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Introduction: The clinical management of breech presentations at term is still a controversially discussed issue among clinicians. Clear predictive criteria for planned vaginal breech deliveries are desperately needed to prevent adverse fetal and maternal outcomes and to reduce elective cesarean section rates. The green-top guideline considers an estimated birth weight of 3.8 kg or more an indication to plan a cesarean section despite the lack of respective evidence.
Objective: To compare maternal and neonatal outcome of vaginal intended breech deliveries of births with children with a birth weight of 2.5 kg– 3.79 kg and children with a birth weight of 3.8 kg and more.
Design: Prospective cohort study.
Sample: All vaginal intended deliveries out of a breech position of newborns weighing between 2.5 kg and 4.5 kg at the Obstetrics department at Goethe University Hospital Frankfurt from January 2004 until December 2016
Methods: Neonatal and maternal outcome of a light weight group (LWG) (< 3.8 kg) was compared to and a high weight group (HWG) (≥ 3.8 kg) using Pearson’s Chi Square test and Fishers exact test. A logistic regression analysis was performed to detect an association between cesarean section rates, fetal outcome and the birth weight.
Results: No difference in neonatal morbidity was detected between the HWG (1.8%, n = 166) and the LWG (2.6%, n = 888). Cesarean section rate was significantly higher in the HWG with 45.2% in comparison to 28.8% in the LWG with an odds ratio of 1.57 (95% CI 1.29–1.91, p<0.0001). In vaginal deliveries, a high birth weight was not associated with an increased risk of maternal birth injuries (LWG in vaginal deliveries: 74.3%, HWG in vaginal deliveries: 73.6%; p = 0.887; OR = 1.9 (95% CI 0.9–1.1))
Conclusion: A fetal weight above 3.79 kg does not predict increased maternal or infant morbidity after delivery from breech presentation at term. Neither the literature nor our analyses document evidence for threshold of estimated birth weight that is associated with maternal and/or infant morbidity. However, patients should be informed about an increased likelihood of cesarean sections during labor when attempting vaginal birth from breech position at term in order to reach an informed shared decision concerning the birth strategy. Further investigations in multi center settings are needed to advance international guidelines on vaginal breech deliveries in the context of estimated birth weight and its impact on perinatal outcome.
Production of K0S, Λ (Λ), Ξ±, and Ω± in jets and in the underlying event in pp and p–Pb collisions
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The production of strange hadrons (K0S, Λ, Ξ±, and Ω±), baryon-to-meson ratios (Λ/K0S, Ξ/K0S, and Ω/K0S), and baryon-to-baryon ratios (Ξ/Λ, Ω/Λ, and Ω/Ξ) associated with jets and the underlying event were measured as a function of transverse momentum (pT) in pp collisions at s√=13 TeV and p-Pb collisions at sNN−−−√=5.02 TeV with the ALICE detector at the LHC. The inclusive production of the same particle species and the corresponding ratios are also reported. The production of multi-strange hadrons, Ξ± and Ω±, and their associated particle ratios in jets and in the underlying event are measured for the first time. In both pp and p-Pb collisions, the baryon-to-meson and baryon-to-baryon yield ratios measured in jets differ from the inclusive particle production for low and intermediate hadron pT (0.6−6 GeV/c). Ratios measured in the underlying event are in turn similar to those measured for inclusive particle production. In pp collisions, the particle production in jets is compared with PYTHIA 8 predictions with three colour-reconnection implementation modes. None of them fully reproduces the data in the measured hadron pT region. The maximum deviation is observed for Ξ± and Ω±, which reaches a factor of about six. In p-Pb collisions, there is no significant event-multiplicity dependence for particle production in jets, in contrast to what is observed in the underlying event. The presented measurements provide novel constraints on hadronisation and its Monte Carlo description. In particular, they demonstrate that the fragmentation of jets alone is insufficient to describe the strange and multi-strange particle production in hadronic collisions at LHC energies.
Measurements of the production of electrons from heavy-flavour hadron decays in pp collisions at s√=13 TeV at midrapidity with the ALICE detector are presented down to a transverse momentum (pT) of 0.2 GeV/c and up to pT=35 GeV/c, which is the largest momentum range probed for inclusive electron measurements in ALICE. In p−Pb collisions, the production cross section and the nuclear modification factor of electrons from heavy-flavour hadron decays are measured in the pT range 0.5<pT<26 GeV/c at sNN−−−√=8.16 TeV. The nuclear modification factor is found to be consistent with unity within the statistical and systematic uncertainties. In both collision systems, first measurements of the yields of electrons from heavy-flavour hadron decays in different multiplicity intervals normalised to the multiplicity-integrated yield (self-normalised yield) at midrapidity are reported as a function of the self-normalised charged-particle multiplicity estimated at midrapidity. The self-normalised yields in pp and p−Pb collisions grow faster than linear with the self-normalised multiplicity. A strong pT dependence is observed in pp collisions, where the yield of high-pT electrons increases faster as a function of multiplicity than the one of low-pT electrons. The measurement in p−Pb collisions shows no pT dependence within uncertainties. The self-normalised yields in pp and p−Pb collisions are compared with measurements of other heavy-flavour, light-flavour, and strange particles, and with Monte Carlo simulations.
The correlations between different moments of two flow amplitudes, extracted with the recently developed asymmetric cumulants, are measured in Pb-Pb collisions at √sNN = 5.02 TeV recorded by the ALICE detector at the CERN Large Hadron Collider. The magnitudes of the measured observables show a dependence on the different moments as well as on the collision centrality, indicating the presence of nonlinear response in all even moments up to the eighth. Furthermore, the higher-order asymmetric cumulants show different signatures than the symmetric and lower-order asymmetric cumulants. Comparisons with state-of-the-art event generators using two different parametrizations obtained from Bayesian optimization show differences between data and simulations in many of the studied observables, indicating a need for further tuning of the models behind those event generators. These results provide new and independent constraints on the initial conditions and transport properties of the system created in heavy-ion collisions.
The elliptic flow (v2) of D0 mesons from beauty-hadron decays (non-prompt D0) was measured in midcentral (30-50%) Pb-Pb collisions at a centre-of-mass energy per nucleon pair sNN−−−√ = 5.02 TeV with the ALICE detector at the LHC. The D0 mesons were reconstructed at midrapidity (|y|<0.8) from their hadronic decay D0→K−π+, in the transverse momentum interval 2<pT<12 GeV/c. The result indicates a positive v2 for non-prompt D0 mesons with a significance of 2.7σ. The non-prompt D0-meson v2 is lower than that of prompt non-strange D mesons with 3.2σ significance in 2<pT<8 GeV/c, and compatible with the v2 of beauty-decay electrons. Theoretical calculations of beauty-quark transport in a hydrodynamically expanding medium describe the measurement within uncertainties.
The azimuthal (Δφ) correlation distributions between heavy-flavor decay electrons and associated charged particles are measured in pp and p−Pb collisions at sNN−−−√=5.02 TeV. Results are reported for electrons with transverse momentum 4<pT<16 GeV/c and pseudorapidity |η|<0.6. The associated charged particles are selected with transverse momentum 1<pT<7 GeV/c, and relative pseudorapidity separation with the leading electron |Δη|<1. The correlation measurements are performed to study and characterize the fragmentation and hadronization of heavy quarks. The correlation structures are fitted with a constant and two von Mises functions to obtain the baseline and the near- and away-side peaks, respectively. The results from p−Pb collisions are compared with those from pp collisions to study the effects of cold nuclear matter. In the measured trigger electron and associated particle kinematic regions, the two collision systems give consistent results. The Δφ distribution and the peak observables in pp and p−Pb collisions are compared with calculations from various Monte Carlo event generators.
The cross section for coherent photonuclear production of J/ψ is presented as a function of the electromagnetic dissociation (EMD) of Pb. The measurement is performed with the ALICE detector in ultra-peripheral Pb-Pb collisions at a centre-of-mass energy per nucleon pair of sNN−−−√=5.02 TeV. Cross sections are presented in five different J/ψ rapidity ranges within |y|<4, with the J/ψ reconstructed via its dilepton decay channels. In some events the J/ψ is not accompanied by EMD, while other events do produce neutrons from EMD at beam rapidities either in one or the other beam direction, or in both. The cross sections in a given rapidity range and for different configurations of neutrons from EMD allow for the extraction of the energy dependence of this process in the range 17<WγPb,n<920 GeV, where WγPb,n is the centre-of-mass energy per nucleon of the γPb system. This range corresponds to a Bjorken-x interval spanning about three orders of magnitude: 1.1×10−5<x<3.3×10−2. In addition to the ultra-peripheral and photonuclear cross sections, the nuclear suppression factor is obtained. These measurements point to a strong depletion of the gluon distribution in Pb nuclei over a broad, previously unexplored, energy range. These results, together with previous ALICE measurements, provide unprecedented information to probe quantum chromodynamics at high energies.
Two-particle correlations with K0S, Λ/Λ¯, and charged hadrons as trigger particles in the transverse momentum range 8<pT,trig<16 GeV/c, and associated charged particles within 1<pT,assoc<8 GeV/c, are studied at mid-rapidity in pp and central Pb-Pb collisions at a centre-of-mass energy per nucleon-nucleon collision sNN−−−√=5.02 TeV with the ALICE detector at the LHC. After subtracting the contributions of the flow background, the per-trigger yields are extracted on both the near and away sides, and the ratio in Pb-Pb collisions with respect to pp collisions (IAA) is computed. The per-trigger yield in Pb-Pb collisions on the away side is strongly suppressed to the level of IAA≈0.6 for pT,assoc>3 GeV/c as expected from strong in-medium energy loss, while an enhancement develops at low pT,assoc on both the near and away sides, reaching IAA≈1.8 and 2.7 respectively. These findings are in good agreement with previous ALICE measurements from two-particle correlations triggered by neutral pions (π0-h) and charged hadrons (h-h) in Pb-Pb collisions at sNN−−−√=2.76 TeV. Moreover, the correlations with K0S mesons and Λ/Λ¯ baryons as trigger particles are compared to those of inclusive charged hadrons. The results are compared with the predictions of Monte Carlo models.
The knowledge of the material budget with a high precision is fundamental for measurements of direct photon production using the photon conversion method due to its direct impact on the total systematic uncertainty. Moreover, it influences many aspects of the charged-particle reconstruction performance. In this article, two procedures to determine data-driven corrections to the material-budget description in ALICE simulation software are developed. One is based on the precise knowledge of the gas composition in the Time Projection Chamber. The other is based on the robustness of the ratio between the produced number of photons and charged particles, to a large extent due to the approximate isospin symmetry in the number of produced neutral and charged pions. Both methods are applied to ALICE data allowing for a reduction of the overall material budget systematic uncertainty from 4.5% down to 2.5%. Using these methods, a locally correct material budget is also achieved. The two proposed methods are generic and can be applied to any experiment in a similar fashion.