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Little is known about the pregnancy outcomes of women who have had a stroke prior to a first pregnancy.
To identify a cohort of primiparous women giving birth to a single baby and compare the pregnancy outcomes of those with a pre-pregnancy stroke hospitalisation record to those without a stroke hospitalisation record.
Record linkage study of all primiparous women aged 15-44years with singleton pregnancies birthing in New South Wales, Australia from 2003 to 2015. Stroke was identified from 2001 to 2015 hospital data using International Classification of Diseases tenth Edition - Australian Modification codes I60-64. Women whose first hospital record of stroke was during pregnancy or <42days after birth were excluded. Immunology chemical Outcomes included diabetes or hypertension during pregnancy, mode of delivery, haemorrhage, severe maternal morbidity (validated composite outcome indicator), gestational age at birth, Apgar score (1min<7), and small-for-gestational age.
Of 487767 women with a first pregnancy, 124 (2.5/10000) had a hospital record which included a pre-pregnancy stroke diagnosis. Women with a stroke history were more likely to have an early-term delivery (37-38weeks; relative risk (RR) 1.49, 95% CI 1.17-1.90) and a pre-labour caesarean (RR 2.83, 95% CI 2.20-3.63). There were no significant differences in other maternal or neonatal outcomes.
This is the largest reported study of pregnancy and birth outcomes for women with a history of stroke. With the exception of pre-labour caesarean, there were no differences in pregnancy outcomes for women with a history of stroke compared with women with no history of stroke.
This is the largest reported study of pregnancy and birth outcomes for women with a history of stroke. With the exception of pre-labour caesarean, there were no differences in pregnancy outcomes for women with a history of stroke compared with women with no history of stroke.
Ridge-furrow mulching farming systems (RFMs) aim to increase field productivity and improve water use efficiency. To explore environment-friendly and efficient farming systems is a central aspect of rainfed wheat field management in Kenya where rainfall utilization is at a low level. We introduced RFMs (including plastic film and grass straw mulching) to semiarid Kenya to evaluate the effects on field productivity, rainwater utilization, soil quality and economic profitability using old and modern wheat cultivars from 2012 to 2013.
Across the cultivars, the RFMs increased grain yield, aboveground biomass and water use efficiency by 74-163%, 36-104% and 89-273%, respectively, compared with conventional flat planting (control). RFMs significantly shortened the vegetative period while prolonging the reproductive period. The net economic output under RFMs was 74-165% higher than that of the control. Grass straw mulching achieved the highest economic output to input ratio, almost 45% higher than plastic film mulching, despite the former harvested only 82% of the maximum field productivity of the latter. Compared with the control, grass straw mulching promoted the contents of soil organic carbon, total nitrogen and CN ratio by 14%, 8% and 5%, respectively, while obviously decreased values of these parameters were observed under plastic mulching.
Through reducing soil water loss, and improving rainwater use efficiency and soil quality, ridge-furrow grass straw mulching would be a sustainable option for boosting field productivity and thus ensuring local food security in rainfed agricultural areas of Kenya. © 2020 Society of Chemical Industry.
Through reducing soil water loss, and improving rainwater use efficiency and soil quality, ridge-furrow grass straw mulching would be a sustainable option for boosting field productivity and thus ensuring local food security in rainfed agricultural areas of Kenya. © 2020 Society of Chemical Industry.
COVID-19 required rapid innovation throughout the healthcare system. Home-based primary care (HBPC) practices faced unique challenges maintaining services for medically complex older populations for whom they needed to adapt a traditionally hands-on, model of care to accommodate restrictions on in-person contact. Our aim was to determine strategies used by New York City (NYC)-area HBPC practices to provide patient care during the first wave of the COVID-19 pandemic with the goal of informing planning and preparation for home-based practices nationwide.
Cross-sectional qualitative design using semi-structured interviews.
HBPC practices in the NYC metro area during spring 2020.
HBPC leadership including clinical/medical directors, program managers, nurse practitioners/nursing coordinators, and social workers/social work coordinators (n = 13) at 6 NYC-area practices.
Semi-structured interviews explored HBPC practices' COVID-19 care delivery challenges, adaptations, and advice for providers. Interviewery, teamwork, and partnerships with outside providers. As the pandemic continues to surge around the United States, HBPC providers may apply these lessons and consider resources needed to prepare for future challenges.
NYC-area HBPC providers adapted care delivery and operations rapidly during the height of the COVID-19 pandemic. Keeping older, medically complex patients safe in their homes required considerable flexibility, transparency, teamwork, and partnerships with outside providers. As the pandemic continues to surge around the United States, HBPC providers may apply these lessons and consider resources needed to prepare for future challenges.Orthodontic tooth movement (OTM) is a specific treatment of malocclusion, whose regulation mechanism is still not clear. This study aimed to reveal the relationship between the sympathetic nervous system (SNS) and OTM through the construction of an OTM rat model through the utilization of orthodontic nickeltitanium coiled springs. The results indicated that the stimulation of SNS by dopamine significantly promote the OTM process represented by the much larger distance between the first and second molar compared with mere exertion of orthodontic force. Superior cervical ganglionectomy (SCGx) can alleviate this promotion effect, further proving the role of SNS in the process of OTM. Subsequently, the ability of orthodontic force to stimulate the center of the SNS was visualized by the tyrosin hydroxylase (TH) staining of neurons in ventromedial hypothalamic nucleus (VMH) and arcuate nucleus (ARC) of the hypothalamus, as well as the up-regulated expression of norepinephrine in local alveolar bone. Moreover, we also elucidated that the stimulation of SNS can promote osteoclast differentiation in periodontal ligament cells (PDLCs) and bone marrow-derived cells (BMCs) through regulation of receptor activator of nuclear factor-κB ligand (RANKL)/osteoprotegerin (OPG) system, thus promoting the OTM process.
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