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Alan J Rosenbaum, Rachel M Smith, Erinn M Hade, Ashish Gupta, Alper Yilmaz, Michael Cackovic
INTRODUCTION: Fetal heart rate monitoring presents one of the few available methods for evaluating the fetus prior to birth. However, current devices on the market have significant shortcomings. We sought to describe the use and experiences with external fetal monitoring (EFM) devices among obstetrical providers. MATERIALS AND METHODS: We performed a cross-sectional survey in an academic medical center between April and July 2017 including nurse, midwife, and physician obstetrical providers (n = 217) who were invited to participate in this study regarding their experiences with the external fetal monitoring (EFM) device utilized by their hospital system in the outpatient, inpatient, and labor and delivery (L&D) settings...
December 12, 2018: Journal of Maternal-fetal & Neonatal Medicine
Kirsten Wisner, Carrie Holschuh
The use of intermittent auscultation (IA) for fetal surveillance during labor decreased with the introduction of electronic fetal monitoring (EFM). The increased use of EFM is associated with an increase in cesarean births. IA is an evidence-based method of fetal surveillance during labor for women with low risk pregnancies and considered one component of comprehensive efforts to reduce the primary cesarean rate and promote vaginal birth. Many clinicians are not familiar with IA practice. This practice monograph includes information on IA techniques; interpretation and documentation; clinical decision-making and interventions; communication; education, staffing, legal issues, and strategies to promote implementation of IA into practice...
December 2018: Nursing for Women's Health
Mohammad Maghsoudi-Ganjeh, Liqiang Lin, Xiaodu Wang, Xiaowei Zeng
Bone ultrastructure at sub-lamellar length scale is a key structural unit in bone that bridges nano- and microscale hierarchies of the tissue. Despite its influence on bulk response of bone, the mechanical behavior of bone at ultrastructural level remains poorly understood. To fill this gap, in this study, a two-dimensional cohesive finite element model of bone at sub-lamellar level was proposed and analyzed under tensile and compressive loading conditions. In the model, ultrastructural bone was considered as a composite of mineralized collagen fibrils (MCFs) embedded in an extrafibrillar matrix (EFM) that is comprised of hydroxyapatite (HA) polycrystals bounded via thin organic interfaces of non-collagenous proteins (NCPs)...
November 23, 2018: Biomechanics and Modeling in Mechanobiology
David W Britt, Mark I Evans, Barry S Schifrin, Robert D Eden
Electronic fetal monitoring (EFM) is a poor predictor of outcomes attributable to delivery problems. Contextualizing EFM by adding maternal, obstetrical, and fetal risk-related information to create an index called the Fetal Reserve Index (FRI) improves the predictive capacity and facilitates the timing of interventions. Here, we test critical assumptions of FRI as a clinical tool. Our conceptualization implies that the earlier one reaches the red zone (FRI ≤25) and the longer one spends in the red zone, the greater the likelihood of emergency operative deliveries (EOD)...
November 21, 2018: Fetal Diagnosis and Therapy
José F Hidalgo, Jose A Egea, Francisco Guil, José M García
BACKGROUND: Although cellular metabolism has been widely studied, its fully comprehension is still a challenge. A main tool for this study is the analysis of meaningful pieces of knowledge called modes and, in particular, specially interesting classes of modes such as pathways and Elementary Flux Modes (EFMs). Its study often has to deal with issues such as the appearance of infeasibilities or the difficulty of finding representative enough sets of modes that are free of repetitions. Mode extraction methods usually incorporate strategies devoted to mitigate this phenomena but they still get a high ratio of repetitions in the set of solutions...
November 20, 2018: BMC Systems Biology
Alessio Petrozziello, Ivan Jordanov, T Aris Papageorghiou, W G Christopher Redman, Antoniya Georgieva
Continuous electronic fetal monitoring (EFM) is used worldwide to visually assess whether a fetus is exhibiting signs of distress during labor, and may benefit from an emergency operative delivery (e.g. Cesarean section). Previously, computerized EFM assessment that mimics clinical experts showed no benefit in randomized clinical trials. However, as an example of routinely collected `big' data, EFM interpretation should benefit from data-driven computational approaches, such as deep learning, which allow automated evaluation based on large clinical datasets...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Kristen Nguyen, Elizabeth Bamgbose, Brian P Cox, Sean P Huang, Andrzej Mierzwa, Susie Hutchins, Brand Caso, Martin Culjat, Cynthia Connelly, D Yvette Lacoursiere, Rahul S Singh
Electronic fetal monitoring (EFM) is used widely during labor & delivery, but existing solutions limit patient mobility, are uncomfortable, and do not consistently capture fetal heart rate (FHR) and uterine activity (UA) signals. A wireless EFM system was developed that features wearable US and tocodynamometer devices that conform to the body and do not require cables or belts. Benchtop testing demonstrated that the devices can accurately and consistently measure simulated FHRs and UAs over clinically meaningful ranges and body curvatures...
July 2018: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Peng Wen, Teng-Gen Hu, Lin Li, Min-Hua Zong, Hong Wu
The antioxidant quercetin (Q) is a bioactive compound that can inhibit colon cancer. However, its poor stability in the upper gastro-intestinal tract and low bioavailability compromised its benefits. In this study, a biopolymer-based colon-specific delivery system for Q was constructed by co-axial electrospinning. Quercetin-loaded chitosan nanoparticles (QCNP) were firstly prepared and characterized. Then, a Q-loaded electrospun fiber mat (Q-loaded EFM) containing prebiotics (galactooligosaccharide, GOS) was fabricated using sodium alginate as the shell layer and the abovementioned QCNP and prebiotics as the core layer...
November 14, 2018: Food & Function
Janine S Rhoades, Molly J Stout, George A Macones, Alison G Cahill
OBJECTIVE:  To estimate the effect of oligohydramnios on fetal heart rate (FHR) patterns in patients undergoing induction of labor (IOL) at term. STUDY DESIGN:  Secondary analysis of a prospective cohort study of consecutive term, singleton deliveries from 2010 to 2015. We included all patients who underwent IOL. Our primary outcomes were electronic fetal monitoring (EFM) characteristics in the 2 hours preceding delivery. Outcomes were compared between those induced with oligohydramnios and those induced without a diagnosis of oligohydramnios...
October 29, 2018: American Journal of Perinatology
Kıymet Yeşilçiçek Çalik, Özlem Karabulutlu, Canan Yavuz
BACKGROUND: Interventions can be lifesaving when properly implemented but can also put the lives of both mother and child at risk by disrupting normal physiological childbirth when used indiscriminately without indications. Therefore, this study was performed to investigate the effect of frequent interventions during labor on maternal satisfaction and to provide evidence-based recommendations for labor management decisions. METHODS: The study was performed in descriptive design in a state hospital in Kars, Turkey with 351 pregnant women who were recruited from the delivery ward...
October 24, 2018: BMC Pregnancy and Childbirth
A V Deryugina, E A Antipenko
AIM: To study an impact of cytoflavin on the functional state of erythrocytes in patients with Charcot - Marie - Toota disease (CMTD). MATERIAL AND METHODS: Thirty patients with CMTD were examined. The main group (n=17) received cytoflavin along with basic therapy (intravenously dropwise 10 ml per 200 ml of 5% glucose solution for 10 days). The comparison group (n=13) received only basic therapy. Functional parameters of erythrocytes, including electrophoretic mobility of erythrocytes (EFME), concentration of malonic dialdehyde (MDA), content of ATP and 2...
2018: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
Yoshihito Takano, Yuji Tomaru, Keizo Nagasaki
HcDNAV (a type species of Genus Dinodnavirus ) is a large double-stranded DNA virus, which lytically infects the bloom-forming marine microalga Heterocapsa circularisquama Horiguchi (Dinophyceae). In the present study, detailed observation of the HcDNAV particle and its infection process was conducted via field emission scanning electron microscopy (FE-SEM) and epifluorescence microscopy (EFM). Each five-fold vertex of the icosahedral virion was decorated with a protrusion, which may be related to the entry process of HcDNAV into the host...
October 11, 2018: Viruses
Weidong Zhao, Wei Cui, Shujun Xu, Yuanyuan Wang, Ke Zhang, Deyu Wang, Ling-Zhi Cheong, Flemming Besenbacher, Cai Shen
Charge transfer plays fundamental roles in information transmission in cells, especially in neurons. To date, direct observation of charge propagation in neurons at nanometer level has not been achieved yet. Herein, a combined charge injection and Electrostatic Force Microscopy (EFM) detection approach is applied to directly study charge propagation and distribution at nanometer resolution in spines and synapses of hippocampal neurons. Charge density, charge mobility and membrane potential in neural signal transmission process through the spines of axons and dendrites of hippocampal neurons were investigated quantitatively...
January 2019: Ultramicroscopy
Robert D Eden, Mark I Evans, David W Britt, Shara M Evans, Barry S Schifrin
OBJECTIVE: The cardiotocograph (CTG) or electronic fetal monitoring (EFM) was developed to prevent fetal asphyxia and subsequent neurological injury. From a public health perspective, it has failed these objectives while increasing emergency operative deliveries (emergency operative deliveries (EODs) - emergency cesarean delivery or operative vaginal delivery) for newborns, who in retrospect, actually did not require the assistance. EODs increase the risks of complications and stress for patients, families, and medical personnel...
October 1, 2018: Journal of Maternal-fetal & Neonatal Medicine
Benazir Huma, Sudip Kundu, Mark G Poolman, Nicholas J Kruger, David A Fell
Analysis of the impact of photorespiration on plant metabolism is usually based on manual inspection of small network diagrams. Here we create a structural metabolic model that contains the reactions that participate in photorespiration in the plastid, peroxisome, mitochondrion and cytosol, and the metabolite exchanges between them. This model was subjected to elementary flux modes analysis, a technique that enumerates all the component, minimal pathways of a network. Any feasible photorespiratory metabolism in the plant will be some combination of the elementary flux modes (EFMs) that contain the Rubisco oxygenase reaction...
September 26, 2018: Plant Journal: for Cell and Molecular Biology
Habiba Kapaya, Roslyn Williams, Grace Elton, Dilly Anumba
Background: Despite major advances in perinatal medicine, intrapartum asphyxia remains a leading and potentially preventable cause of perinatal mortality and long-term morbidity. The umbilical cord pH is considered an essential criteria for the diagnosis of acute intrapartum hypoxic events. The purpose of this study was to evaluate whether obstetric risk factors are associated with fetal acidaemia at delivery. Methodology: In a case-control study, 294 women with term singleton pregnancies complicated by an umbilical artery cord pH < 7...
2018: Journal of Pregnancy
David Hochberg, Josep M Ribó
We use stoichiometric network analysis (SNA) to obtain a flux-based approach for the evaluation and description of the entropy production and exchange for chemical reactions in open systems. For non-equilibrium stationary states (NESS) the production and exchange are expressed as functions over the convex cone of the stationary reaction rates, revealing the reaction pathways and elementary flux modes (EFM) responsible for both entropy production and balance. The analysis of the entropy production of EFMs leads to a unique description of the contribution of the coupling between linear or cyclic reaction network paths, and the fluxes due to the matter exchange of the system with the system's surroundings...
September 19, 2018: Physical Chemistry Chemical Physics: PCCP
Peng Wen, Min-Hua Zong, Teng-Gen Hu, Lin Li, Hong Wu
To improve the oral bioavailability of quercetin (Q) and achieve colon-specific release, a core-sheath electrospun fiber mat containing Q-loaded chitosan nanoparticle (Q-loaded EFM) was developed in this study. The nanoparticle was first fabricated, and its antioxidant activity was as effective as free Q. Then the uniform Q-loaded EFM was obtained using response surface methodology optimization, and its core-sheath structure was characterized by confocal laser scanning microscopy. In vitro release kinetics confirmed the colon targeting profile, and the release rate of Q varied inversely with fiber diameter...
November 7, 2018: Journal of Agricultural and Food Chemistry
Thomas Arn Hansen, Martin Schou Pedersen, Lone Gilmor Nielsen, Chih Man German Ma, Lillian Marie Søes, Peder Worning, Christian Østergaard, Henrik Westh, Mette Pinholt, Kristian Schønning
Background: Primary screening for VRE with PCR directed against vanA allowed identification of vanA+ samples from which VRE could not be isolated when selective culture methods were used. From such a sample a vancomycin-susceptible, vanA+ Enterococcus faecium, Efm-V1511, was isolated, when vancomycin selection was not used during culture. Similar isolates with variable susceptibility to vancomycin were obtained in the following months. Objectives: To characterize Efm-V1511 and investigate the causes of variable susceptibility to vancomycin...
August 2, 2018: Journal of Antimicrobial Chemotherapy
Moses M Solomon, Saviour A Umoren, Ime B Obot, Ahmad A Sorour, Husnu Gerengi
The possibility of utilizing dextran as a green corrosion inhibitor for steel in strong acid environment was explore using weight loss, electrochemical (electrochemical impedance spectroscopy (EIS), electrochemical frequency modulation (EFM), potentiodynamic polarization (PDP), and linear polarization (LPR)) supported with surface analysis via scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDAX), atomic force microscopy (AFM), and X-ray photoelectron spectroscopy (XPS) techniques...
August 22, 2018: ACS Applied Materials & Interfaces
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