504 research outputs found

    Episiotomy healing assessment: Redness, Oedema, Ecchymosis, Discharge, Approximation (REEDA) scale reliability

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    OBJECTIVE: to analyse the Redness, Oedema, Ecchymosis, Discharge, Approximation (REEDA) scale reliability when evaluating perineal healing after a normal delivery with a right mediolateral episiotomy.METHOD: observational study based on data from a clinical trial conducted with 54 randomly selected women, who had their perineal healing assessed at four time points, from 6 hours to 10 days after delivery, by nurses trained in the use of this scale. The kappa coefficient was used in the reliability analysis of the REEDA scale.RESULTS: the results indicate good agreement in the evaluation of the discharge item (0.75< Kappa ≄0.88), marginal and good agreement in the first three assessments of oedema (0.16< Kappa ≄0.46), marginal agreement in the evaluation of ecchymosis (0.25< Kappa ≄0.42) and good agreement regarding redness (0.46< Kappa ≄0.66). For the item coaptation, the agreement decreased from excellent in the first assessment to good in the last assessment. In the fourth evaluation, the assessment of all items displayed excellent or good agreement among the evaluators.CONCLUSION: the difference in the scores among the evaluators when applying the scale indicates that this tool must be improved to allow an accurate assessment of the episiotomy healing process

    Mapping development and health effects of cooking with solid fuels in low-income and middle-income countries, 2000–18: a geospatial modelling study

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    Background: More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehensively analysed. We estimated the prevalence of solid-fuel use with high spatial resolution to explore subnational inequalities, assess local progress, and assess the effects on health in low-income and middle-income countries (LMICs) without universal access to clean fuels. Methods: We did a geospatial modelling study to map the prevalence of solid-fuel use for cooking at a 5 km × 5 km resolution in 98 LMICs based on 2·1 million household observations of the primary cooking fuel used from 663 population-based household surveys over the years 2000 to 2018. We use observed temporal patterns to forecast household air pollution in 2030 and to assess the probability of attaining the Sustainable Development Goal (SDG) target indicator for clean cooking. We aligned our estimates of household air pollution to geospatial estimates of ambient air pollution to establish the risk transition occurring in LMICs. Finally, we quantified the effect of residual primary solid-fuel use for cooking on child health by doing a counterfactual risk assessment to estimate the proportion of deaths from lower respiratory tract infections in children younger than 5 years that could be associated with household air pollution. Findings: Although primary reliance on solid-fuel use for cooking has declined globally, it remains widespread. 593 million people live in districts where the prevalence of solid-fuel use for cooking exceeds 95%. 66% of people in LMICs live in districts that are not on track to meet the SDG target for universal access to clean energy by 2030. Household air pollution continues to be a major contributor to particulate exposure in LMICs, and rising ambient air pollution is undermining potential gains from reductions in the prevalence of solid-fuel use for cooking in many countries. We estimated that, in 2018, 205 000 (95% uncertainty interval 147 000–257 000) children younger than 5 years died from lower respiratory tract infections that could be attributed to household air pollution. Interpretation: Efforts to accelerate the adoption of clean cooking fuels need to be substantially increased and recalibrated to account for subnational inequalities, because there are substantial opportunities to improve air quality and avert child mortality associated with household air pollution. Funding: Bill & Melinda Gates Foundation

    Observation of proton-tagged, central (semi)exclusive production of high-mass lepton pairs in pp collisions at 13 TeV with the CMS-TOTEM precision proton spectrometer

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    The process pp -> pl(+)l(-)p(()*()), with l(+)l(-) a muon or an electron pair produced at midrapidity with mass larger than 110 GeV, has been observed for the first time at the LHC in pp collisions at root s = 13 TeV. One of the two scattered protons is measured in the CMS-TOTEM precision proton spectrometer (CT-PPS), which operated for the first time in 2016. The second proton either remains intact or is excited and then dissociates into a low-mass state p*, which is undetected. The measurement is based on an integrated luminosity of 9.4 fb(-1) collected during standard, high-luminosity LHC operation. A total of 12 mu(+)/mu(-) and 8 e(+)e(-) pairs with m(l(+)l(-)) > 110 GeV, and matching forward proton kinematics, are observed, with expected backgrounds of 1.49 +/- 0.07 (stat) +/- 0.53 (syst) and 2.36 +/- 0.09 (stat) +/- 0.47(syst), respectively. This corresponds to an excess of more than five standard deviations over the expected background. The present result constitutes the first observation of proton-tagged gamma gamma collisions at the electroweak scale. This measurement also demonstrates that CT-PPS performs according to the design specifications.Peer reviewe

    Measurement of single-diffractive dijet production in proton-proton collisions at root s=8 TeV with the CMS and TOTEM experiments

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    A Publisher's Erratum to this article was published on 03 May 2021. https://doi.org/10.1140/epjc/s10052-021-08863-wPeer reviewe

    Measurement of single-diffractive dijet production in proton–proton collisions at s=8 TeV\sqrt{s} = 8\,\text {Te}\text {V} with the CMS and TOTEM experiments

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    Measurements are presented of the single-diffractive dijet cross section and the diffractive cross section as a function of the proton fractional momentum loss Ο Ο and the four-momentum transfer squared t. Both processes p p → p X p p → p X and p p → X p p p → X p , i.e. with the proton scattering to either side of the interaction point, are measured, where X X includes at least two jets; the results of the two processes are averaged. The analyses are based on data collected simultaneously with the CMS and TOTEM detectors at the LHC in proton–proton collisions at s √ =8TeV s=8TeV during a dedicated run with ÎČ âˆ— =90m ÎČ∗=90m at low instantaneous luminosity and correspond to an integrated luminosity of 37.5nb −1 37.5nb−1 . The single-diffractive dijet cross section σ p X jj σjj p X , in the kinematic region Ο<0.1 Ο<0.1 , 0.03<|t|<1GeV 2 0.03<|t|<1GeV2 , with at least two jets with transverse momentum p T >40GeV pT>40GeV , and pseudorapidity |η|<4.4 |η|<4.4 , is 21.7±0.9(stat) +3.0 −3.3 (syst)±0.9(lumi)nb 21.7±0.9(stat)−3.3+3.0(syst)±0.9(lumi)nb . The ratio of the single-diffractive to inclusive dijet yields, normalised per unit of Ο Ο , is presented as a function of x, the longitudinal momentum fraction of the proton carried by the struck parton. The ratio in the kinematic region defined above, for x values in the range −2.9≀log 10 x≀−1.6 −2.9≀log10⁥x≀−1.6 , is R=(σ p X jj /ΔΟ)/σ jj =0.025±0.001(stat)±0.003(syst) R=(σjj p X /ΔΟ)/σjj=0.025±0.001(stat)±0.003(syst) , where σ p X jj σjj p X and σ jj σjj are the single-diffractive and inclusive dijet cross sections, respectively. The results are compared with predictions from models of diffractive and nondiffractive interactions. Monte Carlo predictions based on the HERA diffractive parton distribution functions agree well with the data when corrected for the effect of soft rescattering between the spectator partons

    First Search for Exclusive Diphoton Production at High Mass with Tagged Protons in Proton-Proton Collisions at √s = 13 TeV

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    Erratum to: Measurement of single-diffractive dijet production in proton–proton collisions at s=8 TeV\sqrt{s} = 8\,\text {Te}\text {V} with the CMS and TOTEM experiments

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