bluuebunny/crossref_metadata_2025 huggingface dataset:
Design and implementation of a solar integration in electric smart bench
Authors: Kango Riklan , Hadiyanto  , Pongtularan Ezra Hartarto
Published: February 2021

Energy problems that hit the world have implications for savings in all fields, including lighting public spaces. However, lighting conventional public areas is an inappropriate step because the monthly electricity costs required are already very expensive. This paper proposes new solutions for alternative sources of electrical energy in open spaces. We validate this solution by implementing a solar cell in a park bench object. The experimental results show that the proposed solution has the same performance as conventional lighting. Electric park benches can operate longer by using a solar cell with an output power of 26.76 Watt-peak hours. With the enormous potential of solar power, the application of solar cells in an open environment is very suitable. With this electric bench, it is still energy efficient and green energy.
Determination of the requirement resistant for Ship-RUV trust power to maneuvering and performance
Authors: Rahmad Mohammad Basuki , Sutrisno Imam , Budianto  , Mudjiono Urip , Priyonggo Projek
Published: February 2021

The resistance requirement of Ship-RUV is very much needed for the maneuvering process by placing the motor and the propeller as the driving force. In this case the propeller and motor components in the Ship-RUV component are installed with a KV 1000 KV motor with 12000 RPM with a number of 6 Motor-propellers. Propeller conditions are installed in the rear and bottom conditions of the Ship-RUV. This function is used for operational movement when the hull of the ship. Where the design of the motor propeller selection is based on the calculation of resistance obtained from the empirical calculation formula. In the calculation of resistance, the amount of resistance of the Ship-RUV is 16 N to be able to move and operate. The condition of the speed of the Ship-RUV in its operation is planned to be able to move in the air reaching a service speed of 5 knots.
Optimal solar power for control of smart irrigation system
Authors: Ogidan Olugbenga Kayode , Amusan Akinwumi Abimbola , Temikotan Kehinde Olusesan , Nkanga Iniubong Essien
Published: February 2021

Irrigation is very vital to food security but deployment of effective irrigation requires solar energy especially in the rural areas with no grid power. In this work, the optimal power required in the solar photovoltaic (PV) and the battery of a solar powered system (at any instance) for effective operation of a smart irrigation facility in Elizade University Ilara Mokin, Nigeria is determined. The system uses current and voltage sensors placed at the solar photovoltaic (PV) and the battery sections to perform real-time measurements on irrigation solenoid valves. Acquired current and voltage sensor values are passed to a microcontroller, readable in the computer serial monitor and later used to compute the required power in both PV and battery sections. The developed solar power system was implemented on a pilot farm with irrigation facilities consisting of sensors (moisture content, water level) and actuators (three solenoid valves). Tests were performed under the load-on condition. Results obtained reveal a maximum power threshold of 72.68 W for the solar PV and 14 W for the battery when three solenoid valves were loaded or operated at the same time and a minimum value of 31.55 W for the solar PV and 1.9 W for the battery when one valve is operated. The power thresholds obtained would be useful for configuring the smart irrigation system controller to ensure adequate delivery of water to crops as well as prolong the lifespan of the developed solar powered system.
Decubitus pump health device implementation with pressure sensor based on Atmega 328
Authors: Wicaksana Alan Rifky , Kartika Wisnu , Purwoko Heri
Published: February 2021

The decubitus, also known as pressure ulcer, is a wound that occurs due to pressure mainly on the protruding bones due to the patient is lying in bed on long time. This research purpose is to help prevent decubitus sores for immobility patients who are more bedridden during treatment at the hospital. This research module is a special mattress with an automatic pump which is equipped with an air pressure monitoring system on the mattress. The MPX5700 sensor measures mattress pressure. On the module testing, it can be observing that the largest error value on the low setting value measurement that is 2.25 % while the smallest error value on high setting measurement that is 1.84 %. Based on the results of tests and supported by the research, it can be concluded that the decubitus pump module can run well because it is still at the error tolerance threshold at ± 5 %.
The effect of coffee powder as a carburizing agent and preventing corrosion
Authors: Sidiq M. Fajar , Soebyakto  , Willis Galuh Renggani , Shidik M.Agus
Published: February 2021

Low carbon steel has a carbon content between 0.01% - 0.2% C, has properties of malleability and machining, usually used for machines, machinery and mild steel. The disadvantages of this low carbon steel are its relatively low mechanical strength and poor corrosion resistance. By using coffee powder as a carburizing agent and as an inhibitor corrosion, it is expected that the mechanical strength and corrosion resistance can be increased. This study aims to determine the effect of using coffee grounds in increasing wear resistance, and its hardness and corrosion resistance using coffee powder media. The process is carried out by carburizing at a temperature of 9150C and held for 30 minutes with coffee powder media as charcoal and tempering at a temperature of 3250C to increase its mechanical strength. The next process is testing its corrosion resistance using a coffee powder inhibitor with a percentage of 10 Ppm, 20 Ppm, and 30 Ppm. The results showed an increase in the mechanical strength of low carbon steel by carburizing the process using coffee grounds. There was an increase in the hardness value of the hardness test specimen from 180 HB in raw material to 395.3 HB. In the wear test, there was a decrease in the value of the wear volume from 0.079 mm3 to 0.041 mm3. In testing the corrosion rate using coffee grounds as a corrosion inhibitor medium, it was found that the corrosion rate of the raw material decreased with a value of 2.153 mm / yr to 1.495 mm / yr when using coffee inhibitors with a level of 30 Ppm.
The utilization of ijuk fibre and sawdust for manufacturing composite block with plastic waste as the matrix
Authors: Abdurachman  , Malik Jamaludin
Published: February 2021

This paper presents the results of research on the utilization of wood waste in the form of wood-chips of sengon wood (S) and sawdust of pinewood (P), mixed with palm-fibres and plastic waste of polypropylene (PP) and polyethylene (PE), for the manufacture of wood plastic composite (WPC) products with three variations mixtures of flakes, fibres and the matrix: A = 50:25:25, B = 50:30:15 and C = 50:15:35. Physical and mechanical properties of the composite refer to the procedure and criteria of SNI 8154: 2015. The results revealed that the densities of the WPC are in accordance with the target ≥ 0.60 g/cm3 where the highest by 0.874 g/cm3 belongs to the composition of PEPB. The composite moisture content is much lower than the maximum water content required i.e 12%. MOE and MOR of the WPC that meet the standard requirement belong to the composition of PPSA and PESB by 20450.67 and 20286.67 kg/cm2 (MOE) and by 187.08 and 194.11 kg/cm2 (MOR). The highest screw-withdrawal strength was 71.33 kg achieved by PESC composition. Based on these characteristics, sengon and pine wood chips can be used as raw material for wood plastic composite mixed with palm-fibres as the reinforcing fiber and recycled plastic as the matrix.
Characterization of duck egg shells and bioceramic materials in making denture applications
Authors: Sabir Asmeati , Abbas Hammada , Amini Ahmad Yusran , Asmal Sapta
Published: February 2021

Duck egg shells contain higher calcium which potent to be use as materials of denture-bio-ceramic. Denture bioceramics were made from feldspar, quartz, kaolin, and duck egg shells. In this work, characterization and synthesis hydroxyapatite from duck egg shells as bioceramics for the manufacturing of artificial tooth was carry out. X-Ray Diffraction (XRD) was used to analyze the characteristics of hydroxyapatite. Synthesis hydroxyapatite from duck egg shells were produced calcium (Ca) is 99.63%, and CaO is 99.41%. Furthermore, calcination methods were used by XRD. The XRD results at the calcination temperature of 900°C were feldspar CaO content of 96.87%, SiO2 of 1,85%, quartz CaO of 1.58%, SiO2 of 95.47%, and Kaolin CaO of 68.08%. Among of three various samples used, sample of B with compositions of Ca and Si are 62.89, and 26.89, XRD results of eggshell powder produced the largest CaO compound at a burning temperature of 900°C for 1 hour with a hexagonal-shaped compound with a Ca / P ratio of 1.61. respectively has good result. In addition, bioceramics obtained is in accordance to standard manufacturing of denture. Therefore, synthesis hydroxyapatite from Duck egg shells contains very high calcium which is component that potential to be used for Dentures based bioceramic.
ASpli: integrative analysis of splicing landscapes through RNA-Seq assays
Authors: Mancini Estefania , Rabinovich Andres , Iserte Javier , Yanovsky Marcelo , Chernomoretz Ariel
Published: February 2021

Motivation

Genome-wide analysis of alternative splicing has been a very active field of research since the early days of next generation sequencing technologies. Since then, ever-growing data availability and the development of increasingly sophisticated analysis methods have uncovered the complexity of the general splicing repertoire. A large number of splicing analysis methodologies exist, each of them presenting its own strengths and weaknesses. For instance, methods exclusively relying on junction information do not take advantage of the large majority of reads produced in an RNA-seq assay, isoform reconstruction methods might not detect novel intron retention events, some solutions can only handle canonical splicing events, and many existing methods can only perform pairwise comparisons.

Results

In this contribution, we present ASpli, a computational suite implemented in R statistical language, that allows the identification of changes in both, annotated and novel alternative-splicing events and can deal with simple, multi-factor or paired experimental designs. Our integrative computational workflow, that considers the same GLM model applied to different sets of reads and junctions, allows computation of complementary splicing signals.

Analyzing simulated and real data, we found that the consolidation of these signals resulted in a robust proxy of the occurrence of splicing alterations. While the analysis of junctions allowed us to uncover annotated as well as non-annotated events, read coverage signals notably increased recall capabilities at a very competitive performance when compared against other state-of-the-art splicing analysis algorithms.

Availability and implementation

ASpli is freely available from the Bioconductor project site https://doi.org/doi:10.18129/B9.bioc.ASpli.

Supplementary information

Supplementary data are available at Bioinformatics online.
From the Strengths Perspective to an Empowerment–Participation–Strengths Model in Social Work Practice
Authors: Kam Ping Kwong
Published: February 2021

Over recent years, the strengths perspective has been promoted as a practice model with a range of social service users. Despite acknowledging its positive aspects, there has been increasing discussion about its application in actual practice, underlining the need to advance a practice model that helps enhance its use in social work practice. This article aims to do this by proposing the adoption of an Empowerment–Participation–Strengths (EPS) model that integrates the strengths perspective with two other important concepts in social work, participation and empowerment. The EPS model integrates these three concepts by proposing that social workers use the strengths perspective to look at service users, encourage their participation and then help them to empower themselves. The strengths perspective is the base, participation is considered as a useful method, and empowerment is the goal. These three concepts are equally important, and none can be disregarded. This article first reviews the issues in applying the strengths perspective. It then presents the special features of the model and discusses how this enhances the strengths perspective in social work practice.
Deep Multi-Stage Approach For Emotional Body Gesture Recognition In Job Interview
Authors: Khalifa Intissar , Ejbali Ridha , Schettini Raimondo , Zaied Mourad
Published: February 2021

Affective computing is a key research topic in artificial intelligence which is applied to psychology and machines. It consists of the estimation and measurement of human emotions. A person’s body language is one of the most significant sources of information during job interview, and it reflects a deep psychological state that is often missing from other data sources. In our work, we combine two tasks of pose estimation and emotion classification for emotional body gesture recognition to propose a deep multi-stage architecture that is able to deal with both tasks. Our deep pose decoding method detects and tracks the candidate’s skeleton in a video using a combination of depthwise convolutional network and detection-based method for 2D pose reconstruction. Moreover, we propose a representation technique based on the superposition of skeletons to generate for each video sequence a single image synthesizing the different poses of the subject. We call this image: ‘history pose image’, and it is used as input to the convolutional neural network model based on the Visual Geometry Group architecture. We demonstrate the effectiveness of our method in comparison with other methods in the state of the art on the standard Common Object in Context keypoint dataset and Face and Body gesture video database.
Humans influence shrimp movement: a conservation behavior case study with “Shrimp Watching” ecotourism
Authors: Hongjamrassilp Watcharapong , Blumstein Daniel T
Published: February 2021

An increase in ecotourism adversely impacts many animals and contributes to biodiversity loss. To mitigate these impacts, we illustrate the application of a conservation behavior framework toward the development of a sustainable ecotourism management plan. In Ubon Ratchathani, Thailand, thousands of tourists annually come to see a unique mass migration of shrimps on land (referred to as “shrimp parading”). Preliminary work suggests that this tourism has negatively impacted the shrimps. To reduce tourism-related impacts we studied: 1) the decisions shrimps make when parading and 2) how shrimps respond to different light intensities and colors. We created an artificial stream and tested the conditions that influence parading by experimentally varying the presence of light and systematically manipulating water velocity (10, 60, and 100 cm/s). Additionally, we conducted an in situ experiment to study how shrimps respond to tourists’ lights under three intensities (50,400, and 9,000 lux) and five colors (white, blue, green, orange, and red). We found most shrimps prefer to leave the river when it is dark and there is low water flow. Shrimps responded the least to red (λmax = 630 nm) and orange (λmax = 625 nm) light at 50 lux. These findings were used to develop a management plan by creating three different tourist zones, which maximize tourist needs and minimize the anthropogenic impacts on the shrimps. This work could be used as an example of the application of conservation behavior framework in developing management plan for sustainable ecotourism for other invertebrate taxa.
A statistical framework for QTL hotspot detection
Authors: Wu Po-Ya , Yang Man-Hsia , Kao Chen-Hung
Published: February 2021

Quantitative trait loci (QTL) hotspots (genomic locations enriched in QTL) are a common and notable feature when collecting many QTL for various traits in many areas of biological studies. The QTL hotspots are important and attractive since they are highly informative and may harbor genes for the quantitative traits. So far, the current statistical methods for QTL hotspot detection use either the individual-level data from the genetical genomics experiments or the summarized data from public QTL databases to proceed with the detection analysis. These methods may suffer from the problems of ignoring the correlation structure among traits, neglecting the magnitude of LOD scores for the QTL, or paying a very high computational cost, which often lead to the detection of excessive spurious hotspots, failure to discover biologically interesting hotspots composed of a small-to-moderate number of QTL with strong LOD scores, and computational intractability, respectively, during the detection process. In this article, we describe a statistical framework that can handle both types of data as well as address all the problems at a time for QTL hotspot detection. Our statistical framework directly operates on the QTL matrix and hence has a very cheap computational cost and is deployed to take advantage of the QTL mapping results for assisting the detection analysis. Two special devices, trait grouping and top γn,α profile, are introduced into the framework. The trait grouping attempts to group the traits controlled by closely linked or pleiotropic QTL together into the same trait groups and randomly allocates these QTL together across the genomic positions separately by trait group to account for the correlation structure among traits, so as to have the ability to obtain much stricter thresholds and dismiss spurious hotspots. The top γn,α profile is designed to outline the LOD-score pattern of QTL in a hotspot across the different hotspot architectures, so that it can serve to identify and characterize the types of QTL hotspots with varying sizes and LOD-score distributions. Real examples, numerical analysis, and simulation study are performed to validate our statistical framework, investigate the detection properties, and also compare with the current methods in QTL hotspot detection. The results demonstrate that the proposed statistical framework can effectively accommodate the correlation structure among traits, identify the types of hotspots, and still keep the notable features of easy implementation and fast computation for practical QTL hotspot detection.
Moving Toward the Promise of Participatory Engagement of Older Adults in Gerotechnology
Authors: Grigorovich Alisa , Kontos Pia , Jenkins Amanda , Kirkland Susan
Published: February 2021

Limited uptake and use of developed technologies by older adults have prompted interest in participatory design and related approaches in the gerotechnology field. Despite this, recent systematic reviews suggest that researchers continue to passively engage older adults in research projects, often only providing advice or feedback in the early or later phases of research. A key barrier to more meaningful and active engagement of older adults is a lack of understanding as to how participatory design differs from other participatory approaches, and in particular, participatory action research. We address this gap in understanding by exploring the theoretical similarities and differences of participatory design and participatory action research, including their scope, goals, and the nature of the involvement of older adults in each. We conclude with key barriers that are critical to address in order to achieve greater involvement of older adults in gerotechnology and to broaden and enrich the goals of this field.
Determination of Fentanyl, Alpha-Methylfentanyl, Beta-Hydroxyfentanyl and the Metabolite Norfentanyl in Rat Urine by LC–MS-MS
Authors: Li Lu , Yu Xuejiao , Lyu Lihong , Duan Hongbin , Chen Yao , Bian Jing , Xu Zhiru , Liu Li , Zhang Yurong
Published: February 2021

Fentanyl and its analogs are potent synthetic opioids with a high potential for abuse and dependence. They have become major contributors to opioid deaths. This study aimed to determine whether the metabolites of fentanyl, alpha-methylfentanyl and beta-hydroxyfentanyl, excreted in the urine, can demonstrate historical drug exposure. Fentanyl is primarily metabolized via CYP3A4 into norfentanyl, although there is little research on its metabolization into alpha-methylfentanyl and beta-hydroxyfentanyl. We conducted in vitro experiments with human liver microsomes (HLMs) and rat liver microsomes (RLMs) to elucidate the major metabolic pathways of alpha-methylfentanyl and beta-hydroxyfentanyl using ultra-high-performance liquid chromatography coupled with mass spectrometry. The results showed that both alpha-methylfentanyl and beta-hydroxyfentanyl were predominantly metabolized into norfentanyl in HLM and RLM. Urine samples were collected at different intervals from 0 h to 72 h after intravenous administration of alpha-methylfentanyl and beta-hydroxyfentanyl (20 μg/kg) to Sprague-Dawley rats. We prepared the samples by liquid–liquid extraction, and the internal standard (IS) was cariprazine. A sensitive, rapid liquid chromatography-tandem mass spectrometry method was developed and validated to determine four analytes in the urine. The lower limit of qualification in urine was 2 pg/mL for fentanyl, 5 pg/mL for alpha-methylfentanyl, 10 pg/mL for beta-hydroxyfentanyl and 40 pg/mL for norfentanyl. The analytical range was 0.002–2 ng/mL for fentanyl, 0.005–5 ng/mL for alpha-methylfentanyl, 0.01–10 ng/mL for beta-hydroxyfentanyl and 0.04–40 ng/mL for norfentanyl. All analytes demonstrated good linearity (R2 > 0.99). The extraction recoveries were in the 67.8%–92.1% range, and the IS-normalized matrix effects were between 55.5% and 74.0% (coefficient of variance < 15%). Our data indicated that norfentanyl has a higher concentration in rat urine and was detectable for at least 3 days after exposure to these compounds. This developed method may be useful in various fields, including forensic analysis, workplace drug testing and monitoring drug abuse.
Aquaporins, and not changes in root structure, provide new insights into physiological responses to drought, flooding, and salinity
Authors: Domec Jean-Christophe , King John S , Carmichael Mary J , Overby Anna Treado , Wortemann Remi , Smith William K , Miao Guofang , Noormets Asko , Johnson Daniel M
Published: February 2021

The influence of aquaporin (AQP) activity on plant water movement remains unclear, especially in plants subject to unfavorable conditions. We applied a multitiered approach at a range of plant scales to (i) characterize the resistances controlling water transport under drought, flooding, and flooding plus salinity conditions; (ii) quantify the respective effects of AQP activity and xylem structure on root (Kroot), stem (Kstem), and leaf (Kleaf) conductances; and (iii) evaluate the impact of AQP-regulated transport capacity on gas exchange. We found that drought, flooding, and flooding plus salinity reduced Kroot and root AQP activity in Pinus taeda, whereas Kroot of the flood-tolerant Taxodium distichum did not decline under flooding. The extent of the AQP control of transport efficiency varied among organs and species, ranging from 35–55% in Kroot to 10–30% in Kstem and Kleaf. In response to treatments, AQP-mediated inhibition of Kroot rather than changes in xylem acclimation controlled the fluctuations in Kroot. The reduction in stomatal conductance and its sensitivity to vapor pressure deficit were direct responses to decreased whole-plant conductance triggered by lower Kroot and larger resistance belowground. Our results provide new mechanistic and functional insights on plant hydraulics that are essential to quantifying the influences of future stress on ecosystem function.
Variability, periodicity, and contact binaries in WISE
Authors: Petrosky Evan , Hwang Hsiang-Chih , Zakamska Nadia L , Chandra Vedant , Hill Matthew J
Published: February 2021

The time-series component of Wide-field Infrared Survey Explorer (WISE) is a valuable resource for the study of variable objects. We present an analysis of an all-sky sample of ∼450 000 AllWISE+NEOWISE infrared light curves of likely variables identified in AllWISE. By computing periodograms of all these sources, we identify ∼56 000 periodic variables. Of these, ∼42 000 are short-period (P < 1 d), near-contact, or contact eclipsing binaries, many of which are on the main sequence. We use the periodic and aperiodic variables to test computationally inexpensive methods of periodic variable classification and identification, utilizing various measures of the probability distribution function of fluxes and of time-scales of variability. The combination of variability measures from our periodogram and non-parametric analyses with infrared colours from WISE and absolute magnitudes, colours, and variability amplitude from Gaia is useful for the identification and classification of periodic variables. Furthermore, we show that the effectiveness of non-parametric methods for the identification of periodic variables is comparable to that of the periodogram but at a much lower computational cost. Future surveys can utilize these methods to accelerate more traditional time-series analyses and to identify evolving sources missed by periodogram-based selections.
Sequence-dependent cost for Z-form shapes the torsion-driven B–Z transition via close interplay of Z-DNA and DNA bubble
Authors: Kim Sook Ho , Jung Hae Jun , Lee Il-Buem , Lee Nam-Kyung , Hong Seok-Cheol
Published: February 2021

Despite recent genome-wide investigations of functional DNA elements, the mechanistic details about their actions remain elusive. One intriguing possibility is that DNA sequences with special patterns play biological roles, adopting non-B-DNA conformations. Here we investigated dynamics of thymine-guanine (TG) repeats, microsatellite sequences and recurrently found in promoters, as well as cytosine–guanine (CG) repeats, best-known Z-DNA forming sequence, in the aspect of Z-DNA formation. We measured the energy barriers of the B–Z transition with those repeats and discovered the sequence-dependent penalty for Z-DNA generates distinctive thermodynamic and kinetic features in the torque-induced transition. Due to the higher torsional stress required for Z-form in TG repeats, a bubble could be induced more easily, suppressing Z-DNA induction, but facilitate the B–Z interconversion kinetically at the transition midpoint. Thus, the Z-form by TG repeats has advantages as a torsion buffer and bubble selector while the Z-form by CG repeats likely behaves as torsion absorber. Our statistical physics model supports quantitatively the populations of Z-DNA and reveals the pivotal roles of bubbles in state dynamics. All taken together, a quantitative picture for the transition was deduced within the close interplay among bubbles, plectonemes and Z-DNA.
Maternal Characteristics and Causes Associated With Refractory Postpartum Hemorrhage After Vaginal Birth: A Secondary Analysis of the WHO CHAMPION Trial Data
Authors: Widmer M. , Piaggio G. , Hofmeyr G.J. , Carroli G. , Coomarasamy A. , Gallos I. , Goudar S. , Gulmezoglu A.M. , Lin S.L. , Lumbiganon P. , Mugerwa K. , Owa O. , Qureshi Z. , Althabea F.
Published: February 2021

(BJOG. 2020;127:628–634)

A leading cause of maternal morbidity and mortality in low- and middle-income countries is postpartum hemorrhage (PPH). The most common cause of PPH is uterine atony. As PPH occurs in 6% of all live births worldwide, the World Health Organization (WHO) recommends a set of interventions for women who begin to bleed, which include uterine massage and uterotonic medications. For women who continue to bleed despite this first-line of treatment, additional measures are recommended prior to surgical intervention including secondary uterotonics, tranexamic acid, and intrauterine balloon tamponades.
Coronavirus Disease 2019 (COVID-19) Pandemic and Pregnancy
Authors: Dashraath P. , Wong J.L.J , Lim M.X.K , Lim L.M. , Li S. , Biswas A. , Choolani M. , Mattar C. , Su L.L.
Published: February 2021

(Am J Obstet Gynecol. 2020;222:521–531)

Caring for vulnerable populations is a critical component of pandemic management. Pregnant women are susceptible to respiratory illness with an increased infectious morbidity and mortality. While clinical information is limited on the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on the pregnant population, both the SARS-CoV and MERS-CoV outbreaks of the last 2 decades resulted in approximately one third of infected pregnant women dying from the illness. The purpose of this paper was to summarize the clinical features of coronavirus disease 2019 (COVID-19) in pregnant women, and present a pragmatic and integrated framework for handling complex intricacies involved in disease management.
Reducing Post-cesarean Delivery Surgical Site Infections: A Narrative Review
Authors: Douville S.E. , Callaway L.K. , Amoako A. , Roberts J.A. , Eleya V.A.
Published: February 2021

(Int J Obstet Anesth. 2020;42:76–86)

Surgical site infection (SSI) occurs in both cesarean and vaginal deliveries, though there are many challenges to estimating rates of incidence. There are many proposed and implemented strategies to prevent postcesarean SSI. This review aimed to examine evidence on the prevention of postcesarean SSI with a concentration on pharmacological interventions and their effects on neonates.
Social Determinants of Pregnancy-related Mortality and Morbidity in the United States: A Systematic Review
Authors: Wang E. , Glazer K.B. , Howell E.A. , Janevic T.M.
Published: February 2021

(Obstet Gynecol. 2020;135:896–915)

The United States has one of the highest maternal mortality rates among high-income countries. This rate, along with maternal morbidity in the United States, has been rising. While health factors such as increased obesity and chronic disease, older maternal age, and high cesarean rates may contribute to maternal mortality and morbidity, social determinants of health are also a contributor. Social determinants of health include environmental conditions and socioeconomic factors like income, education, occupation, race and ethnicity, and sex. Previous studies have examined social determinants of health in relation to neonatal or birth outcomes, but there has been little research on the relationship between social determinants of health and maternal outcomes in the United States. This systematic review aimed to examine social determinants of maternal mortality and morbidity in the United States while identifying areas for future research and action.
Pregnancy-related Mortality in the United States, 2003-2016: Age, Race, and Place of Death
Authors: Burgess A.P.H. , Dongarwar D. , Spigel Z. , Salihu H.M. , Moaddab A. , Clark S.L. , Fox K.
Published: February 2021

(Am J Obstet Gynecol. 2020;222:489.e1–489.e8)

In the United States, the pregnancy-related mortality rate (PRMR), is several times higher than that of other high-income countries and this has been attributed to a number of medical, social, political, and cultural factors. Programs aimed at addressing this problem have been developed by the Society for Maternal-Fetal Medicine and the American College of Obstetricians and Gynecologists, but there is a lack of data on their impact. This study used data on the place of death, age of death, and deaths by race and ethnicity to explore the contributions of medical factors compared with social, cultural, and environmental factors in pregnancy-related deaths.
Validation of a Comorbidity Index for Use in Obstetric Patients: A Nationwide Cohort Study
Authors: Bliddal M. , Möller S. , Vinter C.A. , Rubin K.H. , Gagne J.J. , Pottegård A.
Published: February 2021

(Acta Obstet Gynecol Scand. 2020;99:399–405)

Severe maternal morbidity associated with childbirth has increased in the last 30 years in the United States. A score to predict risk for maternal morbidity would be useful to help place high-risk women at better-equipped facilities and also address some confounding factors in research. The Obstetric Comorbidity Index (OCI) was developed by Bateman and Gangne to accomplish these goals, but has only been validated in very specific populations. This study used the Danish health registers, which contain complete data on all obstetric patients, to examine the ability of the OCI to predict morbidity and discriminate between low-risk and high-risk obstetric patients for maternal end-organ injury and death.
A Population-based Analysis of French Transfusion Practice for Women Experiencing Severe Postpartum Hemorrhage
Authors: Deleu F. , Deneux-Tharaux C. , Chiesa-Dubruille C. , Seco A. , Bonneta M.P.
Published: February 2021

(Int J Obstet Anesth. 2020;42:11–19)

Severe postpartum hemorrhage (SPPH) is the leading cause of severe maternal mortality worldwide. Blood transfusion is a central part of managing SPPH, but there is a lack of prospective population-based studies on transfusion practices. The EPIMOMS study on severe acute maternal morbidity provides data on transfusion management for SPPH. This retrospective study used data from the EPIMOMS study and aimed to describe transfusion practices and evaluate those practices in terms of compliance with French PPH management guidelines.
Severe Maternal Morbidity Due to Obstetric Haemorrhage: Potential Preventability
Authors: Lepine S.J. , Geller S.E. , Pledger M. , Lawton B. , MacDonald E.J.
Published: February 2021

(Aust N Z J Obstet Gynaecol. 2020;60:212–217)

Obstetric hemorrhage (postpartum hemorrhage) accounts for 16% of maternal deaths in developed regions and 27% in developing regions. In New Zealand, it is the most common reason for admission to the intensive care unit (ICU) or high-dependency unit (HDU). Yet, many cases of obstetric hemorrhage may be preventable. The aim of this study was to conduct a critical analysis of severe obstetric hemorrhage cases to highlight areas for potential improvements in care.
Target Populations to Reduce Cesarean Rates After Induced Labor: A National Population-based Cohort Study
Authors: Blanc-Petitjean P. , Schmitz T. , Salomé M. , Goffinet F. , Le Ray C.
Published: February 2021

(Acta Obstet Gynecol Scand. 2020;99:406–412)

There is a wide variation in the rate of cesarean delivery following induction of labor (IOL), and the reasons for this difference are unclear. The disparity may be explained in part by differences in obstetric practices or by risk factors like obesity, nulliparity, or previous cesarean delivery. This study used a 10-group classification system to identify populations with higher rates of cesarean delivery after IOL.
Sexual and Gender Minorities Educational Content Within Obstetric Anesthesia Fellowship Programs: A Survey
Authors: MacCormick H. , George R.B.
Published: February 2021

(Can J Anesth/J Can Anesth. 2020;67:532–540)

Sexual and gender minorities (SGM) is an umbrella term for groups of individuals who identify themselves as 2-spirit, transgender, homosexual, bisexual, nonbinary, intersex, or queer. SGM communities face unique difficulties in accessing high-quality health care. Members of SGM communities are at high risk of developing substance or alcohol abuse, homelessness, and depression. More specifically, transgender patients are at higher risk of venous thromboembolism due to hormone therapy. It is critical for anesthesiologists to possess the skills necessary to communicate with obstetric patients, especially in the SGM population. This study surveyed the SGM-related educational content in obstetric anesthesia fellowship programs in North America.
The Association Between the Introduction of a Quantitative Assessment of Postpartum Blood Loss and Institutional Changes in Clinical Practice: An Observational Study
Authors: Katz D. , Wang R. , O’Neil L. , Gerber C. , Lankford A. , Rogers T. , Gal J. , Sandler R. , Beilin Y.
Published: February 2021

(Int J Obstet Anesth. 2020;42:4–10)

Delayed recognition of postpartum hemorrhage significantly contributes to maternal morbidity and mortality. One cause of delayed recognition of postpartum hemorrhage is inaccurate blood loss estimation. The use of quantitative assessment of blood loss (QBL) over visually estimated blood loss has been advocated by maternal safety organizations. QBL methods include gravimetric (weight-based), volumetric, and colorimetric approaches. The Triton system uses both colorimetric and gravimetric techniques and has demonstrated accuracy. This study aimed to examine the use of the Triton QBL system in a single institution.
Do Quantitative Blood Loss Measurements and Postpartum Hemorrhage Protocols Actually Make a Difference? Yes, No, and Maybe
Authors: Chau A. , Farber M.K.
Published: February 2021

(Int J Obstet Anesth. 2020;42:1–3)

Postpartum hemorrhage (PPH) is a leading cause of severe maternal morbidity. In California, hospitals that adopted the United States National Partnership for Maternal Safety (NPMS) Consensus Bundle for Obstetric Hemorrhage reduced hemorrhage-related severe maternal morbidity by 20.8%. Quantitation of blood loss (QBL) and protocol utilization during PPH were 2 elements of the NPMS bundle and have been evaluated in recent studies, which may shed light on the contribution of these 2 practices to the observed improved outcomes.
Spinal Anesthesia for Patients With Coronavirus Disease 2019 and Possible Transmission Rates in Anesthetists: Retrospective, Single-centre, Observational Cohort Study
Authors: Zhong Q. , Liu Y.Y. , Lou Q. , Zou Y.F. , Jiang H.X. , Li H. , Zang J.J. , Li Z. , Yang X. , Ma M. , Tang L.J. , Chen Y.Y. , Zheng F. , Ke J.J. , Zhang Z.Z.
Published: February 2021

(Br J Anaesth. 2020;124:670–675)

Since COVID-19 has been declared an international public health emergency, clinical characteristics of COVID-19 infection, including pregnant women undergoing cesarean section, have been reported. However, there have not been reports on the perioperative characteristics or anesthetic management of infected patients undergoing surgery. Clinicians may be at high risk of infection during surgeries. This single-center, retrospective, observational cohort study was intended to describe experiences of performing spinal anesthesia in infected patients, report on the perioperative characteristics of patients with COVID-19, and report outcomes in patients who received spinal anesthesia, as well as describing the possible transmission rates in anesthetists administering spinal anesthesia.
Enhanced Recovery After Surgery at Cesarean Delivery to Reduce Postoperative Length of Stay: A Randomized Controlled Trial
Authors: Teigen N.C. , Sahasrabudhe N. , Doulaveris G. , Xie X. , Negassa A. , Bernstein J. , Bernstein P.S.
Published: February 2021

(Am J Obstet Gynecol. 2020;222:372.e1–372.e10)

Enhanced recovery after surgery (ERAS) involves multiple changes in perioperative care to improve patient outcomes, reduce postoperative patient stay, and standardize postoperative patient care to optimize patient satisfaction levels. Currently, no randomized studies exist addressing possible postoperative impacts of ERAS for cesarean deliveries. This study aimed to investigate whether the implementation of an ERAS pathway versus standard care could improve patient satisfaction and reduce the postoperative length of stay for patients undergoing cesarean deliveries.
Health Resource Utilization of Labor Induction Versus Expectant Management
Authors: Grobman W.A. , Sandoval G. , Reddy U.M. , Tita A.T.N. , Silver R.M. , Mallett G. , Hill K. , Rice M.M. , El-Sayed Y.Y. , Wapner R.J. , Rouse D.J. , Saade G.R. , Thorp J.M. , Chauhan S.P. , Iams J.D. , Chien E.K. , Casey B.M. , Gibbs R.S. , Srinivas S.K. , Swamy G.K. , Simhan H.N. , Macones G.A.
Published: February 2021

(Am J Obstet Gynecol. 2020;222:369.e1–369.e11)

The A Randomized Trial of Induction Versus Expectant Management (ARRIVE) trial was conducted to analyze the effects of planned elective induction of labor on 6000 low-risk nulliparous women in comparison with expectant management. The ARRIVE trial found that planned elective labor induction at 39 weeks resulted in decreased cesarean delivery, fewer pregnancies with hypertensive disorders, and decreased neonatal respiratory morbidity. The aim of the current study was to compare health care resource utilization between planned elective induction of labor at 39 weeks and expectant management in nulliparous women during 3 time periods: antepartum, delivery admission, and discharge until 8 weeks postpartum.
Carbetocin at Elective Cesarean Section: A Sequential Allocation Trial to Determine the Minimum Effective Dose in Obese Women
Authors: Drew T. , Balki M. , Farine D. , Ye X.Y. , Downey K. , Carvalho J.C.A.
Published: February 2021

(Anaesthesia. 2020;75:331–337)

Uterotonics are widely used in cesarean deliveries to prevent postpartum hemorrhage, which can cause maternal death or severe morbidity. Obesity, among other factors, has been implicated as a contributing factor to the rise in atonic postpartum hemorrhage in developed countries. The use of carbetocin, a synthetic oxytocin analogue, is associated with a reduced need for uterotonics in cesarean deliveries. While previous studies found 90% effective dose (ED90) of carbetocin for women with a body mass index (BMI) <40 kg/m2, none have addressed the ED90 for obese women. This study aimed to find the ED90 of carbetocin in women with a BMI ≥40 kg/m2 undergoing elective cesarean delivery.
Use of a Novel Electronic Maternal Surveillance System and the Maternal Early Warning Criteria to Detect Severe Postpartum Hemorrhage
Authors: Klumpner T.T. , Kountanis J.A. , Meyer S.R. , Justin Ortwine J. , Bauer M.E. , Carver A. , Piehl A.M. , Smith R. , Mentz G. , Tremper K.K.
Published: February 2021

(Anesth Analg. 2020;131:857–865)

Responding early and appropriately to the clinical warning signs of postpartum hemorrhage (PPH) is one factor in preventing maternal death. While procedures to quantify blood loss can support the timely diagnosis of PPH, an early warning surveillance system triggered by maternal vital signs may provide an additional means of detecting this complication after delivery. The aim of this study was to assess the ability of an automated surveillance system and the Maternal Early Warning Criteria (MEWC) to predict severely morbid postpartum hemorrhage (sPPH) outside of the operating room.
Fetal Growth and Fetoplacental Circulation in Pregnancies Following Bariatric Surgery: A Prospective Study
Authors: Maric T. , Kanu C. , Muller D.C. , Tzoulaki I. , Johnson M.R. , Savvidou M.D.
Published: February 2021

(BJOG. 2020;127:839–846)

Nearly one third of the population within the United States and one fourth of the population of the UK can be classified as obese, which includes one quarter of all reproductive-aged women. There are significant short-term and long-term adverse outcomes for both baby and mother associated with pregnancy while obese. Obese mothers exhibit a higher propensity for gestational diabetes mellitus, preeclampsia, cesarean delivery, or postpartum hemorrhage, as well as the development of cardiovascular disease and type 2 diabetes later in life. In addition to macrosomia, children of obese mothers are more likely to develop type 2 diabetes and cardiovascular disease in adulthood. Bariatric surgery, an effective weight-reduction treatment, is becoming more common for women of childbearing age. This study aimed to investigate the intrauterine fetal growth pattern and placental function, in postbariatric pregnancies as compared with patients of no history of maternal weight-loss surgery.
Early Acute Respiratory Support for Pregnant Patients With Coronavirus Disease 2019 (COVID-19) Infection
Authors: Pacheco Luis D. , Saad Antonio F. , Saade George
Published: February 2021

(Obstet Gynecol. 2020;136:1–4)

While pregnant patients appear to have less severe symptoms of coronavirus disease 2019 (COVID-19) than the general population, there are cases of severe disease in pregnancy. This report gives recommendations for basic initial respiratory support interventions for pregnant patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Supporting Lactation Within an Academic Anesthesia Department: Obstacles and Opportunities
Authors: Titler S.S. , Pearson A.C.S.
Published: February 2021

(Anesth Analg. 2020;131:1304–1307)

There is a growing number of women in academic anesthesiology, many of whom are in their prime reproductive years. Following maternity leave, many would like to continue breastfeeding, but there are a number of barriers. This report identifies common barriers to lactation in the workplace, solutions for removing these barriers, and requirements for lactation spaces in the workplace.
Single-Center Outcome of Fetoscopic Tracheal Balloon Occlusion for Severe Congenital Diaphragmatic Hernia
Authors: Baschat A.A. , Rosner M. , Millard S.E. , Murphy J.D. , Blakemore M.J. , Keiser A.M. , Kearney J. , Bullard J. , Nogee L.M. , Bembea M. , Jelin E.B. , Miller J.L.
Published: February 2021

(Obstet Gynecol. 2020;135:511–521)

Congenital diaphragmatic hernia, caused by the absence of the diaphragm or part of the diaphragm, leads to impaired fetal lung development as the abdominal contents move into the chest cavity. This is commonly managed with high-frequency oscillatory ventilation, pulmonary vasodilators, and extracorporeal membrane oxygenation, but the survival rate is <20% in cases with an observed lung/head ratio of <25% and intrathoracic liver herniation. In temporary fetoscopic tracheal balloon occlusion (FETO), the lungs are stretched and increase growth in airways and lung vasculature takes place. FETO has demonstrated increased survival rates, but is also associated with adverse outcomes such as preterm labor, rupture of membranes, and preterm birth. This study aimed to determine feasibility of FETO in cases of severe congenital diaphragmatic hernia.
Causal Genetic Variants in Stillbirth
Authors: Stanley K.E. , Giordano J. , Thorsten V. , Buchovecky C. , Thomas A. , Ganapathi M. , Liao J. , Dharmadhikari A.V. , Revah‐Politi A. , Ernst M. , Lippa N. , Holmes H. , Povysil G. , Hostyk J. , Parker C.B. , Goldenberg R. , Saade G.R. , Dudley D.J. , Pinar H. , Hogue C. , Reddy U.M. , Silver R.M. , Aggarwal V. , Allen A.S. , Wapner R.J. , Goldstein D.B.
Published: February 2021

(N Engl J Med. 2020;383:1107–1116)

Between 25% and 60% of stillbirth cases are unexplained. Exome sequencing has been used to determine the cause of disease, especially in childhood disorders and fetal structural anomalies. There is an opportunity to further apply clinical exome sequencing to investigating the cause of stillbirth. Previous studies on this topic have been small, concentrated on predetermined causes, and used data from early miscarriages. This study aimed to evaluate the diagnostic utility of clinical exome sequencing in stillbirth using a diverse cohort.
Molecular Interaction Between Butorphanol and K-opioid Receptor
Authors: Ji J. , Lin W. , Vrudhula A. , Xi J. , Yeliseev A. , Grothusen J.R. , Bu W. , Liu R.
Published: February 2021

(Anesth Analg. 2020;131:935–942)

An estimated 4% of adults in the United States misuse prescription opioids, caused in part by inappropriate prescribing. There is a lack of understanding of the pharmacological profiles of opioids and their medical indications. Butorphanol is a schedule intravenous opioid, less likely to be abused than morphine, but a more potent analgesic. Morphine is a full μ-opioid receptor agonist, while butorphanol is a partial μ-opioid receptor agonist and a K-opioid receptor (KOR) agonist. The butorphanol and KOR interactions between may be unique and of pharmacological and clinical importance. This study used computational and in vitro experiments to explore the interactions between butorphanol and KOR.