To assess the relationship between the duration of the second stage of labour and postpartum anaemia during vaginal birth.
Methods
An observational, analytical retrospective cohort study was performed at the “Mancha-Centro Hospital” (Spain) during the 2013–2016 period. Data were collected from 3437 women who had a vaginal birth. Postpartum anaemia was defined as a haemoglobin level below 11 g/dL at 24 h postpartum. A univariate analysis was used for potential risk factors and a multivariate analysis with binary logistic regression to control for possible confounding factors.
Findings
The incidence of postpartum anaemia was 42.0%. The risk of postpartum anaemia did not increase in nulliparous women whose duration of the second stage of labour exceeded 4 h. Compared with multiparous women who delivered between 0 and 3 h, multiparous women with a duration of the second stage of labour beyond 3 h were at higher risk of postpartum anaemia (OR = 2.43 [1.30–4.52]).
Conclusion
The duration of the second stage of labour beyond 4 h is safe for postpartum anaemia in nulliparous women. However in multiparous women, monitoring should increase if the second stage of labour exceeds 3 h given the increased risk of postpartum anaemia. 相似文献
VOLUNTAS: International Journal of Voluntary and Nonprofit Organizations - While many scholars have postulated the decline of membership influence as an important consequence of the... 相似文献
We investigate the problem of estimating geodesic tortuosity and constrictivity as two structural characteristics of stationary random closed sets. They are of central importance for the analysis of effective transport properties in porous or composite materials. Loosely speaking, geodesic tortuosity measures the windedness of paths, whereas the notion of constrictivity captures the appearance of bottlenecks resulting from narrow passages within a given materials phase. We first provide mathematically precise definitions of these quantities and introduce appropriate estimators. Then, we show strong consistency of these estimators for unboundedly growing sampling windows. In order to apply our estimators to real data sets, the extent of edge effects needs to be controlled. This is illustrated using a model for a multiphase material that is incorporated in solid oxide fuel cells. 相似文献
A simple connected graph G with 2n vertices is said to be k-extendable for an integer k with \(0<k<n\) if G contains a perfect matching and every matching of cardinality k in G is a subset of some perfect matching. Lakhal and Litzler (Inf Process Lett 65(1):11–16, 1998) discovered a polynomial algorithm that decides whether a bipartite graph is k-extendable. For general graphs, however, it has been an open problem whether there exists a polynomial algorithm. The new result presented in this paper is that the extendability problem is co-NP-complete. 相似文献
Open innovation and absorptive capacity are two concepts based on the idea that companies can leverage the knowledge generated externally to improve their innovation performance. The aim of this paper is to analyse the joint effect of open innovation and absorptive capacity on a firm's radical innovation. Open innovation is expressed in terms of external search breadth and depth strategies and absorptive capacity is described by distinguishing between potential and realized absorptive capacity. In order to test our hypotheses, we carried out empirical research in firms operating in high-technology industries. The results indicate that internal routines and processes for absorbing external knowledge help explain radical innovation as they show a significant effect of potential and realized absorptive capacity. Also, there is a moderating effect of absorptive capacity on open innovation. Specifically, potential absorptive capacity exerts a positive effect on the relationship between external search breadth and depth and radical innovation. Realized absorptive capacity moderates the influence of external search breadth. These findings confirm the complementary nature of absorptive capacity and open innovation search strategies on radical innovation. 相似文献
For large cohort studies with rare outcomes, the nested case-control design only requires data collection of small subsets of the individuals at risk. These are typically randomly sampled at the observed event times and a weighted, stratified analysis takes over the role of the full cohort analysis. Motivated by observational studies on the impact of hospital-acquired infection on hospital stay outcome, we are interested in situations, where not necessarily the outcome is rare, but time-dependent exposure such as the occurrence of an adverse event or disease progression is. Using the counting process formulation of general nested case-control designs, we propose three sampling schemes where not all commonly observed outcomes need to be included in the analysis. Rather, inclusion probabilities may be time-dependent and may even depend on the past sampling and exposure history. A bootstrap analysis of a full cohort data set from hospital epidemiology allows us to investigate the practical utility of the proposed sampling schemes in comparison to a full cohort analysis and a too simple application of the nested case-control design, if the outcome is not rare.
Not only ETO (Engineering to Order), but even serial production industry should know how to deal with projects and their schedule: plant commissioning, shutdown, introducing new products and similar circumstances should be managed with adequate planning and resource allocation techniques to create a schedule useful in decision making during the execution. The current complex reality, with evolving technologies and fierce pressure to reach the market as soon as possible, pushes the project managers to use more advanced techniques than waterfall planning, such as agile or lean. It also requires them to take a holistic view and manage concurrent tasks in complex projects. The contributions of this paper are two: the proposal to control specific parallel groups of waterfall activities under uncertain environments, which can lead to iterations and reworks, as a single concurrent Activity Managed by Kanban Methods (AMKM). This activity can be subsequently embedded into traditional scheduling approaches as CPM-PERT. The second contribution is the feasibility of its application in industrial environments due to the affordability of simulation software. Two use cases are shown as evidence. It is not a disruptive proposal, but a kaizen action based on very mature technologies. Finally, it is suggested some improvements to be implemented in Project Management Software due to this ‘kaizen’ proposal. 相似文献
Social Indicators Research - Monitoring progress towards the Sustainable Development Goals by 2030 requires the global community to disaggregate targets along socio-economic lines, but little has... 相似文献
A graph is locally irregular if the neighbors of every vertex v have degrees distinct from the degree of v. A locally irregular edge-coloring of a graph G is an (improper) edge-coloring such that the graph induced on the edges of any color class is locally irregular. It is conjectured that three colors suffice for a locally irregular edge-coloring. In the paper, we develop a method using which we prove four colors are enough for a locally irregular edge-coloring of any subcubic graph admiting such a coloring. We believe that our method can be further extended to prove the tight bound of three colors for such graphs. Furthermore, using a combination of existing results, we present an improvement of the bounds for bipartite graphs and general graphs, setting the best upper bounds to 7 and 220, respectively. 相似文献