Consent on the labour ward: a qualitative study of the views and experiences of healthcare professionals

Objective: Consent on the labour ward is a complex and controversial topic which is poorly understood. Consenting labouring women is recognised as challenging and problematic, and thus, it is uncertain that pregnant women experience true informed consent during labour. This project aims to explore healthcare professionals’ views and experiences of consent practice on the labour ward. / Design: Qualitative research performed in a tertiary hospital labour ward in Central London with 5,500 patients annually. Eleven obstetricians and seven midwives participated. In-depth one-on-one semi-structured interviews were conducted, and the data were analysed by thematic analysis. / Results: Three themes were identified: 1) The value of women’s choice: healthcare professionals framed consent as an agreement process rather than an exercise of choice. Implicit paternalism was evident with some healthcare professionals imposing their own recommendations upon patients. 2) Communicating risk: many participants viewed full risk communication, including extremely rare risk disclosure as their duty to ensure the validity of obstetric consent despite the risk of overwhelming women. 3) Law and professional practice: many healthcare professionals lacked knowledge of the implications to practice of current law. / Conclusion: Healthcare professionals’ experiences of consent on the labour ward reflect uncertainties and ambiguities in consent practice such that it sometimes falls short of legal and professional requirements. Difficulties in discussing risk with women in an appropriate way at an appropriate time threatens the lawfulness of consent. If consent is to remain as the legal standard of autonomy, we recommend the provision of specialist training to assist professionals in providing timely consultation dialogues which endorse women’s right to choose

Knot invariants in lens spaces

In this survey we summarize results regarding the Kauffman bracket, HOMFLYPT, Kauffman 2-variable and Dubrovnik skein modules, and the Alexander polynomial of links in lens spaces, which we represent as mixed link diagrams. These invariants generalize the corresponding knot polynomials in the classical case. We compare the invariants by means of the ability to distinguish between some difficult cases of knots with certain symmetries

Routine placental histopathology findings from women testing positive for SARS-CoV-2 during pregnancy: Retrospective cohort comparative study

OBJECTIVE: To assess the impact of maternal Coronavirus disease 2019 (COVID-19) infection on placental histopathological findings in an unselected population and evaluate the potential effect on the fetus, including the possibility of vertical transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). DESIGN: Retrospective cohort comparative study of placental histopathological findings in patients with COVID-19, compared with controls. SETTING: During the COVID-19 pandemic, placentas were studied from women at University College Hospital London who reported and/or tested positive for COVID-19. POPULATION: Of 10 508 deliveries, 369 (3.5%) women had COVID-19 during pregnancy, with placental histopathology available for 244 women. METHODS: Retrospective review of maternal and neonatal characteristics, where placental analysis had been performed. This was compared with available, previously published, histopathological findings from placentas of unselected women. MAIN OUTCOME MEASURES: Frequency of placental histopathological findings and relevant clinical outcomes. RESULTS: Histological abnormalities were reported in 117 of 244 (47.95%) cases, with the most common diagnosis being ascending maternal genital tract infection. There was no statistically significant difference in the frequency of most abnormalities compared with controls. There were four cases of COVID-19 placentitis (1.52%, 95% CI 0.04%-3.00%) and one possible congenital infection, with placental findings of acute maternal genital tract infection. The rate of fetal vascular malperfusion (FVM), at 4.5%, was higher compared with controls (p = 0.00044). CONCLUSIONS: In most cases, placentas from pregnant women infected with SARS-CoV-2 virus do not show a significantly increased frequency of pathology. Evidence for transplacental transmission of SARS-CoV-2 is lacking from this cohort. There is a need for further study into the association between FVM, infection and diabetes

J-PLUS: Identification of low-metallicity stars with artificial neural networks using SPHINX

We present a new methodology for the estimation of stellar atmospheric parameters from narrow- and intermediate-band photometry of the Javalambre Photometric Local Universe Survey (J-PLUS), and propose a method for target pre-selection of low-metallicity stars for follow-up spectroscopic studies. Photometric metallicity estimates for stars in the globular cluster M15 are determined using this method. By development of a neural-network-based photometry pipeline, we aim to produce estimates of effective temperature, $T_{\rm eff}$, and metallicity, [Fe/H], for a large subset of stars in the J-PLUS footprint. The Stellar Photometric Index Network Explorer, SPHINX, is developed to produce estimates of $T_{\rm eff}$ and [Fe/H], after training on a combination of J-PLUS photometric inputs and synthetic magnitudes computed for medium-resolution (R ~ 2000) spectra of the Sloan Digital Sky Survey. This methodology is applied to J-PLUS photometry of the globular cluster M15. Effective temperature estimates made with J-PLUS Early Data Release photometry exhibit low scatter, \sigma($T_{\rm eff}$) = 91 K, over the temperature range 4500 < $T_{\rm eff}$ (K) < 8500. For stars from the J-PLUS First Data Release with 4500 < $T_{\rm eff}$ (K) < 6200, 85 $\pm$ 3% of stars known to have [Fe/H] <-2.0 are recovered by SPHINX. A mean metallicity of [Fe/H]=-2.32 $\pm$ 0.01, with a residual spread of 0.3 dex, is determined for M15 using J-PLUS photometry of 664 likely cluster members. We confirm the performance of SPHINX within the ranges specified, and verify its utility as a stand-alone tool for photometric estimation of effective temperature and metallicity, and for pre-selection of metal-poor spectroscopic targets.Comment: 18 pages, 12 figure

Resonance ionization of sputtered atoms-progress toward a quantitative technique

The combination of RIMS and ion sputtering has been heralded as the ideal means of quantitatively probing the surface of a solid. While several laboratories have demonstrated the extreme sensitivity of combining RIMS with sputtering, less effort has been devoted to the question of accuracy. Using the SARISA instrument developed at Argonne National Laboratory, a number of well-characterized metallic samples have been analyzed. Results from these determinations have been compared with data obtained by several other analytical methods. One significant finding is that impurity measurements down to ppb levels in metal matrices can be made quantitative by employing polycrystalline metal foils as calibration standards. This discovery substantially reduces the effort required for quantitative analysis since a single standard can be used for determining concentrations spanning nine orders of magnitude

Dental and physical therapy faculty collaborate in assessing and educating dental students on musculoskeletal disorders

Introduction: Research shows 54% to 93% of practicing dentists suffer from musculoskeletal disorders (MSDs), with many developing afflictions early in their careers. Studies also show that dental students are developing MSDs early in their professional education. Objective: The research goal was to quantify the prevalence, anatomical location and initial onset of MSDs among first-year dental students. The study also assessed the students’ self-reported opinion as to whether there were enough educational touchpoints to improve their ergonomics in daily activities. Methods: At the conclusion of a 9-month preclinical restorative course, that included 2 lectures on MSDs, ergonomics, and postural cueing sessions, a dental and physical therapy faculty member administered a survey to 143 first-year dental students. This survey included questions about the history and presentation of the students’ MSD symptoms and their opinion on the relative value of the educational interventions. Results: There was a 96.5% response rate to the survey with 87.8% of students reporting mild to moderate pain. The cervical spine (41.7%) and hands (42.4%) were the most common areas afflicted. 55.4% reported pain commencing 1 month after starting in the simulation clinic. Over 60.9% of students “agreed” or “somewhat agreed” that the 2 sessions of hands-on ergonomic educational interventions resulted in improved biomechanics and students requested additional educational resources. Conclusion: Dental students are developing MSDs as soon as 1 month after commencing dental school. Dental education should include ongoing ergonomic training throughout the curriculum to help students prevent MSDs

Pyroclastic Deposits on Venus as Indicators of the Youngest Volcanism

While most of the surface of Venus formed by effusive volcanic processes, deposits suggesting eruption styles that distribute airfall debris over large areas, or ground-hugging flows from plume collapse, are not common. Prior work notes radar-bright units with diffuse margins, generally consistent with a plume collapse emplacement model, in Eistla Regio, Dione Regio, and near Sappho Patera. We examine these deposits, and map additional occurrences, using Magellan data and Earth-based polarimetric radar maps from 1988, 2012, and 2015 observations

Methodological considerations in the analysis of fecal glucocorticoid metabolites in tufted capuchins (Cebus apella)

Analysis of fecal glucocorticoid (GC) metabolites has recently become the standard method to monitor adrenocortical activity in primates noninvasively. However, given variation in the production, metabolism, and excretion of GCs across species and even between sexes, there are no standard methods that are universally applicable. In particular, it is important to validate assays intended to measure GC production, test extraction and storage procedures, and consider the time course of GC metabolite excretion relative to the production and circulation of the native hormones. This study examines these four methodological aspects of fecal GC metabolite analysis in tufted capuchins (Cebus apella). Specifically, we conducted an adrenocorticotrophic hormone (ACTH) challenge on one male and one female capuchin to test the validity of four GC enzyme immunoassays (EIAs) and document the time course characterizing GC me- tabolite excretion in this species. In addition, we compare a common field-friendly technique for extracting fecal GC metabolites to an established laboratory extraction methodology and test for effects of storing “field extracts” for up to 1 yr. Results suggest that a corticosterone EIA is most sensitive to changes in GC production, provides reliable measures when extracted according to the field method, and measures GC metabolites which remain highly stable after even 12 mo of storage. Further, the time course of GC metabolite excretion is shorter than that described yet for any primate taxa. These results provide guidelines for studies of GCs in tufted capuchins, and underscore the importance of validating methods for fecal hormone analysis for each species of interest

Ab initio Hartree-Fock Born effective charges of LiH, LiF, LiCl, NaF, and NaCl

We use the Berry-phase-based theory of macroscopic polarization of dielectric crystals formulated in terms of Wannier functions, and state-of-the-art Gaussian basis functions, to obtain benchmark ab initio Hartree-Fock values of the Born effective charges of ionic compounds LiH, LiF, LiCl, NaF, and NaCl. We find excellent agreement with the experimental values for all the compounds except LiCl and NaCl, for which the disagreement with the experiments is close to 10% and 16%, respectively. This may imply the importance of many-body effects in those systems.Comment: 11 pages, Revtex, 2 figures (included), to appear in Phys. Rev. B April 15, 200