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Rh-Catalyzed Asymmetric Hydrogenation of 3-Amino-4-alkyl/aryl Disubstituted Maleimides
Overlapping social structures behind Brazil’s cesarean section births: A decomposition analysis
Increasing cesarean section (CS) rates worldwide have prompted concern for women’s access to quality care and calls for interventions to reduce unnecessary and risky CS. Brazil, where CS births outnumber vaginal births, has one of the highest CS rates in the world. Brazil is also a large and diverse nation, and CS rates differ widely between race/ethnic groups, social classes, and geographic regions. Residential segregation by race/ethnicity and their associations with social class complicate the picture of how each contributes to CS rates and disparities. This article untangles the intersecting social and contextual factors to identify opportunities for interventions to reduce overall CS rates as well as disparities in Brazil. Using Brazil’s national birth registry data from 2019 (n = 2,567,039), this article quantifies how much socioeconomic, prenatal care, pregnancy risk, and geographic factors contribute to racial and ethnic disparities in CS. We applied the Karlson-Holm-Breen (KHB) decomposition method to multivariate logistic regression models. Our findings show that women’s individual risk factors—educational attainment, social status, age, prenatal care, and pregnancy profile—were significant contributors but did not entirely explain racial and ethnic disparities in CS. Geographic factors—where race/ethnic groups tended to live and the region’s risk for CS—also emerged as strong correlates of CS and partially explained unequal rates. The findings untangle the overlapping social structures that predispose some race and ethnic groups to a greater risk of CS and increase overall CS prevalence in Brazil.
A Nucleic Acid Prodrug That Activates Mitochondrial Respiration, Promotes Stress Resilience, and Prolongs Lifespan
Association of center-level operative volume and acute outcomes following robotic-assisted colectomy for colorectal cancer
Background The adoption of robotic-assisted colectomy (RAC) remains limited due to high costs. There is a paucity of data regarding the impact of institutional robotic experience on costs in patients undergoing RAC for colorectal cancer. Methods All adult patients undergoing RAC for colorectal cancer were identified using the 2016–2020 Nationwide Readmissions Database. A multivariable regression to model major adverse events (MAE) was developed with the inclusion of institutional robotic surgery volume as restricted cubic splines. The volume corresponding to the inflection point of the spline was used to stratify hospitals into high- (HVH) or low-volume (LVH). We subsequently examined the association of HVH status with costs, length of stay (LOS), MAE, non-home discharge and 30-day unplanned readmission. Results Among the 39,064 patients undergoing RAC, 65.2% were treated at HVH. Following risk adjustment, RAC at HVH was associated with reduced index hospitalization costs by $2,000 (95%CI $1,500−2,400) and LOS by 0.3 days (95%CI 0.2–0.5 days) as well as decreased odds of MAE (AOR 0.86, 95%CI 0.77–0.96). Both non-home discharge and 30-day unplanned readmission were not associated with hospital volume. In our cross-volume analysis, we found an increase in institutional RAC and overall robotic volumes to be associated with reduced odds of MAE. Conclusion The present study demonstrated higher institutional robotic-assisted operation volume to be associated with reduced MAE and cost in patients undergoing RAC. The findings suggest the potential benefits of increasing expertise and implementing efficient practices in robotic-assisted surgery programs.
Spin–Vibronic Coupling Enhanced Intersystem Crossing beyond El-Sayed Restrictions
The impact of higher education investment on the urban-rural income gap: An analysis of mediating and threshold effects based on data from China’s eight major comprehensive economic zones
Background Since the reform and opening up, China’s urban and rural economic development has exhibited characteristics of imbalance, with the urban-rural income gap being the largest and most noticeable issue facing China’s socio-economic landscape. Alleviating and effectively resolving the urban-rural income disparity is crucial for achieving overall common prosperity. Therefore, this study provides insights for strategically narrowing the urban-rural income gap from the perspective of higher education investment. Methods We employ a panel fixed effects model to examine the basic regression, heterogeneity, mediating effects, and threshold effects. Simultaneously, we address the endogeneity issues in basic regression and mediating effects using the instrumental variable method. Additionally, we adopt the substitution of variables to ensure the robustness of the results. Results This paper selects panel data from China’s eight major comprehensive economic zones from 2003 to 2021 for analysis. The findings reveal that, overall, higher education investment in China’s eight major comprehensive economic zones can narrow the urban-rural income gap. Specifically, higher education investment in 50% of these comprehensive economic zones—namely, the Northern Coastal Comprehensive Economic Zone, Eastern Coastal Comprehensive Economic Zone, Northeast Comprehensive Economic Zone, and Middle Yangtze River Comprehensive Economic Zone—can reduce the urban-rural income disparity. Conversely, higher education investment in the Middle Yellow River Comprehensive Economic Zone, Southern Coastal Comprehensive Economic Zone, Greater Southwest Comprehensive Economic Zone, and Greater Northwest Comprehensive Economic Zone has widened the urban-rural income gap. Additionally, higher education investment can affect the urban-rural income disparity through technological innovation. Overall, the impact of higher education investment on the urban-rural income gap in China’s eight major comprehensive economic zones is also influenced by the level of economic development, exhibiting an “inverted U-shaped” characteristic. This nonlinear impact varies across regions. Conclusions In conclusion, to narrow the urban-rural income gap across China’s eight major integrated economic zones, it is necessary to improve the mechanism for higher education investment in these zones. Strategies should be based on regional differences, tailored to local conditions, and implemented with a differentiated and precise approach to higher education development across regions. Emphasis should also be placed on the research and application of innovative technologies to achieve deep integration between urban and rural areas within China’s eight major integrated economic zones.
Criegee Intermediates Compete Well with OH as a Cleaning Agent for Atmospheric Amides
Glycemic variability and mortality in patients with aortic diseases: A multicenter retrospective cohort study
Background The influence of glycemic variability (GV), defined as blood glucose fluctuations, on short-term mortality in patients with aortic diseases, such as aneurysms and dissections, remains understudied. This study evaluates the association between GV and mortality, explores non-linear patterns, and determines a GV threshold predictive of mortality risk. Methods A retrospective analysis of 2,441 patients with aortic aneurysm or dissection from the MIMIC IV and eICU-CRD databases was performed. Key variables, including demographics, clinical characteristics, comorbidities, laboratory findings, and treatments, were assessed. Logistic and Cox regression models, smooth curve fitting, and subgroup analyses examined associations between GV and ICU and 30-day mortality. Results ICU mortality occurred in 165 patients (6.8%), and 30-day mortality in 235 patients (9.6%). Increased GV was linearly associated with ICU mortality risk (P for non-linearity = 0.666). For 30-day mortality, a U-shaped relationship was observed, with minimal risk at a GV index of 0.2047 (P for non-linearity = 0.041). Adjusted models confirmed these findings (ICU mortality: OR = 1.15, 95% CI = 1.03–1.30, 30-day mortality: HR = 1.10, 95% CI = 1.03–1.18). Conclusions GV is significantly associated with short-term mortality in aortic disease patients, with a U-shaped pattern for 30-day mortality and an optimal threshold of 0.2047. These findings underscore the importance of tailored glucose management strategies and call for further research into underlying mechanisms.
Oxyhydride Synthesis through Facile Water Dissociation on the Electride Intermetallic LaScSi
The 2 Sigma Genus Concept in mammalogy: Lessons from Lasiurus
Species concepts are well established and apply across diverse groups of organisms; however, there is no consensus on what defines higher taxonomic groups. The genus rank is important to taxonomists because it comprises part of the scientific name of an organism. A consistent and biologically meaningful method for determining generic status is needed for taxonomic stability and utility. Lasiurine bats are a group for which there is disagreement on how many genera to recognize. Some authors argue for splitting this group into three genera based on morphology, genetic divergence, and time of divergence; others argue that a single genus should be maintained. Here, we use lasiurines to explore generic-level taxonomy and how it is applied. Genetic divergence levels are compared among sister genera and within genera of vespertilionine bats using Cytochrome b (Cytb) sequences. We used Cytb because it is the most sequenced mitochondrial gene in mammals, but other genes might be more appropriate for a different taxon. Future methods will eventually use complete mitogenomes and genomes. We conclude that lasiurine bats are most appropriately divided into three genera to maintain taxonomic consistency within their subfamily. Since Linnaeus, the quarter millennium of progress in the science of mammalogy has provided a binomial nomenclatural basis from which can be extracted an acceptable range of genetic diversity upon which to establish generic level taxonomy. We offer a biologically meaningful operational definition of the genus, which we call the 2 Sigma Genus Concept, based on genetic divergence between a genus and its sister genus or lineage and compared to the divergence between sister pairs of established genera in the same higher taxonomic category. Our method is phylogenetic; sister genera are based on the best phylogeny for the higher taxonomic category. Genera must be monophyletic and differ from their closest relatives by not more than two standard deviations above or below the mean value of genetic distance for the larger taxonomic group in which they are contained. There should be genetic-based characters (e.g., morphology, protein structure, behavior) that are diagnostic for each genus. Our method is novel in that it uses the statistical distribution of sister divergences within a higher category to guide the allocation of generic status to monophyletic lineages. Within Vespertilioninae, the mean genetic distance between sister genera is 20.68% ± 3.89% (K2P) for the Cytb gene. Therefore, a proposed new genus should have >12.90% genetic distance to its sister genus. Genera that are > 2 standard deviations above the mean (>28.46%) are candidates to be recognized as a higher category such as tribe or subfamily. The sister-genus divergence for the monophyletic lineage that includes all lasiurine bats is 31.14% ± 1.64% which qualifies it as a higher category (i.e., tribe), and the sister-genus divergences of the three monophyletic lineages within Lasiurini (i.e., red, yellow and hoary bats) are 21.77% and 22.91% which qualifies them for genera. We show the applicability of the method beyond Vespertilioninae by providing a case study where we apply it in a distantly related subfamily of bats.
Motion of Molecules in Supramolecular Scaffolds Enhances Bone Regeneration
Generation of Rare Sugars by Electrochemical Oxidation of <scp>d</scp>-Glucose Using Boron-Doped Diamond Electrode
Patient safety culture in resource-limited healthcare settings: A multicentre survey
Objective: To assess healthcare professionals’ perceptions of patient safety culture and to examine variations across clinical units in Eastern Ethiopian public hospitals. Methods: A cross-sectional study was conducted using the Hospital Survey on Patient Safety Culture (HSoPSC 2.0) tool. Analysis of variance and ordinal logistic regression analyses were performed. Results were presented as mean differences and an adjusted odds ratio (AOR) with a 95% confidence interval (CI), and statistical significance was set at a p-value < 0.05. Content analysis was performed for data provided through the open-ended response option. Results: A total of 582 questionnaires were returned, yielding a response rate of 85%. Overall positive patient safety culture score was 47% (95% CI: 41–53%). Intensive care units (ICUs) scored significantly lower on patient safety culture dimensions compared to other clinical units. Factors contributing to the patient safety ratings included Midwives (AOR = 0.20, 95% CI: 0.06–0.71, p = 0.013), Organisational learning and continuous improvement (AOR = 1.35, 95% CI: 1.04–1.76, p = 0.025), Supervisor, manager, or clinical leader support for patient safety (AOR = 1.41, 95% CI: 1.06–1.89, p = 0.02), and Hospital management support for patient safety (AOR = 1.28, 95% CI: 1.00–1.63, p = 0.049). The challenges in ensuring patient safety included the absence of patient safety incident reporting systems, severe resource constraints, limited awareness regarding patient safety, ineffective communication, poor management support, and a blame-oriented organisational culture. Conclusions: Significant improvement in patient safety culture in Ethiopian public hospitals, especially in the ICU, is critically needed to mitigate healthcare risks and ensure patient safety. Addressing these issues requires targeted patient safety training, strong leadership support, and adequate resource allocation. Further exploration of ICU-specific patient safety insights and validation of the HSoPSC 2.0 tool within the Ethiopian healthcare context should be undertaken to ensure cultural and contextual relevance.
Rational Molecular Design of Aryl-Lithium Reagent Enables Precise Chemical Prelithiation of Graphite Anodes for Achieving Ideal 100% Initial Coulombic Efficiency
Multi-region investigation of ‘man’ as default in attitudes
Previous research has studied the extent to which men are the default members of social groups in terms of memory, categorization, and stereotyping, but not attitudes which is critical because of attitudes’ relationship to behavior. Results from our survey (N > 5000) collected via a globally distributed laboratory network in over 40 regions demonstrated that attitudes toward Black people and politicians had a stronger relationship with attitudes toward the men rather than the women of the group. However, attitudes toward White people had a stronger relationship with attitudes toward White women than White men, whereas attitudes toward East Asian people, police officers, and criminals did not have a stronger relationship with attitudes toward either the men or women of each respective group. Regional agreement with traditional gender roles was explored as a potential moderator. These findings have implications for understanding the unique forms of prejudice women face around the world.
Structural Basis and Rational Design of Nucleotide Analogue Inhibitor Evading the SARS-CoV-2 Proofreading Enzyme
Correction: Validation of depression, anxiety, and stress scales (DASS-21) among Thai nursing students in an online learning environment during the COVID-19 outbreak: A multi-center study
Pore-Space-Partition-Oriented Sandwich Platinum Array Confined in a Metal–Organic Framework for Boosting Overall Water Splitting
Effects of maternal anemia on low-birth-weight in Sub-Sahara African countries: Systematic review and meta-analysis
Introduction Maternal anemia is a major public health concern that affects women globally, with a particularly high prevalence in developing countries, notably in sub-Saharan Africa. This condition is linked to negative birth outcomes, with low birth weight being a common consequence of maternal anemia during pregnancy. Therefore, this study aims to evaluate the effect of maternal anemia on low birth weight in the context of sub-Saharan African countries. Methods This study involved searching electronic databases, including PubMed, Embase, Scopus, Cochrane, and Web of Science, as well as reference lists and citation tracking for additional studies. It included cohort, case control, and cross-sectional studies published in English between January 2015 and June 2024. Data were extracted using Covidence and transferred to Microsoft Excel, then to Stata™ Version 17.0 for analysis. Heterogeneity was assessed with forest plots and the Inverse variance (I2) test. Subgroup analysis, sensitivity analysis, and meta-regression were performed to explore sources of heterogeneity, while funnel plot symmetry was evaluated for publication bias. The meta-analytic effect was summarized using pooled odds ratios, 95% confidence intervals, and I2 tests for heterogeneity. This was registered on the PROSPERO under the identification number CRD42024561098. Result A total of 1213 articles were identified, 71 of which were screened for full-text review, and 21 involving women from sub-Saharan African countries met the inclusion criteria, and were included in this meta-analysis. Women with anemia during pregnancy are at higher risk of giving birth to babies with low birth weight compared to women without anemia (AOR = 3.37; 95% CI: 2.66–4.27; I2: 96.71%). Conclusion Maternal anemia during pregnancy was identified as a significant risk factor for low birth weight. Such that the incidence of low birth weight could possibly be reduced with early identification and proper care of anemia during pregnancy.