Vacuum Extraction Research Articles

EP25.06: Clinical and sonographic characteristics and outcome of vacuum extractions in occiput posterior fetuses: a retrospective cohort study

EP25.06: Clinical and sonographic characteristics and outcome of vacuum extractions in occiput posterior fetuses: a retrospective cohort study

Post Vaginal Delivery with Impending Silent Abdominal Catastrophe: A Case of Vernix Caseosa Peritonitis

Vernix caseosa peritonitis (VCP) is a rare condition previously thought to be a complication of Caesarean section caused by the spillage of amniotic fluid and or meconium into the maternal peritoneal cavity during operation.1 This triggered an inflammatory reaction symptom such as an acute abdomen. A total of 34 cases has been reported since 1976.2 Nine of the 10 cases reported have been diagnosed in postpartum period after uneventful Caesarean section and only three reported cases of antenatal leakage since in 1998.3 VCP following vaginal delivery was first reported in 2013, involving a 28 year old with one previous scar who developed acute abdomen symptoms as early as 3 hours post vacuum delivery, with initial diagnosis of possible uterine scar rupture.4 Here we report a case of VCP in a post spontaneous vaginal delivery who presented with impending catastrophe and survived the ordeal.

Comparison of practice vs theory model training for vacuum-assisted delivery: A randomized controlled trial

ObjectiveTo assess the effect of two modalities of simulation training on acquisition/retention of skills for performing operative vaginal delivery. DesignRandomized, controlled, single-centre study. SettingA tertiary referral hospital in Italy. ParticipantsTwenty residents from a single university programme and two young specialists. InterventionGroup 1 had an individual training session with a single senior specialist using a fixed simulator model. After the session, trainees watched a pre-recorded 1-h lecture on vacuum-assisted operative vaginal delivery. Group 1 repeated the simulator session using the same test after 8–12 weeks and 12 months. Group 2 watched the pre-recorded lecture then undertook the same sessions as Group 1. Video recordings of all test performances were evaluated by five specialists in a blinded manner. Main outcome measureEach procedure was evaluated using a Global Rating Scale (GRS), scored with 0–5 points for each item on an Objective Structured Assessment of Technical Skills (OSATS) dataset with seven items (total 35 points). OSATS were evaluated over time, compared for the whole population, and weighted for route and year of residency. The primary outcome was comparison of the effectiveness of training between the two groups based on year of residency by assessing videos of the baseline test and GRS for OSATS scores. The secondary outcome was overall retention of skills at 8–12 weeks and 12 months. ResultsTwenty-two participants were recruited and randomized to either Group 1 (n = 11) or Group 2 (n = 11). Five participants did not complete follow-up. The primary outcome of GRS for OSATS scores at time 0 differed significantly between groups for total GRS score, and ‘Call for help’ and ‘Explanation to woman and relatives’ item scores (p = 0.002 and p = 0.007, respectively). In a multiple linear regression analysis, OSATS scores were not independently influenced by year of residency. At 8–12-week follow-up, the ‘Call for help’ item score showed a significant improvement in Group 1 (p = 0.018), although this was not confirmed when year of residency was included as an independent variable. At 12-month follow-up, none of the item scores demonstrated a significant change (p = 0.033). Year of residency did not influence the difference between groups. One-way analysis of variance found significant differences between the groups for ‘Localization of the flexion point’ (p = 0.005), ‘Traction of vacuum cup’ (p = 0.039) and ‘Use of second hand of the operator’ (p = 0.009) item scores and total GRS score (p = 0.007). The values weighted by year of residency did not demonstrate any significant difference. The secondary outcomes evaluated all the candidates of both groups for retention of technical skills over time. A significant effect of time was found for total GRS score (p < 0.001) and OSATS item scores. ConclusionsIndependent of the sequence of theoretical teaching and simulation training, trainees demonstrated high retention – and, actually, improvement – of technical skills for operative vaginal delivery at 12-month follow-up.

Application of the method of vacuum withdrawal inert radioactive gases to control of fuel rods leaking of nuclear reactors WWER types while operation

Currently, a comprehensive approach is being developed for the integrity control of fuel rod claddings in pressurized water reactor (PWR) nuclear power plants. One of the key stages is the reliable detection of leaking fuel rods within the reactor's active zone during power operation. This study examines the general trends in the activity of fission product radionuclides in the primary coolant of various generations and designs of PWRs. The experience of Novovoronezh Nuclear Power Plant is considered regarding the method of sampling and separation of inert radioactive gases from the primary coolant. A comparison is made between different methods of measuring inert radioactive gases in the primary coolant: direct spectrometry, cryogenic method, and vacuum extraction method. The issue of reliable detection of fuel rod leakage during reactor operation is discussed, using the example of Unit 5 at Novovoronezh Nuclear Power Plant. Comparative results are presented for the analysis of the integrity of fuel rod claddings based on key reference radionuclides. The most reliable results indicating fuel rod leakage were obtained through the control of specific activities and analysis of changes in the ratio of inert radioactive gases using the vacuum extraction method. Control of the specific activity of inert radioactive gases in the primary coolant enables a highly reliable assessment of the condition of physical barriers. The proposed method of sampling and separation of inert radioactive gases demonstrates high reliability and convergence of results, serving as an additional tool for integrity control of fuel rod claddings during power operation. Having representative data on the specific activities of inert radioactive gases allows for a reliable assessment of the condition of fuel rod claddings within the reactor core.

Vacuum-assisted birth in maternal lateral posture versus lithotomy. A simulation study

ObjectiveMaternal lateral postures provide advantages during childbirth. This study aims to investigate the feasibility of assisting vacuum births in maternal lateral postures in a simulation model. Study designIn a simulation model, four obstetricians and four medical students were randomly allocated to perform vacuum-assisted births first in maternal lateral posture or lithotomy. A modification of Aldo Vacca's 5-step technique was developed to assist vacuum-assisted births in lateral posture. The lateral distance, vertical distance, and distance from the cup center to the flexion point were measured for every placement of the cup. Results and conclusionsA total of 128 vacuum-assisted births were performed. The mean distance to the flexion point was 1.15 ± 0.71 cm for the lithotomy posture and 1.31 ± 0.82 cm for the lateral posture (P = 0.127). There were no statistically significant differences in vacuum extractor cup placement accuracy based on maternal posture.Performing vacuum-assisted births in maternal lateral posture is feasible in a simulation model. The technique is easy to learn, and the differences in cup placement between the lateral and lithotomy postures are small.

Evaluating the bias effects of rooting depth and cryogenic vacuum extraction to quantify root water uptake patterns in deep-rooted apple trees

Accurately assessing isotope information on water sources and mixtures is essential for determining root water uptake (RWU) patterns. This study investigates the impact of rooting depth and cryogenic vacuum extraction (CVE) on the isotopic composition of deep soil water and RWU patterns in a 19-year-old apple orchard on China’s Loess Plateau. We used a Bayesian mixing model (MixSIAR) to analyze corrected isotopic data from soil and xylem water samples collected at different depths, ranging from 3 m to 21.6 m. Our findings reveal a progressive decline in the isotopic composition of deep soil water by 0.63‰ m–1, which decreased deep soil water contributions to transpiration by 1–12% at different rooting depths. The xylem and soil water isotopes became more enriched after correction, with xylem water isotopes closer to the soil water isotope line and water isotopes enriched in the shallow soil layer. Consequently, the contributions of shallow soil water to transpiration increased after xylem water isotope correction but decreased after soil water isotope correction. Monthly averages of these ratios decreased by 12.8% or increased by 8.4%, respectively. After correcting for both soil and xylem water isotopes, the average contributions of shallow soil water increased by 7.4% each month, while those of deep soil water were not consistent. Our findings suggest that rooting depth and CVE have a greater impact on seasonal contribution ratios but a comparatively milder influence on seasonal patterns. This delineation is important for accurately quantifying plant water use strategies.

Features of Helium and Tritium Release from Li2TiO3 Ceramic Pebbles under Neutron Irradiation.

The operation of fusion reactors is based on the reaction that occurs when two heavy hydrogen isotopes, deuterium and tritium, combine to form helium and a neutron with an energy of 14.1 MeV D + T → He + n. For this reaction to occur, it is necessary to produce tritium in the facility itself, as tritium is not common in nature. The generation of tritium in the facility is a key function of the breeder blanket. During the operation of a D-T fusion reactor, high-energy tritium is generated as a result of the 6Li(n,α)T reaction in a lithium-containing ceramic material in the breeder blanket. Lithium metatitanate Li2TiO3 is proposed as one of the promising materials for use in the solid breeder blanket of the DEMO reactor. Several concepts for test blanket modules based on lithium ceramics are being developed for testing at the ITER reactor. Lithium metatitanate Li2TiO3 has good tritium release parameters, as well as good thermal and thermomechanical characteristics. The most important property of lithium ceramics Li2TiO3 is its ability to withstand exposure to long-term high-energy radiation at high temperatures and across large temperature gradients. Its inherent thermal stability and chemical inertness are significant advantages in terms of safety concerns. This study was a continuation of research regarding tritium and helium release from lithium metatitanate Li2TiO3 with 96% 6Li during irradiation at the WWR-K research reactor using the vacuum extraction method. As a result of the analysis of experiments regarding the irradiation of lithium metatitanate in vacuum conditions, it has been established that, during irradiation, peak releases of helium from closed pores of the ceramics are observed, which open during the first 7 days of irradiation. The authors assumed that the reasons samples crack are temperature gradients over the ceramic sample, resulting from the internal heating of pebbles under the conditions of their vacuum evacuation, and contact with the bottom of the evacuated capsule. The temperature dependence of the effective diffusion coefficient of tritium in ceramics at the end of irradiation and the parameters of helium effusion were also determined.

Unscarred uterine rupture with catastrophic hemorrhage immediately after vaginal delivery: diagnosis and management of six consecutive cases

Background To describe and explore the risk factors, clinical presentations, timely diagnostic approaches, and management in patients experiencing unscarred uterine rupture with catastrophic hemorrhage. Methods We retrospectively analyzed clinical and imaging data from women who encountered postpartum hemorrhage (PPH) and were diagnosed with unscarred uterine rupture within a three-year timeframe (2018-2020). The data were extracted from medical records obtained from a multi-hospital 24-hour emergency PPH transfer system. Results Six patients were identified as having unscarred uterine rupture after vaginal delivery. All six women were para 2, with four of them undergoing vacuum-assisted delivery. One patient experienced out-of-hospital cardiac arrest (OHCA), while five patients presented with hypovolemic shock. Abdominopelvic ultrasound revealed a boggy lower uterine segment. Initially, five patients underwent transarterial embolization (TAE) of the internal iliac arteries in an attempt to achieve hemostasis, but this approach proved unsuccessful. Abdominopelvic computed tomography (CT) confirmed the diagnosis of ruptured uterus by demonstrating disrupted myometrium and hemoperitoneum. Immediate exploratory laparotomy followed by life-saving hysterectomy was performed in all cases. The median estimated total blood loss was 2725 mL ± 900 mL (ranging from 1600 mL to 7100 mL). Lower segment lacerations were observed in all patients, with more extensive uterine damage noted in those who underwent vacuum extraction. The length of hospital stay varied between 9 and 38 days. Conclusion Instrument-assisted obstetric delivery is a possible contributing factor to unscarred uterine rupture in our study. In specific cases, the use of abdominopelvic CT prior to initiating transarterial embolization (TAE) offers valuable information to complement ultrasound findings. This comprehensive approach helps in accurately identifying the underlying cause of intractable postpartum hemorrhage (PPH). Immediate conversion to laparotomy is essential to explore the intra-abdominal factors causing PPH that cannot be controlled by TAE. The rational etiologies of uterine rupture must be clarified while generating practical guideline in the future.

Maternal and Fetal Outcome Following Post In vitro Fertilization and Embryo Transfer Pregnancy: A Prospective Observational Study

Abstract Background: While the majority of in vitro fertilization (IVF)-conceived children are healthy, IVF has been associated with an increased risk of adverse obstetric and perinatal outcomes including hypertensive disorders of pregnancy, preterm labor and preterm delivery, and low birth weight (LBW). Objective: The objective of the study is to assess pregnancy, maternal, and perinatal outcomes in patients undergoing IVF embryo transfer (IVF-ET) at tertiary care center in North India. Methodology: It was a prospective observational study carried out for duration of 20 months among women who conceived following an IVF-ET. The sample size was 107 consecutive mothers and data were collected using a predesigned semi-structured study pro forma. Detailed menstrual, obstetric, and medical histories of each patient were noted. Findings of the general, physical, systemic, and obstetrical and gynecological examination were noted for all patients. Results: One hundred and seven mothers who fulfilled the study criteria were included. Of these, 4 had an abortion. Rest of the 103 mothers were included in the final analysis. The mean age of the mothers was 30.39 ± 4.7, ranging from 22 to 50 years. Twin pregnancy rate was 45.7%. All were dichorionic-diamniotic twins. Based on gestational age, 5% were extreme preterm births, 14% were very preterm births, 32% were late preterm births, and 48% were early-term births. Normal vaginal delivery (NVD) occurred in 26.2% of the mothers, elective lower-segment cesarean section (LSCS) in 21.4%, emergency LSCS in 51.4%, and one case had vacuum delivery. Hence, NVD occurred in 27% and 73% had LSCS. With respect to neonates born to study participants, 8% were extremely LBW, 7.3% were very LBW, 46% were LBW, and the rest 38.7% weighed 2.5 kg or more at birth. Conclusion: IVF-ET is a safe and highly successful treatment for infertility. Many of adverse outcomes are largely due to an increased risk of multiple gestations in IVF. Patients with infertility are likely to be older and have preexisting comorbid conditions such as hypertension, diabetes, insulin resistance, or other endocrinopathies which may predispose them to adverse obstetric and perinatal outcomes. It is also recommended that patients should be given adequate preconception counseling regarding increased maternal as well as neonatal risk.

Application of training systems in obstetrics and gynecology teaching

The article proposes an educational method that allows you to activate the learning process to improve the practical skills of interns at preclinical students with the help of dummies, what form the current use of study. Our department has some dummies with the topography of the pelvic cavity, which allows you to study the structure of the female pelvis and the peculiarities of the passage of the fetal head through the pelvic plane to help future specialists master when assisting the birth of a child, such as applying a vacuum extractor to the fetal head and obstetric forceps, what provides the source base for this article. At the same time, intern doctors have a unique opportunity to provide emergency care during childbirth and correctly provide classic obstetric assistance during childbirth, in particular, removal of the fetal head and providing classic manual assistance during the birth of the fetus in the breech presentation according to Tsovyanov 1-2. The interactivity of the learning process allows the intern, taking into account feedback, to study the material in a dynamic presentation of textual and graphic materials that is comfortable for him, as well as to consolidate the educational topic on a real-life model. The novelty of the study. Using the technology of standard and graphic hyperlinks in combination with interactive scenarios allows you to increase the didactic value of educational materials and interest the modern intern doctor. At the initial stages of training (the first two classes), interns are shown interactive techniques, and then they form tactile memory in the scope of the skills of examining a sick or pregnant woman using instrumental methods. In the following classes, the algorithm of the manipulations performed in the pathology of the vagina and female genital organs is learned and consolidated by using an educational dummy. Conclusions. The program provides for consistent training of interns using new computer technologies and also provides an opportunity for continuous training of doctors in practical skills on dummies. To provide interns with material for self-training, educational test manuals have been developed that allow them to master basic medical manipulations in obstetrics and gynecology, as well as to study various aspects of the work of a gynecologist with a patient. In addition, the original training systems allow objective control of the quality of interns' assimilation of the theoretical foundations of obstetrics and gynecology thanks to a specially developed interactive teaching method using a study guide. The proposed training methods for teaching interns allow to activate the learning process and increase the level of mastery of practical skills at the pre-clinical stage when using dummies.

Inter-comparison of extraction methods for plant water isotope analysis and its indicative significance

Recent studies have shown that the widely used water extraction method, cryogenic vacuum extraction (CVE), may be biased toward plant water isotope analysis, and the long-standing hypothesis of non-isotopic fractionation between xylem water and sources is being challenged. Thus, there is an urgent need to find alternative approaches for extracting plant water and further verify whether the isotopic composition of water is conserved during its passage from the soil to the plant. To determine the correct methods for extracting plant water for isotope analysis, we performed an inter-method comparison of four plant water extraction techniques on sap-labeled stems and irrigated-pot Malus pumila Mill saplings with known isotopic composition water. Next, we assessed isotope fractionation during root water uptake using an accurate isotope sampling method. Generally, mechanical methods outperformed CVE in recovering the isotopic signals of xylem water. For sap-labeled stems, gas push (GP), centrifugation (CE), and high-pressure mechanical squeezing (HPMS) produced water were not significantly different from the labeling water in 2H and 18O (P > 0.05), while the CVE method induced significant depletion of 2H (Δδ2H = -8.21 ± 0.67 ‰, P < 0.01) and 18O (Δδ18O = -0.79 ± 0.34 ‰, P < 0.05). For irrigated-pot saplings, GP- and CE-obtained water was the closest to the irrigation water isotopically, followed by HPMS and CVE, while the CVE method had the highest extraction success rate (100%), followed by CE (90%), HPMS (50%), and GP (30%). Based on the accurate sampling technique (CE method), we found that 2H and 18O compositions of the labeled-sap water were conserved even when standing in vessels for 24 h. Moreover, CE-obtained xylem water, representing the sap in vessels, showed no significant differences in hydrogen and oxygen isotopic compositions to that of irrigation water. The GP and CE methods can selectively extract sap water from the xylem without significant isotopic fractionation, thus accurately reflecting the isotopic signal of transpiration water. CE might be the most promising alternative technique for extracting woody plant water for isotopic analysis because of its high extraction success rate. This study also confirmed that no isotopic fractionation occurred during root water uptake in Malus pumila Mill trees.

Vacuum extraction: an effective larval sampling method for spotted-wing drosophila in small fruit crops.

Detecting and sampling the pest for pest management, either through enumerating their life stages or by quantifying the crop damage, is the cornerstone in deploying integrated pest management. Currently, for spotted-wing drosophila, Drosophila suzukii Matsumura, larval extraction from the fruit samples involves immersing the fruits in hot water, salt, or sugar solution. We are introducing a novel, fast, and effective larval sampling technique where D. suzukii larvae can be extracted from infested fruits by subjecting the fruit samples to vacuum pressure. We optimized the vacuum pressure and vacuum duration for larval extraction from blueberries by testing a range of vacuum pressures and durations. A vacuum pressure of -98 kPa for 60 min resulted in the maximum larval recovery of the small, medium, and large larvae from blueberries. A 30-min incubation at -98 kPa also yielded similar results. Larval extraction at -98 kPa for 60 min on average recovered 61, 70, and 83% of larvae from 2, 4, and 6-day incubated fruit samples, respectively. The fruit sample size (37, 149, and 298 g) did not affect the larval extraction efficacy. Additionally, comparing larval extraction efficacy at -98 kPa with the salt and sugar extraction, incubated for 10, 30, and 60 min, suggests that vacuum extraction is comparable to or more efficient than the salt and sugar methods in extracting larvae from the infested blueberries. Overall, our results indicate that vacuum sampling is a promising method for detecting D. suzukii larval infestation in small fruit crops.

Is an episiotomy always necessary during an operative vaginal delivery with vacuum? A longitudinal study

Objective: The use of episiotomy during operative vaginal birth (OVB) is rather debated among operators and in literature. It is also important to evaluate the indications for which episiotomy is performed. In fact, the consequences of an episiotomy can be invalidating for patients with long-lasting results. The aim of this study is the evaluation of the role of episiotomy during OVB with the vacuum extractor and its correlation with Obstetric Anal Sphincter Injuries (OASIs). Methods: On of 9165 vaginal births, a total of 498 OVB (5.4%) were enrolled in a longitudinal prospective observational study. The incidence of OASIs was evaluated in our population after OVB performed with the vacuum extractor, during which the execution of episiotomy was performed indicated by clinician in charge. Results: OASIs occurred in 4% of the patients (n = 20). Episiotomy was performed in 39% of them (n = 181). OASIs incidence was 6% (n = 17) in the No Episiotomy and 1.8% (n = 3) in Episiotomy group (p<.001). Performance of episiotomy during OVB determined a protective effect against OASIs (p = 0.025 in full cohort and p = 0.013 in the primiparous group). An expulsive phase under one hour was an almost significant protective factor (p = 0.052). Conclusions: The use of episiotomy during OVB was associated with much lower OASIs rates in nulliparous women with a vacuum extraction; OR 0.23 (CI 95% 0.07-0.81) p = 0.037 in nulliparous women and the number necessary to treat was 18 among nulliparous women to prevent 1 OASIs. A further risk factor that emerged from the analysis is a prolonged expulsive period, whereas fundal pressure does not seem to have a statistically significant influence.

Failed vacuum and preterm delivery risk in the subsequent pregnancy: a multicenter retrospective cohort study

Second-stage cesarean delivery is associated with subsequent preterm delivery. Failed vacuum-assisted delivery is a subgroup of second-stage cesarean delivery in which the fetal head is engaged deeper in the pelvis and, thus, is associated with an increased risk of short-term maternal complications. This study aimed to investigate the maternal and neonatal outcomes of women at their subsequent delivery after a second-stage cesarean delivery with failed vacuum-assisted extraction vs after a second-stage cesarean delivery without a trial of vacuum-assisted extraction. This was a multicenter retrospective cohort study. The study population included all women in their subsequent pregnancy after a second-stage cesarean delivery who delivered in all university-affiliated obstetrical centers (n=4) in a single geographic area between 2003 and 2021. Maternal and neonatal outcomes of women who had second-stage cesarean delivery after a failed vacuum-assisted delivery were compared with women who had second-stage cesarean delivery without a trial of vacuum-assisted delivery. The primary outcome of this study was preterm delivery at <37 weeks of gestation. The secondary outcomes were vaginal birth rate and other adverse maternal and neonatal outcomes. Univariate analysis was followed by multiple logistic regression modeling. During the study period, 1313 women met the inclusion criteria, of whom 215 (16.4%) had a history of failed vacuum-assisted delivery at the previous delivery and 1098 (83.6%) did not. In univariate analysis, women with previously failed vacuum-assisted delivery had similar preterm delivery rates (<37, <34, <32, and <28 weeks of gestation), a successful trial of labor after cesarean delivery rates, uterine rupture, and hysterectomy. However, multivariable analyses controlling for confounders showed that a history of failed vacuum-assisted delivery is associated with a higher risk of preterm delivery at <37 weeks of gestation (adjusted odds ratio, 2.05; 95% confidence interval, 1.11-3.79; P=.02), but not with preterm delivery at <34 or <32 weeks of gestation. Among women with a previous second-stage cesarean delivery, previously failed vacuum-assisted delivery was associated with an increased risk of preterm delivery at <37 weeks of gestation in the subsequent birth.

Is epidural analgesia an independent risk factor for OASIS? A population-based cohort study.

To evaluate whether epidural analgesia is an independent risk factor for OASIS. A population-based cohort study including all women who delivered by spontaneous vaginal delivery or by instrumental delivery beyond 24 weeks gestation was conducted. Deliveries occurred between 1988 and 2016 at a large university tertiary medical center. Women with multiple gestations and those lacking prenatal care were excluded from the analysis. During the study period, 252,542 women delivered at the Soroka University Medical Center and met the inclusion criteria. Of these, 583 (0.23%) were diagnosed with OASIS. Women with OASIS were more likely to be younger, nulliparous, with suspected fetal macrosomia, had higher rates of labor induction and vacuum extraction delivery, higher rates of conceiving after infertility treatments, more advanced gestational age at delivery, higher mean birth weight, higher rates of post-partum hemorrhage and need for blood transfusions. Use of epidural analgesia during pregnancy was significantly high among the OASIS group. Rates of episiotomy were not significantly different between the groups. Using a multimodal logistic regression model, after controlling for vacuum delivery, large for gestational age, nulliparity, gestational age, ethnicity, maternal age, induction of labor, fertility treatments, non-reassuring fetal heart rate and non-progressive second stage of labor, epidural analgesia was found to be significantly associated with OASIS. Epidural analgesia was found to be an independent risk factor for OASIS in our population.

Maternal and fetal outcomes in women undergoing induction of labor with low dose vaginal misoprostol.

To determine Maternal and Fetal outcome in women undergoing induction of labour with low dose misoprostol. A cross-sectional study was carried out to determine the efficacy of Misoprostol for induction of labor (IOL) in MTI, Lady Reading Hospital (LRH), Peshawar from 21st January to 31st December 2021. All pregnant women with singleton pregnancy and cephalic presentation admitted for Induction of Labor were included in the study. Maternal and Fetal outcome was noted. Induction of labor was started with 25 micrograms of Misoprostol, repeated every six hours depending on Bishop Score. Three hundred and thirty-seven women were included in this study. The majority of females (76%) were in 18-35 years age group. In 92.3% of females, the Bishop score was less than six. The maximum number of females (33.5%) delivered after eight hours of IOL. Sixty-six (66.46%) of females had gestational age of 37-40 weeks. Premature rupture of membranes was the most common indication (32.9%). Three doses of misoprostol were required in 31.2% of females. Only 5.6% of females required six doses of misoprostol for induction. With Misoprostol 85.1% of females delivered spontaneously, 2.37% required forceps delivery, 1.7% required vacuum delivery, and 10.68% delivered by Caesarean Section. APGAR score was 8 /10 in 84% of neonates at birth. Eighty-seven %(87.8%) of neonates did not require NICU admission. Misoprostol is a safe medicine to be used to induce labor in females. It can help shorten the duration of labor, with good fetomaternal outcome.

Re-evaluation of modifiable risk factors for obstetric anal sphincter injury in a real-world setting.

The objective was to identify modifiable risk factors for obstetric anal sphincter injury (OASI) in primiparous women. This was a retrospective cohort study of primiparous women with a singleton vaginal delivery. Main outcome measures were incidence of OASI and odds ratios for possible risk factors: maternal age, body mass index and height, fetal birthweight and head circumference, gestational age, epidural analgesia, mediolateral episiotomy, and instrumental deliveries. Univariate and multivariate logistic regressions were performed using forward methods for variable selection. Of 19,786 primiparous women with a singleton vaginal delivery, 369 sustained an OASI (1.9%). Risk factors were identified: vacuum extraction (adjusted OR 2.06, 95% CI, 1.59-2.65, p < 0.001), increased fetal weight (aOR 1.06, 95% CI, 1.02-1.11, p = 0.002, per 100-g increments); head circumference (aOR 1.24, 95% CI, 1.13-1.35, p < 0.001, per 1-cm increments); gestational week (aOR 1.11, 95% CI, 1.02-1.2, p = 0.012, per week). Protective factors: mediolateral episiotomy (aOR 0.75, 95% CI, 0.59-0.94, p = 0.013) particularly in vacuum deliveries (aOR 0.50, 95% CI, 0.29-0.97, p = 0.040); epidural analgesia (aOR 0.64, 95% CI, 0.48-0.84, p = 0.001); maternal height ≥157 cm (aOR 0.97, 95% CI, 0.96-0.98, p = 0.006, risk decreases by 2.6% per 1 cm increase in height). Mediolateral episiotomy was protective against OASI in both spontaneous and instrumental deliveries of primiparae. Increased fetal weight and large fetal head circumference, particularly in short women, were significant risk factors. These findings support the performance of ultrasound to acquire updated fetal measures before admission to the labor ward.

Unique dielectric dispersion induced ultra-broadband microwave absorption of tellurium doped black phosphorus nanoflakes/aramid nanofibers/carbonyl iron nanopowders ultra-lightweight aerogel

With the development of microwave technology and the widespread use of high-frequency electronic equipment, electromagnetic pollution is becoming increasingly serious. The research and development of electromagnetic protection technology and lightweight broadband microwave absorption materials are urgent. In this work, the lightweight and porous tellurium-doped black phosphorus nanoflakes/aramid nanofibers/carbonyl iron nano-powder aerogel (TBAC) was prepared by vacuum extraction and freezing drying method. The low conductivity of TBAC aerogel exhibited a unique dielectric dispersion phenomenon, where the imaginary part of the permittivity spectrum displayed a strong resonance peak. It resulted in the wavelength of the microwave inside the medium no longer decreasing monotonically with frequency, providing new ideas for expanding the microwave absorption bandwidth. Strong magnetic carbonyl iron nanopowders were devoted to adjust the impedance characteristics of the composites by changing the content, achieving strong absorption. Aramid nanofibers were used to prepare porous aerogel, and acted as an adhesive instead of paraffin. Porous aerogel realized the material ultra-lightweight (0.02–0.043 g/cm3), while enhancing the polarization of the medium, as well as the multiple reflection of microwaves. By uniformly dispersing Te-BP and carbonyl iron in ANF aerogel, TBAC-1-3 aerogel exhibited the minimum reflection loss (RLmin) of −55.1 dB and an effective absorption bandwidth (EAB) of 6.55 GHz with the thickness of 1.7 mm. Additionally, the ultra-broadband EAB of 8.46 GHz under single thickness of 1.9 mm was obtained. Therefore, the ultra-lightweight TBAC aerogel offer a high-performance solution for ultra-broadband microwave absorption.

Screening the Chemical Composition and Bioactivity of Cerasus serrulata Flower Extracts Using Two Extraction Methods

Background Cerasus serrulata has an excellent antioxidative, antibacterial, and anti-alopecia effect, but its active ingredients and the underlying mechanism are currently unclear, in addition to the fact that the active products vary with the extraction methods. Aim Therefore, this study aims to clarify the active components and antioxidative property of C. serrulata extracted by two different methods (low-temperature vacuum extraction and ethanol extraction) and explore its potential biofunction. Materials and Methods First, the compositions in extracts were characterized by gas chromatographic mass spectrometry (GC-MS) and liquid chromatography-mass spectrography (LC-MS). Then, the antioxidative activity of both extracts was evaluated using free radical scavenging assay (ABTS) and ORAC. Next, the antibacterial activity of both extracts was measured via a bacteriostatic circle experiment. The anti-alopecia effects of both extracts were studied using a mouse model of alopecia. The hematoxylin and eosin (H&amp;E) staining was used to evaluate hair follicles; vascular endothelial-derived growth factor (VEGF) and interleukin-6 (IL-6) expression in mouse skin were evaluated by immunohistochemistry, while β-catenin expression in tissues was used by immunofluorescence. The expression of FGFR and insulin-like growth factor 1 (IGF-1) in the skin was determined to evaluate using real-time quantitative polymerase chain reaction (RT-qPCR). The levels of DHT and 5α-reductase in the experimental mice were determined by ELISA. Results The GC-MS analysis results showed that the extracts were rich in alkanes and aromatic compounds, specifically benzaldehyde, which was the highest component in the cold vacuum extraction, while pipecolic acid was the main component in the ethanol extract. This indicates that C. serrulata has components that exhibit strong inhibitory ability against the growth of five common bacterial strains, expressing excellent free radical scavenging ability. In addition, the active ingredients in C. serrulata were found to significantly deregulate the protein levels in the skin of androgenetic alopecia (AGA) mice, with the levels of IL-6. They were also able to significantly inhibit VEGF reduction. The β-catenin was being significantly upregulated in skin tissue. In addition, FGFR and IGF-1 gene expression also increased. The 5α-reductase and dihydrotestosterone (DHT) can be reduced in the C. serrulata treatment. Conclusion Our data indicate that C. serrulata extract could be beneficial supplements of natural antioxidative, antibacterial, and anti-alopecia agents.

Hydrogen Permeability of Tectosilicate Glasses for Tank Barrier Liners

The permeation of hydrogen gas was studied in meta-aluminous (tectosilicate) glass powders of Li2O×Al2O3×SiO2 (LAS), Na2O×Al2O3×SiO2 (NAS) and MgO×Al2O3×SiO2 (MAS) systems by pressure loading and vacuum extraction in the temperatures range 210–310 °C. With this method, both the solubility S and the diffusivity D were determined, while the permeability was given by the product SD. For all glasses, S was found to decrease with temperature, while D increased. Since the activation energy of diffusion of H2 molecules exceeded that of dissolution, permeation increased slightly with temperature. When extrapolated to standard conditions (25 °C), the permeability of tectosilicate glasses was found to be only 10-22–10-24 mol H2 (m s Pa)-1, which is 8–10 magnitudes lower than most polymers. Thin glass liners of these compositions are expected to be the most effective barrier for tanks of pressurised hydrogen.