1
|
Yuan Z, Yu D, Wang Y, Liu L, Wang J, Ma C, Wu S. Early delivery of human umbilical cord mesenchymal stem cells improves healing in a rat model of Achilles tendinopathy. Regen Med 2024; 19:93-102. [PMID: 38415316 DOI: 10.2217/rme-2023-0222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/29/2024] Open
Abstract
Objective: This study aimed to explore the efficacy and optimal delivery time of human umbilical cord mesenchymal stem cells (hUC-MSCs) in treating collagenase-induced Achilles tendinopathy. Methods: Achilles tendinopathy in rats at early or advanced stages was induced by injecting collagenase I into bilateral Achilles tendons. A total of 28 injured rats were injected with a hUC-MSC solution or normal saline into bilateral tendons twice and sampled after 4 weeks for histological staining, gene expression analysis, transmission electron microscope assay and biomechanical testing analysis. Results: The results revealed better histological performance and a larger collagen fiber diameter in the MSC group. mRNA expression of TNF-α, IL-1β and MMP-3 was lower after MSC transplantation. Early MSC delivery promoted collagen I and TIMP-3 synthesis, and strengthened tendon toughness. Conclusion: hUC-MSCs demonstrated a therapeutic effect in treating collagenase-induced Achilles tendinopathy, particularly in the early stage of tendinopathy.
Collapse
Affiliation(s)
- Ze Yuan
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Ding Yu
- Department of Rehabilitation Medicine, Guangzhou First People's Hospital, School of Medicine, South China University of Technology
| | - Yanxue Wang
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lijiaqi Liu
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Junchao Wang
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Chao Ma
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Shaoling Wu
- Department of Rehabilitation Medicine, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| |
Collapse
|
2
|
Mendu SB, Neela AR, Tammali S, Kotha R. Impact of Early Bonding During the Maternal Sensitive Period on Long-Term Effects: A Systematic Review. Cureus 2024; 16:e53318. [PMID: 38435959 PMCID: PMC10905202 DOI: 10.7759/cureus.53318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/31/2024] [Indexed: 03/05/2024] Open
Abstract
This research project examines the long-term effects of maternal-neonatal bonding during a mother's "sensitive period." The review explores how early contact between a mother and her newborn can affect their psychosocial and emotional well-being in the future. Within an hour after birth, oxytocin levels increase for mothers, while catecholamine surges enhance neonates' memory retention to encourage immediate skin-to-skin contact (SSC), which promotes breastfeeding with benefits, such as quicker placenta expulsion, less bleeding, and lower stress. As per sources to date, there is no systematic review on this subject; however, numerous studies exist regarding short-term outcomes, exclusive breastfeeding, and childhood problems. The exploration involves rigorous searches of academic databases following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for transparency and reproducibility by using the Population, Intervention, Comparison, and Outcome (PICO) framework. Of the 516 initially identified articles, only five were relevant based on refined selection criteria, making it clear from the analysis that sensitive-period bonding produces long-term impacts in infants. Few studies are available, particularly in recent years; thus, more research is required in this area.
Collapse
Affiliation(s)
| | - Aruna Rekha Neela
- Obstetrics and Gynecology, Government Medical College, Siddipet, Siddipet, IND
| | | | | |
Collapse
|
3
|
Liu G, Zhao L, Liu P, Dao R, Qian Y, Cong X, Janssens G, Li X, Ding X. The first investigation of spot-scanning proton arc (SPArc) delivery time and accuracy with different delivery tolerance window settings. Phys Med Biol 2023; 68:215003. [PMID: 37774715 DOI: 10.1088/1361-6560/acfec5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 09/29/2023] [Indexed: 10/01/2023]
Abstract
Objective. To investigate the impact of various delivery tolerance window settings on the treatment delivery time and dosimetric accuracy of spot-scanning proton arc (SPArc) therapy.Approach. SPArc plans were generated for three representative disease sites (brain, lung, and liver cancer) with an angle sampling frequency of 2.5°. An in-house dynamic arc controller was used to simulate the arc treatment delivery with various tolerance windows (±0.25, ±0.5, ±1, and ±1.25°). The controller generates virtual logfiles during the arc delivery simulation, such as gantry speed, acceleration and deceleration, spot position, and delivery sequence, similar to machine logfiles. The virtual logfile was then imported to the treatment planning system to reconstruct the delivered dose distribution and compare it to the initial SPArc nominal plan. A three-dimensional gamma index was used to quantitatively assess delivery accuracy. Total treatment delivery time and relative lost time (dynamic arc delivery time-fix beam delivery time)/fix beam delivery time) were reported.Main Results. The 3D gamma passing rate (GPR) was greater than 99% for all cases when using 3%/3 mm and 2%/2 mm criteria and the GPR (1%/1 mm criteria) degraded as the tolerance window opens. The total delivery time for dynamic arc delivery increased with the decreasing delivery tolerance window length. The average delivery time and the relative lost time (%) were 630 ± 212 s (253% ± 68%), 322 ± 101 s (81% ± 31%), 225 ± 60 s (27% ± 16%), 196 ± 41 s (11% ± 6%), 187 ± 29 s (6% ± 1%) for tolerance windows ±0.25, ±0.5, ±1, and ±1.25° respectively.Significance. The study quantitatively analyzed the dynamic SPArc delivery time and accuracy with different delivery tolerance window settings, which offer a critical reference in the future SPArc plan optimization and delivery controller design.
Collapse
Affiliation(s)
- Gang Liu
- Cancer Center, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430022, People's Republic of China
- Hubei Key Laboratory of Precision Radiation Oncology, Wuhan, People's Republic of China
- Institute of Radiation Oncology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, People's Republic of China
| | - Lewei Zhao
- Department of Radiation Oncology, Corewell Health Beaumont University, Royal Oak, MI,48073, United States of America
- Department of Radiation Oncology, Stanford University, CA, United States of America
| | - Peilin Liu
- Department of Radiation Oncology, Corewell Health Beaumont University, Royal Oak, MI,48073, United States of America
| | - Riao Dao
- School of Physics and Technology, Wuhan University, Wuhan,430072, People's Republic of China
| | - Yujia Qian
- School of Physics and Technology, Wuhan University, Wuhan,430072, People's Republic of China
| | - Xiaoda Cong
- Department of Radiation Oncology, Corewell Health Beaumont University, Royal Oak, MI,48073, United States of America
| | | | - Xiaoqiang Li
- Department of Radiation Oncology, Corewell Health Beaumont University, Royal Oak, MI,48073, United States of America
| | - Xuanfeng Ding
- Department of Radiation Oncology, Corewell Health Beaumont University, Royal Oak, MI,48073, United States of America
| |
Collapse
|
4
|
Huang S, Mai X, Liu H, Sun W, Zhu J, Du J, Lin X, Du Y, Zhang K, Yang X, Huang X. Plan quality and treatment efficiency assurance of two VMAT optimization for cervical cancer radiotherapy. J Appl Clin Med Phys 2023; 24:e14050. [PMID: 37248800 PMCID: PMC10562038 DOI: 10.1002/acm2.14050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 03/21/2023] [Accepted: 05/11/2023] [Indexed: 05/31/2023] Open
Abstract
To investigate the difference of the fluence map optimization (FMO) and Stochastic platform optimization (SPO) algorithm in a newly-introduced treatment planning system (TPS). METHODS 34 cervical cancer patients with definitive radiation were retrospectively analyzed. Each patient has four plans: FMO with fixed jaw plans (FMO-FJ) and no fixed jaw plans (FMO-NFJ); SPO with fixed jaw plans (SPO-FJ) and no fixed jaw plans (SPO-NFJ). Dosimetric parameters, Modulation Complexity Score (MCS), Gamma Pass Rate (GPR) and delivery time were analyzed among the four plans. RESULTS For target coverage, SPO-FJ plans are the best ones (P ≤ 0.00). FMO plans are better than SPO-NFJ plans (P ≤ 0.00). For OARs sparing, SPO-FJ plans are better than FMO plans for mostly OARs (P ≤ 0.04). Additionally, SPO-FJ plans are better than SPO-NFJ plans (P ≤ 0.02), except for rectum V45Gy. Compared to SPO-NFJ plans, the FMO plans delivered less dose to bladder, rectum, colon V40Gy and pelvic bone V40Gy (P ≤ 0.04). Meanwhile, the SPO-NFJ plans showed superiority in MU, delivery time, MCS and GPR in all plans. In terms of delivery time and MCS, the SPO-FJ plans are better than FMO plans. FMO-FJ plans are better than FMO-NFJ plans in delivery efficiency. MCSs are strongly correlated with PCTV length, which are negatively with PCTV length (P ≤ 0.03). The delivery time and MUs of the four plans are strongly correlated (P ≤ 0.02). Comparing plans with fixed or no fixed jaw in two algorithms, no difference was found in FMO plans in target coverage and minor difference in Kidney_L Dmean, Mu and delivery time between PCTV width≤15.5 cm group and >15.5 cm group. For SPO plans, SPO-FJ plans showed more superiority in target coverage and OARs sparing than the SPO-NFJ plans in the two groups. CONCLUSIONS SPO-FJ plans showed superiority in target coverage and OARs sparing, as well as higher delivery efficiency in the four plans.
Collapse
Affiliation(s)
- Sijuan Huang
- Department of Radiation Oncology, Sun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouGuangdongChina
| | - Xiuying Mai
- Department of Radiation Oncology, Sun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouGuangdongChina
| | - Hongdong Liu
- Department of Radiation Oncology, Sun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouGuangdongChina
| | - Wenzhao Sun
- Department of Radiation Oncology, Sun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouGuangdongChina
| | - Jinhan Zhu
- Department of Radiation Oncology, Sun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouGuangdongChina
| | - Jinlong Du
- Department of Radiation Oncology, Sun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouGuangdongChina
| | - Xi Lin
- Department of Radiation Oncology, Sun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouGuangdongChina
- School of Biomedical EngineeringGuangzhou Xinhua CollegeGuangzhouGuangdongChina
| | - Yujie Du
- Department of Radiation Oncology, Sun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouGuangdongChina
| | | | - Xin Yang
- Department of Radiation Oncology, Sun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouGuangdongChina
| | - Xiaoyan Huang
- Department of Radiation Oncology, Sun Yat‐sen University Cancer CenterState Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer MedicineGuangdong Key Laboratory of Nasopharyngeal Carcinoma Diagnosis and TherapyGuangzhouGuangdongChina
| |
Collapse
|
5
|
López-Jiménez N, García-Sánchez F, Pailos RH, Rodrigo-Álvaro V, Pascual-Pedreño A, Moreno-Cid M, Hernández-Martínez A, Molina-Alarcón M. Use of Vaginal Dinoprostone (PGE(2)) in Patients with Premature Rupture of Membranes (PROM) Undergoing Induction of Labor: A Comparative Study. J Clin Med 2022; 11. [PMID: 35456318 DOI: 10.3390/jcm11082217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/13/2022] [Accepted: 04/14/2022] [Indexed: 12/03/2022] Open
Abstract
Purpose: To evaluate the effect and safety of vaginal dinoprostone in pregnant women with PROM who undergo induction of labor (IoL). Materials and Methods: Prospective observational study conducted at La Mancha Centro hospital from 1 February 2019, to 30 August 2020. Obstetric and neonatal variables of 94 pregnant women with PROM who underwent IoL with vaginal dinoprostone were analyzed, and the results were compared with 330 patients without PROM who also underwent IoL. Bivariate and multivariate analyses were performed using binary and multiple linear regression. Results: A total of 424 women were included in this study. A greater response to cervical ripening (Bishop score > 6) with PGE2 was observed in the PROM group (odds ratio (OR) 2.73, 95% confidence interval (CI) 1.50−4.99, p = 0.001), as well as a shorter total duration of IoL (mean difference (MD) 2823.37 min (min), 95% CI 1257.30−4389.43, p < 0.001). Cesarean sections were performed in 28.7% (n = 27) of patients in the PROM group vs. 34.2% (n = 113) of patients in the non-PROM group, with no significant differences (OR 0.87%, 95% CI 0.47−1.60, p = 0.652). There were no significant differences in changes in the cardiotocographic record (CTG), postpartum hemorrhage (PPH), uterine rupture, or adverse neonatal outcomes between the two groups. Conclusions: The use of vaginal dinoprostone in pregnant women undergoing IoL with PROM is safe for the mother and the fetus, shortens the total delivery time, and does not increase the risk of cesarean section compared with pregnant women undergoing IoL without PROM.
Collapse
|
6
|
Uçar C, Bülbül M, Yıldız S. Cesarean delivery is associated with suppressed activities of the stress axes. Stress 2022; 25:67-73. [PMID: 34931594 DOI: 10.1080/10253890.2021.2015318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Maternal pre- and post-delivery stress levels might be different for vaginal or cesarean deliveries. This study aimed to investigate the effects of type of delivery (vaginal or cesarean) and time of delivery (pre- and post-delivery) on the stress axes of the body, namely the hypothalamic-pituitary adrenal axis (HPA) and autonomic nervous system (ANS).Ninety-one pregnant women were volunteered to participate this prospective study. In these women, pre- and post-delivery HPA and ANS activities were measured noninvasively by salivary cortisol and heart rate variability (HRV), respectively. HRV was measured by 5-min electrocardiogram recording and time- and frequency-domain parameters were computed.Salivary cortisol concentration and HRV parameters were higher in women having vaginal delivery than those having cesarean delivery (p < 0.05). Cortisol levels did not differ between pre- and post-delivery (p > 0.05) but the time-domain parameters of HRV decreased post-delivery (p < 0.05). No interactions were observed between the types and times of delivery (p > 0.05).HPA and ANS axes had different activity patterns throughout the delivery process and they were higher during vaginal delivery, suggesting that they are integral parts of normal birth process and that cesarean delivery perturbs the activity of both axes.
Collapse
Affiliation(s)
- Cihat Uçar
- Department of Physiology, Faculty of Medicine, University of Adıyaman, Adıyaman, Turkey
| | - Mehmet Bülbül
- Department of Gynecology and Obstetrics, Faculty of Medicine, University of Adiyaman, Adiyaman, Turkey
| | - Sedat Yıldız
- Department of Physiology, Faculty of Medicine, University of Inonu, Malatya, Turkey
| |
Collapse
|
7
|
Hjartardóttir H, Lund SH, Benediktsdóttir S, Geirsson RT, Eggebø TM. Can ultrasound on admission in active labor predict labor duration and a spontaneous delivery? Am J Obstet Gynecol MFM 2021; 3:100383. [PMID: 33901721 DOI: 10.1016/j.ajogmf.2021.100383] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/15/2021] [Accepted: 04/19/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Identifying predictive factors for a normal outcome at admission in the labor ward would be of value for planning labor care, timing interventions, and preventing labor dystocia. Clinical assessments of fetal head station and position at the start of labor have some predictive value, but the value of ultrasound methods for this purpose has not been investigated. Studies using transperineal ultrasound before labor onset show possibilities of using these methods to predict outcomes. OBJECTIVE This study aimed to investigate whether ultrasound measurements during the first examination in the active phase of labor were associated with the duration of labor phases and the need for operative delivery. STUDY DESIGN This was a secondary analysis of a prospective cohort study at Landspitali University Hospital, Reykjavík, Iceland. Nulliparous women at ≥37 weeks' gestation with a single fetus in cephalic presentation and in active spontaneous labor were eligible for the study. The recruitment period was from January 2016 to April 2018. Women were examined by a midwife on admission and included in the study if they were in active labor, which was defined as regular contractions with a fully effaced cervix, dilatation of ≥4 cm. An ultrasound examination was performed by a separate examiner within 15 minutes; both examiners were blinded to the other's results. Transabdominal and transperineal ultrasound examinations were used to assess fetal head position, cervical dilatation, and fetal head station, expressed as head-perineum distance and angle of progression. Duration of labor was estimated as the hazard ratio for spontaneous delivery using Kaplan-Meier curves and Cox regression analysis. The hazard ratios were adjusted for maternal age and body mass index. The associations between study parameters and mode of delivery were evaluated using receiver operating characteristic curves. RESULTS Median times to spontaneous delivery were 490 minutes for a head-perineum distance of ≤45 mm and 682 minutes for a head-perineum distance of >45 mm (log-rank test, P=.009; adjusted hazard ratio for a shorter head-perineum distance, 1.47 [95% confidence interval, 0.83-2.60]). The median durations were 506 minutes for an angle of progression of ≥93° and 732 minutes for an angle of progression of <93° (log-rank test, P=.008; adjusted hazard ratio, 2.07 [95% confidence interval, 1.15-3.72]). The median times to delivery were 506 minutes for nonocciput posterior positions and 677 minutes for occiput posterior positions (log-rank test, P=.07; adjusted hazard ratio, 1.52 [95% confidence interval, 0.96-2.38]) Median times to delivery were 429 minutes for a dilatation of ≥6 cm and 704 minutes for a dilatation of 4 to 5 cm (log-rank test, P=.002; adjusted hazard ratio, 3.11 [95% confidence interval, 1.68-5.77]). Overall, there were 75 spontaneous deliveries; among those deliveries, 16 were instrumental vaginal deliveries (1 forceps delivery and 15 ventouse deliveries), and 8 were cesarean deliveries. Head-perineum distance and angle of progression were associated with a spontaneous delivery with area under the receiver operating characteristic curves of 0.68 (95% confidence interval, 0.55-0.80) and 0.67 (95% confidence interval, 0.55-0.80), respectively. Ultrasound measurement of cervical dilatation or position at inclusion was not significantly associated with spontaneous delivery. CONCLUSION Ultrasound examinations showed that fetal head station and cervical dilatation were associated with the duration of labor; however, measurements of fetal head station were the variables best associated with operative deliveries.
Collapse
Affiliation(s)
- Hulda Hjartardóttir
- Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavík, Iceland (Drs Hjartardóttir, Benediktsdóttir, and Geirsson); Faculty of Medicine, University of Iceland, Reykjavík, Iceland (Drs Hjartardóttir, Benediktsdóttir, and Geirsson).
| | | | - Sigurlaug Benediktsdóttir
- Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavík, Iceland (Drs Hjartardóttir, Benediktsdóttir, and Geirsson); Faculty of Medicine, University of Iceland, Reykjavík, Iceland (Drs Hjartardóttir, Benediktsdóttir, and Geirsson)
| | - Reynir T Geirsson
- Department of Obstetrics and Gynecology, Landspitali University Hospital, Reykjavík, Iceland (Drs Hjartardóttir, Benediktsdóttir, and Geirsson); Faculty of Medicine, University of Iceland, Reykjavík, Iceland (Drs Hjartardóttir, Benediktsdóttir, and Geirsson)
| | - Torbjørn M Eggebø
- National Center for Fetal Medicine, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway (Dr Eggebø); Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway (Dr Eggebø); Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway (Dr Eggebø)
| |
Collapse
|
8
|
Chen Y, Sun L, Hua X, Li M, Yu S, Zhang J. Defining intertwin birth weight discordance and optimal delivery time in dichorionic twins: a retrospective cohort study. J Matern Fetal Neonatal Med 2020; 35:3915-3922. [PMID: 33249949 DOI: 10.1080/14767058.2020.1843627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND A high birth weight discordance (BWD) places twins at high risks of adverse perinatal outcomes; however, there is no commonly accepted definition of intertwin BWD. Given that gestational age (GA) is closely associated with both BWD and adverse neonatal outcomes, the aim of our study is to develop a measure that takes both BWD and GA into account to define BWD and explore the potentially optimal delivery time in dichorionic twins, with the balance against the risk of intrauterine demise and adverse neonatal outcomes. METHODS About 99,000 mixed gender twin pairs from the US matched multiple birth file from 1995 to 2000 were enrolled in our study. We set up a two-dimensional matrix model to select the BWD cutoff point related to outcomes. The optimal delivery time was identified based on the risks of adverse neonatal outcomes and fetal death by GA. RESULTS The combination of BWD and GA had a higher predictive performance for adverse neonatal outcomes than BWD alone (area under ROC curve (AUC): 0.816 vs. 0.523, p < .001). When GA was controlled for, the growth discordant cutoff point was BWD at the 40% level. The optimal delivery time suggested in dichorionic twins with BWD higher than 40% was identified at 33-34 gestational weeks. CONCLUSIONS The combination of BWD and GA was a better predictor for adverse neonatal outcomes than BWD alone. In dichorionic twins with BWD >40%, pregnancy may be continued till 33-34 gestation weeks if there is no indication for immediate delivery.
Collapse
Affiliation(s)
- Yan Chen
- Department of Neonatology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Luming Sun
- Department of Fetal Medicine, First Maternity and Infant Hospital Affiliated to Shanghai Tongji University, Shanghai, China
| | - Xiaolin Hua
- Department of Obstetrics, First Maternity and Infant Hospital Affiliated to Shanghai Tongji University, Shanghai, China
| | - Meng Li
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Stella Yu
- Center for Global Health and Health Policy, Global Health and Education Projects, Inc, Riverdale, MD, USA
| | - Jun Zhang
- MOE-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| |
Collapse
|
9
|
Dai CQ, Song Q, Guo L. An Intelligent Computing Method for Contact Plan Design in the Multi-Layer Spatial Node-Based Internet of Things. Sensors (Basel) 2018; 18:E2852. [PMID: 30158493 DOI: 10.3390/s18092852] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Revised: 08/25/2018] [Accepted: 08/26/2018] [Indexed: 11/17/2022]
Abstract
Computational Intelligence (CI) has been addressed as a great challenge in recent years, particularly the aspects of routing, task scheduling, and other high-complexity issues. Especially for the Contact Plan Design (CPD) that schedules contacts in dynamic and resource-constrained networks, a suitable CI algorithm can be exchanged for a high-quality Contact Plan (CP) with the appropriate computational overhead. Previous works on CPD mainly focused on the optimization of satellite network connectivity, but most of them ignored network topology characteristics. In this paper, we study the CPD issue in the spatial node based Internet of Things (IoT), which enables the spatial nodes to deliver data cooperatively via intelligent networking. Specifically, we first introduce a Multi-Layer Space Communication Network (MLSCN) model consisting of satellites, High Altitude Platforms (HAPs), Unmanned Aerial Vehicles (UAVs), and ground stations, on which a Time-Evolving Graph (TEG) is used to illustrate the CPD process. Then, according to the characteristics of each layer in the MLSCN, we design the corresponding CPs for the inter-layer contacts and intra-layer contacts. After that, a CI algorithm named as Multidirectional Particle Swarm Optimization (MPSO) is proposed for inter-layer CPD, which utilizes a grid-based initialization strategy to expand the diversity of individuals, in which a quaternary search method and quaternary optimization are introduced to improve efficiency of particle swarms in iterations and to ensure the continuous search ability, respectively. Furthermore, an optimized scheme is implemented for the intra-layer CPD to reduce congestion and improve transmission efficiency. Simulation results show that the proposed CPD scheme can realize massive data transmission with high efficiency in the multi-layer spatial node-based IoT.
Collapse
|
10
|
Yapca OE, Topdagi YE, Al RA. Fetus delivery time in extraperitoneal versus transperitoneal cesarean section: a randomized trial. J Matern Fetal Neonatal Med 2018; 33:657-663. [PMID: 29996688 DOI: 10.1080/14767058.2018.1499718] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Objective: We compared the extraperitoneal cesarean section to transperitoneal cesarean on fetal delivery time.Material and methods: This randomized study included 210 pregnant women undergoing cesarean section for elective reasons, repeat cesarean (< four), or dystocia. Patients who required an urgent cesarean section, who were at high risk for obstetric or maternal bleeding, who had a uterine or adnexal mass, or who requested tubal ligation were excluded from the study. The primary outcome of the study was the skin incision-to-delivery time. The sample size was set to detect of 1-minute difference in fetal delivery time between groups (two-tailed hypothesis, α = 0.05, β = 0.10). Secondary outcome measures were total operation time, intraoperative nausea, gag reflex, vomiting, pain and anxiety for those receiving regional anesthesia, postoperative pain, change in hemoglobin, postoperative analgesic requirements, nausea, vomiting and shoulder pain, urogenital distress, time until gas passage, and neonatal outcome.Results: No significant difference occurred between the two groups for skin incision-to- delivery time (extraperitoneal cesarean 3.9 minutes [2.1-7.3] versus transperitoneal cesarean 4.2 minutes [1.9-8.2], p = .065). Significant differences regarding intraoperative pain, total operation time, postoperative pain at the surgical site and shoulder pain, analgesic requirements, time until gas passage, and oral tolerability favored the extraperitoneal group. No significant differences between groups occurred regarding other seconder outcome parameters.Conclusions: There is no clinically significant difference between extraperitoneal cesarean section and transperitoneal cesarean on fetal delivery time. Extraperitoneal cesarean reduces postoperative pain, analgesic requirements, and improves oral tolerability.
Collapse
Affiliation(s)
- Omer E Yapca
- Department of Obstetrics and Gynecology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Yunus E Topdagi
- Department of Obstetrics and Gynecology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| | - Ragip A Al
- Department of Obstetrics and Gynecology, Atatürk University Faculty of Medicine, Erzurum, Turkey
| |
Collapse
|
11
|
Wang Y, Chen L, Zhu F, Guo W, Zhang D, Sun W. A study of minimum segment width parameter on VMAT plan quality, delivery accuracy, and efficiency for cervical cancer using Monaco TPS. J Appl Clin Med Phys 2018; 19:609-615. [PMID: 30058257 PMCID: PMC6123131 DOI: 10.1002/acm2.12422] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 06/27/2018] [Accepted: 07/03/2018] [Indexed: 11/15/2022] Open
Abstract
Purpose The purpose of this study was to study the influence of the minimum segment width (MSW) on volumetric modulated arc therapy (VMAT) plan quality, delivery accuracy, and efficiency for cervical cancer treatment. Methods Nineteen patients with cervical cancer were randomly selected to design VMAT plans. Three VMAT plans were generated for each patient incorporating MSWs of 0.5, 1.0, and 1.5 cm while other planning parameters remained constant using the Monaco treatment planning system (TPS) with 6 MV X rays delivered from an Elekta Synergy linear accelerator. Plan quality and delivery efficiency were evaluated based on dose‐volume histograms (DVHs), control points, monitor units (MUs), dosimetric measurement verification results, and plan delivery time. Results Except for the small difference in target dose coverage and maximum dose, there were no statistically significant differences between the other dosimetric parameters in the planning target volumes. The 1.0 and 1.5 cm MSW plans showed lower maximum doses to the spinal cord than the 0.5 cm plan; doses to other organs at risks were similar regardless of MSWs. The mean reductions of total MUs when compared with the 0.5 cm plan were 14.5 ± 6.1% and 20.9 ± 7.9% for MSWs of 1.0 and 1.5 cm, respectively. The calculated gamma indices using the 3% and 3 mm criteria were 96.2 ± 0.6%, 97.0 ± 0.6%, and 97.6 ± 0.6% for the 0.5, 1.0 and 1.5 cm MSW plans, respectively. The plan delivery times decreased with increasing MSWs (p < 0.05). Conclusion Increasing the MSW allows for improved plan delivery accuracy and efficiency without significantly affecting the VMAT plan quality. MSWs of 1.0 and 1.5 cm improved the plan quality, delivery accuracy, and efficiency for cervical VMAT radiation therapy.
Collapse
Affiliation(s)
- Yuanyuan Wang
- Department of Radiation Oncology, Hefei Ion Medical Center, Hefei, China
| | - Li Chen
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Fengying Zhu
- Shunde Hospital of Southern Medical University, Shunde, China
| | | | - Dandan Zhang
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| | - Wenzhao Sun
- State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Sun Yat-sen University Cancer Center, Guangzhou, China
| |
Collapse
|
12
|
Shimizu H, Sasaki K, Tachibana H, Tomita N, Makita C, Nakashima K, Yokoi K, Kubota T, Yoshimoto M, Iwata T, Kodaira T. Analysis of modulation factor to shorten the delivery time in helical tomotherapy. J Appl Clin Med Phys 2017; 18:83-87. [PMID: 28444831 PMCID: PMC5689868 DOI: 10.1002/acm2.12075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2016] [Revised: 02/14/2017] [Accepted: 02/17/2017] [Indexed: 11/12/2022] Open
Abstract
A low modulation factor (MF) maintaining a good dose distribution contributes to the shortening of the delivery time and efficiency of the treatment plan in helical tomotherapy. The purpose of this study was to reduce the delivery time using initial values and the upper limit values of MF. First, patients with head and neck cancer (293 cases) or prostate cancer (181 cases) treated between June 2011 and July 2015 were included in the analysis of MF values. The initial MF value (MFinitial ) was defined as the average MFactual value, and the upper limit of the MF value (MFUL ) was defined according the following equation: MFUL = 2 × standard deviation of MFactual value + the average MFactual Next, a treatment plan was designed for patients with head and neck cancer (62 cases) and prostate cancer (13 cases) treated between December 2015 and June 2016. The average MFactual value for the nasopharynx, oropharynx, hypopharynx, and prostate cases decreased from 2.1 to 1.9 (p = 0.0006), 1.9 to 1.6 (p < 0.0001), 2.0 to 1.7 (p < 0.0001), and 1.8 to 1.6 (p = 0.0004) by adapting the MFinitial and the MFUL values, respectively. The average delivery time for the nasopharynx, oropharynx, hypopharynx, and prostate cases also decreased from 19.9 s cm-1 to 16.7 s cm-1 (p < 0.0001), 15.0 s cm-1 to 13.9 s cm-1 (p = 0.025), 15.1 s cm-1 to 13.8 s cm-1 (p = 0.015), and 23.6 s cm-1 to 16.9 s cm-1 (p = 0.008) respectively. The delivery time was shortened by the adaptation of MFinitial and MFUL values with a reduction in the average MFactual for head and neck cancer and prostate cancer cases.
Collapse
Affiliation(s)
- Hidetoshi Shimizu
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Koji Sasaki
- Department of radiation therapy education and research, Graduate School of Radiological Technology, Gunma Prefectural College of Health Sciences, Maebashi, Gunma, Japan
| | - Hiroyuki Tachibana
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Natsuo Tomita
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Chiyoko Makita
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Kuniyasu Nakashima
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Kazushi Yokoi
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Takashi Kubota
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Manabu Yoshimoto
- Department of Radiology, Aichi Cancer Center Aichi Hospital, Okazaki, Aichi, Japan
| | - Tohru Iwata
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| | - Takeshi Kodaira
- Department of Radiation Oncology, Aichi Cancer Center Hospital, Nagoya, Aichi, Japan
| |
Collapse
|
13
|
Yonetani N, Yamamoto R, Murata M, Nakajima E, Taguchi T, Ishii K, Mitsuda N. Prediction of time to delivery by transperineal ultrasound in second stage of labor. Ultrasound Obstet Gynecol 2017; 49:246-251. [PMID: 27089836 DOI: 10.1002/uog.15944] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 03/26/2016] [Accepted: 04/14/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVE To investigate whether the transperineal sonographic (TPS) parameters angle of progression (AoP) and midline angle (MLA) can predict the time remaining in the second stage of labor. METHODS We evaluated prospectively women with a singleton pregnancy in cephalic presentation at term between October 2013 and September 2014. TPS volumes were obtained immediately after confirmation by digital vaginal examination of a fully dilated cervix. AoP and MLA were measured offline by analyzing the ultrasound volumes. Progression of labor was evaluated every hour during the second stage. The associations of AoP and MLA with the interval between TPS assessment and delivery were evaluated using multivariable Cox proportional hazards analyses in nulliparous and parous women separately. RESULTS A total of 557 women were evaluated. An AoP ≥ 160° (adjusted hazard ratio (aHR), 2.52 (95% CI, 1.98-3.19)) and MLA ≤ 10° (aHR, 1.79 (95% CI, 1.35-2.34)) in nulliparous women and an AoP ≥ 150° (aHR, 1.86 (95% CI, 1.34-2.57)) and MLA ≤ 20° (aHR, 1.69 (95% CI, 1.21-2.34)) in parous women were significantly associated with the remaining time in labor. The positive/negative likelihood ratios of AoP, MLA, clinical station (fetal head descent as observed by digital examination) and clinical rotation (fetal head rotation as observed by digital examination) at these cut-off points were 3.6/0.6, 2.0/0.6, 1.6/0.6 and 1.6/0.8, respectively, in nulliparous women, and 2.4/0.6, 1.3/0.7, 7.6/0.5 and 5.2/0.7, respectively, in parous women. CONCLUSION TPS assessment of AoP and MLA in the second stage of labor was useful for predicting the time remaining in labor and had higher predictive value than did digital vaginal examination in nulliparous women. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.
Collapse
Affiliation(s)
- N Yonetani
- Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
| | - R Yamamoto
- Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
| | - M Murata
- Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan
| | - E Nakajima
- Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
| | - T Taguchi
- Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
| | - K Ishii
- Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
| | - N Mitsuda
- Department of Maternal Fetal Medicine, Osaka Medical Center and Research Institute for Maternal and Child Health, Izumi, Osaka, Japan
| |
Collapse
|