Trends in caesarean section rates in a rural block of southern India

Background: Over the last decade many programmes have been implemented to improve the health of pregnant women and neonates. This study aims to look at the changes in modes of delivery and perinatal mortality rates in a rural block of Tamil Nadu between 2006 and 2015.Methods: Data on all the births that have occurred in this rural block of Tamil Nadu that has been prospectively collected between 2006 and 2015 was analysed. A longitudinal analysis was done to calculate the primary and overall caesarean section rate and the average annual rate of increase. The perinatal mortality rate was also calculated.Results: The primary LSCS rate has increased from 9.08% in 2005 to 16.1% in 2015. The overall caesarean section rate has increased from 11.7% to 19.2% in the same time with an average annual rate of increase of 5.1%. During this period the perinatal mortality has decreased from 33 per 1000 live births to 17 per 1000 live births.Conclusions: Though the overall caesarean section rate is higher than the 15% prescribed by WHO the rates are lower than the rest of the country and rural Tamil Nadu

Identification of stomach contents from a Shepherd's beaked whale Tasmacetus shepherdi stranded on Tristan da Cunha, South Atlantic

Shepherd’s beaked whale Tasmacetus shepherdi is one of the most poorly known cetaceans, whose diet has created some speculation given that its dentition differs greatly from that of most other beaked whales that are primarily teuthophagous. The few stomachs examined previously have given seemingly conflicting dietary information. In this paper the stomach contents of a freshly stranded adult female on Tristan da Cunha have been examined through identification of trace elements and genetic analysis of soft parts. At least 13 cephalopod and 8 fish species were identified from beaks and otoliths respectively, but only undigested fish remains were present in the stomach and identified genetically as Beryx splendens. Reconstituted masses totaled 8809 g for cephalopods and 17,554 g for fish, with four species (Histioteuthis atlantica, Taningia danae, Ommastrephes bartrami and Pholidoteuthis ‘A’) comprising 78.6% of the cephalopods and one species (B. splendens) comprising 87.4% of the fish eaten. It is concluded that Tasmacetus may alternately exploit fish and cephalopods, depending on the time of day and access to seamount or continental slope areas.P.B.B. and M.J.S. acknowledge support from the National Research Foundation, South Africa, and S.v.d.H. thanks the Stellenbosch University Discretionary Fund for financial assistance.http://journals.cambridge.org/action/displayJournal?jid=mbi2015-09-30am201

Burdening and wearing railway switches in exploitation conditions and materials applied for their construction

Kształtowniki szynowe, klockowe i iglicowe (rys. 1) stosowane w budowie rozjazdów i dróg kolejowych muszą posiadać wysokie właściwości mechaniczne, odpowiednią odporność na zużycie ścierne i zmęczeniowe. Materiały o takich charakterystykach zapewniają dłuższy okres użytkowania oraz większe bezpieczeństwo transportu szynowego [1–3]. Zatem problem trwałości szyn i rozjazdów kolejowych w dalszym ciągu pozostaje otwarty na badania technologiczne, związki strukturalne i charakterystyki mechaniczne. Tematyka ta jest również ważna ze względu na przyjętą w kraju strategię rozwoju kolei dużych prędkości

Plasma steroids and nasopharyngeal carcinoma

Singapore Medical Journal154257-260SIMJ

Pasta-filata cheeses

This chapter discusses various kinds of Pasta-Filata cheeses, such as Caciocavallo Podolico PDO, Kachkaval, and Kashar. Kashkaval-type Kashar cheese is common in the Trakia region. Kashar cheese is a hard cheese with no holes but a rind, and it is yellowish in colour. Kasseri has a closed texture with no holes and a mild, mellow, faintly sweet flavour. The flavour is more pronounced when cheeses are well matured. Ragusano PDO is a stretched-curd cheese made with cow's raw whole milk. It is a high in fat and protein cheese, and it has a low moisture content when aged. Ragusano PDO has a parallelepiped shape with a square section and rounded corners. Parenica is a pasta-filata-type cheese, made from full-fat sheep's milk that is not heat-treated. The most characteristic feature of Parenica is its unique form of the double ribbon, as well as its stringy structure and attractive, softly acidic flavour with the sheep's milk overtones

Why blockchains need the law: Secondary rules as the missing piece of blockchain governance

Governance issues limit blockchains’ ability to evolve and face unforeseen challenges. It seems possible to argue that this impasse is because most blockchains lack meta-rules. This work considers blockchains as a socio-technical system of rules, in order to draw a comparison with legal systems. Following the comparison, one finds that most blockchains lack what, in legal theory, are considered secondary rules. That is, the meta-rule of the system. This works examines the relevant concepts and provides their definitions, then proceeds to outline concrete example of the failure of governance among popular blockchains before drawing the parallelism with legal systems and argue that secondary rules might solve some of the issues of the governance of blockchains. Secondary rules are the necessary infrastructure for building sound governance structures and a necessary condition for blockchains to succeed as a new mode of governance. The conclusion provides future research directions