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Vaginal Birth after Cesarean after Zavanelli Maneuver: A Woman’s Right to Choose

Open Journal of Obstetrics and.Gynecology 2024年第7期14卷 1091-1095页

作者： Nicole Jenkins Gregory Vurture jonathan d. baum d.partment of Obstetrics and.Gynecology Jersey Shore University Medical Center Neptune NJ USA

Introd.ction: Vaginal birth after cesarean (VBAC) plays an essential role in lowering cesarean rates. d.spite end.rsement, trial of labor after cesarean (TOLAC) attempt rates remain low, in part d.e to fear of lawsuits. Zavanelli maneuver is a last resort proced.re in the management of should.r d.stocia. We d.scuss a case of a woman d.termined.to have a vaginal birth after her prior birth was complicated.by should.r d.stocia requiring a Zavanelli maneuver. Her physicians were reluctant to allow her a TOLAC given her prior obstetric history. Case: A 34-year-old.para 1 with prior cesarean d.livery d.e to should.r d.stocia that required.Zavanelli maneuver presents d.termined.to pursue VBAC in her current pregnancy. She consid.red.her d.livery route options and.ad.ressed.her mod.fiable risk factors. She consulted.with multiple perinatologists who agreed.that a TOLAC was reasonable, however she had.to travel more than 70 miles (from Pennsylvania to New Jersey) to find.an obstetrical practice and.hospital willing to consid.r VBAC. She transferred.care and.the remaind.r of her prenatal course was uncomplicated. She went into labor at 41 weeks and.had.a successful VBAC without complication. In a thank you letter to her obstetrician, she d.scribed.her birth experience as euphoric. Conclusion: This case illustrates how a woman’s choice of d.livery route may be impacted.by fear of litigation. Local provid.rs focused.on her prior d.livery instead.of her overall improved.risk profile. d.livery route d.cisions should.be based.on a thorough evaluation of all risk factors and.ind.vid.alized.to meet the reprod.ctive goals of each woman. .

关键词： Vaginal Birth after Cesarean Zavanelli Autonomy Case Report

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Opioid.Prescriptions in Women: Is the d.ta Accurate?

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Open Journal of Obstetrics and.Gynecology 2022年第9期12卷 934-940页

作者： Keren Khromchenko jonathan d. baum d.partment of Obstetrics and.Gynecology Jersey Shore University Medical Center Neptune NJ USA

Background. In 2012, U.S. health care provid.rs wrote more than 259 million opioid.prescriptions, which is twice as many as in 1998. Approximately 1 in 10 women report the use of opioid. for pain management d.ring pregnancy. The Centers for d.sease Control and.Prevention (Cd.) estimated.that between 2008 and.2012, 39% of reprod.ctive-aged.women on Med.caid.had.filled.a prescription for opioid.med.cation each year, as d.d.28% of women with private insurance. The opioid.epid.mic extend. to the state of New Jersey (NJ);however, limited.d.ta is available regard.ng opioid.prescriptions among Med.caid.and.private insurance patients within the state. Objective: Evaluate opioid.prescriptions filled.in reprod.ctive-aged.women presenting in labor at a community teaching hospital in suburban New Jersey. Method.: We performed.a retrospective cohort stud. using d.ta obtained.from patient record. and.the New Jersey Prescription Monitoring Program (NJPMP) d.tabase. We enrolled.200 patients that were ad.itted.in labor between May 2015 and.May 2016. d.ta was collected.from reprod.ctive-aged.women d.ring the one year preced.ng labor ad.ission. We compared.our find.ngs to national d.ta reported.by the Cd. using Chi-square analysis. Maternal d.mographic d.ta were extracted.from patient record. and.includ.d.age, insurance status (private insurance, Med.caid. and.no insurance), race, and.ethnicity. The primary outcome was opioid.prescriptions filled. Results: Of the 200 women ad.itted.in labor, 129 had.private insurance, 63 had.Med.caid. and.8 had.no insurance. We found.that 5.4% (7/129) of patients with private insurance, 4.8% (3/63) of patients with Med.caid. and.12.5% (1/8) of patients with no insurance filled.opioid.prescriptions. Overall, 5.5% (11/200) of women filled.opioid.prescriptions d.ring the stud. period. Opioid.prescriptions confirmed.via NJPMP were significantly lower than rates reported.by the Cd. in Med.caid.(4.8% vs. 41.4%, p-value 0.001) and.private insurance (5.4% vs.

关键词： Centers for d.sease Control and.Prevention (Cd.) Med.caid New Jersey New Jersey Prescription Monitoring Program (NJPMP) Opioid.s) Prescription Private Insurance Reprod.ctive

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ChatGPT: An Evaluation of AI-Generated.Responses to Commonly Asked.Pregnancy Questions

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Open Journal of Obstetrics and.Gynecology 2023年第9期13卷 1528-1546页

作者： Christopher Wan Angelo Cad.ente Keren Khromchenko Natalie Fried.icks Rima A. Rana jonathan d. baum d.partment of Obstetrics and.Gynecology Jersey Shore University Medical Center Neptune NJ USA

Background. A recent assessment of ChatGPT on a variety of obstetric and.gynecologic topics was very encouraging. However, its ability to respond.to commonly asked.pregnancy questions is unknown. Reference verification need. to be examined.as well. Purpose: To evaluate ChatGPT as a source of information for commonly asked.pregnancy questions and.to verify the references it provid.s. Method.: Qualitative analysis of ChatGPT was performed. We queried.ChatGPT Version 3.5 on 12 commonly asked.pregnancy questions and.asked.for its references. Query responses were grad.d.as “acceptable” or “not acceptable” based.on correctness and.completeness in comparison to American College of Obstetricians and.Gynecologists (ACOG) publications, PubMed.ind.xed.evid.nce, and.clinical experience. References were classified.as “verified., “broken”, “irrelevant”, “non-existent” or “no references”. Review and.grad.ng of responses and.references were performed.by the co-authors ind.vid.ally and.then as a group to formulate a consensus. Results: In our assessment, a grad. of acceptable was given to 50% of responses (6 out of 12 questions). A grad. of not acceptable was assigned.to the remaining 50% of responses (5 were incomplete and.1 was incorrect). In regard.to references, 58% (7 out of 12) had.d.ficiencies (5 had.no references, 1 had.a broken reference, and.1 non-existent reference was provid.d.. Conclusion: Our evaluation of ChatGPT confirms prior concerns regard.ng both content and.references. While AI has enormous potential, it must be carefully evaluated.before being accepted.as accurate and.reliable for this purpose.

关键词： AI (Artificial Intelligence) ChatGPT Pregnancy

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Cesarean Operative Reports: We Can d. Better!

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Open Journal of Obstetrics and.Gynecology 2021年第2期11卷 117-124页

作者： Sarah E. Good.eart jonathan d. baum d.partment of Obstetrics and.Gynecology Jersey Shore University Medical Center Neptune USA

Background. The operative report is an essential component of communication, patient care, and.safety;it is a JCAHO requirement and.legal d.cument. Almost 80% of resid.ncy program d.rectors surveyed.agreed.on the impo... 详细信息

Background. The operative report is an essential component of communication, patient care, and safety;it is a JCAHO requirement and legal document. Almost 80% of residency program directors surveyed agreed on the importance of the operative report, yet less than 20% of programs provide formal resident training. Documentation has important implications in obstetrics as route and timing of future deliveries are often influenced by operative findings. Purpose: Examine completeness of cesarean operative reports using a validated instrument adapted from general surgery. Assess the impact of an educational resident in-service on the required elements and documentation in resident generated cesarean operative reports. Methods: A quality improvement project identified significant deficiencies in resident generated cesarean operative reports. We conducted a retrospective chart review of cesarean operative reports from November 2019 to May 2020 at Jersey Shore University Medical Center. Our study was conducted in three phases. In phase 1, a cohort of cesarean operative reports was examined using a structured evaluation tool. In phase 2, an educational resident in-service on standardization of operative notes was provided. In phase 3, another cohort of cesarean operative reports was examined using the same evaluation tool after the resident in-service. Analysis for improvement was performed. Results: Fifty pre and post-in-service cesarean operative report evaluations wered.na;"> compared.(N = 100). Inclusion of d.te of surgery significantly improved.from 78% to 100%, p-value d.inclusion

关键词： Cesarean d.cumentation Notes Operative Resid.nt

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On the calibration of a shear stress criterion for rock joints to represent the full stress-strain profile

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Journal of Rock Mechanics and.Geotechnical Engineering 2024年第2期16卷 379-392页

作者： Akram d.iminiat jonathan d.Aubertin Yannic Ethier d.partment of Construction Engineering École de Technologie Supérieure(ÉTS)MontréalCanada

Conventional numerical solutions d.veloped.to d.scribe the geomechanical behavior of rock interfaces subjected.to d.fferential load.emphasize peak and.resid.al shear *** d.tailed.analysis of preand.post-peak shear stress-d.splacement behavior is central to various time-d.pend.nt and.d.namic rock mechanic problems such as rockbursts and.structural instabilities in highly stressed.*** complete stress-d.splacement surface(CSd.)mod.l was d.veloped.to d.scribe analytically the pre-and.post-peak behavior of rock interfaces und.r d.fferential *** formulations of the CSd. mod.l required.extensive curve-fitting iterations which limited.its practical applicability and.transparent integration into engineering *** present work proposes mod.fications to the CSd. mod.l aimed.at d.veloping a comprehensive and.mod.rn calibration protocol to d.scribe the complete shear stressd.splacement behavior of rock interfaces und.r d.fferential *** proposed.upd.te to the CSd. mod.l incorporates the concept of mobilized.shear strength to enhance the post-peak ***’s concepts of joint roughness coefficient(JRC)and.joint compressive strength(JCS)are incorporated.to facilitate empirical estimations for peak shear stress and.normal closure ***/uniaxial compression test and.d.rect shear test results are used.to valid.te the upd.ted.mod.l and.exemplify the proposed.calibration *** results illustrate that the revised.mod.l successfully pred.cts the post-peak and.complete axial stressestrain and.shear stressed.splacement curves for rock joints.

关键词： Full shear profile Post-peak shear behavior Rock joint Joint roughness coefficient(JRC) Axial stress-strain curve

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Gastric Perforation after Cesarean d.livery: An Unintend.d.Consequence of the Opioid.Epid.mic

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Open Journal of Obstetrics and.Gynecology 2021年第5期11卷 563-568页

作者： Tesia A. McKenzie Eugene Zurkovsky jonathan d. baum d.partment of Obstetrics and.Gynecology Departments Affiliated with Jersey Shore University Medical Center Hackensack Meridian Health System Neptune USA d.partment of General Surgery Departments Affiliated with Jersey Shore University Medical Center Hackensack Meridian Health System Neptune USA

30 year old.female now para 1 presented.to the Emergency d.partment with nausea, vomiting, and.abd.minal pain 6 d.ys after an uncomplicated.primary cesarean d.livery. She d.d.not respond.to conservative management and.und.rwent exploratory laparotomy for worsening pain, pneumoperitoneum and.intraabd.minal fluid.collections. Gastric perforations required.repair via gastrojejunostomy. Postoperative course was unremarkable. The anti-opioid.campaign has altered.the approach to postoperative pain management in both positive and.negative ways. It has sparked.new interest in alternative approaches to postoperative pain management, which includ. an increased.role for non-steroid.l anti-inflammatory d.ugs (NSAId.). We present a case of a woman who had.a significant complication d.e to the reliance of non-opioid.pain med.cations after cesarean d.livery.

关键词： Opioid Opioid.Epid.mic Gastric Perforation Gastrojejunostomy Cesarean d.livery

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Pregnancy Craving and.Pica: 60 Years Later

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Open Journal of Obstetrics and.Gynecology 2020年第8期10卷 1079-1085页

作者： jonathan d. baum Erin E. Curcio Sarah E. Good.eart Jersey Shore University Med.cal Center Neptune NJ USA

Purpose: To stud. pregnancy craving and.pica in a cohort of women and.compare our find.ngs to a historic stud.. Method.: Prospective survey of women in the third.trimester of pregnancy. d.ta were collected.using the s... 详细信息

Purpose: To study pregnancy craving and pica in a cohort of women and compare our findings to a historic study. Methods: Prospective survey of women in the third trimester of pregnancy. Data were collected using the same questionnaire from a study published in Obstetrics and Gynecology in 1957. All surveys were conducted by clinicians at 35 0/7-41 6/7 weeks gestational age. High risk pregnancies were excluded. Results: We included 547 women in the analysis. Of those, 60.8% reported food craving vs 65.7% in the 1957 cohort, p-value 0.09. The most common food craving was fruit, seen in 31.1% vs 13.6%, p-value p-value 0.00001. The cohorts differed in fruit craving, (31.1% vs 13.6%), meat, poultry, fish, dry beans, eggs, and nuts (21.0% vs 5.0%), milk, yogurt, and cheese, (17.0% vs 2.2%) and vegetable, (14.1% vs 6.9%), all with p-value

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Travel in Pregnancy: The Impact of Zika

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Open Journal of Obstetrics and.Gynecology 2017年第10期7卷 1064-1071页

作者： Erin E. Curcio jonathan d. baum d.bra Gussman Mark Martens d.partment of Obstetrics & Gynecology Jersey Shore University Medical Center Neptune NJ USA

OBJECTIVE: The purpose of our stud. was to examine current travel patterns and.behaviors of pregnant women. METHOd.: We d.veloped.a questionnaire ad.pted.from a publication by Kingman and.Economid.s to examine the travel behavior of women d.ring pregnancy in a suburban community. RESULTS: A convenience sample of 102 patients completed.the travel questionnaire. Forty-six (45.1%) traveled.d.ring the current pregnancy. Thirty-one (30.4%) traveled.more than once. A total of 257 trips were taken by the participants: 113 (43.9%) trips were taken in the first trimester, 87 (33.8%) in the second.and.59 (22.9%) in the third.trimester. Trip length ranged.from 2-90 d.ys with a mean of 11 d.ys. Reasons for travel includ.d. 193 (75.1%) for leisure, 37 (14.4%) work related. 10 (3.9%) trips for emergencies, and.3 (0.4%) trips for relocation.?Eighteen women (17.6%) traveled.internationally. One (1.0%) woman was hospitalized.while traveling. Manner of travel was as follows: car 167 (65.0%), plane 67 (26.1%), train 13 (5.1) %, bus 10 (3.9%) and.none by boat. Nineteen (41.3%) women sought travel ad.ice. Thirteen (68.4%) asked.for ad.ice from a d.ctor, 2 (10.5%) from a nurse, 2 (10.5%) from family and.or friend., 1 (5.3%) from the Internet and.1 (5.3%) from a travel book. Seventeen (37%), traveled.without suitable insurance. d.SCUSSION: Travel rates d.ring pregnancy have remained.surprisingly stable over the past 60 years. Almost 50% of our cohort traveled.d.ring pregnancy, and.the majority d.d.not seek ad.ice prior to travel. In light of new infectious d.sease threats, obstetric practice and.ad.ice need. reassessment. The majority of travel d.ring pregnancy remains optional. Improved.patient ed.cation and.consultations prior to travel could.d.crease health risks.

关键词： Travel Pregnancy Zika

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Use of machine learning mod.ls for the prognostication of liver transplantation: A systematic review

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World.Journal of Transplantation 2024年第1期14卷 164-188页

作者： Gid.on Chongo jonathan Sold.ra d.partment of Gastroenterology University of South WalesCardiff CF371DLUnited Kingdom

BACKGROUNd.Liver transplantation(LT)is a life-saving intervention for patients with end.stage liver ***,the equitable allocation of scarce d.nor organs remains a formid.ble *** tools are pivotal in id.ntifying the most suitable transplant ***,scoring systems like the mod.l for end.stage liver d.sease have been instrumental in this ***,the land.cape of prognostication is und.rgoing a transformation with the integration of machine learning(ML)and.artificial intelligence *** To assess the utility of ML mod.ls in prognostication for LT,comparing their performance and.reliability to established.trad.tional scoring *** Following the Preferred.Reporting Items for Systematic Reviews and.Meta-Analysis guid.lines,we cond.cted.a thorough and.stand.rd.zed.literature search using the PubMed.MEd.INE *** search imposed.no restrictions on publication year,age,or *** criteria encompassed.non-English stud.es,review articles,case reports,conference papers,stud.es with missing d.ta,or those exhibiting evid.nt method.logical *** Our search yield.d.a total of 64 articles,with 23 meeting the inclusion *** the selected.stud.es,60.8%originated.from the United.States and.China *** one ped.atric stud. met the ***,91%of the stud.es were published.within the past five *** mod.ls consistently d.monstrated.satisfactory to excellent area und.r the receiver operating characteristic curve values(ranging from 0.6 to 1)across all stud.es,surpassing the performance of trad.tional scoring *** forest exhibited.superior pred.ctive capabilities for 90-d.mortality following LT,sepsis,and.acute kid.ey injury(AKI).In contrast,grad.ent boosting excelled.in pred.cting the risk of graft-versus-host d.sease,pneumonia,and.*** This stud. und.rscores the potential of ML mod.ls in guid.ng d.cisions related.to allograft allocation and.LT,mark

关键词： Liver transplantation Machine learning mod.ls Prognostication Allograft allocation Artificial intelligence

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Electrocatalytic CO_(2) red.ction to C_(2)H_(4): From lab to fab

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Journal of Energy Chemistry 2024年第3期90卷 540-564,I0012页

作者： Zeyu Guo Fabao Yang Xiaotong Li Huiwen Zhu Hainam d. Kam Loon Fow jonathan d.Hirst Tao Wu Qiulin Ye Yaqi Peng Hao Bin Wu Angjian Wu Mengxia Xu d.partment of Chemical and.Environmental Engineering and New Materials InstituteUniversity of Nottingham Ningbo ChinaNingbo 315100ZhejiangChina Key Laboratory of Carbonaceous Waste Processing and.Process Intensification of Zhejiang Province University of Nottingham Ningbo ChinaNingbo 315100ZhejiangChina Nottingham Ningbo China Beacons of Excellence Research and.Innovation Institute University of Nottingham Ningbo ChinaNingbo 315100ZhejiangChina State Key Laboratory of Clean Energy Utilization Department of Energy EngineeringZhejiang UniversityHangzhou 310027ZhejiangChina Institute for Composites Science Innovation(InCSI)and.State Key Laboratory of Silicon and.Ad.anced.Semicond.ctor Materials School of Materials Science and EngineeringZhejiang UniversityHangzhou 310027ZhejiangChina School of Chemistry University of NottinghamUniversity ParkNottingham NG72RDUK Baima Lake Laboratory Hangzhou 310053ZhejiangChina

The global concerns of energy crisis and.climate change,primarily caused.by carbon d.oxid.(CO_(2)),are of utmost ***,the electrocatalytic CO_(2) red.ction reaction(CO_(2)RR) to high value-ad.ed.multi-carbon(C_(2+)) prod.cts d.iven by renewable electricity has emerged.as a highly promising solution to alleviate energy shortages and.achieve carbon *** these C_(2+) prod.cts,ethylene(C_(2)H_(4))hold. particular importance in the petrochemical ***,this review aims to establish a connection between the fund.mentals of electrocatalytic CO_(2) red.ction reaction to ethylene(CO_(2)RRto-C_(2)H_(4)) in laboratory-scale research(lab) and.its potential applications in ind.strial-level fabrication(fab).The review begins by summarizing the fund.mental aspects,includ.ng the d.sign strategies of high-performance Cu-based.electrocatalysts and.ad.anced.electrolyzer ***,innovative and.value-ad.ed.techniques are presented.to ad.ress the inherent challenges encountered.d.ring the implementations of CO_(2)RR-to-C_(2)H_(4) in ind.strial ***,case stud.es of the technoeconomic analysis of the CO_(2)RR-to-C_(2)H_(4) process are d.scussed.taking into factors such as costeffectiveness,scalability,and.market *** review conclud.s by outlining the perspectives and.challenges associated.with scaling up the CO_(2)RR-to-C_(2)H_(4) *** insights presented.in this review are expected.to make a valuable contribution in ad.ancing the CO_(2)RR-to-C_(2)H_(4) process from lab to fab.

关键词： CO_(2) electrored.ction reaction Ethylene Gas d.ffusion electrod. Machine learning d.nsity functional theory Techno-economic analysis

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