Implementation Of New Definitions Of Labor Arrest Disorders And Failed Induction Can Decrease The Cesarean Rate

Cesarean delivery for labor arrest currently makes up the largest proportion of primary cesarean delivery in the United States. Because cesarean delivery is associated with significant morbidity, it is important to limit its use to ensure the benefits outweigh the risks. New diagnostic criteria to limit the diagnosis of labor arrest have the potential to decrease the cesarean delivery rate. To investigate how cesarean delivery for arrest of dilation or descent and failed induction contributed to the primary cesarean delivery rate, we analyzed rates of primary cesarean for these indications among 17,864 live births at our institution from 2010 through 2013. We used multiple logistic regression modeling to identify predictors of meeting diagnostic criteria for these indications based on guidelines published in 2012 by Spong et al. From 2010 through 2013 the total primary cesarean delivery rate decreased from 23.5% to 21.1%. Over the same period, primary cesarean delivery due specifically to arrest of dilation or descent and failed induction decreased from 8.5% to 6.7%. Primary cesarean delivery due to arrest of dilation alone decreased from 5.1% to 3.4%. The rate of meeting minimum criteria for arrest of dilation increased from 18.8% to 34.9%. Primary cesarean delivery due to arrest of descent alone remained relatively stable, however, the percent of cases meeting minimum criteria increased from 57.8% to 71.0%. The rate of primary cesarean delivery due to failed induction alone also remained relatively stable, as did the percent of cases meeting minimum criteria with 50.00% meeting criteria in 2013. Attending type was a significant predictor of meetingiii criteria for all three indications. Hospitalist cases were two to seven times as likely to meet criteria compared with private cases. Dilation on admission increased, as well as the likelihood of meeting criteria for arrest of dilation and arrest of descent. Epidural use decreased the likelihood of meeting criteria for arrest of descent. In summary, the decrease in primary cesarean delivery from 2010 through 2013 is significantly attributable to a decrease in the diagnosis of labor arrest disorders and failed induction, and specifically to a decrease in diagnosis of arrest of dilation. An increased likelihood of meeting minimum criteria for arrest of dilation in 2012 and 2013 compared to 2010 suggests that applying new definitions of labor arrest published in 2012 can decrease the overall primary cesarean rate. As of 2013, only 34.9% of primary cesareans performed for arrest of dilation, 71.0% for arrest of descent, and 50.0% for failed induction, met new respective minimum diagnostic criteria. This suggests that an even bigger decrease in the primary cesarean rate can be achieved if a greater effort is made to meet minimum criteria before moving to cesarean

DECIPHERING SUBGLACIAL FROM TECTONIC DEFORMATION IN ANDRILL-1B

The Victoria Land Basin (VLB) has undergone twelve glacial-interglacial cycles during the Late Pliocene. This region was susceptible to tectonic deformation from the half-graben in which the VLB is formed, as well as deformation due to glacial overriding. Furthermore, with the development of the Terror Rift the underlying sediment was further exposed to normal faulting. The samples used in this research were obtained from Andrill-1B located in the Windless Bight Region of the Terror Rift in the VLB. Through the microscopic analysis of thin sections and careful observation of core images between 152.12mbsf and 189.67mbsf I will determine whether the samples have undergone glacial deformation, tectonic deformation, or both.NSF OPP 0342484No embarg

The Relationship Between Resolution of Semantic Interference and Non-verbal Inhibition

Research Question: Is difficulty with resolution of semantic interference correlated with non verbal inhibition ability in healthy controls and individuals with Alzheimer\u27s? Hypothesis: Individuals who have difficulty with nonverbal inhibition will also have difficulty with resolution of semantic interference

The Relationship Between Non-Verbal Inhibition and Lexical Retrieval

Research Question: Is non-verbal inhibition correlated with lexical retrieval speed of both nouns and verbs in healthy individuals? Hypothesis: Non-verbal inhibition will impact performance on lexical retrieval tasks for both nouns and verbs

The Relationship Between Attention and Working Memory in Healthy Individuals

Research Question : Does performance on tasks of non- verbal attention and non-verbal working memory impact performance on lexical retrieval for both young adults and older adults? Hypothesis: Attention and working memory will have additive impact on lexical retrieval. The impact will be most significant for older individuals

The Relationship Between Set Shifting and Lexical Retrieval in Healthy Individuals

Objectives: Is set shifting correlated with noun and verb retrieval in healthy individuals? Is set shifting correlated with noun and verb retrieval in adults in various stages of dementia

Maggots, Rape and Yet Five Stars: How U.S. Ratings of Nursing Homes Mislead the Public.

Nursing homes have manipulated the influential star system in ways that have masked deep problems — and left them unprepared for Covid-19.Nursing homes have manipulated the influential star system in ways that have masked deep problems — and left them unprepared for Covid-19

Lipophilic Tracer DiI Used for Neuronal Tracing in the Fixed Hippocampal Formations of Mice

Both the hippocampus and the entorhinal cortex are involved in memory formation. It is thought that they work together to create a loop that is involved in the formation of long term memories. The entorhinal cortex sends projections to the CA1 field of the hippocampus and the CA1 field sends projections back to the entorhinal cortex. How exactly they communicate is unknown. In order to do electrophysiological studies it is necessary to know in which orientation to cut the brain to preserve the most connections between these two areas. Here we show that DiI crystal application can be used to successfully label known fiber paths from the dentate gyrus to the CA3 field. Then we begin with sagittal and horizontal slices of the brain to see how well connections between the CA1 field and the EC are preserved

Utilization of the Lempert Maneuver for Benign Paroxysmal Positional Vertigo in the Emergency Department.

Benign paroxysmal positional vertigo (BPPV) is a common cause of vertigo. Symptoms from BPPV lead to Emergency Department (ED) visits, and persistence of symptoms, particularly in the elderly, may impact patient disposition. We describe the techniques used in the case of a 72-year-old male with dizziness, who had symptom resolution, and was able to be safely discharged after a Lempert maneuver (barbeque (BBQ) roll) was performed in the ED setting. The patient presented to the ED with left gaze nystagmus, and otherwise normal evaluation results. Physical therapy was consulted, and their initial evaluation indicated right horizontal canalithiasis noted by fatiguing right, geotropic nystagmus, but the patient was unable to tolerate further testing due to vomiting. Antiemetic medications were administered and at his follow-up examination an hour later, a total of three Lempert maneuvers were performed, resulting in total symptom resolution. Successful utilization of the Lempert maneuver to treat BPPV can help to reduce ED length of stay and increase patient satisfaction. Because of this, the Lempert maneuver should be considered a fast, cost-effective, and safe method of alleviating BPPV symptoms