Objectives . To estimate the risk of uterine rupture in women with a previous cesarean delivery before 32 weeks’ gestation and a trial of labor. Design . Retrospective case control study. Setting . Level III maternity center. Methods . Among women with trial of labor, the case and control groups were women with previous cesarean section before and after 32 weeks, respectively. The main outcome was uterine rupture, defined as rupture of the three layers of the uterine wall. Results . The study compared 108 trials of labor in patients with a previous cesarean delivery at a mean gestation of 29.8 weeks±2.0 SD and 137 trials of labor in patients with a previous cesarean delivery at a mean gestation of 39.2 weeks±2.3 SD. Mode of delivery did not differ between groups. Two uterine ruptures (1.9%, 95% CI: 0.0–4.4) occurred in the case group and none in the control group ( p = 0.16). Uterine ruptures caused no serious maternal or neonatal complications. The condition of the neonates was similar in the two groups. Conclusion . In view of the small number of uterine ruptures and the absence of severe maternal and fetal consequences over an 8‐year period, a trial of labor may be proposed to women with a history of cesarean delivery before 32 weeks, when obstetrical conditions are optimal.
Objective . To assess the diagnostic accuracy and show the prognostic influence of different ultrasonographic criteria in triplet pregnancies(TP). Design. Retrospective study. Setting. Tertiary care center in France. Population. Fifty‐one consecutive TP in which at least one of the children, live‐ or stillborn, weighed 500 g or more, and with a gestation period of at least 22 weeks. Methods . Chorionicity, abnormal umbilical artery Doppler waveforms, intrauterine weight (IUW) <10th centile and prenatal diagnosis of fetal anomaly were studied simultaneously as prognostic criteria. Chorionicity was confirmed at birth by placental pathology. Main outcome measures . Diagnosis of chorionicity/amnionicity and IUW <10th centile. Neonatal intensive care unit admission, occurrence of respiratory distress syndrome and perinatal mortality . Results . Prenatal misclassification of chorionicity/amnionicity after postnatal perinatal pathology review was 12%. The positive predictive value of IUW <10th centile diagnosis was 44% for the prediction of birthweight <10th centile. Prenatal diagnosis of mono‐ or dichorionic placentation was associated with increased neonatal morbidity in comparison with that of trichorionic triplets. Perinatal mortality was significantly increased where mono‐ or dichorionic placentation was diagnosed prenatally (OR: 4.2; CI: 1.04–17), IUW <10th centile (OR: 10; CI: 2.4–41), with raised odds for abnormal umbilical Doppler measurements (OR: 9.7; CI: 2–47) and fetal anomaly (OR: 6.4; CI: 1.4–28.9). Conclusion . Early prenatal diagnosis of chorionicity is of major importance in triplet pregnancy. Experienced sonographers must quickly evaluate any uncertain diagnosis. In cases of unknown chorionicity, other ultrasonographic criteria can highlight high‐risk triplet pregnancy, but at a later stage.
International audienceThe isosteric heat of the carbon dioxide adsorption on activated carbon is determined by grand canonical Monte Carlo simulations. The results, obtained at room temperature and low pressures for an adorbent model with a slit type porosity, show that the isosteric heat depends strongly on the slit width. The maximun of the isosteric heat is reached for a pore with a width such as cooperative effects between the adsorbed molecules enhance the adsorption. The possibility to estimate the isosteric heat of a macroscopic sample, from adsorption isotherms computed for a distribution of slit pores with given sizes, is discussed
International audienceIn this paper, we discuss the class of Bilinear GATRCH (BL-GARCH) models which are capable of capturing simultaneously two key properties of non-linear time series : volatility clustering and leverage effects. It has been observed often that the marginal distributions of such time series have heavy tails ; thus we examine the BL-GARCH model in a general setting under some non-Normal distributions. We investigate some probabilistic properties of this model and we propose and implement a maximum likelihood estimation (MLE) methodology. To evaluate the small-sample performance of this method for the various models, a Monte Carlo study is conducted. Finally, within-sample estimation properties are studied using S&P 500 daily returns, when the features of interest manifest as volatility clustering and leverage effects
In an effort to gain better understanding of the assessment of prior informal and non‐formal learning, this article explores assessors’ approaches to portfolio assessment. Through this portfolio assessment, candidates had requested exemptions from specific courses within an educational programme or admission to the programme based on their prior learning. The assessors judged the portfolios according to set rating criteria, and subsequently discussed their approaches. Their decision‐making processes, perception of portfolio use in the Assessment of Prior Learning (APL), deciding factors in portfolio assessment and use of the rating criteria were key elements in this discussion. The results show that they do use the rating criteria as an indicator in decision‐making, but have mixed perceptions regarding the fairness of APL portfolio assessment. They perceive the portfolio evidence in combination with sound argumentation as the deciding elements in portfolio assessment.
A multi-residue method was developed for monitoring antibiotic residues in milk using liquid chromatography coupled to a tandem quadrupole mass spectrometer (LC/MS-MS). Two very short extractions followed by two LC/MS-MS acquisitions allowed the screening of 58 antibiotics belonging to eight different families (penicillins, cephalosporins, sulfonamides, macrolides, lincosamides, aminoglycosides, tetracyclines, and quinolones). This method is currently implemented in the laboratory in a qualitative way, i.e. monitoring the presence or absence of residue in a sample and identification of the analyte before the confirmation step. In order to assess the performance of this method, a validation strategy described in an internal guideline for the validation of screening methods was applied. The aim of the validation was to prove sufficient sensitivity of the method to detect all the targeted antibiotics at the level of interest (maximum residue limit, MRL) at least. According to European Commission Decision 2002/657/EC, the suitable sensitivity of a screening method can be demonstrated when the CCbeta is below or equal to the MRL and so the false-compliant rate below or equal to 5% at the MRL level. The validation scheme was established in order to take into account various variability factors: the apparatus response, the interday repeatability, the matrix effect, etc. The results of the validation clearly demonstrate the suitability of this method for the detection and identification of more than 50 antibiotics and they are in agreement with the results obtained in routine analysis.
We investigated the perception of emotional stimuli in anxious individuals and non-anxious cohorts. Signal detection theory analysis was applied to the discrimination of emotionally charged faces at several points along a continuum of emotional intensity. This design permitted the derivation of multiple measures of sensitivity and response bias for fearful and for happy faces. Anxious individuals lacked a conservative bias in judging fearful stimuli and a liberal bias in judging positive stimuli compared with non-anxious individuals. In addition, anxious participants had lower perceptual sensitivity (d′) than non-anxious participants for mildly threatening stimuli, as well as a trend towards lower perceptual sensitivity for moderately positive stimuli. These results suggest that the processing of threat information in anxiety is affected by sensitivity and bias differently at different levels of affective intensity.
There are few epidemiological data available on rare skin cancer, including Merkel cell carcinoma, Paget's disease, adnexal carcinoma, and sarcoma. We conducted this study to investigate the epidemiology of rare skin cancer diagnosed in the department of Doubs from 1980 to 2004.