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Delivery Rate (delivery + rate)
Kinds of Delivery Rate Selected AbstractsSTOCK LEVELS AND DELIVERY RATES IN VENDORMANAGED INVENTORY PROGRAMSPRODUCTION AND OPERATIONS MANAGEMENT, Issue 1 2001BEN A. CHAOUCH Using the latest information technology, powerful retailers like Wal-Mart have taken the lead in forging shorter replenishment-cycles, automated supply systems with suppliers. With the objective to reduce cost, these retailers are directing suppliers to take full responsibility for managing stocks and deliveries. Suppliers' performance is measured according to how often inventory is shipped to the retailer, and how often customers are unable to purchase the product because it is out of stock. This emerging trend also implies that suppliers are absorbing a large part of the inventory and delivery costs and, therefore, must plan delivery programs including delivery frequency to ensure that the inherent costs are minimized. With the idea to incorporate this shift in focus, this paper looks at the problem facing the supplier who wants quicker replenishment at lower cost. In particular, we present a model that seeks the best trade-off among inventory investment, delivery rates, and permitting shortages to occur, given some random demand pattern for the product. The process generating demand consists of two components: one is deterministic and the other is random. The random part is assumed to follow a compound Poisson process. Furthermore, we assume that the supplier may fail to meet uniform shipping schedules, and, therefore, uncertainty is present in delivery times. The solution to this transportationinventory problem requires determining jointly delivery rates and stock levels that will minimize transportation, inventory, and shortage costs. Several numerical results are presented to give a feel of the optimal policy's general behavior. [source] A Randomized Controlled Trial of Continuous Labor Support for Middle-Class Couples: Effect on Cesarean Delivery RatesBIRTH, Issue 2 2008Susan K. McGrath PhD ABSTRACT: Background: Previous randomized controlled studies in several different settings demonstrated the positive effects of continuous labor support by an experienced woman (doula) for low-income women laboring without the support of family members. The objective of this randomized controlled trial was to examine the perinatal effects of doula support for nulliparous middle-income women accompanied by a male partner during labor and delivery. Methods: Nulliparous women in the third trimester of an uncomplicated pregnancy were enrolled at childbirth education classes in Cleveland, Ohio, from 1988 through 1992. Of the 686 prenatal women recruited, 420 met enrollment criteria and completed the intervention. For the 224 women randomly assigned to the experimental group, a doula arrived shortly after hospital admission and remained throughout labor and delivery. Doula support included close physical proximity, touch, and eye contact with the laboring woman, and teaching, reassurance, and encouragement of the woman and her male partner. Results: The doula group had a significantly lower cesarean delivery rate than the control group (13.4% vs 25.0%, p = 0.002), and fewer women in the doula group received epidural analgesia (64.7% vs 76.0%, p = 0.008). Among women with induced labor, those supported by a doula had a lower rate of cesarean delivery than those in the control group (12.5% vs 58.8%, p = 0.007). On questionnaires the day after delivery, 100 percent of couples with doula support rated their experience with the doula positively. Conclusions: For middle-class women laboring with the support of their male partner, the continuous presence of a doula during labor significantly decreased the likelihood of cesarean delivery and reduced the need for epidural analgesia. Women and their male partners were unequivocal in their positive opinions about laboring with the support of a doula. (BIRTH 35:2 June 2008) [source] Effect of Preexisting Chronic Disease on Primary Cesarean Delivery Rates by Race for Births in U.S. Military Hospitals, 1999,2002BIRTH, Issue 3 2004Andrea Linton MS This finding suggests that other maternal factors may explain the elevated rates. The purpose of this study was to examine the prevalence of specific chronic diseases identified as risk factors for complications during pregnancy, labor, and delivery, and to explore the strength of each disease to predict a cesarean outcome. Methods: United States military hospital discharge records from 1999 to 2002 for singleton births to women without a previous cesarean were used to calculate primary cesarean and chronic disease rates for diabetes, hypertension, cardiovascular disease, renal disease, anemia, asthma, sexually transmitted diseases, and substance abuse. Stepwise logistic regression was used to calculate adjusted odds ratios for dichotomized race and chronic disease indicators for five maternal age groups using the,2difference(p < 0.05) to identify significant variables for inclusion in the model. Primary cesarean delivery rates were then adjusted for the presence of chronic diseases that were significantly associated with a cesarean outcome. Results: Diabetes, genital herpes, and hypertension were significant predictors of cesarean use among all maternal age groups. Cardiovascular disease, renal disease, asthma, and anemia were predictors in some age groups. The remaining disease conditions were not significant predictors for cesarean delivery. Adjustment of cesarean rates for these chronic diseases did not significantly alter the differences in primary cesarean rates for black and Asian mothers relative to white mothers. Conclusions: The presence of certain chronic conditions before pregnancy may increase the likelihood that a woman will deliver by cesarean section. Adjustment of cesarean rates for the presence of these chronic diseases, however, does not account for the difference in cesarean rates observed for white and minority mothers in the study population. The potential for underreporting of chronic diseases complicates a true assessment of the impact of chronic disease on cesarean delivery rate variations between white and minority women. [source] Effects of Maternal Characteristics on Cesarean Delivery Rates among U.S. Department of Defense Healthcare Beneficiaries, 1996,2002BIRTH, Issue 1 2004Andrea Linton MS Nonclinical factors associated with cesarean delivery include maternal age, race, socioeconomic status, and insurance coverage. This study compared cesarean delivery rates and trends for the U.S. Department of Defense healthcare beneficiary population from 1996 to 2002 with those observed nationally, and assessed the association of these nonclinical factors with cesarean rate variation in the U.S. Department of Defense healthcare beneficiary population. Methods: Hospital discharge and claims records for babies born in the military and civilian hospitals that comprise the Department of Defense healthcare network were used to calculate total and primary cesarean delivery rates and vaginal birth after cesarean (VBAC) rates from 1996 to 2002. Annual cesarean rates for subgroups defined by maternal age, race, and socioeconomic status were calculated to examine rate variations and rate trends within the study population. Pooled data from 1999 to 2002 were used to compare rates across socioeconomic status, stratified by age and race. Statistical significance of the differences calculated for subgroups was assessed using chi-square. Results: Total and primary cesarean delivery rates among the U.S. Department of Defense population were lower than those reported nationally for every year examined. Cesarean delivery and VBAC rate trends in the national and Department of Defense populations were similar. Within the Department of Defense population, total cesarean delivery increased with increasing maternal age and was more highly associated with racial minorities relative to white women. The higher socioeconomic subgroup (defined as active duty, retired, and warrant officers and their families in this study) was generally associated with reduced cesarean delivery rates. Conclusions: Cesarean deliveries are performed less frequently for the U.S. Department of Defense healthcare beneficiary population relative to the national population. Associations between socioeconomic factors and cesarean rates reported for the national population were not apparent in the study population. The consistent pattern of rate variation across racial subgroups in the Department of Defense population suggests that factors beyond those examined in this study are needed to explain the elevated cesarean rates for racial minorities. (BIRTH 31:1 March 2004) [source] Mass transport and thermodynamic analysis of PAHs in partitioning systems in the presence and absence of ultrasonicationAICHE JOURNAL, Issue 10 2010Pedro A. Isaza Abstract Transport of PAHs from Desmopan polymers to methanol under various mixing conditions and in the presence of ultrasound was analyzed. PAH transport was influenced by external transport resistances; however, agitation greater than 800 rpm yielded PAH transport completely limited by internal resistances. Delivery rates of phenanthrene, fluoranthene, and pyrene with ultrasonication were faster than that under any mixing condition, suggesting enhanced internal transport properties. Ultrasound also induced increased concentrations of PAHs in solution at equilibrium. The model developed described PAH delivery under sonicated/non-sonicated conditions, while quantifying diffusive and thermodynamic properties. Diffusivities with and without ultrasound decreased with permeant molecular size agreeing with coefficients determined for similar aromatic compounds in polymers. Partitioning coefficients under sonicated and non-sonicated conditions conclusively differed from each other and decreased as a function of PAH molecular size. Quantitative structure-property relationship data of PAHs yielded factors predicting thermodynamic and transport behaviors, with polarizability being the best descriptor. © 2010 American Institute of Chemical Engineers AIChE J, 2010 [source] Mechanism of lidocaine release from carbomer,lidocaine hydrogelsJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 1 2002Alvaro Jimenez-Kairuz Abstract Rheology, acid-base behavior, and kinetics of lidocaine release of carbomer,lidocaine (CL) hydrogels are reported. A series of (CL)x (x,=,mol% of L,=,25, 50, 75, 100) that covers a pH range between 5.33 and 7.96 was used. Concentrations of ion pair ([R-COO,LH+]) and free species (L) and (LH+) were determined by the selective extraction of (L) with cyclohexane (CH) together with pH measurements, i.e., CH in a ratio CH/hydrogel 2:1 extracted 48% of the whole concentration of lidocaine [LT] of a (CL)100, {[LT],=,([R-COO,LH+]),+,(L),+,(LH+)}. The remaining species in the aqueous phase were distributed as: (L) 3.82%, (LH+) 14.5%, and [R-COO, LH+] 81.7%. Rheology and pH as a function of (CL) concentration are also reported. Delivery rates of free base L were measured in a Franz-type bicompartmental device using water and NaCl 0.9% solution as receptor media. (CL) hydrogels behave as a reservoir that releases the drug at a slow rate. pH effects on rate suggest that, under the main conditions assayed, dissociation of [R-COO,LH+] is the slow step that controls releasing rates. Accordingly, release rate was increased upon addition of a second counterion (i.e., Na+), or through the diffusion of neutral salts such as NaCl, into the matrix of the gel. © 2002 Wiley-Liss, Inc. and the American Pharmaceutical Association J Pharm Sci 91:267,272, 2002 [source] Birth at hospitals with co-located paediatric units for infants with correctable birth defectsAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2008Charles S. ALGERT Objectives: To determine the percentage of liveborn infants with selected antenatally identifiable and correctable birth defects who were delivered at hospitals with co-located paediatric surgical units (co-located hospitals). Additionally, to determine the survival rates for these infants. Patients and methods: Data were from linked New South Wales hospital discharge records from 2001 to 2004. Livebirths with one of the selected defects were included if they underwent an appropriate surgical repair, or died during the first year of life. Infants with multiple lethal birth defects were excluded. Deliveries at co-located hospitals were identified, but no data on antenatal diagnosis were available. Results: The study identified 287 eligible livebirths with the selected defects. The highest rates of delivery at co-located hospitals were for gastroschisis (88%), exomphalos (71%), spina bifida (63%) and diaphragmatic hernia (61%), and the lowest for transposition of the great arteries (43%) and oesophageal atresia (40%). Mothers resident outside of metropolitan areas, where the co-located hospitals are located, had a similar rate of delivery at co-located hospitals as metropolitan women. For the non-metropolitan mothers of infants with a birth defect, this represented a 30-fold increase over the baseline delivery rate of 1.8%. Post-surgery survival rates were 87% or higher. Overall survival rates were , 86% except for infants with a diaphragmatic hernia. Conclusions: Delivery rates at co-located hospitals were high for mothers of infants with these correctable birth defects. Regionalised health care appears to work well for these pregnancies, as women living outside metropolitan areas had a similar rate of delivery at co-located hospitals to that of urban women. [source] HABITAT-DEPENDENT SONG DIVERGENCE IN THE LITTLE GREENBUL: AN ANALYSIS OF ENVIRONMENTAL SELECTION PRESSURES ON ACOUSTIC SIGNALSEVOLUTION, Issue 9 2002Hans Slabbekoorn Abstract., Bird song is a sexual trait important in mate choice and known to be shaped by environmental selection. Here we investigate the ecological factors shaping song variation across a rainforest gradient in central Africa. We show that the little greenbul (Andropadus virens), previously shown to vary morphologically across the gradient in fitness-related characters, also varies with respect to song characteristics. Acoustic features, including minimum and maximum frequency, and delivery rate of song notes showed significant differences between habitats. In contrast, we found dialectal variation independent of habitat in population-typical songtype sequences. This pattern is consistent with ongoing gene flow across habitats and in line with the view that song variation in the order in which songtypes are produced is not dependent on habitat characteristics in the same way physical song characteristics are. Sound transmission characteristics of the two habitats did not vary significantly, but analyses of ambient noise spectra revealed dramatic and consistent habitat-dependent differences. Matching between low ambient noise levels for low frequencies in the rainforest and lower minimal frequencies in greenbul songs in this habitat suggests that part of the song divergence may be driven by habitat-dependent ambient noise patterns. These results suggest that habitat-dependent selection may act simultaneously on traits of ecological importance and those important in prezygotic isolation, leading to an association between morphological and acoustic divergence. Such an association may promote assortative mating and may be a mechanism driving reproductive divergence across ecological gradients. [source] Optimization of Full-Scale Permanganate ISCO System Operation: Laboratory and Numerical StudiesGROUND WATER MONITORING & REMEDIATION, Issue 4 2008Jeffrey L. Heiderscheidt Laboratory characterization studies, one-dimensional flow-through studies, and numerical model simulations were conducted to examine site conditions and system features that may have adversely affected in situ chemical oxidation (ISCO) performance at the Naval Training Center's (NTC) Operable Unit 4 located in Orlando, Florida, and to identify potential ISCO system modifications to achieve the desired remediation performance. At the NTC site, ISCO was implemented using vertical injection wells to deliver potassium permanganate into a ground water zone for treatment of tetrachloroethylene and its breakdown products. However, oxidant distribution was much more limited than anticipated. Characterization studies revealed that the ground water zone being treated by ISCO was very fine sand with a small effective particle size and low uniformity coefficient, along with a high organic carbon content, high natural oxidant demand (NOD), and a high ground water dissolved solids concentration, all of which contributed to full-scale ISCO application difficulties. These site conditions contributed to injection well permeability loss and an inability to achieve the design oxidant injection flow rate, limiting the actual oxidant distribution at the site. Flow-through experiments demonstrated that more favorable oxidant delivery and distribution conditions are enabled by applying a lower oxidant concentration at a faster delivery rate for a greater number of pore volumes. Numerical simulations, run for a variety of conditions (injection/extraction well flow rates, injected oxidant concentration, amount of NOD present, and NOD oxidation rate), also revealed that low,oxidant concentration injection at a high flow rate is a more effective method to deliver the required mass of oxidant to the target treatment zone. [source] Translating Electronic Currents to Precise Acetylcholine,Induced Neuronal Signaling Using an Organic Electrophoretic Delivery DeviceADVANCED MATERIALS, Issue 44 2009Klas Tybrandt A miniaturized organic electronic ion pump (OEIP) based on conjugated polymers is developed for delivery of positively charged biomolecules. Characterization shows that applied voltage can precisely modulate the delivery rate of the neurotransmitter acetylcholine. The capability of the device is demonstrated by convection-free, spatiotemporally resolved delivery of acetylcholine via a 10 µm channel for dynamic stimulation of single neuronal cells. [source] The effect of parent sex on prey deliveries to fledgling Eurasian Sparrowhawks Accipiter nisusIBIS, Issue 4 2003Katrine Eldegard The relative contribution of each parent when providing for the fledglings has been recorded in only a few raptor species. We studied prey deliveries by Eurasian Sparrowhawk Accipiter nisus parents to fledglings at seven nests in southern Norway. Parents and young were fitted with radio-transmitters. Males delivered a larger number of prey to the young than did females throughout the post-fledging period (on average c. 80% of the deliveries). Two females were never observed to deliver food to the offspring, and their mates apparently raised the young to independence alone. The duration of the post-fledging period was positively related to per-capita delivery rate in the late stage. [source] Study of MANET routing protocols by GloMoSim simulatorINTERNATIONAL JOURNAL OF NETWORK MANAGEMENT, Issue 6 2005Ashwini K. Pandey This paper compares ad hoc on-demand distance vector (AODV), dynamic source routing (DSR) and wireless routing protocol (WRP) for MANETs to distance vector protocol to better understand the major characteristics of the three routing protocols, using a parallel discrete event-driven simulator, GloMoSim. MANET (mobile ad hoc network) is a multi-hop wireless network without a fixed infrastructure. Following are some of our key findings: (1) AODV is most sensitive to changes in traffic load in the messaging overhead for routing. The number of control packets generated by AODV became 36 times larger when the traffic load was increased. For distance vector, WRP and DSR, their increase was approximately 1.3 times, 1.1 times and 7.6 times, respectively. (2) Two advantages common in the three MANET routing protocols compared to classical distance vector protocol were identified to be scalability for node mobility in end-to-end delay and scalability for node density in messaging overhead. (3) WRP resulted in the shortest delay and highest packet delivery rate, implying that WRP will be the best for real-time applications in the four protocols compared. WRP demonstrated the best traffic scalability; control overhead will not increase much when traffic load increases. Copyright © 2005 John Wiley & Sons, Ltd. [source] Improvement of stone comminution by slow delivery rate of shock waves in extracorporeal lithotripsyINTERNATIONAL JOURNAL OF UROLOGY, Issue 12 2006YUJI KATO Aim: The aim of this study was to investigate the effect of delivery rate of shockwaves (SW) on stone comminution and treatment outcomes in patients with renal and ureteral stones. Methods: Patients with radio-opaque stones in the upper urinary tract that were treated by extracorporeal shock wave lithotripsy (ESWL) were divided into two groups according to delivery rate (120 or 60 SW/min). The effective fragmentation after one ESWL session and treatment success at 3 months after ESWL was compared between the two groups. Results: Of 134 patients (84 men and 50 women), 68 patients were treated at a fast rate and 66 were treated at a slow rate. Thirty and 38 patients in the fast rate group and 28 and 38 in the slow rate group had renal and ureteral stones, respectively. After one ESWL session, effective fragmentation was noted more often in the slow group (65.2%) than the fast group (47.1%) (P = 0.035), particularly for smaller stones (stone area <100 mm2) (P = 0.005) and renal stones (p = 0.005). However, there was no significant difference in treatment success at 3 months after ESWL between the two groups. In univariate logistic regression analysis, slow SW rate and smaller stones were significant factors for effective fragmentation after one ESWL session. In multivariate analysis, slow SW rate and smaller stones were also independent factors. Conclusions: Slow SW rate contributed to better stone comminution than fast rate, particularly for small stones and renal stones. ESWL treatment at a slow SW rate is recommended to obtain efficient stone fragmentation. [source] How different provisioning strategies result in equal rates of food delivery: an experimental study of blue tits Parus caeruleusJOURNAL OF AVIAN BIOLOGY, Issue 4 2002Fabrizio Grieco Food provisioning in birds requires a considerable amount of time and usually has to be traded-off against other parental and non-parental activities. I investigated experimentally the rate at which blue tit Parus caeruleus parents deliver food to their brood after a change in food availability. The main argument behind this study is that parents enjoying an additional food source may use less time for self-feeding and therefore use more time for food provisioning. This could increase the rate at which food is brought to the nest. However, a prey choice model that takes the energetic needs of the parent into account allows for the possibility that the food-supplemented parents would deliver the same amount of food by increasing prey size (through an increase in prey selectivity) and reducing visit rate. The field data indicate that the parents changed provisioning strategy when food-supplemented: they fed the chicks natural food less frequently, but brought larger larvae. On the whole, delivery rate of natural food was the same or lower than in controls. The results suggest that food-supplemented parents used the time saved to increase their degree of food selectivity. When the gains from an increased delivery rate are not worth the increased costs (mainly resulting from an increased visiting rate), the parent with low energetic need may increase selectivity to provide the same amount of food to the brood as the unmanipulated parent, but at a lower cost. [source] Breeding biology of White-rumped Tanagers in central BrazilJOURNAL OF FIELD ORNITHOLOGY, Issue 3 2010Luane R. Dos Santos ABSTRACT White-rumped Tanagers (Cypsnagra hirundinacea) are widely distributed in northern Brazil, Bolivia, and Paraguay, and are classified as vulnerable in the state of Paraná and as endangered in the state of São Paulo, Brazil. Little is currently known about their breeding biology. We studied the breeding behavior of White-rumped Tanagers in the Cerrado (Neotropical savanna) in central Brazil from 2002 to 2007. The breeding period extended from mid-August to mid-December. Nests were cup-shaped and located mainly in trees of the genus Kielmeyera at a mean height of 3.7 ± 0.3 m (SE). Clutch sizes varied from one to three eggs and the incubation period lasted an average of 16.0 ± 0.3 d. Incubation was by females only and started with the laying of the first egg. Mean nest attentiveness (percent time on nests by females) was 64 ± 0.08%. Nestlings were fed by males, females, and, when present, helpers. The mean rate of food delivery rate to nests was 5.2 ± 0.4 items/h, with rates similar for males (mean = 2.7 ± 0.3 items/h) and females (mean = 2.4 ± 0.3 items/h). The mean duration of the nestling period was 12.1 ± 0.5 d. Compared to many temperate species of tanagers, White-rumped Tanagers in our study had relatively small clutches, low nest attentiveness, and long incubation periods. As with other tropical species, such characteristics might be due to food limitation or high rates of nest predation. RESUMEN Cypsnagra hirundinacea está ampliamente distribuida desde el norte de Brasil, Bolivia y Paraguay, y está clasificada como vulnerable en el estado de Paraná y en peligro en el estado de São Paulo, Brasil. Actualmente poco es conocido sobre su biología reproductiva. Estudiamos el comportamiento reproductivo de C. hirundinacea en el cerrado (Sabana Neotropical) en la región central de Brasil desde el 2002 hasta el 2007. El periodo reproductivo se extiende desde mediados de agosto hasta mediados de diciembre. Los nidos en forma de copa estaban localizados principalmente en arboles del genero Kielmeyera a una altura promedio de 3.7 ± 0.3 (ES) m. El tamaño de la nidada vario entre uno y tres huevos y el periodo de incubación duro en promedio 16 ± 0.3 días. La incubación fue realizada exclusivamente por la hembra y comenzó después de la puesta del primer huevo. El promedio de atención al nido (porcentaje del tiempo en el nido por parte de la hembra) fue de 64 ± 0.08%. Los polluelos fueron alimentados por el macho, la hembra y, cuando estaban presentes, ayudantes. El promedio de la tasa de alimentación al nido fue de 5.2 ± 0.4 viajes/hr, con tasas similares entre el macho (promedio = 2.7 ± 0.3 viajes/hr) y la hembra (promedio = 2.4 ± 0.3 viajes/hr). El promedio de duración del periodo de polluelos fue de 12.1 ± 0.5 días. Comparado con muchas especies de tangaras de la zona temperada, C. hirundinacea tiene una nidada relativamente pequeña, baja atención al nido y un periodo largo de incubación. Pero las diferencias con otras especies tropicales en estas variables se pueden deber a variación en la disponibilidad de alimento o altas tasa de depredación. [source] Outcomes of multifetal pregnanciesJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 1 2007Ounjai Kor-anantakul Abstract Aim:, To determine the outcomes of multifetal pregnancies and to compare maternal and neonatal complications between spontaneously conceived and assisted reproductive therapy. Methods:, A retrospective analysis was conducted of the information from medical records relating to all multifetal pregnancies. The outcomes were analyzed and used for a comparison between spontaneous and assisted multifetal pregnancies. Results:, There were 387 multifetal pregnancies during the study period, which was 1.3% of all the deliveries; 334 cases (86.3%) were spontaneous conceptions and 53 cases (13.7%) were the result of assisted reproductive therapy. Higher-order fetuses (,3) represented 8% of all multifetal pregnancies, 13% in the spontaneous group and 87% in the assisted group. The overall cesarean delivery rate was 73.9%. The assisted reproductive therapy group had a cesarean rate of 90.6% compared with 71.3% in the spontaneous group (P = 0.008). The assisted multifetal pregnancy group had more preterm labors and a longer maternal hospital stay than the spontaneous group. One maternal death occurred in the assisted group. The main causes of early neonatal death were prematurity, infection and congenital malformation. The newborns in the assisted group had more complications than the spontaneous group; most notable were respiratory distress syndrome, newborn intensive care admission, infection and longer hospital stay (6 days vs 15 days, P < 0.001). More complications occurred in higher-order fetuses than with twins. Conclusions:, Assisted multifetal pregnancies were more likely to be delivered by cesarean section and had a higher rate of higher-order fetuses, preterm birth and neonatal prematurity-related complications with a longer hospital stay in both mothers and newborns, than spontaneous multifetal pregnancies. [source] Straight-chain naltrexone ester prodrugs: Diffusion and concurrent esterase biotransformation in human skinJOURNAL OF PHARMACEUTICAL SCIENCES, Issue 12 2002Audra L. Stinchcomb Abstract Naltrexone (NTX) is an opioid antagonist used for treatment of narcotic dependence and alcoholism. Transdermal naltrexone delivery is desirable to help improve patient compliance. The purpose of this study was to increase the delivery rate of NTX across human skin by using lipophilic alkyl ester prodrugs. Straight-chain naltrexone-3-alkyl ester prodrugs of 2,7 carbons in chain length were synthesized and evaluated. In vitro human skin permeation rates were measured using a flow-through diffusion cell system. The melting points, solubilities, and skin disposition of the drugs were determined. The prodrugs were almost completely hydrolyzed on passing through the skin and appeared as NTX in the receiver compartment. The mean NTX flux from the prodrug-saturated solutions exceeded the flux of NTX base by ,2,7-fold. The amount of drug detected in the skin was significantly greater after treatment with the prodrug solutions compared with treatment with NTX base. The extent of parent drug (NTX) regeneration in the intact skin ranged from 28 to 91%. Higher NTX regeneration percentages in skin appeared to correlate with increased drug delivery rates. Definitively, the highly oil-soluble prodrugs provide a higher NTX flux across human skin in vitro and undergo significant metabolic conversion in the skin. © 2002 Wiley-Liss, Inc. and the American Pharmaceutical Association J Pharm Sci 91:2571,2578, 2002 [source] Predicting project delivery rates using the Naive,Bayes classifierJOURNAL OF SOFTWARE MAINTENANCE AND EVOLUTION: RESEARCH AND PRACTICE, Issue 3 2002B. Stewart Abstract The importance of accurate estimation of software development effort is well recognized in software engineering. In recent years, machine learning approaches have been studied as possible alternatives to more traditional software cost estimation methods. The objective of this paper is to investigate the utility of the machine learning algorithm known as the Naive,Bayes classifier for estimating software project effort. We present empirical experiments with the Benchmark 6 data set from the International Software Benchmarking Standards Group to estimate project delivery rates and compare the performance of the Naive,Bayes approach to two other machine learning methods,model trees and neural networks. A project delivery rate is defined as the number of effort hours per function point. The approach described is general and can be used to analyse not only software development data but also data on software maintenance and other types of software engineering. The paper demonstrates that the Naive,Bayes classifier has a potential to be used as an alternative machine learning tool for software development effort estimation. Copyright © 2002 John Wiley & Sons, Ltd. [source] Patient-controlled epidural technique improves analgesia for labor but increases cesarean delivery rate compared with the intermittent bolus techniqueACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 6 2004P. Halonen Background:, We tested the hypothesis that patient-controlled epidural analgesia for labor (PCEA) provides better analgesia and satisfaction than the intermittent bolus technique (bolus) without affecting the mode of delivery. Methods:, We randomized 187 parturients to receive labor analgesia using either the PCEA or bolus technique. The PCEA group received a starting bolus of 14 mg of bupivacaine and 60 µg of fentanyl in a 15-ml volume, followed by a background infusion (bupivacaine 0.08% and fentanyl 2 µg ml,1) 5 ml h,1 with a 5-ml bolus and 15-min lock-out interval. The bolus group received boluses of 20 mg of bupivacaine and 75 µg of fentanyl in a 15-ml volume. Results:, Parturients in the PCEA group had significantly (P < 0.05,0.01) less pain during the first and second stages of labor. There was no difference in the spontaneous delivery rate between the groups, but the cesarean delivery rate was significantly (P < 0.05) higher (16.3% vs. 6.7%) in the PCEA group than in the bolus group. Bupivacaine consumption was significantly (P < 0.01) higher (11.2 mg h,1 vs. 9.6 mg h,1) and the second stage of labor was significantly (P < 0.01) longer (70 min vs. 54 min) in the PCEA group than in the bolus group. Patient satisfaction was equally good in both groups. Conclusion:, The PCEA technique provided better pain relief. This was associated with higher bupivacaine consumption, prolongation of the second stage of labor, and an increased rate of cesarean section. [source] The effect of the obstetrician group and epidural analgesia on the risk for cesarean delivery in nulliparous womenACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 8 2000Y. Beilin Background: The effects of regional anesthesia and of the obstetrician on the risk of cesarean delivery remain controversial. The purpose of this study was to determine whether epidural analgesia or the obstetrician group is associated with an increase in the risk for cesarean delivery in nulliparous women. Methods: Data were collected for a two-year period from the medical records of all nulliparous women who had a private obstetrician who delivered >20 babies per year, and who presented with a singleton gestation in the vertex presentation for a trial of labor. Results: Data were collected for 3699 women of whom 1832 were nulliparous. Of the 1832 nulliparous women, data were analyzed for the 1278 women who met our study criteria, representing 14 separate obstetrician groups. Excluding the 50 women whose babies were delivered for fetal distress (leaving 1228 women for analysis), the epidural rate was 93%, range 81,98%, and the cesarean delivery rate was 14%, range 8,34%. Logistic regression analyses revealed that (odds ratio, 95% confidence interval) patient age (1.7, 1.2,2.4), birth weight (1.001, 1.001,1.002), induction of labor (1.9, 1.3,2.7), non-Caucasian (1.9, 1.2,2.9) and the obstetrician group, (P=0.002), were independently associated with the risk of cesarean delivery, but epidural analgesia was not (1.6, 0.7,3.6). Conclusions: The obstetrician group is independently associated with the risk of cesarean delivery in nulliparous women, but we could not demonstrate this association with epidural analgesia. We suggest that in future studies regarding epidural analgesia and cesarean delivery, the obstetrician group should be included as a variable ( ,). [source] The reproductive health of daughters of pregestational diabetic women: Medical Birth Registry of NorwayPAEDIATRIC & PERINATAL EPIDEMIOLOGY, Issue 4 2002Grace M. Egeland Summary Maternal diabetes may have an impact upon a daughter's reproductive health through genetic influences, an altered fetal metabolic environment or both. We examined the reproductive health of daughters of diabetic women using linked generation data from the Medical Birth Registry of Norway. Among all female births between 1967 and 1982 (n = 459 182), 739 had a mother with registered pregestational diabetes, a rate of 1.6 per 1000 deliveries. A total of 142 904 daughters delivered at least one child by 1998. After taking into account differences in survival, we observed no differences in the percentage of childbearing and in the average number of children born by 1998 between daughters with and without a diabetic mother in age-stratified analyses. In analyses limited to singleton deliveries and stratified by mothers' and daughters' diabetic status, we found a threefold excess stillbirth delivery rate among women who had either a mother with pregestational diabetes (2.6%) or pregestational diabetes themselves (2.6%) compared with the stillbirth delivery rate observed in non-diabetic women with no maternal history of diabetes (0.8%). These findings were unaltered in multivariable analyses adjusting for daughters' maternal age and registered obstetric risk factors. Our results indicate that pregestational diabetes remains a health care challenge in Norway and that further evaluation of the reproductive health of daughters of diabetic pregnancies is warranted. [source] Influence of Ovulation Status, Seasonality and Embryo Transfer Method on Development of Cloned Porcine EmbryosREPRODUCTION IN DOMESTIC ANIMALS, Issue 5 2010OJ Koo Contents To improve pig cloning efficiency, the present study evaluated the effect of ovulation status, seasonality and embryo transfer (ET) method on in vivo development of cloned porcine embryos. Cloned embryos were transferred to surrogate mothers on the same day of somatic cell nuclear transfer. In pre-ovulation stage (PO), pregnancy rate (PR) and delivery rate (DR) were 36.3% and 9.4%, respectively. In post-ovulation stage, 22.7% PR and 2.1% DR were recorded (both PR and DR are significantly higher in PO). When ET was performed during winter (December,February), spring (March,May), summer (June,August) and autumn (September,November), the PRs were 13.4%, 37.3%, 24.6% and 51.0%, while DRs were 0%, 12.7%, 4.3% and 7.8%, respectively. The highest PRs were recorded in autumn groups. However, DRs were significantly lower in autumn (7.8%) group compared with spring (12.7%) group. The PR was the lowest and no piglets were born in winter group, which might be because of the effect of low temperature during ET. To overcome the low PR in winter group, 0.25 ml straws were used for ET to minimize exposure time of embryos to ambient temperature. The straw ET group showed significantly higher PR in the winter group (23. 9%) compared with the conventional catheter-loading group (7.7%). We suggest that using PO recipient and ET in spring is the best condition for pig cloning. In addition, alternative method to reduce cold shock during ET in winter is necessary. [source] Birth at hospitals with co-located paediatric units for infants with correctable birth defectsAUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 3 2008Charles S. ALGERT Objectives: To determine the percentage of liveborn infants with selected antenatally identifiable and correctable birth defects who were delivered at hospitals with co-located paediatric surgical units (co-located hospitals). Additionally, to determine the survival rates for these infants. Patients and methods: Data were from linked New South Wales hospital discharge records from 2001 to 2004. Livebirths with one of the selected defects were included if they underwent an appropriate surgical repair, or died during the first year of life. Infants with multiple lethal birth defects were excluded. Deliveries at co-located hospitals were identified, but no data on antenatal diagnosis were available. Results: The study identified 287 eligible livebirths with the selected defects. The highest rates of delivery at co-located hospitals were for gastroschisis (88%), exomphalos (71%), spina bifida (63%) and diaphragmatic hernia (61%), and the lowest for transposition of the great arteries (43%) and oesophageal atresia (40%). Mothers resident outside of metropolitan areas, where the co-located hospitals are located, had a similar rate of delivery at co-located hospitals as metropolitan women. For the non-metropolitan mothers of infants with a birth defect, this represented a 30-fold increase over the baseline delivery rate of 1.8%. Post-surgery survival rates were 87% or higher. Overall survival rates were , 86% except for infants with a diaphragmatic hernia. Conclusions: Delivery rates at co-located hospitals were high for mothers of infants with these correctable birth defects. Regionalised health care appears to work well for these pregnancies, as women living outside metropolitan areas had a similar rate of delivery at co-located hospitals to that of urban women. [source] A Randomized Controlled Trial of Continuous Labor Support for Middle-Class Couples: Effect on Cesarean Delivery RatesBIRTH, Issue 2 2008Susan K. McGrath PhD ABSTRACT: Background: Previous randomized controlled studies in several different settings demonstrated the positive effects of continuous labor support by an experienced woman (doula) for low-income women laboring without the support of family members. The objective of this randomized controlled trial was to examine the perinatal effects of doula support for nulliparous middle-income women accompanied by a male partner during labor and delivery. Methods: Nulliparous women in the third trimester of an uncomplicated pregnancy were enrolled at childbirth education classes in Cleveland, Ohio, from 1988 through 1992. Of the 686 prenatal women recruited, 420 met enrollment criteria and completed the intervention. For the 224 women randomly assigned to the experimental group, a doula arrived shortly after hospital admission and remained throughout labor and delivery. Doula support included close physical proximity, touch, and eye contact with the laboring woman, and teaching, reassurance, and encouragement of the woman and her male partner. Results: The doula group had a significantly lower cesarean delivery rate than the control group (13.4% vs 25.0%, p = 0.002), and fewer women in the doula group received epidural analgesia (64.7% vs 76.0%, p = 0.008). Among women with induced labor, those supported by a doula had a lower rate of cesarean delivery than those in the control group (12.5% vs 58.8%, p = 0.007). On questionnaires the day after delivery, 100 percent of couples with doula support rated their experience with the doula positively. Conclusions: For middle-class women laboring with the support of their male partner, the continuous presence of a doula during labor significantly decreased the likelihood of cesarean delivery and reduced the need for epidural analgesia. Women and their male partners were unequivocal in their positive opinions about laboring with the support of a doula. (BIRTH 35:2 June 2008) [source] Cesarean Delivery in Shantou, China: A Retrospective Analysis of 1922 WomenBIRTH, Issue 2 2000Wang-ling Wu MD Background:In China the cesarean section rate increased significantly during the past four decades. This study examined the frequency and indications of cesarean birth in Shantou, a southern city in China.Methods:An analysis was conducted of the medical records of 1922 women who had cesarean deliveries at Shantou City 2nd People's Hospital between January 1990 and December 1997. The medical records of 10,490 women who gave birth during this period were examined.Results:The average rate of cesarean delivery during the 8-year period was 19.4 ± 2.3 percent (means ± standard error). From 1990 to 1997 the cesarean delivery rates ranged from 11.05 to 29.9 percent, respectively, although during this period the total annual number of deliveries decreased significantly from 1683 to 951. The rates of the most common indications per 100 women for cesarean delivery were failure to progress (23%), premature rupture of membranes (20%), fetal distress (19.4%), breech presentation (18.1%), uterine scar (14.6%), and prolonged pregnancy (11.3%).Conclusion:The cesarean delivery rate in Shantou, China, has increased steadily and significantly between 1990 and 1997, despite a decrease in the total number of births during the same period. This study showed that on an individual basis vaginal delivery was often possible and reduction of the cesarean delivery rate could be achieved safely by paying greater heed to appropriate indications. [source] Antiretroviral therapy and preterm delivery,a pooled analysis of data from the United States and EuropeBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 11 2010CL Townsend Please cite this paper as: Townsend C, Schulte J, Thorne C, Dominguez K, Tookey P, Cortina-Borja M, Peckham C, Bohannon B, Newell M, for the Pediatric Spectrum of HIV Disease Consortium, the European Collaborative Study and the National Study of HIV in Pregnancy and Childhood. Antiretroviral therapy and preterm delivery,a pooled analysis of data from the United States and Europe. BJOG 2010;117:1399,1410. Objective, To investigate reported differences in the association between highly active antiretroviral therapy (HAART) in pregnancy and the risk of preterm delivery among HIV-infected women. Design, Combined analysis of data from three observational studies. Setting, USA and Europe. Population, A total of 19 585 singleton infants born to HIV-infected women, 1990,2006. Methods, Data from the Pediatric Spectrum of HIV Disease project (PSD), a US monitoring study, the European Collaborative Study (ECS), a consented cohort study, and the National Study of HIV in Pregnancy and Childhood (NSHPC), the United Kingdom and Ireland surveillance study. Main outcome measure, Preterm delivery rate (<37 weeks of gestation). Results, Compared with monotherapy, HAART was associated with increased preterm delivery risk in the ECS (adjusted odds ratio [AOR] 2.40, 95% CI 1.49,3.86) and NSHPC (AOR 1.43, 95% CI 1.10,1.86), but not in the PSD (AOR 0.92, 95% CI 0.67,1.26), after adjusting for relevant covariates. Because of heterogeneity, data were not pooled for this comparison, but heterogeneity disappeared when HAART was compared with dual therapy (P = 0.26). In a pooled analysis, HAART was associated with 1.5-fold increased odds of preterm delivery compared with dual therapy (95% CI 1.19,1.87, P = 0.001), after adjusting for covariates. Conclusions, Heterogeneity in the association between HAART and preterm delivery was not explained by study design, adjustment for confounders or a standard analytical approach, but may have been the result of substantial differences in populations and data collected. The pooled analysis comparing HAART with dual therapy showed an increased risk of preterm delivery associated with HAART. [source] Oral nifepidine versus subcutaneous terbutaline tocolysis for external cephalic version: a double-blind randomised trialBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 1 2009R Collaris Objective, To evaluate oral nifedipine versus subcutaneous terbutaline tocolysis for external cephalic version (ECV). Design, A double-blind randomised trial. Setting, A university hospital in Malaysia. Population, Non-labouring women with a term singleton fetus in breech presentation or transverse lie suitable for elective ECV. Methods, Participants were randomised to either 10 mg oral nifedipine tablet and subcutaneous saline placebo or oral placebo tablet and 250 microgram bolus terbutaline subcutaneously. Participants and providers were blinded. Ultrasound assessment and cardiotocogram were performed prior to ECV. ECV was commenced 20,30 minutes after treatment. A maximum of two ECV attempts were permitted. Elective caesarean delivery or a repeat ECV attempt at a later date was offered to participants following failed ECV. After successful ECV, management was expectant. Main outcome measures, Primary outcomes were successful ECV (cephalic presentation immediately after ECV) and caesarean delivery. Results, Ninety women were randomised: 44 to nifedipine and 46 to terbutaline. Initial ECV success rate was 15/44 (34.1%) versus 24/46 (52.2%) (relative risk [RR] 0.7, 95% CI 0.4,1.1; P= 0.094), and caesarean delivery rate was 34/44 (77.3%) versus 26/46 (56.5%) (RR 1.4, 95% CI 1.01,1.85; numbers needed to treat to benefit 5, 95% CI 2.5,55; P= 0.046) for nifedipine and terbutaline groups, respectively. Neonatal outcome was not different. Conclusions, Bolus subcutaneous terbutaline tocolysis for ECV compared with oral nifedipine resulted in less caesarean deliveries. ECV success rate was not significantly higher. Larger studies are indicated. [source] The AmRo study: pregnancy outcome in HIV-1-infected women under effective highly active antiretroviral therapy and a policy of vaginal deliveryBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 2 2007K Boer Objective, To explore pregnancy outcome in HIV-1-positive and HIV-negative women, and mother-to-child transmission (MTCT) according to mode of delivery under effective highly active antiretroviral therapy (HAART). Design, Cohort of 143 pregnant HIV-1-infected women including a matched case,control study in a 2:1 ratio of controls to cases (n = 98). Setting, Academic Medical Center in Amsterdam and Erasmus Medical Center in Rotterdam, the Netherlands. Population, Consecutive referred HIV-1 infected pregnant women treated with HAART and matched control not infected pregnant women. Main outcome measures, MTCT, preterm delivery, low birthweight, pre-eclampsia. Results, MTCT was 0% (95% CI 0,2.1%). Seventy-eight percent of HIV-1-infected women commenced and 62% completed vaginal delivery. The calculated number of caesarean sections needed to prevent a single MTCT was 131 or more. Preterm delivery rates were 18% (95% CI 11,27) in women infected with HIV-1 and 9% (95% CI 5,13) in controls (P = 0.03). HAART used at <13 weeks of gestation was associated with a 44% preterm delivery rate compared with 21% when HAART was started at or after 13 weeks and 14% in controls. (Very) low birthweight and incidence of pre-eclampsia were not different between HIV-1 and controls. Conclusions, We have not demonstrated any MTCT after vaginal delivery in women effectively treated by HAART. The HAART-associated increase in preterm delivery rate is mainly seen after first trimester HAART use. [source] Carbohydrate solution intake during labour just before the start of the second stage: a double-blind study on metabolic effects and clinical outcomeBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 12 2004H.C.J. Scheepers Objective To study the effects of oral carbohydrate ingestion on clinical outcome and on maternal and fetal metabolism. Design Prospective, double-blind, randomised study. Setting Leyenburg Hospital, The Hague, The Netherlands. Population Two hundred and two nulliparous women. Methods In labour, at 8 to 10 cm of cervical dilatation, the women were asked to drink a solution containing either 25 g carbohydrates or placebo. In a subgroup of 28 women, metabolic parameters were measured. Main outcome measures Number of instrumental deliveries, fetal and maternal glucose, free fatty acids, lactate, pH, Pco2, base excess/deficit and ,-hydroxybutyrate. Results Drinking a carbohydrate-enriched solution just before starting the second stage of labour did not reduce instrumental delivery rate (RR 1.1, 95% CI 0.9,1.3). Caesarean section rate was lower in the carbohydrate group, but the difference did not reach statistical significance (1%vs 7%, RR 0.2, 95% CI 0.02,1.2). In the carbohydrate group, maternal free fatty acids decreased and the lactate increased. In the umbilical cord there was a positive venous,arterial lactate difference in the carbohydrate group and a negative one in the placebo group, but the differences in pH and base deficit were comparable. Conclusion Intake of carbohydrates just before the second stage does not reduce instrumental delivery rate. The venous,arterial difference in the umbilical cord suggested lactate transport to the fetal circulation but did not result in fetal acidaemia. [source] Pregnancy outcome in women with heart disease undergoing induction of labourBJOG : AN INTERNATIONAL JOURNAL OF OBSTETRICS & GYNAECOLOGY, Issue 7 2004Galia Oron Objective To examine the safety and outcome of induction of labour in women with heart disease. Design Prospective single-centre comparative study. Setting Major university-based medical centre. Population/Sample One hundred and twenty-one pregnant women with heart disease. Methods The sample included all women with acquired or congenital heart disease who attended our High-Risk Pregnancy Outpatient Clinic from 1995 to 2001. The files were reviewed for baseline data, cardiac and obstetric history, course of pregnancy and induction of labour and outcome of pregnancy. Findings were compared between women who underwent induction of labour and those who did not. Forty-seven healthy women in whom labour was induced for obstetric reasons served as controls. Main outcome measures Pregnancy outcome. Results Of the 121 women with heart disease, 47 (39%) underwent induction of labour. There was no difference in the caesarean delivery rate after induction of labour between the women with heart disease (21%) and the healthy controls (19%). Although the women with heart disease had a higher rate of maternal and neonatal complications than controls (17%vs 2%, P= 0.015), within the study group, there was no difference in complication rate between the patients who did and did not undergo induction of labour. Conclusion Induction of labour is a relatively safe procedure in women with cardiac disease. It is not associated with a higher rate of caesarean delivery than in healthy women undergoing induction of labour for obstetric indications, or with more maternal and neonatal complications than in women with a milder form of cardiac disease and spontaneous labour. [source] | |||||||||||||||||||||||||||||||||||||||||||