2,558 research outputs found
Caesarean section in Malawi: preventable factors in maternal and perinatal mortality.
OBJECTIVES: To examine factors that may influence maternal and perinatal mortality associated with caesarean section in an African country. DESIGN: A prospective observational study, conducted between January 1998 and June 2000, of 8070 caesarean sections. SETTING: 25 district and 2 central hospitals in Malawi. Main outcome measures. Association between hospital type, ward or operative care, training of surgical and anaesthesia personnel, preoperative complications, method of anaesthesia, blood loss and anaesthetic technique on maternal and perinatal mortality. RESULTS: Questionnaires were returned for 5236 caesarean sections in district and 2834 in central hospitals. 95% were emergencies, 65% for obstructed labour. Pre-operative haemorrhagic shock was present in 7.6% of women, anaemia in 6.2% and ruptured uterus in 4.1%. Previous caesarean section did not appear to predispose to ruptured uterus. There were 85 maternal deaths (1.05% mortality), 65 of which occurred postoperatively on the wards. Maternal mortality was increased with ruptured uterus (adjusted odds ratio 3.9, 95% CI 2.3-6.5), little anaesthetic training (2.3, 1.3 to 4.1) and blood loss requiring transfusion (19.3, 9-41). In mothers without preoperative haemorrhage spinal anaesthesia was associated with lower maternal mortality than general anaesthesia (0.23, 0.1-0.7). Perinatal mortality was 11.2% overall, and was significantly associated with ruptured uterus, halothane and ketamine anaesthesia. CONCLUSION: Maternal and perinatal mortality rates among women undergoing caesarean section in Malawi are high. Improving resuscitation in postoperative wards might reduce maternal mortality. Blood loss and pre-operative complications are both strongly associated with mortality. Spinal anaesthesia was associated with good outcome
On the Thermoelectric Effect of Interface Imperfections
Ordinary thermocouples use the well-known Seebeck effect to measure the temperature at the junction of two different conductors. The electromotive force generated by the heat depends on the difference between the respective thermoelectric powers of the contacting metals and the junction temperature. Figure 1 shows the schematic diagram of the thermoelectric measurement as most often used in nondestructive materials characterization. One of the reference electrodes is heated by electrical means to a preset temperature of 100 – 300 °C, pretty much like the tip of a temperature-stabilized soldering iron, and connected to the inverting (−) input of the differential amplifier driving the indicator. The other electrode is left cold at essentially room temperature and connected to the non-inverting (+) input. The measurement is done quickly in a few seconds to assure (i) that the hot reference electrode is not cooled down perceivably by the specimen and (ii) that the rest of the specimen beyond the close vicinity of the contact point is not warmed up perceivably. Ideally, regardless of the temperature difference between the junctions, only thermocouples made of different materials, i.e., materials of different thermoelectric power, will generate thermoelectric signal. This unique feature makes the simple thermoelectric tester one of the most sensitive material discriminators used in nondestructive inspection
Isotope effect on the transition temperature in Fe-based superconductors: the current status
The results of the Fe isotope effect (Fe-IE) on the transition temperature
obtained up to date in various Fe-based high temperature superconductors
are summarized and reanalyzed by following the approach developed in [Phys.
Rev. B 82, 212505 (2010)]. It is demonstrated that the very controversial
results for Fe-IE on are caused by small structural changes occurring
simultaneously with the Fe isotope exchange. The Fe-IE exponent on
[, is the isotope mass]
needs to be decomposed into two components with the one related to the
structural changes () and the genuine (intrinsic)
one (). The validity of such decomposition is
further confirmed by the fact that coincides with
the Fe-IE exponent on the characteristic phonon frequencies as is reported in recent EXAFS and Raman experiments.Comment: 7 pages, 4 figures. The paper is partially based on the results
published in [New J. Phys. 12, 073024 (2010) = arXiv:1002.2510] and [Phys.
Rev. B 82, 212505 (2010) = arXiv:1008.4540
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A randomised controlled trial of cognitive behavioural treatment for obsessive compulsive disorder in children and adolescents
Cognitive behaviour therapy (CBT) for young people with obsessive compulsive disorder (OCD) has become the treatment of first choice. However, the literature is largely based on studies emphasising exposure and response prevention. In this study, we report on a randomised controlled trial of CBT for young people carried out in typical outpatient clinic conditions which focused on cognitions. A randomised controlled trial compares 10 sessions of manualised cognitive behavioural treatment with a 12-week waiting list for adolescents and children with OCD. Assessors were blind to treatment allocation. 21 consecutive patients with OCD aged between 9 and 18 years were recruited. The group who received treatment improved more than a comparison group who waited for 3 months. The second group was treated subsequently using the same protocol and made similar gains. In conclusion, CBT can be delivered effectively to young people with OCD in typical outpatient settings
Measuring hsCRP—An Important Part of a Comprehensive Risk Profile or a Clinically Redundant Practice?
James McCormack and Michael Allan discuss issues and questions surrounding hsCRP measurements in patients
Ocean temperature and salinity components of the Madden-Julian oscillation observed by Argo floats
New diagnostics of the Madden-Julian Oscillation (MJO) cycle in ocean temperature and, for the first time, salinity are presented. The MJO composites are based on 4 years of gridded Argo float data from 2003 to 2006, and extend from the surface to 1,400 m depth in the tropical Indian and Pacific Oceans. The MJO surface salinity anomalies are consistent with precipitation minus evaporation fluxes in the Indian Ocean, and with anomalous zonal advection in the Pacific. The Argo sea surface temperature and thermocline depth anomalies are consistent with previous studies using other data sets. The near-surface density changes due to salinity are comparable to, and partially offset, those due to temperature, emphasising the importance of including salinity as well as temperature changes in mixed-layer modelling of tropical intraseasonal processes. The MJO-forced equatorial Kelvin wave that propagates along the thermocline in the Pacific extends down into the deep ocean, to at least 1,400 m. Coherent, statistically significant, MJO temperature and salinity anomalies are also present in the deep Indian Ocean
Continuous, Semi-discrete, and Fully Discretized Navier-Stokes Equations
The Navier--Stokes equations are commonly used to model and to simulate flow
phenomena. We introduce the basic equations and discuss the standard methods
for the spatial and temporal discretization. We analyse the semi-discrete
equations -- a semi-explicit nonlinear DAE -- in terms of the strangeness index
and quantify the numerical difficulties in the fully discrete schemes, that are
induced by the strangeness of the system. By analyzing the Kronecker index of
the difference-algebraic equations, that represent commonly and successfully
used time stepping schemes for the Navier--Stokes equations, we show that those
time-integration schemes factually remove the strangeness. The theoretical
considerations are backed and illustrated by numerical examples.Comment: 28 pages, 2 figure, code available under DOI: 10.5281/zenodo.998909,
https://doi.org/10.5281/zenodo.99890
Constructing a Stochastic Model of Bumblebee Flights from Experimental Data
PMCID: PMC3592844This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
High energy emission from microquasars
The microquasar phenomenon is associated with the production of jets by X-ray
binaries and, as such, may be associated with the majority of such systems. In
this chapter we briefly outline the associations, definite, probable, possible,
and speculative, between such jets and X-ray, gamma-ray and particle emission.Comment: Contributing chapter to the book Cosmic Gamma-Ray Sources, K.S. Cheng
and G.E. Romero (eds.), to be published by Kluwer Academic Publishers,
Dordrecht, 2004. (19 pages
X-ray emission from isolated neutron stars
X-ray emission is a common feature of all varieties of isolated neutron stars
(INS) and, thanks to the advent of sensitive instruments with good
spectroscopic, timing, and imaging capabilities, X-ray observations have become
an essential tool in the study of these objects. Non-thermal X-rays from young,
energetic radio pulsars have been detected since the beginning of X-ray
astronomy, and the long-sought thermal emission from cooling neutron star's
surfaces can now be studied in detail in many pulsars spanning different ages,
magnetic fields, and, possibly, surface compositions. In addition, other
different manifestations of INS have been discovered with X-ray observations.
These new classes of high-energy sources, comprising the nearby X-ray Dim
Isolated Neutron Stars, the Central Compact Objects in supernova remnants, the
Anomalous X-ray Pulsars, and the Soft Gamma-ray Repeaters, now add up to
several tens of confirmed members, plus many candidates, and allow us to study
a variety of phenomena unobservable in "standard'' radio pulsars.Comment: Chapter to be published in the book of proceedings of the 1st Sant
Cugat Forum on Astrophysics, "ICREA Workshop on the high-energy emission from
pulsars and their systems", held in April, 201
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