bluuebunny/crossref_metadata_2025 huggingface dataset:
Case report on postpartum psychosis
Authors: Ekhar Deepti
Published: July 2023

Background: Postpartum psychosis is a dangerous mental health condition that can occur soon after giving birth. After giving delivery, it affects around 1 in 500 moms. Postpartum psychosis has a multifaceted cause. History of bipolar illness, previous pregnancy with postpartum psychosis, a family history of psychosis or bipolar disorder, a history of schizoaffective disorder or schizophrenia, and the withdrawal of psychiatric drugs during pregnancy are all risk factors. Aim : The purpose of this case report is to establish the first line of therapy for a woman who has been sent to a public mental health hospital for treatment of postpartum psychosis. Objective : To identify symptoms of postpartum psychosis early, provide treatment and prevent possible complications. Method : This case description’s knowledge was obtained through PubMed outlets, search hand, exploring college and personal libraries for research methodologies and case report texts, and engaging in or creating numerous case reports with experience. Result : The patient was taken psychopharmacological treatment with Antipsychotic drugs Aripiprazole along Benzodiazepines tab. Clonazepam with Anti-depressant tab. Nexito and for hypothyroidism tan. Northyx and psychosocial therapy, coping strategies, family therapy, yoga, cognitive behavioral therapy, and medication. After those symptoms were minimized. Conclusion : Clients attain excellent results with therapeutic management, adaptability, and family support. Following adequate psychophysiological treatment, the client responded positively, and all of the specified goals were progressively attained. Finally, the client was released and is now being watched.
Peripheral neuropathy in severe iron deficiency anemia: A case report
Authors: Paunikar Vaishali
Published: July 2023

Anemia is a global health problem that need medical attention. Iron deficiency anemia (IDA), in particular is the most common nutritional deficiency anemia prevalent in India. Iron essential for effective myelination of peripheral nervous system.1 Nerve conduction studies are one of the neurophysiological investigations that can quantitatively detect peripheral nerve dysfunction.2 In this case report, we present findings of nerve conduction studies performed on a case of severe iron deficiency anemia and the associated peripheral neurodeficit observed in the case study. Nerve conduction study (NCS) was performed in bilateral median and ulnar motor and sensory nerves. CMAP (compound muscle action potential) and SNAP(sensory nerve action potential) and motor and sensory NCV (nerve conduction velocity) was decreased and the distal latency was prolonged in both ulnar and median nerves. These observations indicate a sensorimotor demyelinating and axonal peripheral neuropathy in the patient due to iron deficiency.
Airway management in patients with cervical spine injury with a C-MAC Videolaryngoscope : A case report
Authors: Singh Akoijam Nikhil
Published: July 2023

Patients with cervical spine injuries pose a significant challenge to an anesthesiologist. The airway management of these patients involves movements of the cervical spine that may worsen pre-existing injury resulting in poor post-operative neurological outcomes. We present a case report of a patient with cervical spine injury posted for spinal fusion under general anaesthesia. Intubation of the patient was done with C-MAC videolaryngoscope (VDL) with manual inline stabilisation (MILS) after induction with intravenous anaesthetic agents. The perioperative haemodynamic parameters were found to be stable with statistically insignificant deviation from the baseline values. All patients were examined post operatively with no post-operative adverse events including bronchospasm, dysphagia, aspiration or any neurological deficits. We concluded that VDL assisted intubation has several advantages in the care of these patients.
Mixed infection of Entamoeba histolytica and Giardia lamblia in a pregnant woman: Case report
Authors: Chaudhari Kamlesh
Published: July 2023

Aim : The purpose of study is to find out the reasons why parasitic infection are more frequent in rural areas and particularly the pregnant woman. Introduction : Entamoeba histolytica is a major cause for morbidity worldwide, causing approximately 50 million cases of dysentery. Ameobiasis- a parasitic infection caused due to E. histolytica is ranked as third in death behind malaria and schistosomiasis. Giardia lamblia and Entamoeba histolytica are protozoan parasites. Method : A pregnant woman was enrolled in our field survey, DMIMS, Sawangi in July 2017. Saline Iodine wet mount method was used for microscopic examination and q PCR technique has been used for confirmation of result. Result and Conclusion : A woman was infected with both protozoa parasite. Microscopy gives negative result, but q PCR gives sensitive and accurate result about infection i.e. positive result for infection.
Nel regno della necessità
Authors: Caselli Gian Carlo
Published: July 2023

Il contributo di Gian Carlo Caselli riflette sul dibattito relativo all’art. 41 bis – recentemente alimentato dallo sciopero della fame portato avanti dall’anarchico Alfredo Cospito come forma di protesta –, ripercorrendone la genesi e analizzando, anche attraverso una ricostruzione storica, gli effetti prodotti dalla sua applicazione. A partire da queste premesse e da una riflessione sulla situazione attuale, viene così ribadita l’importanza strategica del 41 bis come strumento fondamentale per la lotta alla mafia.
Salud Mental Colectiva y Determinación Social: Posibilidades Paradigmáticas
Authors: Capella Manuel
Published: July 2023

En la presente revisión teórica exploro posibilidades para la construcción de un paradigma de salud mental colectiva. Lo hago tomando distancia de miradas positivistas, funcionalistas, biomédicas e individualistas, y subrayando el rol fundamental de procesos de determinación social comprendidos de forma crítica, intercultural y transdisciplinaria. El procedimiento supuso una revisión exploratoria de fuentes tituladas “salud mental colectiva” (2016-2021) y la inclusión de publicaciones clave adicionales. Los resultados señalan la importancia de teorizar la salud mental de forma compleja y dialéctica, contextualizar ecológicamente los sufrimientos, accionar estrategias de bienestar y procurar reflexividad permanente en torno a la interculturalidad y las relaciones de poder. Las posibilidades exploradas resaltan el aporte esencial de la epidemiología crítica latinoamericana, en diálogo constante con otros valiosos saberes. Desde dicha construcción dialógica, un paradigma de salud mental colectiva emerge como una potente alternativa para abordar sufrimientos mentales en el contexto de sistemas sociales que nos enferman.
Vulnerabilidade ao burnout em profissionais de saúde de um hospital público no norte de Moçambique
Authors: José Coutinho Maurício , Aliante Gildo , Abacar Mussa
Published: July 2023

Esta pesquisa avaliou a frequência de burnout em profissionais de saúde. Aplicou-se o Spanish Burnout Inventory e questionário de dados sociodemográficos e laborais a 300 profissionais de um hospital público da região norte de Moçambique, majoritariamente do sexo feminino (n = 165; 55%), com idades entre 24 a 59 anos. A análise estatística de dados indicou que 95 (31,6%) participantes apresentaram baixos níveis na ilusão pelo trabalho, 232 (77,3%), 216 (72%) e 68 (22,6%) altos níveis em desgaste psíquico, indolência e culpa, respetivamente. Quanto ao perfil, 44 (14,6%) da amostra enquadraram-se no perfil 1 e seis (2,0%) no perfil 2. Verificou-se associação positiva entre as variáveis sexo, trabalho em regime de turnos e especialidade com as dimensões indolência e desgaste psíquico. A implantação de políticas de atenção à saúde do trabalhador pode contribuir na redução da vulnerabilidade ao burnout e na melhoria de qualidade de vida destes profissionais.
Exploring the Relationship between EEG Features of Basic and Academic Emotions
Authors: Herradura Tita , Cordel Macario
Published: July 2023

This study aimed to explore the relationship between basic and academic emotions by analyzing their EEG patterns. Using MAHNOB-HCI (MH) and Academic Emotion (AE) datasets, we performed three experiments based on valence and discrete emotion models. Our analysis revealed no similarity between the valence of basic and academic emotion datasets. However, we found that three out of 84 features in the MH discrete emotion dataset had a statistically significant relationship with the AE frustration dataset, suggesting some commonality between basic and academic emotions, particularly in the case of frustration. We also used random forest (RF), multilayer perceptron (MLP), and support vector machine (SVM) models to validate our findings, with the RF model outperforming the others in terms of valence classification accuracy. Our study provides valuable insights into the relationship between basic and academic emotions and may inform future research in this area.
Studi Kasus Pemidanaan Terhadap Korporasi Yang Tidak Dituntut Dalam Tindak Pidana Kepabeanan Sebagaimana Diputus Dalam Putusan Pengadilan Negeri Sidoarjo Nomor 34/Pid.Sus/2019/Pn.Sda
Authors: Abdiel Widatha Nadhif , Suseno Sigid , Ramdhan Ajie
Published: July 2023

Pengurusan dokumen impor maupun ekspor yang dilakukan oleh Perusahaan Pengurusan Jasa Kepabenan rawan sekali terjadi pemalsuan terhadap dokumen impor maupun ekspor yang ada. Contohnya terjadi dalam Putusan Pengadilan Negero Sidoarjo Nomor 34/Pid.Sus/2019/PN.SDA dimana Perusahaan Pengurusan Jasa Kepabeanan yang tidak didakwakan oleh Jaksa Penuntut Umum dijatuhi pidana oleh Majelis Hakim Pengadilan Negeri Sidoarjo. Tujuan penelitian ini adalah untuk mengetahui apakah korporasi yang tidak dikawakan oleh Jaksa Penuntut Umum dapat dijatuhi pidana oleh Majelis Hakim. Metode penelitian yang digunakan dalam penulisan studi kasus ini adalah dengan melakukan pendekatan yuridis normatif mengkaji dan meneliti data sekunder beruoa bahan hukum primer yaitu KUHAP, Undang-Undang Nomor 17 Tahun 2006 tentang Kepabeanan, 34/Pid.Sus/2019/PN.SDA serta bahan hukum sekunder yaitu kepustakaan terkait untuk menganalisis putusan tersebut. Berdasarkan hasil penelitian ini, dapat disimpulkan bahwa penjatuhan pidana yang dijatuhkan oleh Majelis Hakim Pengadilan Negeri Sidoarjo kepada korporasi dalam putusan ini tidak sesuai dengan hukum acara pidana yang berlaku di Indonesia, karena korporasi dalam putusan ini tidak didakwakan oleh Jaksa Penuntut Umum.
Meningkatkan Kehandalan Safety dengan Menciptakan Alat Coupling Spool Pieces di Conventional Buoy Mooring IT Ampenan
Authors: Adhi Wicaksono Oscar , Bahroni Lutfi
Published: July 2023

Hose connect/disconnect activities to Manifold Tankers in the CBM area have a very high risk (spill overboard, fire, etc.). Therefore, one of the things that can be used as a solution is to create a tool called a Coupling Spool Piece which is made of stainless steel which is anti-rust, seawater resistant, not easily broken, and non-welded. It is designed with an ergonomic size and can be used as a rope tie hook. So that with the solution created, it is hoped that the quality of materials and materials will be more reliable and safety, save costs because they have succeeded in preventing fuel spills and reducing operational losses as well as the effectiveness of tanker operations, and can improve operational safety reliability
Pengaruh Bermain Game Online Terhadap Perilaku Komunikasi Siswa Kelas XII Jurursan Mipa SMA Negeri 1 Andong
Authors: Izdni Rahmawati Fina , Jabal Harjanti , Pratama Rizki
Published: July 2023

This study aims to determine and analyze the Effect of Online Game on Communication Behavior of Students SMA Negeri 1 Andong. This research is a quantitative study using primary data obtained from questionnaires and measured using a Likert scale. Data were analyzed using simple regression analysis. The population of this research is the XII grade field of mathematics and natural sciences students of SMA Negeri 1 Andong with a total of 300 students in which only 26% or 78 students were sampled for this study. The results of this study indicate that the online game have no effect on communication behavior.
Peran Otoritas Jasa Keuangan dalam Menangani Penawaran Pinjaman Uang Online Oleh Layanan Pendanaan Bersama Berbasis Teknologi Informasi (LPBBTI)
Authors: Natalia Wisung Aurelia , Aloysius Sukardan , M. Y. Jacob Yossie , Mauritsius Darius
Published: July 2023

Otoritas Jasa Keuangan adalah lembaga pengawas jasa keuangan yang mempunyai wewenang pengaturan, pengawasan, pemeriksaan dan penyidikan pada lembaga jasa keuangan termasuk pinjaman uang online oleh layanan pendanaan bersama berbasis teknologi informasi. penelitian ini bertujuan untuk mengetahui: (1) Bagaimana peran Otoritas Jasa Keuangan dalam menangani penawaran pinjaman uang online oleh layanan pendanaan bersama berbasis teknologi informasi (2) Upaya-upaya yang sudah dilakukan Otoritas Jasa Keuangan dalam menangani penawaran pinjaman uang secara online oleh layanan pendanaan bersama berbasis teknologi informasi. Penelitian yang digunakan adalah penelitian hukum normatif dengan menggunakan metode deskriptif analisis. Bahan hukum penelitian ini menggunakan bahan hukprimer, sekunder dan tersier. Hasil penelitian ini dapat disimpulkan: (1) Peran Otoritas Jasa Keuangan dalam menangani penawaran pinjaman uang secara online oleh layanan pendanaan bersama berbasis teknologi informasi adalah mengeluarkan regulasi untuk mengatur dan mengawasi. (2) Upaya-upaya yang sudah dilakukan Otoritas Jasa Keuangan dalam menangani penawaran pinjaman uang secara online oleh layanan pendanaan bersama berbasis teknologi informasi adalah melakukan edukasi,menghimbau masyarakat untuk selalu mengecek legalitas pinjaman online ketika menerima penawaran, mengeluarkan layanan baru guna meningkatkan perlindungan konsumen yaitu Consumer Support Technology (CST) berupa Chatbot CST dan Otoritas Jasa Keuangan bersama dengan 11 kementerian berkoordinasi membentuk Satgas Waspada Investasi (SWI) untuk memberantas pinjaman online ilegal yang meresahkan dan merugikan masyarakat.
Una lectura crítica comparada del discurso de la educación para el desarrollo económico: los informes del Banco Mundial como caso de estudio
Authors: Benitez Arenas Sayra
Published: July 2023

El análisis documental de las políticas educativas ofrece un panorama proclive para analizar comparativamente los fenómenos sociales y para comprender nuevas formas de configurar el poder. El análisis crítico del discurso aporta los elementos conceptuales y metodológicos que permiten acercarse a los análisis documentales con las herramientas necesarias para examinar las formas de representación y acción, y las estrategias discursivas que les subyacen. Estas herramientas metodológicas permiten analizar cinco informes de desarrollo mundial de finales de década que, por su calidad de textos típicos de la globalización, se seleccionaron como caso de estudio para reconocer las características discursivas que se ajustaron y permanecieron en las representaciones sobre la educación en el marco del desarrollo económico. El análisis del discurso de los respectivos informes permitió identificar los ajustes profundos, no solo sobre la concepción del desarrollo en los últimos cincuenta años, sino la función de la política educativa en dicho desarrollo. Se concluye que el análisis crítico del discurso es un enfoque que permite centrar la atención en las prácticas discursivas como prácticas sociales y, de manera particular, del diseño de una política en perspectiva histórica. La selección de textos hiper institucionalizados y de alta referencia política, como el Informe de desarrollo mundial, permitió abordar comparativamente su incidencia actual y en perspectiva histórica la fase del diseño de las políticas en el nivel global.
Optimal feature selection and detection of sickle cell anemia detection using enhanced whale optimization with clustering based boosted C5.0 algorithm for tribes of Nilgiris
Authors: C. Maria Sheeba  , K. Sarojini
Published: July 2023

Degradation of red blood cells (RBC) causes many diseases, like sickle cell anemia. Diagnosing this disease takes more time because peripheral blood samples must be examined under the microscope. Since the isolated RBC observation is subjective and high error rate leads to reduce the accuracy, the technology is needed to perform this approach. To fulfil these requirements, optimal feature selection and detection of sickle cell anemia using enhanced whale optimization with clustering based boosted C5.0 algorithm in tribes of Nilgiris is proposed in this manuscript. The input dataset is taken from real data set via non-government organization named NAWA (situated in Kotagiri). The reason behind of Nilgiri region is considered in this work is a collection of sickle cell anemia test results of the tribe people who lives in different areas of Nilgiri region. These images are pre-processed using wavelet packet transform cochlear filter bank method to eradicate the noises and to improve the superiority of image. After that, the features are extracted using force-invariant improved feature extraction method. To select the optimal features, enhanced whale optimization (EWO) algorithm is used. These optimal features are classified utilizing clustering based boosted C5.0 algorithm. The proposed method is activated on PYTHON. The proposed method shows 52.32%, 43.78%, 32.78% and 45.90% higher accuracy compared with the existing methods, such as RGSA-MLP-SCA, CRFA-SVM-SCA, AO-LSTM-SCA and BOA-CNN-SCA.
PANDEMI CORONA VIRUS (COVID 19) DALAM PERSPEKTIF BUDAYA LAMAHOLOT-FLORES TIMUR
Authors: Toron Yosef Masan
Published: July 2023

COVID -19 has been known as the most dangerous disease for human being. The COVID -19 virus started in Wuhan, China, at the end of 2019, and in short time became the health world wide issue. There are no countries in the world that are not influenced by such issue. Governments in different countries, including Indonesia have been triying to make different programmes to cope the issue. But until now, the issue about COVID -19 is still going on. The issue of COVID 19 for most of tribes in Indonesia is not merely a health issue. It is also understood as a socio-religiuos issue. The issue of COVID -19 has a close relationship with their faith on existence of the High Beeing, the spirits and ancestor . They do believe that all realities in the world comes into existence because of the power of God, guided by different spirits and ancestor. In such perspective of faith, different problems and black experiences including different kind of diseases are understood as the punishment of the High Beeing. Human being who come into existence by the creative power of the High Beeing, are supposed not faithfull enough in following the will of the High Beeing, the spirits and ancestor. Based on this religius faith, the High Beeing, the spirits and the ancestor must be invited and get involved in any inisitive to solve the problems. The Corona Virus 19 has become a very crucial experience for human being in all over the world. Facing such issue, the people of Lamaholot, who live in estern part of Flores Island, has practised different rites to overcome the issue. They do believe that by doing such rite in different places, they could make a kind of reconciliation with the High Beeing, the spirits and the ancestor that could make them free from all kind of the punishments.
MODERASI BERAGAMA DALAM PERSPEKTIF PRAGMATISME PEIRCE DAN IMPLIKASINYA BAGI PENDIDIK KEAGAMAAN KATOLIK
Authors: Bandur Hironimus
Published: July 2023

This paper seeks to answer the following three main questions. First, why is religious moderation being socialized intensively; second, how religious moderation is understood in the light of Charles Sander Peirce's philosophical pragmatism; and third, what are the implications of Peirce's thinking for the development of religious moderation for Catholic Education Teachers. To answer the questions referred to, the authors use library research. From the results of the analysis found the following answers. First, the socialization of religious moderation is carried out in the midst of the proliferation of chaotic religions, namely ethno-religiocentrism, island mentality, myopic understanding of religion towards humanity, radicalism in the world of education. Second, religious moderation inspired by Peirce's pragmatism refers to the balance between belief, investigation and meaning. Third, the implications of Peirce's pragmatism for the development of religious moderation in Catholic teachers is that the religioucity of Catholic teachers must uphold a balance between belief, investigation and its meanings for social transformation.
Evaluation of the Physiological Response of Ornamental Summer Season Annuals to Salinity Stress
Authors: Arzoo  , Dubey R. K. , Dubey Manisha , Deepika Ravi , Pant Kritika
Published: July 2023

Over the past several decades, the southwest zone of Punjab is encountering various problems such as waterlogging, high use of surface canal water for irrigation and swift rise in water demand lead to stagnation in saline zone due to salinity ingression. Due to salinization, most of crops failed to grow, therefore, identification of salt tolerant plants and to check the level of tolerance to salinity in order to prevent mortality plants in salt affected areas is highly required for environment sustainability. To understand these salinity issues, the present study was conducted at Punjab Agricultural University to screen four ornamental summer season annual species suitable for salt affected areas of Punjab. Selection of plant species was done on the basis of physiological changes in plant leaves. The one month old seedlings of four different annual species were grown in 8 inch earthen pots were exposed to five different concentrations of sodium chloride salinity stress (control, 30, 60, 90, and 120 mM). The factorial completely randomized block design was followed in the experiment with three replicates in each treatment. The physiological parameters viz., chlorophyll, carotenoid, relative leaf water content, electrolyte leakage and proline content were calculated to depict the salt tolerant ornamental summer season annual species. It has been concluded on the basis of physiological response, the maximum salt tolerance was observed in P. grandiflora followed by B. scoparia, T. erecta  and Z. elegans.
Efficacy of Jatropha curcas Leaf Extract on Some Isolates Associated with Surgical Wounds
Authors: Ikoyi Tobias Agada , Ashien Uju Uchenna , Bobzom Banyonga Saidu , Wilson Ime Aniema-Abasi , Aniefiok Akpabio Ukemeobong , Obi-Anyaorah Chidimma Rosemary
Published: July 2023

Aim: The aim of this study is to determine the antibacterial efficacy of Jatropha curcas leaf extract against some isolates associated with surgical wounds.

Study Design: This was a hospital-based study conducted in 2017 in the Department of medical microbiology unit of Bingham university teaching hospital and the national veterinary research institute (NVRI) both institutions are located in Jos Plateau State Nigeria.

Methodology: A total of twenty (20) isolates from clinical specimens of surgical wounds were used. The following bacteria were identified using biochemical analysis: Staphylococcus aureus (15), Pseudomonas aeruginosa (2), and Klebsiella pneumoniae (3). Using standard methods of ethanol and aqueous extraction techniques, the leaves of the Jatropha curcas were examined for phytochemical content. The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of the isolate were determined using the broth dilution method, while the antibacterial activity of the isolate was observed using the agar well diffusion techniques.

Results: The result of the phytochemical extraction shows the presence of the following Alkaloids (secondary metabolite) Saponins, Tannins, glycosides, Flavonoids, Oxalate, Terpenoids, Resins and steroids. The ethanol extract of Jatropha curcas exhibited antimicrobial activity against all the test bacteria with higher activity recorded with Staphylococcus aureus (15 mm) followed by Klebsiella pneumonia (12 mm) and Pseudomonas aeruginosa (10 mm). Aqueous extract of Jatropha curcas leaves did not exhibit significant antimicrobial activity against all the test isolates when compared to Ethanol Extraction However Aqueous extract of Jatropha curcas had a slight antimicrobial activity against only Staphylococcus aureus in the range of (5 mm to 7 mm). The MIC value for the ethanol extract of Jatropha curcas ranged from 100mg/ml to 200mg/ml while the MIC value for the aqueous extract was 200mg/ml. 

Conclusion: The result of the present study shows that the ethanol and aqueous extracts of Jatropha Curcas leaves possess some antibacterial activities. The ethanol extract had higher antimicrobial activity than the aqueous extract on surgical wounds. It could therefore be inferred that these leaves contain bioactive constituents which can effectively inhibit the growth of some microorganisms. The plant could be used as an alternative therapy in the treatment of surgical wounds.
State Public Insurance Coverage Policies and Postpartum Care Among Immigrants
Authors: Steenland Maria W. , Fabi Rachel E. , Bellerose Meghan , Desir Arielle , White Maggie S. , Wherry Laura R.
Published: July 2023

Importance

Professional medical organizations recommend that adults receive routine postpartum care. Yet, some states restrict public insurance coverage for undocumented immigrants and recently documented immigrants (those who received legal documentation status within the past 5 years).

Objective

To examine the association between public insurance coverage and postpartum care among low-income immigrants and the difference in receipt of postpartum care among immigrants relative to nonimmigrants.

Design, Setting, and Participants

A pooled, cross-sectional analysis was conducted using data from the Pregnancy Risk Assessment Monitoring System for 19 states and New York City including low-income adults with a live birth between 2012 and 2019.

Exposure

Giving birth in a state that offered public insurance coverage for postpartum care to recently documented or undocumented immigrants.

Main Outcomes and Measures

Self-reported receipt of postpartum care by the category of coverage offered (full coverage: states that offered publicly funded postpartum care regardless of immigration status; moderate coverage: states that offered publicly funded postpartum care to lawfully residing immigrants without a 5-year waiting period, but did not offer postpartum care to undocumented immigrants; no coverage: states that did not offer publicly funded postpartum care to lawfully present immigrants before 5 years of legal residence or to undocumented immigrants).

Results

The study included 72 981 low-income adults (20 971 immigrants [29%] and 52 010 nonimmigrants [71%]). Of the 19 included states and New York City, 6 offered full coverage, 9 offered moderate coverage, and 4 offered no coverage; 1 state (Oregon) switched from offering moderate coverage to offering full coverage. Compared with the states that offered full coverage, receipt of postpartum care among immigrants was 7.0–percentage-points lower (95% CI, −10.6 to −3.4 percentage points) in the states that offered moderate coverage and 11.3–percentage-points lower (95% CI, −13.9 to −8.8 percentage points) in the states that offered no coverage. The differences in the receipt of postpartum care among immigrants relative to nonimmigrants were also associated with the coverage categories. Compared with the states that offered full coverage, there was a 3.3–percentage-point larger difference (95% CI, −5.3 to −1.4 percentage points) in the states that offered moderate coverage and a 7.7–percentage-point larger difference (95% CI, −10.3 to −5.0 percentage points) in the states that offered no coverage.

Conclusions and Relevance

Compared with states without insurance restrictions, immigrants living in states with public insurance restrictions were less likely to receive postpartum care. Restricting public insurance coverage may be an important policy-driven barrier to receipt of recommended pregnancy care and improved maternal health among immigrants.
Cu(III) Trifluoromethyl Complexes with 1,3‐Diketonate Ligands and Their Versatile Reactivity in C−H Trifluoromethylation
Authors: Motornov Vladimir , Klepetářová Blanka , Beier Petr
Published: July 2023

High‐valent Cu(III) trifluoromethyl complexes with 1,3‐diketonates as bidentate oxygen donor ligands LCu(III)(CF3)2 were prepared for the first time and fully characterized, including by X‐ray crystallography. These complexes are bench stable and soluble in most organic solvents. Promising reactivity of Cu(III) trifluoromethyl diketonates in radical and radical‐polar crossover trifluoromethylation reactions was demonstrated. Direct C−H trifluoromethylation of electron‐rich arenes and indoles using Cu(III) trifluoromethyl diketonates under blue light irradiation is described. Azolo‐ and oxy‐trifluoromethylation of terminal alkynes and S‐trifluoromethylation of aromatic thiol can be achieved using LCu(III)(CF3)2 in mild conditions.
Hypoiodite‐Catalyzed Oxidative α‐C−N Coupling of Ketones with Imides and Azoles
Authors: Tsukahara Mayuko , Uyanik Muhammet , Ishihara Kazuaki
Published: July 2023

Herein, we report a direct method for the synthesis of α‐imidoketones and α‐azolylketones via hypoiodite‐catalyzed oxidative α‐C−N coupling of ketones with the corresponding imides and azoles, respectively. The use of inorganic base additives such as cesium carbonate in the presence of 18‐crown‐6 as a phase transfer catalyst was crucial to induce high reactivity. Control experiments revealed that the basic additives might not only facilitate high‐turnover hypoiodite catalysis, but also be involved in the activation of coupling partners.
Prodromal dementia with Lewy bodies in REM sleep behavior disorder: A multicenter study
Authors: Joza Stephen , Hu Michele T. , Jung Ki‐Young , Kunz Dieter , Arnaldi Dario , Lee Jee‐Young , Ferini‐Strambi Luigi , Antelmi Elena , Sixel‐Döring Friederike , De Cock Valérie Cochen , Montplaisir Jacques Y. , Welch Jessica , Kim Han‐Joon , Bes Frederik , Mattioli Pietro , Woo Kyung Ah , Marelli Sara , Plazzi Giuseppe , Mollenhauer Brit , Pelletier Amelie , Razzaque Jamil , Sunwoo Jun‐Sang , Girtler Nicola , Trenkwalder Claudia , Gagnon Jean‐François , Postuma Ronald B. ,   for the International REM Sleep Behavior Disorder Study Group
Published: July 2023

INTRODUCTION

Isolated/idiopathic rapid eye movement sleep behavior disorder (iRBD) is a powerful early predictor of dementia with Lewy bodies (DLB) and Parkinson's disease (PD). This provides an opportunity to directly observe the evolution of prodromal DLB and to identify which cognitive variables are the strongest predictors of evolving dementia.

METHODS

IRBD participants (n = 754) from 10 centers of the International RBD Study Group underwent annual neuropsychological assessment. Competing risk regression analysis determined optimal predictors of dementia. Linear mixed‐effect models determined the annual progression of neuropsychological testing.

RESULTS

Reduced attention and executive function, particularly performance on the Trail Making Test Part B, were the strongest identifiers of early DLB. In phenoconverters, the onset of cognitive decline began up to 10 years prior to phenoconversion. Changes in verbal memory best differentiated between DLB and PD subtypes.

DISCUSSION

In iRBD, attention and executive dysfunction strongly predict dementia and begin declining several years prior to phenoconversion.

Highlights

Cognitive decline in iRBD begins up to 10 years prior to phenoconversion.

Attention and executive dysfunction are the strongest predictors of dementia in iRBD.

Decline in episodic memory best distinguished dementia‐first from parkinsonism‐first phenoconversion.
Palladium‐Catalyzed Arylation of Endocyclic 1‐Azaallyl Anions: Concise Synthesis of Unprotected Enantioenriched cis‐2,3‐Diarylpiperidines
Authors: Zhang Biao , Ruan Junhao , Seidel Daniel , Chen Weijie
Published: July 2023

Unprotected cis‐2,3‐diarylpiperidines are synthesized through an unprecedented palladium‐catalyzed cross‐coupling reaction between aryl halides and elusive endocyclic 1‐azaallyl anions. These intermediates are generated in situ by the deprotonation of 2‐aryl‐1‐piperideines, precursors that are readily prepared in two operations from simple piperidines. An asymmetric version of this reaction with (2R, 3R)‐iPr‐BI‐DIME as the ligand provides products in moderate to good yields and enantioselectivities. This study significantly expands the synthetic utility of endocyclic 1‐azaallyl anions.
Asymmetric Intramolecular Hydroalkylation of Internal Olefin with Cycloalkanone to Directly Access Polycyclic Systems
Authors: Wang Ai‐Fang , Tian Jin‐Miao , Zhao Xiao‐Jing , Li Zi‐Hao , Zhang Ye , Lu Ka , Wang Hong , Zhang Shu‐Yu , Tu Yong‐Qiang , Ding Tong‐Mei , Xie Yu‐Yang
Published: July 2023

An asymmetric intramolecular hydroalkylation of unactivated internal olefins with tethered cyclic ketones was realized by the cooperative catalysis of a newly designed chiral amine (SPD‐NH2) and PdII complex, providing straightforward access to either bridged or fused bicyclic systems containing three stereogenic centers with excellent enantioselectivity (up to 99 % ee) and diastereoselectivity (up to >20 : 1 dr). Notably, the bicyclic products could be conveniently transformed into a diverse range of key structures frequently found in bioactive terpenes, such as Δ6‐protoilludene, cracroson D, and vulgarisins. The steric hindrance between the Ar group of the SPD‐NH2 catalyst and the branched chain of the substrate, hydrogen‐bonding interactions between the N−H of the enamine motif and the C=O of the directing group MQ, and the counterion of the PdII complex were identified as key factors for excellent stereoinduction in this dual catalytic process by density functional theory calculations.
A high thermal stable pre‐oxidized polyacrylonitrile nanofiber separator for lithium‐ion battery
Authors: Huang Haitao , Yu Bin , Wang Xiaokuan
Published: July 2023

The separator as a main part of lithium‐ion batteries (LIBs) acts as a primary factor that affects the safety property of the battery. The pre‐oxidized PAN (OPAN) separator as an alternative separator with high temperature resistance was developed through the electrospinning of PAN by thermal stabilization. The prepared OPAN separator showed an exceptional dimensional thermal stabilization, without obvious dimensional shrinkage after treated in the oven at 300°C for 30 min, which improves the safety of LIBs at high temperatures. The OPAN separator had a high porosity and excellent affinity to the electrolyte, along with 351.3% of electrolyte uptake. Furthermore, the ionic conductivity and the interfacial resistance of OPAN separator were 1.63 mS/cm and 881 Ω, better than 0.65 mS/cm and 1463 Ω of commercial Celgard 2400 separator. In addition, the LiFePO4/Li battery assembled with OPAN separator given an outstanding initial discharge specific capacity and coulomb efficiency of 152.1 mAh/g and 97.9% and shown an excellent capacity retention ability of 92.3% after 100 cycles. The battery assembled with OPAN separator exhibits more excellent rate performance than PAN and Celgard 2400 separators at a charge current density of 0.2–3.0 C. It is believed that this excellent separator with such remarkable performances and low cost can be a promising separator candidate for safe LIBs.
hERG stereoselective modulation by mexiletine‐derived ureas: Molecular docking study, synthesis, and biological evaluation
Authors: Milani Gualtiero , Budriesi Roberta , Tavazzani Elisa , Cavalluzzi Maria Maddalena , Mattioli Laura Beatrice , Miniero Daniela Valeria , Delre Pietro , Belviso Benny Danilo , Denegri Marco , Cuocci Corrado , Rotondo Natalie Paola , De Palma Annalisa , Gualdani Roberta , Caliandro Rocco , Mangiatordi Giuseppe Felice , Kumawat Amit , Camilloni Carlo , Priori Silvia , Lentini Giovanni
Published: July 2023

Long QT syndrome (LQTS) is a disorder of cardiac electrophysiology resulting in life‐threatening arrhythmias; nowadays, only a few drugs are available for the management of LQTS. Focusing our attention on LQT2, one of the most common subtypes of LQTS caused by mutations in the human ether‐à‐go‐go‐related gene (hERG), in the present work, the stereoselectivity of the recently discovered mexiletine‐derived urea 8 was investigated on the hERG potassium channel. According to preliminary in silico predictions, in vitro studies revealed a stereoselective behavior, with the meso form showing the greatest hERG opening activity. In addition, functional studies on guinea pig isolated left atria, aorta, and ileum demonstrated that 8 does not present any cardiac or intestinal liability in our ex vivo studies. Due to its overall profile, (R,S)‐8 paves the way for the design and development of a new series of compounds potentially useful in the treatment of both congenital and drug‐induced forms of LQTS.
Herausforderungen in der Membranentwicklung für die Fruchtsaftklarfiltration – vom Labor in die Produktion
Authors: Haupt Alexander
Published: July 2023

Für die Schönung/Klarfiltration von Apfelsäften wird seit vielen Jahren eine Ultrafiltrations‐Polyethersulfon‐Rohrmembran erfolgreich verwendet. Diese findet bei der Filtration dunkler Fruchtsäfte keine Anwendung, da teilweise auch charakteristische Farbstoffe zurückgehalten werden. Um diesen Markt erschließen zu können, soll eine Rohrhülsenmembran auf PVDF‐Basis entwickelt werden, die dunkle Säfte nicht entfärbt, aber Trübstoffe zurückhält. Dabei werden die Schritte vom allgemeinen Verständnis der Fruchtsaftklarfiltration über Labortests, bis zu ersten Feldtests fertiger Membranmodule kurz beschrieben.
The Steady‐State ALTADENA RASER Generates Continuous NMR Signals
Authors: Yang Jing , Wang Peng , Korvink Jan G. , J. Brandner Jürgen , Lehmkuhl Sören
Published: July 2023

The front cover artwork is provided by Dr. Lehmkuhl's group at the Karlsruhe Institute of Technology. The image shows continuous NMR signals complemented by a simulated bifurcation diagram of a nonlinear RASER system. Read the full text of the Research Article at 10.1002/cphc.202300204.
Suboptimal Outcomes and Retreatment Rate of Patients With Crohn's Disease After Forced Discontinuation of Biologics: A Nationwide Population‐Based Study
Authors: Chen Nai‐Yu , Chuang Chiao‐Hsiung , Chang Yu‐Ching , Kao Yang Yea‐Huei , Chen Peng‐Hsu , Cheng Ching‐Lan
Published: July 2023

Taiwan's National Health Insurance (NHI) program forced discontinuation of biologic use in Crohn's disease (CD) after a limited treatment duration, regardless of disease activity. This study investigated the retreatment rate and suboptimal outcomes (i.e., CD‐related surgeries, hospitalizations, emergency room visits, and oral steroid flare‐ups) after forced discontinuation. This retrospective cohort study was conducted using data from the NHI Database. Patients who received ≥40 weeks of biologic treatment followed by a forced discontinuation were included. The time of biologic retreatment and the cumulative incidence of suboptimal outcomes after the forced discontinuation as well as related risk factors were analyzed. Included were 215 patients (68% male). At the beginning of biologic therapy, the mean age (±SD) was 35.7 (±13.5) years, and the disease duration was 4.46 (±3.52) years. The median (interquartile range) biologic treatment duration was 57.86 (50.3–83.3) weeks. Within the first year after forced discontinuation, 67% of patients (n = 144) were retreated with a second course of biologics, and 53% of patients (n = 114) experienced at least one suboptimal outcome. The independent risk factors associated with the occurrence of suboptimal outcomes were CD‐related emergency room visits and hospitalizations during biologic therapy (hazard ratio: 2.49; 95% confidence interval: 1.59–3.89). More than two‐thirds of patients with CD required biological retreatment within 1 year after a forced discontinuation. The substantial proportion of patients with poor disease outcomes highlights the need to continue the biologic.
Introducing Systems Thinking Techniques into an Undergraduate Engineering Education
Authors: Dano Eric B.
Published: July 2023

The world is faced with producing more complex, interdependent systems, and systems of systems. Due to the complexity and interdependencies, these systems do not lend themselves to the traditional reductionist approach, which is feasible only for complicated systems. To architect and develop complex systems requires the use of systems thinking tools and competencies which are an enabler for developing complex engineered systems, humanitarian systems, organizational structures, business strategies, production optimization, solving socio‐technical problems, etc. Because of the power of systems thinking and its global applicability, the question becomes; how can we better produce system thinkers? There are currently many effective systems thinking methods and tools which have been successfully adopted by practicing engineers. This paper will describe how we can introduce similar systems thinking elements into an existing undergraduate education through lectures/mentoring, labs/projects/experiments, case studies/background research, and multi‐discipline capstone projects/internships. Some universities have recently added systems thinking elements to their curricula, and through INCOSE's influence, the Accreditation Board for Engineering and Technology (ABET) now mandates systems thinking for all undergraduate engineering programs. This paper acts to describe a variety of implementation methods to serve as exemplars for those implementing systems thinking into existing curricula. The motivation of this work is to ultimately produce engineers who are better suited to engineering complex systems when they enter the workforce.
System Engineering Heuristics for Complex Systems
Authors: Beale Dean , McKinney Dorothy , Oosthuizen Rudolph , Smith Gary , Watson Michael D.
Published: July 2023

Complex systems are challenging for engineers. In considering the challenges in addressing complex problems as well as designing and developing complex systems, the INCOSE Complex Systems Working Group (CSWG) Heuristics Focus Team, in conjunction with the INCOSE Heuristics Team, has considered a range of systems engineering heuristics that guide the engineering of complex systems. These heuristics provide some initial insight for understanding the engineering of complex systems. This work aims to identify, develop, analyze and curate these heuristics and their potential use in dealing with complexity and developing complex systems. This paper concludes that a range of beneficial heuristics have been identified that cover the breadth of complex problems, as assessed from multiple perspectives. This initial or preliminary set of heuristics needs to be tested through practice and use across the INCOSE community before effort is expended to make them more memorable, either individually, or as a set.
From System Architecting to System Design and Optimization: A Link Between MBSE and MDAO
Authors: Bussemaker Jasper , Boggero Luca , Ciampa Pier Davide
Published: July 2023

Optimization of system architectures can help deal with finding better system architectures in a large design space plagued by combinatorial explosion of alternatives. To enable architecture optimization, the design space should therefore be formalized into a numerical optimization problem, and it should be possible to quantitatively evaluate architecture alternatives. This paper presents a methodology for generating and modeling architecture design spaces using the Architecture Design Space Graph (ADSG), and using collaborative Multidisciplinary Design Analysis and Optimization (MDAO) techniques to evaluate architectures. Collaborative MDAO leverages disciplinary expertise while ensuring that analysis tools exchange data consistently and correctly using a central data schema. The problem solved in this paper is the missing link between architecture optimization and collaborative MDAO: the reflection of generated architectures in the central data schema. It is solved by the authors by mapping architecture components and Quantities of Interest (QOIs) to the central data schema using Data Schema Operations (DSOs). Such a mapping also assists the user in identifying missing or unnecessary disciplinary analysis tools. Three web‐based software tools implementing the methodology are presented. Finally, the methodology and tools are demonstrated using the design of a supersonic business jet as an example.
Realizing the Promise of Digital Engineering: Planning, Implementing, and Evolving the Ecosystem
Authors: Schindel William D.
Published: July 2023

Gaining benefits of Digital Engineering is not only about implementing digital technologies. An ecosystem for innovation is a system of systems in its own right, only partly engineered, subject to risks and challenges of evolving socio‐technical systems. This paper summarizes an aid to planning, analyzing, implementing, and improving innovation ecosystems. Represented as a configurable model‐based Reference pattern used by collaborating INCOSE working groups, it was initially applied in targeted INCOSE case studies, and subsequently elaborated and applied to diverse commercial and defense ecosystems. Explicating the recurrent theme of Consistency Management underlying all historical engineering, it is revealing of Digital Engineering's special promise, and enhances understanding of historical as well as future engineering and life cycle management. It includes preparation of human and technical resources to effectively consume and exploit digital information assets, not just create them, capability enhancements over incremental release trains, and evolutionary steering using feedback and group learning.
Extracurricular projects ‐ Teaching Systems architecting in a limited time‐span
Authors: Kindem Håkon
Published: July 2023

University student projects experience high turnover, resulting in a loss of knowledge and experience. Turnover leads to increased project risk, development delays, and loss of institutional knowledge. These issues are particularly relevant for systems engineering teams as the discipline requires a broad range of competencies and expertise. This paper presents an experience report of a case study with results that suggest that it is possible to provide undergraduate students with a foundational body of SysEng knowledge using mission analysis as a learning platform. This activity can be completed within one semester and allows the undergrad students to continue learning independently.
Applying Model‐Based Systems Engineering Methods to a Novel Shared Systems Simulation Methodology
Authors: Ross Jeremy , Vinarcik Michael , Caron Christopher , Craft Christopher , Pien Stephen , Prajapati Ashishkumar
Published: July 2023

The need to develop increasingly complex, integrated systems and multi‐domain systems‐of‐systems is initiating a transformation within the discipline of systems engineering. The critical trends of increasing interconnectivity, compressed development times, growing cybersecurity concerns, and a rapidly changing workforce are driving current systems engineering practices into obsolescence. Model‐Based Systems Engineering (MBSE) is a formalized approach to systems engineering that uses models as an integral component of a system's technical definition with the objective of enhancing communication through rigor and precision and managing system complexity. This paper discusses the application of MBSE methods to the definition of a shared systems architecture and the development of novel methodologies for extending the model‐based approach from the system definition space into the system simulation and analysis domain. Approaches for interface management of design properties between a model‐based architecture and system simulation will be reviewed, with the effectiveness of each approach discussed.