3,118 research outputs found
Predicting cesarean section and uterine rupture among women attempting vaginal birth after prior cesarean section
<p><b>Background:</b> There is currently no validated method for antepartum prediction of the risk of failed vaginal birth after cesarean section and no information on the relationship between the risk of emergency cesarean delivery and the risk of uterine rupture.</p>
<p><b>Methods and Findings:</b> We linked a national maternity hospital discharge database and a national registry of perinatal deaths. We studied 23,286 women with one prior cesarean delivery who attempted vaginal birth at or after 40-wk gestation. The population was randomly split into model development and validation groups. The factors associated with emergency cesarean section were maternal age (adjusted odds ratio [OR] = 1.22 per 5-y increase, 95% confidence interval [CI]: 1.16 to 1.28), maternal height (adjusted OR = 0.75 per 5-cm increase, 95% CI: 0.73 to 0.78), male fetus (adjusted OR = 1.18, 95% CI: 1.08 to 1.29), no previous vaginal birth (adjusted OR = 5.08, 95% CI: 4.52 to 5.72), prostaglandin induction of labor (adjusted OR = 1.42, 95% CI: 1.26 to 1.60), and birth at 41-wk (adjusted OR = 1.30, 95% CI: 1.18 to 1.42) or 42-wk (adjusted OR = 1.38, 95% CI: 1.17 to 1.62) gestation compared with 40-wk. In the validation group, 36% of the women had a low predicted risk of caesarean section (<20%) and 16.5% of women had a high predicted risk (>40%); 10.9% and 47.7% of these women, respectively, actually had deliveries by caesarean section. The predicted risk of caesarean section was also associated with the risk of all uterine rupture (OR for a 5% increase in predicted risk = 1.22, 95% CI: 1.14 to 1.31) and uterine rupture associated with perinatal death (OR for a 5% increase in predicted risk = 1.32, 95% CI: 1.02 to 1.73). The observed incidence of uterine rupture was 2.0 per 1,000 among women at low risk of cesarean section and 9.1 per 1,000 among those at high risk (relative risk = 4.5, 95% CI: 2.6 to 8.1). We present the model in a simple-to-use format.</p>
<p><b>Conclusions:</b> We present, to our knowledge, the first validated model for antepartum prediction of the risk of failed vaginal birth after prior cesarean section. Women at increased risk of emergency caesarean section are also at increased risk of uterine rupture, including catastrophic rupture leading to perinatal death.</p>
Friedel oscillations in one-dimensional metals: from Luttinger's theorem to the Luttinger liquid
Charge density and magnetization density profiles of one-dimensional metals
are investigated by two complementary many-body methods: numerically exact
(Lanczos) diagonalization, and the Bethe-Ansatz local-density approximation
with and without a simple self-interaction correction. Depending on the
magnetization of the system, local approximations reproduce different Fourier
components of the exact Friedel oscillations.Comment: 3 pages, 3 figures, Manuscript accepted by Journal of Magnetism and
Magnetic Materials, special issue for LAWMMM 2007 conferenc
Was atmospheric CO2 capped at 1000ppm over the past 300 million years?
AbstractAtmospheric carbon dioxide concentration has shifted dynamically over the Phanerozoic according to mass balance models and the majority of proxy estimates. A new paleo-CO2 proxy method underpinned by mechanistic understanding of plant stomatal, isotopic and photosynthetic responses to CO2 has provocatively claimed that maximum paleoatmospheric CO2 was capped at 1000ppm for the majority of the past 300 million years. Here we evaluate the robustness of the new paleo-proxy CO2 model by testing its sensitivity to initial parameterization and to scaling factors employed to estimate paleophysiological function from anatomical and morphological traits. A series of sensitivity analyses find that the model is robust to modification in some of the constants employed, such as CO2 compensation point and mesophyll conductance, resulting in variability in paleo-CO2 estimates which are already accounted for in the error propagation of the model. We demonstrate high sensitivity in the model to key input parameters such as initial fossil plant assimilation rate, termed A0 and scaling factors used to estimate stomatal conductance from measurements of fossil stomata. Incorrect parameterization of A0 has resulted in under estimation of pCO2 by as much as 600ppm. Despite these uncertainties, our analysis highlights that the new mechanistic paleo-CO2 proxy of Franks et al. (2014) has significant potential to derive robust and more accurate CO2 estimates from fossil plant stomata, as long as parameterization of A0 is strongly justified with species appropriate morphological and anatomical data. We highlight methods that can be used to improve current estimates of fossil plant assimilation rates, reduce uncertainty associated with implementation of the Franks et al. (2014) model and importantly add to understanding of patterns of plant productivity over the Phanerozoic, for which there currently is no consensus
The Tensor to Scalar Ratio of Phantom Dark Energy Models
We investigate the anisotropies in the cosmic microwave background in a class
of models which possess a positive cosmic energy density but negative pressure,
with a constant equation of state w = p/rho < -1. We calculate the temperature
and polarization anisotropy spectra for both scalar and tensor perturbations by
modifying the publicly available code CMBfast. For a constant initial curvature
perturbation or tensor normalization, we have calculated the final anisotropy
spectra as a function of the dark energy density and equation of state w and of
the scalar and tensor spectral indices. This allows us to calculate the
dependence of the tensor-to-scalar ratio on w in a model with phantom dark
energy, which may be important for interpreting any future detection of
long-wavelength gravitational waves.Comment: 5 pages, 4 figure
Tunneling ``zero-bias'' anomaly in the quasi-ballistic regime
For the first time, we study the tunneling density of states (DOS) of the
interacting electron gas beyond the diffusive limit. A strong correction to the
DOS persists even at electron energies exceeding the inverse transport
relaxation time, which could not be expected from the well-known
Altshuler-Aronov-Lee (AAL) theory. This correction originates from the
interference between the electron waves scattered by an impurity and by the
Friedel oscillation this impurity creates. Account for such processes also
revises the AAL formula for the DOS in the diffusive limit.Comment: 4 pages, 2 .eps figures, submitted to Phys. Rev. Let
Impurity Energy Level Within The Haldane Gap
An impurity bond in a periodic 1D antiferromagnetic, spin 1 chain with
exchange is considered. Using the numerical density matrix renormalization
group method, we find an impurity energy level in the Haldane gap,
corresponding to a bound state near the impurity bond. When the level
changes gradually from the edge of the Haldane gap to the ground state energy
as the deviation changes from 0 to 1. It seems that there is
no threshold. Yet, there is a threshold when . The impurity level
appears only when the deviation is greater than ,
which is near 0.3 in our calculation.Comment: Latex file,9 pages uuencoded compressed postscript including 4
figure
Impurity state in Haldane gap for S=1 Heisenberg antiferromagnetic chain with bond doping
Using a new impurity density matrix renormalization group scheme, we
establish a reliable picture of how the low lying energy levels of a
Heisenberg antiferromagnetic chain change {\it quantitatively} upon bond
doping. A new impurity state gradually occurs in the Haldane gap as ,
while it appears only if with as . The
system is non-perturbative as . This explains the
appearance of a new state in the Haldane gap in a recent experiment on
YCaBaNiO [J.F. DiTusa, et al., Phys. Rev. Lett. 73 1857(1994)].Comment: 4 pages of uuencoded gzip'd postscrip
Pairing in Cu-O Models: Clues of Joint Electron-Phonon and Electron-Electron Interactions
We discuss a many-electron Hamiltonian with Hubbard-like repulsive
interaction and linear coupling to the phonon branches, having the Cu-O plane
of the superconducting cuprates as a paradigm. A canonical transformation
extracts an effective two-body problem from the many-body theory. As a
prototype system we study the \cu cluster, which yields electronic pairing in
the Hubbard model; moreover, a standard treatment of the Jahn-Teller effect
predicts distortions that destroy electronic pairing. Remarkably, calculations
that keep all the electronic spectrum into account show that vibrations are
likely to be synergic with electronic pairing, if the coupling to
half-breathing modes predominates, as experiments suggest.Comment: 4 pages, 3 figures, accepted by Phys. Rev.
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