73 research outputs found
Concept of defensive medicine and litigation among Sudanese doctors working in obstetrics and gynecology
Computer-based intrapartum fetal monitoring and beyond: A review of the 2nd Workshop on Signal Processing and Monitoring in Labor (October 2017, Oxford, UK).
The second Signal Processing and Monitoring in Labor workshop gathered researchers who utilize promising new research strategies and initiatives to tackle the challenges of intrapartum fetal monitoring. The workshop included a series of lectures and discussions focusing on: new algorithms and techniques for cardiotocogoraphy (CTG) and electrocardiogram acquisition and analyses; the results of a CTG evaluation challenge comparing state-of-the-art computerized methods and visual interpretation for the detection of arterial cord pHÂ <7.05 at birth; the lack of consensus about the role of intrapartum acidemia in the etiology of fetal brain injury; the differences between methods for CTG analysis "mimicking" expert clinicians and those derived from "data-driven" analyses; a critical review of the results from two randomized controlled trials testing the former in clinical practice; and relevant insights from modern physiology-based studies. We concluded that the automated algorithms performed comparably to each other and to clinical assessment of the CTG. However, the sensitivity and specificity urgently need to be improved (both computerized and visual assessment). Data-driven CTG evaluation requires further work with large multicenter datasets based on well-defined labor outcomes. And before first tests in the clinic, there are important lessons to be learnt from clinical trials that tested automated algorithms mimicking expert CTG interpretation. In addition, transabdominal fetal electrocardiogram monitoring provides reliable CTG traces and variability estimates; and fetal electrocardiogram waveform analysis is subject to promising new research. There is a clear need for close collaboration between computing and clinical experts. We believe that progress will be possible with multidisciplinary collaborative research
Criteria-based audit to improve quality of care of foetal distress: standardising obstetric care at a national referral hospital in a low resource setting, Tanzania
U.S. Dependence on Oil in 2008: Facts, Figures and Context
In 2007 and 2008, the price of oil skyrocketed, hitting historic highs. The corresponding increase in gas price was felt sharply in the United States by ordinary people, industries, the military and the government. Citizens were spending more and more of their paychecks to fill their gas tanks, airlines grounded planes to avoid the high cost of fuel, and the military saw its daily price tag for the wars in Afghanistan and Iraq increase due to fuel costs. The U.S. military depended almost exclusively on oil to power its weapons and vehicles. Economists the world over debated whether this sudden price jump was caused by supply and demand dynamics, market "speculation," or the weak dollar. In addition, debate intensified over whether the world was hitting "peak oil,"--a time when global oil production capacity would plateau. If strategy is about gaining and maintaining control of destiny through managing the balance between influence and dependence, the U.S. faced an increasingly dangerous strategic situation in 2008. Although the U.S. had traditionally been strongly influential in the oil industry, by 2008 it seemed that this influence had waned. U.S. oil production had been decreasing steadily since the mid 1980s, and the U.S. was losing clout as a customer as developing nations like China and India began buying increasing amounts of oil. As a result, the U.S. was potentially facing a situation of strategic subordination. The strategic imperatives facing the U.S. in 2008 were therefore first, to gain more control of the forces driving the United States' increased dependency on oil, especially foreign oil, and second, to take decisive action to significantly reduce its dependency on oil as a major source of energy within the shortest possible time. To develop a greater understanding of the strategic challenges facing the U.S. in 2008, this paper provides the key facts and figures, as well as key contextual factors, to describe global and U.S. energy and oil consumption, the history and evolution of the oil industry, the global oil marketplace in 2008, and the relationship between U.S. oil consumption and national security. This greater understanding, we believe, will facilitate taking the decisive strategic actions that the situation calls for.
Re-engineering the interpretation of electronic fetal monitoring to identify reversible risk for cerebral palsy: a case control series
Nile stimulation in late pregnancy causing uterine hyperstimulation and profound fetal bradycardia
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