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Analysis of Perinatal Outcomes of Twin Pregnancy in a Referral Hospital for High Risk

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Open Journal of Obstetrics and Gynecology 2024年第7期14卷 983-995页

作者： Eduarda Paim Pedro Lucas Carneiro Ferreira Luciano Selistre Fernanda Grossi José Mauro Madi gabriela françoes rostirolla Mdica Residente do Programa de Residncia em Ginecologia e Obstetrcia Hospital Geral de Caxias do Sul Rio Grande do Sul Brasil Faculdade de Medicina Universidade de Caxias do Sul Rio Grande do Sul Brasil Programa de Ps-Graduao Universidade de Caxias do Sul Rio Grande do Sul Brasil Servio de Ginecologia e Obstetrcia Hospital Geral de Caxias do Sul Rio Grande do Sul Brasil

Introduction: The incidence of twin pregnancies has increased significantly in recent decades. These pregnancies require more attention due to their worse outcomes than singleton pregnancies. Objective: To analyze the characteristics and perinatal outcomes of twin pregnancies at the Caxias do Sul General Hospital. Methods: This is a descriptive and retrospective study that included all births related to twin pregnancies between March 1998 and June 2018. Maternal and perinatal variables were analyzed. Descriptive analyses were carried out using measures of central tendency and dispersion for continuous variables (mean and standard deviation or median and interquartile range), according to a prior assessment of distribution using the Shapiro-Wilk test, and absolute (n) and relative (n%) frequencies for categorical variables. Results: 172 pairs of twins/21,972 births (0.8%) were identified. There was a high percentage of interpartum interval of less than 12 months, adherence and prenatal visits, body mass index, and need for neonatal intensive care. Stillbirth and neomortality rates were within acceptable parameters. Conclusion: The sample studied showed a percentage similar to that in the literature, a high rate of maternal and perinatal complications, characterizing it as a high-risk fetal pregnancy.

关键词： Pregnancy Twin Pregnancy High Risk Pregnancy Morbidity Perinatal Mortality Perinatal Results

Maternal Effects of Immediate versus Delayed Umbilical Cord Clamping: A Randomized Clinical Trial

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Open Journal of Obstetrics and Gynecology 2021年第11期11卷 1500-1511页

作者： gabriela françoes rostirolla Maria Alexandrina Zanatta Charles francisco Ferreira José Geraldo Lopes Ramos Edimárlei Gonsales Valério Janete Vettorazzi Postgraduation Program in Health Sciences: Gynecology and Obstetrics (PPGGO) Faculdade de Medicina (FAMED) Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brasil Universidade de Caxias do Sul (UCS) Caxias do Sul Brasil Gynecology and Obstetrics Department Clinical Hospital of Porto Alegre (HCPA) Faculdade de Medicina (FAMED) Universidade Federal do Rio Grande do Sul Rio Grande do Sul (UFRGS) Porto Alegre Brasil

OBJECTIVE: To compare maternal preoperative and postoperative hemoglobin variation after cord clamping. METHODS: Randomized clinical trial performed in Porto Alegre, RS from January to December 2012. It was included 356 women with habitual risk gestations. In the immediate cord clamping group, the umbilical cord section was realized between 0 and 60 s (group 1) while in the delayed cord clamping group it was realized >60 s (group 2). RESULTS: The mean (±standard deviation [SD]) preoperative hemoglobin was 12.13 ± 1.06 in the group 1 and 12.13 ± 1.11 in the group 2. The mean (±SD) postoperative day 2 hemoglobin level was 10.19 ± 1.46 in the group 1 and 10.24 ± 1.42 in the group 2. CONCLUSIONS: Delayed umbilical cord clamping resulted in a similar maternal hemoglobin level reduction at postoperative day 2.

关键词： Cord Clamping Delayed Cord Clamping Immediate Cord Clamping Matern Hemoglobin Level

Midline Supraumbilical Incision as an Option for Morbidly Obese Patients? Case Report

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Open Journal of Obstetrics and Gynecology 2021年第11期11卷 1517-1523页

作者： Janete Vettorazzi gabriela françoes rostirolla Gabrielle Soares Behenck Fernanda Oliveira Castilhos Eduardo Vettorazzi-Stuczynski Edimárlei Gonsales Valério Postgraduate Program in Health Sciences: Gynecology and Obstetrics Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brasil Department of Gynecology and Obstetrics Faculdade de Medicina (FAMED) Universidade Federal do Rio Grande do Sul Porto Alegre-Rio Grande do Sul (RS) Brasil Service of Obstetrics and Gynecology Hospital de Clínicas de Porto Alegre Porto Alegre/RS Brasil Hospital Geral de Caxias do Sul e Faculdade de Medicina da Universidade de Caxias do SUl Caxias do Sul/RS Brasil

Background: Nowadays we observe growing rates of obesity, mainly among women. It has a great impact on maternal and fetal morbimortality and requires a specific obstetric approach. Aim: To discuss different approaches to abdominal incision in cesarean section in obese patients. Case presentation: Patient with morbid obesity submitted to an elective cesarean section due to fetal macrosomia and who underwent a cesarean section with a supraumbilical median incision evolving without any postpartum complications. Conclusion: It’s important to evaluate and chose the best incision in morbidly obese pregnant women aiming to reduce difficulties in fetal extraction and postoperative complications. Midline supraumbilical incision is a good choice in these cases, reducing surgical time and postpartum hemorrhage.

关键词： Obesity Caesarean Section Surgical Incision Abdominal Obesity

Correlation between Late Cord Clamping and Phototherapy and Other Neonatal Unfavorable Outcomes: A Randomized Clinical Trial

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Open Journal of Obstetrics and Gynecology 2022年第3期12卷 193-200页

作者： Janete Vettorazzi gabriela françoes rostirolla Maria Alexandrina Zanatta Edimárlei Gonsales Valério Charles francisco Ferreira Jose Geraldo Lopes Ramos Postgraduation Program in Health Sciences: Gynecology and Obstetrics Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil Department of Gynecology and Obstetrics Faculty of Medicine (FAMED) Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil Department of Gynecology and Obstetrics Faculty of Medicine (FAMED) Universidade Federal do Rio Grande do Sul (UFRGS) Porto Alegre Brazil Department of Gynecology and Obstetrics Faculty of Medicine Universidade de Caxias do Sul (UCS)

Background: Recently, late umbilical cord clamping is generally recommended, which decreases neonatal anemia;however, it may also increase neonatal jaundice and some other poor outcomes. Objectives: We here attempted to determine whether late clamping actually increases the incidence of phototherapy for jaundice and other poor outcomes of the term “low-risk newborns”. Methods: With the approval of the Brazilian Registry of Clinical Trials (REBEC), a total of 357 low-risk newborns (singleton, uncomplicated pregnancy/delivery, in a Brazilian public institution) were randomized into two groups: group I (n = 114): cord clamping 1 minute (early clamping) or group II (n = 243): cord clamping between 1 - 3 minutes (late clamping). Statistics were used appropriately (i.e., measures of central tendency, dispersion for continuous variables, Shapiro-Wilk, Mann-Whitney test, or Chi-square test). Results: Phototherapy was performed in 5.3% in both groups. Also, there were no statistical differences in the occurrence of secondary outcomes, such as sepsis, neonatal ICU admission, and transient tachypnea of the newborns: i.e., 0.9%, 15.8%, and 3.5%, respectively for group I versus 1.2%, 15.6%, and 5.8%, respectively for group II. Conclusion: Late umbilical cord clamping does not increase the need for phototherapy in low-risk neonates. This result corroborates the current recommendation of late cord clamping, whenever appropriate.

关键词： Phototherapy Neonatal Anemia Neonatal Jaundice Late Cord Clamping

Non-Ablative Transvaginal Radiofrequency in the Treatment of Stress Urinary Incontinence: Review of the Literature

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Open Journal of Obstetrics and Gynecology 2023年第2期13卷 133-141页

作者： Haley Calcagnotto Laura Leite Vittoria Dreher Longo Gustavo Messinger Piva Thais Gasperin Alexandra Maria Flores Bordignon Renata Rauber Felkl Jose Mauro Madi gabriela françoes rostirolla Obstetric and Gynecology Department Caxias do Sul University Caxias do Sul Brazil Caxias do Sul University Caxias do Sul Brazil

Background: Urinary incontinence is defined as the involuntary loss of urine, which can affect up to 45% of women after menopause. Radiofrequency is a non-invasive procedure that involves the application of an electromagnetic wave that through heat generation promotes neocollagenesis and neoeslatinogenesis in the vaginal epithelium. This energy-based technology has been studied as a potential alternative for the treatment of genitourinary syndrome of menopause and urinary incontinence. Objective: To review the recent literature (from 2020 to June 2022) on the use of transvaginal radiofrequency in the treatment of stress urinary incontinence, by searching articles at databases of Capes, PubMed Cochrane and Scielo. Methods: The descriptor terms “Urinary Incontinence/therapy” [Majr] AND “Urinary Incontinence, Stress/therapy” [Majr] AND RADIOFREQUENCY-Search Results-PubMed, [“woman” OR “women”] AND [“urinary incontinence” OR “stress urinary incontinence”] AND Radiofrequency were used, with a filter for the period 2020 to 2022. Conclusion: The studies evaluated in this review demonstrated significant results of radiofrequency in the resolution or reduction of complaints of women with urinary incontinence, especially stress urinary incontinence, but most of these studies presented a low methodological quality. There is, therefore, a lack of studies with longer follow-ups, evaluation of cost-effectiveness, randomized clinical trials with objective outcomes and the use of validated questionnaires with international acceptance.

关键词： Radiofrequency Urinary Incontinence Genitourinary Syndrome of Meno-pause Vaginal Atrophy

Federated Learning’s Role in Next-Gen TV Ad Optimization

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Computers, Materials & Continua 2025年第1期82卷 675-712页

作者： gabriela Dobrita Simona-Vasilica Oprea Adela Bâra Department of Economic Informatics and Cybernetics Bucharest University of Economic StudiesBucharest010374Romania

In the rapidly evolving landscape of television advertising,optimizing ad schedules to maximize viewer engagement and revenue has become *** methods often operate in silos,limiting the potential insights gained from broader data analysis due to concerns over privacy and data *** article introduces a novel approach that leverages Federated Learning(FL)to enhance TV ad schedule optimization,combining the strengths of local optimization techniques with the power of global Machine Learning(ML)models to uncover actionable insights without compromising data *** combines linear programming for initial ads scheduling optimization with ML—specifically,a K-Nearest Neighbors(KNN)model—for predicting ad spot *** into account the diversity and the difficulty of the ad-scheduling problem,we propose a prescriptivepredictive approach in which first the position of the ads is optimized(using Google’s OR-Tools CP-SAT)and then the scheduled position of all ads will be the result of the optimization ***,this output becomes the target of a predictive task that predicts the position of new entries based on their characteristics ensuring the implementation of the scheduling at large scale(using KNN,Light Gradient Boosting Machine and Random Forest).Furthermore,we explore the integration of FL to enhance predictive accuracy and strategic insight across different broadcasting networks while preserving data *** FL approach resulted in 8750 ads being precisely matched to their optimal category placements,showcasing an alignment with the intended diversity ***,there was a minimal deviation observed,with 1133 ads positioned within a one-category variance from their ideal placement in the original dataset.

关键词： Ad scheduling prescriptive-predictive approach federated learning KNN

Inflammasome links traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease

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Neural Regeneration Research 2025年第6期20卷 1644-1664页

作者： gabriela Seplovich Yazan Bouchi Juan Pablo de Rivero Vaccari Jennifer C.Munoz Pareja Andrew Reisner Laura Blackwell Yehia Mechref Kevin K.Wang J.Adrian Tyndall Binu Tharakan Firas Kobeissy Department of Surgery Morehouse School of MedicineAtlantaGAUSA Department of Neurobiology Center for NeurotraumaMultiomics&Biomarkers(CNMB)Neuroscience InstituteMorehouse School of MedicineAtlantaGAUSA Department of Neurological Surgery and the Miami Project to Cure Paralysis University of Miami Miller School of MedicineMiamiFLUSA Division of Pediatric Critical Care Department of PediatricsUniversity of Miami Miller School of MedicineMiamiFLUSA Department of Pediatrics Emory UniversityAtlantaGAUSA Department of Neurosurgery Children’s Healthcare of AtlantaAtlantaGAUSA Department of Chemistry and Biochemistry Texas Tech UniversityLubbockTXUSA Morehouse School of Medicine AtlantaGAUSA

Traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease are three distinct neurological disorders that share common pathophysiological mechanisms involving neuroinflammation. One sequela of neuroinflammation includes the pathologic hyperphosphorylation of tau protein, an endogenous microtubule-associated protein that protects the integrity of neuronal cytoskeletons. Tau hyperphosphorylation results in protein misfolding and subsequent accumulation of tau tangles forming neurotoxic aggregates. These misfolded proteins are characteristic of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease and can lead to downstream neuroinflammatory processes, including assembly and activation of the inflammasome complex. Inflammasomes refer to a family of multimeric protein units that, upon activation, release a cascade of signaling molecules resulting in caspase-induced cell death and inflammation mediated by the release of interleukin-1β cytokine. One specific inflammasome, the NOD-like receptor protein 3, has been proposed to be a key regulator of tau phosphorylation where it has been shown that prolonged NOD-like receptor protein 3 activation acts as a causal factor in pathological tau accumulation and spreading. This review begins by describing the epidemiology and pathophysiology of traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease. Next, we highlight neuroinflammation as an overriding theme and discuss the role of the NOD-like receptor protein 3 inflammasome in the formation of tau deposits and how such tauopathic entities spread throughout the brain. We then propose a novel framework linking traumatic brain injury, chronic traumatic encephalopathy, and Alzheimer's disease as inflammasomedependent pathologies that exist along a temporal continuum. Finally, we discuss potential therapeutic targets that may intercept this pathway and ultimately minimize long-term neurological decline.

关键词： Alzheimer's disease caspase-1 chronic traumatic encephalopathy inflammasomes neurodegeneration neuroinflammation NLRP1 NLRP3 pyroptosis tauopathy traumatic brain injury

Potential Changes in Net Primary Productivity and Carbon Input of Periurban Agroecosystems Treated with Biosolids in Buenos Aires, Argentina

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Pedosphere 2016年第1期26卷 98-107页

作者： gabriela CIVEIRA Institute of Soil Science Instituto Nacional de Tecnología Agropecuaria

Biosolids application in periurban agroecosystems could mitigate climate change by sequestering C, while improving plant net primary production(NPP). Monitoring NPP is useful for studying ecological responses to human management. The values of NPP and C input in periurban agroecosystems are insufficient or missing. The objective was to use local databases to estimate NPP and C input in periurban areas(south, north and west) of Buenos Aires City, Argentina, using different biosolids application scenarios(low and high effects). The NPP varied with crop and vegetable types(P 70%) to NPP in both projected scenarios. For both scenarios, average C input by crops and vegetables presented similar proportions. Biosolids addition in periurban agroecosystems could be a viable practice to elevate NPP and C input.

关键词： application scenarios plant biomass sewage sludge periurban agriculture

Small Cell Neuroendocrine Carcinoma of the Vulva: Case Report and Literature Review

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Open Journal of Obstetrics and Gynecology 2024年第2期14卷 295-300页

作者： gabriela françóes rostirolla Alessandra Guerra Maria Carolina Rey Alt Luiza Tesser Dalla Libera Maria Eduarda Appel Binda Márcia Appel Fernando De Marco dos Santos Department of Obstetrics and Gynecology Caxias do Sul University Caxias do Sul Brazil Department of Pathology UNIVATES Lajeado RS Medical Student Caxias do Sul University Caxias do Sul Brazil Department of Obstetric and Gynecology Federal University of Rio Grande do Sul Porto Alegre Brazil Department of Oncology Surgeon Caxias do Sul University Caxias do Sul Brazil

Background: Neuroendocrine neoplasms are those that develop from a neuroendocrine cell. They most commonly affect the lungs, gastrointestinal tract, and pancreas, being rare conditions in the female genital tract. When present, these neoplasms often manifest with nonspecific signs and symptoms such as pain, itching, swelling, single-focus lesions, bleeding, and enlargement of inguinal lymph nodes, in addition to the presence of progressively enlarging vulvar nodules. Consequently, the diagnostic investigation involves histopathological examination and confirmation through immunohistochemistry. Objective: To present a comprehensive understanding of this rarely studied pathology. The primary objective is to provide valuable insights that could aid in the future development of universally applicable treatment guidelines. Case Presentation: A 57-year-old female, with no prior comorbidities, menopause at 36, who presented with a left vulvar nodule accompanied by intense pain and swelling, later diagnosed with small cell neuroendocrine carcinoma in the vulva. Conclusion: This case report highlights the importance of enhancing our knowledge regarding small cell neuroendocrine carcinoma in the vulva, given its scarcity in medical literature. The information presented here underscores the need for standardized diagnostic and treatment approaches, paving the way for future consensus on managing this uncommon but challenging neoplasm.

关键词： Vulvar Neoplasms Carcinoma Small Cell Carcinoma Neuroendocrine Genital Neoplasms Female Vulvar Diseases