Childbirth education can help pregnant individuals feel in control, relieve anxiety and fear, and decrease pain perception. However, many barriers exist that impede patients from obtaining adequate ...childbirth education, especially in the era of the COVID-19 pandemic. Advances in technology, such as podcasts, can allow for asynchronous patient education.
This study aimed to assess the effect of a labor education podcast on personal perception of control and patient satisfaction during childbirth.
This was a randomized controlled trial that included nulliparous, low-risk women with singleton gestations who reached 36 weeks’ gestation at 2 academic hospitals in Philadelphia, Pennsylvania. Participants were randomized at 28 weeks and 0 days of gestation to usual education (control) or podcast education (intervention), which included links to 7 labor-related podcast episodes on patient-suggested topics that were available on widely-used podcatchers. Primary outcomes were assessed with a 3-question birth satisfaction survey and the Labour Agentry Scale to evaluate personal perception of control during childbirth. Secondary outcomes included the Edinburgh Postnatal Depression Scale score. Analyses were performed as intention-to-treat. Parametric and nonparametric data were compared using the Student t-test or Wilcoxon rank-sum test, as appropriate.
A total of 201 women were randomized, and 153 were included in the final analysis (78 in podcast and 75 in control group). There were no significant differences in maternal demographics. Patients in the podcast group had higher median birth satisfaction scores compared with the control group (20 18–21 vs 18 16–21; P=.002), without a significant difference in median Labour Agentry Scale scores (57 50–63 vs 54 47–62; P=.12). When restricting analysis to patients who underwent induction, Labour Agentry Scale scores were significantly higher in the podcast group (58 53–64 vs 54 47–61; P=.045), representing an increased perception of control. However, birth satisfaction score was not different between the groups (P=.06). The most downloaded podcasts were on induction and labor anesthesia. More than 95% of participants would recommend the podcasts to family and friends.
An educational podcast on labor topics was well-received, increased patient satisfaction overall, and increased labor agentry among those who were induced. Podcasts are a promising educational modality to improve patient experience during childbirth, and warrant further exploration.
The classical heterocoupling of a 1-haloalkyne with a terminal alkyne catalyzed by copper salts in the presence of a base for the synthesis of unsymmetrical diynes is termed the Cadiot-Chodkiewicz ...coupling reaction. The diynes are of great importance due to their biological, optical and electronic properties. A number of modifications have been developed recently to improve the efficiency of Cadiot-Chodkiewicz coupling reactions in terms of selectivity and yield. This is the first review on the Cadiot-Chodkiewicz cross-coupling reaction which highlights the modern approaches and protocols developed for the synthesis and applications of unsymmetrical 1,3-diynes.
The classical heterocoupling of a 1-haloalkyne with a terminal alkyne catalyzed by copper salts in the presence of a base for the synthesis of unsymmetrical diynes is termed the Cadiot-Chodkiewicz coupling reaction.
To use administrative claims data to evaluate the association of a remote blood pressure monitoring program with adverse postpartum clinical outcomes in patients with a hypertensive disorder of ...pregnancy.
This was a retrospective cohort study of Independence Blue Cross members with a hypertensive disorder of pregnancy diagnosis across three obstetric hospitals from 2017 to 2021. Patients who were enrolled in twice-daily text-based blood pressure monitoring for 10 days postpartum were compared with two propensity-score matched cohorts of patients who met the program criteria: an asynchronous cohort (cohort A), consisting of patients at any of the three participating hospitals before remote monitoring program implementation, and a contemporaneous cohort (cohort C), consisting of patients at other hospitals during the same time period as clinical use of the program. Patients with less than 16 months of continuous insurance enrollment before delivery were excluded. Claims for adverse clinical outcomes after delivery discharge were evaluated. Health care service utilization and total medical costs were evaluated.
The 1,700 patients in remote blood pressure monitoring program were matched to 1,021 patients in cohort A and 1,276 in cohort C. Within the first 6 months after delivery, patients enrolled in remote monitoring were less likely to have the composite adverse outcome than those in cohort A (2.9% vs 4.7%; OR 0.61, 95% CI 0.40-0.98). There was no statistically significant difference relative to cohort C (3.2% vs 4.5%; OR 0.71, 95% CI 0.47-1.07). The remote monitoring group had more cardiology visits and fewer postnatal emergency department (ED) visits and readmissions compared with both comparison cohorts. Reductions in ED visits and readmissions drove overall lower total medical costs for the program cohort.
Patients enrolled in a remote blood pressure monitoring program were less likely to experience an adverse outcome in the first 6 months after delivery. Reductions in ED visits and readmissions resulted in lower postpartum total medical costs compared with both control cohorts. Broad implementation of evidence-based remote monitoring programs may reduce postpartum adverse outcomes, thereby reducing morbidity and mortality in populations such as the one studied here.
The objective of the present investigation was to assess the potential of magnesium oxide nanoparticle (MgO NP)-loaded electrospun polycaprolactone (PCL) polymer composites as a bone-soft tissue ...engineering scaffold. MgO NPs were synthesized using a hydroxide precipitation sol-gel method and characterized using field emission gun-scanning electron microscopy/energy-dispersive x-ray spectroscopy (FEG-SEM/EDS), field emission gun-transmission electron microscopy (FEG-TEM), and x-ray diffraction (XRD) analysis. PCL and MgO-PCL nanocomposite fibers were fabricated using electrospinning with trifluoroethanol as solvent at 19 kV applied voltage and 1.9 ml h−1 flow rate as optimized process parameters, and were characterized by FEG-TEM, FEG-SEM/EDS, XRD, and differential scanning calorimetry analyses. Characterization studies of as-synthesized nanoparticles revealed diffraction peaks indexed to various crystalline planes peculiar to MgO particles with hexagonal and cubical shape, and 40-60 nm size range. Significant improvement in mechanical properties (tensile strength and elastic modulus) of nanocomposites was observed as compared to neat polymer specimens (fourfold and threefold, respectively), due to uniform dispersion of nanofillers along the polymer fiber length. There was a remarkable bioactivity shown by nanocomposite scaffolds in immersion test, as indicated by formation of surface hydroxyapatite layer by the third day of incubation. MgO-loaded electrospun PCL mats showed enhanced in-vitro biological performance with osteoblast-like MG-63 cells in terms of adhesion, proliferation, and marked differentiation marker activity owing to greater surface roughness, nanotopography, and hydrophilicity facilitating higher protein adsorption. In-vivo subcutaneous implantation study in Sprague Dawley rats revealed initial moderate inflammatory tissue response near implant site at the second week timepoint that subsided later (eighth week) with no adverse effect on vital organ functionalities as seen in histopathological analysis supported by serum biochemical and hematological parameters which did not deviate significantly from normal physiological range, indicating good biocompatibility in-vivo. Thus, MgO-PCL nanocomposite electrospun fibers have potential as an efficient scaffold material for bone-soft tissue engineering applications.
The prevalence of Helicobacter pylori infection remains significant worldwide and it depends on many factors: gender, age, socio-economic status, geographic area, diet, and lifestyle. All successful ...infectious diseases treatments use antibiotic-susceptibility testing, but this strategy is not currently practical for H. pylori and the usual cure rates of H. pylori are lower than other bacterial infections. Actually, there is no treatment that ensures complete eradication of this pathogen. In the context of an alarming increase in resistance to antibiotics (especially to clarithromycin and metronidazole), alternative and complementary options and strategies are taken into consideration. As the success of antibacterial therapy depends not only on the susceptibility to given drugs, but also on the specific doses, formulations, use of adjuvants, treatment duration, and reinfection rates, this review discusses the current therapies for H. pylori treatment along with their advantages and limitations. As an alternative option, this work offers an extensively referenced approach on natural medicines against H. pylori, including the significance of nanotechnology in developing new strategies for treatment of H. pylori infection.
Traumatic brain injury (TBI) survivors often suffer from long-lasting cognitive impairment that stems from hippocampal injury. Systemic administration of insulin-like growth factor-1 (IGF-1), a ...polypeptide growth factor known to play vital roles in neuronal survival, has been shown to attenuate posttraumatic cognitive and motor dysfunction. However, its neuroprotective effects in TBI have not been examined. To this end, moderate or severe contusion brain injury was induced in mice with conditional (postnatal) overexpression of IGF-1 using the controlled cortical impact (CCI) injury model. CCI brain injury produces robust reactive astrocytosis in regions of neuronal damage such as the hippocampus. We exploited this regional astrocytosis by linking expression of hIGF-1 to the astrocyte-specific glial fibrillary acidic protein (GFAP) promoter, effectively targeting IGF-1 delivery to vulnerable neurons. Following brain injury, IGF-1Tg mice exhibited a progressive increase in hippocampal IGF-1 levels which was coupled with enhanced hippocampal reactive astrocytosis and significantly greater GFAP levels relative to WT mice. IGF-1 overexpression stimulated Akt phosphorylation and reduced acute (1 and 3d) hippocampal neurodegeneration, culminating in greater neuron survival at 10d after CCI injury. Hippocampal neuroprotection achieved by IGF-1 overexpression was accompanied by improved motor and cognitive function in brain-injured mice. These data provide strong support for the therapeutic efficacy of increased brain levels of IGF-1 in the setting of TBI.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
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