Postpartum Visit Attendance Increases the Use of Modern Contraceptives

Background. Delays in postpartum contraceptive use may increase risk for unintended or rapid repeat pregnancies. The postpartum care visit (PPCV) is a good opportunity for women to discuss family planning options with their health care providers. This study examined the association between PPCV attendance and modern contraceptive use using data from a managed care organization. Methods. Claims and demographic and administrative data came from a nonprofit managed care organization in Virginia (2008–2012). Information on the most recent delivery for mothers with singleton births was analyzed (N = 24,619). Routine PPCV (yes, no) and modern contraceptive use were both dichotomized. Descriptive analyses provided percentages, frequencies, and means. Multiple logistic regression was conducted and ORs and 95% CIs were calculated. Results. More than half of the women did not attend their PPCV (50.8%) and 86.9% had no modern contraceptive use. After controlling for the effects of confounders, women with PPCV were 50% more likely to use modern contraceptive methods than women with no PPCV (OR = 1.50, 95% CI = 1.31, 1.72). Conclusions. These findings highlight the importance of PPCV in improving modern contraceptive use and guide health care policy in the effort of reducing unintended pregnancy rates

Dydrogesterone and norethisterone regulate expression of lipoprotein lipase and hormones-sensitive lipase in human subcutaneous abdominal adipocytes

Aim: In premenopausal women, hyper-androgenicity is associated with central obesity and an increased cardiovascular risk. We investigated the effects of dydrogesterone (DYD)(a non-androgenic progestogen) and norethisterone (NET)(an androgenic progestogen) on lipoprotein lipase (LPL), hormone-sensitive lipase (HSL) and glycerol release in adipocytes isolated from subcutaneous abdominal adipose tissue. Methods: Adipose tissue was obtained from 12 non-diabetic women, mean age 51 years (range 37-78) and mean BMI 25.4kg/m2 (range 20.3-26.4). Adipocytes were treated with increasing doses of DYD and NET for 48 hours prior to protein extraction. Effects on lipogenesis and lipolysis were assessed using western blotting to determine the expression of key enzymes, LPL (56kDa) and HSL (84kDa) respectively. Measurement of glycerol release into the medium provided an assessment of lipolytic activity. Results: Expression of LPL was increased by DYD and NET (mean protein expression relative to control ± SEM); with greatest effect at 10-8M for DYD: 2.32±0.51(p0.05). Conclusions: DYD and NET significantly increased LPL expression relative to control whilst significantly reducing HSL expression. At the concentrations studied, similar effects were observed with the androgenic NET and the non-androgenic DYD despite differing effects on the lipid profile when taken in combination with estrogen. Further work in this area may improve knowledge about the effects of different progestogens on body fat distribution and enable progestogen use to be tailored to the individual to achieve maximal benefits

A convenient approach to characterizing model uncertainty with application to early dark energy solutions of the Hubble tension

Despite increasingly precise observations and sophisticated theoretical models, the discrepancy between measurements of H0 from the cosmic microwave background or from Baryon Acoustic Oscillations combined with Big-Bang Nucleosynthesis versus those from local distance ladder probes -- commonly known as the $H_0$ tension -- continues to perplex the scientific community. To address this tension, Early Dark Energy (EDE) models have been proposed as alternatives to $\Lambda$CDM, as they can change the observed sound horizon and the inferred Hubble constant from measurements based on this. In this paper, we investigate the use of Bayesian Model Averaging (BMA) to evaluate EDE as a solution to the H0 tension. BMA consists of assigning a prior to the model and deriving a posterior as for any other unknown parameter in a Bayesian analysis. BMA can be computationally challenging in that one must approximate the joint posterior of both model and parameters. Here we present a computational strategy for BMA that exploits existing MCMC software and combines model-specific posteriors post-hoc. In application to a comprehensive analysis of cosmological datasets, we quantify the impact of EDE on the H0 discrepancy. We find an EDE model probability of $\sim$90% whenever we include the H0 measurement from Type Ia Supernovae in the analysis, whereas the other data show a strong preference for the standard cosmological model. We finally present constraints on common parameters marginalized over both cosmological models. For reasonable priors on models with and without EDE, the H0 tension is reduced by at least 20%

The Stellar Content of Obscured Galactic Giant H II Regions IV.: NGC3576

We present deep, high angular resolution near-infrared images of the obscured Galactic Giant H II region NGC3576. Our images reach objects to ~3M_sun. We collected high signal-to-noise K-band spectra of eight of the brightest objects, some of which are affected by excess emission and some which follow a normal interstellar reddening law. None of them displayed photospheric features typical of massive OB type stars. This indicates that they are still enshrouded in their natal cocoons. The K-band brightest source (NGC3576 #48) shows CO 2.3 micron bandhead emission, and three others have the same CO feature in absorption. Three sources display spatially unresolved H_2 emission, suggesting dense shocked regions close to the stars. We conclude that the remarkable object NGC3576 #48 is an early-B/late-O star surrounded by a thick circumstellar disk. A number of other relatively bright cluster members also display excess emission in the K-band, indicative of reprocessing disks around massive stars (YSOs). Such emission appears common in other Galactic Giant H II regions we have surveyed. The IMF slope of the cluster, Gamma = -1.51, is consistent with Salpeter's distribution and similar to what has been observed in the Magellanic Cloud clusters and in the periphery of our Galaxy.Comment: 14 pages, 11 figures, accepted for publication in A

A New Differential Absorption Lidar to Measure Sub-Hourly Fluctuation of Tropospheric Ozone Profiles in the Baltimore - Washington D.C. Region

Tropospheric ozone profiles have been retrieved from the new ground based National Aeronautics and Space Administration (NASA) Goddard Space Flight Center TROPospheric OZone DIfferential Absorption Lidar (GSFC TROPOZ DIAL) in Greenbelt, MD (38.99 N, 76.84 W, 57 meters ASL) from 400 m to 12 km AGL. Current atmospheric satellite instruments cannot peer through the optically thick stratospheric ozone layer to remotely sense boundary layer tropospheric ozone. In order to monitor this lower ozone more effectively, the Tropospheric Ozone Lidar Network (TOLNet) has been developed, which currently consists of five stations across the US. The GSFC TROPOZ DIAL is based on the Differential Absorption Lidar (DIAL) technique, which currently detects two wavelengths, 289 and 299 nm. Ozone is absorbed more strongly at 289 nm than at 299 nm. The DIAL technique exploits this difference between the returned backscatter signals to obtain the ozone number density as a function of altitude. The transmitted wavelengths are generated by focusing the output of a quadrupled Nd:YAG laser beam (266 nm) into a pair of Raman cells, filled with high pressure hydrogen and deuterium. Stimulated Raman Scattering (SRS) within the focus generates a significant fraction of the pump energy at the first Stokes shift. With the knowledge of the ozone absorption coefficient at these two wavelengths, the range resolved number density can be derived. An interesting atmospheric case study involving the Stratospheric-Tropospheric Exchange (STE) of ozone is shown to emphasize the regional importance of this instrument as well as assessing the validation and calibration of data. The retrieval yields an uncertainty of 16-19 percent from 0-1.5 km, 10-18 percent from 1.5-3 km, and 11-25 percent from 3 km to 12 km. There are currently surface ozone measurements hourly and ozonesonde launches occasionally, but this system will be the first to make routine tropospheric ozone profile measurements in the Baltimore-Washington DC area

NGC 3576 and NGC 3603: Two Luminous Southern HII Regions Observed at High Resolution with the Australia Telescope Compact Array

NGC 3576 (G291.28-0.71; l=291.3o, b=-0.7o) and NGC 3603 (G291.58-0.43; l=291.6o, b=-0.5o) are optically visible, luminous HII regions located at distances of 3.0 kpc and 6.1 kpc, respectively. We present 3.4 cm Australian Telescope Compact Array (ATCA) observations of these two sources in the continuum and the H90a, He90a, C90a and H113b recombination lines with an angular resolution of 7" and a velocity resolution of 2.6 km/s. All four recombination lines are detected in the integrated profiles of the two sources. Broad radio recombination lines are detected in both NGC 3576 (DV_{FWHM}>= 50 km/s) and NGC 3603 (DV_{FWHM}>=70 km/s). In NGC 3576 a prominent N-S velocity gradient (~30 km/s/pc) is observed, and a clear temperature gradient (6000 K to 8000 K) is found from east to west, consistent with a known IR color gradient in the source. In NGC 3603, the H90a, He90a and the H113b lines are detected from 13 individual sources. The Y^+ (He/H) ratios in the two sources range from 0.08+/-0.04 to 0.26+/-0.10. We compare the morphology and kinematics of the ionized gas at 3.4 cm with the distribution of stars, 10 micron emission and H_2O, OH, and CH_3OH maser emission. These comparisons suggest that both NGC 3576 and NGC 3603 have undergone sequential star formation.Comment: 24 pages, 12 Postscript figure

The equilibrium flow and mass balance of the Taku Glacier, Alaska 1950?2006

International audienceThe Taku Glacier, Alaska has advanced 7.5 km since the late nineteenth century, while all other primary outlet glaciers of the Juneau Icefield are in retreat. The Juneau Icefield Research Program has completed field work on the Taku Glacier annually since 1946. The collected observations of surface mass balance, glacier velocity and glacier thickness at Profile IV 29 km above the terminus and 4 km above the equilibrium line provide a means to assess the equilibrium nature of the Taku Glacier. Velocity measured over a twelve month span and annual summer velocity measurements completed at a Profile IV from 1950?2006 indicate insignificant variations in velocity seasonally or from year to year. The consistency of velocity over the 56-year period indicates that in the vicinity of the equilibrium line, the flow of the Taku Glacier has been in an equilibrium state. Surface mass balance was positive from 1946?1988 averaging +0.42 m a?1. This led to glacier thickening. From 1988?2006 an important change has occurred and annual balance has been ?0.14 m a?1, and the glacier thickness has ceased increasing along Profile IV. Field measurements of ice depth and surface velocity allow calculation of the volume flux at Profile IV. Volume flux is then compared with the surface balance flux from the region of the glacier above Profile IV, determined annually in the field. Above Profile IV the observed mean surface flux is 5.50×108 m3/a (±5%), while the calculated volume flux range flowing through profile IV is 5.00?5.47×108 m3/a. The mean surface flux has been greater than the volume flux, which has led to slow thickening of the Taku Glacier up to 1988. The thickening has not led to a change in the flow of Taku Glacier at Profile IV

Rotational Dynamics of Vortices in Confined Bose-Einstein Condensates

We derive the frequency of precession and conditions for stability for a quantized vortex in a single-component and a two-component Bose-Einstein condensate. The frequency of precession is proportional to the gradient of the free energy with respect to displacement of the vortex core. In a two-component system, it is possible to achieve a local minimum in the free energy at the center of the trap. The presence of such a minimum implies the existence of a region of energetic stability where the vortex cannot escape and where one may be able to generate a persistent current.Comment: 6 Pages, 6 Figure

Robotic telepathology: efficacy and usability in pulmonary pathology

Abstract Robotic telepathology is well established in the USA as a method of case referral, but is less frequently used in the UK. Using cases covering a broad spectrum of pulmonary pathology, this study assessed its application in primary diagnosis and its functionality in terms of accuracy of diagnosis and time per case, for both small biopsies and open lung biopsies/resections. Forty cases (20 bronchoscopic and 20 surgical lung biopsy/resection specimens) were reviewed in blinded fashion by a single pathologist using robotic telepathology. Connection between the John Radcliffe and Royal Brompton Hospitals was via 10 Mb/s LAN to the Internet (supported by the Joint Academic Network). The cases were then randomized and reviewed a second time with conventional light microscopy. Diagnosis, initial time to reach diagnosis, and overall time per case were recorded. In two bronchoscopic biopsy cases, there were clinically significant differences between telepathology and conventional light microscopy, one probably attributable to user inexperience and the other to either speed of image capture or digital image quality. In the surgical lung biopsies and resections, there was one variation of opinion: with telepathology a case was considered to be probably mesothelioma, whereas this was thought less likely on light microscopy. In both instances, immunohistochemistry was requested prior to clinical management. Telepathology was 14 times slower than conventional light microscopy when examining bronchoscopic biopsies. The average time spent per slide was 7 min 21 s, compared with 32 s per slide with conventional light microscopy. When assessing open lung biopsies and resections, telepathology was five times slower, at 6 min 13 s compared with 1 min 10 s with conventional light microscopy. This study showed that robotic telepathology is accurate for primary diagnosis in pulmonary histopathology, but modifications in both laboratory protocols and telepathology hardware are needed to decrease the time difference between telepathology and conventional light microscopy, for telepathology to be usable within the framework of a busy referral practice