The Rate of Caesarean Sections in Burkina Faso’s Regional and University Hospitals According to the Classification System of Robson’s Ten Groups

Background: Quality assurance in labor and delivery is needed. The method must be simple and consistent, and be of universal value. The 10-Group Classification System is a simple method providing a common starting point for further detailed analysis within which all perinatal events and outcomes can be measured and compared. Objective: The purpose of this study was to analyze cesarean section (CS) rates using the classification system of Robson’s ten groups and to identify the main contributors to the overall CS rate in Burkina Faso’s regional and university hospitals. Materials and Method: A cross-sectional study with retrospective collection was carried out. All women who gave birth between July 1, 2017 and June 30, 2018, in the Regional Hospital Centres (RHC) and University Hospital Centres (UHC) of Burkina Faso were classified according to the Robson ten-group method. The overall CS rates and in each Robson group were calculated, as well as the contribution of each group to the overall CS rate. Results: The CS rate was 26.5% (8543 out of 32,240 deliveries) during the study period. nulliparous women with single term pregnancy in cephalic presentation during spontaneous labour (group 1), multiparous women with single pregnancy in cephalic presentation, gestational age ≥37SA, spontaneous labour (group 3) and multiparous women with previous CS (group 5) were the main contributors (67.7%) to the overall CS rate. In addition, we observed a variation in CS rates between different hospitals, especially among women with full-term pregnancies in cephalic presentation without previous CS (groups 1 to 4), showing large differences in emergency obstetric and neonatal care across the country. Conclusions: Women in groups 1, 3 and 5 were the most important contributors to the overall CS rate in Burkina Faso. It appears that efforts to reduce the overall rate of CS should focus on vaginal delivery on the scarred uterus, reduction of CS rates in nulliparous women with full-term pregnancy in cephalic presentation (groups 1) and proper monitoring of multiparous women with full-term pregnancy in spontaneous labour (group 3).

Group Psychological Intervention for Children with Hyperactivity Disorder

ADHD is a broad psychiatric disorder that affects children of normal or near-normal intelligence.It is character-ized by inattention,hyperactivity,and age-inappropriate impulsivity,and it is often accompanied by learning dif-ficulties,behavioral,emotional,and interpersonal problems.On the other hand,hyperactive tendencies in children with ADHD exhibit ADHD-like behaviors such as lack of self-control,inattention,hyperactivity,and emotional impulsivity.However,because their symptoms are less severe,they do not meet the diagnostic criteria for ADHD but are ADHD or at risk of developing ADHD.The purpose of this study is to alleviate and reduce children’s hyperactivity symptoms by investigating the current situation of the children studied,and systemati-cally intervening and educating children with ADHD through psychological group intervention.Research data shows that ADHD is most commonly diagnosed in school-age children,and in 70%–80%of children with ADHD,symptoms persist into adolescence and 30%into adulthood.Through the use of group psychological intervention in the experiment,the prevalence rate of children with hyperactivity disorder tendency has been effectively reduced.This shows that group psychological intervention training has a significant effect on improving hyper-activity symptoms in children with ADHD tendency.

基于Robson十分类法分析大连市部分医院剖宫产指征的分布

目的 基于Robson十分类法分析大连市部分医院剖宫产指征的分布。方法 选取2021年1月至12月大连市8家助产医疗机构收治的17 270例孕产妇(约占大连市2021年全市分娩量的52%),根据Robson十分类进行分类,并分析剖宫产指征。结果 孕产妇总体剖宫产率为42.29%(7304/17 270),基于Robson十分类法分析占比较高者为1组(单胎头位、自然临产、29.35%,5069/17 270)、2A组(单胎头位、初产妇引产临产、16.83%,2908/17 270)、2B组(单胎头位、初产妇临产前剖宫产、16.55%,2858/17270)。剖宫产指征中占比较高者为:瘢痕子宫(29.57%,2160/7304)、臀位(9.06%,662/7304)、无指征剖宫产(8.41%,614/7304)。剖宫产总数较高组为2B组(39.13%,2858/7304),前3名剖宫产指征:无指征剖宫产(17.98%,514/2858)、高龄初产(15.61%,446/2858)、巨大儿(14.59%,417/2858)。5A组(1次剖宫产史组)占剖宫产总数27.60%(2016/7304),首位剖宫产指征:瘢痕子宫(99.12%,1999/2016)。2A组占剖宫产总数的7.86%(574/7304),首位剖宫产指征:产程异常(21.77%,125/574)。结论 基于Robson十分类法,对不同组别产妇剖宫产率及剖宫产指征进行分析,有助于识别降低剖宫产率的目标人群,并做出针对性干预措施。

Cesarean Sections according to the Robson’s Classification in Two University Hospitals of Yaoundé: Indications and Maternofetal Outcome

Introduction: Cesarean section is a surgical intervention which consists in the extraction of a fetus from the uterus after its incision. The rate of cesarean section varies depending on the country and the health facility. For this reason, in 2015, the World Health Organization (WHO) recommended the use of Robson’s classification to evaluate the practice of cesarean sections in order to identify the groups of women who had abnormally high rates. The objective of our study was to evaluate cesarean sections using the Robson’s classification in CHRACERH and in the Yaoundé Central Hospital (YCH). Methodology: We carried out a retrospective cross sectional and descriptive study in two (02) university hospitals in Yaoundé which took place from December 2017 to May 2018. We included in our study all women who gave birth over a period of two (02) years from January 2016 to December 2017 in these two health facilities. Our sampling was exhaustive over the study period. The parturients’ information was collected using an anonymous and pretested questionnaire. The Robson’s group of every parturient was determined. Descriptive parameters like mean and proportions were calculated. We compared the rates and indications of cesarean sections between the both hospitals using Chi2 test. Results: Out of 330 deliveries realized in CHRACERH, we had 90 cesarean sections;hence, a rate of 27.2%. Out of 1863 deliveries carried out at the YCH, 462 were by cesarean section, hence a rate of 24.8%. The women who belonged to groups 1, 3 and 5 contributed to the highest rates of cesarean sections in both hospitals: in CHRACERH, group 5 (31.1%), group 3 (20%) and group 1 (15.6%), at YCH: group 3 (22.5%), group 1 (21.6%) and group 5 (17.3%). The indications of the cesarean sections varied depending on the Robson’s group and the hospital, the principal indication in group 1 was acute fetal distress (28.6%) in CHRACERH and cephalopelvic disproportion (36.7%) at YCH. Cephalopelvic disproportion was the predominant indication in groups 3 of CHRACERH (44.4%) and YCH (39.2%). In groups 5, CHRACERH and of YCH, a scarred uterus was the principal indication for the cesarean section at 82.4% and 78.4% respectively. At CHRACERH, the maternofetal complications were more frequent in groups 1 and 2 at the YCH, this was the case mostly in groups 1 and 3. Conclusion: The Robson’s classification is an adequate tool for the evaluation and comparison of the rates of cesarean sections. The rates of cesarean section in CHRACERH (27.2%) and at YCH (24.8%) were higher than the rates recommended by WHO. Robson’s groups 1, 3 and 5 were identified as the groups most at risk for cesarean sections in the both hospitals.

Link between mutations in ACVRL1 and PLA2G4A genes and chronic intestinal ulcers:A case report and review of literature

BACKGROUND Genetic factors of chronic intestinal ulcers are increasingly garnering attention.We present a case of chronic intestinal ulcers and bleeding associated with mu-tations of the activin A receptor type II-like 1(ACVRL1)and phospholipase A2 group IVA(PLA2G4A)genes and review the available relevant literature.CASE SUMMARY A 20-year-old man was admitted to our center with a 6-year history of recurrent abdominal pain,diarrhea,and dark stools.At the onset 6 years ago,the patient had received treatment at a local hospital for abdominal pain persisting for 7 d,under the diagnosis of diffuse peritonitis,acute gangrenous appendicitis with perforation,adhesive intestinal obstruction,and pelvic abscess.The surgical treat-ment included exploratory laparotomy,appendectomy,intestinal adhesiolysis,and pelvic abscess removal.The patient’s condition improved and he was dis-charged.However,the recurrent episodes of abdominal pain and passage of black stools started again one year after discharge.On the basis of these features and results of subsequent colonoscopy,the clinical diagnosis was established as in-flammatory bowel disease(IBD).Accordingly,aminosalicylic acid,immunotherapy,and related symptomatic treatment were administered,but the symptoms of the patient did not improve significantly.Further investigations revealed mutations in the ACVRL1 and PLA2G4A genes.ACVRL1 and PLA2G4A are involved in angiogenesis and coagulation,respectively.This suggests that the chronic intestinal ulcers and bleeding in this case may be linked to mutations in the ACVRL1 and PLA2G4A genes.Oral Kangfuxin liquid was administered to promote healing of the intestinal mucosa and effectively manage clinical symptoms.CONCLUSION Mutations in the ACVRL1 and PLA2G4A genes may be one of the causes of chronic intestinal ulcers and bleeding in IBD.Orally administered Kangfuxin liquid may have therapeutic potential.

Comprehensive effects of traditional Chinese medicine treatment on heart failure and changes in B-type natriuretic peptide levels: A meta-analysis

BACKGROUND Heart failure(HF),a common cardiovascular condition,is characterized by significant morbidity and mortality.While traditional Chinese medicine(TCM)is often used as a complementary approach in HF management,systematic evalua-tions of its impact on clinical outcomes,TCM syndrome scores,and B-type natriuretic peptide(BNP)levels are lacking.This study fills this gap through a comprehensive analysis of randomized controlled trials(RCTs)focusing on TCM for HF treatment.It encompasses an assessment of methodological quality,a meta-analysis,and an evaluation of evidence quality based on established standards.The results offer crucial insights into the potential advantages and constraints of TCM in HF management.RCTs on TCM for HF treatment published since the establishment of the database were searched in four Chinese and English databases,including China National Knowledge Infrastructure,Wanfang,VIP Information Chinese Science and Technology Journal,and PubMed.Methodological quality was assessed for the included studies with the Cochrane risk-of-bias assessment tool,and the meta-analysis and publication bias assessment was performed with the RevMan5.3 software.Finally,the quality of evidence was rated according to the GRADE criteria.RESULTS A total of 1098 RCTs were initially retrieved.After screening,16 RCTs were finally included in our study,which were published between 2020 and 2023.These RCTs involved 1660 HF patients,including 832 in the TCM group[TCM combined with conventional Western medicine(CMW)treatment]and 828 in the CWM group(CWM treatment).The course of treatments varied from 1 wk to 3 months.TCM syndrome differentiation was analyzed in 11 of the included RCTs.In all included RCTs,outcome indicators included comprehensive clinical outcomes,TCM syndrome scores,and BNP levels.The meta-analysis results showed significant differences between the TCM and CWM groups in terms of comprehensive clinical outcomes[risk ratio=-0.54;95%confidence interval(CI)=-0.61,-0.47;P<0.00001],TCM syndrome scores[weighted mean difference(WMD)=-142.07;95%CI=-147.56,-136.57;P<0.00001],and BNP levels(WMD=-142.07;95%CI=-147.56,-136.57;P<0.00001).According to the GRADE criteria,RCTs where"TCM improves clinical comprehensive outcomes"were rated as low-quality evidence,and RCTs where"TCM reduces TCM syndrome scores"or"TCM decreases BNP levels"were rated as medium-quality evidence.CONCLUSION TCM combined with CWM treatment effectively improves comprehensive clinical outcomes and diminishes TCM syndrome scores and BNP levels in HF patients.Given the low and medium quality of the included RCTs,the application of these results should be cautious.

On s＊-Completions of Maximal Subgroups of Finite Groups

Given a maximal subgroup M of a group G, a θ*-completion C of M is called an s*-completion if either C = G or there exists a subgroup D of G which is not a θ*-completion of M such that D contains C as a maximal subgroup. In this paper, we obtain several results on s*-completions which imply G to be solvable or supersolvable.

应用Robson分类分析江苏省不同级别医院剖宫产情况

目的应用Robson分类分析江苏省不同级别医院孕产妇危急重症救治中心(简称救治中心)的产妇人群特征及剖宫产原因。方法回顾性分析2018年1月1日至2019年1月1日在江苏省一省级和一市级医院救治中心住院分娩的产妇资料,依据产次、临产方式、孕周、胎位及胎儿数目5个基本产科特征,将所有产妇归入10个组(G1G10),应用Robson分类比较各组产妇人群的构成比及剖宫产率,并进一步对单胎足月头位初产妇的剖宫产指征进行分析。结果不同级别救治中心收治均以单胎足月头位初产妇为主,占54.1%。省级救治中心产妇合并高龄、产后出血、胎盘并发症、妊娠期高血压疾病、妊娠合并心脏疾病、妊娠合并糖尿病发生率均显著高于市级救治中心(χ^(2)=7.647200.783,P<0.05),新生儿的早产率及新生儿重症监护病房(NICU)入住率均显著高于市级救治中心(χ^(2)值分别为130.960、194.104,P<0.05)。在单胎足月头位经产妇中,疤痕子宫剖宫产(G5)的省级和市级救治中心对总剖宫产率贡献值分别为和9.5%和18.7%;在单胎足月头位初产妇中,择期剖宫产(G2b)的省级和市级救治中心对总剖宫产率贡献值分别为和5.6%和24.2%。在单胎足月头位初产妇剖宫产指征中,省级救治中心以其他母儿并发症为主要原因,市级救治中心以无医学指征为主要原因。结论 Robson分类可用于不同级别救治中心的剖宫产率差异性分析,不同级别救治中心的高剖宫产率原因存在差别。

ON CRITICAL CASES OF SOBOLEV'S INEQUALITIES FOR HEISENBERG GROUPS

We prove some Trudinger-type inequalities and Brezis-Gallouet-Wainger inequality on the Heisenberg group, extending to this context the Euclidean results by T. Ozawa.

Synthesis and mesomorphic properties of fluorinated Schiff's base liquid crystals containing vinyl end groups

Three kinds of fluorinated Schiff＇s base esters, 4-allyloxy-2-X-6-X-benzoic acid 4-[（2, 3, 4-trifluorophenylimino）methyl]phenyl ester, where X=H or F, were synthesized and characterized. Their chemical structures were identified by Fourier transform infrared spectroscopy （FTIR） and ^1H nuclear magnetic resonance （^1H NMR）. Their mesomorphic properties were studied by polarized optical microscopy （POM） and differential scanning calorimetry （DSC）. It was found that all the three compounds exhibited enantiotropic nematic phases only. And their cleating point temperature and thermal range of mesophase decreased with the number of fluorine atoms on the rigid core of the compounds; while their melting point temperature showed no distinct regularity.

Entanglement of E8E8 Exceptional Lie Symmetry Group Dark Energy, Einstein’s Maximal Total Energy and the Hartle-Hawking No Boundary Proposal as the Explanation for Dark Energy

The present note is concerned with two connected and highly important fundamental questions of physics and cosmology, namely if E8E8 Lie symmetry group describes the universe and where cosmic dark energy comes from. Furthermore, we reason following Wheeler, Hartle and Hawking that since the boundary of a boundary is an empty set which models the quantum wave of the cosmos, then it follows that dark energy is a fundamental physical phenomenon associated with the boundary of the holographic boundary. This leads directly to a clopen universe which is its own Penrose tiling-like multiverse with energy density in full agreement with COBE, WMAP and Type 1a supernova cosmic measurements.

A Framework for Exploring the Dynamics of Autonomous Work Groups in Manufacturing Organizations

Nowadays, new paradigm of enterprise organization i s constantly changing due to the emergence of the global marketplace, the rise of information technology, and the emphasis of the social developments. This re quires a more flexible form of organization that are more adaptable to rapid cha nges in business environment such as autonomous work groups (AWGs) in order to achieve higher productivity and effectiveness. AWGs are work units responsib le for the production of goods and the provision of services. They involve team members in making decisions that are traditionally the responsibility of the sup ervisors and managers (Cohen & Bailey, 1997). Team members of AWGs are allowed t o self-regulate their behavior on jobs such as task assignments, methods for ca rrying out the work, and scheduling of activities etc. (Cohen & Ledford, 1994). For example, Motorola achieved a high organizational performance due to the succ essful implementation of AWGs in quality management (Piczak & Hauser, 1996). Xer ox also reported their operational successes based on the team-oriented work gr oups (Wageman, 1997). In recent years many organizations have replaced the traditional layers of manag ement with autonomous team-based work arrangements. Surveys indicated that the adoption of AWGs has soared in responding to the competitive business challenges . Many enterprises are making a deliberate effort to use AWGs to carry out work and operational processes as an alternative for hierarchical approaches (Lawler et al., 1995). There is a growing body of evidence that AWGs are more effective than traditionally managed groups and they contributes to organizational perform ance, such as improvement in operational performance, productivity, quality, cos t savings, employee attitude and behavior, and employee satisfaction (e.g. Pears on, 1992; Cohen & Ledford, 1994; Seers et al. 1995). Given the complexity and cognitive nature of team-based organizations, the mech anisms that the enterprises use in the development of the increasingly sophistic ated models, which can contribute to the effective functioning of AWGs, are extr emely important. The process of developing effective AWGs enables enterprises to inherent built-in intelligence of the organizations so that they will be more able to accommodate to external pressures and changes. The context of this paper is the construction of a dynamics framework and a stra tegic path for autonomous work groups in the technology-oriented manufacturing organization re-design. The framework is a conceptual one drawn from the litera ture survey. The importance of studying autonomous work groups for today’s manuf acturing organizations is claimed. Based on the General System Theory (GST), the characterization of AWGs is addressed. Three-dimensional domains such as t echnical content, service content, and relationship content are identified. A st rategic path is proposed to guide the organizations how the development of AWGs progresses at different levels of maturity that are associated with organization al effectiveness and performance. The utility of the model for AWGs is expected to provide technology-oriented organizations with a strategic path to achieve h igher organizational performance.

Future Development Strategies for S Group Based on SWOT Analysis

In recent years,the real estate development enterprises are facing the gradually increased government's macro-control,and the increasingly fierce market competition,so it is very imperative to timely adjust and change the enterprises' development strategies to adapt to the new development situation.With S Group as the study object,we use SWOT analysis to analyze the company's internal and external environment,study the current situation of the company and the existing problems,and clearly point out the opportunities and challenges facing the company.Finally we put forth some targeted strategic recommendations,in order to provide a reference for the development of S Group.

Synthesis and characterization functionalized poly(ether ether ketone)s with carboxylic groups

A novel type of aromatic poly（ ether ether ketone） s with carboxyl groups were prepared by polycondensation of 4,4-bis（4-hydroxyphenyl）pentanoic acid with difluoro-monomers. Their mo- lecular structures were determined by ^1H-NMR and IR, respectively. Their molecular weights were measured by gel permeation chromatography （ GPC ）, which showed that all the polymers had high molecule weights （ 〉 42 000）. Due to the long side chains of polymers, all the polymers had good solubility （soluble in NMP, DMAc, THF, etc. ）. The differential scanning calorimeter （DSC） detected their excellent glass transition temperatures （ Tg ） up to 195 ℃. The Tg increased with the content of carboxylic units in the polymer chains, because the interactions of H bonds increased with increasing content of carboxylic. The polymers could form transparent and flexible films, which make them a candidate for membrane materials.

Group Purchasing Organizations (GPOs) in the U.S.: Development and Reform

Objective To study the characteristics, specific functions and policy improvement process of the Group Purchasing Organizations (GPOs) in the U.S. and to provide references for drug group purchasing practices in China. Methods Domestic and foreign relevant literatures, websites were reviewed or searched to analyze the functions and policy improvement process of the GPOs in the U.S. so as to provide references for drug group purchasing practices in China. Results and Conclusion As a third party in the U.S. GPOs has formed a relatively integrated business process and projects service system after long-term development. Supported by corresponding policies and industrial regulations, GPOs have made a great contribution to control the growth of medical and healthcare expenses and improve the efficiency of medical institutions, and its development experience can enlighten the practices in China.

HEAT KERNELS AND HARDY'S UNCERTAINTY PRINCIPLE ON H-TYPE GROUPS

This article obtains an explicit expression of the heat kernels on H-type groups and then follow the estimate of heat kernels to deduce the Hardy＇s uncertainty principle on the nilpotent Lie groups.

THE WREATH PRODUCT GROUP FOR NMR SPECTRA ANALYSES OF MOLECULA WITH S_4[S_2]SYMMETRY

This paper presents a character table of S_4 wr S_2 wreath product group.Using this character table,~1H or ^(13)C NMR spectra analysis of molecula with S_4[S_2]symmetry,especially simplification of the secular determinant equation will be easy to carry out. Molecules with S_4[S_2]symmetry,are exemplified by octaphenylcyclo- tetrasiloxane and 2,3,7,8,12,13,17,18-octaethyl-21H,23H-porphine chromium (Ⅲ)chloride.

The Power of Group Generators and Relations: An Examination of the Concept and Its Applications

This paper investigates the approach of presenting groups by generators and relations from an original angle. It starts by interpreting this familiar concept with the novel notion of “formal words” created by juxtaposing letters in a set. Taking that as basis, several fundamental results related to free groups, such as Dyck’s Theorem, are proven. Then, the paper highlights three creative applications of the concept in classifying finite groups of a fixed order, representing all dihedral groups geometrically, and analyzing knots topologically. All three applications are of considerable significance in their respective topic areas and serve to illustrate the advantages and certain limitations of the approach flexibly and comprehensively.

Nikodým-Type Theorems for Lattice Group-Valued Measures with Respect to Filter Convergence

We present some convergence and boundedness theorems with respect to filter convergence for lattice group-valued measures. We give a direct proof, based on the sliding hump argument. Furthermore we pose some open problems.