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TC was associated with a higher risk of preterm birth. Our findings provide initial evidence that severe storms may trigger preterm birth.Objective It is important to train clinicians to maintain and optimise maternal and neonatal outcomes after vaginal twin delivery. BI-3231 molecular weight Simulation-based training provides opportunities for training in a realistic way without harming patients. The aim of this study is to evaluate the effect of simulation-based training concerning twin vaginal delivery on knowledge and comfort of obstetrician-gynaecologists. Study design Obstetrician-gynaecologists participated in a twin vaginal delivery simulation between March 2018 and May 2019. Simulation-based training consisted of standardized patient interviews, didactic sessions and three different simulation-based scenarios internal podalic version and breech extraction, assisted vaginal delivery and vaginal breech delivery with problems of aftercoming head. Pre- and posttraining, participants were asked to fill out questionnaires exploring knowledge concerning vertex-vertex twin deliveries and vertex-nonvertex twin deliveries, level of comfort performing various obstetric md to 73.5% after training (p = 0.07). Conclusions Simulation-based training results in beneficial effects on knowledge and comfort concerning vaginal twin deliveries for obstetrician-gynaecologists. This training suggested a potential impact on provider practice with a more favourable attitude towards twin vaginal birth.In the course of productive phonological development, fricatives are among the last speech sounds to emerge and to be mastered by children, probably because of the high degree of articulatory precision they require or because of difficulties with their perception. Children with cochlear implants (CI) face additional difficulties with fricative perception, since high spectral frequency components are shown to be especially difficult to perceive with a cochlear implant. Studying fricative production in children with CIs allows to study how the partial transmission of speech sounds by cochlear implants influences children's speech production, and therefore to explore how perceptual abilities influence the late stages of phonological development. This acoustic study focuses on fricative production at three places of articulation (i.e., /f/, /s/ and /ʃ/), comparing productions by two groups of children (20 children with normal hearing (NH) vs. 13 children with CIs, all aged 5;7 to 10;7 years), and taking into accothat age span. The results also show that the acquisition of coarticulation strategies can be impeded by degraded or delayed access to audio.We report on familial 5 epilepsy patients with autosomal dominant inheritance of a novel heterozygous NUS1 frameshift mutation. All patients had cerebellar ataxia and tremor. Three patients were diagnosed with childhood absence epilepsy, 1 patient with generalized epilepsy, and 1 patient with parkinsonism without epilepsy. Our cases and previously reported cases with deletions of chromosome 6q22 that include NUS1 share these common symptoms. In a cellular experiment, NUS1 mutation led to a substantial reduction of the protein level of NUS1. NUS1 mutation could contribute to epilepsy pathogenesis and also constitute a distinct syndromic entity with cerebellar ataxia and tremor.Background Guanxin V (GXV), a traditional herbal mixture, has been widely used in clinical practice for the treatment of coronary artery disease (CAD). This retrospective study was designed to assess the safety and effectiveness of GXV for CAD. Methods In our study, December 2006 to January 2009, 101 patients with CAD from Nanjing Hospital of Chinese Medicine Affiliated to Nanjing University of Chinese Medicine were enrolled, of whom 52 patients received GXV plus guideline-recommended medical therapy (GMT) (GXV group), 49 patients received GMT alone (GMT group). The general clinical information, traditional Chinese medicine syndrome score (TSS), the therapeutic effects, 6-minute walk test (6MWT), adverse events, echocardiography, and laboratory information were collected and analyzed pre-and post-treatment. Results We did not find differences in the information between the two groups before treatment. Patients in the GXV group had decreased TSS (P less then 0.0001) and increased therapeutic effects (P = 0.763) and 6MWT (P less then 0.0001) than those in the GMT group and there were no significant differences in safety between the two groups. Moreover, patients in the GXV group improved ejection fraction, cardiac output, and stroke volume (P = 0.2113, 0.0001, 0.0002, respectively), and dropped BNP (P = 0.3856) compared with those in the GMT group. Conclusions Superiority in the GXV group for patients with CAD was demonstrated over the GMT group for both the safety and effectiveness endpoints. This suggests that GXV is a potentially safe and effective treatment for CAD patients.Objective This article introduces SCALPEL3 (Scalable Pipeline for Health Data), a scalable open-source framework for studies involving Large Observational Databases (LODs). It focuses on scalable medical concept extraction, easy interactive analysis, and helpers for data flow analysis to accelerate studies performed on LODs. Materials and methods Inspired from web analytics, SCALPEL3 relies on distributed computing, data denormalization and columnar storage. It was compared to the existing SAS-Oracle SNDS infrastructure by performing several queries on a dataset containing a three years-long history of healthcare claims of 13.7 million patients. Results and discussion SCALPEL3 horizontal scalability allows handling large tasks quicker than the existing infrastructure while it has comparable performance when using only a few executors. SCALPEL3 provides a sharp interactive control of data processing through legible code, which helps to build studies with full reproducibility, leading to improved maintainability and audit of studies performed on LODs. Conclusion SCALPEL3 makes studies based on SNDS much easier and more scalable than the existing framework [1]. It is now used at the agency collecting SNDS data, at the French Ministry of Health and soon at the National Health Data Hub in France [2].