A comparison of neonatal outcomes between adolescent and adult mothers in developed countries: A systematic review and meta-analysis

Evidence suggests that adolescent pregnancies are at increased risk of adverse neonatal outcomes compared to adult pregnancies; however, there are significant inconsistencies in the literature, particularly in studies conducted in developed countries. The objective of this study therefore is to systematically review the current literature with regard to the relationship between adolescent pregnancy and neonatal outcomes. A literature search was conducted in eight electronic databases (AMED, ASSIA, Child Development and Adolescent Studies, CINAHL, Cochrane Library, Health Source: Nursing, Maternity and Infant Care, MEDLINE and Scopus. The reference lists of included studies were also hand searched. Studies were included if: they were conducted in countries with very high human development according to the United Nations Human Development Index; reported at least one comparison between adolescents (19 years or under) and adult mothers (20–34 years); and were published between January 1998 and March 2018. Studies were screened for inclusion and data extracted by one reviewer. A second reviewer independently reviewed a sub-set of studies. Disagreements were resolved by consensus. Meta-analysis was performed using RevMan 5.3 using crude counts reported in the included studies. Sub-group analyses of adolescents aged 17 and under and 18–19 were conducted. Pooled analysis of adjusted odds ratios was also undertaken in order to consider the effect of confounding factors. Meta-analysis effect estimates are reported as risk ratios (RR) and pooled association as adjusted odds ratios (aORs). Point estimates and 95% confidence intervals are presented. After removal of duplicates a total of 1791 articles were identified, of which 20 met the inclusion criteria. The results of the meta-analysis showed adolescents to have increased risk of all primary adverse outcomes investigated. Sub-group analysis suggests an increased risk of perinatal death and low birthweight for children born to adolescent mothers; 17 and under (perinatal death: RR 1.50, CI 1.32–1.71: low birthweight RR 1.43, CI 1.20–1.70); 18–19 (perinatal death RR 1.21, CI 1.06–1.37: low birthweight RR 1.10, CI 1.08–1.57). Mothers aged 17 and under were also at increased risk of preterm delivery (RR 1.64, CI 1.54–1.75). Analysis adjusted for confounders showed increased risk of preterm delivery (aOR 1.23, CI 1.09–1.38), very preterm delivery (aOR 1.22, CI 1.03–1.44) and neonatal death (aOR 1.31, CI 1.14–1.52). Findings show that young maternal age is a significant risk factor for adverse neonatal outcomes in developed countries. Adolescent maternal age therefore should be considered as a potential cause for concern in relation to neonatal health and it is recommended that health care professionals respond accordingly with increased support and monitoring

Breast feeding practices and views among diabetic women: a retrospective cohort study

Objective: to explore the pattern and experiences of breast-feeding practices among diabetic women. Design: retrospective cohort study using maternal records and postal questionnaires in a Baby-Friendly hospital. Participants: diabetic mothers including women with gestational diabetes, and type 1 and 2 diabetes mellitus. Findings: from the total group of respondents, 81.9% intended to breast feed. The actual breast feeding rates were 81.9% at birth, 68.1% at 2 weeks and 28.7% at 6 months postpartum. Major themes that were identified from women's experiences included information and advice, support vs. pressure, classification and labelling, and expectations. Conclusions: more than two-thirds of the diabetic women intended to breast feed and actually did breast feed in this study. For both the total study population and the type 1 and 2 diabetics alone, more than half were still breast feeding at 2 weeks postpartum, and approximately one-third were still breast feeding at 6 months postpartum. Implications for practice: structured support, provided for women through Baby-Friendly initiatives, was appreciated by the diabetic women in this study. The extent to which this support influenced the highly successful breast feeding practices in this group of women needs focused investigation. The need for a delicate balancing act between pressure and advice in order to prevent coercion was noted.</p

Gender Determination Using Diagnostic Values of Foramen Magnum

Background: Foramen magnum is a big hole in the base of the skull. Its appearance can be useful in gender determination. So far, no study has been conducted in Iran that evaluates the value of foramen magnum in sex determination and calculates the cut-off points. This study aimed to evaluating of diagnostic value of the foramen magnum and to calculate the cut-off points for sex determination.Methods: In this cross sectional study 50 male and 50 female patients referring to the radiology department of Rasol Akram Hospital in Tehran were evaluated. The required information about the sagittal diameter, transverse diameter, and diameter of foramen magnum were assessed by brain CT scan. Chi-square and independent t test was used for the comparison of different shapes and diameters between the sexes. ROC curve was used to determine the optimal cut-off point for each indicator.Results: The best cut-off point to distinguish males from females along the anterior-posterior foramen magnum was calculated as 36.45 mm, at the transverse diameter of 30.4 mm. The proper cut-off points for the area of the foramen magnum were 877.477 mm2 and 870.29 mm2, based on the Teixeria formula and Routal formula respectively. Overall, the accuracy of these indicators was calculated as 85%.Conclusion: Based on the results of this study using CT scans images, the diameter of the foramen magnum and its area had a high accuracy in sex determination

General methods for designing single-mode planar photonic crystal waveguides in hexagonal lattice structures

We systematically investigate and compare general methods of designing single mode photonic crystal waveguides in a two-dimensional hexagonal lattice of air holes in a dielectric material. We apply the rather general methods to dielectric-core hexagonal lattice photonic crystals since they have not been widely explored before. We show that it is possible to obtain single mode guiding in a limited portion of the photonic bandgap of hexagonal lattice structures. We also compare the potentials of different photonic crystal lattices for designing single-mode waveguides and conclude that triangular lattice structures are the best choice

Studying the efficacy of fipronil (WG 80%) against alfalfa weevil, Hypera postica (Coleoptera: Curculionidae)

The alfalfa weevil, Hypera postica Gyll. (Coleoptera: Curculionidae), is a key pest of alfalfa in different regions of the world where it causes sometimes complete crop destruction. Application of insecticides is the most important and major control method of this pest. The efficacy of fipronil (WG 80%), 50, 70 and 90 g/ha along with fosalon (EC 35%), 2.5 l/ha and malathion (EC 57%), 3 l/ha were assessed against this pest in the field based on a completely randomized block design. Based on Henderson–Tilton formula, on the fourteenth day after treatment, the minimum efficacy of fipronil, 50, 70 and 90 g/ha, fosalon, 2.5 l/ha and malathion, 3 l/ha bait was 80%, 89%, 98%, 76% and 75%, respectively. Results showed that fipronil (WG 80%) at 50–70 g/ha can be used against alfalfa weevil

Online augmentation of learned grasp sequence policies for more adaptable and data-efficient in-hand manipulation

When using a tool, the grasps used for picking it up, reposing, and holding it in a suitable pose for the desired task could be distinct. Therefore, a key challenge for autonomous in-hand tool manipulation is finding a sequence of grasps that facilitates every step of the tool use process while continuously maintaining force closure and stability. Due to the complexity of modeling the contact dynamics, reinforcement learning (RL) techniques can provide a solution in this continuous space subject to highly parameterized physical models. However, these techniques impose a trade-off in adaptability and data efficiency. At test time the tool properties, desired trajectory, and desired application forces could differ substantially from training scenarios. Adapting to this necessitates more data or computationally expensive online policy updates. In this work, we apply the principles of discrete dynamic programming (DP) to augment RL performance with domain knowledge. Specifically, we first design a computationally simple approximation of our environment. We then demonstrate in physical simulation that performing tree searches (i.e., lookaheads) and policy rollouts with this approximation can improve an RL-derived grasp sequence policy with minimal additional online computation. Additionally, we show that pretraining a deep RL network with the DP-derived solution to the discretized problem can speed up policy training.Comment: 7 pages (6+1 bibliography), 4 figures, 1 table, 2 algorithms, to appear in ICRA 202

Successful Suicide in a Child: Depression-Related or Paroxetine-Induced?

Background: Children and adolescents are prone to develop psychiatric problems after stressful life events. These problems need appropriate treatment because of negative consequences like disease-related suicide. Antidepressants (especially "Serotonin Selective Reuptake Inhibitors") are common treatments for psychiatric problems of children and adolescents; but different side effects, including drug-induced suicide, have been reported.Case Report: In this article, we describe a nine-year-old girl who developed depression after parental divorce and was prescribed paroxetine. During pharmacotherapy, she had suicidal thoughts and several unsuccessful attempts which have been neglected and finally last attempt was successful. This report is an evidence for physicians to prescribe antidepressants cautiously with reasonable indication. As still there is no certain contraindication of using antidepressants in pediatric patients, importance of follow-ups and screening of suicide in pediatric patients during treatment with antidepressants seems essential.Conclusion: This study discloses the magnitude of explaining the side effects of antidepressants to caregivers of children with psychiatric problems

The effect of gut microbiota and probiotics on metabolism in fish and shrimp

The present paper presents an overview of the effects of gut microbiota and probiotics on lipid-, carbohydrate-, protein- and amino acid metabolism in fish and shrimp. In probiotic fish studies, the zebrafish (Danio rerio) model is the most frequently used, and probiotic administration reveals the effect on glucose homeostasis, anti-lipidemic effects and increasing short-chain fatty acids, and increased expressions of genes related to carbohydrate metabolism and innate immunity, along with down-regulation of oxidative stress-related genes. Further, improved length of the intestinal villi and expression of nutrient transporters in fish owing to probiotics exposure have been documented. The present review will present an appraisal of the effect of intestinal microbiota and probiotic administration on the metabolism of nutrients and metabolites related to stress and immunity in diverse fish- and shrimp species. Furthermore, to give the reader satisfactory information on the topics discussed, some information from endothermic animals is also presented

Systematic design of single-mode coupled-resonator optical waveguides in photonic crystals

By establishing a direct relation between the dispersion and the field profile of a coupled-resonator optical waveguide (CROW) and those of its constituent cavities, we present a systematic method for the design of a single-mode CROW and for control of its dispersion. The procedure includes the design of a single-mode cavity and control of its frequency by engineering its structure. Then, by chaining these cavities in the proper direction and at an appropriate distance, we achieve the desired dispersion for the CROW