Name of Ukraine There are different hypotheses as to the etymology of the name Ukraine. According to the older widespread hypothesis, it means "borderland",  while some more recent linguistic studies claim a different meaning: The Goths stayed in the area but came under the sway of the Huns from the s AD. At the end of the century, the majority of Bulgar tribes migrated in different directions, and the Khazars took over much of the land.
It is a clinical scenario defined as when a urinary pregnancy test is positive but neither an intrauterine pregnancy IUP nor extra-uterine pregnancy can be visualized on a transvaginal ultrasound scan TVS. Due to a lack of standardized protocols, the management of PUL varies and may be stressful for women who are often subjected to repeated blood tests and scans before the final outcome of the pregnancy is known.
In general, research in this field has focused on identifying a test that enables clinicians to identify ectopic pregnancies EP within the overall population of PUL.
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Prediction models have also been developed to aid the management of women classified as having a PUL, including logistic regression models and Bayesian networks. These have considered biochemical variables such as serum hCG, the hCG ratio and progesterone levels, in combination with ultrasound-based variables such as the endometrial thickness and clinical parameters such as vaginal bleeding Banerjee et al.
The most widely evaluated prediction model developed is M4 Condous et al.
Currently, the focus for management of PUL has shifted from identifying the location of a pregnancy to classifying them as being at low or high risk of complications. In a further study on PUL, Guha et al. The M4 model performed better than both the hCG ratio and progesterone alone.
In this study, the primary aim was to assess the number of complications or adverse outcomes associated with using the M4 model in everyday practice for triaging PUL as either low or high risk. The secondary aim was to further prospectively validate the diagnostic performance of the M4 model on a new population of women with a PUL.
Two were university teaching hospitals: The third was an outer London district general hospital: Following previous publications Van Calster et al. Accordingly, after discussion with the research and development departments within the respective National Health Service hospitals, the study was registered as an audit, having been advised that ethical approval was not required as there was no change to the routine clinical management.
The following specific inclusion and exclusion criteria were set. Inclusion criteria—any woman seen that was classified as a PUL at the initial visit to the EPAU and was haemodynamically stable and therefore fit for outpatient management.
EP ; any participant unsuitable for outpatient management with serial serum hCG levels e. At presentation, all women were seen and a TVS performed by a trained sonographer nurse specialist, sonographer or gynaecologist.
A history was taken which included past history of EP and their method of treatment, amount of vaginal bleeding expressed as a pictorial bleeding assessment score of 1—4 Bottomley et al.
Serum hCG measurement All patients had blood samples taken for serum hCG at the initial visit and 48 h later. It also uses chemiluminescent technology. Triage using the M4 model The M4 prediction model algorithm was embedded into a simple protected excel file, and all staff, including junior doctors on call in the evening and at weekends, had access to this file.
On being classified as a PUL, women had the initial serum hCG level measured, and the results entered onto the excel spreadsheet. They were then asked to return 48 h later for a repeat serum hCG. Participants were also asked to telephone or return to the unit in the event of any deterioration in their clinical condition, such as increased levels of pain or vaginal bleeding.
These classifications were linked to agreed management plans. If the urine pregnancy test was positive after 2 weeks, the women were brought back for a repeat serum hCG and TVS if required. If they remained a PUL, a repeat serum hCG was measured and the woman was managed according to the clinical scenario.
Clinicians were told that the model was a guide to management and that it should not be followed blindly if they felt the clinical situation demanded a different management plan. The M4 model gave guidance on follow up but not on whether there was a need for intervention. The decision for intervention was always made by the responsible clinical team.When applying DLP policies such as SSN in Exchange Online, it actually needs to have SSN in the email to trigger the message tip to show.
Just the fact that the actual SSN numbers show up in the email should be triggering the message tip. Despite the heightened interest in developing biomarkers predicting treatment response that are used to optimize patient treatment decisions, there has been relatively little development of statistical methodology to evaluate these markers.
Methods. We collected and harmonized data on mortality and risk factors by educational level for 21 European populations in the early s. The impact of the risk factors on mortality in each educational group was determined using Population Attributable Fractions. The Kerch Strait and the Black Sea open-shelf North-Western wind diagram for the winds exceeding 10 m/sec shows predominance of the North-Eastern, Eastern and Southern winds (Fig.
a). CIS/ Week 4 MS Access Exercise - Part I Complete the following tasks using Microsoft Access. The database consists of two tables. Name both tables.
Establish a primary key for each table.
Create a relationship between the two tables. Set appropriate properties for all fields. Enter at least five mock student records in Table One. The Community Emergency Response Team (CERT) program educates volunteers about disaster preparedness for the hazards that may impact their area and trains them in basic disaster response skills, such as fire safety, light search and rescue, team organization, and disaster medical operations.