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Pregnancy simulation

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https://www.readbyqxmd.com/read/29776399/simulation-based-power-calculations-for-planning-a-two-stage-individual-participant-data-meta-analysis
#1
Joie Ensor, Danielle L Burke, Kym I E Snell, Karla Hemming, Richard D Riley
BACKGROUND: Researchers and funders should consider the statistical power of planned Individual Participant Data (IPD) meta-analysis projects, as they are often time-consuming and costly. We propose simulation-based power calculations utilising a two-stage framework, and illustrate the approach for a planned IPD meta-analysis of randomised trials with continuous outcomes where the aim is to identify treatment-covariate interactions. METHODS: The simulation approach has four steps: (i) specify an underlying (data generating) statistical model for trials in the IPD meta-analysis; (ii) use readily available information (e...
May 18, 2018: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/29762798/a-prenatal-standardized-patient-experience-for-medical-students-on-their-family-medicine-clerkship
#2
Sarah E Stumbar, Suzanne Minor, Marquita Samuels
BACKGROUND AND OBJECTIVES: Students on their family medicine clerkship at Herbert Wertheim College of Medicine get little clinical exposure to obstetric care, which is not commonly provided by family physicians in urban settings. To address this, we added to our clerkship didactic curriculum a 2-hour session involving a standardized patient (SP). The SP is collectively interviewed by the student group during four simulated prenatal visits, each of which present a different complication of pregnancy...
May 2018: Family Medicine
https://www.readbyqxmd.com/read/29761047/a-survey-of-the-views-and-capabilities-of-community-pharmacists-in-western-australia-regarding-the-rescheduling-of-selected-oral-antibiotics-in-a-framework-of-pharmacist-prescribing
#3
Fatima Sinkala, Richard Parsons, Bruce Sunderland, Kreshnik Hoti, Petra Czarniak
Background: Antibiotic misuse in the community contributes to antimicrobial resistance. One way to address this may be by better utilizing community pharmacists' skills in antibiotic prescribing. The aims of this study were to examine the level of support for "down-scheduling" selected antibiotics and to evaluate factors determining the appropriateness of community pharmacist prescribing for a limited range of infections, including their decision to refer to a doctor. Methods: Self-administered questionnaires, including graded case vignette scenarios simulating real practice, were sent to Western Australian community pharmacists...
2018: PeerJ
https://www.readbyqxmd.com/read/29757875/surgery-and-platinum-etoposide-based-chemotherapy-for-the-treatment-of-epithelioid-trophoblastic-tumor
#4
Janelle Sobecki-Rausch, Abigail Winder, Kruti P Maniar, Anna V Hoekstra, Emily Berry, Karen Novak, John R Lurain
OBJECTIVE: Epithelioid trophoblastic tumor (ETT) is a rare variant of gestational trophoblastic neoplasia that develops from chorionic-type intermediate trophoblast, simulates carcinoma, presents years after a pregnancy event, is associated with low or normal human chorionic gonadotropin levels, and is relatively resistant to chemotherapy. Our aim was to identify the role of surgery in combination with platinum/etoposide-based chemotherapy in the management of both localized and metastatic ETT...
May 4, 2018: International Journal of Gynecological Cancer
https://www.readbyqxmd.com/read/29752117/antifertility-effectiveness-of-a-novel-copper-containing-intrauterine-device-material-and-its-influence-on-the-endometrial-environment-in-rats
#5
Shifu Hu, Yingying Wang, Dandan Ke, Fang Zhou, Guiping Cheng, Wei Xia, Changhong Zhu
This study was designed to investigate the antifertility effectiveness of a novel copper-containing intrauterine device material containing a composite of micro-copper (Cu), low-density polyethylene (LDPE), and methyl vinyl silicone rubber (MVQ) and its effects on the endometrial environment in rats. The contraceptive effectiveness was examined 12 days after pregnancy. The pathological changes; factors associated with bleeding, pain, and inflammation in the endometrium; and the surface condition of the implants were investigated after insertion for 90 days...
August 1, 2018: Materials Science & Engineering. C, Materials for Biological Applications
https://www.readbyqxmd.com/read/29736154/decreased-il-33-production-contributes-to-trophoblast-cell-dysfunction-in-pregnancies-with-preeclampsia
#6
Hong Chen, Xiaobo Zhou, Ting-Li Han, Philip N Baker, Hongbo Qi, Hua Zhang
Preeclampsia (PE) is a life-threatening pregnancy complication which is related to aggradation of risk regarding fetal and maternal morbidity and mortality. Dysregulation of systemic inflammatory response and dysfunction of trophoblast cells have been proposed to be involved in the development and progression of PE. Some studies have demonstrated that interleukin-33 (IL-33) is an immunomodulatory cytokine that is associated with the immune regulation of tumor cells. However, little is known whether IL-33 and its receptor ST2/IL-1 R4 could regulate trophoblast cells, which are associated with the pathogenesis of PE...
2018: Mediators of Inflammation
https://www.readbyqxmd.com/read/29701187/-effects-of-7-difluoromethy-5-4-dimethoxygenistein-on-stress-urinary-incontinence-model-in-rats-and-its-mechanisms
#7
Aiqiong Tang, Jun Luo
To investigate the effects of 7-difluoromethy-5, 4'-dimethoxygenistein (DFMG) on stress urinary incontinence (SUI) model in Sprague Dawley (SD) rats and its possible mechanisms.
 Methods: SD rat model of SUI was established through simulating pregnancy, birth trauma and ovarian castration. The rats were divided into a normal control group, a SUI group, and a DFMG group at 10 or 20 mg/kg. They were treated with 10 mg/kg normal saline (NS), 10 mg/kg NS, 10 mg/kg DFMG and 20 mg/kg DFMG, respectively, via gastric gavage every other day...
March 28, 2018: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
https://www.readbyqxmd.com/read/29694344/elective-induction-of-labor-at-39-weeks-among-nulliparous-women-the-impact-on-maternal-and-neonatal-risk
#8
Rachel G Sinkey, Jasmin Lacevic, Tea Reljic, Iztok Hozo, Kelly S Gibson, Anthony O Odibo, Benjamin Djulbegovic, Charles J Lockwood
OBJECTIVE: Optimal management of pregnancies at 39 weeks gestational age is unknown. Therefore, we sought to perform a comparative effectiveness analysis of elective induction of labor (eIOL) at 39 weeks among nulliparous women with non-anomalous singleton, vertex fetuses as compared to expectant management (EM) which included IOL for medical or obstetric indications or at 41 weeks in undelivered mothers. MATERIALS AND METHODS: A Monte Carlo micro-simulation model was constructed modeling two mutually exclusive health states: eIOL at 39 weeks, or EM with IOL for standard medical or obstetrical indications or at 41 weeks if undelivered...
2018: PloS One
https://www.readbyqxmd.com/read/29691766/characterization-of-the-hemodynamic-wall-shear-stresses-in-human-umbilical-vessels-from-normal-and-intrauterine-growth-restricted-pregnancies
#9
Shier Nee Saw, Yu Wei Poh, Dawn Chia, Arijit Biswas, Citra Nurfarah Zaini Mattar, Choon Hwai Yap
Significant reductions in blood flow and umbilical diameters were reported in pregnancies affected by intrauterine growth restriction (IUGR) from placental insufficiency. However, it is not known if IUGR umbilical blood vessels experience different hemodynamic wall shear stresses (WSS) compared to normal umbilical vessels. As WSS is known to influence vasoactivity and vascular growth and remodeling, which can regulate flow rates, it is important to study this parameter. In this study, we aim to characterize umbilical vascular WSS environment in normal and IUGR pregnancies, and evaluate correlation between WSS and vascular diameter, and gestational age...
April 24, 2018: Biomechanics and Modeling in Mechanobiology
https://www.readbyqxmd.com/read/29680650/feeding-increasing-amounts-of-ruminally-protected-choline-decreased-fatty-liver-in-nonlactating-pregnant-holstein-cows-in-negative-energy-status
#10
M G Zenobi, T L Scheffler, J E Zuniga, M B Poindexter, S R Campagna, H F Castro Gonzalez, A T Farmer, B A Barton, J E P Santos, C R Staples
The objectives were to determine the optimal feeding amount of choline in a ruminally protected form to reduce the triacylglycerol (TAG) concentration in liver and to increase TAG in blood plasma of dairy cows. Pregnant, nonlactating multiparous Holstein cows (n = 77) were blocked by body condition score (3.59 ± 0.33) and assigned to treatment at 64 ± 10 d before calculated calving date. Dietary treatments were top-dressing of 0, 30, 60, 90, or 120 g/d of ruminally protected choline (RPC; Balchem Corp., New Hampton, NY) ions to supply the equivalent of 0, 6...
April 18, 2018: Journal of Dairy Science
https://www.readbyqxmd.com/read/29590129/humanin-hn-and-glucose-transporter-8-glut8-in-pregnancies-complicated-by-intrauterine-growth-restriction
#11
Carla Janzen, Margarida Y Y Lei, Il Seok D Jeong, Amit Ganguly, Peggy Sullivan, Vladislava Paharkova, Gina Capodanno, Hiromi Nakamura, Alix Perry, Bo-Chul Shin, Kuk-Wha Lee, Sherin U Devaskar
BACKGROUND: Intrauterine growth restriction (IUGR) results from a lack of nutrients transferred to the developing fetus, particularly oxygen and glucose. Increased expression of the cytoprotective mitochondrial peptide, humanin (HN), and the glucose transporter 8, GLUT8, has been reported under conditions of hypoxic stress. However, the presence and cellular localization of HN and GLUT8 in IUGR-related placental pathology remain unexplored. Thus, we undertook this study to investigate placental expression of HN and GLUT8 in IUGR-affected versus normal pregnancies...
2018: PloS One
https://www.readbyqxmd.com/read/29581094/prenatal-remote-monitoring-of-women-with-gestational-hypertensive-diseases-cost-analysis
#12
Dorien Lanssens, Thijs Vandenberk, Christophe Jp Smeets, Hélène De Cannière, Sharona Vonck, Jade Claessens, Yenthel Heyrman, Dominique Vandijck, Valerie Storms, Inge M Thijs, Lars Grieten, Wilfried Gyselaers
BACKGROUND: Remote monitoring in obstetrics is relatively new; some studies have shown its effectiveness for both mother and child. However, few studies have evaluated the economic impact compared to conventional care, and no cost analysis of a remote monitoring prenatal follow-up program for women diagnosed with gestational hypertensive diseases (GHD) has been published. OBJECTIVE: The aim of this study was to assess the costs of remote monitoring versus conventional care relative to reported benefits...
March 26, 2018: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/29580376/high-throughput-non-invasive-prenatal-testing-for-fetal-rhesus-d-status-in-rhd-negative-women-not-known-to-be-sensitised-to-the-rhd-antigen-a-systematic-review-and-economic-evaluation
#13
Pedro Saramago, Huiqin Yang, Alexis Llewellyn, Ruth Walker, Melissa Harden, Stephen Palmer, Susan Griffin, Mark Simmonds
BACKGROUND: High-throughput non-invasive prenatal testing (NIPT) for fetal rhesus (D antigen) (RhD) status could avoid unnecessary treatment with routine anti-D immunoglobulin for RhD-negative women carrying a RhD-negative fetus, although this may lead to an increased risk of RhD sensitisations. OBJECTIVES: To systematically review the evidence on the diagnostic accuracy, clinical effectiveness and implementation of high-throughput NIPT and to develop a cost-effectiveness model...
March 2018: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/29560809/mbrrace-in-simulation-an-evaluation-of-a-multi-disciplinary-simulation-training-for-medical-emergencies-in-obstetrics-memo
#14
Mary Lavelle, Jennifer Abthorpe, Thomas Simpson, Gabriel Reedy, Fiona Little, Anita Banerjee
The majority of maternal deaths in the UK are due to pre-existing or new-onset medical conditions, known as 'indirect deaths'. The MBRRACE report identified serious gaps in clinicians' human factors skills, including communication, leadership and teamwork, which contributed to maternal death. In response, we developed the first multi-disciplinary simulation-based training programme designed to address Medical Emergencies in Obstetrics (MEmO). Employing a mixed methods design, this study evaluated the educational impact of this training programme on the healthcare staff (n = 140), including the medical doctors (n = 91) and the midwives (n = 49)...
March 21, 2018: Journal of Obstetrics and Gynaecology: the Journal of the Institute of Obstetrics and Gynaecology
https://www.readbyqxmd.com/read/29554930/health-system-strategies-to-increase-hiv-screening-among-pregnant-women-in-mesoamerica
#15
Charbel El Bcheraoui, Paola Zúñiga-Brenes, Diego Ríos-Zertuche, Erin B Palmisano, Claire R McNellan, Sima S Desai, Marielle C Gagnier, Annie Haakenstad, Casey Johanns, Alexandra Schaefer, Bernardo Hernandez, Emma Iriarte, Ali H Mokdad
BACKGROUND: To propose health system strategies to meeting the World Health Organization (WHO) recommendations on HIV screening through antenatal care (ANC) services, we assessed predictors of HIV screening, and simulated the impact of changes in these predictors on the probability of HIV screening in Guatemala, Honduras, Mexico (State of Chiapas), Nicaragua, Panama, and El Salvador. METHODS: We interviewed a representative sample of women of reproductive age from the poorest Mesoamerican areas on ANC services, including HIV screening...
March 20, 2018: Population Health Metrics
https://www.readbyqxmd.com/read/29547881/intermittent-preventive-treatment-for-malaria-in-pregnancy-optimization-of-target-concentrations-of-dihydroartemisinin-piperaquine
#16
Rada M Savic, Prasanna Jagannathan, Richard Kajubi, Liusheng Huang, Nan Zhang, Moses Were, Abel Kakuru, Mary K Muhindo, Norah Mwebaza, Erika Wallender, Tamara D Clark, Bishop Opira, Moses Kamya, Diane V Havlir, Philip J Rosenthal, Grant Dorsey, Francesca T Aweeka
Background: Dihydroartemsinin-piperaquine is highly efficacious as intermittent preventive therapy for malaria during pregnancy (IPTp). Determining associations between piperaquine exposure, malaria risk, and adverse birth outcomes informs optimal dosing strategies. Methods: HIV-uninfected pregnant women were enrolled in a placebo-controlled trial of IPTp at 12-20 weeks gestation and randomized to: sulfadoxine-pyrimethamine every 8 weeks (n=106), dihydroartemsinin-piperaquine every 8 weeks (n=94), or dihydroartemsinin-piperaquine every 4 weeks (n=100) during pregnancy...
March 14, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29512480/knowledge-and-adherence-to-the-national-guidelines-for-malaria-diagnosis-in-pregnancy-among-health-care-providers-and-drug-outlet-dispensers-in-rural-western-kenya
#17
Christina Riley, Stephanie Dellicour, Peter Ouma, Urbanus Kioko, Ahmeddin Omar, Simon Kariuki, Zipporah Ng'ang'a, Meghna Desai, Ann M Buff, Julie R Gutman
Prompt diagnosis and effective treatment of acute malaria in pregnancy (MiP) is important for the mother and fetus; data on health-care provider adherence to diagnostic guidelines in pregnancy are limited. From September to November 2013, a cross-sectional survey was conducted in 51 health facilities and 39 drug outlets in Western Kenya. Provider knowledge of national diagnostic guidelines for uncomplicated MiP were assessed using standardized questionnaires. The use of parasitologic testing was assessed in health facilities via exit interviews with febrile women of childbearing age and in drug outlets via simulated-client scenarios, posing as pregnant women or their spouses...
May 2018: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/29471802/the-short-term-economic-burden-of-gestational-diabetes-mellitus-in-italy
#18
Michela Meregaglia, Livia Dainelli, Helen Banks, Chiara Benedetto, Patrick Detzel, Giovanni Fattore
BACKGROUND: The incidence of Gestational Diabetes Mellitus (GDM) is rising in all developed countries. This study aimed at assessing the short-term economic burden of GDM from the Italian healthcare system perspective. METHODS: A model was built over the last pregnancy trimester (i.e., from the 28th gestational week until childbirth included). The National Hospital Discharge Database (2014) was accessed to estimate delivery outcome probabilities and inpatient costs in GDM and normal pregnancies (i...
February 23, 2018: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29467596/cost-effectiveness-of-antiviral-prophylaxis-during-pregnancy-for-the-prevention-of-perinatal-hepatitis-b-infection-in-south-korea
#19
Donghoon Lee, Hyun-Young Shin, Sang Min Park
Background: In Korea, hepatitis B virus (HBV) infection accounts for approximately 65-75% of HBV-related diseases, such as chronic hepatitis and liver cancer, and mother-to-child transmission is presumed to be a major source of the infection. To tackle this issue, the Korean government launched the national Perinatal Hepatitis B Prevention Program (PHBPP) in 2002. This study analyzed the cost-effectiveness of the PHBPP with antiviral prophylaxis compared with the current PHBPP and/or universal vaccination, as well as identified the optimal strategy to eliminate mother-to-child transmission of HBV in Korea...
2018: Cost Effectiveness and Resource Allocation: C/E
https://www.readbyqxmd.com/read/29463201/effectiveness-of-gonacon-as-an-immunocontraceptive-in-colony-housed-cats
#20
Amy Fischer, Valerie Aw Benka, Joyce Briggs, Marc-Antoine Driancourt, Joanne Maki, Darcy So Mora, Kevin Morris, Kayla A Myers, Linda Rhodes, Lindsey M Vansandt, George Robert Weedon, Julie Wolf, Julie K Levy
Objectives Non-surgical contraceptive management of free-roaming cat populations is a global goal for public health and humane reasons. The objectives of this study were to measure the duration of contraception following a single intramuscular injection of a gonadotropin-releasing hormone-based vaccine (GonaCon) and to confirm its safe use in female cats living in colony conditions. Methods GonaCon (0.5 ml/cat) was administered intramuscularly to 20 intact female cats (queens), and saline was administered to 10 queens serving as sham-treated controls...
February 1, 2018: Journal of Feline Medicine and Surgery
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