Perineal care and outcomes in a birth center

Objective: to analyse the perineal outcomes in childbirth and post-partum perineal care in a freestanding birth centre. Method: a cross-sectional study, with data collection performed in the women’s birth records forms from Casa Angela, a freestanding birth centre, São Paulo, Brazil, in 2016-2017 (n=415). The following data was analysed: occurrence and perineal tear degree; maternal, neonatal and birth care-related variables; perineal suture prevalence; complications in wound healing and natural methods on perineal care. Data were subjected to descriptive, inferential and multiple analyses. Results: in 11.8% of women, the perineum was kept intact, 61.9% had spontaneous first-degree tear and 26.3% had second-degree tear. The variables related to the occurrence and higher spontaneous degree tears were maternal age and second period of childbirth >2 hours. The protective factors against the occurrence and higher degree tears were number of previous vaginal childbirths and maternal position different from vertical during childbirth. Perineal suture was performed in 16.0% and 70.6% of women with spontaneous first- and second-degree tears, respectively. The main perineal complications after birth were edema (53.6%) and pain (29.4%); and the perineal suture increased the chance for these complications (OR=2.5; 95%CI 1.5-4.3). Perineum icepack compress was used in 53.8% of women during post-partum period. Conclusion: maternal and health-care related factors were associated to the prevalence and degree of spontaneous perineal tear. First-degree spontaneous perineal tears were prevalent and sutured in a low number of women. There were more complications in the wound healing process when the perineal suture was performed, regardless the tear degree. The number of natural methods in post-partum perineal care was higher than the use of medicines

A multispectral view of the periodic events in eta Carinae

A full description of the 5.5-yr low excitation events in Eta Carinae is presented. We show that they are not as simple and brief as previously thought, but a combination of two components. The first, the 'slow variation' component, is revealed by slow changes in the ionization level of circumstellar matter across the whole cycle and is caused by gradual changes in the wind-wind collision shock-cone orientation, angular opening and gaseous content. The second, the 'collapse' component, is restricted to around the minimum, and is due to a temporary global collapse of the wind-wind collision shock. High energy photons (E > 16 eV) from the companion star are strongly shielded, leaving the Weigelt objects at low ionization state for >6 months. High energy phenomena are sensitive only to the 'collapse', low energy only to the 'slow variation' and intermediate energies to both components. Simple eclipses and mechanisms effective only near periastron (e.g., shell ejection or accretion onto the secondary star) cannot account for the whole 5.5-yr cycle. We find anti-correlated changes in the intensity and the radial velocity of P Cygni absorption profiles in FeII 6455 and HeI 7065 lines, indicating that the former is associated to the primary and the latter to the secondary star. We present a set of light curves representative of the whole spectrum, useful for monitoring the next event (2009 January 11).Comment: 16 pages, 7 EPS figures, accepted for publication on MNRA

Urinary incontinence related to perineal muscle strength in the first trimester of pregnancy: cross-sectional study

Objective To analyze pelvic floor muscle strength (PFMS), urinary continence and quality of life related to urinary incontinence (UI) of women in the first trimester of pregnancy. Method Cross-sectional study with a sample of 500 women who started prenatal care in a complementary healthcare facility in Guarulhos, state of São Paulo, from 2012 and 2013. Pelvic floor muscle strength was evaluated through perineometry. The pregnant women who presented UI answered the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF). Results It was found that maternal age (OR=1.06; CI95% 1.02-1.11) and prior UI (OR=15.12; 95%CI 8.19-27.92) are the variables that, in tandem, best explain the occurrence of UI at the beginning of pregnancy. The mean score on the ICIQ-SF was 8.2 (SD=3.9), considered a moderate impact on quality of life. Conclusion Older pregnant women with prior UI are more likely to have UI in the first trimester of pregnancy.
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MINERvA neutrino detector response measured with test beam data

The MINERvA collaboration operated a scaled down replica of the solid scintillator tracking and sampling calorimeter regions of the MlNERvA detector in a hadron test beam at the Fermilab Test Beam Facility. This paper reports measurements with samples of protons, pions, and electrons from 0.35 to 2.0 GeV/c momentum. The calorimetric response to protons, pions, and electrons is obtained from these data. A measurement of the parameter in Birks\u27 law and an estimate of the tracking efficiency are extracted from the proton sample. Overall the data are well described by a Geant4-based Monte Carlo simulation of the detector and particle interactions with agreements better than 4% for the calorimetric response, though some features of the data are not precisely modeled. These measurements are used to tune the MINERvA detector simulation and evaluate systematic uncertainties in support of the MINERvA neutrino cross-section measurement program. (C) 2015 Published by Elsevier B.V

CAD modeling, multibody system formalisms and visualization : an integrated approach

In this paper an integrated approach of CAD (Computer Aided Design) modeling, generation of equations of motion, simulation and visualization of multibody systems is described. An object-oriented data model for different multibody formalisms is integrated in a commercially available CAD-3D-system. With respect to existing CAD-interfaces, different solid model design methods and various visualization demands the datamodel allow, multi body modeling with a direct interface to a data base. Different software tools like an integrated Newton-Euler formalism are able to use immediately the parametrized multi body system data base. For multibody systems with closed kinematic loops a set of ordinary differential equations and decoupled algebraic equations is formulated automatically which can be solved with explicit multistep integration algorithms. This is achieved by a minimal set of generalized coordinates being specified during the numerical integration. A additional interface provides data for visualization from the simulation tool

MINERvA neutrino detector response measured with test beam data

The MINERvA collaboration operated a scaled-down replica of the solid scintillator tracking and sampling calorimeter regions of the MINERvA detector in a hadron test beam at the Fermilab Test Beam Facility. This article reports measurements with samples of protons, pions, and electrons from 0.35 to 2.0 GeV/c momentum. The calorimetric response to protons, pions, and electrons are obtained from these data. A measurement of the parameter in Birks' law and an estimate of the tracking efficiency are extracted from the proton sample. Overall the data are well described by a Geant4-based Monte Carlo simulation of the detector and particle interactions with agreements better than 4%, though some features of the data are not precisely modeled. These measurements are used to tune the MINERvA detector simulation and evaluate systematic uncertainties in support of the MINERvA neutrino cross section measurement program.Comment: as accepted by NIM