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Midtrimester sonographic short cervix is a good predictor of preterm birth in singleton pregnancies.

This study aimed to assess the impact of implementing a universal transvaginal cervical length screening program on preterm birth rate.

This study consisted of 2 parts a before-and-after multicenter study and a study on the ECHOCOL ("echo"="ultrasound" and "col"="cervix" in French) prospective cohort. We compared the rate of preterm birth before and after the introduction of universal cervical length screening at the time of midtrimester anatomy ultrasound. The multicenter before-and-after regional study included all women with a singleton pregnancy who gave birth after 24 weeks' gestation in the South East of France from January 1, 2012 to April 30, 2018. In parallel, the ECHOCOL cohort study was prospectively conducted from May 2015 to July 2018, including 17 maternity hospitals in the South East region of France. In case of asymptomatic short cervix <25 mm, treatments offered included 200 mg of vag of a universal cervical length screening and treating policy during the second trimester of pregnancy. The clinical trial was registered under NCT02598323.

This study showed a significantly lower rate of preterm birth after the implementation of a universal cervical length screening and treating policy during the second trimester of pregnancy. The clinical trial was registered under NCT02598323.

For decades, the Apgar scoring system has been used to evaluate neonatal status and determine need for resuscitation or escalation in care, such as admission to a neonatal intensive care unit. However, the variation and accuracy of provider-assigned Apgar scores across neonatal racial groups have yet to be evaluated.

This study aimed to investigate how provider-assigned Apgar scores vary by neonatal race independently of clinical factors and umbilical cord gas values.

We conducted a retrospective cohort study at an urban academic medical center. All live births at ≥23 weeks and 0 days of gestation from January 1, 2019 through December 31, 2019 with complete data available were included. Data were queried from the electronic medical record and included race, ethnicity, gestational age of neonate, umbilical cord gas values (umbilical artery pH and base deficit), admission to the neonatal intensive care unit, and presence of maternal-fetal complications. Primary outcome measures were neonates' Apgar scoreses exist among healthcare providers.

Smoking during pregnancy and prenatal secondhand smoke exposure increase the risk of preterm birth. As Kentucky has the second highest rate of smoking in the United States and no statewide smoke-free law, an examination of the effect of municipal smoke-free legislation on preterm birth is warranted.

This study used state-level live birth data and county-level municipal smoke-free legislation status to assess the association between the presence and strength of smoke-free laws and the likelihood of preterm birth. Moreover, this study hypothesized that pregnant persons living in counties with comprehensive municipal smoke-free laws prohibiting smoking inside all workplaces and enclosed public places would exhibit a lower likelihood of preterm birth than those living in counties with weak or moderate laws (ie, smoke-free laws with exemptions that do not cover all workplaces and enclosed public places) or no smoke-free law.

Using live birth data from the Kentucky Office of Vital Statistics with birth years that moderate or weak smoke-free laws are not. The findings have major implications for public health policy and underscore the potential influence of healthcare providers' advocacy for strong smoke-free policies, prohibiting smoking in all workplaces (including restaurants, bars, and casinos), to support healthy pregnancies.

This study demonstrated that comprehensive municipal smoke-free laws are associated with reduced risk of preterm birth and that moderate or weak smoke-free laws are not. The findings have major implications for public health policy and underscore the potential influence of healthcare providers' advocacy for strong smoke-free policies, prohibiting smoking in all workplaces (including restaurants, bars, and casinos), to support healthy pregnancies.

This study aimed to evaluate the risk of endometrial carcinoma and atypical endometrial hyperplasia in asymptomatic postmenopausal women concerning the endometrial thickness measured by stratified threshold categories used for performing subsequent endometrial sampling and histologic evaluation.

MEDLINE, Scopus, ClinicalTrials.gov, SciELO, Embase, the Cochrane Central Register of Controlled Trials, LILACS, conference proceedings, and international controlled trials registries were searched without temporal, geographic, or language restrictions.

Studies were selected if they had a crossover design evaluating the risk of atypical endometrial hyperplasia and endometrial carcinoma in postmenopausal asymptomatic women and calculated the diagnostic accuracy of transvaginal ultrasonography thresholds (at least 3.0 mm) confirmed by histopathologic diagnosis.

This was a systematic review and diagnostic test accuracy meta-analysis according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses o3.0 to 5.9 mm cutoff results in a lower specificity, the offsetting improvement in sensitivity may justify using this cutoff for further endometrial evaluation in patients with suspected endometrial malignancy.

To determine the implications of the merit-based incentive payment system (MIPS) for urology practices. MIPS is a Medicare payment model that determines whether a physician is financially penalized or receives bonus payment based on performance in four categories quality, practice improvement, promotion of interoperability, and spending.

We performed a cross-sectional analysis of urologist performance in MIPS for 2017 and 2019 using Medicare data. Urologist practice organization was categorized as single-specialty (small, medium, large) or multispecialty groups. MIPS scores were estimated by practice organization. Logistic regression models were used to examine the association between urology practice characteristics, including proportion of dual eligible beneficiaries, and bonus payment adjustment as defined by Medicare methodology. Rates of consolidation (movement from smaller to larger practices) between 2017 and 2019 were compared between those who were and those who were not penalized in 2017.

Urologists in small practices performed worse in MIPS and had a significantly lower adjusted odds ratio of receiving bonus payments in both 2017 and 2019 compared to larger group practices (odds ratio [OR] 0.04, 95% confidence interval [95%CI] 0.03-0.05 in 2017 and OR 0.37, 95%CI 0.30-0.47 in 2019). Increasing percent of dual eligible beneficiaries within a patient panel was associated with decreased odds of receiving bonus payment in both performance years. Urologists penalized in 2017 had higher rates of consolidation by 2019 compared to those who were not (14% vs 5%, P <.05).

Small urology practices and those caring for a higher proportion of dual eligible beneficiaries tended to perform worse in MIPS.

Small urology practices and those caring for a higher proportion of dual eligible beneficiaries tended to perform worse in MIPS.In this article we describe the natural hydrogeomorphological and biogeochemical cycles of dryland fluvial ecosystems that make them unique, yet vulnerable to land use activities and climate change. We introduce Natural Infrastructure in Dryland Streams (NIDS), which are structures naturally or anthropogenically created from earth, wood, debris, or rock that can restore implicit function of these systems. This manuscript further discusses the capability of and functional similarities between beaver dams and anthropogenic NIDS, documented by decades of scientific study. In addition, we present the novel, evidence-based finding that NIDS can create wetlands in water-scarce riparian zones, with soil organic carbon stock as much as 200 to 1400 Mg C/ha in the top meter of soil. We identify the key restorative action of NIDS, which is to slow the drainage of water from the landscape such that more of it can infiltrate and be used to facilitate natural physical, chemical, and biological processes in fluvial environments. Specifically, we assert that the rapid drainage of water from such environments can be reversed through the restoration of natural infrastructure that once existed. We then explore how NIDS can be used to restore the natural biogeochemical feedback loops in these systems. We provide examples of how NIDS have been used to restore such feedback loops, the lessons learned from installation of NIDS in the dryland streams of the southwestern United States, how such efforts might be scaled up, and what the implications are for mitigating climate change effects. GKT137831 in vivo Our synthesis portrays how restoration using NIDS can support adaptation to and protection from climate-related disturbances and stressors such as drought, water shortages, flooding, heatwaves, dust storms, wildfire, biodiversity losses, and food insecurity.Microplastics (MPs) are classified as emerging pollutants and greatly threatens soil ecosystems. To determine the impact of microplastic migration on soil bacterial diversity, we conducted a 90-day indoor soil column simulation test. Soil and microplastic (granular polystyrene, polypropylene MPs) samples were collected from different soil layers on days 30, 60, and 90. The downward migration trend of MPs was obvious, and its surface functional groups, hydrophobic properties, and crystallinity changed. Bacterial diversity was significantly higher in the surrounding soil than on microplastic surfaces. Also, the topsoil has more bacterial diversity than the middle soil. A higher number of OTUs were detected on microplastic surfaces for the middle soil than in the topsoil. Proteobacteria abundance on microplastic surfaces in the topsoil gradually increased over the course of the experiment, while an opposite trend was observed for the middle soil. Nevertheless, Proteobacteria abundances in both layers were higher than in the surrounding soils. MPs alters the bacterial community composition of soils and provides unique substrates for colonization. The impacts of MPs on soil bacterial communities were better understood in this study. Our findings highlighted the relevance of MPs in soil ecosystems as well as the potential threats they pose.Groundwater resources are important water sources for people living in arid-semiarid China. To solve the problem of continuously declining groundwater levels, groundwater artificial recharge has been widely conducted by using available aquifers. However, the effects of land use changes on the available aquifer storage, especially on the remaining available aquifer storage (RAAS), have not been fully explored. Here, we quantitatively evaluated the effects of land use changes on the RAAS, exemplifying the Taoerhe alluvial-proluvial fan. Independent component analysis (ICA) is used to determine precipitation- and groundwater extraction-affected RAASs, and regression equations are established for land use type areas and precipitation- and groundwater extraction-affected RAASs through stepwise regression and all-subsets regression. An integrated model combining the future land use simulation (FLUS) model and Markov-chain model is established to predict three land use change scenarios in 2036, and the impacts of land use changes on the precipitation- and groundwater extraction-affected RAASs are evaluated.