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At least 19 recordsLinked to original sources
PubMed1977

The cost of providing restorative dentistry in an alternative delivery mode.

This study is based on the Forsyth Dental School experiment, where it was shown that dental hygienists can be trained to perform restorative dental functions which are now the exclusive responsibility of dentists. The focus of the Forsyth study was to determine the length of training time required and to measure the qualitative and quantitative aspects of services carried out by the hygienists. As a follow-up to that study, this paper is concerned with the economic aspects of the personnel substitution suggested by the Forsyth project. The basic hypothesis of the study is that there would be a considerable gain from this change, and that this gain can be measured by estimating the costs of operation in the new setting anc comparing them to costs in the conventional setting. Combining estimated clinic costs and productivity data provides a measure of the per-surface supply price for an amalgam restoration. This estimate is 44 percent lower than usual fees and 29 percent lower than current welfare fees. The magnitude of this difference implies that the introduction of Forsyth clinics would lead to considerable economics in the elivery of these services.

Adolescent↗
PubMed1979

[Mode of delivery, postnatal condition and neonatal outcome in preterm infants].

There were under examination 578 preterm infants of two groups--28. up to 31. and 32. up to 36. week of gestation--after birth of vertex as well as breech prevention. Postnatal condition and neonatal outcome were put into relation to the mode of delivery. We compared Apgar-Score (one and five minute value), morbidity on respiratory distress syndrom as well as rate of survival and neonatal mortality in spontaneous delivery with and without episiotomia, with specula delivery, Shute-forceps and vacuum extraction of vertex presentation as well as with breech presentation after vaginal delivery and primary Caesarean section. In respect of the management of the second stage of labour it is our opinion that prophylactic additional measures in preterm delivery of vertex presentation after 32 weeks of gestation are not necessary and that this question should be examined in a larger study of much more cases. But we were able to demonstrate that up to 32. week of gestation well-timed episiotomia of optimal size is necessary. Our good experiences in breech presentation between 31. and 35. week of gestation treated by obligate Caesarean section have to prove true in future.

Apgar Score↗
PubMed1977

Human umbilical arterial and venous progesterone concentrations: effect of fetal sex, weight, and mode of delivery.

Umbilical venous and umbilical arterial progesterone concentrations were determined in 99 pregnancies by radioimmunoassay. The mean +/- SE plasma progesterone in the umbilical vein was 1295 +/- 73 ng/ml, and in the umbilical artery it was 520 +/- 38 ng/ml with an arterio-venous difference of 775 +/- 58 ng/ml and a vein:artery progesterone ratio of 3.6 +/- 0.3. The secretion rate of progesterone into the fetal compartment was calculated to be 84 mg/24 hr. There was no significant difference in these parameters between male and female fetuses, fetal weight, mode of delivery, Apgar score, and duration of labor. It was therefore concluded that the fetal genotype and stress on the fetus did not appear to significantly affect fetal extraction and utilization of progesterone.

Body Weight↗
PubMed1979

Mode of delivery and developmental characteristics in a thousand Dunedin three year olds: a report from the Dunedin Multidisciplinary Child Development Study.

A study of 1037 representative Dunedin children delivered by a variety of modes was described. The results showed that there were no significant differences in maternal general mental ability, training in child development, or background of child experiences among the five delivery groups studied. Also, there were no significant differences between children who were spontaneous deliveries or any of the other groups in age at which the developmental milestones were achieved, nor in any of the developmental characteristics assessed.

Breech Presentation↗
PubMed1979

Mode of delivery and the lecithin/sphingomyelin ratio.

Babies born by elective Caesarean section are more likely to develop the respiratory distress syndrome that babies born vaginally. We studied the amniotic fluid and pharyngeal lecithin/sphingomyelin (L/S) ratios in three groups of babies born at term: 20 were delivered vaginally after elective induction of labour; 20 were delivered by elective Caesarean section; and 14 by Caesarean section after spontaneous onset of labour. Babies born after induction of labour had higher pharyngeal L/S ratios than babies born by elective Caesarean section. Those born by Caesarean section after spontaneous onset of labour had significantly higher pharyngeal L/S ratios than those in both of the elective delivery groups. There were no significant differences in the amniotic fluid L/S ratios of the two groups who underwent elective delivery. Regression analysis showed a significant relationship between length of labour and increase in the L/S ratio. These results indicate that, during labour, there is a release of fetal lung surfactant into the airways.

Amniotic Fluid↗
PubMed2026

Exploring birth options after three or four cesarean sections in Poland: maternal and neonatal outcomes following vaginal vs repeat surgical deliveries.

OBJECTIVES: The study aimed to analyze maternal and neonatal outcomes of women with a history of three or four caesarean sections (CS) and to evaluate the feasibility and safety of vaginal birth after multiple caesarean sections (VBAC ≥ 3) in Polish clinical practice. MATERIAL AND METHODS: A retrospective analysis was conducted on medical records of 186 women with three or four prior CS who delivered at St. Sophia Specialist Hospital in Warsaw between 2017 and 2024. Data on delivery mode, obstetric management, complications, and neonatal outcomes were assessed. Multivariate logistic regression was applied to identify factors associated with successful VBAC. RESULTS: Of the study group, 62 women attempted trial of labour after caesarean (TOLAC), resulting in 32 successful vaginal births (success rate 53.2%). 124 women chose Elective CS. Logistic regression showed that prior vaginal birth (OR = 20.34; p = 0.008) and the use of epidural anaesthesia (OR = 22.88; p = 0.006) significantly increased the likelihood of successful VBAC. Spontaneous onset of labour showed a positive but non-significant trend (OR = 2.52; p = 0.230). The model demonstrated a classification accuracy of 77.4% and a good overall fit (Nagelkerke R² = 0.456). Uterine rupture occurred in three cases (4.8%), while no maternal or neonatal deaths were reported. CONCLUSIONS: Vaginal birth after three or more CS may be a viable option for carefully selected women, provided it is offered in tertiary centers with immediate surgical readiness. Key predictors of success include prior vaginal birth and epidural anaesthesia. Further large-scale studies are needed to refine guidelines and inform clinical practice in this high-risk group.

Humans↗
PubMed2026

Differences in Radiological Risk Perceptions Following Online and In-Person Workshops.

Nuclear energy is widely regarded as a critical part of the pathway toward a secure, low-carbon electricity grid, yet long-term management of used nuclear fuel remains a persistent challenge. Although technically viable options for interim and consolidated storage exist, public concern and community opposition - rooted in historical distrust and risk perception - continue to complicate siting decisions. In response, recent federal efforts have emphasized collaboration-based approaches and community engagement, though empirical evidence on the effectiveness of different engagement strategies remains limited. This study examines how the structure and delivery of community engagement influence changes in public attitudes toward hosting interim used nuclear fuel storage facilities. Using survey data from 13 educational workshops around the United States, we evaluate: (1) the inclusion of trust-building content prior to technical content, and (2) engagement format, comparing online and in-person workshops. Analyses focus on participant changes in perceptions of safety, risk, and support for hosting, using the Wilcoxon rank-sum test and other non-parametric hypothesis tests on surveys conducted before and after workshops. Results indicate that workshop participation is associated with some measurable attitude changes, with significant (p < 0.05) differences in response variability for some questions across workshop formats. In particular, when comparing nuclear energy to other clean energy sources, in-person workshop participants are substantially more likely to gain a more favorable opinion of nuclear energy than online participants. These findings contribute empirical evidence on how trust-building and delivery mode shape outcomes in public engagement on complex and contested energy policy issues such as storage of used nuclear fuel.

nuclear fuel cycle↗
PubMed2026

Metagenomic polymorphic toxin effector and immunity profiling predicts microbiome development and disease-related dysbiosis.

Bacteria use antagonistic interbacterial weapons, such as polymorphic toxin secretion systems (TSS), to compete for niches in the human gut microbiome. We hypothesized that TSS influence gut microbiome development and disease-related dysbiosis. We developed a bioinformatic marker gene approach (PolyProf) to quantify TSS including ~200 effector and immunity genes and applied it to ~15,000 publicly available human metagenomes. PolyProf alpha and beta diversity readily distinguished 12 different human disease states and enabled the construction of highly accurate linear regression classifier machine learning models. Elastic net machine learning models integrating bacterial taxonomy with PolyProf had strong predictive value for 12 disease states, outperforming models utilizing taxonomy alone. During microbiome development in the first year of life, PolyProf alpha diversity increases, and beta diversity becomes increasingly like the maternal microbiome, influenced by vertical transfer, delivery mode, and breastfeeding. PolyProf is related to strain sharing among adults through social interactions. In summary, TSS genes strongly correlate with microbiome development and interpersonal strain sharing, suggesting roles for interbacterial antagonism. Since PolyProf distinguishes diverse adult disease statuses, these dynamics may contribute to non-genetic inheritance.IMPORTANCEPrevious research has demonstrated that bacteria compete within the gut microbiome using toxin secretion systems (TSS). How TSS contribute to human microbiome development and the microbiome alterations observed in human diseases is not known. This study develops a new bioinformatic tool for profiling TSS-related genes in metagenomic data. Application of this approach to large-scale human fecal metagenomic data demonstrates the dynamic association of TSS during microbiome development, including the exchange of strains among social contacts. TSS gene abundance patterns are highly predictive of 12 disease states. This study advances the field by enabling TSS profiling in metagenomes and by identifying disease and microbiome development biomarkers that provide hypotheses for future mechanistic studies and may be useful for disease diagnosis.

Dysbiosis↗
PubMed2026

Presence of Dolosigranulum pigrum in the nasopharynx and its relationship with respiratory health status in paediatric population.

BACKGROUND: Respiratory tract infections range from asymptomatic colonisation to an invasive disease. Recent studies suggest that nasopharyngeal microbiota may influence this variability. Emerging evidence points to Dolosigranulum pigrum, a nasopharyngeal commensal, as a potentially protective bacterium. This study aimed to identify variables associated with the presence of D. pigrum in the nasopharynx of children with varying respiratory health statuses. METHODS: Nasopharyngeal aspirates were collected from children <18 years who were asymptomatic (n&#x2009;=&#x2009;65), had banal viral infection (n&#x2009;=&#x2009;48), or Invasive Pneumococcal Disease (IPD) (n&#x2009;=&#x2009;27). The presence of D. pigrum was defined as >0.1% of total sequences obtained by 16S rRNA gene sequencing. Variables included sex, breastfeeding, delivery mode, S. pneumoniae carriage, respiratory viruses and clinical features. RESULTS: Among 140 children (73 males, 67 females), D. pigrum was detected in 79 (56.4%): 44/65 in the healthy group; 26/48 of viral and 9/27 IPD cases. Multivariate analysis revealed significant associations with health status and sex. Healthy children were more likely to carry D. pigrum than IPD cases (44/79 vs. 26/79; p&#x2009;=&#x2009;0.028). Males were more frequently D. pigrum carriers than females (48/79 vs. 31/79; p&#x2009;=&#x2009;0.033). CONCLUSION: D. Pigrum was associated with respiratory health, being more prevalent in healthy children, and showed potential sex-related differences.

Humans↗
PubMed1975

Acid-base and electrolyte balance in infants of diabetic mothers. Vaginal delivery versus caesarean section.

The acid-base and electrolyte balance of 30 women studied at delivery and in their infants during the first 48 h. 18 women were diabetics, 10 of these were delivered vaginally (DMvag) and 8 by elective caesarean section (DMcs). 12 healthy women were vaginally delivered (HMvag). The infants of diabetic mothers (IDM) received active infusion therapy. At birth the DMvag and their infants (IDMvag) had a more pronounced metabolic acidosis than the DMcs and their babies (IDMcs). The largest metabolic acidosis occurred, however, in the group of HMvag and their infants (IHMvag). After birth no significant differences were obtained in the acid-base and electrolyte balance between IDMvag and IDMcs. The plasma potassium level remained lower in IDM than in IHM. The study stress the importance of adequate management of diabetes in pregnancy in combination with active intravenous therapy during delivery and to the infant in the immediate neonatal period. The slightly larger metabolic acidosis seen in combination with vaginal delivery suggests that this mode of delivery should not be attempted uncritically in diabetic women.

Acid-Base Equilibrium↗
PubMed1979

Method of delivery and developmental outcome at five years of age.

A controlled follow-up study examined the impact of delivery method on developmental outcome of the child. The modes of delivery investigated were low forceps delivery (188 infants), midcavity forceps delivery (51 infants), forceps rotation with forceps delivery (57 infants), manual rotation with forceps delivery (67 infants), elective caesarean section (101 infants) and spontaneous delivery (control, 207 infants). Breech presentation (100 infants) was separately compared with the vertex presentation groups. Sample selection controlled for complications during pregnancy and low birthweight and was restricted to married English-speaking mothers. The children were assessed at the age of five years on verbal and non-verbal subtests of a standardized intelligence scale, tests of gross motor coordination, and auditory and visual tests. A full paediatric examination was also performed. Breech presentation children performed less well on tests of balance and fine motor coordination and on visual acuity and stereopsis testing than children who presented in the vertex position. No deleterious effect of delivery method was found. In the absence of other complicating events (like a poor antenatal history, prematurity, and a disorganized home environment) delivery complication constitutes an early risk factor which the growing child is able to overcome.

Cesarean Section↗
PubMedDate not supplied

Neonatal gastric pH.

The pH of gastric juice, obtained 3 to 4 minutes after birth in 158 unselected neonates, varied between 7.5 and 8.5 in 8 meconium-containing specimens and ranged from 1.4 to 7.8 in 150 meconium-free samples. In mature infants of the latter group, pH was (1) significantly lower after vaginal delivery than after cesarean section; (2) tended to be lower after section preceded by labor than after elective section; and (3) was lowest after precipitate delivery. In premature infants, pH was above 7 regardless of mode of delivery. Three was no correlation between neonatal gastric pH and pH of simultaneously obtained maternal gastric juice, pH of amniotic fluid, pH of cord blood duration of rupture of membranes, birth weight, or Apgar score. It was concluded that the mature human fetus produces gastric acidity in response to stresses associated with labor and vaginal delivery. The possibility of a low gastric pH and the resultant pulmonary damage if aspirated must be considered in the initial care of thew newborn with poor muscle tone or reflex activity as well as in the anesthetic management of neonates undergoing emergency surgery.

Amniotic Fluid↗
PubMed1979

Fetal cranial injuries related to delivery with the Malmström vacuum extractor.

The literature regarding the propensity of the vacuum extractor to cause fetal cranial injuries is reviewed. Eighteen subaponeurotic hemorrhages occurred in 14,276 vacuum extractions (VE). Scalp abrasion or laceration occurred in 12.6%, cephalohematoma in 6%, and intracranial hemorrhage in 0.35%. Assessments of early and late manifestations of neurologic damage indicate little difference between VE deliveries and spontaneous deliveries. An uncorrected perinatal mortality rate of 25.8 per thousand is tabulated, which reduced to 15 per thousand when corrected for deaths not related to the mode of delivery. Scalp anatomy and the forces exerted on it with vacuum extraction are examined, and suggestions to minimize scalp injuries are offered.

Craniocerebral Trauma↗
PubMed1979

[pH measurements following delivery from breech presentation (author's transl)].

In 1977 the adaptation capability of 22 out of 89 breech presentation new-borns was studied by way of punctual pH-measurements within the first 30 minutes after birth. Thus, it was possible to gain an insight into the extra-uterine adaptation, especially with respect to the mode of delivery. Further points of comparison were parity, maturity and a possible correlation with the Apgar Score. The study included a comparison with identical measurements of 20 spontaneous head position new-borns. According to the results under certain preconditions a vaginal delivery in breech presentation is also today by all means to be justified.

Adaptation, Physiological↗
PubMed1979

Contemporary management and conduct of preterm labor and delivery: a review.

Current concepts in the conduct of preterm labor and management of delivery of the premature infant are reviewed. Pharmacologic modalities available for inhibiting preterm labor are discussed as well as the efficacy, indications and contraindications for these agents. An analysis of the role of corticosteroids in achieving fetal pulmonary maturity in the preterm infant is reviewed, and based on the existent literature the intrapartum management of the small fetus is outlined. The mode of delivery, vaginal or via cesarean section, for these infants is likewise discussed.

Adrenal Cortex Hormones↗