Impact des techniques de fermeture utérine lors de la césarienne

Contexte: La césarienne est une procédure chirurgicale qui survient dans plus du quart des accouchements en Amérique du Nord. Les techniques chirurgicales de fermeture de l’utérus lors de la césarienne sont variées, influencent la cicatrisation et le risque de complications chez la femme à court et long terme. Il a été suggéré que la fermeture en un plan barré augmentait le risque de rupture de l’utérus et de défaut de cicatrisation de l’utérus. Cependant, en l’absence d’un haut niveau d’évidence, cette technique est toujours pratiquée au Canada et en Amérique du Nord. Objectif: Comparer l’impact des différentes techniques de fermeture de l’utérus lors de la césarienne sur les complications maternelles à court et long terme. Méthode : Trois revues systématiques et méta-analyses d’études observationnelles ou d’essais randomisés contrôlés (ECR) ont été réalisées. La prévalence des défauts de cicatrisation et les issues à court et long terme ont été comparées entre les techniques de fermeture de l’utérus. Par la suite, un essai randomisé contrôlé a évalué trois techniques de fermeture de l’utérus : un plan barré, deux plans barrés et deux plans non barrés excluant la déciduale, chez 81 femmes avec une césarienne primaire élective à ≥ 38 semaines de grossesse. L’épaisseur du myomètre résiduel a été mesurée six mois après la césarienne à l’aide d’une échographie transvaginale et comparée par un test t de Student. Résultats : Les résultats des revues systématiques et méta-analyses ont montré que 37% à 59% des femmes présentaient un défaut de cicatrisation de l’utérus après leur césarienne. Concernant les complications à court terme, les types de fermeture de l’utérus étudiés sont comparables, à l’exception de la fermeture en un plan barré qui est associée à un temps opératoire plus court que celle en deux plans (-6.1 minutes, 95% intervalle de confiance (IC) -8.7 à -3.4, p<0.001). Les fermetures de l’utérus en un plan barré sont associées à plus de risque de rupture utérine qu’une fermeture en deux plans barrés (rapport de cote 4.96; IC 95%: 2.58–9.52, P< 0.001). L’ECR a également démontré que la fermeture de l’utérus en un plan barré était associée à une épaisseur du myomètre résiduel plus mince que la fermeture en deux plans non barrés excluant la déciduale (3.8 ± 1.6 mm vs 6.1 ± 2.2 mm; p< 0.001). Finalement, aucune différence significative n’a été détectée concernant la fréquence des points d’hémostases entre les techniques (p=1.000). Conclusion : Lors d’une césarienne élective primaire à terme, une fermeture en deux plans non barrés est associée à un myomètre plus épais qu’une fermeture en un plan barré, sans augmenter le recours à des points d’hémostase. De plus, il est suggéré que la fermeture en deux plans réduirait le risque de rupture utérine lors d’une prochaine grossesse. Finalement, la fermeture chez les femmes en travail doit être plus étudiée.

Yrkeselevers motivation till ämnet matematik på gymnasienivå : Finns det skillnader mellan olika yrkesprogram?

Yrkesprogram är den del av gymnasiet som uppvisar störst andel elever med det underkända betyget F i matematik. Men även mellan de olika yrkesprogrammen finns det skillnader. Syftet med denna undersökning är att få en förståelse för elevers motivation för ämnet matematik inom yrkesprogrammen. Finns det skillnader mellan olika program och möjliga orsaker? Undersökningen genomfördes genom gruppintervjuer där elever från El- och energiprogrammet, Handels- och administrationsprogrammet samt Bygg- och anläggningsprogrammet deltog. Gruppintervjuerna genomfördes program för program och Peter Kloostermans intervjuverktyg användes. Resultatet visade på ganska stora skillnader mellan de deltagande programmen i vissa aspekter. Utifrån resultatet fördes diskussion som pekade på att det kunde vara kulturella aspekter som låg bakom skillnader på motivation mellan de olika programmen. Även studieteknik kan påverka motivationen för ämnet matematik.

Uusi aapis-kirja

Tekijä mahdollisesti C. H. Ståhlberg.

Kort, men nödig underrättelse för den som tänker begå den heliga nattwarden

Imprimatur: Götheb. consist. 2.6.1784 A. W. Ekebom.

Rakkauden ateria: jonka Jesus Kristus on asettanut ja meille mailmaan jättänyt, koska hän tahtoi mailmasta luopua ..

Tekijä Tiililän mukaan Villadtz Nielsøn.

Genometa - A Fast and Accurate Classifier for Short Metagenomic Shotgun Reads

Metagenomic studies use high-throughput sequence data to investigate microbial communities in situ. However, considerable challenges remain in the analysis of these data, particularly with regard to speed and reliable analysis of microbial species as opposed to higher level taxa such as phyla. We here present Genometa, a computationally undemanding graphical user interface program that enables identification of bacterial species and gene content from datasets generated by inexpensive high-throughput short read sequencing technologies. Our approach was first verified on two simulated metagenomic short read datasets, detecting 100% and 94% of the bacterial species included with few false positives or false negatives. Subsequent comparative benchmarking analysis against three popular metagenomic algorithms on an Illumina human gut dataset revealed Genometa to attribute the most reads to bacteria at species level (i.e. including all strains of that species) and demonstrate similar or better accuracy than the other programs. Lastly, speed was demonstrated to be many times that of BLAST due to the use of modern short read aligners. Our method is highly accurate if bacteria in the sample are represented by genomes in the reference sequence but cannot find species absent from the reference. This method is one of the most user-friendly and resource efficient approaches and is thus feasible for rapidly analysing millions of short reads on a personal computer.

Bovine Streptococcus uberis Intramammary Infections and Mastitis

Streptococcus (S.) uberis is a causative agent for clinical and subclinical bovine mastitis which significance for the udder health has increased over the last decades. Molecular diagnosis methods revealed that S. uberis may be subdivided into many different varieties with different epidemiological properties. In addition, some varieties were reclassified as Streptococcus parauberis and Globicatella sanguinis. The present paper reviews S. uberis and its role in modern dairy farming. This pathogen is ubiquitous for which it is considered as environment- associated. Straw bedding and pasture, but also the bovine skin and digestive mucosae are typical localizations inhabited by S. uberis. Due to its capacity to persist within the mammary tissue, some infections may eventually turn cow-associated. In other cases, the infection is short, but in any case, there is a high risk of re-infection. Although many varieties remain susceptible to most antimicrobial agents, the problem for the dairy farm lies in the high rate of re-infection. This paper also reviews risk factors, therapies and measures to control S. uberis at farm level.

Entwicklung eines Funktionsumfangs für Augmented Reality Führungen in Hochschulbibliotheken

Anwendungen in Bibliotheken auf Basis von Augmented Reality (AR), der Erweiterung der Realität durch zusätzliche, virtuelle Informationen, existieren bislang nur vereinzelt. Das vom Bundesministerium für Wirtschaft und Energie geförderte Forschungsprojekt mylibrARy ermittelt seit Juni 2014 Szenarien für den Einsatz von AR in Bibliotheken und Informationseinrichtungen. Das Projekt zielt auf die Entwicklung einer deutschlandweit einsetzbaren Applikation (App). An diesen Gedanken knüpft die vorliegende Arbeit mit der Entwicklung eines Konzepts für Einführungen in Hochschulbibliotheken mittels AR-Technik. Aus der Analyse aktueller Führungsmodelle von Bibliotheken der Hochschulen im Exzellenzcluster 2012-2017, werden die für die Modellführung benötigten charakteristischen Merkmale einer Bibliotheksführung abgeleitet. Auf die technisch relevanten Grundlagen der AR folgt eine Bestandsaufnahme der bisherigen Augmented-Reality-Projekte im internationalen Bibliothekskontext. Daran schließt die Formulierung der theoretischen Anforderungen und die Ausarbeitung der Funktionen im Einzelnen. Nachfolgend lenkt eine kritische Betrachtung den Fokus auf Mehrwert und Risiken der AR für Bibliothek und Nutzer. Mit einer Zusammenfassung und dem Ausblick auf die zukünftige Entwicklung findet die Arbeit ihren Abschuss.

Methane Clathrates in the Solar System

We review the reservoirs of methane clathrates that may exist in the different bodies of the Solar System. Methane was formed in the interstellar medium prior to having been embedded in the protosolar nebula gas phase. This molecule was subsequently trapped in clathrates that formed from crystalline water ice during the cooling of the disk and incorporated in this form into the building blocks of comets, icy bodies, and giant planets. Methane clathrates may play an important role in the evolution of planetary atmospheres. On Earth, the production of methane in clathrates is essentially biological, and these compounds are mostly found in permafrost regions or in the sediments of continental shelves. On Mars, methane would more likely derive from hydrothermal reactions with olivine-rich material. If they do exist, martian methane clathrates would be stable only at depth in the cryosphere and sporadically release some methane into the atmosphere via mechanisms that remain to be determined. In the case of Titan, most of its methane probably originates from the protosolar nebula, where it would have been trapped in the clathrates agglomerated by the satellite's building blocks. Methane clathrates are still believed to play an important role in the present state of Titan. Their presence is invoked in the satellite's subsurface as a means of replenishing its atmosphere with methane via outgassing episodes. The internal oceans of Enceladus and Europa also provide appropriate thermodynamic conditions that allow formation of methane clathrates. In turn, these clathrates might influence the composition of these liquid reservoirs. Finally, comets and Kuiper Belt Objects might have formed from the agglomeration of clathrates and pure ices in the nebula. The methane observed in comets would then result from the destabilization of clathrate layers in the nuclei concurrent with their approach to perihelion. Thermodynamic equilibrium calculations show that methane-rich clathrate layers may exist on Pluto as well. Key Words: Methane clathrate-Protosolar nebula-Terrestrial planets-Outer Solar System.

Gibt es den „elektronischen Nürnberger Trichter? Das Konzept des Blended Learning, dargestellt am Lernnetz WiBA-Net

WiBA-Net ist ein Lernnetzwerk zum Thema „Werkstoffe im Bauwesen“ und wird in der universitären Ausbildung von Bauingenieuren und Architekten verwendet. Dieser Aufsatz soll das Konzept von WiBA-Net vorstellen und zeigen, wie neue Technologien und didaktische Konzepte überzeugend angewendet werden können, um „Blended Learning“ umzusetzen und damit den Hochschulalltag sowohl von Studierenden als auch von Professoren zu erleichtern.(DIPF/Orig.)

The Virtual International Stroke Trials Archive

Background and Purpose - Stroke has global importance and it causes an increasing amount of human suffering and economic burden, but its management is far from optimal. The unsuccessful outcome of several research programs highlights the need for reliable data on which to plan future clinical trials. The Virtual International Stroke Trials Archive aims to aid the planning of clinical trials by collating and providing access to a rich resource of patient data to perform exploratory analyses. Methods - Data were contributed by the principal investigators of numerous trials from the past 16 years. These data have been centrally collated and are available for anonymized analysis and hypothesis testing. Results - ”Currently, the Virtual International Stroke Trials Archive contains 21 trials. There are data on 15 000 patients with both ischemic and hemorrhagic stroke. Ages range between 18 and 103 years, with a mean age of 6912 years. Outcome measures include the Barthel Index, Scandinavian Stroke Scale, National Institutes of Health Stroke Scale, Orgogozo Scale, and modified Rankin Scale. Medical history and onset-to-treatment time are readily available, and computed tomography lesion data are available for selected trials. Conclusions - This resource has the potential to influence clinical trial design and implementation through data analyses that inform planning. (Stroke. 2007;38:1905-1910.)

Should data monitoring committees assess efficacy when considering safety in trails in acute stroke?

The primary role of a trials Data Monitoring Committee (DMC) is to ensure the safety of enrolled patients. In stroke trials, safety is monitored typically by comparing death and stroke specific events between treatment groups. DMCs may also have the remit for monitoring efficacy depending on the aims of the trial. We hypothesised that functional outcome at end of follow-up, a measure of efficacy, is also a powerful measure of safety and tested this in a systematic review

From omics and etics to policy and ethics: regulating evolution

A commentary on ELSI 2.0forgenomicsandsociety by Kaye,J.,Meslin,E.,Knoppers,B.,Juengst, E., Deschênes,M.,Cambon-Thomsen,A., etal. (2012). Science336, 673–674. doi: http://dx.doi.org/10.1126/science.1218015