Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room...Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room in our health facility. Patients and methods: Prospective, descriptive and analytical study, conducted at the Jeanne Ebori Foundation Mother-Child University Hospital over 4 years (January 2019-December 2022). All neonatal deaths in the delivery room or foetal death in utero, were included. Results: Among the 18,346 deliveries performed, 512 newborns were declared dead in the delivery room (27.9‰ live births), divided into in utero foetal death (19.0‰) and immediate neonatal death (8.9‰). The mean age was 34.3 weeks of amenorrhea. The rate of preterm birth was 60.4%. The sex ratio was 1.1. The average weight was 2186.6. The main causes were vascular (46.1%), foetal (20.2%), adnexal (17.1%) and asphyxia per partum (16.6%). Foetal causes were more likely to result in IUFD than other causes (OR = 6.4 [2.4 - 15.7], p < 0.001). After birth, partum asphyxia was more likely to lead to death before 15 minutes of life than other causes (OR = 11 [6.1 - 18.9], p Conclusion: The causes of stillbirth and early neonatal mortality are dominated by maternal vascular pathologies. However, the proportion of childbirth-related causes remains worrying. Better monitoring of pregnancy and labour will minimize this prevalence in our hospital.展开更多
Effective communication and emotional support of parturient women improve the outcome of childbirth. Reduction in Duration of labor, cesarean rate, use of anesthesia, and 5 minute Apgar Score less than 7 can achieve. ...Effective communication and emotional support of parturient women improve the outcome of childbirth. Reduction in Duration of labor, cesarean rate, use of anesthesia, and 5 minute Apgar Score less than 7 can achieve. This study was a part of a large mixed method study during 2013-2014. In this qualitative study, in-depth interviews were conducted with 32 participants (16 mother and 16 midwife), using semi-structured interviews. Participants were recruited by pur-posive sampling with maximum diversity in terms of age, occupation, education and etc. Educational hospital of Arak University of Medical Sciences was considered as the setting. Each interview was conducted at a private and convenient location and took about 30 to 45 minutes. Interviews were audio taped and transcribed verbatim. Conventional content analysis was done for data analysis. Interviews continued until data saturation was obtained. Data were coded in MAXQDA software (version 11). The main category emerged as “outcome” of midwife-mother relationship. Facilitating childbirth, positive experience, mental health promotion and improvement in quality of life were derived as subcategories. Good midwife-mother relationship could promote positive outcome in labour. Results could assist midwives in providing holistic quality care to mothers during labour, thus providing positive consequence in child birth. Also, results could provide a framework and guidance for policymakers to create appropriate context for the midwife-mother relationship in maternity care.展开更多
The incidence of allergic airway diseases continues to increase in industrial countries while remaining much more stable in developing countries. Allergens inhaled are eventually also swallowed and evidently the gastr...The incidence of allergic airway diseases continues to increase in industrial countries while remaining much more stable in developing countries. Allergens inhaled are eventually also swallowed and evidently the gastrointestinal immune system has a role in regulating allergic responses in the pulmonary as well as the GI system. While some studies have pointed out the role of probiotic bacteria as a supplementary protection against the early development of various allergies, little attention has been paid to the composition of the airborne microflora first and continuosly inhaled by newborns and infants. This study compares the composition of two airborne microbial communities, one from hospital delivery rooms and the other from a nature reserve, evidently in use as a birthing place as early as 7500 B.C. around the air from the outdoor birthing place was marked by a far greater variation in microbial composition and a much higher representation of fungi than the air from the hospitals. The dominant bacterial species from the delivery rooms were Staphylococcus areus and Micrococcus luteus, originating from the staff and the hospital environment;the outdoor flora, however, was dominated by Pseudomonas spp. and Bacillus spp. In addition, 56% of all the bacterial isolates from the delivery rooms were most closely related to strains previously associated with clinical infections, whereas only 15% of isolates in the outdoor bacterial sample had such relationships. The role of airborne microorganisms could be important to infants with developing immune systems considering the microbial bias of hospital air presented in this study.展开更多
Among the proposed techniques for delivering drugs to specific sites within the human body, magnetic targeting drug delivery surpasses due to its non-invasive character and its high targeting efficiency. Although ther...Among the proposed techniques for delivering drugs to specific sites within the human body, magnetic targeting drug delivery surpasses due to its non-invasive character and its high targeting efficiency. Although there have been some analyses theoretically for magnetic drug targeting, very few researchers have addressed the hydrodynamic models of magnetic fluids in the blood vessel of human body. This paper presents a mathematical model to describe the hydrodynamics of ferrofluids as drug carriers flowing in a blood vessel under the applied magnetic field. A 3D flow field of magnetic particles in a blood vessel model is numerically simulated in order to further understand clinical application of magnetic targeting drug delivery. Simulation results show that magnetic nanoparticles can be enriched in a target region depending on the applied magnetic field intensity. Magnetic resonance imaging confirms the enrichment of ferrofluids in a desired body tissue of Sprague-Dawley rats. The simulation results coincide with those animal experiments. Results of the analysis provide the important information and can suggest strategies for improving delivery in favor of the clinical application.展开更多
Background The aim of this study was to review current delivery room(DR)resuscitation intensity in Chinese tertiary neonatal intensive care units and to investigate the association between DR resuscitation intensity a...Background The aim of this study was to review current delivery room(DR)resuscitation intensity in Chinese tertiary neonatal intensive care units and to investigate the association between DR resuscitation intensity and short-term outcomes in preterm infants born at 24+0_31+6 weeks gestation age(GA).Methods This was a retrospective cross-sectional study.The source population was infants born at 24+0_31+6 weeks'GA who were enrolled in the Chinese Neonatal Network 2019 cohort.Eligible infants were categorized into five groups:(1)regular care;(2)oxygen supplementation and/or continuous positive airway pressure(O2/CPAP);(3)mask ventilation;(4)endotracheal intubation;and(5)cardiopulmonary resuscitation(CPR).The association between DR resuscitation and shortterm outcomes was evaluated by inverse propensity score-weighted logistic regression.Results Of 7939 infants included in this cohort,2419(30.5%)received regular care,1994(25.1%)received O,/CPAP,1436(18.1%)received mask ventilation,1769(22.3%)received endotracheal intubation,and 321(4.0%)received CPR in the DR.Advanced maternal age and maternal hypertension correlated with a higher need for resuscitation,and antenatal steroid use tended to be associated with a lower need for resuscitation(P<0.001).Severe brain impairment increased significantly with increasing amounts of resuscitation in DR after adjusting for perinatal factors.Resuscitation strategies vary widely between centers,with over 50%of preterm infants in eight centers requiring higher intensity resuscitation.Conclusions Increased intensity of DR interventions was associated with increased mortality and morbidities in very preterm infants in China.There is wide variation in resuscitative approaches across delivery centers,and ongoing quality improvement to standardize resuscitation practices is needed.展开更多
This study demonstrates that our previously reported polywraplex, a synthetic siRNA carrier consisting of a uni-molecular polyplex core of customizable size and a self-assembled triblock copolymer envelop, may be cons...This study demonstrates that our previously reported polywraplex, a synthetic siRNA carrier consisting of a uni-molecular polyplex core of customizable size and a self-assembled triblock copolymer envelop, may be constructed using dendrimers as the crosslinking junctions. Replacing the branched low molecular weight PEI with polyamidoamine(PAMAM) dendrimer in the zeta potential regulated polymerization resulted in the similar network structured cationic polymer with electron microscopically visible crosslinking junctions. This visibility may offer a convenient way to characterize the molecular structure of the rationally designed networked siRNA-packing cationic polymer without altering its chemical properties and biologic functions. A series of physical-chemical characterizations and biological assays, comprising size, zeta potential, pre-phagocytic siRNA leaking and degradation, and silencing of functional genes, confirmed that the advanced properties of polywraplexes remained with the dendrimer junctions. Although sixth generation PAMAM dendrimer was used as the crosslinking junctions in the size-customizable polymerization for electron microscopic observation, lower generation dendrimer should also work in case more practical and structurally defined cationic polymer is needed.展开更多
Introduction: In order to prevent the vertical transmission of the Human Immunodeficiency Virus (HIV), it is essential that pregnant women must know their HIV serological status. Objective: To determine the proportion...Introduction: In order to prevent the vertical transmission of the Human Immunodeficiency Virus (HIV), it is essential that pregnant women must know their HIV serological status. Objective: To determine the proportion of parturients with unknown Human Immunodeficiency Virus (HIV) status in the delivery room and to identify the associated factors. Methods: We conducted a prospective descriptive study carried out at the Reference Health Center of Commune IV in the district of Bamako from July 1, 2017 to July 1, 2018. The sample size was 267 parturients. The word processing was carried out on World software from the 2016 office suite at the end of the data entry and analysis was carried out on the IBM software, SPSS version 22.0. Results: A total of 267 women were eligible for our study, among which 14 parturients were seropositive, i.e., a proportion of 5.2% of cases. The knowledge of parturients on HIV was 95.5% of cases, but more than half did not know the mode of mother-child transmission. Unschooled parturients were the most represented with 41.2%. Conclusion: In view of the large proportion (5.2%) of HIV-positive parturients in our study, voluntary screening activities in the delivery room remain necessary for the future of children born to HIV-positive mothers.展开更多
When I interviewed Droma,she had already retired and was staying at home to look after her grandson.This was on June 3rd,2017.At the Apple Orchard in Lhoka City,Tibet Autonomous Region,the sun was hanging in sky with ...When I interviewed Droma,she had already retired and was staying at home to look after her grandson.This was on June 3rd,2017.At the Apple Orchard in Lhoka City,Tibet Autonomous Region,the sun was hanging in sky with sparkling light."I was born in the winter of 1956.展开更多
<strong>Purpose:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">The purpose of this study was to determine HIV prevalen...<strong>Purpose:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">The purpose of this study was to determine HIV prevalence among participants admitted to the delivery room and recent birth attendants. </span><b><span style="font-family:Verdana;">Materials and </span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">M</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">ethods: </span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">This was a descriptive, cross-sectional, analytical study, with a prospective collection from February 1, 2018 to January 31, 2019 at fousseyni Daou Hospital in Kayes, Mali. </span><b><span style="font-family:Verdana;">Results: </span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">D</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">uring our study period</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> we </span><span style="font-family:Verdana;">recorded 4269 deliveries. HIV-positive patients known before labour ac</span><span style="font-family:Verdana;">counted for 0.21%. Four hundred and six participants received counselling/testing in the delivery room;of which 36 refused the test: 8.87% and 370 accepted or 91.13%. Thirteen patients tested positive or 3.51%. The 20</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">35 age group was the most represented at 76.92%. Positive patients tested received ARV treatment in the delivery room in 92.31% of cases;and 1 patient or 7.69% did not receive treatment for refusal. Vaginal delivery was the most common at 77%, </span><span style="font-family:Verdana;">with caesarean section 23%. Newborns had a good prognosis in their first </span><span style="font-family:Verdana;">weeks of life in 85%;fetal lethality was observed in 15% of newborns including 1 case of fresh stillbirth and 1 case of pediatric deaths for neonatal suffering. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Counselling and voluntary HIV/AIDS testing during labour </span><span style="font-family:Verdana;">and immediate postpartum can detect many pregnant women who escape</span><span style="font-family:Verdana;"> screening during antenatal consultations.</span></span></span></span>展开更多
Respecting the on-time<span><span><span> </span></span></span><span><span><span>delivery (OTD) for manufacturing orders is mandatory. However, for non-JIT Batch &a...Respecting the on-time<span><span><span> </span></span></span><span><span><span>delivery (OTD) for manufacturing orders is mandatory. However, for non-JIT Batch & Queue Push-manufacturing systems, the compliance of OTD is not intrinsically guaranteed.</span></span></span><span><span><span> As an OTD related manufacturing theory is largely missing it is crucial to understand and formalize the necessary conditions of OTD compliance for complex production environments for maximum exploitation of the production capacity. This paper evaluates the conditions of post-optimality while being OTD compliant for production systems, which are characterized </span></span></span><span><span><span>by</span></span></span><span><span><span> stochastic order rate and a deterministic product-mix. Instead of applying discrete event simulation to explore the real case-by-case order scheduling optimization for OTD compliance, a Cartesian approach is followed. This enables to define theoretically the solution space of order backlog for OTD, which contributes to develo</span></span></span><span><span><span>ping</span></span></span><span><span><span> further manufacturing theory. At the base stands the recently defined new concept of virtual manufacturing elasticity by reducing lead-time to increase virtually production capacity. The result has led to defin</span></span></span><span><span><span>ing</span></span></span><span><span><span> additional two corollaries to the OTD theorem, which sets up basic OTD theory. Apart from defining the post-optimal requirements to guarantee for orders at least a weak solution for OTD compliance, this paper reveals that for a deterministic product-mix a non-ergodic order arrival rate can be rescheduled into an ergodic order input rate to the shopfloor if the virtual elasticity </span></span></span><span><span><span><span><span style="font-size:10.0pt;font-family:;" "=""><span style="font-size:10.0pt;font-family:;" "=""><img src="Edit_e545052a-10c6-459e-aa8a-2bccefd4a1a7.png" alt="" /></span></span></span><i><span>T</span></i><span> is large enough</span></span></span></span><span><span><span>, </span></span></span><span><span><span>hence the importance of having fast and flexible production lines.</span></span></span>展开更多
文摘Introduction: Stillbirths are estimated at 2 million each year, of which more than 40% occur during labour. Our objective was to study the epidemiological aspects of stillbirth and neonatal deaths in the delivery room in our health facility. Patients and methods: Prospective, descriptive and analytical study, conducted at the Jeanne Ebori Foundation Mother-Child University Hospital over 4 years (January 2019-December 2022). All neonatal deaths in the delivery room or foetal death in utero, were included. Results: Among the 18,346 deliveries performed, 512 newborns were declared dead in the delivery room (27.9‰ live births), divided into in utero foetal death (19.0‰) and immediate neonatal death (8.9‰). The mean age was 34.3 weeks of amenorrhea. The rate of preterm birth was 60.4%. The sex ratio was 1.1. The average weight was 2186.6. The main causes were vascular (46.1%), foetal (20.2%), adnexal (17.1%) and asphyxia per partum (16.6%). Foetal causes were more likely to result in IUFD than other causes (OR = 6.4 [2.4 - 15.7], p < 0.001). After birth, partum asphyxia was more likely to lead to death before 15 minutes of life than other causes (OR = 11 [6.1 - 18.9], p Conclusion: The causes of stillbirth and early neonatal mortality are dominated by maternal vascular pathologies. However, the proportion of childbirth-related causes remains worrying. Better monitoring of pregnancy and labour will minimize this prevalence in our hospital.
文摘Effective communication and emotional support of parturient women improve the outcome of childbirth. Reduction in Duration of labor, cesarean rate, use of anesthesia, and 5 minute Apgar Score less than 7 can achieve. This study was a part of a large mixed method study during 2013-2014. In this qualitative study, in-depth interviews were conducted with 32 participants (16 mother and 16 midwife), using semi-structured interviews. Participants were recruited by pur-posive sampling with maximum diversity in terms of age, occupation, education and etc. Educational hospital of Arak University of Medical Sciences was considered as the setting. Each interview was conducted at a private and convenient location and took about 30 to 45 minutes. Interviews were audio taped and transcribed verbatim. Conventional content analysis was done for data analysis. Interviews continued until data saturation was obtained. Data were coded in MAXQDA software (version 11). The main category emerged as “outcome” of midwife-mother relationship. Facilitating childbirth, positive experience, mental health promotion and improvement in quality of life were derived as subcategories. Good midwife-mother relationship could promote positive outcome in labour. Results could assist midwives in providing holistic quality care to mothers during labour, thus providing positive consequence in child birth. Also, results could provide a framework and guidance for policymakers to create appropriate context for the midwife-mother relationship in maternity care.
文摘The incidence of allergic airway diseases continues to increase in industrial countries while remaining much more stable in developing countries. Allergens inhaled are eventually also swallowed and evidently the gastrointestinal immune system has a role in regulating allergic responses in the pulmonary as well as the GI system. While some studies have pointed out the role of probiotic bacteria as a supplementary protection against the early development of various allergies, little attention has been paid to the composition of the airborne microflora first and continuosly inhaled by newborns and infants. This study compares the composition of two airborne microbial communities, one from hospital delivery rooms and the other from a nature reserve, evidently in use as a birthing place as early as 7500 B.C. around the air from the outdoor birthing place was marked by a far greater variation in microbial composition and a much higher representation of fungi than the air from the hospitals. The dominant bacterial species from the delivery rooms were Staphylococcus areus and Micrococcus luteus, originating from the staff and the hospital environment;the outdoor flora, however, was dominated by Pseudomonas spp. and Bacillus spp. In addition, 56% of all the bacterial isolates from the delivery rooms were most closely related to strains previously associated with clinical infections, whereas only 15% of isolates in the outdoor bacterial sample had such relationships. The role of airborne microorganisms could be important to infants with developing immune systems considering the microbial bias of hospital air presented in this study.
基金supported by National Natural Science Foundation of China (Grant No. 50875169)National Basic Research Program of China (973 Program, Grant No. 2007CB936004).
文摘Among the proposed techniques for delivering drugs to specific sites within the human body, magnetic targeting drug delivery surpasses due to its non-invasive character and its high targeting efficiency. Although there have been some analyses theoretically for magnetic drug targeting, very few researchers have addressed the hydrodynamic models of magnetic fluids in the blood vessel of human body. This paper presents a mathematical model to describe the hydrodynamics of ferrofluids as drug carriers flowing in a blood vessel under the applied magnetic field. A 3D flow field of magnetic particles in a blood vessel model is numerically simulated in order to further understand clinical application of magnetic targeting drug delivery. Simulation results show that magnetic nanoparticles can be enriched in a target region depending on the applied magnetic field intensity. Magnetic resonance imaging confirms the enrichment of ferrofluids in a desired body tissue of Sprague-Dawley rats. The simulation results coincide with those animal experiments. Results of the analysis provide the important information and can suggest strategies for improving delivery in favor of the clinical application.
文摘Background The aim of this study was to review current delivery room(DR)resuscitation intensity in Chinese tertiary neonatal intensive care units and to investigate the association between DR resuscitation intensity and short-term outcomes in preterm infants born at 24+0_31+6 weeks gestation age(GA).Methods This was a retrospective cross-sectional study.The source population was infants born at 24+0_31+6 weeks'GA who were enrolled in the Chinese Neonatal Network 2019 cohort.Eligible infants were categorized into five groups:(1)regular care;(2)oxygen supplementation and/or continuous positive airway pressure(O2/CPAP);(3)mask ventilation;(4)endotracheal intubation;and(5)cardiopulmonary resuscitation(CPR).The association between DR resuscitation and shortterm outcomes was evaluated by inverse propensity score-weighted logistic regression.Results Of 7939 infants included in this cohort,2419(30.5%)received regular care,1994(25.1%)received O,/CPAP,1436(18.1%)received mask ventilation,1769(22.3%)received endotracheal intubation,and 321(4.0%)received CPR in the DR.Advanced maternal age and maternal hypertension correlated with a higher need for resuscitation,and antenatal steroid use tended to be associated with a lower need for resuscitation(P<0.001).Severe brain impairment increased significantly with increasing amounts of resuscitation in DR after adjusting for perinatal factors.Resuscitation strategies vary widely between centers,with over 50%of preterm infants in eight centers requiring higher intensity resuscitation.Conclusions Increased intensity of DR interventions was associated with increased mortality and morbidities in very preterm infants in China.There is wide variation in resuscitative approaches across delivery centers,and ongoing quality improvement to standardize resuscitation practices is needed.
基金the grant of the Natural Science Foundation of China(Grant nos.81373352 and 81690262)。
文摘This study demonstrates that our previously reported polywraplex, a synthetic siRNA carrier consisting of a uni-molecular polyplex core of customizable size and a self-assembled triblock copolymer envelop, may be constructed using dendrimers as the crosslinking junctions. Replacing the branched low molecular weight PEI with polyamidoamine(PAMAM) dendrimer in the zeta potential regulated polymerization resulted in the similar network structured cationic polymer with electron microscopically visible crosslinking junctions. This visibility may offer a convenient way to characterize the molecular structure of the rationally designed networked siRNA-packing cationic polymer without altering its chemical properties and biologic functions. A series of physical-chemical characterizations and biological assays, comprising size, zeta potential, pre-phagocytic siRNA leaking and degradation, and silencing of functional genes, confirmed that the advanced properties of polywraplexes remained with the dendrimer junctions. Although sixth generation PAMAM dendrimer was used as the crosslinking junctions in the size-customizable polymerization for electron microscopic observation, lower generation dendrimer should also work in case more practical and structurally defined cationic polymer is needed.
文摘Introduction: In order to prevent the vertical transmission of the Human Immunodeficiency Virus (HIV), it is essential that pregnant women must know their HIV serological status. Objective: To determine the proportion of parturients with unknown Human Immunodeficiency Virus (HIV) status in the delivery room and to identify the associated factors. Methods: We conducted a prospective descriptive study carried out at the Reference Health Center of Commune IV in the district of Bamako from July 1, 2017 to July 1, 2018. The sample size was 267 parturients. The word processing was carried out on World software from the 2016 office suite at the end of the data entry and analysis was carried out on the IBM software, SPSS version 22.0. Results: A total of 267 women were eligible for our study, among which 14 parturients were seropositive, i.e., a proportion of 5.2% of cases. The knowledge of parturients on HIV was 95.5% of cases, but more than half did not know the mode of mother-child transmission. Unschooled parturients were the most represented with 41.2%. Conclusion: In view of the large proportion (5.2%) of HIV-positive parturients in our study, voluntary screening activities in the delivery room remain necessary for the future of children born to HIV-positive mothers.
文摘When I interviewed Droma,she had already retired and was staying at home to look after her grandson.This was on June 3rd,2017.At the Apple Orchard in Lhoka City,Tibet Autonomous Region,the sun was hanging in sky with sparkling light."I was born in the winter of 1956.
文摘<strong>Purpose:</strong> <span><span><span style="font-family:""><span style="font-family:Verdana;">The purpose of this study was to determine HIV prevalence among participants admitted to the delivery room and recent birth attendants. </span><b><span style="font-family:Verdana;">Materials and </span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">M</span></b></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><b><span style="font-family:Verdana;">ethods: </span></b></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">This was a descriptive, cross-sectional, analytical study, with a prospective collection from February 1, 2018 to January 31, 2019 at fousseyni Daou Hospital in Kayes, Mali. </span><b><span style="font-family:Verdana;">Results: </span></b></span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">D</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">uring our study period</span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">,</span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;"> we </span><span style="font-family:Verdana;">recorded 4269 deliveries. HIV-positive patients known before labour ac</span><span style="font-family:Verdana;">counted for 0.21%. Four hundred and six participants received counselling/testing in the delivery room;of which 36 refused the test: 8.87% and 370 accepted or 91.13%. Thirteen patients tested positive or 3.51%. The 20</span></span></span></span><span><span><span style="font-family:""> </span></span></span><span style="font-family:Verdana;"><span style="font-family:Verdana;"><span style="font-family:Verdana;">-</span></span></span><span><span><span style="font-family:""> </span></span></span><span><span><span style="font-family:""><span style="font-family:Verdana;">35 age group was the most represented at 76.92%. Positive patients tested received ARV treatment in the delivery room in 92.31% of cases;and 1 patient or 7.69% did not receive treatment for refusal. Vaginal delivery was the most common at 77%, </span><span style="font-family:Verdana;">with caesarean section 23%. Newborns had a good prognosis in their first </span><span style="font-family:Verdana;">weeks of life in 85%;fetal lethality was observed in 15% of newborns including 1 case of fresh stillbirth and 1 case of pediatric deaths for neonatal suffering. </span><b><span style="font-family:Verdana;">Conclusion:</span></b><span style="font-family:Verdana;"> Counselling and voluntary HIV/AIDS testing during labour </span><span style="font-family:Verdana;">and immediate postpartum can detect many pregnant women who escape</span><span style="font-family:Verdana;"> screening during antenatal consultations.</span></span></span></span>
文摘Respecting the on-time<span><span><span> </span></span></span><span><span><span>delivery (OTD) for manufacturing orders is mandatory. However, for non-JIT Batch & Queue Push-manufacturing systems, the compliance of OTD is not intrinsically guaranteed.</span></span></span><span><span><span> As an OTD related manufacturing theory is largely missing it is crucial to understand and formalize the necessary conditions of OTD compliance for complex production environments for maximum exploitation of the production capacity. This paper evaluates the conditions of post-optimality while being OTD compliant for production systems, which are characterized </span></span></span><span><span><span>by</span></span></span><span><span><span> stochastic order rate and a deterministic product-mix. Instead of applying discrete event simulation to explore the real case-by-case order scheduling optimization for OTD compliance, a Cartesian approach is followed. This enables to define theoretically the solution space of order backlog for OTD, which contributes to develo</span></span></span><span><span><span>ping</span></span></span><span><span><span> further manufacturing theory. At the base stands the recently defined new concept of virtual manufacturing elasticity by reducing lead-time to increase virtually production capacity. The result has led to defin</span></span></span><span><span><span>ing</span></span></span><span><span><span> additional two corollaries to the OTD theorem, which sets up basic OTD theory. Apart from defining the post-optimal requirements to guarantee for orders at least a weak solution for OTD compliance, this paper reveals that for a deterministic product-mix a non-ergodic order arrival rate can be rescheduled into an ergodic order input rate to the shopfloor if the virtual elasticity </span></span></span><span><span><span><span><span style="font-size:10.0pt;font-family:;" "=""><span style="font-size:10.0pt;font-family:;" "=""><img src="Edit_e545052a-10c6-459e-aa8a-2bccefd4a1a7.png" alt="" /></span></span></span><i><span>T</span></i><span> is large enough</span></span></span></span><span><span><span>, </span></span></span><span><span><span>hence the importance of having fast and flexible production lines.</span></span></span>