. (orig.)

Deciding Type Equivalence in a Language with Singleton Kinds

National Research Council Canada - National Science Library

Stone, Christopher

1999-01-01

...: S(A) is the kind of all types provably equivalent to the type A. Singletons are interesting because they provide a very general form of definitions for type variables and allow fine-grained control of type computations...

Risk Factors for Cesarean Delivery following Labor Induction in Multiparous Women

NARCIS (Netherlands)

Verhoeven, Corine J.; van Uytrecht, Cedric T.; Porath, Martina M.; Mol, Ben Willem J.

2013-01-01

Objective. To identify potential risk factors for cesarean delivery following labor induction in multiparous women at term. Methods. We conducted a retrospective case-control study. Cases were parous women in whom the induction of labor had resulted in a cesarean delivery. For each case, we used the

Physical and Organizational Job Stressors in Pregnancy and Associations With Primary Cesarean Deliveries.

Science.gov (United States)

Guendelman, Sylvia; Gemmill, Alison; Hosang, Nap; MacDonald, Leslie A

2017-06-01

The aim of this study was to assess the relationship between exposure to physical and organizational job stressors during pregnancy and cesarean delivery. We sampled 580 employed women in California who participated in a nested population-based case-control study of birth outcomes. Adjusted multivariate regression analyses estimated associations between heavy lifting, frequent bending, high noise, extreme temperature, prolonged standing and organizational stressors (shift work, inflexible schedules, effort-reward ratio), and primary cesarean (vs vaginal) delivery, controlling for covariates. Women occupationally exposed had higher odds of cesarean. Those exposed to daily manual lifting more than 15 pounds [adjusted odds ratio = 2.54; 95% confidence interval (95% CI) 1.21 to 5.32] and at least four physical job stressors (adjusted odds ratio = 3.49; 95% CI 1.21 to 10.09) had significantly elevated odds of cesarean delivery. Exposed morbid women experienced greater risk; risk was lower among those with schedule flexibility. Associations were found between modifiable exposure to physical job stressors during pregnancy and cesarean delivery.

Cesarean section and offspring's risk of multiple sclerosis

DEFF Research Database (Denmark)

Nielsen, Nete M; Bager, Peter; Stenager, Egon

2013-01-01

Apart from a recent study reporting a 2- to 3-fold increased risk of multiple sclerosis (MS) among women and men who were delivered by Cesarean section (C-section), little attention has been given to the possible association between mode of delivery and the risk of MS.......Apart from a recent study reporting a 2- to 3-fold increased risk of multiple sclerosis (MS) among women and men who were delivered by Cesarean section (C-section), little attention has been given to the possible association between mode of delivery and the risk of MS....

Efficacy of Intrauterine Bakri Balloon Tamponade in Cesarean Section for Placenta Previa Patients.

Directory of Open Access Journals (Sweden)

Hee Young Cho

Full Text Available The aims of this study were to analyze the predictive factors for the use of intrauterine balloon insertion and to evaluate the efficacy and factors affecting failure of uterine tamponade with a Bakri balloon during cesarean section for abnormal placentation.We reviewed the medical records of 137 patients who underwent elective cesarean section for placenta previa between July 2009 and March 2014. Cesarean section and Bakri balloon insertion were performed by a single qualified surgeon. The Bakri balloon was applied when blood loss during cesarean delivery exceeded 1,000 mL.Sixty-four patients (46.7% required uterine balloon tamponade during cesarean section due to postpartum bleeding from the lower uterine segment, of whom 50 (78.1% had placenta previa totalis. The overall success rate was 75% (48/64 for placenta previa patients. Previous cesarean section history, anterior placenta, peripartum platelet count, and disseminated intravascular coagulopathy all significantly differed according to balloon success or failure (all p<0.05. The drainage amount over 1 hour was 500 mL (20-1200 mL in the balloon failure group and 60 mL (5-500 mL in the balloon success group (p<0.01.Intrauterine tamponade with a Bakri balloon is an adequate adjunct management for postpartum hemorrhage following cesarean section for placenta previa to preserve the uterus. This method is simple to apply, non-invasive, and inexpensive. However, possible factors related to failure of Bakri balloon tamponade for placenta previa patients such as prior cesarean section history, anterior placentation, thrombocytopenia, presence of DIC at the time of catheter insertion, and catheter drainage volume more than 500 mL within 1 hour of catheter placement should be recognized, and the next-line management should be prepared in advance.

[Gestational trophoblastic diseases in cesarean scar: an analysis of 20 cases].

Science.gov (United States)

Zhang, Ge'er; Pan, Zimin

2017-05-25

To analyze the clinical features, diagnosis and treatment of gestational trophoblastic diseases in cesarean scar. Clinical data of three cases of gestational trophoblastic diseases in cesarean scar diagnosed in Women's Hospital, Zhejiang University School of Medicine during December 2011 and December 2016 were collected. And literature search was performed in Wanfang data, VIP, CNKI, PubMed, ISI Web of Knowledge and EMbase database. A total of 20 cases of gestational trophoblastic diseases were included in the analysis. Clinical features were mainly abnormal vaginal bleeding after menopause, artificial abortion or medical abortion, which might be accompanied by abdominal pain. Serum β-human chorionic gonadotropin (β-hCG) levels were increased in 19 patients. The sonographic features were increase of uterine volume, honeycomb-like abnormal intrauterine echo (or described as multiple cystic dark area, multiple anechoic area and multiple liquid dark area) or heterogeneity echo conglomeration, and no clear bound with muscular layer in some cases. There were abundant blood flow signals inside or around the lesions. The ultrasonography indicated that the lesions were located in the anterior side of the uterine isthmus with the involvement of cesarean section scar. In 12 cases with lesions in cesarean scar shown by preliminary diagnosis, 9 underwent uterine artery embolization (UAE) for pretreatment; the blood loss greater than 1500 mL was observed in only one case without UAE; no patient received hysterectomy. In 8 patients whose lesions were not shown in cesarean scar, only one case received UAE pretreatment, and hysterectomy was performed in 3 cases due to blood loss greater than 1500 mL. Two cases were lost in follow-up and no death was reported in remaining 18 cases. The serum β-hCG levels returned to normal or satisfactory level during the follow-up in 17 cases with increased β-hCG levels before treatment and no recurrence was observed. The misdiagnosis rate and

The Micro-Vertex-Detector for the P-bar ANDA experiment

International Nuclear Information System (INIS)

Zotti, Laura

2013-01-01

P-bar ANDA is a fixed target experiment that will be carried out at the future FAIR facility. P-bar ANDA will provide an excellent tool to address fundamental question in the field of hadronic physics, with a physic program that extends from the investigation of QCD (providing insight in the mechanisms of mass generation and confinement) to the test of fundamental symmetries. The Micro-Vertex-Detector located in the innermost part of the central tracking system will be composed by hybrid pixel and double-sided micro-strip silicon detectors. The Micro-Vertex-Detector will play an important role for the P-bar ANDA physics goals. The possibility to reconstruct the secondary vertices and the applicability of a precise D meson tagging is essential for the spectroscopy in the open charm sector and the charmonium mass region. To this aim the Micro-Vertex-Detector features a spatial resolution better than 100μm, a time resolution better than 20ns, a limited material budget, and a high data rate capability in a triggerless environment. An overview of the Micro-Vertex-Detector related to the physics goals will be presented.

Impact of obstetric history on the risk of spontaneous preterm birth in singleton and multiple pregnancies: a systematic review.

Science.gov (United States)

Kazemier, B M; Buijs, P E; Mignini, L; Limpens, J; de Groot, C J M; Mol, B W J

2014-09-01

Information about the recurrence of spontaneous preterm birth in subsequent twin/singleton pregnancies is scattered. To quantify the risk of recurrence of spontaneous preterm birth in different subtypes of subsequent pregnancies. An electronic literature search in OVID MEDLINE and EMBASE, complemented by PubMed, to find recent studies. Studies comparing the risk of spontaneous preterm birth after a previous preterm and previous term pregnancy. The absolute risk of recurrence with a 95% confidence interval and the absolute risk of preterm birth after a term delivery were calculated. Data from studies were pooled using the Mantel-Haenszel method. We detected 13 relevant studies. The risk of recurrence of preterm birth was significantly increased in all preterm pregnancy subtypes, compared with their term counterparts. Women pregnant with twins after a previous preterm singleton had the highest absolute risk of recurrence (57.0%, 95% CI 51.9-61.9%), and after a previous term singleton their absolute risk was 25% (95% CI 24.3-26.5%). Women pregnant with a singleton after a previous preterm twin pregnancy have an absolute recurrence risk of 10% (95% CI 8.2-12.3%), whereas a singleton pregnancy after delivering a previous twin up to term yields a low absolute risk of only 1.3% (95% CI 0.8-2.2). Women pregnant with a singleton after a previous preterm singleton have an absolute recurrence risk of 20% (95% CI 19.9-20.6). The risk of recurrence of preterm birth is influenced by the singleton/twin order in both pregnancies, and varies between 10% for a singleton after previous preterm twins to 57% for twins after a previous preterm singleton. © 2014 Royal College of Obstetricians and Gynaecologists.

Factors associated with successful vaginal birth after cesarean section and outcomes in rural area of Anatolia

Science.gov (United States)

Senturk, Mehmet Baki; Cakmak, Yusuf; Atac, Halit; Budak, Mehmet Sukru

2015-01-01

Successful vaginal birth after cesarean section is more comfortable than repeat emergency or elective cesarean section. Antenatal examinations are important in selection for trial of labor, while birth management can be difficult when the patients present at emergency condition. But there is an increased chance of vaginal birth with advanced cervical dilation. This study attempts to evaluate factors associated with success of vaginal birth after cesarean section and to compare the maternal and perinatal outcomes between vaginal birth after cesarean section and intrapartum cesarean section in patients who were admitted to hospital during the active or second stage of labor. A retrospective evaluation was made from the results of 127 patients. Cesarean section was performed in 57 patients; 70 attempted trial of labor. The factors associated with success of vaginal birth after cesarean section were investigated. Maternal and neonatal outcomes were compared between the groups. Vaginal birth after cesarean section was successful in 55% of cases. Advanced cervical opening, effacement, gravidity, parity, and prior vaginal delivery were factors associated with successful vaginal birth. The vaginal birth group had more complications (P0.05). In this study, cervical opening, effacement, gravidity, parity, and prior vaginal delivery were important factors for successful vaginal birth after cesarean section. The patients’ requests influenced outcome. Trial of labor should take into consideration the patient’s preference, together with the proper setting. PMID:26203286

The RAVE/VERTIGO vertex reconstruction toolkit and framework

Energy Technology Data Exchange (ETDEWEB)

Waltenberger, W; Mitaroff, W; Moser, F; Pflugfelder, B; Riedel, H V [Austrian Academy of Sciences, Institute of High Energy Physics, A-1050 Vienna (Austria)], E-mail: walten@hephy.oeaw.ac.at

2008-07-15

A detector-independent toolkit for vertex reconstruction (RAVE{sup 1}) is being developed, along with a standalone framework (VERTIGO{sup 2}) for testing, analyzing and debugging. The core algorithms represent state-of-the-art for geometric vertex finding and fitting by both linear (Kalman filter) and robust estimation methods. Main design goals are ease of use, flexibility for embedding into existing software frameworks, extensibility, and openness. The implementation is based on modern object-oriented techniques, is coded in C++ with interfaces for Java and Python, and follows an open-source approach. A beta release is available.

Auditory Attentional Capture: Effects of Singleton Distractor Sounds

Science.gov (United States)

Dalton, Polly; Lavie, Nilli

2004-01-01

The phenomenon of attentional capture by a unique yet irrelevant singleton distractor has typically been studied in visual search. In this article, the authors examine whether a similar phenomenon occurs in the auditory domain. Participants searched sequences of sounds for targets defined by frequency, intensity, or duration. The presence of a…

Obstetric interventions and maternal morbidity among women who experience severe postpartum hemorrhage during cesarean delivery.

Science.gov (United States)

Seligman, K; Ramachandran, B; Hegde, P; Riley, E T; El-Sayed, Y Y; Nelson, L M; Butwick, A J

2017-05-01

Compared to vaginal delivery, women undergoing cesarean delivery are at increased risk of postpartum hemorrhage. Management approaches may differ between those undergoing prelabor cesarean delivery compared to intrapartum cesarean delivery. We examined surgical interventions, blood component use, and maternal outcomes among those experiencing severe postpartum hemorrhage within the two distinct cesarean delivery cohorts. We performed secondary analyses of data from two cohorts who underwent prelabor cesarean delivery or intrapartum cesarean delivery at a tertiary obstetric center in the United States between 2002 and 2012. Severe postpartum hemorrhage was classified as an estimated blood loss ≥1500mL or receipt of a red blood cell transfusion up to 48h post-cesarean delivery. We examined blood component use, medical and surgical interventions and maternal outcomes. The prelabor cohort comprised 269 women and the intrapartum cohort comprised 278 women. In the prelabor cohort, one third of women received red blood cells intraoperatively or postoperatively, respectively. In the intrapartum cohort, 18% women received red blood cells intraoperatively vs. 44% postoperatively (Pcesarean delivery had the highest rates of morbidity, with 18% requiring hysterectomy and 16% requiring intensive care admission. Our findings provide a snapshot of contemporary transfusion and surgical practices for severe postpartum hemorrhage management during cesarean delivery. To determine optimal transfusion and management practices in this setting, large pragmatic studies are needed. Copyright © 2017 Elsevier Ltd. All rights reserved.

Validation of models that predict Cesarean section after induction of labor

NARCIS (Netherlands)

Verhoeven, C. J. M.; Oudenaarden, A.; Hermus, M. A. A.; Porath, M. M.; Oei, S. G.; Mol, B. W. J.

2009-01-01

Objective Models for the prediction of Cesarean delivery after induction of labor can be used to improve clinical decision-making. The objective of this study was to validate two existing models, published by Peregrine et al. and Rane et al., for the prediction of Cesarean section after induction of

Analysis on Indications and Causes of Cesarean Section on Pemba Island of Zanzibar in Africa

Directory of Open Access Journals (Sweden)

Liping Zhou

2013-03-01

Full Text Available Objective: To explore and analyze the indications and causes of cesarean section on Pemba island of Zanzibar in Africa to improve the quality of obstetrics. Methods: 564 patients performed cesarean section in Abdulla Mzee Hospital of Pemba from January, 2008 to December, 2011 were selected, and statistics was conducted by the method of retrospective analysis. Results: The rate of cesarean section in Abdulla Mzee Hospital of Pemba was 10.01%. The primary causes of cesarean section included cephalopelvic disproportion (27.13%, scar uterus (23.40%, preeclampsia and eclampsia (13.30%, fetal distress in uterus (9.40%, fetal factors (9.75% and complication of pregnancy (6.91%. Conclusion: Cesarean section plays a great role in the treatment of dystocia, some complications of pregnancy and reducing the mortality of pregnant women and perinatal infants, but in the area with relatively undeveloped medical conditions in Africa, cesarean section still takes great risks. Unnecessary cesarean section cannot reduce the incidence of postpartum hemorrhage and neonatal morbidity. The local medical staff should improve the midwifery technique, establish and perfect the formal antenatal examination system to improve the quality of maternity.

The OPAL vertex detector prototype

International Nuclear Information System (INIS)

Roney, J.M.; Armitage, J.C.; Carnegie, R.K.; Giles, G.L.; Hemingway, R.J.; McPherson, A.C.; Pinfold, J.L.; Waterhouse, J.; Godfrey, L.; Hargrove, C.K.

1989-01-01

The prototype test results of a high resolution charged particle tracking detector are reported. The detector is designed to measure vertex topologies of particles produced in the e + e - collisions of the OPAL experiment at LEP. The OPAL vertex detector is a 1 m long, 0.46 m diameter cylindrical drift chamber consisting of an axial and stereo layer each of which is divided into 36 jet cells. A prototype chamber containing four axial and two stereo cells was studied using a pion test beam at CERN. The studies examined the prototype under a variety of operating conditions. An r-Φ resolution of 60 μm was obtained when the chamber was operated with argon (50%)-ethane (50%) at 3.75 bar, and when CO 2 (80%)-isobutane (20%) at 2.5 bar was used a 25 μm resolution was achieved. A z measurement using end-to-end time difference has a resolution of 3.5 cm. The details of these prototype studies are discussed in this paper. (orig.)

Complications of cesarean deliveries among HIV-infected women in the United States

Science.gov (United States)

Kourtis, Athena P.; Ellington, Sascha; Pazol, Karen; Flowers, Lisa; Haddad, Lisa; Jamieson, Denise J.

2015-01-01

Objective To compare rates of complications associated with cesarean delivery in HIV-infected and HIV-uninfected women in the United States and to investigate trends in such complications across four study cycles spanning the implementation of HAART in the United States (1995–1996, 2000–2001, 2005–2006, 2010–2011). Design The Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project is the largest all-payer hospital inpatient care database in the United States; when weighted to account for the complex sampling design, nationally representative estimates are derived. After restricting the study sample to women aged 15–49 years, our study sample consisted of approximately 1 090 000 cesarean delivery hospitalizations annually. Methods Complications associated with cesarean deliveries were categorized as infection, hemorrhage, or surgical trauma, based on groups of specific International Classification of Diseases 9th revision codes. Length of hospitalization, hospital charges, and in-hospital deaths were also examined. Results The rate of complications significantly decreased during the study periods for HIV-infected and HIV-uninfected women. However, rates of infectious complications and surgical trauma associated with cesarean deliveries remained higher among HIV-infected, compared with HIV-uninfected women in 2010–2011, as did prolonged hospital stay and in-hospital deaths. Length of hospitalization decreased over time for cesarean deliveries of HIV-infected women to a greater extent compared with HIV-uninfected women. Conclusion In the United States, rates of cesarean delivery complications decreased from 1995 to 2011. However, rates of infection, surgical trauma, hospital deaths, and prolonged hospitalization are still higher among HIV-infected women. Clinicians should remain alert to this persistently increased risk of cesarean delivery complications among HIV-infected women. PMID:25574961

Urinary bladder injury during cesarean delivery: Maternal outcome from a contemporary large case series.

Science.gov (United States)

Salman, Lina; Aharony, Shachar; Shmueli, Anat; Wiznitzer, Arnon; Chen, Rony; Gabbay-Benziv, Rinat

2017-06-01

Urinary bladder injury is a rare complication during cesarean delivery. Little is known on maternal outcome following this injury. To evaluate short and long-term maternal outcome following bladder injury during cesarean delivery. A retrospective case series of all pregnancies complicated by full-thickness bladder injury during cesarean delivery in a single university affiliated tertiary medical center (August 2007-June 2016). Data on demographics, labor and surgery parameters, postpartum sequelae, and cystography were collected and reviewed by study personnel. Short-term maternal outcome included catheterization period, cystography results (if performed), any febrile illness and/or need for second operation prior to maternal discharge. Long term maternal outcome was obtained by searching our urology departmental and ambulatory database for follow up for all women. Univariate analysis was used to compare maternal outcome following first or repeat cesarean delivery. Of 17,326 cesarean deliveries performed during study period, 81 (0.47%) were complicated by bladder injury. Of them, 8 cases (9.9%) occurred during primary cesarean delivery (overall risk in primary cesarean 0.07%). Of the other 73 cases that followed repeated cesarean, adhesions were documented in 55 (75.3%) of them. Six cases (8.2%) had placenta accreta. Bladder injury occurred at peritoneal entry in 55 (67.9%) cases, and involved the bladder dome in 49 (60.5%) of them. Injury was diagnosed during cesarean delivery in all but 3 women, in whom abdominal pain and bloating prompted evaluation on first to third postoperative day. All 3 underwent re-laparotomy with bladder closure without further adverse sequelae. Cystography was performed in 35 patients on median postoperative day 8 (6-11 days). Eleven patients had abnormal findings as follows: 5 urinary leakage, 4 bladder wall irregularity and two urinary reflux. Two of the 11 patients (18%) required additional interventions: One patient required

Hysteroscopic findings in patients with post-menstrual spotting with prior cesarean section

Directory of Open Access Journals (Sweden)

Valdely Helena Talamonte

2012-03-01

Full Text Available Objective: To identify uterine hysteroscopic findings among patientswith prior cesarean section and whom had post-menstrual bleedingspotting type. Methods: We conducted a descriptive and prospective study between June 2008 and December 2009 involving women admitted to our clinic in Ji-Paraná (RO, Brazil, and who complained of prolonged genital bleeding after menstrual period. A total of 20 women with the simultaneous following characteristics were selected: at least one prior cesarean section, aged between 18 and 45 years, no use of hormonal contraceptives, and no history of uterine surgery that could change the cavity anatomy. All participants underwent a hysteroscopic examination. Results: During hysteroscopy, in 90% of the patients, the presence of a cesarean section scar was observed in the last third of the cervix. This scarring causes an anomaly in the uterine cavity anatomy, characterized by the viewing of an enlargement followed by a retraction of the anterior wall, which affords the presence of a pseudocavity with depth and lumen narrowing in variable degrees. Two patients did not present the pseudocavity. Conclusion: Pseudocavities in cesarean section scar are usually found in hysteroscopic examination of patients with prior cesarean section and abnormal uterine spotting.

Placenta previa and risk of major congenital malformations among singleton births in Finland.

Science.gov (United States)

Kancherla, Vijaya; Räisänen, Sari; Gissler, Mika; Kramer, Michael R; Heinonen, Seppo

2015-06-01

Placenta previa has been associated with adverse birth outcomes, but its association with congenital malformations is inconclusive. We examined the association between placenta previa and major congenital malformations among singleton births in Finland. We performed a retrospective population register-based study on all singletons born at or after 22+0 weeks of gestation in Finland during 2000 to 2010. We linked three national health registers: the Finnish Medical Birth Register, the Hospital Discharge Register, and the Register of Congenital Malformations, and examined several demographic and clinical characteristics among women with and without placenta previa, in association with major congenital malformations. We estimated adjusted odds ratios and 95% confidence intervals using multivariable logistic regression models. The prevalence of placenta previa was estimated as 2.65 per 1000 singleton births in Finland (95% confidence interval, 2.53-2.79). Overall, 6.2% of women with placenta previa delivered a singleton infant with a major congenital malformation, compared with 3.8% of unaffected women (p ≤ 0.001). Placenta previa was positively associated with almost 1.6-fold increased risk of major congenital malformations in the offspring, after controlling for maternal age, parity, fetal sex, smoking, socio-economic status, chorionic villus biopsy, In vitro fertilization, pre-existing diabetes, depression, preeclampsia, and prior caesarean section (adjusted odds ratio = 1.55; 95% confidence interval, 1.27-1.90). Using a large population-based study, we found that placenta previa was weakly, but significantly associated with an increased risk of major congenital malformations in singleton births. Future studies should examine the association between placenta previa and individual types of congenital malformations, specifically in high-risk pregnancies. © 2015 Wiley Periodicals, Inc.

Vaginal Cleansing Before Cesarean Delivery: A Systematic Review and Meta-analysis.

Science.gov (United States)

Caissutti, Claudia; Saccone, Gabriele; Zullo, Fabrizio; Quist-Nelson, Johanna; Felder, Laura; Ciardulli, Andrea; Berghella, Vincenzo

2017-09-01

To assess the efficacy of vaginal cleansing before cesarean delivery in reducing postoperative endometritis. MEDLINE, Ovid, EMBASE, Scopus, Clinicaltrials.gov, and Cochrane Library were searched from their inception to January 2017. Selection criteria included all randomized controlled trials comparing vaginal cleansing (ie, intervention group) with a control group (ie, either placebo or no intervention) in women undergoing cesarean delivery. Any method of vaginal cleansing with any type of antiseptic solution was included. The primary outcome was the incidence of endometritis. Meta-analysis was performed using the random-effects model of DerSimonian and Laird to produce summary treatment effects in terms of relative risk (RR) with 95% CI. Sixteen trials (4,837 women) on vaginal cleansing immediately before cesarean delivery were identified as relevant and included in the review. In most of the included studies, 10% povidone-iodine was used as an intervention. The most common way to perform the vaginal cleansing was the use of a sponge stick for approximately 30 seconds. Women who received vaginal cleansing before cesarean delivery had a significantly lower incidence of endometritis (4.5% compared with 8.8%; RR 0.52, 95% CI 0.37-0.72; 15 studies, 4,726 participants) and of postoperative fever (9.4% compared with 14.9%; RR 0.65, 95% CI 0.50-0.86; 11 studies, 4,098 participants) compared with the control group. In the planned subgroup analyses, the reduction in the incidence of endometritis with vaginal cleansing was limited to women in labor before cesarean delivery (8.1% compared with 13.8%; RR 0.52, 95% CI 0.28-0.97; four studies, 440 participants) or those with ruptured membranes (4.3% compared with 20.1%; RR 0.23, 95% CI 0.10-0.52; three studies, 272 participants). Vaginal cleansing immediately before cesarean delivery in women in labor and in women with ruptured membranes reduces the risk of postoperative endometritis. Because it is generally inexpensive and a

Child Maltreatment Among Singletons and Multiple Births in Japan: A Population-Based Study.

Science.gov (United States)

Yokoyama, Yoshie; Oda, Terumi; Nagai, Noriyo; Sugimoto, Masako; Mizukami, Kenji

2015-12-01

The occurrence of multiple births has been recognized as a risk factor for child maltreatment. However, few population-based studies have examined the relationship between multiple births and child maltreatment. This study aimed to evaluate the degree of risk of child maltreatment among singletons and multiple births in Japan and to identify factors associated with increased risk. Using population-based data, we analyzed the database of records on child maltreatment and medical checkups for infants aged 1.5 years filed at Nishinomiya City Public Health Center between April 2007 and March 2011. To protect personal information, the data were transferred to anonymized electronic files for analysis. After adjusting by logistic regression for each associated factor and gestation number, multiples themselves were not associated with the risk of child maltreatment. However, compared with singletons, multiples had a significantly higher rate of risk factors for child maltreatment, including low birth weight and neural abnormality. Moreover, compared with mothers of singleton, mothers of twins had a significantly higher rate of poor health, which is a risk factor of child maltreatment. Multiples were not associated with the risk of child maltreatment. However, compared with singletons, multiples and their mothers had a significantly higher rate of risk factors of child maltreatment.

Technologies for Future Vertex and Tracking Detectors at CLIC

CERN Document Server

Spannagel, Simon

2018-01-01

CLIC is a proposed linear e$^{+}$e$^{-}$ collider with center-of-mass energies of up to 3 TeV. Its main objectives are precise top quark and Higgs boson measurements, as well as searches for Beyond Standard Model physics. To meet the physics goals, the vertex and tracking detectors require not only a spatial resolution of a few micrometers and a very low material budget, but also timing capabilities with a precision of a few nanoseconds to allow suppression of beam-induced backgrounds. Different technologies using hybrid silicon detectors are explored for the vertex detectors, such as dedicated readout ASICs, small-pitch active edge sensors as well as capacitively coupled High-Voltage CMOS sensors. Monolithic sensors are considered as an option for the tracking detector, and a prototype using a CMOS process with a high-resistivity epitaxial layer is being designed. Different designs using a silicon-on-insulator process are under investigation for both vertex and tracking detector. All prototypes are evaluate...

Aleph silicon microstrip vertex detector

CERN Multimedia

Laurent Guiraud

1998-01-01

This microstrip vertex locator was located at the heart of the ALEPH experiment, one of the four experiments at the Large Electron-Positron (LEP) collider. In the experiments at CERN's LEP, which ran from 1989 to 2000, modern silicon microvertex detectors, such as those used at ALEPH, monitored the production of short-lived particles close to the beam pipe.

The ARGUS silicon vertex detector

International Nuclear Information System (INIS)

Michel, E.; Ball, S.; Ehret, K.; Geyer, C.; Hesselbarth, J.; Hoelscher, A.; Hofmann, W.; Holzer, B.; Huepper, A.; Khan, S.; Knoepfle, K.T.; Seeger, M.; Spengler, J.; Brogle, M.; Horisberger, R.

1994-01-01

A silicon microstrip vertex detector has been built as an upgrade to the ARGUS detector for increased precision and efficiency in the reconstruction of decay vertices. This paper discusses the mechanical and electronic design of this device and presents first results from its successful test operation yielding an impact parameter resolution of about 18 μm. ((orig.))

Feasibility of abdominoplasty with Cesarean section [Retraction

Directory of Open Access Journals (Sweden)

Thabet WN

2013-01-01

Full Text Available The Editor-in-Chief and Publisher of the International Journal of Women’s Health have been alerted by Dr Nadine Sherif, the corresponding author, to unacceptable levels of duplication with a previously published paper: Ali A, Essam A. Abdominoplasty Combined with Cesarean Delivery: Evaluation of the Practice. Aesthetic Plastic Surgery. 2011;35(1:80–86.It is worth noting that this paper was peer-reviewed by two peer-reviewers and the Editor-in-Chief of the International Journal of Women’s Health before publication. The paper concerned is: Thabet WN, Hossny AS, Sherif NA. Feasibility of abdominoplasty with Cesarean section. International Journal of Women’s Health. 2012;4:115–121.

Tracking and vertexing with the ATLAS detector at the LHC

International Nuclear Information System (INIS)

Hirsch, F.

2011-01-01

The Inner Detector of the ATLAS experiment at the Large Hadron Collider at CERN contains three tracking systems: The silicon Pixel Detector, the Silicon Microstrip Tracker and the Transition Radiation Tracker. In combination these detectors provide excellent track and vertex reconstruction efficiencies and resolutions. This paper describes studies which show the performance of track and vertex reconstruction on data collected at 7 TeV center-of-mass energy.

Employment during pregnancy and obstetric intervention without medical reason: labor induction and cesarean delivery.

Science.gov (United States)

Kozhimannil, Katy Backes; Attanasio, Laura B; Johnson, Pamela Jo; Gjerdingen, Dwenda K; McGovern, Patricia M

2014-01-01

Rising rates of labor induction and cesarean delivery, especially when used without a medical reason, have generated concern among clinicians, women, and policymakers. Whether employment status affects pregnant women's childbirth-related care is not known. We estimated the relationship between prenatal employment and obstetric procedures, distinguishing whether women reported that the induction or cesarean was performed for medical reasons. Using data from a nationally representative sample of women who gave birth in U.S. hospitals (n = 1,573), we used propensity score matching to reduce potential bias from nonrandom selection into employment. Outcomes were cesarean delivery and labor induction, with and without a self-reported medical reason. Exposure was prenatal employment status (full-time employment, not employed). We conducted separate analyses for unmatched and matched cohorts using multivariable regression models. There were no differences in labor induction based on employment status. In unmatched analyses, employed women had higher odds of cesarean delivery overall (adjusted odds ratio [AOR], 1.45; p = .046) and cesarean delivery without medical reason (AOR, 1.94; p = .024). Adding an interaction term between employment and college education revealed no effects on cesarean delivery without medical reason. There were no differences in cesarean delivery by employment status in the propensity score-matched analysis. Full-time prenatal employment is associated with higher odds of cesarean delivery, but this association was not explained by socioeconomic status and no longer existed after accounting for sociodemographic differences by matching women employed full time with similar women not employed during pregnancy. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Repeat cesarean section in subsequent gestation of women from a birth cohort in Brazil.

Science.gov (United States)

Mascarello, Keila Cristina; Matijasevich, Alicia; Barros, Aluísio J D; Santos, Iná S; Zandonade, Eliana; Silveira, Mariângela Freitas

2017-08-25

The current literature indicates increasing concern regarding the number of safe cesarean sections which a woman can undergo, mainly in face of the high cesarean section rates, which are growing in Brazil and worldwide. Aimed to describe the prevalence and associated factors of repeat cesarean section in a cohort of Brazilian women who had a cesarean section in the first birth. This is a prospective cohort study using data from the 2004 Pelotas Birth Cohort. The sample included 480 women who had their first delivery in 2004, regardless of the form of delivery, and who had a second delivery identified in the cohort's follow-ups (in 2005, 2006, 2008, and 2010). Descriptive, bivariate and multivariate analyses using Poisson regression with robust error variance were carried out. Among the women who underwent a cesarean section in their first delivery (49.47%), 87.44% had a second surgical delivery. The risk factors for repeat cesarean section included ages 21-34 (PR 1.67, CI 95% 1.07-2.60), not being seen by SUS (Public Healthcare System) in 2004 (PR 2.27, CI 95% 1.44-3.60), and the number of prenatal medical visits, i.e., women with ten or more visits were at 2.33 times higher risk (CI 95% 1.10-4.96) compared to those who had five or fewer visits. The proportion of cesarean sections both in the first and in the subsequent delivery is quite high. This high rate may compromise the reproductive future of the women who undergo consecutive cesarean sections with possible consequent complications and changes in care policies for pregnant women should be implemented.

Three-coloring graphs with no induced seven-vertex path II : using a triangle

OpenAIRE

Chudnovsky, Maria; Maceli, Peter; Zhong, Mingxian

2015-01-01

In this paper, we give a polynomial time algorithm which determines if a given graph containing a triangle and no induced seven-vertex path is 3-colorable, and gives an explicit coloring if one exists. In previous work, we gave a polynomial time algorithm for three-coloring triangle-free graphs with no induced seven-vertex path. Combined, our work shows that three-coloring a graph with no induced seven-vertex path can be done in polynomial time.

Factors Associated With Increased Cesarean Risk Among African American Women: Evidence From California, 2010

Science.gov (United States)

Doctor, Jason N.

2015-01-01

Objectives. We studied if both observed and unobserved maternal health in African American women in hospitals or communities were associated with cesarean delivery of infants. Methods. We examined the relationship between African American race and cesarean delivery among 493 433 women discharged from 255 Californian hospitals in 2010 using administrative data; we adjusted for patient comorbidities and maternal, fetal, and placental risk factors, as well as clustering of patients within hospitals. Results. Cesarean rates were significantly higher overall for African American women than other women (unadjusted rate 36.8% vs 32.7%), as were both elective and emergency primary cesarean rates. Elevated risks persisted after risk adjustment (odds ratio generally > 1.27), but the prevalence of particular risk factors varied. Although African American women were clustered in some hospitals, the proportion of African Americans among all women delivering in a hospital was not related to its overall cesarean rate. Conclusions. To address the higher likelihood of elective cesarean delivery, attention needs to be given to currently unmeasured patient-level health factors, to the quality of provider–physician interactions, as well as to patient preferences. PMID:25790391

Acute parotiditis after cesarean section; case report

Directory of Open Access Journals (Sweden)

Cristina Moisei

2017-11-01

Full Text Available The enlargement of the parotid gland develops in inflammatory or stenotic conditions but after Cesarean section the symptomatology is unusual. A 38 year old patient with no obstetrical history referred to our clinic for pregnancy, which followed our national program of prenatal care. The outcome of the pregnancy was favorable for both mother and fetus. During labor the fetus developed bradycardia and the patient delivered by Cesarean section a 3400 g baby-boy with 8 Apgar Score; the anesthesia was spinal. 18 hours after delivery the patient presented mild respiratory distress. The symptomatology was caused by the enlargement of the parotid gland. The treatment was supportive and the remission occurred 10 hours after the onset. The initial discussion that raised this case was caused by the viral, infection and stenotic cause of the parotiditis. All these reasons had no medical argument. It was also debated about the anesthesia but, until now, the medical literature didn’t report any case of association between parotiditis and spinal anesthesia. It is also impossible to correlate the parotiditis with IVF procedure. As a conclusion, this case is unique because it represents the parotiditis without unknown case that appeared after Cesarean section and spinal anesthesia in a healthy woman.

Risk of Asthma from Cesarean Delivery Depends on Membrane Rupture

DEFF Research Database (Denmark)

Sevelsted, Astrid; Stokholm, Jakob; Bisgaard, Hans

2016-01-01

in Childhood2000 is a high-risk birth cohort of 411 Danish children. Asthma was diagnosed prospectively by physicians at the research site, and associations with cesarean delivery were investigated using Cox proportional hazard models. From the Danish national prospective registry we included data from 1997......-2010. Childhood asthma was defined from recurrent use of inhaled corticosteroids filled at pharmacies. Cesarean delivery was classified as either before or after rupture of membranes, and the risk of asthma was compared with vaginal delivery. Results were adjusted stepwise for age and calendar year, sex, birth...... weight, gestational age, multiple births, parity, and maternal factors (age, smoking/antibiotics during pregnancy, employment status, and asthma). RESULTS: In the Copenhagen Prospective Studies on Asthma in Childhood2000 cohort, the adjusted hazard ratio for asthma was increased by cesarean delivery...

Disclosing doubtful indications for emergency cesarean sections in rural hospitals in Tanzania

DEFF Research Database (Denmark)

Maaløe, Nanna; Bygbjerg, Ib Christian; Onesmo, Rwakyendela

2012-01-01

To investigate in depth to what extent indications for emergency cesarean sections followed evidence-based audit criteria for realistic best practice.......To investigate in depth to what extent indications for emergency cesarean sections followed evidence-based audit criteria for realistic best practice....

Patient-Initiated Elective Cesarean Section of Nulliparous Women in British Columbia, Canada

NARCIS (Netherlands)

Hutton, E.K.; Kornelsen, J.

2012-01-01

Background: The proportion of cesarean sections is increasing in Canada overall and in British Columbia in particular. It has been suggested that this increase is partially the result of women requesting the procedure, although the prevalence of patient-initiated elective cesarean section is

Vertex and Tracker Research and Development for CLIC

CERN Document Server

Munker, M

2017-01-01

Challenging detector requirements are imposed by the physics goals at the future multi-TeV e+e− Compact Linear Collider (CLIC). A single point resolution of 3 μm for the vertex detector and 7 μm for the tracker is required. Moreover, the CLIC vertex detector and tracker need to be extremely light weighted with a material budget of 0.2%X0 per layer in the vertex detector and 1 - 2%X0 in the tracker. A fast time slicing of 10 ns is further required to suppress background from beam-beam interactions. A wide range of sensor and readout ASIC technologies are investigated within the CLIC silicon pixel R&D; effort. Various hybrid planar sensor assemblies with a pixel size of 25 × 25 μm2 and 55 × 55 μm2 have been produced and characterised by laboratory measurements and during test-beam campaigns. Experimental and simulation results for thin (50 μm- 500 μm) slim edge and active-edge planar, and High-Voltage CMOS sensors hybridised to various readout ASICs (Timepix, Timepix3, CLICpix) are presented.

Shifts of visuospatial attention to invisible (metacontrast-masked) singletons: Clues from reaction times and event-related potential

OpenAIRE

Manfred Heumann; Ulrich Ansorge

2006-01-01

In the current study, we tested whether a masked and, thus, invisible singleton-cue captures atten-tion in a stimulus-driven manner or in a top-down contingent manner. The manual RT (Reaction Time) capture effect with the invisible singleton--cue decreased substantially when a match between the singleton-cue and the top-down controlled set of searched-for target features was also decreased. By contrast, with the PCN (Posterior Contralateral Negativity), an electrophysiological measure of the ...

Likelihood of cesarean delivery after applying leading active labor diagnostic guidelines.

Science.gov (United States)

Neal, Jeremy L; Lowe, Nancy K; Phillippi, Julia C; Ryan, Sharon L; Knupp, Amy M; Dietrich, Mary S; Thung, Stephen F

2017-06-01

Friedman, the United Kingdom's National Institute for Health and Care Excellence (NICE), and the American College of Obstetricians and Gynecologists/Society for Maternal-Fetal Medicine (ACOG/SMFM) support different active labor diagnostic guidelines. Our aims were to compare likelihoods for cesarean delivery among women admitted before vs in active labor by diagnostic guideline (within-guideline comparisons) and between women admitted in active labor per one or more of the guidelines (between-guideline comparisons). Active labor diagnostic guidelines were retrospectively applied to cervical examination data from nulliparous women with spontaneous labor onset (n = 2573). Generalized linear models were used to determine outcome likelihoods within- and between-guideline groups. At admission, 15.7%, 48.3%, and 10.1% of nulliparous women were in active labor per Friedman, NICE, and ACOG/SMFM diagnostic guidelines, respectively. Cesarean delivery was more likely among women admitted before vs in active labor per the Friedman (AOR 1.75 [95% CI 1.08-2.82] or NICE guideline (AOR 2.55 [95% CI 1.84-3.53]). Between guidelines, cesarean delivery was less likely among women admitted in active labor per the NICE guideline, as compared with the ACOG/SMFM guideline (AOR 0.55 [95% CI 0.35-0.88]). Many nulliparous women are admitted to the hospital before active labor onset. These women are significantly more likely to have a cesarean delivery. Diagnosing active labor before admission or before intervention to speed labor may be one component of a multi-faceted approach to decreasing the primary cesarean rate in the United States. The NICE diagnostic guideline is more inclusive than Friedman or ACOG/SMFM guidelines and its use may be the most clinically useful for safely lowering cesarean rates. © 2017 Wiley Periodicals, Inc.

Perinatal Outcomes Associated With Isolated Velamentous Cord Insertion in Singleton and Twin Pregnancies.

Science.gov (United States)

Sinkin, Joshua A; Craig, Wendy Y; Jones, Michael; Pinette, Michael G; Wax, Joseph R

2018-02-01

To evaluate perinatal outcomes in singleton and twin pregnancies with pathologically confirmed velamentous cord insertion without vasa previa. This retrospective case-control study included all nonanomalous singleton and twin pregnancies with pathologically confirmed velamentous cord insertion delivered in a single institution between January 1, 2005, and July 1, 2015, and having an ultrasound examination by maternal-fetal medicine. For each case, the next 2 consecutive deliveries matched for gestational age at delivery ± 1 week and, in twins, amnionicity and chorionicity served as controls. Primary outcomes included surgical delivery for a nonreassuring intrapartum fetal heart rate tracing, umbilical arterial cord pH of less than 7.2, 5-minute Apgar score of less than 7, birth weight below the 10th percentile, neonatal intensive care unit admission, fetal or neonatal death, and cord avulsion necessitating manual placental extraction. Outcomes were available for 53 singletons with 103 matched controls and 33 twin pregnancies with 65 matched controls. In singletons, velamentous cord insertion was associated with cord pH of less than 7.2 (odds ratio [OR] 3.5; 95% confidence interval [CI], 1.1-11.2; P = .039), 5-minute Apgar score of less than 7 (OR, 5.3; 95% CI, 0.99-28.1; P = .045), and cord avulsion requiring manual placental extraction (7.5% versus 0%; P = .012). Associations were suggested with increased surgical delivery for a nonreassuring intrapartum fetal heart rate tracing (OR, 2.4; 95% CI, 0.9-6.9; P = .14), birth weight below the 10th percentile (OR, 2.1; 95% CI, 0.8-5.9; P = .21), and fetal or neonatal death (3.8% versus 0%; P = .11). Velamentous cord insertions were also associated with placental abruption in singletons (7.5% versus 0%; P = .013). Among twins, velamentous cord insertion was associated with fetal or neonatal death (9.1% versus 0%; P = .036). Isolated confirmed velamentous cord insertion is associated

Markov branching in the vertex splitting model

International Nuclear Information System (INIS)

Stefánsson, Sigurdur Örn

2012-01-01

We study a special case of the vertex splitting model which is a recent model of randomly growing trees. For any finite maximum vertex degree D, we find a one parameter model, with parameter α element of [0,1] which has a so-called Markov branching property. When D=∞ we find a two parameter model with an additional parameter γ element of [0,1] which also has this feature. In the case D = 3, the model bears resemblance to Ford's α-model of phylogenetic trees and when D=∞ it is similar to its generalization, the αγ-model. For α = 0, the model reduces to the well known model of preferential attachment. In the case α > 0, we prove convergence of the finite volume probability measures, generated by the growth rules, to a measure on infinite trees which is concentrated on the set of trees with a single spine. We show that the annealed Hausdorff dimension with respect to the infinite volume measure is 1/α. When γ = 0 the model reduces to a model of growing caterpillar graphs in which case we prove that the Hausdorff dimension is almost surely 1/α and that the spectral dimension is almost surely 2/(1 + α). We comment briefly on the distribution of vertex degrees and correlations between degrees of neighbouring vertices

Association Between Type of Health Insurance and Elective Cesarean Deliveries: New Jersey, 2004–2007

Science.gov (United States)

2011-01-01

Objectives. I examined the relationship between insurance coverage, which may influence physician incentives and maternal choices, and cesarean delivery before labor. Methods. I analyzed hospital discharge data for mothers without previous cesarean deliveries in New Jersey between 2004 and 2007, with adjustment for maternal age, race, marital status, and maternal, fetal, and placental conditions. Results. Nearly 1 in 7 women (13.9%) had a cesarean delivery without laboring. Insurance status was strongly associated with cesarean birth. Women insured by Medicaid (adjusted relative risk [ARR] = 0.88; 95% confidence interval [CI] = 0.84, 0.91) or self-paying (ARR = 0.81; 95% CI = 0.78, 0.85) had a significantly lower likelihood, and women insured by BlueCross (ARR = 1.06; 95% CI = 1.03, 1.09) or standard commercial plans (ARR = 1.06; 95% CI = 1.02, 1.10) had a significantly higher likelihood of cesarean delivery than did women insured by commercial health maintenance organizations. These associations persisted in subsets restricted to lower-risk women and in qualitative sensitivity analyses for a hypothetical single, binary, unmeasured confounder. Conclusions. Insurance status has a small, independent impact on whether a woman without a previous cesarean delivery proceeds to labor or has a cesarean delivery without labor. PMID:21940911

Vertex Stimulation as a Control Site for Transcranial Magnetic Stimulation: A Concurrent TMS/fMRI Study.

Science.gov (United States)

Jung, JeYoung; Bungert, Andreas; Bowtell, Richard; Jackson, Stephen R

2016-01-01

A common control condition for transcranial magnetic stimulation (TMS) studies is to apply stimulation at the vertex. An assumption of vertex stimulation is that it has relatively little influence over on-going brain processes involved in most experimental tasks, however there has been little attempt to measure neural changes linked to vertex TMS. Here we directly test this assumption by using a concurrent TMS/fMRI paradigm in which we investigate fMRI blood-oxygenation-level-dependent (BOLD) signal changes across the whole brain linked to vertex stimulation. Thirty-two healthy participants to part in this study. Twenty-one were stimulated at the vertex, at 120% of resting motor threshold (RMT), with short bursts of 1 Hz TMS, while functional magnetic resonance imaging (fMRI) BOLD images were acquired. As a control condition, we delivered TMS pulses over the left primary motor cortex using identical parameters to 11 other participants. Vertex stimulation did not evoke increased BOLD activation at the stimulated site. By contrast we observed widespread BOLD deactivations across the brain, including regions within the default mode network (DMN). To examine the effects of vertex stimulation a functional connectivity analysis was conducted. The results demonstrated that stimulating the vertex with suprathreshold TMS reduced neural activity in brain regions related to the DMN but did not influence the functional connectivity of this network. Our findings provide brain imaging evidence in support of the use of vertex simulation as a control condition in TMS but confirm that vertex TMS induces regional widespread decreases in BOLD activation. Copyright © 2015 The Authors. Published by Elsevier Inc. All rights reserved.

Conservation laws, vertex corrections, and screening in Raman spectroscopy

Science.gov (United States)

Maiti, Saurabh; Chubukov, Andrey V.; Hirschfeld, P. J.

2017-07-01

We present a microscopic theory for the Raman response of a clean multiband superconductor, with emphasis on the effects of vertex corrections and long-range Coulomb interaction. The measured Raman intensity, R (Ω ) , is proportional to the imaginary part of the fully renormalized particle-hole correlator with Raman form factors γ (k ⃗) . In a BCS superconductor, a bare Raman bubble is nonzero for any γ (k ⃗) and diverges at Ω =2 Δmax , where Δmax is the largest gap along the Fermi surface. However, for γ (k ⃗) = constant, the full R (Ω ) is expected to vanish due to particle number conservation. It was sometimes stated that this vanishing is due to the singular screening by long-range Coulomb interaction. In our general approach, we show diagrammatically that this vanishing actually holds due to vertex corrections from the same short-range interaction that gives rise to superconductivity. We further argue that long-range Coulomb interaction does not affect the Raman signal for any γ (k ⃗) . We argue that vertex corrections eliminate the divergence at 2 Δmax . We also argue that vertex corrections give rise to sharp peaks in R (Ω ) at Ω <2 Δmin (the minimum gap along the Fermi surface), when Ω coincides with the frequency of one of the collective modes in a superconductor, e.g., Leggett and Bardasis-Schrieffer modes in the particle-particle channel, and an excitonic mode in the particle-hole channel.

The impact of nonclinical factors on repeat cesarean section.

Science.gov (United States)

Stafford, R S

1991-01-02

Nonclinical factors, including the setting in which health care takes place, influence clinical decisions. This research measures the independent effects of organizational and socioeconomic factors on repeat cesarean section use in California. Of 45,425 births to women with previous cesarean sections in 1986, vaginal birth after cesarean section occurred in 10.9%. Sizable nonclinical variations were noted. By hospital ownership, rates ranged from 4.9% (for-profit hospitals) to 29.2% (University of California). Variations also existed by hospital teaching level (nonteaching hospitals, 7.0%, vs formalized teaching hospitals, 23.3%); payment source (private insurance, 8.1%, vs indigent services, 25.2%); and obstetric volume (low-volume hospitals, 5.4%, vs high-volume hospitals, 16.6%). Multiple logistic regression demonstrated that these variables had independent effects after accounting for their overlapping influences and the effects of patient characteristics. The observed variations demonstrate the prominence of nonclinical factors in decision making and question the clinical appropriateness of current practice patterns.

Status of vertex and tracking detector R&D at CLIC

CERN Document Server

AUTHOR|(SzGeCERN)754272

2015-01-01

The physics aims at the future CLIC high-energy linear e+e- collider set very high precision requirements on the performance of the vertex and tracking detectors. Moreover, these detectors have to be well adapted to the experimental conditions, such as the bunch train structure of the beam and the presence of beam-induced backgrounds. The principal challenges are: a point resolution of a few micron, ultra-low mass (~0.2% X0 per layer for the inner vertex region), very low power dissipation (compatible with air-flow cooling in the inner vertex region) and pulsed power operation, complemented with ~10 ns time stamping capabilities. An overview of the R&D program for pixel and tracking detectors at CLIC will be presented, including recent results on an innovative hybridisation concept based on capacitive coupling between active sensors (HV-CMOS) and readout ASICs (CLICpix).

The Yang-Baxter equation for PT invariant 19-vertex models

International Nuclear Information System (INIS)

Pimenta, R A; Martins, M J

2011-01-01

We study the solutions of the Yang-Baxter equation associated with 19-vertex models invariant by the parity-time symmetry from the perspective of algebraic geometry. We determine the form of the algebraic curves constraining the respective Boltzmann weights and find that they possess a universal structure. This allows us to classify the integrable manifolds into four different families reproducing three known models, besides uncovering a novel 19-vertex model in a unified way. The introduction of the spectral parameter on the weights is made via the parameterization of the fundamental algebraic curve which is a conic. The diagonalization of the transfer matrix of the new vertex model and its thermodynamic limit properties are discussed. We point out a connection between the form of the main curve and the nature of the excitations of the corresponding spin-1 chains.

Birthweight distribution in ART singletons resulting from embryo culture in two different culture media compared with the national population.

Science.gov (United States)

Lemmen, J G; Pinborg, A; Rasmussen, S; Ziebe, S

2014-10-10

Is there a difference in birthweight distribution in ART singletons born after IVF culture in two different culture media? There is no effect of culture media on both crude and adjusted birthweight distributions in ART singletons from nulliparous mothers. Studies on human ART singletons have reported a difference in birthweight in singletons following IVF culture in different culture media. However, other studies comparing different culture media have not shown any significant differences in birthweight. This study was a retrospective comparison of birthweights in IVF/ICSI singletons conceived after fresh embryo transfer following embryo culture in Cook or Medicult medium and in a national cohort of naturally conceived singletons in nulliparous women. The study compares four independent groups consisting of singletons in nulliparous women from Cook-d2: 2-day culture in Cook medium at Rigshospitalet (n = 974), Medicult-d2: 2-day culture in Medicult EmbryoAssist medium at Rigshospitalet (n = 147), Medicult-d3: 3-day culture in Medicult EmbryoAssist medium with and without added GM-CSF (n = 204), and DK: pregnancies from the Danish birth registry (n = 106842). The study compares the birthweights of singletons from nulliparous women in the four independent groups mentioned above; Cook-d2: Medicult-d2: Medicult-d3: and DK. In addition, distributions of large and small for gestational age infants were compared between the groups and a multiple linear regression analysis was used to determine which factors determined birthweight. We found no significant difference in the crude birthweight distributions between singletons born after culture in Cook-d2 or Medicult-groups. Singleton girls from the Cook-d2 group weighed 3302 ± 28 g, versus 3252 ± 76 in the Medicult-d2 group (difference 50 g; P = 0.547). Singleton boys from the Cook-d2 group weighed 3430 ± 27 g, versus 3354 ± 56 in the Medicult-d2 group (difference 76 g; P = 0.279). In the background population, mean

Silicon technologies for the CLIC vertex detector

Science.gov (United States)

Spannagel, S.

2017-06-01

CLIC is a proposed linear e+e- collider designed to provide particle collisions at center-of-mass energies of up to 3 TeV. Precise measurements of the properties of the top quark and the Higgs boson, as well as searches for Beyond the Standard Model physics require a highly performant CLIC detector. In particular the vertex detector must provide a single point resolution of only a few micrometers while not exceeding the envisaged material budget of around 0.2% X0 per layer. Beam-beam interactions and beamstrahlung processes impose an additional requirement on the timestamping capabilities of the vertex detector of about 10 ns. These goals can only be met by using novel techniques in the sensor and ASIC design as well as in the detector construction. The R&D program for the CLIC vertex detector explores various technologies in order to meet these demands. The feasibility of planar sensors with a thickness of 50-150 μm, including different active edge designs, are evaluated using Timepix3 ASICs. First prototypes of the CLICpix readout ASIC, implemented in 65 nm CMOS technology and with a pixel size of 25×25μm 2, have been produced and tested in particle beams. An updated version of the ASIC with a larger pixel matrix and improved precision of the time-over-threshold and time-of-arrival measurements has been submitted. Different hybridization concepts have been developed for the interconnection between the sensor and readout ASIC, ranging from small-pitch bump bonding of planar sensors to capacitive coupling of active HV-CMOS sensors. Detector simulations based on Geant 4 and TCAD are compared with experimental results to assess and optimize the performance of the various designs. This contribution gives an overview of the R&D program undertaken for the CLIC vertex detector and presents performance measurements of the prototype detectors currently under investigation.

Development of strategies to reduce cesarean delivery rates in iran 2012-2014: A mixed methods study

Directory of Open Access Journals (Sweden)

Razieh Lotfi

2014-01-01

Full Text Available Background: With the change in population policy from birth control toward encouraging birth and population growth in Iran, repeated cesarean deliveries as a main reason of cesarean section are associated with more potential adverse consequences. The aim of this research was to explore effective strategies to reduce cesarean delivery rates in Iran. Methods: A mixed methodological study was designed and implemented. First, using a qualitative approach, concepts and influencing factors of increased cesarean delivery were explored. Based on the findings of this phase of the study, a questionnaire including the proposed strategies to reduce cesarean delivery was developed. Then in a quantitative phase, the questionnaire was assessed by key informants from across the country and evaluated to obtain more effective strategies to reduce cesarean delivery. Ten participants in the qualitative study included policy makers from the Ministry of Health, obstetricians, midwives and anthropologists. In the next step, 141 participants from private and public hospitals, insurance experts, Academic Associations of Midwifery, and policy makers in Maternity Health Affairs of Ministry of Health were invited to assess and provide feedback on the strategies that work to reduce cesarean deliveries. Results: Qualitative data analysis showed four concept related to increased cesarean delivery rates including; "standardization", "education", "amending regulations", and "performance supervision". Effective strategies extracted from qualitative data were rated by participants then, using ACCEPT derived from A as attainability, C as costing, C as complication, E as effectiveness, P as popularity, and T as timing table 19 strategies were detected as priorities. Conclusions: Although developing effective strategies to reduce cesarean delivery rates is complex process because of the multi-factorial nature of increased cesarean deliveries, in this study we have achieved

Using direct clinical observation to assess the quality of cesarean delivery in Afghanistan: an exploratory study

Science.gov (United States)

2014-01-01

Background As part of a National Emergency Obstetric and Newborn Care (EmONC) Needs Assessment, a special study was undertaken in July 2010 to examine the quality of cesarean deliveries in Afghanistan and examine the utility of direct clinical observation as an assessment method in low-resource settings. Methods This cross-sectional assessment of the quality of cesareans at 14 facilities in Afghanistan included a survey of surgeons regarding their routine cesarean practices, direct observation of 29 cesarean deliveries and comparison of observations with facility records for 34 additional cesareans conducted during the 3 days prior to the observation period at each facility. For both observed cases and record reviews, we assessed time intervals between specified points of care-arrival to the ward, first evaluation, detection of a complication, decision for cesarean, incision, and birth. Results All time intervals with the exception of “decision to skin incision” were longer in the record reviews than in observed cases. Prior cesarean was the most common primary indication for all cases. All mothers in both groups observed survived through one hour postpartum. Among newborns there were two stillbirths (7%) in observed births and seven (21%) record reviews. Although our sample is too small to show statistical significance, the difference is noteworthy. In six of the reviewed cesareans resulting in stillbirth, a fetal heart rate was recorded in the operating theater, although four were recorded as macerated. For the two fresh stillbirths, the cesarean surgeries were recorded as scheduled and not urgent. Conclusions Direct observation of cesarean deliveries enabled us to assess a number of preoperative, postoperative, and intraoperative procedures that are often not described in medical records in low resource settings. Comparison of observations with findings from provider interviews and facility records allowed us to infer whether observed practices were typical

Vertex operators and Jordan fields

International Nuclear Information System (INIS)

Ferreira, L.A.; Gomes, J.F.; Zimerman, A.H.

1988-01-01

The construction of Lie algebras in terms of Jordan algebras generators is discussed. The key to the construction is the triality relation already incorporated into matrix products. A generalisation to Kac-Moody algebras in terms of vertex operators is proposed and may provide a clue for the construction of new representations of Kac-Moody algebras in terms of Jordan fields. (author) [pt

High speed digital TDC for D0 vertex reconstruction

International Nuclear Information System (INIS)

Gao Guosheng; Partridge, R.

1992-01-01

A high speed digital TDC has been built as part of the Level 0 trigger for the D0 experiment at Fermilab. The digital TDC is used to make a fast determination of the primary vertex position by timing the arrival time of beam jets detected in the Level 0 counters. The vertex position is then used by the Level 1 trigger to determine the proper sinθ weighting factors for calculation transverse energies. Commercial GaAs integrated circuits are used in the digital TDC to obtain a time resolution of σ t == 226 ps

Measurement of the double-vertex reconstruction efficiency of the inclusive vertex finder with accidentally overlapping b-jets in ttbar events

Energy Technology Data Exchange (ETDEWEB)

Marchesini, Ivan; Nowatschin, Dominik; Ott, Jochen; Schmidt, Alexander; Tholen, Heiner [University of Hamburg (Germany)

2015-07-01

In LHC Run II, CMS b-tagging algorithms will employ a new core algorithm, named Inclusive Vertex Finder (IVF). The IVF is designed to perform decay vertex reconstruction of long-lived particles, such as B hadrons. Using only tracks from the silicon tracker, it does not depend on jet clustering and allows for higher reconstruction efficiency of decay vertices, which particularly applies to topologies with two or more decay vertices at low distance. Thus, the IVF will offer increased sensitivity for SM measurements (e.g. angular correlations), but also for the search of BSM physics (e.g. final states with boosted Higgs bosons decaying into b-quarks). For the first time, the dependence of the IVF reconstruction efficiency on the distance of vertices in the η-φ plane is investigated with a data-driven approach. We use a clean set of top quark pair events, selected from data recorded in 2012 in pp-collisions at 8 TeV with the CMS detector, and perform a template fit to a 2D-distribution of the masses of the vertices in an event. Correction factors are derived for the application to simulated events. We conclude that our technique will enable precise calibration of double vertexing with the IVF in the LHC Run II.

Distinguishing among potential mechanisms of singleton suppression.

Science.gov (United States)

Gaspelin, Nicholas; Luck, Steven J

2018-04-01

Previous research has revealed that people can suppress salient stimuli that might otherwise capture visual attention. The present study tests between 3 possible mechanisms of visual suppression. According to first-order feature suppression models , items are suppressed on the basis of simple feature values. According to second-order feature suppression models , items are suppressed on the basis of local discontinuities within a given feature dimension. According to global-salience suppression models , items are suppressed on the basis of their dimension-independent salience levels. The current study distinguished among these models by varying the predictability of the singleton color value. If items are suppressed by virtue of salience alone, then it should not matter whether the singleton color is predictable. However, evidence from probe processing and eye movements indicated that suppression is possible only when the color values are predictable. Moreover, the ability to suppress salient items developed gradually as participants gained experience with the feature that defined the salient distractor. These results are consistent with first-order feature suppression models, and are inconsistent with the other models of suppression. In other words, people primarily suppress salient distractors on the basis of their simple features and not on the basis of salience per se. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

The clinical outcome of cesarean scar pregnancies implanted "on the scar" versus "in the niche".

Science.gov (United States)

Kaelin Agten, Andrea; Cali, Giuseppe; Monteagudo, Ana; Oviedo, Johana; Ramos, Joanne; Timor-Tritsch, Ilan

2017-05-01

The term cesarean scar pregnancy refers to placental implantation within the scar of a previous cesarean delivery. The rising numbers of cesarean deliveries in the last decades have led to an increased incidence of cesarean scar pregnancy. Complications of cesarean scar pregnancy include morbidly adherent placenta, uterine rupture, severe hemorrhage, and preterm labor. It is suspected that cesarean scar pregnancies that are implanted within a dehiscent scar ("niche") behave differently compared with those implanted on top of a well-healed scar. To date there are no studies that have compared pregnancy outcomes between cesarean scar pregnancies implanted either "on the scar" or "in the niche." The purpose of this study was to determine the pregnancy outcome of cesarean scar pregnancy implanted either "on the scar" or "in the niche." This was a retrospective 2-center study of 17 patients with cesarean scar pregnancy that was diagnosed from 5-9 weeks gestation (median, 8 weeks). All cesarean scar pregnancies were categorized as either implanted or "on the scar" (group A) or "in the niche" (group B), based on their first-trimester transvaginal ultrasound examination. Clinical outcomes based on gestational age at delivery, mode of delivery, blood loss at delivery, neonate weight and placental histopathologic condition were compared between the groups with the use of the Mann-Whitney U test. Myometrial thickness overlying the placenta was compared among all the patients who required hysterectomy and those who did not with the use of the Mann-Whitney U test. Myometrial thickness was also correlated with gestational age at delivery with the use of Spearman's correlation. Group A consisted of 6 patients; group B consisted of 11 patients. Gestational age at delivery was lower in group B (median, 34 weeks; range, 20-36 weeks) than in group A (median, 38 weeks; range, 37-39 weeks; P=.001). In group A, 5 patients were delivered via cesarean delivery (with normal placenta), and

Trends in preterm birth: singleton and multiple pregnancies in the Netherlands, 2000-2007.

Science.gov (United States)

Schaaf, J M; Mol, B W J; Abu-Hanna, A; Ravelli, A C J

2011-09-01

Several studies have reported increasing trends in preterm birth in developed countries, mainly attributable to an increase in medically indicated preterm births. Our aim was to describe trends in preterm birth among singleton and multiple pregnancies in the Netherlands. Prospective cohort study. Nationwide study. We studied 1,451,246 pregnant women from 2000 to 2007. We assessed trends in preterm birth. We subdivided preterm birth into spontaneous preterm birth after premature prelabour rupture of membranes (pPROM), medically indicated preterm birth and spontaneous preterm birth without pPROM. We performed analyses separately for singletons and multiples. The primary outcome was preterm birth, defined as birth before 37 weeks of gestation, with very preterm birth (birth was 7.7% and the risk of very preterm birth was 1.3%. In singleton pregnancies, the preterm birth risk decreased significantly from 6.4% to 6.0% (P birth without pPROM (3.6-3.1%, P birth risk increased significantly (47.3-47.7%, P = 0.047), mainly as a result of medically indicated preterm birth, which increased from 15.0% to 17.9% (P birth risk in singleton pregnancies decreased significantly over the years. The trend of increasing preterm birth risk reported in other countries was only observed in (medically indicated) preterm birth in multiple pregnancies. © 2011 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2011 RCOG.

Chromosomal Aberrations in Monozygotic and Dizygotic Twins Versus Singletons in Denmark During 1968-2009

DEFF Research Database (Denmark)

Kristensen, Lone Krøldrup; Larsen, Lisbeth A; Fagerberg, Christina

2017-01-01

BACKGROUND: Hall (Embryologic development and monozygotic twinning. Acta Geneticae Medicae et Gemellologiae, Vol. 45, 1996, pp. 53-57) hypothesized that chromosomal aberrations can lead to monozygotic (MZ) twinning. However, twinning and chromosomal aberrations increase prenatal mortality and could...... reduce the prevalence of chromosomal aberrations in live-born twins. We compared prevalence proportion ratios (PPR) of chromosomal aberrations and trisomy 21 (T21) in live-born twins versus singletons born in Denmark during 1968-2009. METHODS: We linked the Danish Twin Registry and a 5% random sample...... of all singletons to the Danish Cytogenetic Central Register and calculated PPR adjusted for maternal age for MZ, dizygotic (DZ), and all twins versus singletons. Zygosity was based on questionnaires or genetic markers. RESULTS: No overall difference in risk of chromosomal aberrations or T21 in twins...

Microscopic models for hadronic form factors and vertex functions

International Nuclear Information System (INIS)

Santhanam, I.; Bhatnagar, S.; Mitra, A.N.

1990-01-01

We review the status of nucleon (N) and few-nucleon form factors (f.f.'s) from the view-point of a gradual unfolding of successively inner degrees of freedom (d.o.f.) with increase in q 2 . To this end we focus attention on the problem of a microscopic formulation of hadronic vertex functions (v.f.) from the point of view of their key role in understanding the physics of a large variety of few-hadron reactions on the one hand, and their practical usefulness in articulating the internal dynamics of hadron and few-hadron systems on the other hand. The criterion of an integrated view from low-energy spectroscopy to high-q 2 amplitudes is employed to emphasize the desirability of formulations in terms of relativistic dynamical equations based on Lorentz and gauge invariance in preference to phenomenological models, which often require additional assumptions beyond their original premises to extend their applicability domains. In this respect, the practical possibilities of the Bethe-Salpeter equation (BSE) in articulating the necessary dynamical ingredients are emphasized on a two-tier basis, the basis constants (3) being pre-determined from the mass spectral data (1 st stage) in preparation for the construction of the hadron-quark vertex functions (2 nd stage). An explicit construction is outlined for meson-quark and baryon-quark vertex functions as well as of meson-nucleon vertex functions in a stepwise fashion. The role of the latter as basic parameter-free ingredients is discussed for possible use in the more serious treatment in the current literature of quark-meson level (α) and meson-isobar (β) d.o.f. in 2-N and 3-N form factor studies. Since most of these studies are characterized by the use of RGM techniques at the six-quark level, a comparative discussion is also given of several contemporary RGM based models. Finally, the concrete prospects for employing such hardon-quark vertex functions for evaluating pp-bar annihilation amplitudes are briefly indicated

Magnetic resonance imaging evaluation of incision healing after cesarean sections

Energy Technology Data Exchange (ETDEWEB)

Dicle, O. [Department of Radiodiagnosis, Dokuz Eyluel University, Izmir (Turkey); Kuecuekler, C. [Department of Radiodiagnosis, Dokuz Eyluel University, Izmir (Turkey); Pirnar, T. [Department of Radiodiagnosis, Dokuz Eyluel University, Izmir (Turkey); Erata, Y. [Department of Gynecology and Obstetrics, Dokuz Eyluel University, Izmir (Turkey); Posaci, C. [Department of Gynecology and Obstetrics, Dokuz Eyluel University, Izmir (Turkey)

1997-02-01

The purpose of this study was to examine the healing period of incision scar in myometrial wall and the normal pelvis after cesarean sections by means of MRI. In this study 17 voluntary women were examined after their first delivery with cesarean section in the early postpartum period (first 5 days), and following this, three more times in 3-month intervals. The MRI examinations were performed on a 1.0-T system (Magnetom, Siemens, Erlangen, Germany), and sagittal T1-weighted (550/17 TR/TE) and T2-weighted (2000/80 TR/TE) spin-echo (SE) images of the pelvis were obtained. During follow-up examinations incision scar tissues lost their signals within the first 3 months on both SE sequences, and little alteration was observed in the subsequent tests. Zonal anatomy of the uterus reappeared completely 6 months after cesarean sections. The time for the involution of the uterus was independent of the zonal anatomy recovery, and the maximum involution was inspected within the first 3 months. In conclusion, the maturation time of myometrial scar tissue in uncomplicated cesarean sections, which can be evaluated by the signal alterations in MRI, is approximately 3 months, whereas the complete involution and the recovery of the zonal anatomy need at least 6 months. (orig.). With 6 figs.

Magnetic resonance imaging evaluation of incision healing after cesarean sections

International Nuclear Information System (INIS)

Dicle, O.; Kuecuekler, C.; Pirnar, T.; Erata, Y.; Posaci, C.

1997-01-01

The purpose of this study was to examine the healing period of incision scar in myometrial wall and the normal pelvis after cesarean sections by means of MRI. In this study 17 voluntary women were examined after their first delivery with cesarean section in the early postpartum period (first 5 days), and following this, three more times in 3-month intervals. The MRI examinations were performed on a 1.0-T system (Magnetom, Siemens, Erlangen, Germany), and sagittal T1-weighted (550/17 TR/TE) and T2-weighted (2000/80 TR/TE) spin-echo (SE) images of the pelvis were obtained. During follow-up examinations incision scar tissues lost their signals within the first 3 months on both SE sequences, and little alteration was observed in the subsequent tests. Zonal anatomy of the uterus reappeared completely 6 months after cesarean sections. The time for the involution of the uterus was independent of the zonal anatomy recovery, and the maximum involution was inspected within the first 3 months. In conclusion, the maturation time of myometrial scar tissue in uncomplicated cesarean sections, which can be evaluated by the signal alterations in MRI, is approximately 3 months, whereas the complete involution and the recovery of the zonal anatomy need at least 6 months. (orig.). With 6 figs

Cesarean Section and Rate of Subsequent Stillbirth, Miscarriage, and Ectopic Pregnancy: A Danish Register-Based Cohort Study

Science.gov (United States)

O'Neill, Sinéad M.; Agerbo, Esben; Kenny, Louise C.; Henriksen, Tine B.; Kearney, Patricia M.; Greene, Richard A.; Mortensen, Preben Bo; Khashan, Ali S.

2014-01-01

Background With cesarean section rates increasing worldwide, clarity regarding negative effects is essential. This study aimed to investigate the rate of subsequent stillbirth, miscarriage, and ectopic pregnancy following primary cesarean section, controlling for confounding by indication. Methods and Findings We performed a population-based cohort study using Danish national registry data linking various registers. The cohort included primiparous women with a live birth between January 1, 1982, and December 31, 2010 (n = 832,996), with follow-up until the next event (stillbirth, miscarriage, or ectopic pregnancy) or censoring by live birth, death, emigration, or study end. Cox regression models for all types of cesarean sections, sub-group analyses by type of cesarean, and competing risks analyses for the causes of stillbirth were performed. An increased rate of stillbirth (hazard ratio [HR] 1.14, 95% CI 1.01, 1.28) was found in women with primary cesarean section compared to spontaneous vaginal delivery, giving a theoretical absolute risk increase (ARI) of 0.03% for stillbirth, and a number needed to harm (NNH) of 3,333 women. Analyses by type of cesarean section showed similarly increased rates for emergency (HR 1.15, 95% CI 1.01, 1.31) and elective cesarean (HR 1.11, 95% CI 0.91, 1.35), although not statistically significant in the latter case. An increased rate of ectopic pregnancy was found among women with primary cesarean overall (HR 1.09, 95% CI 1.04, 1.15) and by type (emergency cesarean, HR 1.09, 95% CI 1.03, 1.15, and elective cesarean, HR 1.12, 95% CI 1.03, 1.21), yielding an ARI of 0.1% and a NNH of 1,000 women for ectopic pregnancy. No increased rate of miscarriage was found among women with primary cesarean, with maternally requested cesarean section associated with a decreased rate of miscarriage (HR 0.72, 95% CI 0.60, 0.85). Limitations include incomplete data on maternal body mass index, maternal smoking, fertility treatment, causes of

N-point g-loop vertex for free bosonic theory with vacuum charge Q

International Nuclear Information System (INIS)

Di Vecchia, P.; Pezzella, F.; Frau, M.; Hornfeck, K.

1988-12-01

Starting from the N-Point Vertex on the sphere and using the sewing procedure we construct the N-Point g-Loop Vertex for a free bosonic theory with vacuum charge Q. We then show that, when this vertex is saturated with N highest weight states, it gives their correlation function on an arbitrary Riemann surface of genus g. We also extend our formalism to the case of a free scalar field compactified on a circle, which is related to the Coulomb gas description of minimal models. (orig.)

Impact of introducing specific measures to reduce the frequency of cesarean delivery for non-obstetric indications.

Science.gov (United States)

Psenkova, Petra; Bucko, Marek; Braticak, Michal; Baneszova, Ruth; Zahumensky, Jozef

2018-03-25

To identify the frequency of cesarean delivery for non-obstetric indications before and after the introduction of specific measures to lower the rate of elective cesarean, and to evaluate the effectiveness of the introduced measures. In the present single-center retrospective cohort study at University Hospital Trnava, Trnava, Slovak Republic, the frequency of elective cesarean was evaluated before (January 1, 2010, to December 31, 2014) and after (January 1, 2015, to December 31, 2016) the implementation of specific measures applied in January 2015 to confirm the indications for primary cesarean delivery. The frequency of elective cesarean delivery for non-obstetric indications was compared between the two periods. Before the intervention in 2015, 229 (2.9%) of 7768 women had elective cesarean deliveries for non-obstetric indications. After implementation of the intervention, the frequency decreased to 27 (0.8%) of 3203 women (Pdelivery for non-obstetric indications was reduced significantly by introducing specific reasonable measures. These included all non-obstetric indications for cesarean delivery being approved by a leading specialist of the related department, close cooperation with professionals from other specialties, and, additionally, staff attending professional educational lectures. © 2018 International Federation of Gynecology and Obstetrics.

A momentum space analysis of the Triple Pomeron Vertex in pQCD

International Nuclear Information System (INIS)

Bartels, J.

2007-10-01

We study properties of the momentum space Triple Pomeron Vertex in perturbative QCD. Particular attention is given to the collinear limit where transverse momenta on one side of the vertex are much larger than on the other side. We also comment on the kernels in nonlinear evolution equations. (orig.)

A momentum space analysis of the Triple Pomeron Vertex in pQCD

Energy Technology Data Exchange (ETDEWEB)

Bartels, J. [Hamburg Univ. (Germany). 2. Inst. fuer Theoretische Physik; Kutak, K. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany)]|[Instytut Fizyki Jadrowej Polskiej Akademii Nauk, Krakow (Poland)

2007-10-15

We study properties of the momentum space Triple Pomeron Vertex in perturbative QCD. Particular attention is given to the collinear limit where transverse momenta on one side of the vertex are much larger than on the other side. We also comment on the kernels in nonlinear evolution equations. (orig.)

Effect of remote cesarean delivery on complications during hysterectomy: a cohort study.

Science.gov (United States)

Hesselman, Susanne; Högberg, Ulf; Jonsson, Maria

2017-11-01

Cesarean delivery is performed frequently worldwide, and follow-up studies that report complications at subsequent surgery are warranted. The aim of the study was to investigate the association between a previous abdominal delivery and complications during a subsequent hysterectomy and to estimate the fraction of complications that are driven by the presence of adhesions. This was a longitudinal population-based register study of 25354 women who underwent a benign hysterectomy at 46 hospital units in Sweden 2000-2014. Adhesions were found in 45% of the women with a history of cesarean delivery. Organ injury affected 2.2% of the women. The risk of organ injury (adjusted odds ratio, 1.74; 95% confidence interval, 1.41-2.15) and postoperative infection (adjusted odds ratio, 1.26; 95% confidence interval, 1.15-1.39) was increased with previous cesarean delivery, irrespective of whether adhesions were present or not. The direct effect on organ injury by a personal history of cesarean delivery was estimated to 73%, and only 27% was mediated by the presence of adhesions. Previous cesarean delivery was a predictor of bladder injury (adjusted odds ratio, 1.86; 95% confidence interval, 1.40-2.47) and bowel injury (adjusted odds ratio, 1.83; 95% confidence interval, 1.10-3.03), but not ureter injury. A personal history of other abdominal surgeries was associated with bowel injury (adjusted odds ratio, 2.27; 95% confidence interval, 1.37-3.78), and the presence of endometriosis increased the risk of ureter injury (adjusted odds ratio, 2.15; 95% confidence interval, 1.34-3.44). Previous cesarean delivery is associated with an increased risk of complications during a subsequent hysterectomy, but the risk is only partly attributable to the presence of adhesions. Previous cesarean delivery and presence of endometriosis were major predisposing factors of organ injury at the time of the hysterectomy, whereas background and perioperative characteristics were of minor importance

Birthweight distribution in ART singletons resulting from embryo culture in two different culture media compared with the national population

DEFF Research Database (Denmark)

Lemmen, Josephine Gabriela; Pinborg, Anja; Rasmussen, S

2014-01-01

IS KNOWN ALREADY: Studies on human ART singletons have reported a difference in birthweight in singletons following IVF culture in different culture media. However, other studies comparing different culture media have not shown any significant differences in birthweight. STUDY DESIGN, SIZE, DURATION......: This study was a retrospective comparison of birthweights in IVF/ICSI singletons conceived after fresh embryo transfer following embryo culture in Cook or Medicult medium and in a national cohort of naturally conceived singletons in nulliparous women. The study compares four independent groups consisting...... of singletons in nulliparous women from Cook-d2: 2-day culture in Cook medium at Rigshospitalet (n = 974), Medicult-d2: 2-day culture in Medicult EmbryoAssist medium at Rigshospitalet (n = 147), Medicult-d3: 3-day culture in Medicult EmbryoAssist medium with and without added GM-CSF (n = 204), and DK...

Oculomotor capture by colour singletons depends on intertrial priming.

Science.gov (United States)

Becker, Stefanie I

2010-10-12

In visual search, an irrelevant colour singleton captures attention when the colour of the distractor changes across trials (e.g., from red to green), but not when the colour remains constant (Becker, 2007). The present study shows that intertrial changes of the distractor colour also modulate oculomotor capture: an irrelevant colour singleton distractor was only selected more frequently than the inconspicuous nontargets (1) when its features had switched (compared to the previous trial), or (2) when the distractor had been presented at the same position as the target on the previous trial. These results throw doubt on the notion that colour distractors capture attention and the eyes because of their high feature contrast, which is available at an earlier point in time than information about specific feature values. Instead, attention and eye movements are apparently controlled by a system that operates on feature-specific information, and gauges the informativity of nominally irrelevant features. Copyright © 2010 Elsevier Ltd. All rights reserved.

Track and vertex reconstruction: From classical to adaptive methods

International Nuclear Information System (INIS)

Strandlie, Are; Fruehwirth, Rudolf

2010-01-01

This paper reviews classical and adaptive methods of track and vertex reconstruction in particle physics experiments. Adaptive methods have been developed to meet the experimental challenges at high-energy colliders, in particular, the CERN Large Hadron Collider. They can be characterized by the obliteration of the traditional boundaries between pattern recognition and statistical estimation, by the competition between different hypotheses about what constitutes a track or a vertex, and by a high level of flexibility and robustness achieved with a minimum of assumptions about the data. The theoretical background of some of the adaptive methods is described, and it is shown that there is a close connection between the two main branches of adaptive methods: neural networks and deformable templates, on the one hand, and robust stochastic filters with annealing, on the other hand. As both classical and adaptive methods of track and vertex reconstruction presuppose precise knowledge of the positions of the sensitive detector elements, the paper includes an overview of detector alignment methods and a survey of the alignment strategies employed by past and current experiments.

The Belle II Silicon Vertex Detector

Energy Technology Data Exchange (ETDEWEB)

Friedl, M., E-mail: markus.friedl@oeaw.ac.at [HEPHY – Institute of High Energy Physics, Nikolsdorfer Gasse 18, 1050 Vienna (Austria); Ackermann, K. [MPI Munich, Föhringer Ring 6, 80805 München (Germany); Aihara, H. [University of Tokyo, Department of Physics, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033 (Japan); Aziz, T. [Tata Institute of Fundamental Research, Experimental High Energy Physics Group, Homi Bhabha Road, Mumbai 400 005 (India); Bergauer, T. [HEPHY – Institute of High Energy Physics, Nikolsdorfer Gasse 18, 1050 Vienna (Austria); Bozek, A. [Institute of Nuclear Physics, Division of Particle Physics and Astrophysics, ul. Radzikowskiego 152, 31 342 Krakow (Poland); Campbell, A. [DESY, Notkestrasse 85, 22607 Hamburg (Germany); Dingfelder, J. [University of Bonn, Department of Physics and Astronomy, Nussallee 12, 53115 Bonn (Germany); Drasal, Z. [Charles University, Institute of Particle and Nuclear Physics, Ke Karlovu 3, 121 16 Praha 2 (Czech Republic); Frankenberger, A. [HEPHY – Institute of High Energy Physics, Nikolsdorfer Gasse 18, 1050 Vienna (Austria); Gadow, K. [DESY, Notkestrasse 85, 22607 Hamburg (Germany); Gfall, I. [HEPHY – Institute of High Energy Physics, Nikolsdorfer Gasse 18, 1050 Vienna (Austria); Haba, J.; Hara, K.; Hara, T. [KEK, 1-1 Oho, Tsukuba, Ibaraki 305-0801 (Japan); Higuchi, T. [University of Tokyo, Kavli Institute for Physics and Mathematics of the Universe, 5-1-5 Kashiwanoha, Kashiwa, Chiba 277-8583 (Japan); Himori, S. [Tohoku University, Department of Physics, Aoba Aramaki Aoba-ku, Sendai 980-8578 (Japan); Irmler, C. [HEPHY – Institute of High Energy Physics, Nikolsdorfer Gasse 18, 1050 Vienna (Austria); Ishikawa, A. [Tohoku University, Department of Physics, Aoba Aramaki Aoba-ku, Sendai 980-8578 (Japan); Joo, C. [Seoul National University, High Energy Physics Laboratory, 25-107 Shinlim-dong, Kwanak-gu, Seoul 151-742 (Korea, Republic of); and others

2013-12-21

The KEKB machine and the Belle experiment in Tsukuba (Japan) are now undergoing an upgrade, leading to an ultimate luminosity of 8×10{sup 35}cm{sup −2}s{sup −1} in order to measure rare decays in the B system with high statistics. The previous vertex detector cannot cope with this 40-fold increase of luminosity and thus needs to be replaced. Belle II will be equipped with a two-layer Pixel Detector surrounding the beam pipe, and four layers of double-sided silicon strip sensors at higher radii than the old detector. The Silicon Vertex Detector (SVD) will have a total sensitive area of 1.13m{sup 2} and 223,744 channels—twice as many as its predecessor. All silicon sensors will be made from 150 mm wafers in order to maximize their size and thus to reduce the relative contribution of the support structure. The forward part has slanted sensors of trapezoidal shape to improve the measurement precision and to minimize the amount of material as seen by particles from the vertex. Fast-shaping front-end amplifiers will be used in conjunction with an online hit time reconstruction algorithm in order to reduce the occupancy to the level of a few percent at most. A novel “Origami” chip-on-sensor scheme is used to minimize both the distance between strips and amplifier (thus reducing the electronic noise) as well as the overall material budget. This report gives an overview on the status of the Belle II SVD and its components, including sensors, front-end detector ladders, mechanics, cooling and the readout electronics.

The Belle II Silicon Vertex Detector

International Nuclear Information System (INIS)

Friedl, M.; Ackermann, K.; Aihara, H.; Aziz, T.; Bergauer, T.; Bozek, A.; Campbell, A.; Dingfelder, J.; Drasal, Z.; Frankenberger, A.; Gadow, K.; Gfall, I.; Haba, J.; Hara, K.; Hara, T.; Higuchi, T.; Himori, S.; Irmler, C.; Ishikawa, A.; Joo, C.

2013-01-01

The KEKB machine and the Belle experiment in Tsukuba (Japan) are now undergoing an upgrade, leading to an ultimate luminosity of 8×10 35 cm −2 s −1 in order to measure rare decays in the B system with high statistics. The previous vertex detector cannot cope with this 40-fold increase of luminosity and thus needs to be replaced. Belle II will be equipped with a two-layer Pixel Detector surrounding the beam pipe, and four layers of double-sided silicon strip sensors at higher radii than the old detector. The Silicon Vertex Detector (SVD) will have a total sensitive area of 1.13m 2 and 223,744 channels—twice as many as its predecessor. All silicon sensors will be made from 150 mm wafers in order to maximize their size and thus to reduce the relative contribution of the support structure. The forward part has slanted sensors of trapezoidal shape to improve the measurement precision and to minimize the amount of material as seen by particles from the vertex. Fast-shaping front-end amplifiers will be used in conjunction with an online hit time reconstruction algorithm in order to reduce the occupancy to the level of a few percent at most. A novel “Origami” chip-on-sensor scheme is used to minimize both the distance between strips and amplifier (thus reducing the electronic noise) as well as the overall material budget. This report gives an overview on the status of the Belle II SVD and its components, including sensors, front-end detector ladders, mechanics, cooling and the readout electronics

Cesarean delivery on maternal request: wise use of finite resources? A view from the trenches.

Science.gov (United States)

Druzin, Maurice L; El-Sayed, Yasser Y

2006-10-01

Cesarean section rates are rising in the United States and were at an all time high of 29 percent in 2004. Within this context, the issue of cesarean section on maternal request has been described as being part of a "perfect storm" of medical, legal and personal choice issues, and the lack of an opposing view. An increasing cesarean section rate adds an economic burden on already highly stressed medical systems. There is an incremental cost of cesarean section compared to vaginal delivery. The issue of cost must also be considered more broadly. Rising cesarean section rates are associated with a longer length of stay and a higher occupancy rate. This high occupancy rate leads to the diversion of critical care obstetric transports and has dramatically reduced patient satisfaction. These diversions, and the resultant inability to provide needed care to pregnant women, represent a profound societal cost. These critical care diversions and reduced patient satisfaction also negatively impact a health care institution's financial bottom line and competitiveness. The impact of a rising cesarean section rate on both short and long-term maternal and neonatal complications, and their associated costs, must also be taken into account. The incidence of placenta accreta is increasing in conjunction with the rising cesarean section rate. The added costs associated with this complication (MRI, Interventional Radiology, transfusion, hysterectomy, and intensive care admission) can be prohibitive. It has also been demonstrated that infants born by scheduled cesarean delivery are more likely to require advanced nursery support (with all its associated expense) than infants born to mothers attempting vaginal delivery. The practice of maternal request cesarean section, with limited good data and obvious inherent risk and expense, is increasing in the USA. Patient autonomy and a woman's right to choose her mode of delivery should be respected. However, in our opinion, based on the

Institutional setting and wealth gradients in cesarean delivery rates: Evidence from six developing countries.

Science.gov (United States)

Sepehri, Ardeshir

2018-06-01

The influence of the type of institutional setting on cesarean delivery is well documented. However, the traditional boundaries between public and private providers have become increasingly blurred with the commercialization of the state health sector that allows providers to tailor the quantity and quality of care according to patients' ability to pay. This study examined wealth-related variations in cesarean rates in six lower- and upper-middle income countries: the Dominican Republic, Egypt, Guatemala, Jordan, Pakistan, and the Philippines. Demographic and Health Survey data and a hierarchical regression model were used to assess wealth-related variations in cesarean rates in government and private hospitals while controlling for a wide range of women's socioeconomic and risk profiles. The odds of undergoing a cesarean delivery were greater in private facilities than government hospitals by 58% in Jordan, 129% in Guatemala, and 262% and 279% in the Dominican Republic and Egypt, respectively. Additional analysis involving interactions between the type of facility and wealth quintiles indicated that wealthier women were more likely to undergo a cesarean birth in government hospitals than poorer women in all countries but the Dominican Republic and Guatemala. Moreover, in both Egypt and Jordan, differences in cesarean rates between government and private hospitals were smaller for the wealthier strata than for the nonwealthy. Large wealth-related variations in the mode of delivery across government and private hospitals suggest the need for well-developed guidelines and standards to achieve a more appropriate selection of cases for cesarean delivery. © 2018 Wiley Periodicals, Inc.

A cross-sectional study exploring the incidence of and indications for second-stage cesarean delivery over three decades.

Science.gov (United States)

Pearson, Greg A; MacKenzie, Ian Z

2017-09-01

To observe the incidence of, indications for, and complications associated with second-stage cesarean delivery in 10-year intervals over 30 years. The present analysis of prospectively collected data compared cesarean deliveries during 1976, 1986, 1996, and 2006 at John Radcliffe Hospital in Oxford, UK (n=3222). Pregnancy, delivery, and neonatal details were reviewed. The proportion of deliveries by cesarean in the second stage of labor increased from 0.5% (22/4464) in 1976 to 2.1% (124/5998) in 2006 (Pcesarean deliveries during the second stage because of failed instrumental delivery also increased over the study period from 59.1% (13/22) in 1976 to 71.0% (88/124) in 2006. Compared with cesareans at other stages, uterine trauma (Pcesarean delivery. Neonates delivered by second-stage cesarean had lower Apgar scores (Pcesarean earlier in labor. A trend towards an increase in neonatal trauma with second-stage cesarean compared with cesarean delivery before labor or during the first stage did not reach statistical significance. The proportion of deliveries by cesarean in the second stage of labor increased; these deliveries were associated with greater maternal and neonatal morbidity, but were not influenced by the indication for cesarean. © 2017 International Federation of Gynecology and Obstetrics.

Emergency cesarean section and the 30-minute rule: definitions.

Science.gov (United States)

Schauberger, Charles W; Chauhan, Suneet P

2009-03-01

We explored the role that lack of a standard definition and heterogeneity in patient selection criteria in the literature might have on the apparent inability to routinely begin an emergency cesarean section in less than 30 minutes. A review of the literature on emergency cesarean delivery was performed. Although there are some similarities in definitions and the criteria used for patient selection in multiple studies, the variability in the definitions could be responsible for some of the apparent timeliness performance deficiency in the literature. A standard definition and directions for future research are suggested.

A Vertex and Tracking Detector System for CLIC

CERN Document Server

AUTHOR|(SzGeCERN)718101

2017-01-01

The physics aims at the proposed future CLIC high-energy linear $e^+e^−$ collider pose challenging demands on the performance of the detector system. In particular the vertex and tracking detectors have to combine precision measurements with robustness against the expected high rates of beam-induced backgrounds. The requirements include ultra-low mass, facilitated by power pulsing and air cooling in the vertex-detector region, small cell sizes and precision hit timing at the few-ns level. A detector concept meeting these requirements has been developed and an integrated R&D program addressing the challenges is progressing in the areas of ultra-thin sensors and readout ASICs, interconnect technology, mechanical integration and cooling.

The CDF Silicon Vertex Detector

International Nuclear Information System (INIS)

Tkaczyk, S.; Carter, H.; Flaugher, B.

1993-01-01

A silicon strip vertex detector was designed, constructed and commissioned at the CDF experiment at the Tevatron collider at Fermilab. The mechanical design of the detector, its cooling and monitoring are presented. The front end electronics employing a custom VLSI chip, the readout electronics and various components of the SVX system are described. The system performance and the experience with the operation of the

[Cesarean birth: justifying indication or justified concern?].

Science.gov (United States)

Muñoz-Enciso, José Manuel; Rosales-Aujang, Enrique; Domínguez-Ponce, Guillermo; Serrano-Díaz, César Leopoldo

2011-02-01

Caesarean section is the most common surgery performed in all hospitals of second level of care in the health sector and more frequently in private hospitals in Mexico. To determine the behavior that caesarean section in different hospitals in the health sector in the city of Aguascalientes and analyze the indications during the same period. A descriptive and cross in the top four secondary hospitals in the health sector of the state of Aguascalientes, which together account for 81% of obstetric care in the state, from 1 September to 31 October 2008. Were analyzed: indication of cesarean section and their classification, previous pregnancies, marital status, gestational age, weight and minute Apgar newborn and given birth control during the event. were recorded during the study period, 2.964 pregnancies after 29 weeks, of whom 1.195 were resolved by Caesarean section with an overall rate of 40.3%. We found 45 different indications, which undoubtedly reflect the great diversity of views on the institutional medical staff to schedule a cesarean section. Although each institution has different resources and a population with different characteristics, treatment protocols should be developed by staff of each hospital to have the test as a cornerstone of labor, also request a second opinion before a caesarean section, all try to reduce the frequency of cesarean section.

Pregnancy outcome in singleton term breeches from a referral ...

African Journals Online (AJOL)

It is recommended that attention should be given to trainee obstetrician in selective external cephalic version at term and also the procedure of AVBD so as to reduce the caesarean section rate and also neonatal morbidity in term breeches in our community. Keywords: Pregnancy outcome, Singleton breech, Vaginal ...

Influences on achieving motor milestones: A twin-singleton study

NARCIS (Netherlands)

Brouwer, S.I.; van Beijsterveldt, C.E.M.; Bartels, M.; Hudziak, J.; Boomsma, D.I.

2006-01-01

In order to determine if twinning impacted achievement of motor milestones the attainment of early motor milestones in twins was examined and compared to published data from singletons of the same age from the same culture and birth years. We examined the influence of twinning, sex, zygosity and

LHCb Vertex Locator Upgrade Work Report

CERN Document Server

Estrada, Michael

2017-01-01

As the LHCb prepares for the planned upgrade of its vertex locator, there is a great need for supporting work such as the design and testing of apparatus that will ensure the smooth implementation of new hardware and infrastructure. My work this summer consisted largely of tasks to support this process.

Colour-independent partition functions in coloured vertex models

Energy Technology Data Exchange (ETDEWEB)

Foda, O., E-mail: omar.foda@unimelb.edu.au [Dept. of Mathematics and Statistics, University of Melbourne, Parkville, VIC 3010 (Australia); Wheeler, M., E-mail: mwheeler@lpthe.jussieu.fr [Laboratoire de Physique Théorique et Hautes Energies, CNRS UMR 7589 (France); Université Pierre et Marie Curie – Paris 6, 4 place Jussieu, 75252 Paris cedex 05 (France)

2013-06-11

We study lattice configurations related to S{sub n}, the scalar product of an off-shell state and an on-shell state in rational A{sub n} integrable vertex models, n∈{1,2}. The lattice lines are colourless and oriented. The state variables are n conserved colours that flow along the line orientations, but do not necessarily cover every bond in the lattice. Choosing boundary conditions such that the positions where the colours flow into the lattice are fixed, and where they flow out are summed over, we show that the partition functions of these configurations, with these boundary conditions, are n-independent. Our results extend to trigonometric A{sub n} models, and to all n. This n-independence explains, in vertex-model terms, results from recent studies of S{sub 2} (Caetano and Vieira, 2012, [1], Wheeler, (arXiv:1204.2089), [2]). Namely, 1.S{sub 2}, which depends on two sets of Bethe roots, {b_1} and {b_2}, and cannot (as far as we know) be expressed in single determinant form, degenerates in the limit {b_1}→∞, and/or {b_2}→∞, into a product of determinants, 2. Each of the latter determinants is an A{sub 1} vertex-model partition function.

Colour-independent partition functions in coloured vertex models

International Nuclear Information System (INIS)

Foda, O.; Wheeler, M.

2013-01-01

We study lattice configurations related to S n , the scalar product of an off-shell state and an on-shell state in rational A n integrable vertex models, n∈{1,2}. The lattice lines are colourless and oriented. The state variables are n conserved colours that flow along the line orientations, but do not necessarily cover every bond in the lattice. Choosing boundary conditions such that the positions where the colours flow into the lattice are fixed, and where they flow out are summed over, we show that the partition functions of these configurations, with these boundary conditions, are n-independent. Our results extend to trigonometric A n models, and to all n. This n-independence explains, in vertex-model terms, results from recent studies of S 2 (Caetano and Vieira, 2012, [1], Wheeler, (arXiv:1204.2089), [2]). Namely, 1.S 2 , which depends on two sets of Bethe roots, {b 1 } and {b 2 }, and cannot (as far as we know) be expressed in single determinant form, degenerates in the limit {b 1 }→∞, and/or {b 2 }→∞, into a product of determinants, 2. Each of the latter determinants is an A 1 vertex-model partition function

Association Between Cesarean Birth and Risk of Obesity in Offspring in Childhood, Adolescence, and Early Adulthood.

Science.gov (United States)

Yuan, Changzheng; Gaskins, Audrey J; Blaine, Arianna I; Zhang, Cuilin; Gillman, Matthew W; Missmer, Stacey A; Field, Alison E; Chavarro, Jorge E

2016-11-07

Cesarean birth has been associated with higher risk of obesity in offspring, but previous studies have focused primarily on childhood obesity and have been hampered by limited control for confounders. To investigate the association between cesarean birth and risk of obesity in offspring. A prospective cohort study was conducted from September 1, 1996, to December 31, 2012, among participants of the Growing Up Today Study, including 22 068 offspring born to 15 271 women, followed up via questionnaire from ages 9 to 14 through ages 20 to 28 years. Data analysis was conducted from October 10, 2015, to June 14, 2016. Birth by cesarean delivery. Risk of obesity based on International Obesity Task Force or World Health Organization body mass index cutoffs, depending on age. Secondary outcomes included risks of obesity associated with changes in mode of delivery and differences in risk between siblings whose modes of birth were discordant. Of the 22 068 offspring (20 950 white; 9359 male and 12 709 female), 4921 individuals (22.3%) were born by cesarean delivery. The cumulative risk of obesity through the end of follow-up was 13% among all participants. The adjusted risk ratio for obesity among offspring delivered via cesarean birth vs those delivered via vaginal birth was 1.15 (95% CI, 1.06-1.26; P = .002). This association was stronger among women without known indications for cesarean delivery (adjusted risk ratio, 1.30; 95% CI, 1.09-1.54; P = .004). Offspring delivered via vaginal birth among women who had undergone a previous cesarean delivery had a 31% (95% CI, 17%-47%) lower risk of obesity compared with those born to women with repeated cesarean deliveries. In within-family analysis, individuals born by cesarean delivery had 64% (8%-148%) higher odds of obesity than did their siblings born via vaginal delivery. Cesarean birth was associated with offspring obesity after accounting for major confounding factors. Although additional research is

Preliminary studies for the LHCb vertex detector vacuum system

CERN Document Server

Doets, M; Van Bakel, N; Van den Brand, J F J; van den Brand, Jo

2000-01-01

We lay down some general considerations which will serve as a starting point for design studies of a realistic LHCb vertex detector vacuum system. Based on these considerations, we propose a design strategy and identify issues to be further studied. In particular we try to outline some boundary conditions imposed by LHC and LHCb on the vacuum system. We discuss two possibilities for the LHCb vertex detector vacuum system. The preferred strategy uses a differentially pumped vacuum system with the silicon detectors separated from the beam line vacuum. Some estimations on static vacuum pressures and gas flows are presented.

Electromagnetic form factors and vertex constants for 6Li

International Nuclear Information System (INIS)

Blokhintsev, L.D.; Shvarts, I.A.

1977-01-01

It has been assumed that the main contribution to the rapidly changing part of the charge form factor of 6 Li provides the amplitude of the triangle diagram containing virtual lines of deuteron and α particle. The vertex constant G 2 for the 6 Li→α+d decay is expressed through the nuclear charge radii for 6 Li, d, and α. Taking into account coulomb interaction in the vertex of the 6 Li→α+d reaction increases G 2 by about a factor of two. The account of virtuality of a deuteron cluster also leads to an increase in G 2

[Experience with combined spinal and epidural anesthesia at cesarean section].

Science.gov (United States)

Levinzon, A S; Taran, O I; Pura, K R; Mishchenko, G S; Mamaeva, N V

2006-01-01

The paper analyzes some experience gained in using various modes of regional anesthesia as an anesthetic appliance at cesarean sections and comparatively characterizes various types of central segmental blocks. The results of 213 cases of cesarean section performed under spinal or combined spinal and epidural anesthesia (CSEA) were generalized by the following parameters: block onset, maternal and fetal action, the quality of anesthesia and postoperative analgesia, which leads to the conclusion that CSEA is the method of choice.

Mirror of the refined topological vertex from a matrix model

CERN Document Server

Eynard, B

2011-01-01

We find an explicit matrix model computing the refined topological vertex, starting from its representation in terms of plane partitions. We then find the spectral curve of that matrix model, and thus the mirror symmetry of the refined vertex. With the same method we also find a matrix model for the strip geometry, and we find its mirror curve. The fact that there is a matrix model shows that the refined topological string amplitudes also satisfy the remodeling the B-model construction.

The Color Antisymmetric Ghost Propagator and One-Loop Vertex Renormalization

OpenAIRE

Furui, Sadataka

2007-01-01

The color matrix elements of the ghost triangle diagram that appears in the triple gluon vertex and the ghost-ghost-gluon triangle diagram that appears in the ghost-gluon-ghost vertex are calculated. The ghost-ghost-gluon triangle contains a loop consisting of two color diagonal ghosts and one gluon and a loop consisting of two color antisymmetric ghosts and one gluon. Consequently, the pQCD argument in the infrared region based on the one particle irreducible diagram should be modified. Impl...

A Randomized Trial Comparing Skin Antiseptic Agents at Cesarean Delivery.

Science.gov (United States)

Tuuli, Methodius G; Liu, Jingxia; Stout, Molly J; Martin, Shannon; Cahill, Alison G; Odibo, Anthony O; Colditz, Graham A; Macones, George A

2016-02-18

Preoperative skin antisepsis has the potential to decrease the risk of surgical-site infection. However, evidence is limited to guide the choice of antiseptic agent at cesarean delivery, which is the most common major surgical procedure among women in the United States. In this single-center, randomized, controlled trial, we evaluated whether the use of chlorhexidine-alcohol for preoperative skin antisepsis was superior to the use of iodine-alcohol for the prevention of surgical-site infection after cesarean delivery. We randomly assigned patients undergoing cesarean delivery to skin preparation with either chlorhexidine-alcohol or iodine-alcohol. The primary outcome was superficial or deep surgical-site infection within 30 days after cesarean delivery, on the basis of definitions from the Centers for Disease Control and Prevention. From September 2011 through June 2015, a total of 1147 patients were enrolled; 572 patients were assigned to chlorhexidine-alcohol and 575 to iodine-alcohol. In an intention-to-treat analysis, surgical-site infection was diagnosed in 23 patients (4.0%) in the chlorhexidine-alcohol group and in 42 (7.3%) in the iodine-alcohol group (relative risk, 0.55; 95% confidence interval, 0.34 to 0.90; P=0.02). The rate of superficial surgical-site infection was 3.0% in the chlorhexidine-alcohol group and 4.9% in the iodine-alcohol group (P=0.10); the rate of deep infection was 1.0% and 2.4%, respectively (P=0.07). The frequency of adverse skin reactions was similar in the two groups. The use of chlorhexidine-alcohol for preoperative skin antisepsis resulted in a significantly lower risk of surgical-site infection after cesarean delivery than did the use of iodine-alcohol. (Funded by the National Institutes of Health and Washington University School of Medicine in St. Louis; ClinicalTrials.gov number, NCT01472549.).

Complications of cesarean delivery in the massively obese parturient.

Science.gov (United States)

Alanis, Mark C; Villers, Margaret S; Law, Tameeka L; Steadman, Elizabeth M; Robinson, Christopher J

2010-09-01

The objective of the study was to determine predictors of cesarean delivery morbidity associated with massive obesity. This was an institutional review board-approved retrospective study of massively obese women (body mass index, > or = 50 kg/m(2)) undergoing cesarean delivery. Bivariable and multivariable analyses were used to assess the strength of association between wound complication and various predictors. Fifty-eight of 194 patients (30%) had a wound complication. Most (90%) were wound disruptions, and 86% were diagnosed after hospital discharge (median postoperative day, 8.5; interquartile range, 6-12). Subcutaneous drains and smoking, but not labor or ruptured membranes, were independently associated with wound complication after controlling for various confounders. Vertical abdominal incisions were associated with increased operative time, blood loss, and vertical hysterotomy. Women with a body mass index > or = 50 kg/m(2) have a much greater risk for cesarean wound complications than previously reported. Avoidance of subcutaneous drains and increased use of transverse abdominal wall incisions should be considered in massively obese parturients to reduce operative morbidity. Published by Mosby, Inc.

Intertwiner dynamics in the flipped vertex

Energy Technology Data Exchange (ETDEWEB)

Alesci, Emanuele; Bianchi, Eugenio; Magliaro, Elena; Perini, Claudio, E-mail: alesci@fis.uniroma3.i, E-mail: e.bianchi@sns.i, E-mail: elena.magliaro@gmail.co, E-mail: claude.perin@libero.i [Centre de Physique Theorique de Luminy, Case 907, F-13288 Marseille (France)

2009-09-21

We continue the semiclassical analysis, started in a previous paper, of the intertwiner sector of the flipped vertex spinfoam model. We use independently both a semi-analytical and a purely numerical approach, finding the correct behavior of wavepacket propagation and physical expectation values. In the end, we show preliminary results about correlation functions.

Algebraic characterization of the Witten vertex

International Nuclear Information System (INIS)

Embacher, F.

1989-01-01

The Witten vertex of open bosonic string field theory is characterized by a set of algebraic properties written down in the Fock-space operator formalism. The typical 3-string overlap structure as well as the correct ghost midpoint insertion are not required from the outset but arise as consequences. 20 refs. (Author)

Lifetime tests for MAC vertex chamber

International Nuclear Information System (INIS)

Nelson, H.N.

1986-07-01

A vertex chamber for MAC was proposed to increase precision in the measurement of the B hadron and tau lepton lifetimes. Thin-walled aluminized mylar drift tubes were used for detector elements. A study of radiation hardness was conducted under the conditions of the proposed design using different gases and different operating conditions

Factors associated with successful vaginal birth after cesarean section and outcomes in rural area of Anatolia

Directory of Open Access Journals (Sweden)

Senturk MB

2015-07-01

Full Text Available Mehmet Baki Senturk,1 Yusuf Cakmak,2 Halit Atac,2 Mehmet Sukru Budak3 1Department of Obstetrics and Gynecology, Bakirkoy Dr Sadi Konuk Teaching and Research Hospital, Istanbul, Turkey; 2Department of Obstetrics and Gynecology, Batman State Hospital, Batman, Turkey; 3Department of Obstetrics and Gynecology, Diyarbakir Research Hospital, Diyarbakir, Turkey Abstract: Successful vaginal birth after cesarean section is more comfortable than repeat emergency or elective cesarean section. Antenatal examinations are important in selection for trial of labor, while birth management can be difficult when the patients present at emergency condition. But there is an increased chance of vaginal birth with advanced cervical dilation. This study attempts to evaluate factors associated with success of vaginal birth after cesarean section and to compare the maternal and perinatal outcomes between vaginal birth after cesarean section and intrapartum cesarean section in patients who were admitted to hospital during the active or second stage of labor. A retrospective evaluation was made from the results of 127 patients. Cesarean section was performed in 57 patients; 70 attempted trial of labor. The factors associated with success of vaginal birth after cesarean section were investigated. Maternal and neonatal outcomes were compared between the groups. Vaginal birth after cesarean section was successful in 55% of cases. Advanced cervical opening, effacement, gravidity, parity, and prior vaginal delivery were factors associated with successful vaginal birth. The vaginal birth group had more complications (P<0.01, but these were minor. The rate of blood transfusion and prevalence of changes in hemoglobin level were similar in both groups (P>0.05. In this study, cervical opening, effacement, gravidity, parity, and prior vaginal delivery were important factors for successful vaginal birth after cesarean section. The patients’ requests influenced outcome. Trial of

Cosmic ray test of the Belle II z-vertex trigger

Energy Technology Data Exchange (ETDEWEB)

Neuhaus, Sara; Skambraks, Sebastian [Technische Universitaet Muenchen (Germany); Chen, Yang; Kiesling, Christian [Max-Planck-Institut fuer Physik, Muenchen (Germany)

2016-07-01

The z-vertex trigger is part of the first level track trigger in the Belle II experiment. Its task is the rejection of tracks not coming from the interaction region, suppressing a large part of the machine background. Therefore the z-vertex trigger allows to relax other track trigger conditions and thus strongly increases the efficiency for channels with low track multiplicity (e.g. tau pair production). The track trigger works in several steps, first combining hits to track segments, followed by a 2D track finding in the transverse plane and finally the 3D reconstruction. Our method employs neural networks to estimate the z-vertex without explicit track reconstruction. For the first real test with cosmic rays special neural networks have been prepared. Although the track shape in the cosmic test is different than in the Belle II experiment, the neural networks require only a retraining with an appropriate data set to adapt to the new geometry.

Studies of the Triple Pomeron Vertex in perturbative QCD and its applications in phenomenology

International Nuclear Information System (INIS)

Kutak, K.

2006-12-01

We study the properties of the Triple Pomeron Vertex in the perturbative QCD using the twist expansion method. Such analysis allows us to find the momenta configurations preferred by the vertex. When the momentum transfer is zero, the dominant contribution in the limit when N c →∞ comes from anticollinear pole. This is in agreement with result obtained without expanding, but by direct averaging of the Triple Pomeron Vertex over angles. Resulting theta functions show that the anticollinear configuration is optimal for the vertex. In the finite N c case the collinear term also contributes. Using the Triple Pomeron Vertex we construct a pomeron loop and we also consider four gluon propagation between two Triple Pomeron Vertices. We apply the Triple Pomeron Vertex to construct the Hamiltonian from which we derive the Balitsky-Kovchegov equation for an unintegrated gluon density. In order to apply this equation to phenomenology, we apply the Kwiecinski-Martin-Stasto model for higher order corrections to a linear part of the Balitsky-Kovchegov equation. We introduce the definition of the saturation scale which reflects properties of this equation. Finally, we use it for computation of observables, such as the F 2 structure function and diffractive Higgs boson production cross section. The impact of screening corrections on F 2 is negligible, but those effects turn out to be significant for diffractive Higgs boson production at LHC

The type of culture medium and the duration of in vitro culture do not influence birthweight of ART singletons.

Science.gov (United States)

De Vos, A; Janssens, R; Van de Velde, H; Haentjens, P; Bonduelle, M; Tournaye, H; Verheyen, G

2015-01-01

Does the type of in vitro culture medium or the duration of in vitro culture influence singleton birthweight after IVF/ICSI treatment? In a comparison of two culture media, neither the medium nor the duration of culture (Day 3 versus Day 5 blastocyst transfer) had any effect on mean singleton birthweight. Previous studies indicated that in vitro culture of human embryos may affect birthweight of live born singletons. Both the type of culture medium and the duration of culture may be implicated. However, these studies are small and report conflicting results. A large retrospective analysis was performed including all singleton live births after transferring fresh Day 3 or Day 5 embryos. IVF and ICSI cycles performed between April 2004 and December 2009 at a tertiary care centre were included for analysis. A total of 2098 singleton live births resulting from singleton pregnancies were included for analysis. Two different sequential embryo culture media were concurrently used in an alternating way: Medicult (n = 1388) and Vitrolife (n = 710). Maternal age, maternal and paternal BMI, maternal parity, maternal smoking, main cause of infertility, cycle rank, stimulation protocol, method of fertilization (IVF or ICSI), time in culture and number of embryos transferred were taken into account. Embryo transfers were performed either on Day 3 (n = 1234) or on Day 5 (n = 864). Singleton birthweight was the primary outcome parameter. Gestational age and gender of the newborn were accounted for in the multiple regression analysis. No significant differences in mean singleton birthweight were observed between the two culture media: Medicult 3222 g (±15 SE) and Vitrolife 3251 g (±21 SE) (P = 0.264). The mean singleton birthweight was not different between Day 3 embryo transfers (3219 ± 16 g) and Day 5 blastocyst transfers (3250 ± 19 g; P = 0.209). Multiple regression analysis controlling for potential maternal, paternal, treatment and newborn confounders confirmed the non

[Severe Adverse Pregnancy Outcomes in Placenta Previa and Prior Cesarean Delivery].

Science.gov (United States)

Zhou, Mi; Chen, Meng; Zhang, Li; He, Guo-Lin; He, Lei; Wei, Qiang; Li, Tao; Liu, Xing-Hui

2017-09-01

To investigate the severe adverse pregnancy outcomes in pregnancies with placenta previa and prior cesarean delivery and its risk factors. This retrospective casecontrol study reviewed all pregnancies with placenta previa and prior cesarean delivery delivered by repeat cesarean section in our institution between January 2005 and June 2015,and investigated the incidence of severe adverse pregnancy outcome. A composite of severe adverse pregnancy outcomes (including transfusion of 10 units or more red blood cells,maternal ICU admission,unanticipated injuries,repeat operation,hysterectomy,and maternal death) and other maternal and neonatal outcomes were described. Univariate and multivariable logistic regression analysis were used to quantify the effects of risk factors on severe adverse pregnancy outcomes. There were 478 women with placenta previa and prior cesarean delivery in our hospital over the last decade. The average age of them was 32.5±4.8 years old,most women were beyond 30 years old,the average gravidity and parity were 4 and 1,131 cases (27.4%) had severe adverse pregnancy outcomes. Transfusion of 10 units or more red blood cells happened in 75 cases (15.7%,75/478); 44 cases (9.2%,44/478) necessitated maternal ICU admission; unanticipated bladder injury occurred in 11 cases,but non ureter or bowel injury happened; All 4 repeat operations were due to delayed hemorrhage after conservative management during cesarean delivery,and an emergent hysterectomy was performed for all of the 4 cases. Hysterectomy (107 cases,22.4%) was the most common severe adverse pregnancy outcome. Among all 311 morbidly adherent placenta cases finally confirmed by pathological or surgical findings or both,only 172 (55.3%) were suspected before delivery. Multivariable logistic regression analysis showed that the risk of severe adverse pregnancy outcomes was significantly increased by pernicious placenta previa (i.e. anterior placenta overlying the prior cesarean scar),suspicion of

Intrathecal hypobaric versus hyperbaric bupivacaine with morphine for cesarean section.

Science.gov (United States)

Richardson, M G; Collins, H V; Wissler, R N

1998-08-01

Both hyper- and hypobaric solutions of bupivacaine are often combined with morphine to provide subarachnoid anesthesia for cesarean section. Differences in the baricity of subarachnoid solutions influence the intrathecal distribution of anesthetic drugs and would be expected to influence measurable clinical variables. We compared the effects of hyper- and hypobaric subarachnoid bupivacaine with morphine to determine whether one has significant advantages with regard to intraoperative anesthesia and postoperative analgesia in term parturients undergoing elective cesarean section. Thirty parturients were randomized to receive either hyper- or hypobaric bupivacaine (15 mg) with morphine sulfate (0.2 mg). Intraoperative outcomes compared included extent of sensory block, quality of anesthesia, and side effects. Postoperative outcomes, including pain visual analog scale scores, systemic analgesic requirements, and side effects, were monitored for 48 h. Sedation effects were quantified and compared using Trieger and digit-symbol substitution tests. We detected no differences in sensory or motor block, quality of anesthesia, quality of postoperative analgesia, incidence of side effects, or psychometric scores. Both preparations provide highly satisfactory anesthesia for cesarean section and effective postoperative analgesia. Dextrose alters the density of intrathecal bupivacaine solutions and is thought to influence subarachnoid distribution of the drug. We randomized parturients undergoing cesarean section to one of two often used spinal bupivacaine preparations, hypobaric and hyperbaric. We detected no differences in clinical outcomes between groups.

Anesthesia for cesarean section in pregnancies complicated by placenta previa

International Nuclear Information System (INIS)

Imarengiaye, Charles O.; Osaigbovo, Etinosa P.; Tudjegbe, Sampson O.

2008-01-01

Objective was to evaluate the factors affecting the choice of anesthetic technique for cesarean section in women with placenta previa. In this retrospective study, the records of the labor Ward Theatre of the University of Benin Teaching Hospital, Benin City, Nigeria were examined from January 2000 to December 2004 to identify all the women who had cesarean section for placenta previa. The patient's socio-demographic characteristics, type of placenta previa, anesthesia technique, estimated blood loss, maternal and fetal outcomes were recorded. One hundred and twenty-six patients had cesarean section for placenta previa, however, only 81 patients 64.3% were available for analysis. General anesthesia was administered to 52/81 patients 64.2% and 29/81 patients 35.8% received spinal anesthesia. A history of antepartum bleeding was recorded in 61.7% n=50. Of 31 patients without antepartum hemorrhage APH, 15/31 had general anesthesia and 16/31 had spinal anesthesia. The patients who had APH, 37/50 had general anesthesia and 1/50 had spinal anesthesia. There was an increased chance of using general anesthesia and if APH were present p=0.03, odds ratio=3.1, 95% confidence interval=1.2-7.7. Spinal anesthesia may useful in patients with placenta previa. The presence of APH may encourage the use of general anesthesia for cesarean delivery. (author)

The role of unique color changes and singletons in attention capture.

Science.gov (United States)

von Mühlenen, Adrian; Conci, Markus

2016-10-01

Previous studies have shown that a sudden color change is typically less salient in capturing attention than the onset of a new object. Von Mühlenen, Rempel, and Enns (Psychological Science 16: 979-986, 2005) showed that a color change can capture attention as effectively as the onset of a new object given that it occurs during a period of temporal calm, where no other display changes happen. The current study presents a series of experiments that further investigate the conditions under which a change in color captures attention, by disentangling the change signal from the onset of a singleton. The results show that the item changing color receives attentional priority irrespective of whether this change goes along with the appearance of a singleton or not.

Measuring coverage in MNCH: validating women's self-report of emergency cesarean sections in Ghana and the Dominican Republic.

Directory of Open Access Journals (Sweden)

Ozge Tunçalp

Full Text Available BACKGROUND: Cesarean section is the only surgery for which we have nearly global population-based data. However, few surveys provide additional data related to cesarean sections. Given weaknesses in many health information systems, health planners in developing countries will likely rely on nationally representative surveys for the foreseeable future. The objective is to validate self-reported data on the emergency status of cesarean sections among women delivering in teaching hospitals in the capitals of two contrasting countries: Accra, Ghana and Santo Domingo, Dominican Republic (DR. METHODS AND FINDINGS: This study compares hospital-based data, considered the reference standard, against women's self-report for two definitions of emergency cesarean section based on the timing of the decision to operate and the timing of the cesarean section relative to onset of labor. Hospital data were abstracted from individual medical records, and hospital discharge interviews were conducted with women who had undergone cesarean section in two hospitals. The study assessed sensitivity, specificity, and positive predictive value of responses to questions regarding emergency versus non-emergency cesarean section and estimated the percent of emergency cesarean sections that would be obtained from a survey, given the observed prevalence, sensitivity, and specificity from this study. Hospital data were matched with exit interviews for 659 women delivered via cesarean section for Ghana and 1,531 for the Dominican Republic. In Ghana and the Dominican Republic, sensitivity and specificity for emergency cesarean section defined by decision time were 79% and 82%, and 50% and 80%, respectively. The validity of emergency cesarean defined by operation time showed less favorable results than decision time in Ghana and slightly more favorable results in the Dominican Republic. CONCLUSIONS: Questions used in this study to identify emergency cesarean section are promising

The OPAL vertex drift chamber

International Nuclear Information System (INIS)

Carter, J.R.; Elcombe, P.A.; Hill, J.C.; Roach, C.M.; Armitage, J.C.; Carnegie, R.K.; Estabrooks, P.; Hemingway, R.; Karlen, D.; McPherson, A.; Pinfold, J.; Roney, J.M.; Routenburg, P.; Waterhouse, J.; Hargrove, C.K.; Klem, D.; Oakham, F.G.; Carter, A.A.; Jones, R.W.L.; Lasota, M.M.B.; Lloyd, S.L.; Pritchard, T.W.; Wyatt, T.R.

1990-01-01

A high precision vertex drift chamber has been installed in the OPAL experiment at LEP. The design of the chamber and the associated readout electronics is described. The performance of the system has been studied using cosmic ray muons and the results of these studies are presented. A space resolution of 50 μm in the drift direction is obtained using the OPAL central detector gas mixture at 4 bar. (orig.)

Cesarean Scar Ectopic Pregnancy: Laparoscopic Resection and Total Scar Dehiscence Repair.

Science.gov (United States)

Mahgoub, Sara; Gabriele, Victor; Faller, Emilie; Langer, Bruno; Wattiez, Arnaud; Lecointre, Lise; Akladios, Cherif

2018-02-01

To illustrate a laparoscopic technique for the resection of cesarean scar ectopic pregnancy, associated with isthmocele repair. Case report (Canadian Task Force classification III). A tertiary referral center in Strasbourg, France. Cesarean scar pregnancy is a rare form of ectopic pregnancy. The major risk of this type of pregnancy is the early uterine rupture with massive, sometimes life-threatening, bleeding. Thus, active management of these pregnancies starting immediately after diagnosis is crucial. Therapeutic options can be medical, surgical, or a combination. Numerous case reports or case series can be found in the literature, but there are few clinical studies, which are difficult to conduct because of case rarity and inconclusiveness. A 2016 meta-analysis that included 194 articles published between 1978 and 2014 (126 case reports, 45 cases series, and 23 clinical studies) concluded that hysteroscopy or laparoscopic hysterotomy seems to be the best first-line approach to treating cesarean scar ectopic pregnancy, with uterine artery embolization reserved for significant bleeding and/or a high suspicion index for arteriovenous malformation [1]. There is no consensus on the treatment of reference, however. The case involves a 38-year-old primiparous women who underwent a cesarean section delivery in 2010 and who was diagnosed by ultrasound scan at 7 weeks gestation with cesarean scar ectopic pregnancy, which was confirmed by pelvic magnetic resonance imaging. The patient initially received medical treatment with 2 intramuscular injections of methotrexate and one local intragestational injection of KCl. Her initial human chorionic gonadotropin (hCG) level was 82 000 IU/L. Rigorous weekly biological and ultrasound monitoring revealed an involution of the ectopic pregnancy associated with decreasing hCG. No bleeding or infectious complications occurred during this period. After 10 weeks of monitoring, her hCG had stabilized at 300 IU/L, and a residual image

What we have learned about scheduling elective repeat cesarean delivery at term.

Science.gov (United States)

Tita, Alan T N

2016-08-01

The optimal timing of delivery in the setting of various clinical conditions and scenarios remains one of the most common questions for obstetric providers. Over the past 5-10 years, the optimal timing of delivery at term, particularly for elective repeat cesareans, has been the subject of considerable investigation and discussion. There is an increasing consensus that when women opt for an elective repeat cesarean delivery, it should be performed at term rather than preterm. The recent redefinition of the "term" period into early term (37-38 weeks), full-term (39-40 weeks), late term (41 weeks), and post term designations (≥42 weeks) underscores observed heterogeneity in outcomes following delivery at term. The American College of Obstetricians and Gynecologists currently recommends that elective repeat cesarean delivery be performed at full-term. Herein, the available data to support this recommendation regarding timing of elective repeat cesarean delivery are reviewed, including contributions from the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD) Maternal-Fetal Medicine Units (MFMU) Network. Copyright © 2016. Published by Elsevier Inc.

A vertex including emission of spin fields for an arbitrary bc system

International Nuclear Information System (INIS)

Di Vecchia, P.; Madsen, R.A.; Roland, K.

1990-01-01

We construct the (N+2M) Point Vertex involving the emission of N Neveu-Schwarz and 2M Ramond states for a bosonic and fermionic bc system with a bockground charge Q. From it one can compute correlation functions on the sphere involving any number of spin fields. We show in detail that the vertex satisfies overlap conditions. (orig.)

Simulations of silicon vertex tracker for star experiment at RHIC

Energy Technology Data Exchange (ETDEWEB)

Odyniec, G.; Cebra, D.; Christie, W.; Naudet, C.; Schroeder, L.; Wilson, W. [Lawrence Berkeley Lab., CA (United States); Liko, D. [Institut fur Hochenenergiephysik, Vienna, (Austria); Cramer, J.; Prindle, D.; Trainor, T. [Univ. of Washington, Seattle (United States); Braithwaite, W. [Univ. of Arkansas, Little Rock (United States)

1991-12-31

The first computer simulations to optimize the Silicon Vertex Tracker (SVT) designed for the STAR experiment at RHIC are presented. The physics goals and the expected complexity of the events at RHIC dictate the design of a tracking system for the STAR experiment. The proposed tracking system will consist of a silicon vertex tracker (SVT) to locate the primary interaction and secondary decay vertices and to improve the momentum resolution, and a time projection chamber (TPC), positioned inside a solenoidal magnet, for continuous tracking.

Disciplinary discourses: rates of cesarean section explained by medicine, midwifery, and feminism.

Science.gov (United States)

Lee, Amy Su May; Kirkman, Maggie

2008-05-01

In the context of international concern about increasing rates of cesarean sections, we used discourse analysis to examine explanations arising from feminism and the disciplines of medicine and midwifery, and found that each was positioned differently in relation to the rising rates. Medical discourses asserted that doctors are authorities on birth and that, although cesareans are sometimes medically necessary, women recklessly choose unnecessary cesareans against medical advice. Midwifery discourses portrayed medicine as paternalistic toward both women and midwifery, and feminist discourses situated birth and women's bodies in the context of a patriarchally structured society. The findings illustrate the complex ways in which this intervention in birth is discursively constructed, and demonstrate its significance as a site of disciplinary conflict.

The silicon vertex locator for the LHCb upgrade

CERN Document Server

Head, Tim

2014-01-01

The upgrade of the LHCb experiment, planned for 2018, will transform the entire readout to a triggerless system being read out at 40 MHz. The upgraded silicon vertex detector (VELO) must be light weight, radiation hard, and compatible with LHC vacuum requirements. It must be capable of fast pattern recognition, fast track reconstruction and high precision vertexing. This challenge is being met with a new VELO design based on hybrid pixel detectors positioned to within 5 mm of the LHC colliding beams. The detector will be shielded from the beam by a View the MathML source~300μm thick aluminium foil. Evaporative CO2 coolant circulating in micro-channels embedded in a thin silicon substrate will be used for cooling.

Effects of a Paternal Participation Program during Cesarean Section on Paternal Infant Attachment

Directory of Open Access Journals (Sweden)

Hyun Kyoung Kim

2013-06-01

Full Text Available PurposeIn this study effects of a paternal participation program during cesarean section on paternal infant attachment were investigate. The experimental treatment was an integrative nursing intervention to promote father to infant attachment.MethodsStudy design was a non-equivalent control group posttest design. The program consisted of emotional support to spouse and father towards infant attachment immediately following cesarean birth. Participants were 66 men, partners of women with normal full term pregnancy having a cesarean section with spinal or epidural anesthesia, (experimental group, 34; control group, 32. The experiment was carried out from August 1 to October 30, 2010. Control group data were obtained from May 1 to June 30, 2012. Posttest was performed 72 hours after cesarean birth. A self-report questionnaire including a paternal attachment instrument was used. Data were analyzed using t-test, propensity score matching, and analysis of covariance with the SPSS/WIN 18.0 program.ResultsTotal score for paternal infant attachment in the experimental group was significantly higher than the control group (p<.001. After matching, significant differences were found between the two groups through all subcategories. Adjusted mean score for paternal infant attachment verified experimental effects.ConclusionResults indicate that this paternal participation program during cesarean section is effective in improving paternal infant attachment.

Vertex models, TASEP and Grothendieck polynomials

International Nuclear Information System (INIS)

Motegi, Kohei; Sakai, Kazumitsu

2013-01-01

We examine the wavefunctions and their scalar products of a one-parameter family of integrable five-vertex models. At a special point of the parameter, the model investigated is related to an irreversible interacting stochastic particle system—the so-called totally asymmetric simple exclusion process (TASEP). By combining the quantum inverse scattering method with a matrix product representation of the wavefunctions, the on-/off-shell wavefunctions of the five-vertex models are represented as a certain determinant form. Up to some normalization factors, we find that the wavefunctions are given by Grothendieck polynomials, which are a one-parameter deformation of Schur polynomials. Introducing a dual version of the Grothendieck polynomials, and utilizing the determinant representation for the scalar products of the wavefunctions, we derive a generalized Cauchy identity satisfied by the Grothendieck polynomials and their duals. Several representation theoretical formulae for the Grothendieck polynomials are also presented. As a byproduct, the relaxation dynamics such as Green functions for the periodic TASEP are found to be described in terms of the Grothendieck polynomials. (paper)

Is the birthweight of singletons born after IVF reduced by ovarian stimulation or by IVF laboratory procedures?

NARCIS (Netherlands)

Pelinck, M. J.; Hadders-Algra, M.; Haadsma, M. L.; Nijhuis, W. L.; Kiewiet, S. M.; Hoek, A.; Heineman, M. J.; Middleburg, K. J.