A follow up study of postpartum intrauterine device insertion in a tertiary health care centre

Background: In view of high rate of unintended pregnancy in our country, particularly in post-partum women, there is a need for reliable, effective and long-term contraception such as intrauterine device (IUCD) in post-partum women. This study was done to determine the efficacy and safety of Post-Partum Intrauterine Device (PPIUCD) and to compare the outcomes of PPIUCD insertion after vaginal delivery and caesarean section.Methods: This follow up study was carried out in the department of Obstetrics and Gynecology, Dr. R.M.L Hospital, PGIMER, New Delhi over a period of 7 month from January 2016 to July 2016. PPIUCD (cu T- 380 A) insertions were done in 136 women who fulfilled the inclusion criteria. Women having haemoglobin less than 8 gm%, rupture of membranes more than 18 hours, obstructed labour, Uterine anomalies, distorted uterine cavity by fibroid, significant postpartum haemorrhage, coagulation disorders, fever or clinical symptoms of infection during labour were excluded from the study. Post insertion counselling was done, and these women were advised to follow up at 6 weeks and then after 6 months postpartum in the family planning O.P.D. At the follow-up visit, the women were asked for any symptoms of unusual vaginal discharge, irregular or heavy bleeding per vagina, and any expulsions if noticed.Results: Total number of cases that reported for follow up in family planning OPD was 118. Therefore, 18 patients were lost in the follow up. In 58.47% women, there was no complaint. Heavy menstrual bleeding was found in 17.79% women and pelvic pain in 16.10% women. The expulsion rate was 5.08% and IUCD removal was done in 12.71% women. Though, the incidence of expulsion and removal rate was more in vaginal insertions than in caesarean insertions but this difference was not statistically significant, while the incidence of missing threads were found more in intra caesarean insertion (28% vs. 11.76% with p value <0.05). Continuation rate at 6 month was 82.20%.Conclusions: PPIUCD insertion is a safe, convenient and effective method of contraception. Although the expulsion rate and removal rate was more in vaginal PPIUCD insertions, the benefits of providing highly effective contraception immediately after delivery outweigh this disadvantage, particularly in our country where most of the women do not come for contraceptive advice after delivery

Saline infusion sonography in evaluation of uterine cavity abnormalities in infertility: a comparative study

Background: Infertility is defined as one year of unprotected intercourse without pregnancy. Female factor is responsible for 40-50% of cases of infertility. Uterine pathologies are the cause of infertility in as many as 15% of couples seeking treatment. The objective of this study was to evaluate the accuracy of trans-vaginal sonography (TVS) and saline infusion sonography (SIS) for detection of uterine cavity abnormalities in patients of infertility taking hysteroscopy as gold standard.Methods: A prospective comparative study was done in 60 patients of infertility. Patients were selected from gynaecology OPD of a tertiary care hospital. Patient selected underwent TVS and SIS followed by hysteroscopy for presence of uterine cavity abnormalities. The presence of uterine cavity abnormality and its type (endometrial polyp, submucous myoma, intrauterine synechiae or any other) was noted. The results of TVS and SIS were compared with hysteroscopy.Results: In 60 infertile patients, hysteroscopy revealed intrauterine pathology in 22 patients (36.7%). Among them eight had endometrial polyp and another eight patients had intrauterine synechiae. Submucous myoma was detected in five patients and one patient had thin endometrium. SIS detected eight out of 22 uterine cavity abnormalities indicating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 36.4%, 100%, 100% and 73.1% respectively. In comparison TVS showed abnormalities in six patients only and thus had sensitivity, specificity, PPV and NPV of 27.35%, 100%, 100% and 70.4 % respectively. Sensitivity of SIS for specific lesion was least for intrauterine synechiae (12.5%) and maximum for submucous myoma (60%).Conclusions: The sensitivity of both TVS and SIS for detection of uterine cavity abnormalities in patients of infertility was low in the present study and they cannot be recommended as replacement for hysteroscopy

De novo sequencing and characterization of Picrorhiza kurrooa transcriptome at two temperatures showed major transcriptome adjustments

<p>Abstract</p> <p>Background</p> <p><it>Picrorhiza kurrooa </it>Royle ex Benth. is an endangered plant species of medicinal importance. The medicinal property is attributed to monoterpenoids picroside I and II, which are modulated by temperature. The transcriptome information of this species is limited with the availability of few hundreds of expressed sequence tags (ESTs) in the public databases. In order to gain insight into temperature mediated molecular changes, high throughput <it>de novo </it>transcriptome sequencing and analyses were carried out at 15°C and 25°C, the temperatures known to modulate picrosides content.</p> <p>Results</p> <p>Using paired-end (PE) Illumina sequencing technology, a total of 20,593,412 and 44,229,272 PE reads were obtained after quality filtering for 15°C and 25°C, respectively. Available (e.g., De-Bruijn/Eulerian graph) and in-house developed bioinformatics tools were used for assembly and annotation of transcriptome. A total of 74,336 assembled transcript sequences were obtained, with an average coverage of 76.6 and average length of 439.5. Guanine-cytosine (GC) content was observed to be 44.6%, while the transcriptome exhibited abundance of trinucleotide simple sequence repeat (SSR; 45.63%) markers.</p> <p>Large scale expression profiling through "read per exon kilobase per million (RPKM)", showed changes in several biological processes and metabolic pathways including <it>cytochrome P450s </it>(<it>CYPs</it>), <it>UDP-glycosyltransferases </it>(<it>UGTs</it>) and those associated with picrosides biosynthesis. RPKM data were validated by reverse transcriptase-polymerase chain reaction using a set of 19 genes, wherein 11 genes behaved in accordance with the two expression methods.</p> <p>Conclusions</p> <p>Study generated transcriptome of <it>P. kurrooa </it>at two different temperatures. Large scale expression profiling through RPKM showed major transcriptome changes in response to temperature reflecting alterations in major biological processes and metabolic pathways, and provided insight of GC content and SSR markers. Analysis also identified putative <it>CYPs </it>and <it>UGTs </it>that could help in discovering the hitherto unknown genes associated with picrosides biosynthesis.</p

Towards Mobility Data Science (Vision Paper)

Mobility data captures the locations of moving objects such as humans, animals, and cars. With the availability of GPS-equipped mobile devices and other inexpensive location-tracking technologies, mobility data is collected ubiquitously. In recent years, the use of mobility data has demonstrated significant impact in various domains including traffic management, urban planning, and health sciences. In this paper, we present the emerging domain of mobility data science. Towards a unified approach to mobility data science, we envision a pipeline having the following components: mobility data collection, cleaning, analysis, management, and privacy. For each of these components, we explain how mobility data science differs from general data science, we survey the current state of the art and describe open challenges for the research community in the coming years.Comment: Updated arXiv metadata to include two authors that were missing from the metadata. PDF has not been change

Mobility Data Science (Dagstuhl Seminar 22021)

This report documents the program and the outcomes of Dagstuhl Seminar 22021 "Mobility Data Science". This seminar was held January 9-14, 2022, including 47 participants from industry and academia. The goal of this Dagstuhl Seminar was to create a new research community of mobility data science in which the whole is greater than the sum of its parts by bringing together established leaders as well as promising young researchers from all fields related to mobility data science. Specifically, this report summarizes the main results of the seminar by (1) defining Mobility Data Science as a research domain, (2) by sketching its agenda in the coming years, and by (3) building a mobility data science community. (1) Mobility data science is defined as spatiotemporal data that additionally captures the behavior of moving entities (human, vehicle, animal, etc.). To understand, explain, and predict behavior, we note that a strong collaboration with research in behavioral and social sciences is needed. (2) Future research directions for mobility data science described in this report include a) mobility data acquisition and privacy, b) mobility data management and analysis, and c) applications of mobility data science. (3) We identify opportunities towards building a mobility data science community, towards collaborations between academic and industry, and towards a mobility data science curriculum

Unveiling SEER-CAHPS®: A New Data Resource for Quality of Care Research

BACKGROUND: Since 1990, the National Cancer Institute (NCI) and Centers for Medicare and Medicaid Services (CMS) have collaborated to create linked data resources to improve our understanding of patterns of care, health care costs, and trends in utilization. However, existing data linkages have not included measures of patient experiences with care. OBJECTIVE: To describe a new resource for quality of care research based on a linkage between the Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS®) patient surveys and the NCI’s Surveillance, Epidemiology and End Results (SEER) data. DESIGN: This is an observational study of CAHPS respondents and includes both fee-for-service and Medicare Advantage beneficiaries with and without cancer. The data linkage includes: CAHPS survey data collected between 1998 and 2010 to assess patient reports on multiple aspects of their care, such as access to needed and timely care, doctor communication, as well as patients’ global ratings of their personal doctor, specialists, overall health care, and their health plan; SEER registry data (1973–2007) on cancer site, stage, treatment, death information, and patient demographics; and longitudinal Medicare claims data (2002–2011) for fee-for-service beneficiaries on utilization and costs of care. PARTICIPANTS: In total, 150,750 respondents were in the cancer cohort and 571,318 were in the non-cancer cohort. MAIN MEASURES: The data linkage includes SEER data on cancer site, stage, treatment, death information, and patient demographics, in addition to longitudinal data from Medicare claims and information on patient experiences from CAHPS surveys. KEY RESULTS: Sizable proportions of cases from common cancers (e.g., breast, colorectal, prostate) and short-term survival cancers (e.g., pancreas) by time since diagnosis enable comparisons across the cancer care trajectory by MA vs. FFS coverage. CONCLUSIONS: SEER-CAHPS is a valuable resource for information about Medicare beneficiaries’ experiences of care across different diagnoses and treatment modalities, and enables comparisons by type of insurance

Optimasi Portofolio Resiko Menggunakan Model Markowitz MVO Dikaitkan dengan Keterbatasan Manusia dalam Memprediksi Masa Depan dalam Perspektif Al-Qur`an

Risk portfolio on modern finance has become increasingly technical, requiring the use of sophisticated mathematical tools in both research and practice. Since companies cannot insure themselves completely against risk, as human incompetence in predicting the future precisely that written in Al-Quran surah Luqman verse 34, they have to manage it to yield an optimal portfolio. The objective here is to minimize the variance among all portfolios, or alternatively, to maximize expected return among all portfolios that has at least a certain expected return. Furthermore, this study focuses on optimizing risk portfolio so called Markowitz MVO (Mean-Variance Optimization). Some theoretical frameworks for analysis are arithmetic mean, geometric mean, variance, covariance, linear programming, and quadratic programming. Moreover, finding a minimum variance portfolio produces a convex quadratic programming, that is minimizing the objective function ðð¥with constraintsð ð 𥠥 ðandð´ð¥ = ð. The outcome of this research is the solution of optimal risk portofolio in some investments that could be finished smoothly using MATLAB R2007b software together with its graphic analysis

Search for heavy resonances decaying to two Higgs bosons in final states containing four b quarks

A search is presented for narrow heavy resonances X decaying into pairs of Higgs bosons (H) in proton-proton collisions collected by the CMS experiment at the LHC at root s = 8 TeV. The data correspond to an integrated luminosity of 19.7 fb(-1). The search considers HH resonances with masses between 1 and 3 TeV, having final states of two b quark pairs. Each Higgs boson is produced with large momentum, and the hadronization products of the pair of b quarks can usually be reconstructed as single large jets. The background from multijet and t (t) over bar events is significantly reduced by applying requirements related to the flavor of the jet, its mass, and its substructure. The signal would be identified as a peak on top of the dijet invariant mass spectrum of the remaining background events. No evidence is observed for such a signal. Upper limits obtained at 95 confidence level for the product of the production cross section and branching fraction sigma(gg -> X) B(X -> HH -> b (b) over barb (b) over bar) range from 10 to 1.5 fb for the mass of X from 1.15 to 2.0 TeV, significantly extending previous searches. For a warped extra dimension theory with amass scale Lambda(R) = 1 TeV, the data exclude radion scalar masses between 1.15 and 1.55 TeV

Impact of opioid-free analgesia on pain severity and patient satisfaction after discharge from surgery: multispecialty, prospective cohort study in 25 countries

Background: Balancing opioid stewardship and the need for adequate analgesia following discharge after surgery is challenging. This study aimed to compare the outcomes for patients discharged with opioid versus opioid-free analgesia after common surgical procedures.Methods: This international, multicentre, prospective cohort study collected data from patients undergoing common acute and elective general surgical, urological, gynaecological, and orthopaedic procedures. The primary outcomes were patient-reported time in severe pain measured on a numerical analogue scale from 0 to 100% and patient-reported satisfaction with pain relief during the first week following discharge. Data were collected by in-hospital chart review and patient telephone interview 1 week after discharge.Results: The study recruited 4273 patients from 144 centres in 25 countries; 1311 patients (30.7%) were prescribed opioid analgesia at discharge. Patients reported being in severe pain for 10 (i.q.r. 1-30)% of the first week after discharge and rated satisfaction with analgesia as 90 (i.q.r. 80-100) of 100. After adjustment for confounders, opioid analgesia on discharge was independently associated with increased pain severity (risk ratio 1.52, 95% c.i. 1.31 to 1.76; P &lt; 0.001) and re-presentation to healthcare providers owing to side-effects of medication (OR 2.38, 95% c.i. 1.36 to 4.17; P = 0.004), but not with satisfaction with analgesia (beta coefficient 0.92, 95% c.i. -1.52 to 3.36; P = 0.468) compared with opioid-free analgesia. Although opioid prescribing varied greatly between high-income and low- and middle-income countries, patient-reported outcomes did not.Conclusion: Opioid analgesia prescription on surgical discharge is associated with a higher risk of re-presentation owing to side-effects of medication and increased patient-reported pain, but not with changes in patient-reported satisfaction. Opioid-free discharge analgesia should be adopted routinely

Search for supersymmetry in events with one lepton and multiple jets in proton-proton collisions at root s=13 TeV

Peer reviewe