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This article complements the coverage of the status of women in ocean science as contained in the recently published Global Ocean Science Report 2020 – Charting capacity for ocean sustainability. Using the seven Science, Technology and Innovation Gender Objectives (STI GOs) of UNESCO's SAGA (STEM and Gender Advancement) project, it reviews available information on women's education and careers in ocean science for some of the countries with the highest numbers of ocean scientists in order to highlight STI GOs of concern. It also provides some information on resources for each STI GO to help institutions to achieve gender equality amongst their ocean science research staff. [ABSTRACT FROM AUTHOR]

Graph I It is the first week of parent-teacher conferences, and Sarah, a first-year teacher, is preparing for meetings with the families of fourth graders on her caseload. Teacher stress, specifically in special education teachers, is a leading reason why teachers are leaving the profession at an alarming rate ([2]; [3]; [16]). Further, in a qualitative study of teacher stressors, [16] found challenging parent interactions among the top reasons teachers are stressed and leaving the profession. There is a reason there are mentor teachers, department meetings, faculty meetings, teacher leaders, and numerous social media support groups for teachers. [Extracted from the article]

BACKGROUND: The dynamic role of autophagy in cancer development is a topic of considerable research and debate. Previously published studies have shown that anal cancer development can be promoted or prevented with the pharmacologic inhibition or induction, respectively, of autophagy in a human papillomavirus (HPV) mouse model. However, these results are confounded by the fact that the drugs utilized are known to affect other pathways besides autophagy. It has also been shown that autophagic inhibition occurs in the setting of HPV16 oncoprotein expression (E6 and E7) and correlates with increased susceptibility to anal carcinogenesis. MATERIALS AND METHODS: In this study, we employed a conditional, genetic, autophagic (Atg7) knockout mouse model to determine conclusively that autophagy has a role in anal cancer development, in the absence or presence of E6 and E7. RESULTS: In mice lacking both HPV16 oncogenes, knockout of autophagy followed by exposure to a carcinogen resulted in a tumor incidence of 40%, compared to 0% in mice treated with a carcinogen alone with an intact autophagic pathway (P = 0.007). In mice expressing either one or both HPV16 oncoproteins, the addition of genetic knockout of autophagy to carcinogen treatment did not lead to a significant difference in tumor incidence compared to carcinogen treatment alone, consistent with the ability of HPV oncogenes to inhibit autophagy in themselves. CONCLUSIONS: These results provide the first conclusive evidence for the distinct role of autophagy in anal carcinogenesis, and suggest that autophagy is a plausible target for therapies aimed at reducing anal dysplasia and anal cancer development. [ABSTRACT FROM AUTHOR]

Objectives: Metropolitan areas must be prepared to manage large numbers of casualties related to a major incident. Most US cities do not have adequate trauma center capacity to manage large-scale mass casualty incidents (MCIs). Creating surge capacity requires the distribution of casualties to hospitals that are not designated as trauma centers. Our objectives were to extrapolate MCI response research into operational objectives for MCI distribution plan development; formulate a patient distribution model based on research, hospital capacities, and resource availability; and design and disseminate a casualty distribution tool for use by emergency medical services (EMS) personnel to distribute patients to the appropriate level of care.Methods: Working with hospitals within the region, we refined emergency department surge capacity for MCIs and developed a prepopulated tool for EMS providers to use to distribute higher-acuity casualties to trauma centers and lower-acuity casualties to nontrauma hospitals. A mechanism to remove a hospital from the list of available resources, if it is overwhelmed with patients who self-transport to the location, also was put into place.Results: The number of critically injured survivors from an MCI has proven to be consistent, averaging 7% to 10%. Moving critically injured patients to level 1 trauma centers can result in a 25% reduction in mortality, when compared with care at nontrauma hospitals. US cities face major gaps in the surge capacity needed to manage an MCI. Sixty percent of "walking wounded" casualties self-transport to the closest hospital(s) to the incident.Conclusions: Directing critically ill patients to designated trauma centers has the potential to reduce mortality associated with the event. When applied to MCI responses, damage-control principles reduce resource utilization and optimize surge capacity. A universal system for mass casualty triage was identified and incorporated into the region's EMS. Flagship regional coordinating hospitals were designated to coordinate the logistics of the disaster response of both trauma-designated and undesignated hospitals. Finally, a distribution tool was created to direct the flow of critically injured patients to trauma centers and redirect patients with lesser injuries to centers without trauma designation. The tool was distributed to local EMS personnel and validated in a series of tabletop and functional drills. These efforts demonstrate that a regional response to MCIs can be implemented in metropolitan areas under-resourced for trauma care. [ABSTRACT FROM AUTHOR]

Data underlying the findings described in this manuscript may be obtained in accordance with AstraZeneca's data sharing policy described at https://astrazenecagrouptrials.pharmacm.com/ST/Submission/Disclosure. Lack of effect of benralizumab on signs and symptoms of moderate-to-severe atopic dermatitis: Results from the phase 2 randomized, double-blind, placebo-controlled HILLIER trial Ninety-six patients (including 26 adolescents) and 98 patients (27 adolescents) were randomized into the benralizumab and placebo groups, respectively. [Extracted from the article]

Autophagy is an intracellular, catabolic process that maintains cellular health. We examined the response of pharmacologic modulation of autophagy in an HPV mouse model of anal carcinogenesis. K14E6/E7 mice were treated with the topical carcinogen DMBA weekly and assessed for tumors over 20 weeks. Concurrently, they were given either chloroquine or BEZ235, to inhibit or induce autophagy, respectively. Time to tumor onset was examined. Immunofluorescence (IF) was performed for LC3β and p62 to examine autophagy. All DMBA treated K14E6/E7 mice developed anal cancer, contrary to zero of the no DMBA treated mice. Chloroquine plus DMBA resulted in a significant decrease in the time to tumor onset compared to K14E6/E7 treated with DMBA. Only 40% BEZ235 plus DMBA treated mice developed anal cancer. Autophagic induction with DMBA and BEZ235, and autophagic inhibition with chloroquine were confirmed via IF. Anal carcinogenesis can be inhibited or induced via pharmacologic modulation of autophagy. [ABSTRACT FROM AUTHOR]

Background This study compares the morphology and outcomes of acute retrograde type A dissections (RTADs) with acute antegrade type A dissections (ATADs), and acute type B dissections. Materials and methods From 2000 to 2016, there were 12 acute RTADs, 96 ATADs, and 92 type B dissections with available imaging. Dissections were characterized using computerized tomography angiography images. We examined clinical features, tear characteristics, and various morphologic measurements. Results Compared with acute type B dissections, RTAD primary tears were more common in the distal arch (75% versus 43%, P = 0.04), and the false-to-true lumen contrast intensity ratio at the mid-descending thoracic aorta was lower (0.46 versus 0.71, P = 0.020). RTAD had less false lumen decompression because there were fewer aortic branch vessels distal to the subclavian that were perfused through the false lumen (0.40 versus 2.19, P < 0.001). Compared with ATAD, RTAD had less root involvement where root true-to-total lumen area ratio was higher (0.88 versus 0.76, P = 0.081). Furthermore, RTAD had a lower false-to-true lumen contrast intensity ratio at the root (0.25 versus 0.57, P < 0.05), ascending aorta (0.25 versus 0.72, P < 0.001), and proximal arch (0.39 versus 0.67, P < 0.05). RTAD were more likely to undergo aortic valve resuspension (100% versus 74%, P = 0.044). Conclusions RTAD tends to occur when primary tears occur in close proximity to the aortic arch and when false lumen decompression through the distal aortic branches are less effective. Compared with ATAD, RTAD has less root involvement, and successful aortic valve resuspension is more likely. [ABSTRACT FROM AUTHOR]

Grasses, including native switchgrass (SG), can be grown on marginal land and can produce large amounts of biomass. As these grasses are perennials, they can be used as buffers to help prevent nutrients from entering watersheds, and, once established, are productive for long periods of time. Chopped SG possesses the necessary qualities needed to be a good alternative bedding: it is lightweight, highly absorbent, dries quickly, and can be used as a fertilizer. While research has demonstrated that SG is a viable alternative bedding material in pen trials, no research has reported on the long-term viability of this bedding alternative in commercial houses during multiple grow-outs. The objective of this study is to evaluate the feasibility of using SG as an alternative bedding material in commercial production houses over consecutive flocks. Three farms were used to run comparisons of pine shaving (PS) vs. SG. No significant differences in bird wt. (PS 3.87 kg, SG 3.83 kg), feed conversion (PS 2.01, SG 1.98), livability, (PS 94.31%, SG 94.81%) or foot pad quality (PS = 0.775416, SG = 0.84658) were found. Additionally, no difference in the number of Darkling beetles (Alphitobius diaperinus [panzer]) was observed. These results suggest that in areas where SG grows well, it can be used as an alternative source of poultry bedding for commercial growers. [ABSTRACT FROM AUTHOR]

Among the milestones that occur during T-cell development in the thymus is the expression of T-cell receptor-β ( TCR-β) and the formation of the pre- TCR complex. Signals emanating from the pre- TCR trigger survival, proliferation and differentiation of T-cell precursors. Although the pre- TCR is essential for these cell outcomes, other receptors, such as Notch and CXCR4, also contribute. Whether interleukin-7 ( IL-7) participates in promoting the survival or proliferation of pre- TCR-expressing cells is controversial. We used in vitro and in vivo models of T-cell development to examine the function of IL-7 in TCR-β-expressing thymocytes. Culturing TCR-β-expressing CD4− CD8− double-negative thymocytes in an in vitro model of T-cell development revealed that IL-7 reduced the frequency of CD4+ CD8+ double-positive thymocytes at the time of harvest. The mechanism for this change in the percentage of double-positive cells was that IL-7 promoted the survival of thymocytes that had not yet differentiated. By preserving the double-negative population, IL-7 reduced the frequency of double-positive thymocytes. Interleukin-7 was not required for proliferation in the in vitro system. To follow this observation, we examined mice lacking CD127 ( IL-7Rα). In addition to the known effect of CD127 deficiency on T-cell development before TCR-β expression, CD127 deficiency also impaired the development of TCR-β-expressing double-negative thymocytes. Specifically, we found that Bcl-2 expression and cell cycle progression were reduced in TCR-β-expressing double-negative thymocytes in mice lacking CD127. We conclude that IL-7 continues to function after TCR-β is expressed by promoting the survival of TCR-β-expressing double-negative thymocytes. [ABSTRACT FROM AUTHOR]

Abstract: We previously reported that higher serum concentrations of C-reactive protein (CRP) are associated with shorter survival in men with castration-resistant prostate cancer (CRPC). To confirm this finding in an independent data set, we used 119 CRPC patients enrolled in 6 phase II clinical trials and examined the relationship of CRP, alkaline phosphatase, hemoglobin, age, ECOG PS, and prostate specific antigen (PSA) with survival. Median follow-up was 19.7 months (0.9–98.5 months), and 89% have died. After analyzing the form of the risk function using the generalized additive model method, univariate and multivariate Cox proportional hazard models were used to assess associations between baseline individual categorical and continuous variables. Quartiles of CRP were: 0–1.0, 1.1–4.9, 5.0–17.0, and 17.1–311 mg/L. In a Cox multivariate model, log2 (CRP) (HR 1.106, P = 0.013) as well as hemoglobin and alkaline phosphatase were independently associated with survival, confirming that higher CRP is associated with shorter survival in CRPC. Since CRP is a marker of inflammation, this finding suggests that inflammation may play an important role in the natural history of advanced prostate cancer. CRP is a readily measurable biomarker that has the potential to improve prognostic models and should be validated in a prospective clinical trial. [Copyright &y& Elsevier]

The Gads adaptor protein is critical for TCR-mediated Ca2+ mobilization. We investigated the effect of Gads deficiency on the proliferation of CD8+ T cells following peptide stimulation and in the context of infection with an intracellular pathogen. We stimulated CD8+ T cells from Gads+/+ OT-I and Gads-/- OT-I mice with cognate Ag (SIINFEKL) or altered peptide ligand. In vitro experiments revealed that Gads was required for optimal proliferation of CD8+ T cells. This defect was most evident at the early time points of proliferation and when low doses of Ag were used as stimuli. Cell cycle analysis demonstrated that Gads-/- CD8+ T cells had impaired TCR-mediated exit from the G0 phase of the cell cycle. Furthermore, Gads-/- CD8+ T cells had delayed expression of c-myc and CD69 upon the stimulation with SIINFEKL. We then investigated how Gads deficiency would impact CD8+ T cell-mediated immunity in the context of infection with an intracellular pathogen. At early time points, Gads+/+ and Gads-/- CD8+ T cells proliferated to a similar extent, despite the fact that expression of CD69 and CD25 was reduced in the absence of Gads. After 5 d postinfection, Gads was required to sustain the expansion phase of the immune response; the peak response of Gads-/- cells was significantly lower than for Gads+/+ cells. However, Gads was not required for the differentiation of naive CD8+ T cells into memory cells. We conclude that the primary function of Gads is to regulate the sensitivity of the TCR to Ag ligation. [ABSTRACT FROM AUTHOR]

The search for Dyson Spheres has been propelled not only by the hope of discovering intelligent alien life, but by humanity's ever-increasing need for energy. However, the Dyson Sphere is not a practical design, requiring too much matter to build and too much energy to stabilize. Here we discuss the various designs of a Dyson Sphere and propose the Solar Wind Power (SWP) Satellite, a simplistic, self-sustaining system that draws power from the solar wind and uses a laser to fire energy to collectors (on space stations, bases, etc.) positioned anywhere in the Solar System. While a small SWP Satellite can provide an estimated 2 MW of power, larger (or networks of) satellites could provide terawatts of power or more. The cost of the SWP Satellite would be relatively cheap - it primarily consists of shaped copper, with only a few complex systems onboard. Detection of such a satellite would be difficult using current technology, because at this time we can only detect solar wind deviations of up to 10-13 MS yr-1, while a 2 MW satellite would only divert 10-34 MS yr-1. Thus, only very large SWP Satellites could possibly be detected. [ABSTRACT FROM AUTHOR]

Sugar beet press pulp (SBP) accumulates as a by-product in sugar factories and it is generally silaged or dried to be used as animal food. Rising energy prices and the opening of the European Union sugar market has put pressure on the manufacturers to find alternatives for energy supply. The aim of this project was to develop a technology in the treatment of SBP that would lead to savings in energy consumption and would provide a more competitive sugar production from sugar beets. These goals were met by the anaerobic digestion of SBP for biogas production. Lab-scale experiments confirmed the suitability of SBP as substrate for anaerobic bacteria. Pilot-scale experiments focused on process optimization and procedures for a quick start up and operational control. Both single-stage and two-stage process configurations showed similar removal efficiency. A stable biogas production could be achieved in single-stage at a maximum volumetric loading rate of 10 kgCSB/(m3·d). Degradation efficiency was 75% for VS and 72% for COD. Average specific gas production reached 530 NL/kgCODSBP or 610 NL/kgVSSBP. (CH4: 50 to 53%). The first large-scale biogas plant was put into operation during the sugar processing period 2007 at a Hungarian sugar factory. Digesting approximately 50% of the SBP (800 t/d, 22%TS), the biogas produced could substitute about 40% of the natural gas required for the thermal energy supply within the sugar processing. [ABSTRACT FROM AUTHOR]

Although teen pregnancy rates in the U.S. have recently declined, the need for programs for pregnant and parenting teens remains. This report presents information from 53 programs that served pregnant and parenting teens in New Mexico between 1997 and 2000. Data on 3,194 teens, including their characteristics, the services they received, and several key outcomes, are examined. These data indicate that the programs were successful in promoting educational attainment as well as gains in employment. Prevalence of late prenatal care and low birth weight babies was lower than statewide averages, and the rate of repeat pregnancy was lower than that reported by many other programs. How these programs achieved these results is discussed. [ABSTRACT FROM AUTHOR]

p73 was studied in squamous cancers and precursor lesions of the vulva. Over-expression of p73 occurred commonly in both human papillomavirus (HPV)-positive and -negative squamous cell cancers (SCC) and high-grade premalignant lesions. Whereas expression in normal vulval epithelium was detected only in the basal and supra-basal layers, expression in neoplastic epithelium increased with grade of neoplasia, being maximal at both protein and RNA levels in SCC. p73 Δ2 was the principal over-expressed isoform in the majority of cases of vulval SCC and often the sole form expressed in SCC. Over-expression of p73 was associated with expression of HPV-encoded E7 or with hypermethylation or mutation of p16[SUPINK4a] in HPV-negative cases. There was a close correlation between expression of p73 and p14[SUPARF] in cancers with loss of p53 function. The frequent over-expression of p73D2 in neoplastic but not normal vulval epithelium, and its co-ordinate deregulation with other E2F-1 responsive genes suggests a role in the oncogenic process. [ABSTRACT FROM AUTHOR]

Expression of viral genes in tumour cells of the virus-associated cancers could provide highly selective ways of targeting expression of therapeutic vectors to the tumour cells. The ubiquitous presence of EBNA-1 in Epstein–Barr virus-associated cancers could be used to activate expression constructs containing oriP in the tumour cells. This is demonstrated for a variety of model systems including epithelial cells, which would be the target cell type for the treatment of undifferentiated nasopharyngeal carcinoma, a cancer that always contains Epstein–Barr virus in the tumour cells. Combining an oriP/EBNA-1-dependent Epstein–Barr virus Cp promoter with delayed assay of reporter gene, a 108-fold differential was obtained between the activity of a transfected plasmid in cells containing or lacking EBNA-1 expression. This might provide sufficient specificity for a successful in vivo therapeutic strategy. [ABSTRACT FROM AUTHOR]

Focuses on the role of airpower in peacekeeping operations. Need for airpower's support on general and specific principles of peacekeeping; Difference between peacekeeping and other international methods of conflict resolution; Contributions of American airpower to international peacekeeping operations.

There have been no significant changes in anal cancer treatment options in 4 decades. In this study, we highlight two preclinical models designed to assess anal cancer treatments. Transgenic K14E6/E7 mice were treated with 7, 12-dimethylbenz(a)anthracene until anal tumors developed. Mice were treated with localized radiation in addition to chemotherapy (combined-modality therapy [CMT]) and compared to no treatment control (NTC). K14E6/E7 mouse anal spheroids with and without Pik3ca mutations were isolated and treated with vehicle, LY3023414 (LY3) (a drug previously shown to be effective in cancer prevention), CMT, or CMT + LY3. In the in vivo model, there was a significant increase in survival in the CMT group compared to the NTC group (P = 0.0392). In the ex vivo model, there was a significant decrease in the mean diameter of CMT and CMT + LY3-treated spheroids compared to vehicle (P ≤ 0.0001). For LY3 alone compared to vehicle, there was a statistically significant decrease in spheroid size in the K14E6/E7 group without mutation (P = 0.0004). We have provided proof of concept for two preclinical anal cancer treatment models that allow for the future testing of novel therapies for anal cancer. [ABSTRACT FROM AUTHOR]

Low-grade anal dysplasia is a disease that can progress to high-grade anal dysplasia and eventually anal cancer if left untreated. Research has shown that low-grade anal dysplasia is marked by significant autophagic dysfunction. We hypothesized that systemic induction of autophagy, via phosphoinositide 3-kinase/mammalian target of rapamycin (PI3K/mTOR) inhibition, would be effective in preventing anal cancer development in human papillomavirus (HPV) mice (K14E6/E7) with established low-grade anal dysplasia. Mice began treatment at 15 weeks of age, when 75% of mice spontaneously develop low-grade anal dysplasia, and were divided into the following groups: no treatment, systemic LY3023414 (4.5 mg/kg, dual PI3K/mTOR inhibitor) alone, topical 7,12 dimethylbenz[ a ]anthracene (DMBA) alone, or systemic LY3023414 and topical DMBA. Groups were compared for final histology, PI3K activity, mTOR activity, autophagic induction (light chain 3B (LC3β)), autophagic function (p62 protein), and tumor-free survival. Untreated mice or mice treated with LY3023414 alone did not progress to cancer. There was a statistically significant decrease in the number of mice that developed histologic evidence of cancer when comparing mice that received systemic LY3203414 with topical DMBA versus those that received topical DMBA alone (p = 0.0003). PI3K and mTOR activity decreased in groups treated with systemic LY3023414 and topical DMBA as compared with those treated with topical DMBA alone (p = 0.0005 and p = 0.0271, respectively). LC3β and p62 expression was not statistically altered with systemic LY3023414 treatment. Mice developed less overt tumors and had increased tumor-free survival when treated with systemic LY3023414 in the presence of topical DMBA compared to topical DMBA alone (p = 0.0016 and p < 0.001, respectively). Systemic LY3023414 treatment is effective in anal cancer prevention in the setting of established low-grade anal dysplasia in an HPV-associated mouse model of anal cancer. • Treatment with a PI3K/mTOR inhibitor reduced the rate of anal cancer in HPV transgenic mice with low-grade anal dysplasia. • The delay in progression cancer using LY3023414 correlated with PI3K/mTOR pathway inhibition. • The delay in progression to cancer using a dual PI3K/mTOR inhibitor did not correlate with markers of autophagy. • LY3023414 increased tumor-free survival, even in the presence of the carcinogen, 7, 12 dimethylbenz[a]anthracene (DMBA). [ABSTRACT FROM AUTHOR]

Interferon alpha and ribavirin (REV) combination therapy is associated with decreases in haemoglobin (Hb) concentrations and anaemia. The aim of this analysis was to better characterize the magnitude and frequency of Hb changes and risk factors. This retrospective analysis evaluated treatment-related changes in Hb in 677 patients who participated in either of two interferon alpha-2b plus RBV studies for chronic hepatitis C virus (HCV) infection. Study 1 included 192 interferon alpha-naïve patients randomized to receive RBV 1000-1200 mg/day plus interferon alpha-2b 3 million 11.1 daily or three times weekly for 48 weeks. Study 2 included 485 interferon alpha-experienced patients randomized to receive RBV 1000-1200 mg daily plus interferon alpha-2b 3 million R.J daily or three times weekly for 4 weeks, followed by three times weekly dosing for 44 weeks. More than 50% of all patients experienced a decrease in Hb ≥ 30 g/L. Women were 4.4 times as likely as men to experience a Hb level of <100 g/L; however, men were at a 40% higher risk to experience a Hb decline of >30 gIL from baseline. Daily use of interferon alpha-2b did not impact the magnitude of Hb decrease. In this pooled analysis, RBV dose reduction resulted in increases in Hb concentration of approximately 10 g/L. Lower baseline creatinine clearance, higher baseline Hb levels and increased age were independently associated with increased risk of Hb decreases of >27.7%. Lower baseline weight was not associated with increased risk of Hb decrease. Substantial Hb decreases occur frequently with interferon alpha/REV combination therapy. Sex, the magnitude of the Hb decline and renal function are potentially important factors to consider in patients receiving REV. Further research is needed to determine the impact on virological response and to develop strategies to manage the medical consequences. [ABSTRACT FROM AUTHOR]

Introduction: Traumatic intracranial hemorrhages (TIH) have traditionally been managed in the intensive care unit (ICU) setting with neurosurgery consultation and repeat head CT (HCT) for each patient. Recent publications indicate patients with small TIH and normal neurological examinations who are not on anticoagulation do not require ICU-level care, repeat HCT, or neurosurgical consultation. It has been suggested that these patients can be safely discharged home after a short period of observation in emergency department observation units (EDOU) provided their symptoms do not progress. Methods: This study is a retrospective cross-sectional evaluation of an EDOU protocol for minor traumatic brain injury (mTBI). It was conducted at a Level I trauma center. The protocol was developed by emergency medicine, neurosurgery and trauma surgery and modeled after the Brain Injury Guidelines (BIG). All patients were managed by attendings in the ED with discretionary neurosurgery and trauma surgery consultations. Patients were eligible for the mTBI protocol if they met BIG 1 or BIG 2 criteria (no intoxication, no anticoagulation, normal neurological examination, no or non-displaced skull fracture, subdural or intraparenchymal hematoma up to 7 millimeters, trace to localized subarachnoid hemorrhage), and had no other injuries or medical co-morbidities requiring admission. Protocol in the EDOU included routine neurological checks, symptom management, and repeat HCT for progression of symptoms. The EDOU group was compared with historical controls admitted with primary diagnosis of TIH over the 12 months prior to the initiation of the mTBI protocols. Primary outcome was reduction in EDOU length of stay (LOS) as compared to inpatient LOS. Secondary outcomes included rates of neurosurgical consultation, repeat HCT, conversion to inpatient admission, and need for emergent neurosurgical intervention. Results: There were 169 patients placed on the mTBI protocol between September 1, 2016 and August 31, 2019. The control group consisted of 53 inpatients. Median LOS (interquartile range [IQR]) for EDOU patients was 24.8 (IQR: 18.8 – 29.9) hours compared with a median LOS for the comparison group of 60.2 (IQR: 45.1 – 85.0) hours (P < .001). In the EDOU group 47 (27.8%) patients got a repeat HCT compared with 40 (75.5%) inpatients, and 106 (62.7%) had a neurosurgical consultation compared with 53 (100%) inpatients. Subdural hematoma was the most common type of hemorrhage. It was found in 60 (35.5%) patients, and subarachnoid hemorrhage was found in 56 cases (33.1%). Eleven patients had multicompartment hemorrhage of various classifications. Twelve (7.1%) patients required hospital admission from the EDOU. None of the EDOU patients required emergent neurosurgical intervention. Conclusion: Patients with minor TIH can be managed in an EDOU using an mTBI protocol and discretionary neurosurgical consults and repeat HCT. This is associated with a significant reduction in length of stay. [ABSTRACT FROM AUTHOR]

Objectives: To investigate if descent of the fetal head during active pushing is associated with duration of operative vaginal delivery, mode of delivery and neonatal outcome in nulliparous women with prolonged second stage of labor.Methods: This was a prospective cohort study of nulliparous women with prolonged second stage of labor, conducted between November 2013 and July 2016 in five European countries. Fetal head descent was measured using transperineal ultrasound. Head-perineum distance (HPD) was measured between contractions and on maximum contraction during active pushing, and the difference between these values (ΔHPD) was calculated. The main outcome was duration of operative vaginal delivery, estimated using survival analysis to calculate hazard ratios (HRs) for vaginal delivery, with values > 1 indicating a shorter duration. HR was adjusted for prepregnancy body mass index, maternal age, induction of labor, augmentation with oxytocin and use of epidural analgesia. Pregnancies were grouped according to ΔHPD quartile, and delivery mode and neonatal outcome were compared between groups.Results: The study population comprised 204 women. Duration of vacuum extraction was shorter with increasing ΔHPD. Estimated mean duration was 10.0, 9.0, 8.8 and 7.5 min in pregnancies with ΔHPD in the first to fourth quartiles, respectively, and the adjusted HR for vaginal delivery, using increasing ΔHPD as a continuous variable, was 1.04 (95% CI, 1.01-1.08). Mean ΔHPD was 7 mm (range, -10 to 37 mm). ΔHPD was either negative or ≤ 2 mm in the lowest quartile. In this group, 7/50 (14%) pregnancies were delivered by Cesarean section, compared with 8/154 (5%) of those with ΔHPD > 2 mm (P < 0.05). There was no significant association between umbilical artery pH < 7.10 or 5-min Apgar score < 7 and ΔHPD quartile.Conclusion: Minimal or no fetal head descent during active pushing was associated with longer duration of operative vaginal delivery and higher frequency of Cesarean section in nulliparous women with prolonged second stage of labor. © 2019 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Water electrolysis is one of the greenest ways to generate clean energy. However, it is critical to develop durable and cost-effective electrocatalysts using earth-abundant materials for overall water splitting. Here we report, a facile method to fabricate N-doped cotton cloth as an electrocatalyst. The N-doped cotton cloth showed outstanding performance as an electrocatalyst for overall water splitting. For oxygen evolution reaction (OER), N-doped cotton cloth requires a low overpotential of 351 mV to deliver 10 mA/cm 2 of current density with a Tafel slope of 88 mV/dec. On the other hand, it requires 233 mV to achieve a current density of 10 mA/cm 2 for hydrogen evolution reaction (HER) with a Tafel slope of 135 mV/dec. Furthermore, the electrocatalyst showed outstanding electrocatalytic stability and flexibility. The observed overpotential and stability are among the best for the metal-free electrocatalyst. Such a binder-free approach for fabrication of high performance, durable and flexible bi-functional (HER and OER) electrocatalyst could be a promising way to generate green energy from water. [ABSTRACT FROM AUTHOR]