bluuebunny/crossref_metadata_2025 huggingface dataset:
Multi-Objective Optimization of the Dressing Parameters in Fine Cylindrical Grinding
Authors: Stefanova Aleksandrova Irina
Published: February 2019

The optimum conditions for dressing grinding wheels determined and recommended in the literature are valid only for particular types and tools of dressing and grinding. In this paper, an attempt has been made to optimize the dressing process parameters in fine cylindrical grinding. To define the optimum values of the dressing process variables (radial feed rate of diamond roller dresser frd , dressing speed ratio qd , dress-out time td , diamond roller dresser grit size/grinding wheel grit size ratio qg , type of synthetic diamonds and direction of dressing), a multi-objective optimization has been performed based on a genetic algorithm. In the capacity of the optimization parameter, a generalized geometric-mean utility function has been chosen, which appears to be a complex indicator characterizing the roughness and accuracy of the ground surface, the grinding wheel lifetime and the manufacturing net costs of the grinding operation. The optimization problem has been solved in the following sequence: 1) a model of the generalized utility function has been created reflecting the complex effect of the dressing system parameters; 2) the optimum conditions of uni-directional and counter-directional dressing of aluminium oxide grinding wheels by experimental diamond roller dressers of synthetic diamonds of АС32 and АС80 types and different grit size at which the generalized utility function has a maximum have been determined; 3) a Pareto optimum solution has been found (frd = 0.2 mm/min; qd = 0.8; td = 4.65 s; qg = 2.56), which guarantees the best combination between the roughness and the deviation from cylindricity of the ground surface, the grinding wheel lifetime and the manufacturing net costs of the grinding operation.
A Single-session Crisis Intervention Therapy Model for Emergency Psychiatry
Authors: Simpson Scott
Published: February 2019

Presentations for anxiety and depression constitute the fastest growing category of mental health diagnoses seen in emergency departments (EDs). Even non-psychiatric clinicians must be prepared to provide psychotherapeutic interventions for these patients, just as they might provide motivational interviewing for a patient with substance use disorders. This case report of an 18-year-old woman with suicidal ideation illustrates the practicality and utility of a brief, single-session, crisis intervention model that facilitated discharge from the ED. This report will help practitioners to apply this model in their own practice and identify patients who may require psychiatric hospitalization.
Early Identification of Central Retinal Artery Occlusion Using Point-of-care Ultrasound
Authors: Stoner-Duncan Ben , Morris Stephen
Published: February 2019

A 69-year-old woman with a history of untreated hypertension presented with acute-onset monocular vision loss. Initial workup was delayed due to lack of immediate specialty consultation and dilated funduscopic exam. Point-of-care ultrasound in the emergency department identified a small hyperechoic structure within the distal area of the central retinal artery; in conjunction with specialty ophthalmologic evaluation in a tertiary care center, the diagnosis of central retinal artery occlusion was made. The patient was admitted to the neurology service for stroke risk stratification and was discharged in stable condition with re-initiation of her antihypertensive medication regimen.
Emergent Treatment of Neuroleptic Malignant Syndrome Induced by Antipsychotic Monotherapy Using Dantrolene
Authors: Ngo Vivian , Guerrero Alfredo , Lanum David , Burgett-Moreno Michelle , Fenati Gregory , Barr Steven , Neeki Michael
Published: February 2019

Neuroleptic malignant syndrome (NMS) is a rare but potentially fatal complication resulting from neuroleptic drug therapy. Presentation of NMS can vary, and diagnosis relies primarily upon medical history and symptomatology. Due to the potential delay in diagnosis, emergency physicians should remain vigilant in recognizing the symptoms of NMS and be prepared to initiate immediate treatment following diagnosis. Dantrolene, which has been used for spasticity and malignant hyperthermia, has been reported as a potential treatment for NMS and led to off-label use for NMS. We report two cases of NMS induced by antipsychotic monotherapy for which dantrolene was administered.
Point-of-care Ultrasound Diagnosis of Pulmonary Embolism with Thrombus in Transit
Authors: Kahl Nicolas , Gabriel Christopher , Lahham Shadi , Thompson Maxwell , Hoonpongsimanont Wirachin
Published: February 2019

A 95-year-old female with a history of dementia and atrial fibrillation (not on anticoagulation) presented to the emergency department (ED) by ambulance from her skilled nursing facility due to hypoxia. Point-of-care ultrasound was performed, and showed evidence of a large mobile thrombus in the right ventricle on apical four-chamber view. Further evidence of associated right heart strain was seen on the corresponding parasternal short-axis view. These ultrasound findings in combination with the patient’s clinical presentation are diagnostic of acute pulmonary embolism with right heart strain. Point-of-care transthoracic cardiac ultrasound in the ED is an effective tool to promptly diagnose acute pulmonary embolism with right heart strain and thrombus in transit and guide further treatment.
Use of Emergency Department Extracorporeal Membrane Oxygenation for Treatment of Acute Necrotizing Myocarditis
Authors: Loner Carly , Crane Peter
Published: February 2019

We report a case of acute necrotizing eosinophilic myocarditis (ANEM) secondary to drug rash with eosinophilia and systemic symptoms (DRESS) related to administration of minocycline. Myocarditis is a rare complication of DRESS and can manifest as either a self-limited hypersensitivity myocarditis or as the frequently fatal ANEM. Due to the high morbidity and mortality caused by this disease, emergency physicians should be aware of the potential of ANEM in patients with history of DRESS and new-onset cardiac dysfunction. This case reviews the clinical presentation and management of ANEM and the potential role of extracorporeal membrane oxygenation use in the emergency department.
Abdominal Cerebrospinal Fluid Pseudocyst Diagnosed with Point-of-care Ultrasound
Authors: Guest Brittany , Merjanian Michael , Chiu Emily , Canders Caleb
Published: February 2019

Abdominal pseudocysts are rare complications of ventriculoperitoneal (VP) shunts characterized by accumulations of cerebrospinal fluid surrounded by fibrous layers in the intra-abdominal cavity or abdominal wall. We present a woman with bilateral VP shunts who presented with right-sided abdominal distension, pain, and tenderness and who was found to have an abdominal pseudocyst on point-of-care ultrasound and computed tomography. Given the potential to develop a secondary infection or VP shunt malfunction, it is important for emergency providers to consider intra-abdominal complications of VP shunts, including rare ones such as abdominal pseudocysts, in these patients who present with vague abdominal complaints.
Segmental Bone Loss of the Clavicle due to Fracture-Related Infection: A Multidisciplinary Challenge
Authors: Goormans Femke , Vranckx Jan , Herteleer Michiel , Onsea Jolien , Noppe Nathalie , Depypere Melissa , Nijs Stefaan , Metsemakers Willem-Jan
Published: February 2019

Abstract. As the surgical treatment of clavicular fractures is increasingly utilized in orthopedics, the number of related complications rises as well. We present a case of segmental bone loss of the clavicle due to fracture-related infection. Treatment was based on a multidisciplinary team approach, which was important for a successful outcome.
ENVIRONMENTAL TAXES AS THE INSTRUMENT OF ENVIRONMENTAL POLICY IN DEVELOPING COUNTRIES
Authors: Đorđević Marina , Ristić Milica
Published: February 2019

Many environmental and naturalresource problems, which have been solved indeveloped countries with the use of appropriateinstruments, are becoming increasingly common indeveloping countries. Due to poverty, theefficiency of conceiving environmental policiesand minimizing costs, are inherent issues of thesecountries. The aim of this paper is to highlight theimportance of environmental taxes in developingcountries, as environmental taxes are aninstrument of environmental policy that conveneswith the level of their development. Most countriestoday pay great attention to environmental taxes.However, in the tax systems of developingcountries, their significance is neglected. Weanalyzed 12 developing countries, which aremembers of the European Union, with thetendency to point out the benefits they could havefrom environmental taxes. A regression analysiswas applied on the data series for the period 2001-2016. The results of the model show that thegrowth of tax revenues from ecological taxesimplicitly increases the state allocation in the fieldof environmental protection.
Magnetic Resonance Imaging Parameters Selected for Optimal Visualization of the Occipitoatlantal Interspace
Authors: Hallgren Richard C. , Rowan Jacob J
Published: February 2019

Context

Disorders of the rectus capitis posterior minor (RCPm) muscles have been associated with chronic headache. Magnetic resonance (MR) imaging protocols currently used in clinical settings do not result in image sets that can be used to adequately visualize the integrity of occipitoatlantal structures or to definitively quantify time-dependent functional morphologic changes.

Objective

To develop an MR imaging protocol that provides the superior image quality needed to visualize occipitoatlantal soft tissue structures and quantify time-dependent pathologic changes.

Methods

Asymptomatic participants were recruited from the Michigan State University College of Osteopathic Medicine student body. Magnetic resonance imaging data were collected from each participant at enrollment and 2 weeks after enrollment using a 3T magnet. A conventional spin-echo pulse sequence was used to construct 24 axial, T1-weighted images with the following measurement parameters: repetition time, 467 milliseconds; echo time, 13.5 milliseconds; number of excitations, 4; slice thickness, 3.0 mm; and in-plane resolution, 0.625×0.625 mm. Image planes were aligned approximately perpendicular to the long axes of the RCPm muscles to facilitate the authors' ability to accurately draw regions of interest around the specific muscle boundaries. Cross-sectional area (CSA) of the right and left RCPm muscles was quantified for each participant at the 2 points in time. The null hypothesis was that there would be no significant difference between mean values of muscle CSA collected at enrollment and 2 weeks after enrollment for a given participant and a given side of his or her body.

Results

Thirteen participants were enrolled. No significant difference was found between mean values of either right or left RCPm muscle CSA for any of the participants measured at enrollment and 2 weeks after enrollment (all P>.05).

Conclusion

The protocol achieves the superior image quality necessary to compare the functional form of occipitoatlantal structures at progressive points in time.
Nelson-Denny Reading Test Scores as a Predictor of Student Success in Osteopathic Medical Education
Authors: Linsenmeyer Machelle , Ridpath Lance
Published: February 2019

Background

Reading skills are crucial in medical school, where students are expected to absorb an onslaught of new and complex material. Studies on reading assessment in osteopathic medical education are lacking.

Objective

To address gaps in the literature related to reading assessment and to investigate the correlation of the Nelson-Denny Reading Test with various performance indicators in osteopathic medical education.

Methods

The West Virginia School of Osteopathic Medicine administered the Nelson-Denny Reading Test to first- and second-year students between 2015 and 2017. Raw scores were translated into the percentile rank, scale score, grade equivalent score, and stanine score based on guidelines supplied with the Nelson-Denny Reading Test. These translated scores were compared with Medical College Admission Test (MCAT) scores, first- and second-year performance on course examinations, Comprehensive Osteopathic Medical Licensing Examination-USA (COMLEX-USA) Level 1 scores, and scores provided in a 2002 study by Haught and Walls.

Results

A total of 623 students took the first-year Nelson-Denny Reading Test, and 408 took both the first- and second-year Nelson-Denny Reading Test. Findings showed a large correlation between the Nelson-Denny Reading Test and the verbal reasoning section (r=0.56 for the class of 2020 and 0.46 for the class of 2021) of the old MCAT (before 2015) and the reasoning skills section (r=0.42 for the class of 2020 and 0.49 for the class of 2021) of the new MCAT (released in 2015). There were no correlations with first- and second-year course examination scores or COMLEX-USA Level 1 scores. The Nelson-Denny Reading Test scores reported by Haught and Walls for medical students and health professional students were slightly higher than those found for osteopathic medical students in this study.

Conclusion

The reasoning skills section of the new MCAT could serve as a good proxy for a reading test. There were no correlations between the Nelson-Denny Reading Test and performance in the first 2 years of medical school or COMLEX-USA Level 1 performance. Further research can strengthen the findings and determine whether correlations exist with clinical performance.
Death of a Fetus With Myeloproliferative Disorder and Trisomy 21
Authors: Prentice Danielle , Deiter Raymond , Stanley John
Published: February 2019

A 27-year-old woman, gravida 2, para 1, presented at 24 weeks gestation with an intrauterine death. She previously consulted with maternal-fetal medicine because of a high suspicion of trisomy 21 after abnormal maternal serum screen and cell-free DNA test results. The patient elected to have chromosomal analysis following the death of the fetus, which confirmed a trisomy 21 diagnosis. Placental pathologic findings suggested that the cause of fetal death was total occlusion of the major vessels due to the accumulation of myeloid precursor cells, a novel mechanism. This case report discusses the rare finding of myeloproliferative disorder as a cause of death of a fetus with trisomy 21.
Bacteriology Screening of Roasted and Raw Chicken Sold in Tripoli
Authors: Shubar Hend , Doro Basma , Ghalboun Aida , Hamed Azher S. Ben , Atewa Aisha M. , Saleem Aya F. Ben , Aboud Fadia B. , Ramadan Asma
Published: February 2019

Aims: This work was carried out to screen for the presence of bacteria in roasted chicken sold in the market, poultries shop and restaurants in Tripoli.

Study Design: A total of 25 roasted chicken and 25 raw chicken parts randomly collected from different selling points in Tripoli.

Place and Duration of Study: Microbiology laboratory in microbiology and immunology department in the faculty of pharmacy in university of Tripoli, January 2013 to September 2013.

Methodology: Bacteriologically examined using the standard microbiological method according to Based on the colonial morphological and biochemical test, the following bacteria species were isolated.

Results: Prevalence of Salmonella was higher in raw chicken samples (100%) compared to the roasted one (28%), E. coli was detected in both raw and roasted chicken (32%), whereas Shigella and E. coli O157:H7 were detected only in roasted chicken [(8%) and (24%)] respectively.

Conclusion: The study found that the raw chicken samples were more susceptible to bacterial contamination than the roasted chicken samples, therefore special strategies are needed to decrease the prevalence of bacterial pathogens in chicken samples present in Tripoli area. Therefore good handling/hygiene in processing and preheating of roasted chicken before consumption is recommended.
Evaluation of Education Policy Implementation in Vietnam
Authors: Hai Do Phu
Published: February 2019

The public policy evaluation receives the most concern from different public policy actors. The article is represented for the evaluation of education policy implementation in Vietnam. The implementation evaluation concentrated on the education policy objective and policy solutions and their instruments under the policy conditions which are the point of views of the political party and policy actors. As a result of the policy implementation evaluation, it supports for the policy change to enhance the implementation of education policy in Vietnam. Some of findings are really interesting for developing countries in the education policy such as choosing optimal policy solutions and appropriate policy instruments.
Forecasting the Future Farm Size in Grasscutter Production in Osun State, Nigeria: A Markov Chain Approach
Authors: Olatidoye M. S. , Kehinde A. D. , Alimi T.
Published: February 2019

Aim: The study investigated the prospects of increasing Grasscutter production and projecting the future farm size of its production in the study area. Specifically described socio-economi characteristics and some management practices of the respondents, assessed and predicted the pattern of change and the equilibrium farm size of the Grasscutter enterprise in the study area, examined the costs and returns to grasscutter production and examined the relationships between gross margin and some selected socio-economic characteristics.

Study Design: A simple random sampling technique was employed in selecting 60% of the total population of registered grasscutter farmers.

Place and Duration of Study: The study was carried out in Osun State, Nigeria between years 2016 and 2017.

Methodology: Primary data were collected through a well-structured questionnaire administration from the three agricultural zones in the State. Twenty four Grasscutter farmers each were randomly selected from each of the agricultural zones. Data were collected on demographics of grasscutter farmers, production activities in terms of inputs, outputs and their respective prices for the years 2016 and 2017. Data were analyzed through Descriptive statistics, Markov chain, Gross margin and Pearson r test of correlation.

Results: The study revealed that male respondents (85%) dominated Grasscutter production in the study area while the mean age of respondents was 43 years. Majority (97%) of the respondents had formal education with an average grassutter farming experience of 11 years while the mean flock size was 2.5 colonies. The gross margin results showed that grasscutter production had a profit margin of ₦11,333.33/respondent/month. The mean grasscutter farm size revealed an upward trend in farm size until the year 2025 and thereafter stabilizes at about 3.3 colonies of grasscutter farm size.  The correlation analysis showed significant relationship between gross margin and level of education and farming experience with r-values of 0.817 and 0.697 respectively. 

Conclusion: Grasscutter production, though in small scale, is profitable in the study area and the grasscutter farmers in the study area have great potential to boost local production
The Historical Perspective of Botnet Tools
Authors: Osagie Maxwell Scale Uwadia , Enagbonma Osatohanmwen , Inyang Amanda Iriagbonse
Published: February 2019

Bot as it is popularly called is an inherent attributes of botnet tool. Botnet is a group of malicious tools acting as an entity. Furthermore, history has it that the aim of what gave rise to botnet was the idea to simplify the method of message exchange within networking platform. However, this has led to several botnet tools ravaging the server environments in recent times. The working principle of these botnet tools is to get client systems that are vulnerable and thereafter, steal valuable credentials. This work is part of a comprehensive research work into botnet detection mechanism but, on this paper it primarily look at how botnet as threat tool began, the trend since inception and as well as few approaches that have been used to curb it.
Antibacterial Activity of Acacia nilotica Stem-Bark Fractions against Staphylococcus aureus and Escherichia coli
Authors: Jabaka R. D. , Manga S. B. , Daniel Attah, D. , Nuhu U. D.
Published: February 2019

Aims: This research was carried out to determine the antibacterial activity of Acacia nilotica stem bark extract and bioactive fractions against the test bacteria (Staphylococcus aureus and Escherichia coli).

Place and Duration of Study: Acacia nilotica was collected within Aliero town, Kebbi State, Nigeria between April and September, 2017.

Methodology: The crude and bioactive fractions were obtained using soxhlet extraction and column chromatographic method respectively. The qualitative phytochemical screening was conducted to detect the presence of some phytochemical constituents in the crude extract and fractions. The antibacterial activity was determined at various concentrations (10, 50, 100, 150 and 200 mg/ml) using disc diffusion method.

Results: The crude antibacterial activity indicated that ethanol extract showed higher activity than the n-hexane extract with 14.0±0.00 and 12.0±0.00 mm zones of inhibition compared with the control drug (10 µg Ciprofloxacin drug), which showed 14.0±0.00 and 13.0±0.00 mm zone of inhibition against the test bacteria. The MIC and MBC values determined for ethanol extracts against the test bacteria was 12.5 mg/ml and 25 mg/ml, while the MIC and MBC values obtained for n-hexane extracts were 25 and 50 mg/ml against the test bacteria. The bioactive fractions (Yellow, Purple and Blue Black Fractions) tested against the test bacteria showed higher activity compared with the crude extract. The phytochemical properties of the plant crude extract and the bioactive fractions indicated the presence of phenol, tannins, alkaloids, saponins, flavonoids, terpenoids, steroids and glycosides and  this attributed to the high antibacterial activities of 17.0±0.00 and 16.0±0.00 mm showed by the fractions against Staphylococcus aureus and 15.67± and 14.0±0.00 mm against Escherichia coli respectively.

Conclusion: Acacia nilotica crude extract and fractions exhibited antibacterial activity which was comparable to the standard drug ciprofloxacin. This validates the folkloric medicinal use of this plant by the indigenous people of Aliero, Kebbi State.
Sexual Experiences of Nursing Students and Its Correlates at the University of Benin Teaching Hospital, Benin City, Nigeria
Authors: Otakpor A. N. , Aina I. O.
Published: February 2019

Background: The sexual experiences of individuals impacts on their psychological well-being. The study determined the sexual experiences of student nurses at the University of Benin Teaching Hospital (UBTH), as well as other factors which may be contributory to the enjoyment of their sexual experience and psychological health.

Methods: The Sexual Experience Inventory (SEI) and the Index of Self-Esteem (ISE) were administered on the final year nursing students at the University of Benin Teaching Hospital.

Results: One hundred and twenty nine (129) nursing students participated. All participants were females; 123 (95.3%) were single, 84% of them were aged 21 to 28 years. Eighty seven (67.4%) were sexually active.

The desire for sexual satisfaction and religious teachings were the factors which determined the frequency of sexual activities in 39.1% and 36.8% of the respondents respectively. Among the sexually active, 47% had more than one sexual partner. The experience of orgasm was statistically related to the enjoyment of sexual activity (χ2=12.08, p=0.00) Circumcision was not found to be statistically important in the determination of sexual enjoyment in the respondents studied (χ2= 0.03, p=0.85). Both circumcision and sexual enjoyment did not significantly affect self-esteem.

Conclusion: Over half of the students in this study were sexually active with first intercourse occurring early between 17 to 22 years. Achievement of orgasm was important for sexual satisfaction and enjoyment however, the presence or absence of orgasm and circumcision did not affect the self-esteem of the students.
Differential Legal Protections for Biologics vs Small-Molecule Drugs in the US
Authors: Wouters Olivier J. , Vogel Matthew , Feldman William B. , Beall Reed F. , Kesselheim Aaron S. , Tu S. Sean
Published: November 2024

Importance

Biologics approved by the US Food and Drug Administration (FDA) receive 12 years of guaranteed protection from biosimilar competition compared with 5 years of protection from generic competition for new small-molecule drugs. Under the 2022 Inflation Reduction Act, biologics are exempt from selection for Medicare price negotiation for 11 years compared with 7 years for small-molecule drugs. Congress codified these differing legal protections on the premise that biologics require more time and resources to develop and have weaker patent protection, necessitating additional protections for manufacturers to recoup their development costs and generate adequate returns on investment.

Objective

To review empirical evidence from the US experience with biologics to analyze the assumptions underlying longer periods of market exclusivity and protection from price negotiation compared with small-molecule drugs.

Evidence Review

Recent data on development times, clinical trial success rates, research and development costs, patent protection, market exclusivity periods, revenues, and treatment costs of biologics vs small-molecule drugs were analyzed.

Findings

The FDA approved 599 new therapeutic agents from 2009-2023, of which 159 (27%) were biologics and 440 (73%) were small-molecule drugs. Median development times were 12.6 years (IQR, 10.6-15.3 years) for biologics vs 12.7 years (IQR, 10.2-15.5 years) for small-molecule drugs (P = .76). Biologics had higher clinical trial success rates at every phase of development. Median development costs were estimated to be $3.0 billion (IQR, $1.3 billion-$5.5 billion) for biologics and $2.1 billion (IQR, $1.3 billion-$3.7 billion) for small-molecule drugs (P = .39). Biologics were protected by a median of 14 patents (IQR, 5-24 patents) compared with 3 patents (IQR, 2-5 patents) for small-molecule drugs (P < .001). The median time to biosimilar competition was 20.3 years (IQR, 16.9-21.7 years) compared with 12.6 years (IQR, 12.5-13.5 years) for small-molecule drugs. Biologics achieved higher median peak revenues ($1.1 billion in year 13; IQR, $0.5 billion-$2.9 billion) than small-molecule drugs ($0.5 billion in year 8; IQR, $0.1 billion-$1.2 billion; P = .01) and had higher median revenues in each year following FDA approval. The median annual cost of treatment was $92 000 (IQR, $31 000-$357 000) for biologics and $33 000 (IQR, $4000-$177 000) for small-molecule drugs (P = .005).

Conclusions and Relevance

There is little evidence to support biologics having longer periods of market exclusivity or protection from negotiation. As a result of differential treatment, US law appears to overly reward the development of biologics relative to small-molecule drugs.
Medical Education’s Learning Opportunity
Authors: Grover Atul
Published: November 2024

This Viewpoint discusses the importance of teaching health policy to medical students so they can be informed on the everyday policy issues that patients may ask them about or for which their specialty societies may ask them to lobby.
Association of Severe Maternal Morbidity With Subsequent Birth
Authors: Tsamantioti Eleni , Sandström Anna , Lindblad Wollmann Charlotte , Snowden Jonathan M. , Razaz Neda
Published: November 2024

Importance

Women who experience severe maternal morbidity (SMM) might have lasting health issues, and the association of SMM with the probability of future reproductive intentions is unknown.

Objective

To examine the association between SMM in a first birth and the probability of a subsequent birth.

Design, Setting, and Participants

Retrospective, population-based cohort study conducted among 1 046 974 women in Sweden who had their first birth between 1999 and 2021.

Exposure

Overall SMM and SMM subtypes were identified among all deliveries at 22 weeks of gestation or later (including complications within 42 days of delivery) from the Swedish Medical Birth Register and National Patient Register.

Main Outcomes and Measures

All women with a recorded first delivery were followed up from 43 days postpartum until the first day of the last menstrual period of the second pregnancy that resulted in a birth (stillbirth or live birth) or until death, emigration, or end of follow-up on December 31, 2021. Multivariable Cox proportional hazards regression was used to estimate associations between SMM and time to subsequent birth with adjusted hazard ratios (aHRs). Sibling analysis was performed to evaluate potential genetic and familial confounding.

Results

A total of 36 790 women (3.5%) experienced an SMM condition in their first birth. Women with any SMM had a lower incidence rate of subsequent birth compared with those without SMM in their first delivery (136.6 vs 182.4 per 1000 person-years), with an aHR of 0.88 (95% CI, 0.87-0.89). The probability of subsequent birth was substantially lower among women with severe uterine rupture (aHR, 0.48; 95% CI, 0.27-0.85), cardiac complications (aHR, 0.49; 95% CI, 0.41-0.58), cerebrovascular accident (aHR, 0.60; 95% CI, 0.50-0.73), and severe mental health conditions (aHR, 0.48; 95% CI, 0.44-0.53) in their first birth. The associations were not influenced by familial confounding as indicated by sibling analyses.

Conclusions and Relevance

Our findings suggest that women who experience SMM in their first birth are less likely to have a subsequent birth. Adequate reproductive counseling and enhancing antenatal care are crucial for women with a history of SMM.
COVID-19 Vaccine Reactogenicity Among Young Children
Authors: Madni Sabrina A. , Strickland Kieauna , Konrad Victoria , Zauche Lauren Head , Olson Christine K. , Sharma Andrea J.
Published: November 2024

This cross-sectional study examines reactogenicity among children of participants in the Centers for Disease Control and Prevention COVID-19 Vaccine Pregnancy Registry from November 2022 to September 2023 to understand the frequency and types of reactions experienced.
Psychiatric Comorbidities in Persons With Epilepsy Compared With Persons Without Epilepsy
Authors: Kwon Churl-Su , Rafati Ali , Ottman Ruth , Christensen Jakob , Kanner Andres M. , Jetté Nathalie , Newton Charles R.
Published: November 2024

Importance

Several psychiatric disorders have been found to occur more frequently in persons with epilepsy (PWE) than in persons without epilepsy.

Objective

To summarize the prevalence of 20 psychiatric disorders in PWE compared with persons without epilepsy.

Data Sources

The search included records from inception to February 2024 in Ovid, MEDLINE, Embase, and PsycINFO.

Study Selection

Published epidemiological studies examining the prevalence of psychiatric disorders among PWE compared with persons without epilepsy were systematically reviewed. There were no restrictions on language or publication date.

Data Extraction and Synthesis

Abstracts were reviewed in duplicate, and data were extracted using a standardized electronic form. Descriptive statistics and meta-analyses are presented.

Main Outcomes and Measures

Data were recorded on the prevalence of 20 psychiatric disorders among PWE compared with persons without epilepsy. Meta-analyses were performed along with descriptive analyses.

Results

The systematic search identified 10 392 studies, 27 of which met eligibility criteria. The meta-analyses included 565 443 PWE and 13 434 208 persons without epilepsy. The odds of most psychiatric disorders studied were significantly increased in PWE compared with those without epilepsy, including anxiety (odds ratio [OR], 2.11; 95% CI, 1.73-2.58); depression (OR, 2.45; 95% CI, 1.94-3.09); bipolar disorder (OR, 3.12; 95% CI, 2.23-4.36); suicidal ideation (OR, 2.25; 95% CI, 1.75-2.88) but not suicide attempt (OR, 3.17; 95% CI, 0.49-20.46); psychotic disorder (OR, 3.98; 95% CI, 2.57-6.15); schizophrenia (OR, 3.72; 95% CI, 2.44-5.67); obsessive-compulsive disorder (OR, 2.71; 95% CI, 1.76-4.15); posttraumatic stress disorder (OR, 1.76; 95% CI, 1.14-2.73); eating disorders (OR, 1.87; 95% CI, 1.73-2.01); alcohol misuse (OR, 3.64; 95% CI, 2.27-5.83) and alcohol dependence (OR, 4.94; 95% CI, 3.50-6.96) but not alcohol abuse (OR, 2.10; 95% CI, 0.60-7.37); substance use disorder (OR, 2.75; 95% CI, 1.61-4.72); autism spectrum disorder (OR, 10.67; 95% CI, 6.35-17.91); and attention-deficit/hyperactivity disorder (OR, 3.93; 95% CI, 3.80-4.08).

Conclusions and Relevance

In this comprehensive study, most psychiatric comorbidities examined were significantly more prevalent in PWE than in those without epilepsy. These findings show the high burden of psychiatric comorbidities in PWE. This, in turn, underscores the need for appropriately identifying and treating psychiatric comorbidity in epilepsy to manage patients effectively and improve quality of life.
Incidence of Side Effects Associated With Acetaminophen in People Aged 65 Years or More: A Prospective Cohort Study Using Data From the Clinical Practice Research Datalink
Authors: Kaur Jaspreet , Nakafero Georgina , Abhishek Abhishek , Mallen Christian , Doherty Michael , Zhang Weiya
Published: November 2024

Objective

The main objective of this study is to examine the safety of oral acetaminophen at its therapeutic dose in adults aged ≥65 years.

Methods

This population‐based cohort study used the Clinical Practice Research Datalink‐Gold data. Participants were aged ≥65 years registered with a UK general practice for at least 12 months between 1998 and 2018. Acetaminophen exposure was defined as at least two acetaminophen prescriptions within six months of the first acetaminophen prescription, the first prescription date being the index date. Acetaminophen nonexposure was defined as the absence of two acetaminophen prescriptions within six months over the study period. We calculated propensity score (PS) for acetaminophen prescription and undertook inverse probability treatment weighting using PS and PS‐matched analyses to account for confounding. Missing data were handled using multiple imputation. The adjusted hazard ratio (aHR) and 95% confidence interval (95% CI) were calculated using the Cox proportional hazards regression model.

Results

In total, 180,483 acetaminophen exposed and 402,478 unexposed participants were included in this study. Acetaminophen exposure was associated with an increased risk of perforation or ulceration or bleeding (aHR 1.24; 95% CI 1.16–1.34), uncomplicated peptic ulcers (aHR 1.20; 95% CI 1.10–1.31), lower gastrointestinal bleeding (aHR 1.36; 95% CI 1.29–1.46), heart failure (aHR 1.09; 95% CI 1.06–1.13), hypertension (aHR 1.07; 95% CI 1.04–1.11), and chronic kidney disease (aHR 1.19; 95% CI 1.13–1.24).

Conclusion

Despite its perceived safety, acetaminophen is associated with several serious complications. Given its minimal analgesic effectiveness, acetaminophen as the first‐line oral analgesic option for long‐term conditions in older people requires careful reconsideration.

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Restoring Plasticity in Nickel‐Based Superalloy Using High‐Density Pulsed Electric Current
Authors: Yan Xinming , Gu Shaojie , Yoon Sungmin , Kimura Yasuhiro , Kobayashi Daisuke , Ju Yang , Toku Yuhki
Published: November 2024

This study explores the efficacy of high‐density pulsed electric current (HDPEC) in healing plastic deformation damage in single‐crystal Ni‐based superalloys. Single‐crystal specimens are prepared from directionally solidified nickel‐based superalloy to assess the potential of electric current treatment in restoring plastic deformation capability. Experiments involving various current densities and pulse durations reveal that a pulsed electric current of 17 ms at 400 A mm−2 yields optimal results, enhancing fracture elongation from 7.8% to 12.3% without compromising strength. The study conducts a comprehensive analysis of microstructural changes induced by pulsed electric current, employing quasi‐in‐situ electron backscatter diffraction and transmission electron microscopy techniques. The results demonstrate that HDPEC disrupts the planar dislocation network, homogenizes dislocation distribution, and promotes dislocation entanglement. Consequently, microdefects in the alloy are eliminated, restoring the material's ductility. The findings suggest that this technology holds significant promise for repairing fatigued components and underscore the potential for further research in this domain.
2D Ferroelectric Metal–Organic Frameworks for Ultralow Power Field Effect Transistors
Authors: Xian Zhenhui , Li Changjian , Dong Yangda , Peng Mengping , Yu Ye , Zhang Yuan , Huang Boyuan , Zhong Gaokuo , Xie Shuhong , Li Jiangyu
Published: November 2024

2D ferroelectrics open a new realm of nonvolatile memory and computing devices, while metal–organic frameworks (MOF) offer tremendous possibilities to design and optimize ferroelectric performance. Integrating a MOF ferroelectric gate with a semiconducting channel provides new strategy toward ultralow power ferroelectric field effect transistors (FeFETs), yet no 2D MOF is experimentally demonstrated to be ferroelectric yet. Here, the study successfully develops 2D ferroelectric MOF nanosheets, {CuL2(H2O)2(NO3)2(H2O)1.5·(CH3OH)}∞ wherein L denotes PhPO(NH4Py)2, abbreviated as {CuIIL2}n‐MOF, and confirm its ferroelectricity down to 7 nm thickness. A large polarization of ≈14.2 µC cm−2, small coercive field of ≈33.3 V µm−1, and excellent endurability >106 cycles are found in 2D {CuIIL2}n‐MOF nanosheets. This enables to fabricate FeFETs using 2D {CuIIL2}n‐MOF as the gate and MoS2 as the channel, achieving an on/off ratio of 107 with ultralow off‐state current of 100 fA and tunable memory window, making it exceptional among known FeFETs and very promising for next‐generation ultralow power memories and computing devices
Synergistic Fe/Fe3C@Fe‐NC@Carbon Nanotube Heterostructure for Enhanced CO2 Capture and Mineral Recovery from Desalination Brine
Authors: Vo Truong‐Giang , Ng Yan‐Ting , Thangasamy Pitchai , Xi Shibo , Venkatramanan Raghunath , Shiong Simon Choo Sze , Gao Jiajian , Liu Yan
Published: November 2024

Metal recovery coupled with CO2 mineralization from sustainable sources, such as seawater, has garnered significant attention from environmental science and resource utilization perspectives. Herein, an earth‐abundant and efficient Fe/Fe3C@Fe‐N‐codoped carbon@carbon nanotube (Fe/Fe3C@Fe‐NC@CNT) hybrid cathodic catalyst is introduced for electrochemically extracting magnesium and calcium from desalination brine while capturing CO2 to produce valuable Mg(OH)2 and CaCO3. The Fe/Fe3C@Fe‐NC@CNT, featuring the combination of single‐atomic Fe sites and graphitic layer‐wrapped Fe/Fe3C nanoparticles encapsulated within N‐doped mesoporous carbon tubes, achieves over 90% of Ca2+ and Mg2+ metal cations recovery efficiency at 25 mA cm−2 for 6 h. More importantly, the Fe/Fe3C@Fe‐NC@CNT hybrid catalyst efficiently suppresses the competitive hydrogen evolution side reaction even at high currents and boasts a wider operating potential range compared to benchmark Pt/C, enhancing the metal recovery efficiency and CO2 capture capability. These findings underscore the potential of the Fe/Fe3C@Fe‐NC@CNT hybrid catalyst in revolutionizing brine management and waste stream handling, offering a promising and sustainable solution to these critical environmental challenges.
Quantitative Identification of Dopant Occupation in Li‐Rich Cathodes
Authors: Wu Tianhao , Zhang Xu , Li Yuqiang , Du Haozhe , Liu Tongchao , Yang Yubo , Zhang Zihe , Liu Xiaosong , Huang Qingzhen , Ren Yang , Qu Jiangtao , Zhao Shu , Wang Boya , Zheng Rongkun , Amine Khalil , Yu Haijun
Published: November 2024

Elemental doping is widely used to improve the performance of cathode materials in lithium‐ion batteries. However, macroscopic/statistical investigation on how doping sites are distributed in the material lattice, despite being a key prerequisite for understanding and manipulating the doping effect, has not been effectively established. Herein, to solve this predicament, a universal strategy is proposed to quantitatively identify the locations of Al and Mg dopants in lithium‐rich layered oxides (LLOs). Solid evidence confirms that Al prefers to occupy the transition metal (TM) layer, while Mg evenly occupies both TM and Li layers. As a result, Mg significantly reduces the thickness of LiO2 slabs at room temperature, which will increase the energy barrier of oxygen activation and enhance the structure stability of LLOs. The suppressed oxygen activity in Mg‐doped LLO can be kinetically unlocked at 55 °C. The different characteristics of Al and Mg enlighten an Al/Mg co‐doping strategy to optimize LLOs, which significantly improves the cycle performance while lifting the capacity. These insights from the quantitative identification of doping sites shed light on the manipulation of doping effects toward better cathodes.
Quantification of Interfacial Charges in Multilayered Nanocapacitors by Operando Electron Holography
Authors: Zhang Leifeng , Raza Muhammad Hamid , Wu Rong , Gruel Kilian , Dubourdieu Catherine , Hÿtch Martin , Gatel Christophe
Published: November 2024

Interfaces in heterostructures play a major role in the functionality of electronic devices. Phenomena such as charge trapping/detrapping at interfaces under electric field affect the dynamics of metal/oxide/metal capacitors and metal/oxide/semiconductor transistors used for memory and logic applications. Charge traps are also key for the stabilization of a ferroelectric polarization and its ability to switch in ferroelectric devices such as ferroelectric tunnel junctions (FTJs). However, electric‐field induced charging phenomena remain unclear even in conventional dielectric heterostructures due to a lack of direct measurement methods. Here, it is shown how operando off‐axis electron holography can be used to quantify the charges trapped at the dielectric/dielectric interfaces as well as metal/dielectric interfaces in HfO2‐ and Al2O3‐based nanocapacitors. By mapping the electrostatic potential at sub‐nanometer spatial resolution while applying a bias, it is demonstrated that these interfaces present a high density of trapped charges, which strongly influence the electric field distribution within the device. The unprecedented sensitivity of the electron holography experiments coupled with numerical simulations highlights for the first time the linear relationship between the trapped charges at each interface and the applied bias, and the effect of the trapped charges on the local electrical behavior.
Vertical‐Structure Overcomes the Strain Limit of Stretchable Organic Electrochemical Transistors
Authors: Dai Shilei , Zhang Xinran , Liu Xu , Tian Xinyu , Cui Binbin , Pang Ivo , Luo Haixuan , Liu Dingyao , He Xuecheng , Chen Xiaonan , Zhang Junyao , Wang Zhongrui , Huang Jia , Zhang Shiming
Published: November 2024

Intrinsically stretchable organic electrochemical transistors (IS‐OECTs), utilizing organic mixed ionic‐electronic conductors (OMIECs) as their channel materials, have drawn great attention recently because of their potential to enable seamless integration between bioelectronic devices and living systems. However, the fabrication of IS‐OECTs presents challenges due to the limited availability of OMIEC materials that possess the desired combination of mechanical and electrical properties. In this work, 1) we report the first successful fabrication of a vertical intrinsically stretchable OECT (VIS‐OECT), achieved by using elastoadhesive electrodes; 2) we experimentally proved that vertical architecture can push the strain limit of an IS‐OECT from 20% to 50%; and 3) the above finding introduces an unconventional design concept: the strain limit of an IS‐OECT can surpass the intrinsic stretchability of the constituent OMIECs by employing vertical structure.
Ultrafast Symmetry Control in Photoexcited Quantum Dots
Authors: Guzelturk Burak , Portner Joshua , Ondry Justin , Ghanbarzadeh Samira , Tarantola Mia , Jeong Ahhyun , Field Thomas , Chandler Alicia M. , Wieman Eliza , Hopper Thomas R. , Watkins Nicolas E. , Yu Jin , Cheng Xinxin , Lin Ming‐Fu , Luo Duan , Kramer Patrick L. , Shen Xiaozhe , Reid Alexander H. , Borkiewicz Olaf , Ruett Uta , Zhang Xiaoyi , Lindenberg Aaron M. , Ma Jihong , Schaller Richard D. , Talapin Dmitri V. , Cotts Benjamin L.
Published: November 2024

Symmetry control is essential for realizing unconventional properties, such as ferroelectricity, nonlinear optical responses, and complex topological order, thus it holds promise for the design of emerging quantum and photonic systems. Nevertheless, fast and reversible control of symmetry in materials remains a challenge, especially for nanoscale systems. Here, reversible symmetry changes are unveiled in colloidal lead chalcogenide quantum dots on picosecond timescales. Using a combination of ultrafast electron diffraction and total X‐ray scattering, in conjunction with atomic‐scale structural modeling and first‐principles calculations, it is revealed that symmetry‐broken lead sulfide quantum dots restore to a centrosymmetric phase upon photoexcitation. The symmetry restoration is driven by photoexcited electronic carriers, which suppress lead off‐centering for about 100 ps. Furthermore, the change in symmetry is closely correlated with the electronic properties, and the bandgap transiently red‐shifts in the symmetry‐restored quantum dots. Overall, this study elucidates reversible symmetry changes in colloidal quantum dots, and more broadly defines a new methodology to optically control symmetry in nanoscale systems on ultrafast timescales.
Engineered Nickel–Iron Nitride Electrocatalyst for Industrial‐Scale Seawater Hydrogen Production
Authors: Hu Huashuai , Wang Xunlu , Zhang Zhaorui , Liu Jiahao , Yan Xiaohui , Wang Xiaoli , Wang Jiacheng , Attfield J. Paul , Yang Minghui
Published: November 2024

Seawater electrolysis under alkaline conditions is a crucial technology for sustainable hydrogen production. However, achieving the long‐term stability of the electrocatalyst remains a significant challenge. In this study, it is demonstrated that surface reconstruction of a transition metal nitride (TMN) can be used to develop a highly stable oxygen evolution reaction (OER) electrocatalyst. Rapid introduction of phosphate groups (PO43−) accelerates the in situ surface reconstruction of Ni3FeN, generating a catalyst, with a conductive nitride core and Cl−‐resistant hydroxide shell that demonstrates outstanding performance, maintaining stability for over 2500 h at 1 A cm−2 current density in alkaline seawater. In situ characterization and density functional theory (DFT) calculations reveal the dynamic evolution of active sites, providing insights into the mechanisms driving long‐term stability. This work not only introduces an efficient approach to TMN‐based catalyst design but also advances the development of durable electrocatalysts for industrial‐scale seawater hydrogen production.