Building a Prediction Model for Vacuum-Assisted Operative Vaginal Delivery Risk

Aim: The objective of this study was to evaluate the risk factors for operative vaginal delivery and to propose a new nomogram for predicting the risk. Methods: We retrospectively analyzed the data of 1,955 pregnancies that occurred in our clinic between the years 2007 and 2008. Included were singleton pregnancies with labor diagnosis after the 36th gestational week in which spontaneous or operative vaginal deliveries occurred. In this study, the operative delivery was carried out exclusively by vacuum extraction. Results: After univariate analysis and multivariate logistic regression stepwise model selection, maternal age, nulliparity, medically assisted procreation, gestational age at birth, male fetus, epidural analgesia and medical induction of labor were found to be the most predictive variables for operative vaginal delivery. Considering these factors we propose a new nomogram for an objectified determination of the risk of operative vaginal delivery. Conclusions: The new nomogram we propose could be an important tool for an objectified determination of the risk of operative vaginal delivery by vacuum extraction in individualized patient counseling

Updates and Debate Concerning Margin Adequacy and Management following Breast-Conserving Surgery

Objective: Breast-conserving surgery (BCS) experienced a significant surge during the last decades due to the increase of early breast cancer detection. Central to the discussion is margin adequacy which represents one of the most significant predictive factors for local relapse. This paper aims to shed light on the problem of margins in breast surgery. Mechanism: We performed a systematic narrative review of the literature by conducting a search using Medline/PubMed, Scopus, and Embase. The following keywords were considered: "breast-conserving surgery"AND "margins"/"margin". Findings in Brief: In the case of invasive breast cancer, "no ink on tumor"can be considered an adequate margin, while for ductal carcinoma in situ (DCIS), a distance of 2 mm from tumor should be obtained. Many novel tools have been developed based both on the latest radiological imaging techniques and on the tissue expression of certain markers, with the aim of precise navigation of tumor excision and intraoperative evaluation of cavity excision margins. Oncoplastic surgery can be considered oncologically safe while improving the cosmetic outcome and patients' quality of life. The appropriate use of adjuvant treatments in the context of a multidisciplinary and personalized management of breast cancer is the only means to omit a second intervention in some carefully selected cases. Conclusions: Debate still exists concerning the definition of adequate clear margin following BCS for DCIS. Further studies are required to better assess multimodal treatment approaches in this condition

Desorption of n-alkanes from graphene: a van der Waals density functional study

A recent study of temperature programmed desorption (TPD) measurements of small n-alkanes (CNH2N+2) from C(0001) deposited on Pt(111) shows a linear relationship of the desorption energy with increasing n-alkane chain length. We here present a van der Waals density functional study of the desorption barrier energy of the ten smallest n-alkanes (N = 1 to 10) from graphene. We find linear scaling with N, including a nonzero intercept with the energy axis, i.e., an offset at the extrapolation to N = 0. This calculated offset is quantitatively similar to the results of the TPD measurements. From further calculations of the polyethylene polymer we offer a suggestion for the origin of the offset.Comment: 3 pictures, 1 tabl

Nanotechnologies in Obstetrics and Cancer during Pregnancy: A Narrative Review

Nanotechnology, the art of engineering structures on a molecular level, offers the opportunity to implement new strategies for the diagnosis and management of pregnancy-related disorders. This review aims to summarize the current state of nanotechnology in obstetrics and cancer in pregnancy, focusing on existing and potential applications, and provides insights on safety and future directions. A systematic and comprehensive literature assessment was performed, querying the following databases: PubMed/Medline, Scopus, and Endbase. The databases were searched from their inception to 22 March 2022. Five independent reviewers screened the items and extracted those which were more pertinent within the scope of this review. Although nanotechnology has been on the bench for many years, most of the studies in obstetrics are preclinical. Ongoing research spans from the development of diagnostic tools, including optimized strategies to selectively confine contrast agents in the maternal bloodstream and approaches to improve diagnostics tests to be used in obstetrics, to the synthesis of innovative delivery nanosystems for therapeutic interventions. Using nanotechnology to achieve spatial and temporal control over the delivery of therapeutic agents (e.g., commonly used drugs, more recently defined formulations, or gene therapy-based approaches) offers significant advantages, including the possibility to target specific cells/tissues of interest (e.g., the maternal bloodstream, uterus wall, or fetal compartment). This characteristic of nanotechnology-driven therapy reduces side effects and the amount of therapeutic agent used. However, nanotoxicology appears to be a significant obstacle to adopting these technologies in clinical therapeutic praxis. Further research is needed in order to improve these techniques, as they have tremendous potential to improve the accuracy of the tests applied in clinical praxis. This review showed the increasing interest in nanotechnology applications in obstetrics disorders and pregnancy-related pathologies to improve the diagnostic algorithms, monitor pregnancy-related diseases, and implement new treatment strategies

Produção de forragem e grãos de variedades de feijão-miúdo em consórcio com milho.

Espécies leguminosas tropicais são melhoradoras de solos, pela capacidade de fixação biológica de nitrogênio e pelo residual de fertilidade que permitem aos cultivos subsequentes. O feijãomiúdo é uma espécie que tem se destacado na região Sul do Brasil devido à sua multiplicidade de uso. Seu cultivo vem se difundindo rapidamente, principalmente nas bacias leiteiras, mas informações sobre seu cultivo e potencial de uso são escassos. Um experimento foi conduzido com o objetivo de avaliar a produção de forragem e grãos de quatro variedades de feijão-miúdo em cultivo consorciado com milho. Foram determinadas a densidade real de plantas e as produções de massa verde e seca totais e de massa seca de lâminas foliares, colmos e de grãos (kg ha-1) de feijão-miúdo, na ocasião da colheita do milho. Não foram verificadas diferenças estatísticas nas variáveis analisadas, devido, provavelmente, aos altos coeficientes de variação obtidos. Contudo, verificam-se diferenças numéricas expressivas entre os tratamentos. As produções podem ser consideradas satisfatórias para o sistema e região de cultivo, mas outros estudos deverão ser realizados para que sejam possíveis conclusões mais pontuais sobre as características das variedades de feijão-miúdo e seu cultivo consorciado com milho. Mesmo sem respaldo estatístico, podem ser destacadas as produções de massa seca total, de lâminas foliares e de grãos obtidas pela variedade Amendoim

Encoding a qubit into multilevel subspaces

We present a formalism for encoding the logical basis of a qubit into subspaces of multiple physical levels. The need for this multilevel encoding arises naturally in situations where the speed of quantum operations exceeds the limits imposed by the addressability of individual energy levels of the qubit physical system. A basic feature of the multilevel encoding formalism is the logical equivalence of different physical states and correspondingly, of different physical transformations. This logical equivalence is a source of a significant flexibility in designing logical operations, while the multilevel structure inherently accommodates fast and intense broadband controls thereby facilitating faster quantum operations. Another important practical advantage of multilevel encoding is the ability to maintain full quantum-computational fidelity in the presence of mixing and decoherence within encoding subspaces. The formalism is developed in detail for single-qubit operations and generalized for multiple qubits. As an illustrative example, we perform a simulation of closed-loop optimal control of single-qubit operations for a model multilevel system, and subsequently apply these operations at finite temperatures to investigate the effect of decoherence on operational fidelity.Comment: IOPart LaTeX, 2 figures, 31 pages; addition of a numerical simulatio

Comparación técnico-económica de pequeños sistemas fotovoltaicos

El presente trabajo tiene por objetivo comparar pequeños sistemas fotovoltaicos desde el punto de vista técnico y un somero análisis económico, con un alcance limitado a los sistemas considerados más importantes. La metodología empleada consiste en estudiar dos sistemas de corriente continua y uno de corriente alterna con consumos en orden creciente según se analiza, determinando las características técnicas de los sistemas fotovoltaicos y banco de baterías asociados, por último se realizan consideraciones económicas que permitan sacar conclusiones comparativas de los distintos sistemas. Encontramos qué que cuando se incorporan motores en la carga resulta menos conveniente el uso de generación fotovoltaica, además que no es conveniente utilizar convertidores en las aplicaciones fotovoltaicas sino emplear artefactos de 12V de CC.The present work must by objective compare small photovoltaic systems from the technical point of view and a brief economic analysis, with a reach limited the considered systems more important. The used methodology consists of studying two systems of DC and one of alternating current with in sequence increasing consumptions according to is analyzed, determining the technical characteristics of the photovoltaic systems and bank of associated batteries, finally economic considerations are made that allow to draw comparative conclusions from the different systems. We found what that when motors in the load are gotten up the use is less advisable from photovoltaic generation, in addition that is not advisable to use converters in the photovoltaic applications but to use devices of 12V of CC.Asociación Argentina de Energías Renovables y Medio Ambiente (ASADES

Comparación técnico-económica de pequeños sistemas fotovoltaicos

El presente trabajo tiene por objetivo comparar pequeños sistemas fotovoltaicos desde el punto de vista técnico y un somero análisis económico, con un alcance limitado a los sistemas considerados más importantes. La metodología empleada consiste en estudiar dos sistemas de corriente continua y uno de corriente alterna con consumos en orden creciente según se analiza, determinando las características técnicas de los sistemas fotovoltaicos y banco de baterías asociados, por último se realizan consideraciones económicas que permitan sacar conclusiones comparativas de los distintos sistemas. Encontramos qué que cuando se incorporan motores en la carga resulta menos conveniente el uso de generación fotovoltaica, además que no es conveniente utilizar convertidores en las aplicaciones fotovoltaicas sino emplear artefactos de 12V de CC.The present work must by objective compare small photovoltaic systems from the technical point of view and a brief economic analysis, with a reach limited the considered systems more important. The used methodology consists of studying two systems of DC and one of alternating current with in sequence increasing consumptions according to is analyzed, determining the technical characteristics of the photovoltaic systems and bank of associated batteries, finally economic considerations are made that allow to draw comparative conclusions from the different systems. We found what that when motors in the load are gotten up the use is less advisable from photovoltaic generation, in addition that is not advisable to use converters in the photovoltaic applications but to use devices of 12V of CC.Asociación Argentina de Energías Renovables y Medio Ambiente (ASADES