Emergency peripartum hysterectomy- a study in tertiary care centre and medical college in Hubli, North Karnataka, India

Background: Post-partum haemorrhage is a significant cause of maternal mortality and morbidity. The objective of the study was to evaluate the incidence, predisposing factors & associated complications and outcome of emergency peripartum hysterectomy.            Methods: It is a prospective analysis of emergency peripartum hysterectomy conducted at tertiary care centre at Karnataka Institute of Medical Sciences, Hubli, Karnataka, India between June 2013 to December 2015. Age, parity, traumatic or atonic PPH, risk factors, complications were all studied in detail and analysed.               Results: 43 women underwent peripartum hysterectomy among 28,620 deliveries, accounting to an incidence of 0.15%. Incidence of subtotal hysterectomy after caesarean delivery was higher as compared to vaginal deliveries. The common indications were uterine atony (46.5%), uterine rupture of scared and unscared uterus (44.1%), placenta previa of major degree and sepsis (6.9%). Post-operatively 13 patients developed DIC (30.2%), 5 patients developed febrile illness (11.6%), 5 patients of ruptured uterus experienced injury to the bladder (11.6%). Maternal mortality in this study was 13.9%.Conclusions: Hysterectomy is a lifesaving procedure to control postpartum hemorrhage, but is associated with significant maternal morbidity and mortality. Uterine atony, uterine ruptures, also due to prior caesarean delivery, placenta previa were identified as risk factors. The incidence in this part of Karnataka was found to be significantly high due to referral cases from neighboring 5 government district hospitals. Hence only proper awareness, timely referral and correction of anemia are the key factors to be addressed to this part of the state

Cross-language Wikipedia Editing of Okinawa, Japan

This article analyzes users who edit Wikipedia articles about Okinawa, Japan, in English and Japanese. It finds these users are among the most active and dedicated users in their primary languages, where they make many large, high-quality edits. However, when these users edit in their non-primary languages, they tend to make edits of a different type that are overall smaller in size and more often restricted to the narrow set of articles that exist in both languages. Design changes to motivate wider contributions from users in their non-primary languages and to encourage multilingual users to transfer more information across language divides are presented.Comment: In Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, CHI 2015. AC

Discontinuation of reflex testing of stool samples for vancomycin-resistant enterococci resulted in increased prevalence

Discontinuation of reflex testing stool submitted for Clostridium difficile testing for vancomycin-resistant enterococci (VRE) led to an increase of patients with healthcare-associated VRE bacteremia and bacteriuria (2.1 versus 3.6 per 10,000 patient days; p<0.01 ). Cost-benefit analysis showed reflex screening and isolation of VRE reduced hospital costs

NICE: Social translucence through UI intervention

ABSTRACT Social production systems such as Wikipedia rely on attracting and motivating volunteer contributions to be successful. One strong demotivating factor can be when an editor&apos;s work is discarded, or &quot;reverted&quot;, by others. In this paper we demonstrate evidence of this effect and design a novel interface aimed at improving communication between the reverting and reverted editors. We deployed the interface in a controlled experiment on the live Wikipedia site, and report on changes in the behavior of 487 contributors who were reverted by editors using our interface. Our results suggest that simple interface modifications (such as informing Wikipedians that the editor they are reverting is a newcomer) can have substantial positive effects in protecting against contribution loss in newcomers and improving the quality of work done by more experienced contributors

A Minimal Set of Tissue-Specific Hypomethylated CpGs Constitute Epigenetic Signatures of Developmental Programming

Background: Cell specific states of the chromatin are programmed during mammalian development. Dynamic DNA methylation across the developing embryo guides a program of repression, switching off genes in most cell types. Thus, the majority of the tissue specific differentially methylated sites (TS-DMS) must be un-methylated CpGs. Methodology and Principal Findings Comparison of expanded Methyl Sensitive Cut Counting data (eMSCC) among four tissues (liver, testes, brain and kidney) from three C57BL/6J mice, identified 138,052 differentially methylated sites of which 23,270 contain CpGs un-methylated in only one tissue (TS-DMS). Most of these CpGs were located in intergenic regions, outside of promoters, CpG islands or their shores, and up to 20% of them overlapped reported active enhancers. Indeed, tissue-specific enhancers were up to 30 fold enriched in TS-DMS. Testis showed the highest number of TS-DMS, but paradoxically their associated genes do not appear to be specific to the germ cell functions, but rather are involved in organism development. In the other tissues the differentially methylated genes are associated with tissue-specific physiological or anatomical functions. The identified sets of TS-DMS quantify epigenetic distances between tissues, generated during development. We applied this concept to measure the extent of reprogramming in the liver of mice exposed to in utero or early postnatal nutritional stress. Different protocols of food restriction reprogrammed the liver methylome in different but reproducible ways. Conclusion and Significance Thus, each identified set of differentially methylated sites constituted an epigenetic signature that traced the developmental programing or the early nutritional reprogramming of each exposed mouse. We propose that our approach has the potential to outline a number of disease-associated epigenetic states. The composition of differentially methylated CpGs may vary with each situation, behaving as a composite variable, which can be used as a pre-symptomatic marker for disease

The Cognitive Atlas: Toward a Knowledge Foundation for Cognitive Neuroscience

Cognitive neuroscience aims to map mental processes onto brain function, which begs the question of what “mental processes” exist and how they relate to the tasks that are used to manipulate and measure them. This topic has been addressed informally in prior work, but we propose that cumulative progress in cognitive neuroscience requires a more systematic approach to representing the mental entities that are being mapped to brain function and the tasks used to manipulate and measure mental processes. We describe a new open collaborative project that aims to provide a knowledge base for cognitive neuroscience, called the Cognitive Atlas (accessible online at http://www.cognitiveatlas.org), and outline how this project has the potential to drive novel discoveries about both mind and brain

Dynamics of conflicts in Wikipedia

In this work we study the dynamical features of editorial wars in Wikipedia (WP). Based on our previously established algorithm, we build up samples of controversial and peaceful articles and analyze the temporal characteristics of the activity in these samples. On short time scales, we show that there is a clear correspondence between conflict and burstiness of activity patterns, and that memory effects play an important role in controversies. On long time scales, we identify three distinct developmental patterns for the overall behavior of the articles. We are able to distinguish cases eventually leading to consensus from those cases where a compromise is far from achievable. Finally, we analyze discussion networks and conclude that edit wars are mainly fought by few editors only.Comment: Supporting information adde

Opinions, Conflicts and Consensus: Modeling Social Dynamics in a Collaborative Environment

Information-communication technology promotes collaborative environments like Wikipedia where, however, controversiality and conflicts can appear. To describe the rise, persistence, and resolution of such conflicts we devise an extended opinion dynamics model where agents with different opinions perform a single task to make a consensual product. As a function of the convergence parameter describing the influence of the product on the agents, the model shows spontaneous symmetry breaking of the final consensus opinion represented by the medium. In the case when agents are replaced with new ones at a certain rate, a transition from mainly consensus to a perpetual conflict occurs, which is in qualitative agreement with the scenarios observed in Wikipedia.Comment: 6 pages, 5 figures. Submitted for publicatio

Interpreting ambiguous ‘trace’ results in Schistosoma mansoni CCA Tests: Estimating sensitivity and specificity of ambiguous results with no gold standard

Background The development of new diagnostics is an important tool in the fight against disease. Latent Class Analysis (LCA) is used to estimate the sensitivity and specificity of tests in the absence of a gold standard. The main field diagnostic for Schistosoma mansoni infection, Kato-Katz (KK), is not very sensitive at low infection intensities. A point-of-care circulating cathodic antigen (CCA) test has been shown to be more sensitive than KK. However, CCA can return an ambiguous ‘trace’ result between ‘positive’ and ‘negative’, and much debate has focused on interpretation of traces results. Methodology/Principle findings We show how LCA can be extended to include ambiguous trace results and analyse S. mansoni studies from both Côte d’Ivoire (CdI) and Uganda. We compare the diagnostic performance of KK and CCA and the observed results by each test to the estimated infection prevalence in the population. Prevalence by KK was higher in CdI (13.4%) than in Uganda (6.1%), but prevalence by CCA was similar between countries, both when trace was assumed to be negative (CCAtn: 11.7% in CdI and 9.7% in Uganda) and positive (CCAtp: 20.1% in CdI and 22.5% in Uganda). The estimated sensitivity of CCA was more consistent between countries than the estimated sensitivity of KK, and estimated infection prevalence did not significantly differ between CdI (20.5%) and Uganda (19.1%). The prevalence by CCA with trace as positive did not differ significantly from estimates of infection prevalence in either country, whereas both KK and CCA with trace as negative significantly underestimated infection prevalence in both countries. Conclusions Incorporation of ambiguous results into an LCA enables the effect of different treatment thresholds to be directly assessed and is applicable in many fields. Our results showed that CCA with trace as positive most accurately estimated infection prevalence