Spontaneous versus Induced Labor Delivery, a Retrospective Analysis

Background: Induction of labor is the stimulation of the uterus to initiate the labor process whether by administering oxytocin, prostaglandin or reputing the membrane [1]. It was realized that the number of induction of labor patients was thought to be increasing in comparison with the spontaneous labor patients. Therefore, the complications of induced labor were higher. A detailed analysis was needed to confirm that. Objective: The aim of the study is to analyze the outcomes between spontaneous versus induced labor. Materials and Methods: A retrospective analysis was conducted at our tertiary care university hospital, in the period from December 2015 to December 2016 when 311 women were divided into two groups: group 1, women who had spontaneous labor (n = 106) compared with group 2, women who were labor induced (n = 205). Complications of pregnancy, delivery type, tear, episiotomy, blood transfusion and instruments used were analyzed retrospectively. Results: The mean ± SD of baseline characteristics, like age, height, weight, BMI and hemoglobin level for all study samples was 28.59 ± 5.95 years, 1.58 ± 0.06 m, 71.77 ± 13.42 kg, 28.59 ± 5.89 kg/m2 and 11.08 ± 1.45 g/dl respectively. A statistically significant difference was noticed in the duration of labor between spontaneous and induced labor (95% CI: 9.194 - 152.130;p-value 0.004 and OR: 0.239). There was no significant difference in complications, delivery type (Spontaneous Vaginal Delivery (SVD) or other), blood transfusion, and instrument used between women who had spontaneous labor versus induced labor. However, significant differences in tear (95% CI: 4.354 - 0.996;p-value 0.035) and episiotomy (95% CI: 0.928 - 0.224;p-value 0.028) were found between the two groups. In conclusion, the induced labor was found to be associated with high incidence of duration of labor, tear and episiotomy. Patients should always be counseled when there it is an option between the two delivery types.

Uterine Rupture in an Unscarred Uterus Following Induced Labor with Titrated Oral Misoprostol

Misoprostol (Cytotec, Pfizer) is a prostaglandin E1 analogue widely used in labor induction. Understanding of potential risks of misoprostol in labor induction is lacking as the drug is used off-label in most countries. A 35-year-old G3P2 woman with post-date pregnancy at 40 + 3 weeks was induced using titrated oral misoprostol. Following delivery, post-partum hemorrhage was noted and, upon discovery of a uterine wall rupture due to congenital weakness of the myometrium, emergency abdominal total hysterectomy was conducted. Following surgery, the patient made a full recovery and was discharged. The main contraindications for misoprostol in labor induction are a scarred uterus or multipara greater than 4. Uterine wall weakness should be considered as a potential contraindication. Extreme vigilance is required in use of misoprostol for labor induction.

Laboratory Experiment on Wave Induced Turbulence

A laboratory experiment was conducted inside a wind wave tank to investigate the wave induced turbulence. In this experiment, the wave surface elevation and velocity beneath the water surface were measured simultaneously to investigate the relation between the wave status and wave induced turbulence. The profile of the turbulent dissipation rate and Reynolds stress were calculated using experimental data. The effect of the wave status on turbulence is investigated with regard to the wind wave, swell, and mixed wave conditions. It was depicted that the turbulence decreased with increasing depth from the water surface and that the turbulence that was induced by a wave with larger wavelength and wave height is much stronger for the same wave status. Finally, we observed that the wind wave is more effective in activating the wave induced turbulence.

Butorphanol in epidural:Could this be the breakthrough solution for safe and effective labor analgesia that we've been waiting for?

The authors have conducted a comprehensive investigation into the safety and effectiveness of butorphanol for epidural analgesia during labor.Their critical analysis of the paper and discussion of the technique's advantages and disadvantages provide a thorough understanding of the topic.

Rural labor migration and farmers’arrangements of rice production systems in Central China:Insight from the intergenerational division of labor

Rice production is crucial for food security in China,and its relationship with rural labor migration has been studied extensively.Labor migration in rural China has taken new forms in recent years.There has been a discernible trend wherein adult children have started migrating to cities while their elderly parents return to villages to re-engage in on-farm work.The phenomenon has notably shaped the intergenerational division of labor(IDL)within households.However,it remains to be seen how farmers adjust their rice production systems in response to the IDL.The age of 60 years for employment injury insurance is the eligibility threshold for off-farm employment and is used to obtain a source of exogenous variation in the IDL.Based on a representative household survey of 1,752 rice farmers in the Hubei Province of Central China,our fuzzy regression discontinuity analysis reveals that farmers in IDL households are more likely to adopt ratoon rice(RR)than single cropping rice(SR)or double cropping rice(DR).The effect of the IDL varies under different levels of operational scales and specialized agricultural service availability.Further analysis suggests that farmers’arrangements are associated with two potential mechanisms of downward intergenerational transfer.Monetary transfer for urban housing purchases increases RR in IDL households,and time transfer for intergenerational childcare significantly promotes SR in IDL households.This study enhances the understanding of the relationship between rural labor migration and rice production in China,providing a reference for adjusting rice production systems to ensure food security.

Safety and effectiveness of butorphanol in epidural labor analgesia:A protocol for a systematic review and meta-analysis

BACKGROUND Epidural analgesia is the most effective analgesic method during labor.Butorphanol administered epidurally has been shown to be a successful analgesic method during labor.However,no comprehensive study has examined the safety and efficacy of using butorphanol as an epidural analgesic during labor.AIM To assess butorphanol's safety and efficacy for epidural labor analgesia.METHODS The PubMed,Cochrane Library,EMBASE,Web of Science,China National Knowledge Infrastructure,and Google Scholar databases will be searched from inception.Other types of literature,such as conference abstracts and references to pertinent reviews,will also be reviewed.We will include randomized controlled trials comparing butorphanol with other opioids combined with local anesthetics for epidural analgesia during labor.There will be no language restrictions.The primary outcomes will include the visual analog scale score for the first stage of labor,fetal effects,and Apgar score.Two independent reviewers will evaluate the full texts,extract data,and assess the risk of bias.Publication bias will be evaluated using Egger's or Begg's tests as well as visual analysis of a funnel plot,and heterogeneity will be evaluated using the Cochran Q test,P values,and I2 values.Meta-analysis,subgroup analysis,and sensitivity analysis will be performed using RevMan software version 5.4.This protocol was developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)Protocols statement,and the PRISMA statement will be used for the systematic review.RESULTS This study provides reliable information regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.CONCLUSION To support clinical practice and development,this study provides evidence-based findings regarding the safety and efficacy of using butorphanol as an epidural analgesic during labor.

Coupled multiphysical model for investigation of influence factors in the application of microbially induced calcite precipitation

The study presents a comprehensive coupled thermo-bio-chemo-hydraulic(T-BCH)modeling framework for stabilizing soils using microbially induced calcite precipitation(MICP).The numerical model considers relevant multiphysics involved in MICP,such as bacterial ureolytic activities,biochemical reactions,multiphase and multicomponent transport,and alteration of the porosity and permeability.The model incorporates multiphysical coupling effects through well-established constitutive relations that connect parameters and variables from different physical fields.It was implemented in the open-source finite element code OpenGeoSys(OGS),and a semi-staggered solution strategy was designed to solve the couplings,allowing for flexible model settings.Therefore,the developed model can be easily adapted to simulate MICP applications in different scenarios.The numerical model was employed to analyze the effect of various factors,including temperature,injection strategies,and application scales.Besides,a TBCH modeling study was conducted on the laboratory-scale domain to analyze the effects of temperature on urease activity and precipitated calcium carbonate.To understand the scale dependency of MICP treatment,a large-scale heterogeneous domain was subjected to variable biochemical injection strategies.The simulations conducted at the field-scale guided the selection of an injection strategy to achieve the desired type and amount of precipitation.Additionally,the study emphasized the potential of numerical models as reliable tools for optimizing future developments in field-scale MICP treatment.The present study demonstrates the potential of this numerical framework for designing and optimizing the MICP applications in laboratory-,prototype-,and field-scale scenarios.

Advances in epidural labor analgesia:Effectiveness and treatment strategies of butorphanol

In this editorial,we provide a critical review of the article by Tang et al published in the World J Clin Cases,focusing on the utilization of butorphanol for epidural analgesia during labor.Our discussion encompasses recent research developments in epidural labor analgesia,specifically highlighting the current status of clinical applications of butorphanol and associated treatment approaches.Epidural analgesia is widely acknowledged as the primary method for pain management during labor,offering effective and prolonged pain relief while allowing mothers to remain alert and actively participate in the delivery process.Among the various drugs utilized for epidural labor analgesia,butorphanol has received increasing attention due to its potential efficacy and distinctive pharmacological properties.As a synthetic opioid analgesic,butorphanol exhibits both agonistic and antagonistic activity on opioid receptors,striking a balance between analgesia and minimizing side effects.Nevertheless,the safety and efficacy of butorphanol in epidural labor analgesia remains controversial.While certain studies have reported positive outcomes with butorphanol,including effective pain relief and a reduced incidence of side effects,others have raised concerns about its safety and efficacy compared to traditional opioids or alternative analgesics.In addition,the optimal dosing strategy and regimen of butorphanol as an adjuvant in epidural labor analgesia still need to be verified.Through comprehensive synthesis and analysis of existing literature,we aim to evaluate the current evidence regarding the use of butorphanol for epidural labor analgesia,delineate areas of consensus and controversy,and propose future avenues for research and clinical practice in this domain.

Association of Squatting Activities of Pregnant Women during the Antenatal Period and Labor Outcomes

Aim: To investigate impact of antenatal squatting activities on labour outcomes. Methods: All eligible primigravida women, with singleton cephalic fetuses, who presented to ward 18 of Colombo South Teaching Hospital, Sri Lanka, during the period 1st of February to 28th of May 2017 were invited into the study. Those who were already in active stage of labor (at least more than two moderate contractions per 10 minutes) on admission were excluded. Demographic data such as age, ethnicity, religion, educational level, occupation, latrine type in use, and booking Body mass index (BMI) were collected via an interviewer administered questionnaire. Data related to labor (modified Bishop score at onset of active labor, labor augmentation, pain relief, labor duration, mode of delivery, episiotomy or tears) and neonatal outcome (birth weight, APGAR score at 1, 5, 10 minutes) were collected from delivery notes. A pre tested interviewer administered questionnaire was used to obtain data regarding routine squatting activities during the previous 6 months. Pain visual analogue scale was used on day after delivery to assess the degree of labour pain. Duration of each squatting activity per day and number of days engaged with the activity per week;were used to calculate total squatting hours per week. In the absence of an accepted threshold for adequate squatting, we employed the sample mean as an operational data-driven threshold to define “more” against “less” squatting activities. Women who did not have squatting activities were considered as the controls. We used chi-square and Fisher’s exact tests to compare characteristics and outcomes between those engaging in more and less levels of squatting activity. We fitted a series of logistic regression models with each dichotomized outcome as the dependent variable, more/less squatting activity as the main independent variable of interest, and age, gestation period, BMI and patient’s occupation as covariates. The resulting adjusted odds ratios (AOR) and their 95% confidence intervals (CI) and statistical significance (p < 0.05) were used to draw conclusions of adjusted associations. Results: We recruited 430 women into this study. Overall, 68% of the women were of 20 - 30 years old, 47% had normal body mass index and 65% were housewives. The most frequent squatting activities were for urination/defecation and clothes washing (146 and 62 minutes/week, respectively). Mean total time was 246 minutes per week, of which more than 147 women (34%) achieved above this level of squatting activities. Those with more squatting activities had a greater modified Bishop Score ≥ 6/10 (92% vs 82%;p < 0.01);labor duration of <6 hours (82% vs 56%;p < 0.01), less likely for labour augmentation (39% vs 51%;p < 0.01) and pain relief (53% vs 65%;p = 0.013). Similar results were obtained after adjustments for maternal age, BMI, gestational age and occupation. However, there were no significant differences in the mode of delivery (normal vaginal vs instrumental vs caesarean), episiotomy rate, birth weight and neonatal Apgar scores. Conclusion: Squatting activities of more than 246 minutes per week may improve labor outcome. Women should be encouraged to increase squatting exercises or incorporate more habitual squatting activities antenatally.

Flow-Slip Stability Behavior of Calcareous Sand Treated by Microbially Induced Carbonate Precipitation Technology

Flow-slip damage commonly destabilizes coastal slopes.Finding a slope stabilization method for calcareous sands in the South China Sea is crucial.Microbially induced calcite precipitation is a promising,eco-friendly method for soil stabilization.This study investigates the effect of microbial treatments,initial relative density,initial cell pressure,and initial stress ratio on the flow-slip stability of calcareous sand specimens by using constant shear drained tests.These tests lay the foundation to study the mechanical instability of sand slopes.Results show that the microbial-treated specimens maintain stable stresses longer,take longer to reach the instability,and withstand larger volumetric strains.Microbial treatment effectively enhances sand stability under constant shear drainage,with improvements amplified by higher initial relative density and initial cell pressure.In addition,a smaller initial stress ratio reduces shear effects on the specimen and increases resistance to flow slides.Microanalysis reveals that the flow-slip stability of calcareous sand slopes is enhanced by contact cementation,particle coating,void filling,and mutual embedment of calcium carbonate crystals.

Is Induction of Labor with Early Rupture of Membranes Associated with an Increased Rate of Clinical Chorioamnionitis?

Objective: The objective of this study was to determine if early rupture of membranes (ROM) in women undergoing induction of labor (IOL) at term is associated with an increased rate of clinical chorioamnionitis. Study Design: A retrospective cohort study was performed on women undergoing IOL. Early ROM was defined as ROM at a modified Bishop score less than 5, cervical dilation less than 4 cm, or cervical effacement less than 80%. The rate of clinical chorioamnionitis was compared between women with early and late ROM. Results: The rate of clinical chorioamnionitis was 8.6% (24/279). ROM at an effacement of less than 80% was associated with a rate of clinical chorioamnionitis of 15.4% (12/78) compared to 6.0% (12/201) at an effacement of equal to or greater than 80%, p = 0.017. The rate of cesarean delivery was higher for patients with early ROM by any definition: 32% compared to 17.5% by modified Bishop score (p = 0.031), 32.4% versus 18.2% by cervical dilation (p = 0.049), and 33.3% versus 14.9% by cervical effacement (p = 0.001). Conclusions: In patients undergoing IOL, early ROM may be associated with an increased rate of clinical chorioamnionitis when performed at a cervical effacement of less than 80% and an increased rate of cesarean delivery.

Implications for fault reactivation and seismicity induced by hydraulic fracturing

Evaluating the physical mechanisms that link hydraulic fracturing(HF) operations to induced earthquakes and the anticipated form of the resulting events is significant in informing subsurface fluid injection operations. Current understanding supports the overriding role of the effective stress magnitude in triggering earthquakes, while the impact of change rate of effective stress has not been systematically addressed. In this work, a modified critical stiffness was brought up to investigate the likelihood, impact,and mitigation of induced seismicity during and after hydraulic fracturing by developing a poroelastic model based on rate-and-state fraction law and linear stability analysis. In the new criterion, the change rate of effective stress was considered a key variable to explore the evolution of this criterion and hence the likelihood of instability slip of fault. A coupled fluid flow-deformation model was used to represent the entire hydraulic fracturing process in COMSOL Multiphysics. The possibility of triggering an earthquake throughout the entire hydraulic fracturing process, from fracturing to cessation, was investigated considering different fault locations, orientations, and positions along the fault. The competition between the effects of the magnitude and change rate of effective stress was notable at each fracturing stage. The effective stress magnitude is a significant controlling factor during fracturing events, with the change rate dominating when fracturing is suddenly started or stopped. Instability dominates when the magnitude of the effective stress increases(constant injection at each fracturing stage) and the change rate of effective stress decreases(the injection process is suddenly stopped). Fracturing with a high injection rate, a fault adjacent to the hydraulic fracturing location and the position of the junction between the reservoir and fault are important to reduce the Coulomb failure stress(CFS) and enhance the critical stiffness as the significant disturbance of stresses at these positions in the coupled process. Therefore,notable attention should be given to the injection rate during fracturing, fault position, and position along faults as important considerations to help reduce the potential for induced seismicity. Our model was verified and confirmed using the case of the Longmaxi Formation in the Sichuan Basin, China, in which the reported microseismic data were correlated with high critical stiffness values. This work supplies new thoughts of the seismic risk associated with HF engineering.

Patient-derived induced pluripotent stem cells with a MERTK mutation exhibit cell junction abnormalities and aberrant cellular differentiation potential

BACKGROUND Human induced pluripotent stem cell(hiPSC)technology is a valuable tool for generating patient-specific stem cells,facilitating disease modeling,and invest-igating disease mechanisms.However,iPSCs carrying specific mutations may limit their clinical applications due to certain inherent characteristics.AIM To investigate the impact of MERTK mutations on hiPSCs and determine whether hiPSC-derived extracellular vesicles(EVs)influence anomalous cell junction and differentiation potential.METHODS We employed a non-integrating reprogramming technique to generate peripheral blood-derived hiPSCs with and hiPSCs without a MERTK mutation.Chromo-somal karyotype analysis,flow cytometry,and immunofluorescent staining were utilized for hiPSC identification.Transcriptomics and proteomics were employed to elucidate the expression patterns associated with cell junction abnormalities and cellular differentiation potential.Additionally,EVs were isolated from the supernatant,and their RNA and protein cargos were examined to investigate the involvement of hiPSC-derived EVs in stem cell junction and differentiation.RESULTS The generated hiPSCs,both with and without a MERTK mutation,exhibited normal karyotype and expressed pluripotency markers;however,hiPSCs with a MERTK mutation demonstrated anomalous adhesion capability and differentiation potential,as confirmed by transcriptomic and proteomic profiling.Furthermore,hiPSC-derived EVs were involved in various biological processes,including cell junction and differentiation.CONCLUSION HiPSCs with a MERTK mutation displayed altered junction characteristics and aberrant differentiation potential.Furthermore,hiPSC-derived EVs played a regulatory role in various biological processes,including cell junction and differentiation.

Research on the mechanism of rockburst induced by mined coal-rock linkage of sharply inclined coal seams

In recent years,the mining depth of steeply inclined coal seams in the Urumqi mining area has gradually increased.Local deformation of mining coal-rock results in frequent rockbursts.This has become a critical issue that affects the safe mining of deep,steeply inclined coal seams.In this work,we adopt a perspective centered on localized deformation in coal-rock mining and systematically combine theoretical analyses and extensive data mining of voluminous microseismic data.We describe a mechanical model for the urgently inclined mining of both the sandwiched rock pillar and the roof,explaining the mechanical response behavior of key disaster-prone zones within the deep working face,affected by the dynamics of deep mining.By exploring the spatial correlation inherent in extensive microseismic data,we delineate the“time-space”response relationship that governs the dynamic failure of coal-rock during the progression of the sharply inclined working face.The results disclose that(1)the distinctive coal-rock occurrence structure characterized by a“sandwiched rock pillar-B6 roof”constitutes the origin of rockburst in the southern mining area of the Wudong Coal Mine,with both elements presenting different degrees of deformation localization with increasing mining depth.(2)As mining depth increases,the bending deformation and energy accumulation within the rock pillar and roof show nonlinear acceleration.The localized deformation of deep,steeply inclined coal-rock engenders the spatial superposition of squeezing and prying effects in both the strike and dip directions,increasing the energy distribution disparity and stress asymmetry of the“sandwiched rock pillar-B3+6 coal seam-B6 roof”configuration.This makes worse the propensity for frequent dynamic disasters in the working face.(3)The developed high-energy distortion zone“inner-outer”control technology effectively reduces high stress concentration and energy distortion in the surrounding rock.After implementation,the average apparent resistivity in the rock pillar and B6 roof substantially increased by 430%and 300%,respectively,thus guaranteeing the safe and efficient development of steeply inclined coal seams.

High performance micromachining of sapphire by laser induced plasma assisted ablation(LIPAA)using GHz burst mode femtosecond pulses

GHz burst-mode femtosecond(fs)laser,which emits a series of pulse trains with extremely short intervals of several hundred picoseconds,provides distinct characteristics in materials processing as compared with the conventional irradiation scheme of fs laser(single-pulse mode).In this paper,we take advantage of the moderate pulse interval of 205 ps(4.88 GHz)in the burst pulse for high-quality and high-efficiency micromachining of single crystalline sapphire by laser induced plasma assisted ablation(LIPAA).Specifically,the preceding pulses in the burst generate plasma by ablation of copper placed behind the sapphire substrate,which interacts with the subsequent pulses to induce ablation at the rear surface of sapphire substrates.As a result,not only the ablation quality but also the ablation efficiency and the fabrication resolution are greatly improved compared to the other schemes including single-pulse mode fs laser direct ablation,single-pulse mode fs-LIPAA,and nanosecond-LIPAA.

Local Climate Change Induced by Urbanization on a South China Sea Island

The South China Sea is a hotspot for regional climate research.Over the past 40 years,considerable improvement has been made in the development and utilization of the islands in the South China Sea,leading to a substantial change in the land-use of the islands.However,research on the impact of human development on the local climate of these islands is lacking.This study analyzed the characteristics of local climate changes on the islands in the South China Sea based on data from the Yongxing Island Observation Station and ERA5 re-analysis.Furthermore,the influence of urbanization on the local climate of the South China Sea islands was explored in this study.The findings revealed that the 10-year average temperature in Yongxing Island increased by approximately 1.11℃from 1961 to 2020,and the contribution of island development and urbanization to the local warming rate over 60 years was approximately 36.2%.The linear increasing trend of the annual hot days from 1961–2020 was approximately 14.84 days per decade.The diurnal temperature range exhibited an increasing trend of 0.05℃per decade,whereas the number of cold days decreased by 1.06days per decade.The rapid increase in construction on Yongxing Island from 2005 to 2021 led to a decrease in observed surface wind speed by 0.32 m s^(-1)per decade.Consequently,the number of days with strong winds decreased,whereas the number of days with weak winds increased.Additionally,relative humidity exhibited a rapid decline from 2001 to 2016 and then rebounded.The study also found substantial differences between the ERA5 re-analysis and observation data,particularly in wind speed and relative humidity,indicating that the use of re-analysis data for climate resource assessment and climate change evaluation on island areas may not be feasible.

Dengue induced acute liver failure:A meta summary of case reports

BACKGROUND Dengue fever is the most common cause of viral hemorrhagic fever,with more than 400 million cases being reported annually,worldwide.Even though hepatic involvement is common,acute liver failure(ALF)is a rare complication of dengue fever.AIM To analyze the demographic profile,symptomology,hospital course and outcomes of patients presenting with ALF secondary to dengue infection by reviewing the published case reports.METHODS A systematic search was performed from multiple databases including PubMed,Reference Citation Analysis,Science Direct,and Google Scholar.The search terms used were"dengue"OR"severe dengue"OR"dengue shock syndrome"OR"dengue haemorrhagic syndrome"OR"dengue fever"AND"acute liver failure"OR"hepatic failure"OR"liver injury".The inclusion criteria were:(1)Case reports or case series with individual patient details;(2)Reported acute liver failure secondary to dengue infection;and(3)Published in English language and on adult humans.The data were extracted for patient demographics,clinical sympto-matology,clinical interventions,hospital and intensive care unit course,need for organ support and clinical outcomes.RESULTS Data from 19 case reports fulfilling the predefined inclusion criteria were included.The median age of patients was 38 years(inter quartile range:Q3-Q126.5 years)with a female preponderance(52.6%).The median days from diagnosis of dengue to development of ALF was 4.5 d.The increase in aspartate aminotransferase was higher than that in alanine aminotransferase(median 4625 U/L vs 3100 U/L).All the patients had one or more organ failure,with neurological failure present in 73.7%cases.42.1%patients required vasopressor support and hepatic enceph-alopathy was the most reported complication in 13(68.4%)cases.Most of the patients were managed conser-vatively and 2 patients were taken up for liver transplantation.Only 1 death was reported(5.3%).CONCLUSION Dengue infection may rarely lead to ALF.These patients may frequently require intensive care and organ support.Even though most of these patients may improve with supportive care,liver transplantation may be a therapeutic option in refractory cases.

Analysis of the Effect of Midwives’ Psychological Care Intervention on the Progress of Labor and Cesarean Rate of Elderly Women in Labor

Objective:To analyze the effect of midwife psychological nursing intervention in the clinical care of elderly women in labor.Methods:According to the order of admission,74 elderly women were divided into the control group and the observation group.In addition to the routine perinatal nursing interventions,the observation group strengthened the implementation of midwives’psychological nursing interventions.The duration of labor,mode of delivery,psychological state,and stress response indexes of the two groups were analyzed and compared.Results:The observation group had a shorter duration of all labor stages and total duration of labor than the control group,a lower cesarean section rate than the control group,and a higher degree of improvement in anxiety,depression,and stress response indexes in the 3-day postpartum period as compared to the control group(P<0.05).Conclusion:The implementation of midwife psychological care intervention in perinatal care of elderly women can further shorten the duration of labor,reduce the cesarean section rate,and improve the psychological state and stress indicators,which is worth promoting.

A Study on the Correlation of Body Mass Management During Pregnancy with Adverse Pregnancy Outcomes and Labor Progression

Objective:To investigate the effects of body mass management during pregnancy on adverse pregnancy outcomes,duration of labor,and neonatal birth weight.Methods:472 pregnant women who visited Beijing Anzhen Hospital from January to December 2023 were selected,and the pregnant women were divided into 236 each in the observation group and the control group.Body mass of pregnant women was measured and BMI was calculated in early and late pregnancy respectively,and the pregnant women in the control group were guided by routine management,while the observation group was guided by body mass management during pregnancy.The growth of maternal body mass,mode of delivery,postpartum hemorrhage,neonatal score,neonatal blood glucose at birth,and umbilical artery blood,as well as the comparison of the duration of labor,were observed.Results:The observation group was significantly better than the control group in terms of mode of delivery,postpartum hemorrhage,and body mass growth,with statistically significant differences(P<0.05),and there was no statistical significance in terms of neonatal scores,neonatal blood glucose at birth,and umbilical artery blood(P>0.05);the time of the first stage of labor and the time of the second stage of labor of the mothers in the observation group was significantly better than that of the control group,with statistical differences(P<0.05),and the time of the third stage of labor of the mothers in the observation group was statistically better than that of the control group.There was no statistically significant difference between the time of the third stage of labor in the observation group and the control group(P>0.05),and the time of the total stage of labor in the observation group was statistically better than that in the control group(P<0.05).Conclusion:Body mass management during pregnancy can effectively improve maternal control of weight gain,reduce labor time,and decrease the occurrence of adverse pregnancy outcomes.

Contribution of the MERISE-Type Conceptual Data Model to the Construction of Monitoring and Evaluation Indicators of the Effectiveness of Training in Relation to the Needs of the Labor Market in the Republic of Congo

This study proposes the use of the MERISE conceptual data model to create indicators for monitoring and evaluating the effectiveness of vocational training in the Republic of Congo. The importance of MERISE for structuring and analyzing data is underlined, as it enables the measurement of the adequacy between training and the needs of the labor market. The innovation of the study lies in the adaptation of the MERISE model to the local context, the development of innovative indicators, and the integration of a participatory approach including all relevant stakeholders. Contextual adaptation and local innovation: The study suggests adapting MERISE to the specific context of the Republic of Congo, considering the local particularities of the labor market. Development of innovative indicators and new measurement tools: It proposes creating indicators to assess skills matching and employer satisfaction, which are crucial for evaluating the effectiveness of vocational training. Participatory approach and inclusion of stakeholders: The study emphasizes actively involving training centers, employers, and recruitment agencies in the evaluation process. This participatory approach ensures that the perspectives of all stakeholders are considered, leading to more relevant and practical outcomes. Using the MERISE model allows for: • Rigorous data structuring, organization, and standardization: Clearly defining entities and relationships facilitates data organization and standardization, crucial for effective data analysis. • Facilitation of monitoring, analysis, and relevant indicators: Developing both quantitative and qualitative indicators helps measure the effectiveness of training in relation to the labor market, allowing for a comprehensive evaluation. • Improved communication and common language: By providing a common language for different stakeholders, MERISE enhances communication and collaboration, ensuring that all parties have a shared understanding. The study’s approach and contribution to existing research lie in: • Structured theoretical and practical framework and holistic approach: The study offers a structured framework for data collection and analysis, covering both quantitative and qualitative aspects, thus providing a comprehensive view of the training system. • Reproducible methodology and international comparison: The proposed methodology can be replicated in other contexts, facilitating international comparison and the adoption of best practices. • Extension of knowledge and new perspective: By integrating a participatory approach and developing indicators adapted to local needs, the study extends existing research and offers new perspectives on vocational training evaluation.