Ultrasound assessment of cervical status compared to the Bishop score - predicting the success of labor induction using a machine learning-based model

OBJECTIVE

The main aim of this study was to develop a machine-learning-based model for predicting the success of labor induction (IOL). To that end, the clinical and ultrasound parameters that affect the successfulness of labor induction were assessed. Then, a new ultrasound scoring system (USS) was developed and assessed.

PATIENTS AND METHODS

This prospective observational study included 192 term women who underwent induction of labor. First, a wide range of clinical and ultrasound pre-induction parameters were recorded. The induction was initiated by endocervical administration of dinoprostone gel (for Bishop score ≤5) or intravenous oxytocin (for Bishop score ≥6). After evaluating ultrasound parameters, we created an ultrasound scoring system and compared it with the Bishop score and clinical parameters. Finally, a comprehensive model using machine learning algorithms for predicting the success of the induction of labor was developed.

RESULTS

In terms of clinical parameters, this study found that IOL correlates with parity, body mass index (BMI) (both at p<0.05), and the Bishop score (p<0.001). All ultrasound parameters were statistically significant (p<0.05) apart from the posterior cervical angle. However, compared to the Bishop score, the new USS showed a slightly lower sensitivity (0.55 compared to 0.64) but much higher specificity (0.75 compared to 0.44) at a cut-off of 1.66. The proposed model, which can predict 83% of the events correctly, encompasses the Bishop score, USS, and clinical parameters.

CONCLUSIONS

The findings imply that the model developed in this study, which takes into account clinical parameters (parity, BMI), the ultrasound parameters and the Bishop score and uses machine learning algorithms, yields better results than models using other parameters.

Data blinding for the nEDM experiment at PSI

Psychological bias towards, or away from, prior measurements or theory predictions is an intrinsic threat to any data analysis. While various methods can be used to try to avoid such a bias, e.g. actively avoiding looking at the result, only data blinding is a traceable and trustworthy method that can circumvent the bias and convince a public audience that there is not even an accidental psychological bias. Data blinding is nowadays a standard practice in particle physics, but it is particularly difficult for experiments searching for the neutron electric dipole moment (nEDM), as several cross measurements, in particular of the magnetic field, create a self-consistent network into which it is hard to inject a false signal. We present an algorithm that modifies the data without influencing the experiment. Results of an automated analysis of the data are used to change the recorded spin state of a few neutrons within each measurement cycle. The flexible algorithm may be applied twice (or more) to the data, thus providing the option of sequentially applying various blinding offsets for separate analysis steps with independent teams. The subtle manner in which the data are modified allows one subsequently to adjust the algorithm and to produce a re-blinded data set without revealing the initial blinding offset. The method was designed for the 2015/2016 measurement campaign of the nEDM experiment at the Paul Scherrer Institute. However, it can be re-used with minor modification for the follow-up experiment n2EDM, and may be suitable for comparable projects elsewhere.

Prostaglandin E2, trace elements and levels of oxidative processes in spontaneous miscarriages

OBJECTIVE

We investigated the significance of prostaglandin (PG)E2, trace elements level, pro-oxidative and antioxidative parameters changes in spontaneous miscarriages.

PATIENTS AND METHODS

In the 125 first trimester pregnancies, 35 with complete spontaneous abortion (group S), 40 with missed abortion (M) and 50 healthy (H), PGE2 plasma concentrations were analysed by commercial ELISA kits, plasma trace elements colorimetrically, lipid peroxidation and the antioxidative enzyme activities in hemolysate by commercial sets. Student's t-test and ANOVA were applied.

RESULTS

Average PGE2 plasma concentration in the group H was higher than in S and M (p < 0.05). The higher average plasma Cu concentration, glutathione peroxidase and catalase contents were in the group H than in groups S and M (p < 0.01). Significantly lower value of lipid peroxidation was in the group H than in the groups S and M (p < 0.01). The lowest superoxide dismutase (SOD) content was in the group H and the highest in group S (p < 0.01).

CONCLUSIONS

In patients with abortions significantly lower levels of plasma PGE2, plasma Cu and anti-oxidative enzymes, except SOD, and significantly higher level of lipid peroxidation products than in healthy pregnancies may be important for miscarriage etiology and prevention.

Enhancement of electromagnetically induced absorption with elliptically polarized light--laser intensity dependent coherence effect

Using the (2)S(1/2)F(g) = 2 --> (2)P(3/2)F(e) = 3 transition in (87)Rb vapor at room temperature, we study effect of the laser light polarization on the electromagnetically induced absorption (EIA). This work extends the recent study of the behavior of the EIA as a function of the laser ellipticity (Brazhnikov et. al., JETP Lett. 83, 64, 2006). We have shown that such behavior strongly depends on the laser power. For the low laser power EIA amplitude has maximum for linearly polarized light, while for high laser power elliptically polarized light of ellipticity 15-20 degrees generates maximum of the EIA amplitude. EIA width varies slowly with the laser ellipticity at lower laser power, and much stronger at higher laser power. Through our theoretical model we attributed observed results to combined effect of the laser ellipticity and power on the population of ground state Zeeman sublevels.

Collaborative study on drug use in pregnancy: the results of the follow-up 10 years after (Novi Sad Centre)

An international multicenter study entitled Collaborative Study on Drug Use in Pregnancy (DUP) was initiated in 1987 by the Mario Negri Institute (Milano) and co-sponsored by the WHO Regional Office for Europe (Copenhagen). The study covered the use of medicines during pregnancy, labour and postpartum period. The Novi Sad centre contributed with 296 questionnaires. The aim of the study was to evaluate the pharmacotherapy by means of comparison, to identify problems in a particular settings and to plan actions toward improvement. The prescribing of some medicines in the Novi Sad center was found to be at the extreme, being among the lowest in the use of iron preparations during pregnancy and among the highest in the use of ergot alkaloids in the postpartum period. Educational efforts have been made to change this practice after the conclusion of the study in 1989. Ten years later, in 1999, the same questionnaire was applied to 100 women in the postpartum period in the same nursery, the Department of Obstetrics and Gynecology in Novi Sad. The results have shown a distinct improvement with the increase of iron prescribing during pregnancy and almost complete abandonment of postpartum use of ergot alkaloids. In the second study period some other inconsistencies with accepted therapeutical principles were identified. For example, although the use of analgesics fell from 22.3 to 8%, the selection changed towards the high use of metamizole (noraminophenazone) and no use of paracetamol (acetaminophen). It was concluded that international pharmacoepidemiological studies such as DUP, could substantially contribute to the improvement of pharmacotherapy if followed by appropriate actions in changing the prescribing behaviour of the physicians and information directed to the target population.

[Microalbuminuria in diabetics treated with insulin for more than 30 years]

Microalbuminuria was determined in the urine of 6 diabetics who had been treated with Insulin for over 30 years an had a normal kidney function. The values gained by the radial immunodiffusion method (VLC--Partigen Albumin) range from 0.001 gr/l to 0.008 gr/l of albumins in the urine. These values are much below the risky ones (over 0.020 gr/l), which signalize the evolution to the macroproteinuria and the development of the diabetic nephropathy. Over 30 years duration of the insulin-dependent diabetes, with no macroproteinuria pretors on the expression of diabetic nephropathy. 5 locus which is known to have the influence on the intensity of the immunological response.