Pushing the bounds of second stage in term nulliparas with a predictive model.

Background: Management of the second stage of labor continues to be a clinical challenge with unclear indications for abandoning attempts at spontaneous vaginal delivery. The conflict between diminishing chances of spontaneous vaginal delivery and increasing maternal and neonatal morbidity is difficult to quantify, leading to significant variation in management between providers, and variation in rates of operative vaginal delivery and cesarean birth.

Objective: The objective of the study was to develop an hourly prediction model for spontaneous vaginal delivery during the second stage of labor in nulliparous women with epidural anesthesia.

Inhibition of glycogen catabolism induces intrinsic apoptosis and augments multikinase inhibitors in hepatocellular carcinoma cells.

Hepatocellular carcinoma (HCC) is one of the leading cancers in the world in incidence and mortality. Current pharmacotherapy of HCC is limited in the number and efficacy of anticancer agents. Metabolic reprogramming is a prominent feature of many cancers and has rekindled interest in targeting metabolic proteins for cancer therapy.