bluuebunny/crossref_metadata_2025 huggingface dataset:
SCORE Kardiyovasküler Risk Puanlama Sistemi ile Non-dipper Hipertansiyon Arasındaki İlişki
Authors: ÖKSÜZ Fatih , YAYLA Cagrı
Published: December 2018

Amaç: Non-dipper kan basıncının (KB) uç organ hasarı ve

ölümcül - ölümcül olmayan kardiyovasküler hastalıklarla (KVH) anlamlı şekilde

ilişkili olduğu gösterilmiştir. Kardiyovasküler (KV) olay riskinde artış

bulunan bireylerde sistematik KV risk değerlendirmesi önerilir. SCORE risk

sistemi, ilk ölümcül aterosklerotik olayın 10 yıllık riskini değerlendirir. Bu

çalışmanın amacı hipertansiyon (HT)hastalarında non-dipper KB ile SCORE risk

sistemi arasındaki bir ilişki olup olmadığının araştırılmasıdır.

Yöntemler: Bu çalışma retrospektif bir çalışmadır ve

esansiyel HT tanısı konulan ardışık 213 hastayı içermektedir. Non-dipper ve

dipper hasta grupları 24 saatlik ambulatuar kan basıncı izlemine (AKBİ) göre belirlendi.

SCORE sistemine göre yaş, cinsiyet, sigara kullanımı, sistolik kan basıncı

(SKB) ve total kolesterol (TK) gibi risk faktörleri kullanılarak 10 yıllık

ölümcül KV olay riski hesaplandı.

Bulgular: Non-dipper HT hasta grubunda SCORE risk sistemi anlamlı olarak

yüksek saptandı (p=0.017). Ayrıca sigara içme alışkanlığı sıklığı ve TK

değerleri non-dipper

HT’li hasta grubunda anlamlı olarak daha yüksek saptandı. Diğer demografik,

klinik ve laboratuvar parametreler iki grup arasında benzerdi. SCORE risk oranı

ile gece sistolik ve diyastolik KB’leri arasında orta derecede olmasına rağmen

anlamlı pozitif korelasyon izlendi (r = 0.354, p < 0.001; r = 0.339,

p<0.001; sırasıyla)

Sonuç: Bu çalışmada ilk defa non-dipper HT ile SCORE risk

sistemi arasında önemli bir ilişki olduğu gösterilmiştir. SCORE risk sistemi

ile hesaplanan 10 yıllık fatal KV olay ihtimalinin non-dipper hasta grubunda daha yüksek

saptanması, esansiyel HT tanılı hastaların AKBİ ile takibinin önemini ortaya

çıkarmıştır.
Axiller lenf nodu pozitif meme kanserinde non-sentinel lenf nodu pozitifliğine etki eden faktörler ve nomogramların etkinliğinin karşılaştırılması
Authors: KOCA Bülent , KURU Bekir
Published: December 2018

Amaç: Amacımız aksiller lenf nodu pozitif meme kanserinde nonsentinel lenf nodu (NSLN) pozitifliğine etki eden faktörleri araştırmak ve hasta grubumuzda Memorial Sloan-Kettering Cancer Center (MSKCC) ve Stanford nomogramlarının etkinliğini karşılaştırmaktır. Yöntemler: 01.01.2008 - 31.08.2011 tarihleri arasında Ondokuz Mayıs Üniversitesi Tıp Fakültesi Genel Cerrahi Kliniği’nde sentinel lenf nodu biyopsisi (SLNB) sonucunda sentinel lenf nodunda metastaz saptanan invaziv meme kanseri olan 112 hasta çalışmaya alındı. Karşılaştırılacak değişkenler SPSS 15.0 versiyonu programından yararlanılarak kaydedildi. Lojistik regresyon analizi ile NSLN pozitifliğine etki eden risk faktörleri araştırıldı. P< 0.05 anlamlılık düzeyi olarak kabul edildi. Her iki nomogram icin “Receiver Operating Characteristics (ROC)” eğrileri oluşturuldu ve eğriler altındaki alanlar(AUC) hesaplandı. AUC değeri 0.70 ve üzerinde hesaplanan yöntem etkin olarak kabul edildi. Bulgular: Tek değişkenli analizde tümör boyutu, multifokalite, lenfovasküler invazyon varlığı, SLN’daki metastazın makrometastaz oluşu, SLN’da kapsül dışı invazyon varlığı ve metastatik SLN sayısının toplam SLN sayısına oranı anlamlı bulundu. Çok değişkenli analizde lenfovasküler invazyon, SLN’da kapsül dışı invazyon ve metastatik SLN sayısının toplam SLN sayısına oranı NSLN metastazı ile ilgili bağımsız prediktif faktörler olarak saptandı. MSKCC ve Stanford nomogramlarının ikisinin de hasta grubumuzda etkin olmakla birlikte MSKCC nomogramının daha etkin olduğu sonucuna vardık. Sonuç: Nomogramlar aksillada NSLN’unda metastataz olasılığı hakkında yol gösterici yöntemlerdir. Ancak henüz aksiller lenf nodu diseksiyonunun (ALND) yerini alacak kapasitede değildirler. NSLN pozitifliğine etki eden yeni prediktif faktörlerin ortaya konulması ile etkinlikleri artırılabilir. Her klinik kendisine en uygun nomogramı belirlemeli ve kullanmalı veya kendi nomogramını oluşturmalıdır.
From sexualized torture and gender-based torture to genderized torture: The urgent need for a conceptual evolution
Authors: Pérez-Sales Pau , Zraly Maggie
Published: December 2018

Classical perspectives on sexualized torture are being increasingly challenged by contemporary debates informed by emerging claims (Mendez, 2016; Sáez, 2016; Sifris, 2014). Gender-based analysis based on feminist and other theoretical approaches is needed to adequately address these.

Arriving at a general framework for the reconceptualization of torture, and progressively widening the analytical scope of gender and torture, are priorities. Gender analyses of torture needs to encompass a broader range of phenomena, from rape and attacks on sexual integrity to any suffering inflicted on human beings that is intricately intertwined with gender (Jakobsen, 2014), including and not limited to discrimination against LGTBI persons,1 genital mutilation, and the restriction of any of the broad range of issues under the frame of reproductive freedom, such as abortion and involuntary sterilization.2

The push for a gender transformative rethinking of conceptual and analytical approaches to torture is accompanied by the need to develop specific tools to detect and assess sexual and gender-based torture (including the necessity for a reconsideration of gender perspectives on the Istanbul Protocol), to incorporate a feminist perspective in the rehabilitation of victims. This requires specific treatment approaches as well as holistic survivor-centered rehabilitation models that include access to high quality and comprehensive services. Services that support stigma reduction are particularly important.

Our own desk review on all papers published in Torture Journal since 2006 until 2018 showed a clear gender analysis gap: only 32% of papers included the word ‘gender’ and 38% the word ‘female’ in any part of the text. In 84% of the cases, these mentions simply indexed the presentation of data disaggregated by sex. Only 4% of all the papers published in the Journal attempted a gender analysis. To help address this gap, the Journal circulated a call for papers on gender and torture that aligned with research priorities identified in our Delphi study (Pérez-Sales, Witcombe, & Otero, 2017). The response to this call has been encouraging.

This issue features a collection of texts that highlight important aspects of sexualized and gender-based torture and provide reflections that contribute to framing the theoretical debate on the nature and scope of gender-based and genderized forms of torture. The Journal believes that even more research and reflection is necessary to adequately clarify and raise the terms of this debate and additional texts relevant to the topic are planned to appear in forthcoming issues. This current issue draws out key concepts that are important to making an impact, both on the debate and in practice.
Impactos da Volvo Ocean Race – Itajaí Stopover: análise pós-evento da percepção dos residentes da cidade de Itajaí (SC)
Authors: Vieira Josy , Ardigó Carlos Marcelo , Behling Hans Peder
Published: December 2018

A Volvo Ocean Race (VOR) é um megaevento mundial, com potencial para atrair público e investimentos para os diferentes países que o recebe, sendo ainda um importante atrativo relacionado ao turismo náutico. Passadas as edições de 2012/2013 e 2014/2015 e as vésperas de sediar uma das etapas da edição 2017/2108 este estudo procurou analisar a percepção dos residentes da cidade de Itajaí (SC), após a realização do Itajaí Stopover (recepção do evento na cidade), em relação aos impactos econômicos, socioculturais e ambientais gerados pela VOR. A metodologia aplicada seguiu um delineamento descritivo, com natureza dos dados predominantemente quantitativa e procedimento survey, aplicado a uma amostra não probabilística de 484 respondentes. Para a análise utilizou-se além da estatística descritiva também o teste ANOVA para identificação de diferenças de média entre perfis diferentes de residentes respondentes. Os resultados apontam que para a maioria dos residentes a VOR proporcionou impactos positivos, independentemente do nível de proximidade de suas residências da Vila da Regata do Itajaí Stopover. Grupos etários, de gênero, níveis de instrução e renda também tendem a perceber de maneira distinta para determinadas variáveis e dimensões analisadas.
Finerenone in Women and Men With Heart Failure With Mildly Reduced or Preserved Ejection Fraction
Authors: Chimura Misato , Wang Xiaowen , Jhund Pardeep S. , Henderson Alasdair D. , Claggett Brian L. , Desai Akshay S. , Fonseca Cândida , Goncalvesova Eva , Katova Tzvetana , Mueller Katharina , Glasauer Andrea , Rohwedder Katja , Viswanathan Prabhakar , Nodari Savina , Lam Carolyn S. P. , Saldarriaga Clara Inés , Senni Michele , Sharma Kavita , Voors Adriaan A. , Zannad Faiez , Pitt Bertram , Vardeny Orly , Vaduganathan Muthiah , Solomon Scott D. , McMurray John J. V.
Published: November 2024

Importance

Sex is associated with the clinical presentation, outcomes, and response to treatment in patients with heart failure (HF). However, little is known about the safety and efficacy of treatment with finerenone according to sex.

Objective

To estimate the efficacy and safety of finerenone compared with placebo in both women and men.

Design, Setting, and Participants

Prespecified analyses were conducted in the phase 3 randomized clinical trial Finerenone Trial to Investigate Efficacy and Safety Superior to Placebo in Patients with Heart Failure (FINEARTS-HF). The trial was conducted across 653 sites in 37 countries. Participants were adults aged 40 years and older with symptomatic HF and left ventricular ejection fraction (LVEF) of 40% or greater randomized between September 2020 and January 2023.

Intervention

Finerenone (titrated to 20 mg or 40 mg) or placebo.

Main Outcomes and Measures

The primary outcome was a composite of cardiovascular death and total (first and recurrent) HF events (unplanned HF hospitalizations or urgent HF visits).

Results

A total of 6001 patients were randomized in FINEARTS-HF, of whom 2732 were women (45.5%), with a mean (SD) age of 73.6 (9.1) years. Women had higher rates of any obesity, higher LVEF (54.6 [7.6%] vs 50.9 [7.6] for men), lower mean (SD) estimated glomerular filtration rate than men (59.7 [19.1] vs 64.1 [20.0] for men; P<.001) , worse New York Heart Association functional class, and lower Kansas City Cardiomyopathy Questionnaire-Total Symptom Scores (KCCQ-TSS) (mean [SD] 62.3 [24.0] vs 71.0 [23.1]). The incident rate of the primary outcome was slightly lower in women (15.7; 95% CI, 14.3-17.3) than in men (16.8; 95% CI, 15.4-18.3) per 100 person-years. Compared with placebo, finerenone reduced the risk of the primary end point similarly in women and men: rate ratio 0.78 (95% CI, 0.65-0.95) in women and 0.88 (95% CI, 0.74-1.04) in men (P = .41 for interaction). Consistent effects were observed for the components of the primary outcome and all-cause mortality. The mean increase (improvement) in KCCQ-TSS from baseline to 12 months was greater with finerenone, regardless of sex (P = .73 for interaction). Finerenone had similar tolerability in women and men.

Conclusions and Relevance

In FINEARTS-HF, finerenone reduced the risk of the primary end point similarly in women and men with heart failure with mildly reduced or preserved ejection fraction. Finerenone had similar tolerability in women and men.

Trial Registration

ClinicalTrials.gov Identifier: NCT04435626
Partial Cardiac Denervation to Prevent Postoperative Atrial Fibrillation After Coronary Artery Bypass Grafting
Authors: Yang Ziang , Tiemuerniyazi Xieraili , Xu Fei , Wang Yang , Sun Yang , Yan Peng , Tian Liangxin , Han Chao , Zhang Yan , Pan Shiwei , Hu Zhan , Li Xi , Zhao Wei , Feng Wei
Published: November 2024

Importance

Efficient approaches to prevent postoperative atrial fibrillation (POAF) after coronary artery bypass grafting (CABG) are still needed.

Objective

To investigate whether partial cardiac denervation, achieved by cutting off the ligament of Marshall (LOM) and resecting the fat pad along the Waterston groove, can reduce the risk of POAF following CABG.

Design, Setting and Participants

This single-center, randomized clinical trial enrolled adult patients scheduled for isolated CABG in China. Enrollment was from August 15, 2022, to December 13, 2023; follow-up visits were 30 days after discharge.

Interventions

Participants were randomized into the intervention group (CABG plus partial cardiac denervation) and the control group (CABG only) in a 1:1 pattern. All participants were continuously monitored for the incidence of POAF until day 6 after the operation.

Main outcome and Measures

The primary end point was the incidence of POAF in 6 days, defined as a supraventricular arrhythmia lasting for more than 30 seconds.

Results

The trial enrolled 430 patients (79 [18.4%] female; mean [SD] age, 61.9 [7.8] years). Compared with the control group, the 6-day incidence of POAF was significantly lower in the intervention group (18.1% vs 31.6%; P = .001; risk ratio, 0.57 [95% CI, 0.41-0.81]). To further support these results, a sensitivity analysis performed with Kaplan-Meier survival curves also showed a significant reduction in the occurrence of POAF in the intervention group (hazard ratio, 0.53 [95% CI, 0.36-0.79]; P = .002). Safety assessments showed no difference between the 2 groups, while postoperative medical cost was reduced in the intervention group.

Conclusions and Relevance

This randomized clinical trial found that partial cardiac denervation was an effective procedure to reduce the occurrence of POAF after isolated CABG without additional postoperative complications. These results suggest that partial cardiac denervation may be a good option for cardiac surgeons to consider for preventing POAF after CABG.

Trial Registration

ClinicalTrials.gov Identifier: NCT05009914
Online Linearized Confidence‐Weighted Learning on a Budget
Authors: Wu Jacky Chung‐Hao , Lin Yu‐Shiou , Lu Henry Horng‐Shing , Hang Hsueh‐Ming
Published: November 2024

Online learning aims to solve a sequence of consecutive prediction tasks by leveraging the knowledge gained from previous tasks. Linearized confidence‐weighted (LCW) learning is the first online learning algorithm introducing the concept of weight confidence into the prediction model through distributions over weights. It provides the flexibility for weights to update their values at different scales. The kernel trick in machine learning can be applied to LCW for a better prediction performance. However, the kernel‐based LCW algorithm is subject to the curse of kernelization which makes it vulnerable to the unlimited growth of the prediction model in runtime and memory consumption. In this study, we present the budgeted LCW (BLCW) algorithm which puts a limit on the growth by a predefined budget with optimization. Consequently, BLCW performs the LCW update and then reduces the information loss by projection. Based on the resource perspective that reinterprets LCW in terms of resources and utilization degrees, we demonstrated that BLCW approximates the kernel‐based LCW algorithm. We evaluate four budget maintenance strategies and suggest that the mean removal is the most stable. By various numerical experiments on real datasets, we demonstrate that BLCW performs competitively and effectively when compared to leading budgeted online algorithms.
Spring and Power in Hovering Ornithopters
Authors: Lau Gih‐Keong , Chin Yao‐Wei , Lin Shih‐Chun , Lai Yu‐Hsiang , Khoo Boo Cheong
Published: November 2024

Ornithopters are bird‐like flapping‐wing robots. Only small ornithopters can hover, with long endurance at hummingbird size. Could larger ornithopters be improved further to hover longer? This paper reviews and examines the drive and power of hovering ornithopters, and elastic means of energy or thrust boosters. While the rotation of flexible wings enhance the thrust generation, two‐winged ornithopters did not scale up well because of higher disk loading. In comparison, the X‐winged or multiple‐V‐winged ornithopters enjoy a lower disk loading by beating multiple wings slower, at a smaller stroke angle or a longer span. Further, the clap‐and‐fling interaction of V and X‐wings boosts the thrust generation. Future works can explore the wing flexibility and morphology change to improve the hoverability and flight agility of ornithopters.
Patient‐reported persistent lymphedema and peripheral neuropathy among long‐term breast cancer survivors in the Carolina Breast Cancer Study
Authors: Yarosh Rina A. , Nichols Hazel B. , Wang Qichen , Hirschey Rachel , Kent Erin E. , Carey Lisa A. , Hayes Sandra C. , Ogunleye Adeyemi A. , Troester Melissa A. , Butler Eboneé N.
Published: November 2024

Background

Improved breast cancer treatment has lengthened survival but also has long‐term impacts. Lymphedema and peripheral neuropathy are treatment‐related sequelae that extend into survivorship. Co‐occurrence of these conditions may further impair functional well‐being. Few studies have estimated the burden of these conditions among diverse survivors.

Methods

Carolina Breast Cancer Study Phase 3 enrolled survivors diagnosed between 2008 and 2013 in North Carolina. Black and younger women (aged <50 years at diagnosis) were oversampled. With the use of ≥10 years of follow‐up data, the prevalence of persistent lymphedema, peripheral neuropathy, and their co‐occurrence was assessed. Prevalence differences (PDs) and 95% confidence intervals (CIs) were assessed according to patient and disease characteristics.

Results

A total of 1688 survivors were included, with an average of 11.1 years (SD, 0.6) postdiagnosis. The prevalence of persistent lymphedema, peripheral neuropathy, and their co‐occurrence was 18.7%, 27.7%, and 8.8%, respectively. Lymphedema was higher among those receiving a mastectomy and with >5 lymph nodes removed, and peripheral neuropathy was higher among women treated with taxane‐based chemotherapy. Co‐occurrence was higher among women with >5 lymph nodes removed (vs. <5; PD, 5.4; 95% CI, 2.1 to 8.8) and those treated with taxane‐based chemotherapy (vs. no chemotherapy; PD, 6.8; 95% CI, 3.9 to 9.7). The burden of lymphedema (PD, 2.7; 95% CI, 0.9 to 6.3) and peripheral neuropathy (PD, 5.8; 95% CI, 1.7 to 9.9) was higher among Black than White women. The prevalence of lymphedema (PD, 1.8; 95% CI, −1.5 to 5.1) and peripheral neuropathy (PD, 4.6; 95% CI, 0.8 to 8.4) was elevated among younger compared to older women.

Conclusions

Lymphedema and peripheral neuropathy affect a substantial proportion of survivors. Interventions are needed to reduce this burden.
Algae‐Derived Precursors for Sustainable Electrochemical Energy Storage
Authors: Dongre Manas , Varma Payal , Parthasarathy Aravindhalochanan , Kandasubramanian Balasubramanian
Published: November 2024

The simple production and harvesting of algae, along with its lower environmental impact and fewer geopolitical issues, make it a viable precursor for electrochemical energy storage devices. Algae represent a promising biomaterial for electrode materials in electrochemical energy storage devices, including hard carbon, sol–gel‐based anode batteries, sodium batteries, oxygen reduction reaction catalysts in zinc–air batteries, and cathode materials in zinc‐ion and lithium‐ion batteries. Algae‐based batteries are fabricated using methods like pyrolysis, hydrothermal processes, agar‐aided dissolution, electrolysis, annealing, and sol–gel methods. Among these, the sol–gel method using agar to construct refillable hydrogel batteries stands out. Agar's compatibility with acetylene black enhances electrochemical properties and offers the advantage of refill ability, which is challenging in metal‐ion batteries. Algae carbons have demonstrated enhanced specific capacity and cyclic performance, paving the way for their use in both medical and industrial applications. The article reviews the utilization of algae‐based batteries in different industrial and medical pacemaker applications as well as examines the feasibility of the operation of algae‐based batteries synthesized through various parameters and precursors.
Improving Solar Cell Efficiency of Silicon and Silicon Tandem Structure by Using Surface Modification
Authors: Aida Maha Nur , Madara Polgampola Chamani , Khokhar Muhammad Quddamah , Yousuf Hasnain , Chu Mengmeng , Rahman Rafi Ur , Park Sangheon , Yi Junsin
Published: November 2024

Silicon heterojunction (SHJ) solar cells face challenges in maximizing energy capture due to limitations in light collection and surface passivation. To address this, the use of SHJ tandem solar cells in a back‐to‐back configuration is explored, allowing illumination from both sides to enhance light absorption and energy generation. This study aims to improve the stability and efficiency of these cells through Al2O3 and Nafion surface treatments. Al2O3 is deposited to enhance bifacial light collection, while Nafion is applied for surface passivation to increase the fill factor (FF). The method involves adding 0.1–0.6 units of incident light to the rear of the cells to evaluate the effects of these treatments. The results show a 2.06% increase in efficiency with Al2O3 and a 1.72% improvement with Nafion under standard illumination conditions. The optimized tandem SHJ with Al2O3 and Nafion achieves a Jsc of 62.01 mA cm−2, Voc of 650.63 mV, FF of 76.49%, and an efficiency of 30.86%. These findings demonstrate the significant potential of these surface treatments to enhance the overall performance of bifacial back‐to‐back tandem SHJ solar cells.
Enhancing Supercapacitor Performance of NiCoMn‐Layered Double Hydroxide with Ag–Citrate/Polyaniline Nanocomposites
Authors: Makda Ammar , Marwat Mohsin Ali , Mahmood Muhammad Hamza , Naeem Abdullah , Abdullah Syed Muhammad , Humayun Muhammad , Karim Muhammad Ramzan Abdul , Bououdina Mohamed , Khan Muhammad Zubair , Hanif Muhammad Bilal
Published: November 2024

Layered double hydroxide (LDH) has a layered structure, which makes it a strong candidate for supercapacitors (SC) due to its high surface area. However, they suffer from low conductivity due to insufficient charge transfer across their layers. This research aims to overcome this obstacle by introducing conductive channels among the layers by the addition of Ag–citrate and polyaniline (PANI). Consequently, five electrodes (S1–5) were made from NiCoMn LDH (referred to as LDH henceforth) and 2:1 Ag–citrate and PANI composite (Ag/PANI) in different ratios and made into electrodes. Electrochemical analysis revealed successful improvement in the performance of LDH as the fraction of Ag/PANI increased until it equaled Ag/PANI  where the highest specific capacitance of 617 F g−1 was obtained, which is 12% greater than the value for solely LDH electrode (550 F g−1). A device was fabricated with the best electrode (S3) and activated carbon electrode, which demonstrated energy densities and power densities of 41 WhKg−1 and 412.5 W Kg−1 and 14 WhKg−1and 8250 W Kg−1 at 0.5 and 10 A g−1 current densities, respectively. It also exhibited a capacitive retention of about 75% at 3000 galvanostatic charge–discharge cycles. These results encourage the use in of NiCoMn LDH, in a 1:1 ratio with Ag/PANI in SCs due to its remarkable performance.
A Tale of Two Storms: Inter‐Storm Variability of Stable Water Isotopes in a Solute Transport Model
Authors: Grande Emilio , Delgadillo Moreno Brenda K. , Moran Jean E.
Published: November 2024

Stable isotopic methods in hydroclimate monitoring are powerful for improving water resources management, but applications are limited, especially in semi‐arid regions where such management is needed most. Here, we show that we can address shortcomings related to the lack of a seasonal signal using stable water isotopic signatures measured in precipitation over the East San Francisco Bay area, California, during two contrasting events sampled at more than 20 locations in the winter of 2023. The observed range in δ18O in the rain samples is similar for both storms. However, the distributions do not overlap—the mean air temperature and δ18O during Winter Storm Olive (February 2023) were 2°C and − 12‰, respectively, while a warm atmospheric river event (March 2023) had a mean temperature of 9°C and δ18O of −6‰, close to the long‐term average δ18O measured in local precipitation. The Winter Storm showed expected trends in δ18O related to geography (i.e., lower with greater distance inland and elevation), while the atmospheric river δ18O pattern was more spatially uniform. We use hydrometric data from a gaged watershed in the study area and isotopic signatures of rain sampled during the two storm events and apply a solute transport model (StorAge selection) with a travel‐time approach to examine predicted watershed responses and potential water tracing applications. In this virtual experiment, we find that event size exerts a strong control on the relative amounts of runoff versus pre‐event water in the stream, while uncertainty in stream hydrograph separation is related to the degree of contrast between precipitation/runoff and pre‐event water. Key to flood prediction, adaptation, and mitigation, especially in coastal urban areas, is knowledge of the contributing water sources and timing of stream flow. The strong contrast in stable isotopes between these two events, close in time and over the same area, illustrates the potential to use stable isotope signatures to track the transport and mixing of events through natural and engineered watersheds that are threatened by climate whiplash events.
Experiences of loneliness and social isolation among young people with chronic physical conditions: A thematic synthesis of qualitative studies
Authors: Miao Yifan , Jasim Nibras , Guha Chandana , Sluiter Amanda , Owen Katherine B. , Yudianto Benedicta , Lim Michelle H. , Smith Ben J. , Manera Karine
Published: November 2024

Introduction

Young people with chronic health conditions are among the most at risk of having poor social connections, however, little is known about their experiences of loneliness and social isolation. We aimed to describe the perspectives and experiences of loneliness and social isolation among young people with chronic physical conditions.

Methods

We searched MEDLINE, Embase, PsycINFO, CINAHL, and CENTRAL from inception to May 2023 for qualitative studies that described the perspectives of loneliness and social isolation in young people aged 10–24 years with chronic physical conditions. Findings from the included studies were analyzed using thematic synthesis.

Results

We included 35 studies across 12 countries involving 723 participants (56% female). Most studies (63%) were conducted in young people with cancer. Four major themes were identified: suffering from repercussions of disease (struggling with body image and physical changes, intensified disconnection while hospitalized); hindering relationships with peers and friends (missing out on formative experiences, feeling stuck behind, restrictive parental attitudes); grappling with social exclusion (facing concerns alone, bullying and ostracism); seeking social support and self‐help (reliance on family, kindness and empathy from friends, developing rapport with healthcare professionals, discovering self in adversity).

Conclusions

Symptoms, treatments, and hospitalizations limited young people's social participation and ability to maintain friendships, and this was compounded by social exclusion and bullying. Supportive friends, family, and healthcare professionals helped mitigate feelings of isolation. Interventions and strategies are needed to improve social support and foster meaningful connections. This can be achieved through education and awareness initiatives that promote inclusion in schools and the community, as well as efforts to enhance social support and continuity of care in hospitals.
The Value of Ultrasonography in the Diagnosis of Abdominal Pregnancy
Authors: Zhu Hongyan , Zong Zhen , Gao Feng
Published: November 2024

Objectives

Analyze the clinical and ultrasound characteristics of 15 cases of abdominal pregnancy (AP) to improve the ultrasonography‐based diagnosis.

Methods

A retrospective research of AP patients from 2010 to 2021 with pathology was performed, clinical and ultrasound characteristics were analyzed and summarized.

Results

Fifteen cases of AP occurred in early pregnancy. Most cases of AP were implanted in the pelvic cavity, with a few on the greater omentum and diaphragm, etc. Eight cases showed mixed hyperechoic, four cases had gestational sacs, and three cases exhibited mixed hypoechoic.

Conclusion

Combined with the characteristics of AP, ultrasound can provide a valuable diagnosis.
Factors associated with the development of recurrent and contralateral Charcot neuroarthropathy in individuals with diabetes mellitus: A scoping review
Authors: Cheong Keet Yeng , Bergin Shan M. , Munteanu Shannon E. , Perrin Byron M. , Landorf Karl B.
Published: November 2024

Introduction

Charcot neuroarthropathy (CN) can result in fractures and dislocations of the foot and ankle in individuals with diabetes and neuropathy, leading to ulceration, amputation and a poor quality of life. Additional episodes of acute CN can lead to extended periods of physical and psychosocial distress. The aim of this scoping review was to identify and synthesise the evidence relating to factors associated with the development of recurrent and contralateral Charcot neuroarthropathy (CN) in individuals with diabetes.

Methods

A systematic search of four electronic databases was conducted from inception to February 06, 2023. All relevant study designs, except single case studies, that had been published in full in peer‐reviewed journals were included. Studies were excluded if they were not published in English and did not provide data on individuals with diabetes.

Results

The search identified two studies that investigated factors associated with the development of recurrent CN, but none that related to the development of contralateral CN. Ten factors were investigated for association with recurrent CN development: age, body mass index, diabetes type and duration, glycated haemoglobin, anatomical site affected, duration of offloading applied to treat the primary CN episode, use of pharmacological intervention, severity of neuropathy, and skin temperature. However, no significant associations were reported.

Conclusions

There is an alarming lack of evidence‐based findings in this research area to guide practice. Clearly, more research in the form of rigorous prospective studies is urgently required to identify risk factors for the development of recurrent and contralateral CN in individuals with diabetes.
Regulating Second‐Harmonic Generation in 2D Chiral Perovskites Through Achiral Organic Spacer Cation Alloying Strategy
Authors: Li Junzi , Guo Zhihang , Wang Meiting , Shao Yonghong , Chen Yi , Qin Yan , Zhang Wenjing , Wang Changshun , Jin Hao , Wang Luyang , He Tingchao
Published: November 2024

The inherent structural flexibility and chiroptical activity of 2D chiral perovskites make them promising for the nonlinear optical (NLO) application. A comprehensive understanding of the second‐harmonic generation (SHG) mechanism in 2D chiral perovskites is essential for developing NLO devices. However, the rational design of 2D chiral perovskite structures to regulate SHG properties remains challenging. Herein, to regulate SHG response, an achiral organic spacer cation alloying strategy is employed to construct a series of 2D chiral perovskites. Through the measurement of temperature‐dependent photoluminescence (PL) spectra, it is revealed that the material design strategy can effectively modulating self‐trapped exciton (STE) emission. More importantly, it is confirmed that there is a competitive relationship between STE emission and SHG in 2D chiral perovskites. Meanwhile, the microscopic imaging of circularly polarized‐SHG is demonstrated in chiral perovskites. This work will not only advance the understanding of the SHG mechanism in 2D chiral perovskites but also provide inspiration for the rational design and synthesis of perovskites for NLO devices.
Large Optical Nonlinearity Enhancement and All‐Optical Logic Gate Implementation in Silver‐Modified Violet Phosphorus
Authors: Xu Xiaodan , Cui Zexin , Yang Yifan , Zhang Yaqing , Li Qifan , Tong Lihua , Li Jun , Zhang Xinzheng , Wu Yanling
Published: November 2024

As the most stable allotrope of phosphorus, violet phosphorus (VP) has attracted extensive research in the field of all‐optical modulation due to its excellent broadband spatial self‐phase modulation (SSPM) effect. To better exploit the great potential of VP in nonlinear photonics devices, this work explores chemical doping method to artificially enhance the nonlinear optical response of VP. Herein, silver‐modified few‐layer VP (Ag‐VP) is constructed for SSPM experiments. In comparison to pristine VP, a significantly improved third‐order nonlinear susceptibility (χ(3)) and nonlinear optical response for Ag‐VP is obtained in visible light band, and the enhancement ratio increases with the increase of wavelength. Moreover, the excitation threshold of SSPM effect is also significantly reduced, with a reduction ratio up to 3.61. The enhanced nonlinear optical response is attributed to the improved light–matter interaction induced by impurity energy levels. By taking advantage of the outstanding SSPM effect of Ag‐VP, an all‐optical logic gate is designed to demonstrate “OR” logical information transmission. This work provides a new avenue for the design and application of energy‐saving and tunable nonlinear photonic devices in the future.
Parotidectomy Trends Toward Outpatient for Benign Disease
Authors: Prince Andrew D. P. , Oslin Kimberly , Smith Josh D. , Hershey Emma , Chionis Lisa , Allevato Michael , Chinn Steven B. , Prince Mark E. P.
Published: November 2024

Objective

We evaluate the safety of outpatient parotidectomy. We evaluate factors that lead to planned admission and compare costs. We evaluate trends toward outpatient, and the outcomes of switching admission status, total versus superficial approach, and ambulatory versus hospital site.

Study Design

Retrospective cohort study.

Setting

Single tertiary academic center.

Methods

Retrospective review of patients who underwent parotidectomy for benign tumors from 2018 to 2023.

Results

Of 370 parotidectomies performed, there were a planned 162 admissions and 208 outpatient procedures. A travel time > 60 minutes (odds ratio [OR] = 0.487, confidence interval [CI]: 0.296‐0.803, P = .005) and total parotidectomy (OR = 0.448, CI: 0.226‐0.89, P = .022) decreased the odds of a planned outpatient procedure. In a multivariable model, longer operative time increased the odds of switching to inpatient (n = 29, OR = 1.02, CI: 1.007‐1.033, P = .002) and drain placement decreased the odds of switching to outpatient (n = 15, OR = 0.035, CI: 0.004‐0.298, P = .002). There was no significant difference in surgical complications, phone calls, clinic visits, readmission rates, or recurrence between outpatient and inpatient. This remained true when comparing surgical facility and superficial versus total parotidectomy. After COVID was declared an emergency, there was a trend toward outpatient parotidectomy (72.7% vs 48.9%, P < .001), but no change in complication rates. At our institution, outpatient parotidectomy saved $3838 compared to overnight admission.

Conclusion

This study supports that outpatient parotidectomy is safe. This remained true for patients switching admission status, undergoing superficial or total parotidectomy, and having their operation at an ambulatory site. We demonstrate that institutions can safely increase outpatient parotidectomy rates and outpatient parotidectomy is cost effective.
Ancient and contemporary shellfish cultivation practices bolster bivalve communities and diversity‐biomass relationships
Authors: Cox Kieran D. , Davies Hailey L. , Millard‐Martin Ben , Black Morgan , Hessing‐Lewis Margot , Smith Nicole F. , Juanes Francis , Dudas Sarah E.
Published: November 2024

Marine ecosystems provide humans with access to nutritious food. The discussion surrounding the cultivation of intertidal resources currently focuses on recent decades, disregarding a robust history of complex social‐ecological interactions and environmental stewardship.

Here, we use the co‐occurrence of Indigenous clam gardens, shellfish aquaculture farms, and unmodified beaches along Canada's West Coast to test the hypothesis that two different resource management practices, one engineered over millennia and the other decades, bolster contemporary bivalve communities. We quantified the diversity, density and estimated biomass of the bivalve communities within 24 intertidal sites and evaluated the communities' association with the habitat's substrate composition, sediment characteristics and physical complexity. We examined these data using a combination of diversity indices, structural complexity metrics, non‐parametric multivariate statistics and supervised machine learning algorithms.

We show that both cultivation methods create distinct biological communities, with community composition proportional to how each cultivation practice alters the habitats' substrate, sediment and physical complexity. Increases in bivalve biomass were comparable across cultivation methods but varied considerably among taxa. We identify a previously undocumented correlation between bivalve biomass and species richness, which is highly influenced by habitat complexity.

Our work contributes to the mounting evidence that shellfish cultivation fosters ecologically diverse communities while enhancing food production. We propose that an ecosystem‐wide management approach that considers multiple bivalve species, ecological processes and socio‐cultural practices will elevate the conservation and cultivation of marine resources.

Read the free Plain Language Summary for this article on the Journal blog.
Diagnostic usefulness of 24‐h polysomnography for idiopathic hypersomnia co‐occurring with neurodevelopmental disorders: A case report
Authors: Kido Keisuke , Sugita Naoko , Murai Toshiya , Tachibana Naoko , Kubota Manabu
Published: November 2024

Background

Although central disorders of hypersomnolence (CDH) and attention‐deficit/hyperactivity disorder (ADHD) are frequently comorbid, they often remain underdiagnosed, leading to insufficient treatment and sociopsychological outcomes.

Case Presentation

Here, we present a case of a male in his late 20s with ADHD and autism spectrum disorder who exhibited symptoms suggestive of idiopathic hypersomnia (IH), a subtype of CDH. The patient experienced difficulty waking up and dropped out of university. Additionally, although methylphenidate extended‐release was prescribed, he often forgot to take his medication, resulting in difficulty waking up until late afternoon. No symptoms related to rapid eye movements sleep were observed. Considering the possibility of concurrent hypersomnia with neurodevelopmental disorders, we conducted 24‐h polysomnography (PSG). The results demonstrated total sleep time of 774.5 min (≥660 min). Together with other criteria, we diagnosed him as having IH. Following discharge and discussion with the patient, we provided sleep hygiene education for him, and he resumed day care attendance to establish a social routine.

Conclusion

In cases where hypersomnia may co‐occur with neurodevelopmental disorders, active utilization of 24‐h PSG enables detailed evaluation of sleep–wake patterns and behaviors, facilitating effective guidance on sleep hygiene and promoting improvements in social rhythms and sociability.
New Non‐Invasive Approach for a Woman With Dyssynergic Defecation Associated With Dyspareunia: A Case Report
Authors: Hady Doaa A. Abdel , Maqsoud Nehad M. Reda Abdel
Published: November 2024

Background

The pelvic floor muscles are a complicated muscular structure with three major functions: defecation, urination, and sexual function. Constipated patients rarely have sexual or urinary complaints. The objective of this case is to provide a new and successful therapy strategy for a patient with dyssynergic defection and dyspareunia.

Study Design

The case study below discusses physical therapy rehabilitation and the consequences for both current and future physical therapy programs of constipation caused by PFM dyssynergia and dyspareunia.

Case Description

A 22‐year‐old married nulliparous woman was referred by her urogynecologist for the management of PFM tightness, with the main complaints being pain during intercourse and chronic constipation. The diagnosis had been confirmed by MR defecography, which revealed puborectalis and external anal muscle tightness. Neuromuscular reeducation employing electromyography biofeedback, improved rectal sensation, intravagival massage, the application of an intermittent pneumatic compression belt on the abdominiopelvic region, and suprapubic water bag ultrasound therapy were among the pelvic floor rehabitation strategies.

Conclusion

The intermittent pneumatic compression belt and water bag ultrasound approach, combined with standard program rehabitation, was successfully used in patients with defection dyssynergia and dyspareunia. After 3 weeks, stool frequency decreased from once every 10 days to one bowel movement per week; a condition reported less bloating and stomach pain, as well as a pain rating of 5/10 during sexual activity and 0/10 immediately afterward; and FSFI increased from 15.1 to 19.1. After 12 weeks, stool frequency is three bowel movements per week, a condition has less bloating and stomach discomfort and rates pain as 1/10 during sexual activity and 0/10 immediately, and FSFI has risen from 15.1 to 25.1.
Asymmetric right ventricular myocardial work correlates with gold standard measurements of cardiac function in pulmonary hypertension
Authors: Diab Simone G. , Ebata Ryota , Mroczek Dariusz , Hui Wei , Remme Espen W. , Möller Thomas , Friedberg Mark K.
Published: November 2024

Right ventricular (RV) (dys)function determines outcomes in pulmonary hypertension (PH). We previously found that asymmetric RV myocardial work (MW) corresponds with inefficient RV function in experimental PH models. We therefore aimed to investigate regional distribution of RV MW and its correlation with catheter hemodynamics in children with PH. RV MW was calculated by longitudinal strain and simultaneous catheter pressure measurements in 14 patients with PH. Wasted MW was defined as the ratio of inappropriate myocardial lengthening to favorable shortening work. Segment‐wise and averaged MW and wasted MW were evaluated at baseline and during pulmonary vasodilation therapy with oxygen and nitric oxide, and their relationship to hemodynamic measurements was analyzed. We found that MW was higher for the lateral wall than the septum: 1013 ± 374 mmHg · % versus 532 ± 190 mmHg · % at baseline. Wasted MW ratio did not differ significantly between wall regions. Pulmonary vasodilators slightly reduced mean pulmonary artery pressure and was accompanied by a more symmetrical MW distribution. Averaged MW correlated with the rate of RV pressure development (dP/dt maximum) and decay (dP/dt minimum) at all conditions (p  0.047). The results suggest that MW contribute to, and may be used as a marker of, systolic and diastolic efficiency in the PH RV.
Factors Affecting Mother‐Infant Bonding in Women with Gestational Diabetes Mellitus: A Cross‐Sectional Study
Authors: Baykoca Jeni , Barry Eleanor , Benton Madeleine
Published: November 2024

Objective

To explore the impact of psychological and social factors on mother‐infant bonding in women with gestational diabetes mellitus (GDM) living in the United Kingdom.

Design

A cross‐sectional online survey study conducted between November 2022 and January 2023 administered to women who self‐reported current or past (within the previous 1 year) GDM.

Methods

The survey comprised demographic and validated self‐report measures for depression, anxiety, eating disorders, perceived social support, pregnancy and birth experience, and breastfeeding. Mother‐infant bonding was measures using the Maternal Antenatal Attachment Scale for women who were currently pregnant with GDM (antenatal) and the Maternal Postnatal Attachment Scale for women with past GDM (postnatal).

Results

N = 149 women (n = 37 antenatal, and n = 112 postnatal) completed the survey. Higher anxiety and depression symptoms and managing GDM using metformin and insulin were associated with poorer mother‐infant bonding for women in both antenatal and postnatal periods. Higher social support was associated with higher mother‐infant bonding scores in women in both the antenatal and postnatal period.

Conclusion

The experience of GDM may be amplifying the known risk factors for impaired mother‐infant bonding. Targeted psychological support for women with GDM may be necessary to ensure that their emotional well‐being is addressed as part of comprehensive perinatal care.
Exploring the Knowledge, Attitudes, and Practise of Healthy Eating Among Lactating Mothers in a Poor Rural Setting in North‐Western Ghana
Authors: Molle Mildred Naamwintome , Domapielle Maximillian Kolbe , Sumankuuro Joshua
Published: November 2024

Introduction

Recognised as one of the most effective ways to guarantee positive maternal and child health outcomes, optimal nutrition for lactating mothers has received significant attention and investment both globally and locally. Despite this recognition, studies on maternal and child nutrition in Ghana have revealed that adherence to prescribed healthy eating regimens among lactating mothers in deprived settings has not received adequate scholarly attention. Thus, this study explores lactating mothers knowledge, attitudes, and practices regarding healthy eating to better understand the barriers to optimal nutritional outcomes for mothers and children, especially when chronic poverty is widespread.

Methods

This was a case study to explore the knowledge, attitudes, and practise of healthy eating among lactating mothers in the Wa West District. Convenience and purposive sampling procedures were followed to select lactating mothers and healthcare providers, respectively. Semi‐structured interviews were used to collect the data. The data were analysed using Anderson's behavioural model. The model offers a comprehensive analysis of factors—predisposition, enabling factors, and need for care—potentially influencing lactating mothers' knowledge, attitudes, and practise of healthy eating.

Results

The findings show that while lactating mothers in the district were aware of the importance of optimal nutrition for their health and wellbeing; food insecurity and pervasive poverty limit their opportunities to adhere to a balanced eating regimen.

Conclusion

An integrated development approach is needed to expand and sustain awareness of the importance of optimal nutrition for maternal and child health, improve local food production, and promote household economic empowerment.