Practice variation in late-preterm deliveries: a physician survey

Objective: Late preterm (LPT) neonates account for over 70% of all preterm births in the US. Approximately 60% of LPT births are the result of non-spontaneous deliveries.The optimal timing of delivery for many obstetric conditions at LPT gestations is unclear, likely resulting in obstetric practice variation. The purpose of this study is to identify variation in the obstetrical management of LPT pregnancies. Study design: We surveyed obstetrical providers in NC identified from NC Medical Board and NC Obstetrical and Gynecological Society membership lists. Participants answered demographic questions and 6 multiple-choice vignettes on management of LPT pregnancies. Result: We obtained 215/859 (29%) completed surveys; 167 (78%) from Obstetrics/Gynecology, 27 (13%) from Maternal-Fetal Medicine, and 21 (10%) from Family Medicine physicians. Overall, we found more agreement on respondents’ management of chorioamnionitis (97% would proceed with delivery), mild preeclampsia (84% would delay delivery/expectantly manage), and fetal growth restriction (80% would delay delivery/expectantly manage). We found less agreement on the management of severe preeclampsia (71% would proceed with delivery), premature preterm rupture of membranes (69% would proceed with delivery), and placenta previa (67% would delay delivery/expectantly manage). Management of LPT pregnancies complicated by PPROM, FGR, and placenta previa vary by specialty. Conclusion: Obstetrical providers report practice variation in the management of LPT pregnancies. Variation might be influenced by provider specialty. The absence of widespread agreement on best practice might be a source of modifiable LPT birth

Radiocarbon and Luminescence Dating at Flamingo Bay (38AK469): Implications for Site Formation Processes and Artifact Burial at a Carolina Bay

This Article is brought to you for free and open access by the Archaeology and Anthropology, South Carolina Institute of at Scholar Commons. It ha

Equine asthma: current understanding and future directions

The 2019 Havemeyer Workshop brought together researchers and clinicians to discuss the latest information on Equine Asthma and provide future research directions. Current clinical and molecular asthma phenotypes and endotypes in humans were discussed and compared to asthma phenotypes in horses. The role of infectious and non-infectious causes of equine asthma, genetic factors and proposed disease pathophysiology were reviewed. Diagnostic limitations were evident by the limited number of tests and biomarkers available to field practitioners. The participants emphasized the need for more accessible, standardized diagnostics that would help identify specific phenotypes and endotypes in order to create more targeted treatments or management strategies. One important outcome of the workshop was the creation of the Equine Asthma Group that will facilitate communication between veterinary practice and research communities through published and easily accessible guidelines and foster research collaboration

Probing the upper end of intracontinental earthquake magnitude: a prehistoric example from the Dzhungarian and Lepsy faults of Kazakhstan

The study of surface ruptures is key to understanding the earthquake occurrence of faults especially in the absence of historical events. We present a detailed analysis of geomorphic displacements along the Dzhungarian Fault, which straddles the border of China and Kazakhstan. We use digital elevation models derived from structure-from-motion analysis of Pléiades satellite imagery and drone imagery from specific field sites to measure surface offsets. We provide direct age constraints from alluvial terraces displaced by faulting and indirect dating from morphological analysis of the scarps. We find that the southern 250 km of the fault likely ruptured in a single event in the last 4,000 years, with displacements of 10–15 m, and potentially up to 20 m at one site. We infer that this Dzhungarian rupture is likely linked with a previously identified paleo-earthquake rupture on the Lepsy Fault through a system of splays in the intervening highlands. Though there are remaining uncertainties regarding consistency in age constraints between the two fault ruptures, most of the sites along the two faults are consistent with a most recent event 2,000–4,000 years ago. Rupture on the Dzhungarian Fault alone is likely to have exceeded Mw 8, and the combined Lepsy-Dzhungarian rupture scenario may have been up to Mw 8.4. Despite being at the upper end of known or inferred continental earthquake magnitudes, our proposed scenario combining the 375 km of the Dzhungarian and Lepsy ruptures yields a slip-to-length ratio consistent with global averages and so do other historical intracontinental earthquakes in Central Asia

Comparative efficacy of inhaled albuterol between two hand-held delivery devices in horses with recurrent airway obstruction

Reasons for performing study: Studies investigating the clinical efficacy of albuterol administered with the same propellant and commercially available delivery devices in horses with recurrent airway obstruction (RAO) are not currently available. Objectives: To determine the efficacy of aerosolised albuterol administered to horses with RAO by means of 2 commercially available, hand-held delivery devices. Methods: Ten horses with RAO were kept in a dusty environment and fed mouldy hay to induce airway obstruction. Lung mechanics were measured before and after the procedure. ΔP was measured 5min after administration of 180μg of albuterol from a pressurised metered dose inhaler, using an aerosol delivery device chosen randomly. This process was repeated every 5min until maximal bronchodilation was achieved. After a 24h washout period, lung mechanics data were again collected using the other aerosol delivery device. Results: Aerosolised albuterol induced a significant and rapid bronchodilation in the horses using both aerosol delivery devices. No statistically significant difference in pulmonary function was observed in response to albuterol therapy between the 2 devices. The dose required to achieve 50% of maximal bronchodilation was not statistically different between the 2 devices (173.35 ± 78.35μg with Device 1 and 228.49 ± 144.99μg with Device 2, P = 0.26). The decrease in lung resistance tended to be more pronounced after albuterol administration with Device 1 (P = 0.066). Conclusions: Aerosolised albuterol is an effective bronchodilator in horses with recurrent airway obstruction. There is no statistically significant difference between the 2 commercially available aerosol delivery devices in terms of efficacy. Potential relevance: Aerosolised albuterol is effectively delivered using currently available devices leading to maximal bronchodilation in horses with RAO at an average dose of 540μg