100,313 research outputs found

    Trend in primary caesarean delivery. A five-year experience in Abruzzo, Italy

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    Background: Primary caesarean section (PCS) rate is one of the main indicators of quality of care suggested by the Italian Government. Hospital rankings are usually based on it, therefore lower rates reflect more appropriate clinical practice. The aim of this study is to describe a five-year trend of PCS rate in Abruzzo region from 2009 to 2013 and to examine the medical indications for this mode of delivery. Methods: Forty-five thousand one hundred forty-nine deliveries occurring from 2009 to 2013 were collected from all hospital discharge records (HDR) and analyzed. Among them we found 12,542 PCS. Odds ratios (ORs) with 95% confidence interval (95% CI) were estimated using logistic regression methods to evaluate the relationship between maternal risk factors and PCS in hospital over 1000 delivery/yrs. Results: The five-year PCS rate was 28.9%, with a decreasing trend from 31.4% in 2009 to 26.1% in 2013. Vasto Civil Hospital shows the lowest PCS rate (17.9% in 2013) among hospitals with a maximum of 1000 deliveries per year, while Pescara Civil Hospital shows the lowest PCS rate (25.4% in 2013) among hospitals with over 1000 deliveries per year. Women with major risk factors for cesarean section delivered more frequently in maternity units over 1000 delivery/yrs. Logistic regression analyses showed as diabetes, hypertension, twin pregnancy, fetal distress and preterm delivery were significant risk factors to deliver in unit over 1000 delivery/yrs. The most frequent (overall 66.6%) discharge diagnosis recorded in Hospital discharge records (HDR) is "Caesarean Delivery Without Indication". 7.3% of PCS made in Abruzzo concerns women living in other Italian regions. 11.4% of PCS contains one of the indications to caesarean section (CS) that the Italian Guidelines consider appropriate. Conclusions: During the analyzed period, Abruzzo showed a decreasing, but still too high, PCS rate, compared to the limits fixed by the Italian Ministry of Health. Considering the limitation of this study, based on administrative data that are poor in clinical information, it is not possible to define the appropriateness of all caesarean sections

    Comorbidities and Risk-Adjusted Maternal Outcomes: A Retrospective Study on Administrative Data

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    Abstract Objective: The aim of this study was the evaluation of maternal outcomes and of the associated risk factors occurred in Abruzzo region, Italy, from 2009 to 2013. Methods: The study considered all the deliveries performed from 2009 to 2013 in Abruzzo region, Italy. Data were collected from all hospital discharge records. Univariate logistic regression analyses were performed to calculate crude odds ratios for each comorbidity. Stepwise multiple logistic regression models with backward selection were performed to identify predictors of the most frequent outcomes. Results: 57, 260 deliveries were analyzed. Severe complication occurred in 0.9% of all deliveries. The most frequent complications were “Severe Hemorrhage”, “Hysterectomy”, “Uterine rupture” and “Severe pre-eclampsia/eclampsia”. Malignant cancer (OR=55.76), coagulation disorders (OR=37.21), acute pulmonary disease (OR=29.75), placenta previa (OR=26.51), caesarean section (OR=3.24) and age (OR=1.08) were associated with a higher risk of hysterectomy. Anemia (OR=14.64), coagulation disorders (OR=10.31), cardiac disease (OR=12.74), pregnancy hypertension (OR=2.66), major pre-eclampsia/eclampsia (OR=2.78), placenta previa (OR=9.42) and multiple pregnancy (OR=3.69) were associated to severe hemorrhage. Thrombocytopenia (OR=26.04) and diabetes (OR=5.05) were associated to uterine rupture. Overweight or obesity (OR=25.88) and pregnancy cardiovascular disease (OR=25.85) were associated to pre-eclampsia. Conclusions: Maternal comorbidities are associated with increased risk of complications and may result in substantial costs to the health care system

    Letter, [Author unclear] to Paulina T. Merritt

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    Handwritten letter to Paulina Merritt from an unknown author, October 1, 1876.

    Antiviral activity of different extracts of standardized propolis preparations against HSV

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    Background: Viral infections are among the most common problems in health-care practice. Natural products offer great promise as potentially effective antiviral drugs. Propolis is a honeybee product with biological properties and therapeutic applications. We aimed to investigate the antiviral activity of different extracts of Standardized Propolis Preparations (M.E.D.(R)) with glycol, ethanol, glycerol and soya oil, against herpes simplex type-1 (HSV-1) and type 2 (HSV-2) viruses. Methods: Chemical composition and antiviral activity of each extract were determined. The selective index (SI=CC50/EC50) was determined as a parameter to indicate the in vitro antiviral activity of the extracts compared with acyclovir as the control. Results: SI values of glycol, ethanol, glycerol, soya oil extracts and acyclovir were determined as 6.8, 4.1, 2.2, 3.3 and 6.3 against HSV-1, and as 6.4, 7.7, 1.9, 4.2 and 2.9 against HSV-2, respectively. Glycolic propolis extract was found to possess a greater antiviral activity than acyclovir for both HSV-1 and 2, while glycolic, ethanolic and soya oil preparations were found to have more significant activity than acyclovir for HSV-2. Conclusions: It was determined that standardized propolis preparations have antiviral bioactivity against HSV

    Handwritten biographical information on Paulina T. McClung Merritt

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    A handwritten biography of Paulina T. McClung Merritt by an unknown author, 1892.

    Heterogeneous and tissue-specific regulation of effector T cell responses by IFN-gamma during Plasmodium berghei ANKA infection.

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    IFN-γ and T cells are both required for the development of experimental cerebral malaria during Plasmodium berghei ANKA infection. Surprisingly, however, the role of IFN-γ in shaping the effector CD4(+) and CD8(+) T cell response during this infection has not been examined in detail. To address this, we have compared the effector T cell responses in wild-type and IFN-γ(-/-) mice during P. berghei ANKA infection. The expansion of splenic CD4(+) and CD8(+) T cells during P. berghei ANKA infection was unaffected by the absence of IFN-γ, but the contraction phase of the T cell response was significantly attenuated. Splenic T cell activation and effector function were essentially normal in IFN-γ(-/-) mice; however, the migration to, and accumulation of, effector CD4(+) and CD8(+) T cells in the lung, liver, and brain was altered in IFN-γ(-/-) mice. Interestingly, activation and accumulation of T cells in various nonlymphoid organs was differently affected by lack of IFN-γ, suggesting that IFN-γ influences T cell effector function to varying levels in different anatomical locations. Importantly, control of splenic T cell numbers during P. berghei ANKA infection depended on active IFN-γ-dependent environmental signals--leading to T cell apoptosis--rather than upon intrinsic alterations in T cell programming. To our knowledge, this is the first study to fully investigate the role of IFN-γ in modulating T cell function during P. berghei ANKA infection and reveals that IFN-γ is required for efficient contraction of the pool of activated T cells

    Dispelling the Myths Behind First-author Citation Counts

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    We conducted a full-scale evaluative citation analysis study of scholars in the XML research field to explore just how different from each other author rankings resulting from different citation counting methods actually are, and to demonstrate the capability of emerging data and tools on the Web in supporting more realistic citation counting methods. Our results contest some common arguments for the continued use of first-author citation counts in the evaluation of scholars, such as high correlations between author rankings by first-author citation counts and other citation counting methods, and high costs of using more realistic citation counting methods that are not well-supported by the ISI databases. It is argued that increasingly available digital full text research papers make it possible for citation analysis studies to go beyond what the ISI databases have directly supported and to employ more sophisticated methods

    Pelevin’s Trinity in the novel “t”: author – protagonist – reader

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    The article attempts to interpret Pelevin's artistic strategy in the novel "T" by exploring its subject organization and addressing the key problems of the author, the protagonist, and the reader as they are seen by the researcher. The article analyzes the peculiarities of constructing the narrative reality in the novel "T", and goes on to discuss Pelevin's philosophic models of the development of the humankind, and the emergence of his new anthropology

    Measuring industry-science links through inventor-author relations: A profiling method

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    In this pilot study we examine the performance of text-based profiling in recovering a set of validated inventor-author links. In a first step we match patents and publications solely based on their similarity in content. Next, we compare inventor and author names on the highest ranked matches for the occurrence of name matches. Finally, we compare these candidate matches with the names listed in a validated set of inventor-author names. Our text-based profile methodology performs significantly better than a random matching of patents and publications, suggesting that text-based profiling is a valuable complementary tool to the name searches used in previous studies.innovation; industry-science links; text-based profiling;

    Wave turbulence of a rotating array of quantized vortices in the T → 0 temperature limit

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    The dynamics of quantized vortices in the zero temperature limit T0T \rightarrow 0 is currently of great interest, particularly in the case of the Fermi superfluid 3^3He-B. Here we study wave turbulence, generated by the librating motion of a rotating cylindrical container filled with 3^3He-B, in the limit of vanishing viscous forces at temperatures T0.2TcT \leq 0.2 T_{c}. The polarization of the quantized vortices with respect to the axis of rotation is measured using non-invasive NMR techniques. We observe a decrease of the polarization when the librating motion is started, and a two-stage relaxation process when the modulation of the rotation velocity is stopped. The first relaxation process is associated with the dissipation of large-scale flow stored in inertial waves and the solid body rotation of the vortex array. From the decay of these energy reservoirs we determine the rate of energy dissipation of large-scale flow. The later second process is related to the relaxation of Kelvin waves on individual vortices. This process is monitored by the recovery of the polarization. The existence of a Kelvin wave cascade at the lowest temperatures is currently a central open question. We supply some evidence for the cascade
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