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Eesti Arst 2012; 91(5):27

帝王切開分娩後の経腟分娩

近年帝王切開分娩は著しく増加している。約30年前に全分娩数に占める帝切率はたかだか5%であった。しかし、内外を問わず、最近この数字は20～25%になり、その増加率の内容を再検討するとともに、これを減らすための方策が種々議論されている。帝切分娩に伴う種々のリスクや医療経済学的側面が問題とされるに至ったからである。しかし、帝王切開分娩後の経腟分娩のためには試験分娩を行わねばならず、慎重な態度で臨む必要がある。その実現には症例を選んで、試験分娩を試みること。その結果うまくゆけば経腟分娩へと導くことである。しかしながら、試験分娩中に方針転換により帝切分娩に移行することもある。したがって、試験分娩は設備、スタッフの整備された病院でしか行えないという憾みがある。その取り組みについて内外の論文、及び私見を交えて考察を行った。In recent years, cesarean delivery is markedly increasing. Its increase is almost 4～5 times more in recent years compared with that of about 30 years ago worldwidely. The cesarean delivery has more disadvantages than vaginal delivery;Anesthetic troubles, bleeding during surgery, intestinal injuries, deep vein thrombosis, ileus, prolongation of ward-admission and more cost for them. To reduce the rate of cesarean birth, vaginal delivery after cesarean birth(VBAC) has been trying. The rationale for VBAC following trial of labor has been discussed. Well equipped hospitals with sufficient staff-members, not only attending obstetricians, nursing staffs but also anesthesiologisits and pediatricians are essential for emergency care in trial of labor

Hiina inimõiguste diskursuse põhijooned aastatel 1991-2012

http://tartu.ester.ee/record=b2657281~S1*es

Test bench for small displacement internal combustion engine

Antud magistritöö eesmärgiks on välja arendada väikese töömahuga kahetaktiliste mootorite katsestend. Katsestend on vajalik Eesti Maaülikooli mootorilaborisse kuna praegu vastav seade laboris puudub. Stendi olulisemad omadused on tema kompaktsus ja madal hind. Katsestendiga on võimalik mõõta mootori pöördemomenti ning arvutuste teel leida mootori võimsus. Samuti on võimalik läbi viia kütusekulu ja heitgaaside analüüsid. Katseseadme peamiseks eesmärgiks on edaspidised uuringud bioetanooliga. Katseliselt on vaja välja selgitada, millist mõju mootori mehaanilistele komponentidele ja võimsuslikele parameetritele avaldab bioetanooli kütusesegu kasutamine kahetaktilises mootoris. Katsete tulemusena saab vajalikke andmeid nii mootori toitesüsteemi kui ka bioetanooli kui kütuse edasi arendamiseks. Töö teostamiseks on teostatud antud erialase kirjanduse uuring ning võrreldud erinevate dünamomeetrite tööpõhimõtteid ja ülesehitust, leidmaks sobivaim lahendus ehitatavale katsestendile. Samuti on ülevaade analoogsetest, juba valmis ehitatud katseseadmetes. Tutvutud on katseobjektidega, milleks on keskmise võimsusklassi mootorsaed võimsusega kuni 3 kW. Katseseadmele projekteeritud pendeldünamomeeter baseerub laagritele asetatud hüdraulikapumbale, mille võlli käitab kettülekandega mootorsaag. Pöördemomenti mõõdetakse elektroonilise koormusanduriga. Katsetatavale mootorile tekitatakse koormust hüdraulikapumba väljundrõhu tõstmise teel. Katsestendile on projekteeritud hüdraulikapumba kinnitamiseks raam, sobiva ülekandearvuga kettülekanne, hüdraulika õli mahuti, õli jahutus süsteem ja teostatud ajamivõlli tugevusarvutus. Valitud katsestendi lahendus tagab seadme kompaktsuse ja on teostatav mõistlike rahaliste vahenditega. Samuti ei sisalda seade keerulist elektroonikat ning on universaalselt kasutatav erinevate tootjate keskmise võimsusklassi mootorsaagidega.In order to carry out sudies on the usage of bioethanol fuels in two-stroke engines, it is essential to develop a suitable test bench for a two-stroke small displacement internal combustion engine. I intended is to evolve a reasonably priced engine dynamometer for chain saw engine in order to conduct torque and power measurements. The solution for the brake system dynamometer is to creat hydraulic a circuit where the pump is set of by the engine under the test and the load of the pump is controlled by the throttle valve. Moreover, it is necessary to find suitable equipment for the analysis of exhaust fumes and fuel consumption. This way essential data can be gathered for improving bioethanol fuels and making them more efficient and cleaner. Furthermore, the fuel systems of engines can be adjusted or rebuilt for the use of bioethanol

Identifying special operative trainees at-risk for musculoskeletal injury using full body kinematics

Introduction: Non-combat musculoskeletal injuries (MSKIs) during military training significantly impede the US military’s functionality, with an annual cost exceeding $3.7 billion. This study aimed to investigate the effectiveness of a markerless motion capture system and full-body biomechanical movement pattern assessments to predict MSKI risk among military trainees.Methods: A total of 156 male United States Air Force (USAF) airmen were screened using a validated markerless biomechanics system. Trainees performed multiple functional movements, and the resultant data underwent Principal Component Analysis and Uniform Manifold And Projection to reduce the dimensionality of the time-dependent data. Two approaches, semi-supervised and supervised, were then used to identify at-risk trainees.Results: The semi-supervised analysis highlighted two major clusters with trainees in the high-risk cluster having a nearly five times greater risk of MSKI compared to those in the low-risk cluster. In the supervised approach, an AUC of 0.74 was produced when predicting MSKI in a leave-one-out analysis.Discussion: The application of markerless motion capture systems to measure an individual’s kinematic profile shows potential in identifying MSKI risk. This approach offers a novel way to proactively address one of the largest non-combat burdens on the US military. Further refinement and wider-scale implementation of these techniques could bring about substantial reductions in MSKI occurrence and the associated economic costs