Changing trends in cesarean section: from 1950 to 2020

Caesarean section (C.S) is a part of the standard care in modern obstetrics. The indications for a caesarean section as an alternative to vaginal delivery have evolved over the centuries. Its practicality, disponibility, and apparent safety have placed caesarean section, a first-line procedure in many clinical scenarios. The awareness of perinatal mortality and morbidity associated with safety of caesarean, expert anaesthesia, potent antibiotics, blood transfusion facilities and better neonatal care have increased incidence of caesarean section very fast. Thus, there is fast, steady and definite rise in incidence of caesarean section everywhere. But the question is ‘Is a rising caesarean section rate is inevitable?’. Studies carried out to understand CS deliveries has adopted different framework. The issue treats elements of ethics in the medical profession, gender issues, choices of women, the quality of institutional services, etc. The findings of retrospective studies have suggested that the caesarean section rate could be reduced in certain categories. In this study, we discuss the various ways in which it can be achieved

Creative Approaches to the Creation of Contemporary Art Objects and Features of their Legal Protection

This study is devoted to the analysis of the current state of legislation of Ukraine and EU countries on copyright protection of works with an unstable form of expression, as well as to determine the features of the legal protection of such objects. The purpose of the article was to explore the existing possibilities in the law of Ukraine and the law of the EU countries for the protection of works with an unstable form of their expression. The article, based on the analysis of international legal acts and national legislation, highlights the elements of protection of works. A significant place in work is devoted to the analysis of theoretical, legislative approaches to the definition of "creativity", "originality", "novelty". It is stated that there is no single waste to the definition of these concepts in the literature and not regulated in the legislation in the field of copyright. A comparative legal analysis of the case-law of the United Kingdom and the United States on the provision of legal protection to works with an unstable form. It is concluded that the normative definition of “creative work”, which is associated exclusively with works of cultural value, is not acceptable for copyright. The article analyses the judicial practice of Ukraine, which has developed in the definition of creative work and illustrates its ambiguity. It is concluded that judges, considering such cases, try to find some stable elements that are inherent in works with an unstable form of expression. Keywords: Intellectual property law, object of intellectual property law, subjects of intellectual property law

Application of multiplexed ion mobility spectrometry towards the identification of host protein signatures of treatment effect in pulmonary tuberculosis.

RationaleThe monitoring of TB treatments in clinical practice and clinical trials relies on traditional sputum-based culture status indicators at specific time points. Accurate, predictive, blood-based protein markers would provide a simpler and more informative view of patient health and response to treatment.ObjectiveWe utilized sensitive, high throughput multiplexed ion mobility-mass spectrometry (IM-MS) to characterize the serum proteome of TB patients at the start of and at 8 weeks of rifamycin-based treatment. We sought to identify treatment specific signatures within patients as well as correlate the proteome signatures to various clinical markers of treatment efficacy.MethodsSerum samples were collected from 289 subjects enrolled in CDC TB Trials Consortium Study 29 at time of enrollment and at the end of the intensive phase (after 40 doses of TB treatment). Serum proteins were immunoaffinity-depleted of high abundant components, digested to peptides and analyzed for data acquisition utilizing a unique liquid chromatography IM-MS platform (LC-IM-MS). Linear mixed models were utilized to identify serum protein changes in the host response to antibiotic treatment as well as correlations with culture status end points.ResultsA total of 10,137 peptides corresponding to 872 proteins were identified, quantified, and used for statistical analysis across the longitudinal patient cohort. In response to TB treatment, 244 proteins were significantly altered. Pathway/network comparisons helped visualize the interconnected proteins, identifying up regulated (lipid transport, coagulation cascade, endopeptidase activity) and down regulated (acute phase) processes and pathways in addition to other cross regulated networks (inflammation, cell adhesion, extracellular matrix). Detection of possible lung injury serum proteins such as HPSE, significantly downregulated upon treatment. Analyses of microbiologic data over time identified a core set of serum proteins (TTHY, AFAM, CRP, RET4, SAA1, PGRP2) which change in response to treatment and also strongly correlate with culture status. A similar set of proteins at baseline were found to be predictive of week 6 and 8 culture status.ConclusionA comprehensive host serum protein dataset reflective of TB treatment effect is defined. A repeating set of serum proteins (TTHY, AFAM, CRP, RET4, SAA1, PGRP2, among others) were found to change significantly in response to treatment, to strongly correlate with culture status, and at baseline to be predictive of future culture conversion. If validated in cohorts with long term follow-up to capture failure and relapse of TB, these protein markers could be developed for monitoring of treatment in clinical trials and in patient care

Surrogate light curve models for kilonovae with comprehensive wind ejecta outflows and parameter estimation for AT2017gfo

The electromagnetic emission resulting from neutron star mergers have been shown to encode properties of the ejected material in their light curves. The ejecta properties inferred from the kilonova emission has been in tension with those calculated based on the gravitational wave signal and numerical relativity models. Motivated by this tension, we construct a broad set of surrogate light curve models derived for kilonova ejecta. The four-parameter family of two-dimensional anisotropic simulations and its associated surrogate explore different assumptions about the wind outflow morphology and outflow composition, keeping the dynamical ejecta component consistent. We present the capabilities of these surrogate models in interpolating kilonova light curves across various ejecta parameters and perform parameter estimation for AT2017gfo both without any assumptions on the outflow and under the assumption that the outflow must be representative of solar r-process abundance patterns. Our parameter estimation for AT2017gfo shows these surrogate models help alleviate the ejecta property discrepancy while also illustrating the impact of systematic modeling uncertainties on these properties, urging further investigation.Comment: 15 pages, 6 figures, data available in Zenodo (https://zenodo.org/record/7335961) and GitHub (https://github.com/markoris/surrogate_kne

Proposing new variables for the identification of strategic groups in franchising

The identification of strategic groups in the Spanish franchising area is the main aim of this study. The authors have added some new strategic variables (not used before) to the study and have classified franchisors between sectors and distribution strategy. The results reveal the existence of four perfectly differentiated strategic groups (types of franchisors). One of the major implications of this study is that the variables that build a strategic group vary depending on the respective sector the network operates in and its distribution strategy. This fact indicates that including sector and distribution strategy is absolutely necessary to achieve good classifications of franchisor type

Volumetric laser endomicroscopy and its application to Barrett's esophagus: results from a 1,000 patient registry.

Volumetric laser endomicroscopy (VLE) uses optical coherence tomography (OCT) for real-time, microscopic cross-sectional imaging. A US-based multi-center registry was constructed to prospectively collect data on patients undergoing upper endoscopy during which a VLE scan was performed. The objective of this registry was to determine usage patterns of VLE in clinical practice and to estimate quantitative and qualitative performance metrics as they are applied to Barrett's esophagus (BE) management. All procedures utilized the NvisionVLE Imaging System (NinePoint Medical, Bedford, MA) which was used by investigators to identify the tissue types present, along with focal areas of concern. Following the VLE procedure, investigators were asked to answer six key questions regarding how VLE impacted each case. Statistical analyses including neoplasia diagnostic yield improvement using VLE was performed. One thousand patients were enrolled across 18 US trial sites from August 2014 through April 2016. In patients with previously diagnosed or suspected BE (894/1000), investigators used VLE and identified areas of concern not seen on white light endoscopy (WLE) in 59% of the procedures. VLE imaging also guided tissue acquisition and treatment in 71% and 54% of procedures, respectively. VLE as an adjunct modality improved the neoplasia diagnostic yield by 55% beyond the standard of care practice. In patients with no prior history of therapy, and without visual findings from other technologies, VLE-guided tissue acquisition increased neoplasia detection over random biopsies by 700%. Registry investigators reported that VLE improved the BE management process when used as an adjunct tissue acquisition and treatment guidance tool. The ability of VLE to image large segments of the esophagus with microscopic cross-sectional detail may provide additional benefits including higher yield biopsies and more efficient tissue acquisition. Clinicaltrials.gov NCT02215291

Design, Development & Functional Validation of Magnets system in support of 42 GHz Gyrotron in India

A multi institutional initiative is underway towards the development of 42 GHz, 200 kW gyrotron system in India under the frame work of Department of Science and Technology, Government of India. Indigenous realization comprising of design, fabrication, prototypes and functional validations of an appropriate Magnet System is one of the primary technological objective of these initiatives. The 42 GHz gyrotron magnet system comprises of a warm gun magnet, a NbTi/Cu based high homogenous superconducting cavity magnet and three warm collector magnets. The superconducting cavity magnet has been housed inside a low loss cryostat. The magnet system has been designed in accordance with gyrotron physics and engineering considerations respecting highly homogenous spatial field profile as well as maintaining steep gradient as per the compression and velocity ratios between the emission and resonator regions. The designed magnet system further ensures the co-linearity of the magnetic axis with that of the beam axis with custom winding techniques apart from a smooth collection of beam with the collector magnet profiles. The designed magnets have been wound after several R & D validations. The superconducting magnet has been housed inside a low loss designed cryostat with in-built radial and axial alignment flexibilities to certain extent. The cryostat further houses liquid helium port, liquid nitrogen ports, current communication ports, ports for monitoring helium level and other instrumentations apart from over-pressure safety intensive burst disks etc. The entire magnet system comprising of warm and superconducting magnets has been installed and integrated in the Gyrotron test set-up. The magnet system has been aligned in both warm and when the superconducting cavity magnet is cold. The integrated geometric axes have been experimentally ensured as well as the field profiles have been measured with the magnets being charged. Under experimental conditions, all magnets including the superconducting magnet have been charged to their nominal values with appropriate protection measures against the quench. This is the first time in India that a gyrotron specific magnet system with superconducting magnet has been realized