Management Strategies of Cesarean Section Ectopic Pregnancy: A Case Report

Introduction: Cesarean scar ectopic pregnancy is a rare form of pregnancy with potential life-threatening complications such as severe hemorrhage, uterine rupture, and emergency hysterectomy Currently, there is no consensus regarding a standardized treatment algorithm for this specific variant of ectopic pregnancies. Case Description: This case describes a 28-year-old female with history of two prior cesarean sections who was diagnosed with cesarean section scar ectopic pregnancy. Initial management with intramuscular methotrexate was unsuccessful in the setting of inadequate decrease in β-hCG level. The patient ultimately underwent surgical management with dilation and suction evacuation under ultrasound guidance for removal of the ectopic pregnancy. Following surgery, the patient continued to have an appropriate downward trend of β-hCG, indicating a successful result of the procedure. Discussion: The objective of this case report is to review this case of cesarean scar ectopic pregnancy, identify various treatment modalities for this condition, and analyze their success rates and possible reasons for failure based on literature review. We conclude that the wide use of methotrexate for cesarean section ectopic pregnancies should be reconsidered and minimally invasive techniques such as the double-balloon catheter procedure be further researched

Applicant Reactions to Artificial Intelligence in the Selection Process

The use of advanced technology such as artificial intelligence (AI) in the selection process has become an increasingly popular practice within organizations. However, little research has examined how applicants react to these new procedures and how those reactions may affect outcomes such as perceptions of fairness, organizational attraction, and job pursuit intentions. Previous research has suggested that the use of technology in the selection process may lead to more negative outcomes when compared to using traditional selection procedures such as face-to-face interviewing. The purpose of this study is to examine applicant reactions to the use of advanced decision-making technologies in the selection process, such as artificial intelligence systems that make hiring decisions. Determining how applicants react to the use of technology in the selection process serves to help organizations better understand how these practices affect job seekers’ perceptions of the organization. The results of this study may help organizations weigh the pros and cons of using computer information systems to select applicants instead of using a traditional selection procedure

Coastal Upwelling Off Southwest Nova Scotia Simulated With a High-Resolution Baroclinic Ocean Model

A high‐resolution baroclinic coastal ocean model is applied to study seasonal circulation and upwelling off South West Nova Scotia (SWNS) based on 1 year simulations for 2010. The model reasonably reproduces tidal currents, seasonal hydrography, and circulation from multiyear observations, in consistence with the observed strong seasonal variations of these properties in the study area. The main physical processes affecting circulation are analyzed using numerical experiments, with focus on the effect of tidal and density induced currents on topographic upwelling. It is confirmed that the shoreward near‐bottom currents and associated upwelling are tidally induced and persistent throughout the year. It is revealed that these currents have seasonal variability, with cross‐isobath component being strong in summer throughout a large area, but weaker and confined to deeper regions in winter. The seasonal variability of Scotian Current is the dominant forcing affecting the variability of onshore bottom currents. Lagrangian particle tracking identifies two major pathways of source waters arriving at the SWNS upwelling region. A large proportion of particles come from the east with the Scotian Current, mostly from the surface layer; and a small portion of water parcels come from a mean depth exceeding 100 m from the Gulf of Maine and Northeast Channel

HIV/AIDS information promotion at the library: creative campaigns for young adults

Background: While rates of new HIV diagnoses have gone down nationally, Florida’s HIV-positive population is growing and remains one of the largest in the country. Given this landscape, it is clear that diverse, creative, and collaborative efforts are needed to better inform the public about HIV risks, prevention, and treatment and to encourage healthy behaviors. Case Presentation: Building on previous work, librarians at the University of Florida engaged in a yearlong project to raise awareness about HIV/AIDS risks, prevention, and treatment among university students and to improve their information-seeking behaviors related to this disease. The “Creative Campaigns” project included 3 distinct elements of activity and engagement, designed to complement one another: a graphic novel contest, a social media campaign, and training for campus health care providers. The contest yielded 4 high-quality submissions, and the monthlong social media campaign garnered over 50,000 views and utilized Facebook ads to extend beyond the library’s typical audience. The instruction proved useful to campus counseling and wellness staff. Conclusions: Overall, the team considered the project a success in terms of reaching new audiences in new ways, and several of its components have been integrated into subsequent projects and regular operations. Exploring new methods of outreach through social media and creative formats required careful planning and the development of new skill sets amongst project team members but proved to be a rewarding way to generate engagement in the local community

Practice nurse-supported weight self-management delivered within the national child immunisation programme for postnatal women:a feasibility cluster RCT

Background: Pregnancy is a high-risk time for excessive weight gain. The rising prevalence of obesity in women, combined with excess weight gain during pregnancy, means that there are more women with obesity in the postnatal period. This can have adverse health consequences for women in later life and increases the health risks during subsequent pregnancies. Objective: The primary aim was to produce evidence of whether or not a Phase III trial of a brief weight management intervention, in which postnatal women are encouraged by practice nurses as part of the national child immunisation programme to self-monitor their weight and use an online weight management programme, is feasible and acceptable. Design: The research involved a cluster randomised controlled feasibility trial and two semistructured interview studies with intervention participants and practice nurses who delivered the intervention. Trial data were collected at baseline and 3 months later. The interview studies took place after trial follow-up. Setting: The trial took place in Birmingham, UK. Participants: Twenty-eight postnatal women who were overweight/obese were recruited via Birmingham Women’s Hospital or general practices. Nine intervention participants and seven nurses were interviewed. Interventions: The intervention was delivered in the context of the national child immunisation programme. The intervention group were offered brief support that encouraged self-management of weight when they attended their practice to have their child immunised at 2, 3 and 4 months of age. The intervention involved the provision of motivation and support by nurses to encourage participants to make healthier lifestyle choices through self-monitoring of weight and signposting to an online weight management programme. The role of the nurse was to provide regular external accountability for weight loss. Women were asked to weigh themselves weekly and record this on a record card in their child’s health record (‘red book’) or using the online programme. The behavioural goal was for women to lose 0.5-1 kg per week. The usual-care group received a healthy lifestyle leaflet. Main outcome measures: The primary outcome was the feasibility of a Phase III trial to test the effectiveness of the intervention, as assessed against three traffic-light stop-go criteria (recruitment, adherence to regular self-weighing and registration with an online weight management programme). Results: The traffic-light criteria results were red for recruitment (28/80, 35% of target), amber for registration with the online weight loss programme (9/16, 56%) and green for adherence to weekly self-weighing (10/16, 63%). Nurses delivered the intervention with high fidelity. In the qualitative studies, participants indicated that the intervention was acceptable to them and they welcomed receiving support to lose weight at their child immunisation appointments. Although nurses raised some caveats to implementation, they felt that the intervention was easy to deliver and that it would motivate postnatal women to lose weight. Limitations: Fewer participants were recruited than planned. Conclusions: Although women and practice nurses responded well to the intervention and adherence to self-weighing was high, recruitment was challenging and there is scope to improve engagement with the intervention.Future work: Future research should focus on investigating other methods of recruitment and, thereafter, testing the effectiveness of the intervention.Trial registration: Current Controlled Trials ISRCTN12209332.Funding: This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 49. See the NIHR Journals Library website for further project information.</p

Biomechanical forces promote blood development through prostaglandin E2 and the cAMP-PKA signaling axis

Blood flow promotes emergence of definitive hematopoietic stem cells (HSCs) in the developing embryo, yet the signals generated by hemodynamic forces that influence hematopoietic potential remain poorly defined. Here we show that fluid shear stress endows long-term multilineage engraftment potential upon early hematopoietic tissues at embryonic day 9.5, an embryonic stage not previously described to harbor HSCs. Effects on hematopoiesis are mediated in part by a cascade downstream of wall shear stress that involves calcium efflux and stimulation of the prostaglandin E2 (PGE2)-cyclic adenosine monophosphate (cAMP)-protein kinase A (PKA) signaling axis. Blockade of the PGE2-cAMP-PKA pathway in the aorta-gonad-mesonephros (AGM) abolished enhancement in hematopoietic activity. Furthermore, Ncx1 heartbeat mutants, as well as static cultures of AGM, exhibit lower levels of expression of prostaglandin synthases and reduced phosphorylation of the cAMP response element-binding protein (CREB). Similar to flow-exposed cultures, transient treatment of AGM with the synthetic analogue 16,16-dimethyl-PGE2 stimulates more robust engraftment of adult recipients and greater lymphoid reconstitution. These data provide one mechanism by which biomechanical forces induced by blood flow modulate hematopoietic potential