Retrospective study of cesarean section by using the Robson’s ten group classification system

Background: The present study was done to determine the relative contribution of each of ten groups of robson´s classification to overall cesarean section rate and identify modifiable group for intervention to reduce the cesarean rate.Methods: Retrospective review of record of cesarean section from the statistical Dept of Obstetrics and Gynecology sir T. hospital, Bhavnagar from January 2017 to October 2017 and classify them in to Robson´s ten group classification system to find out total number of cesarean among total number of delivery in above 10 months duration.Results: Total number of delivery in my study institute in 10 months was 3804 out of them 1182 was cesarean section, so the overall cesarean section rate in Sir T. hospital, Bhavnagar was 31%. Group 1 (Nulliparous, single cephalic, >37 weeks in spontaneous labor), 2 (Nulliparous, single cephalic, >37 weeks, induced or CS before labor) and 5 (Previous CS, single cephalic, >37 weeks) contributes for around 66% of total cesarean. Group 5 (Previous CS, single cephalic, >37 weeks) was the major contributor among all. Least common cause of cesarean was group 8 (All multiple pregnancies (including previous CS)) and group 9 (All abnormal lies including previous CS).Conclusions: Incidence of cesarean was more common with patient having previous cesarean section. So, to decrease cesarean rate trial of labour should be given to the patient who was suitable for vaginal birth after cesarean section. Adequate assessment of pelvis and giving trial to patient having borderline pelvis also decrease the rate of cesarean in primi gravid (group 1)

CSNL: A cost-sensitive non-linear decision tree algorithm

This article presents a new decision tree learning algorithm called CSNL that induces Cost-Sensitive Non-Linear decision trees. The algorithm is based on the hypothesis that nonlinear decision nodes provide a better basis than axis-parallel decision nodes and utilizes discriminant analysis to construct nonlinear decision trees that take account of costs of misclassification. The performance of the algorithm is evaluated by applying it to seventeen datasets and the results are compared with those obtained by two well known cost-sensitive algorithms, ICET and MetaCost, which generate multiple trees to obtain some of the best results to date. The results show that CSNL performs at least as well, if not better than these algorithms, in more than twelve of the datasets and is considerably faster. The use of bagging with CSNL further enhances its performance showing the significant benefits of using nonlinear decision nodes. The performance of the algorithm is evaluated by applying it to seventeen data sets and the results are compared with those obtained by two well known cost-sensitive algorithms, ICET and MetaCost, which generate multiple trees to obtain some of the best results to date. The results show that CSNL performs at least as well, if not better than these algorithms, in more than twelve of the data sets and is considerably faster. The use of bagging with CSNL further enhances its performance showing the significant benefits of using non-linear decision nodes

Development of an atmospheric chemistry model coupled to the PALM model system 6.0: Implementation and first applications

In this article we describe the implementation of an online-coupled gas-phase chemistry model in the turbulence-resolving PALM model system 6.0 (formerly an abbreviation for Parallelized Large-eddy Simulation Model and now an independent name). The new chemistry model is implemented in the PALM model as part of the PALM-4U (PALM for urban applications) components, which are designed for application of the PALM model in the urban environment (Maronga et al., 2020). The latest version of the Kinetic PreProcessor (KPP, 2.2.3) has been utilized for the numerical integration of gas-phase chemical reactions. A number of tropospheric gas-phase chemistry mechanisms of different complexity have been implemented ranging from the photostationary state (PHSTAT) to mechanisms with a strongly simplified volatile organic compound (VOC) chemistry (e.g. the SMOG mechanism from KPP) and the Carbon Bond Mechanism 4 (CBM4; Gery et al., 1989), which includes a more comprehensive, but still simplified VOC chemistry. Further mechanisms can also be easily added by the user. In this work, we provide a detailed description of the chemistry model, its structure and input requirements along with its various features and limitations. A case study is presented to demonstrate the application of the new chemistry model in the urban environment. The computation domain of the case study comprises part of Berlin, Germany. Emissions are considered using street-type-dependent emission factors from traffic sources. Three chemical mechanisms of varying complexity and one no-reaction (passive) case have been applied, and results are compared with observations from two permanent air quality stations in Berlin that fall within the computation domain. Even though the feedback of the model's aerosol concentrations on meteorology is not yet considered in the current version of the model, the results show the importance of online photochemistry and dispersion of air pollutants in the urban boundary layer for high spatial and temporal resolutions. The simulated NOx and O3 species show reasonable agreement with observations. The agreement is better during midday and poorest during the evening transition hours and at night. The CBM4 and SMOG mechanisms show better agreement with observations than the steady-state PHSTAT mechanism. © 2021 Copernicus GmbH. All rights reserved

Development of an atmospheric chemistry model coupled to the PALM model system 6.0 : implementation and first applications

In this article we describe the implementation of an online-coupled gas-phase chemistry model in the turbulence-resolving PALM model system 6.0 (formerly an abbreviation for Parallelized Large-eddy Simulation Model and now an independent name). The new chemistry model is implemented in the PALM model as part of the PALM-4U (PALM for urban applications) components, which are designed for application of the PALM model in the urban environment (Maronga et al., 2020). The latest version of the Kinetic PreProcessor (KPP, 2.2.3) has been utilized for the numerical integration of gas-phase chemical reactions. A number of tropospheric gas-phase chemistry mechanisms of different complexity have been implemented ranging from the photostationary state (PHSTAT) to mechanisms with a strongly simplified volatile organic compound (VOC) chemistry (e.g. the SMOG mechanism from KPP) and the Carbon Bond Mechanism 4 (CBM4; Gery et al., 1989), which includes a more comprehensive, but still simplified VOC chemistry. Further mechanisms can also be easily added by the user. In this work, we provide a detailed description of the chemistry model, its structure and input requirements along with its various features and limitations. A case study is presented to demonstrate the application of the new chemistry model in the urban environment. The computation domain of the case study comprises part of Berlin, Germany. Emissions are considered using street-type-dependent emission factors from traffic sources. Three chemical mechanisms of varying complexity and one no-reaction (passive) case have been applied, and results are compared with observations from two permanent air quality stations in Berlin that fall within the computation domain. Even though the feedback of the model's aerosol concentrations on meteorology is not yet considered in the current version of the model, the results show the importance of online photochemistry and dispersion of air pollutants in the urban boundary layer for high spatial and temporal resolutions. The simulated NOx and O-3 species show reasonable agreement with observations. The agreement is better during midday and poorest during the evening transition hours and at night. The CBM4 and SMOG mechanisms show better agreement with observations than the steady-state PHSTAT mechanism.Peer reviewe

Tissue-engineered tracheal replacement in a child: a 4-year follow-up study

In 2010, a tissue-engineered trachea was transplanted into a 10-year-old child using a decellularized deceased donor trachea repopulated with the recipient's respiratory epithelium and mesenchymal stromal cells. We report the child's clinical progress, tracheal epithelialization and costs over the 4 years. A chronology of events was derived from clinical notes and costs determined using reference costs per procedure. Serial tracheoscopy images, lung function tests and anti-HLA blood samples were compared. Epithelial morphology and T cell, Ki67 and cleaved caspase 3 activity were examined. Computational fluid dynamic simulations determined flow, velocity and airway pressure drops. After the first year following transplantation, the number of interventions fell and the child is currently clinically well and continues in education. Endoscopy demonstrated a complete mucosal lining at 15 months, despite retention of a stent. Histocytology indicates a differentiated respiratory layer and no abnormal immune activity. Computational fluid dynamic analysis demonstrated increased velocity and pressure drops around a distal tracheal narrowing. Cross-sectional area analysis showed restriction of growth within an area of in-stent stenosis. This report demonstrates the long-term viability of a decellularized tissue-engineered trachea within a child. Further research is needed to develop bioengineered pediatric tracheal replacements with lower morbidity, better biomechanics and lower costs

Soil Organic Carbon Storage in Restored Salt Marshes in Huntington Beach, California

There is a growing interest in managing wetland restoration and conservation projects to maximize carbon sequestration. We measured soil organic carbon storage and methane flux from two southern California salt marshes which had been restored for 2 and 22 years. We hypothesized that organic carbon would accumulate following restoration and that methane flux would be negligible in both sites. While methane flux was minimal, soil organic carbon content was generally higher in the more recently restored site. Although there is a potential for carbon sequestration in salt marshes, tracking this process through time may be complicated by initial site conditions

A new form of Saturn's magnetopause using a dynamic pressure balance model, based on in situ, multi‐instrument Cassini measurements

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/95429/1/jgra19967.pd

Electron heating at Saturn's bow shock

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/94695/1/jgra21551.pd

Dynamic auroral storms on Saturn as observed by the Hubble Space Telescope

We present observations of significant dynamics within two UV auroral storms observed on Saturn using the Hubble Space Telescope in April/May 2013. Specifically, we discuss bursts of auroral emission observed at the poleward boundary of a solar wind-induced auroral storm, propagating at ∼330% rigid corotation from near ∼01 h LT toward ∼08 h LT. We suggest that these are indicative of ongoing, bursty reconnection of lobe flux in the magnetotail, providing strong evidence that Saturn’s auroral storms are caused by large-scale flux closure. We also discuss the later evolution of a similar storm and show that the emission maps to the trailing region of an energetic neutral atom enhancement. We thus identify the auroral form with the upward field-aligned continuity currents flowing into the associated partial ring current