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Variations of autonomic arousal mediate the reportability of mind blanking occurrences

Where is communication breaking down? Narrative tensions in obesity-in-pregnancy clinical encounters

There are numerous biomedical and psychosocial challenges associated with obesity in pregnancy that impede communication between healthcare providers (HCPs) and patients. We conducted a narrative study informed by stigma theory to understand specific areas of communication breakdown in obesity-in-pregnancy clinical encounters. Sixteen patients and 19 HCPs participated in in-depth, semi-structured interviews. We explored how participants positioned obesity-in-pregnancy clinical encounters within their broader narratives. Employing narrative analysis, we identified five narrative tensions contributing to communication challenges: 1) obesity as a detriment to health versus an acceptable biologic variation ; 2) obesity as the result of personal choice versus the result of uncontrollable circumstances ; 3) a regular pregnancy versus a high-risk diagnosis; 4) a typical and problem-free clinical encounter v ersus a tremendously difficult clinical encounter ; and 5) talking openly about Body Mass Index (BMI) and related co-morbidities versus sidestepping the topic . How participants positioned themselves relative to prevailing societal discourses regarding obesity in general influenced these tensions. These narrative tensions revealed specific areas where communication is vulnerable to breaking down during the obesity-in-pregnancy clinical encounter. Participants’ (both HCPs and patients) past experiences of clinical encounters–and the meanings they ascribe to them–shape subsequent encounters, and our analysis illuminates the complexities of this interactive space. This research has implications for improving clinical practice and education.

Mangroves, fauna compositions and carbon sequestration after ten years restoration on Flores Island, Indonesia

Does patients’ age predict their clinical outcomes following non-infectious epiglottitis? A systematic review

Background Non-infectious epiglottitis, an infrequent but significant condition, presents challenges in airway management and treatment due to its potential for rapid progression. Objective To analyze differences in clinicodemographic characteristics, management strategies, and clinical outcomes between pediatric and adult cases of non-infectious epiglottitis. Methods A systematic search of four databases identified 57 patient records, all diagnosed with non-infectious epiglottitis. Children (<18 years) were compared to adults (≥18 years). Differences in clinicodemographic characteristics, management strategies, and clinical outcomes were analyzed. Outcomes included intubation, complications, and intensive care unit (ICU) admission. Risk factors of these outcomes were identified through uni- and multi-variable logistic regression analyses. Results Twenty-three children and 34 adults were analyzed. The presentation with stridor (56.52% vs. 14.7%), drooling (56.52% vs. 26.47%), cyanosis (17.39% vs. 0%), and sternal retraction (13.04% vs. 0%) was more common among children. Prior vaccination was evident in only 5 pediatric cases. The etiology of epiglottitis was similar across groups. Children had significantly higher chances of receiving epinephrine (34.78% vs. 8.82%), undergoing intubation (82.60% vs. 20.58%), being admitted to the ICU (56.52% vs. 17.64%), and having complications (47.82% vs. 14.70%), compared to adults. In the multivariate regression model, pediatric age was a risk factor for intubation (p = 0.015) and ICU admission (p = 0.040), while foreign body ingestion (p = 0.039) and dyspnea (p = 0.014) were predictors of intubation and complications, respectively. Conclusions The study highlights the necessity for age-specific management strategies in non-infectious epiglottitis. Understanding the distinct clinical presentations and responses in different age groups can lead to improved patient care.

Influence of biochar on the partitioning of iron and arsenic from paddy soil contaminated by acid mine drainage

Daily briefing: How did childhood evolve?

Bivariate multilevel modeling of antenatal care contacts and place of delivery among reproductive-aged women in Ethiopia

Background Antenatal care (ANC) contacts, along with enhanced health facilities for delivery, are essential components of maternal and child healthcare, as these significantly contribute to both mothers and their newborn child’s health. Antennal care contacts primarily help women maintain normal pregnancies by detecting pre-existing conditions and preventing complications that may arise during childbirth. This study intended to determine possible factors that affect both ANC contact and place of delivery among women in Ethiopia. Methods The 2019 Ethiopian Mini Demographic and Health Survey data were used for this study. A total weighted sample of 3,926 women nested within 68 zones was used. The bivariate multilevel logistic regression model was utilized to assess the association between antenatal care contact and place of delivery and determinant factors among reproductive-aged women in Ethiopia. Results In this study, 57% and 47.5% of women had no ANC contacts and home delivery respectively. Similarly, about 36.73% of women delivered at home and didn’t utilize the recommended ANC contacts. Only 32.99% of women have both health facility delivery and at least four ANC contacts during their pregnancy. Women who reside in rural areas were 0.612 and 0.352 times less likely to have ANC and health facility delivery compared to women who reside in urban areas. Whereas, the estimated odds of women with higher education levels were 3.803 and 8.406 times the estimated odds of women with no education. Conclusion A high proportion of women are still delivering their new child at home and still don’t have at least four ANC contacts during their pregnancy. Women’s age, women education level, marital status, wealth status, sex of household head, place of residence, and region were significant predictors of antenatal care visits and place of delivery simultaneously in Ethiopia. Although the country tried to maximize these services, it still requires expansion of health facilities media campaigns, and women’s literacy to reduce maternal and newborn child mortality in Ethiopia.

Minimizing makespan for mixed batch scheduling with identical machines and unequal ready times

Research on the construction of a sustainable scientific research capability evaluation model for university teachers based on the T-S fuzzy neural network

Introduction This study aims to enhance educational quality and academic standards by proposing a model based on critical research ability indicators to objectively evaluate the sustainable scientific research capabilities of university teachers. Methods Using T-S fuzzy neural network technology, we developed an evaluation model to measure the sustainability of university teachers’ research capabilities. We collected data from 126 university teachers, using 90 samples for training and 36 for testing, to ascertain the model’s applicability and accuracy. Results The T-S fuzzy neural network showcased exceptional learning efficiency and achieved a 98.15% accuracy rate in assessing the sustainable scientific research capabilities of university teachers, outperforming both Naive Bayes and BP neural networks in effectiveness. Conclusion The research successfully constructs a T-S fuzzy neural network-based evaluation model for assessing the sustainable scientific research capabilities of university teachers. With high accuracy and broad applicability, this model is an effective tool for objectively evaluating university teachers’ research capabilities, clearly achieving the study’s objective.

Phenotypic and genotypic characterization of Candida parapsilosis complex isolates from a Lebanese hospital

Gains vs losses in pay-for-performance: Stated preference evidence from a U.S. survey

Background Pay-for-performance (P4P) incentives can be paid as a bonus (gain) or a penalty (loss). Diminishing marginal utility of wealth suggests that, starting from the same initial wealth, individuals dislike losses more than they like equivalent gains. Objective This study reports the minimum financial gain or loss required to motivate primary care providers and clinical staff to try to increase their human papillomavirus (HPV) vaccination rates. Data In 2022, we conducted a national U.S. survey through WebMD’s Medscape Network of clinical staff working in primary care clinics that provided HPV vaccination to children ages 9 through 12 years (N = 2,527; response rate = 57%). Methods We randomized respondents to one of two hypothetical HPV vaccine incentive designs: a bonus for reaching an unspecified target HPV vaccination rate and a penalty for failing to reach the unspecified target. The primary outcome is the self-reported smallest incentive amount (U.S. dollars) that would motivate participants to try and increase their HPV vaccination rates. We tested for differences across P4P designs using unadjusted responses and linear regressions adjusting for clinic and respondent characteristics. We also tested for heterogeneous responses by experience with incentizves, training, and rurality. Results The mean amount required to motivate effort was $2,155 in the gain P4P design and $1,185 in the loss P4P design (unadjusted difference =  $970 [p < 0.001], adjusted difference =  $967 [p < 0.001]). There were no heterogeneous effects by rurality or experience with incentives. Physicians reported the highest differences (in dollars) between gain and loss P4P designs. Conclusions Stated preference data from primary care clinical staff suggests that effective P4P incentives could be half as large if designed as losses rather than gains.

Unraveling a novel therapeutic facet of Etravirine to confront Hepatocellular Carcinoma via disruption of cell cycle

Abstract Hepatocellular Carcinoma (HCC) is a malignancy with high mortality rates and limited treatment options. This study aimed to unearth the repurposable potential of FDA-approved drugs against specific genetic targets governing the HCC pathological pathways. The transcriptomics microarray datasets were explored to retrieve the HCC specific differentially expressed genes, and the significant genes were fed in Search Tool for the Retrieval of Interacting Genes/Proteins (STRING) database to capture the protein-protein interactions, which were visualized in Cytoscape. This revealed CCNA2, a cell cycle regulator, as a potential target, which mediates its action by interacting with CDK1 and CDK2. Further, with the intention of identifying inhibitors for CDK1 and CDK2, a drug library was created, and the drugs were virtually screened against their respective targets via molecular docking and dynamics studies. This captured the binding affinity of Steviolbioside towards CDK1 and Etravirine and Fludarabine towards CDK2. In vitro, validation confirmed the cytotoxic potential of Etravirine and Fludarabine in Huh-7 cell lines. Further, enzymatic assays, gene expression analysis, and cell cycle analysis signified the anti-proliferative potential of Etravirine in Huh-7 cells via inhibition of CDK2. In this drug repurposing venture, Etravirine, a non-nucleoside reverse transcriptase inhibitor indicated for the treatment of HIV, emerged as a promising candidate for HCC treatment. The findings warrant further preclinical and clinical investigations to ascertain the repurposable potential of Etravirine against HCC, particularly in patients with viral infections.

3 kV fully vertical <i>β</i>-Ga2O3 junction termination extension Schottky barrier diode with sputtered p-GaN

In this work, we present the fabrication of a fully vertical β-Ga2O3 Schottky barrier diode with junction termination extension (JTE-SBD) utilizing a p-GaN layer produced by sputtering, offering a solution to the absence of p-Ga2O3 materials. The p-GaN/n-Ga2O3 JTE-SBD demonstrates a turn-on voltage (Von) of 0.8 V, a specific on-resistance (Ron,sp) of 6.15 mΩ·cm2, an ideality factor (n) of 1.24, a breakdown voltage of 3 kV, and a Baliga's Figure of Merit of 1.46 GW/cm2. The current–voltage–temperature (I–V–T) testing has confirmed a transition in the dominant leakage mechanisms from the Poole–Frenkel mechanism to variable-range hopping.

Research on intelligent routing with VAE-GAN in the internet of body

The "Internet of Body" is an emerging technology that is centered on the human body and connected to the Internet. It can monitor a variety of human data (such as heart rate, blood oxygen content, etc.) and communicate with digital pills, wearable devices, etc. It has been widely used in the field of medical health. However, when other devices access the Internet of Body on a large scale, there will be load imbalance caused by the difficulty in selecting the optimal route, which will affect the overall throughput and may even fail to transmit and endanger life. The traditional artificial intelligence routing algorithm cannot deal with the low model prediction accuracy and poor generalization ability caused by large noise and small data volume. This paper proposes an artificial intelligence routing algorithm, combines the variational autoencoder (VAE) and the generative adversarial network model (GAN) to construct a VAE-GAN model to generate multiple sets of data to achieve data enhancement on the Internet of Body. The optimization goals are to maximize the throughput of the Internet of Body and minimize the transmission cost. The entire routing problem is expressed as a Markov decision and the optimal transmission path is solved by learning previous historical experience to generate the real-time optimal route. Experiments have shown that this scheme can achieve the optimal route according to the transmission capacity of the real-time path and only requires fewer computing resources. It achieves load balancing of the entire network and avoids network congestion. The average throughput is much higher than that of traditional routing, and the advantage is more obvious under high load.

A texture enhanced attention model for defect detection in thermal protection materials

Characterization and reduction of RF loss up to 110 GHz by optimizing the UID-GaN layer in N-polar GaN material

In this work, the mechanism of RF loss up to 110 GHz for N-polar GaN has been studied. With the assistance of S-parameter characterization combined with secondary ion mass spectroscopy analyses, the incorporated oxygen impurity has been identified to be the main source bringing about the severe RF loss of N-polar GaN. The compensation of Fe-doping enables an effective reduction in RF loss. Moreover, the unintentionally doped (UID) GaN layer grown on top of the Fe-doped GaN buffer requires a careful design due to the distinct memory effect of Fe-doping in N-polar GaN. With an optimization of its thickness, a very low RF loss of 0.36 dB/mm at 94 GHz has been attained. Furthermore, by fitting the Fe concentration profile of UID-GaN according to the mass balance rate equation, it is found that the desorption of Fe on the N-polar GaN surface is significant. A bond-based model is introduced to elucidate the difference of the Fe memory effect between Ga-polar and N-polar GaN.

Modeling daily evapotranspiration time series based on Non-Linear Autoregressive Exogenous (NARX) method and climate variables for a data-deficient region

For flood-prone, developing nations where hydrological data is scarce, an innovative methodological approach is essential. This study aims to explore the potentiality of modelling daily evapotranspiration time series by checking causal relationship among the available climate variables in a flood-prone, data-deficient region like Samar in the Philippines. First, to verify if the available variables (rainfall, air pressure and the four (4) Niño Sea Surface Temperature (SST) Indices) have direct effects to evapotranspiration, a causality test called Convergent Cross-Mapping (CCM) was used. Interestingly, only the Niño SST indices and air pressure were found to have direct effects. Results showed that air pressure and the four (4) Niño SST Indices when combined with Non-Linear Autoregressive Exogenous (NARX) method, can effectively model evapotranspiration. This study raises a significant advancement in evapotranspiration modelling as it is the first to model and pinpoint the potentiality of causal relationship of air pressure and the four (4) Niño SST Indices to daily evapotranspiration time series. This method is found to be potentially suitable for disaster-prone regions where hydrological data is limited.

Advancing artemisinin resistance monitoring using a high sensitivity ddPCR assay for Pfkelch13 mutation detection in Asia

Spin wave propagation in YIG waveguides with magnetic microvolcanoes: Experiment and simulation

Control of spin wave transport in polymer 3D films was realized by magnetic microvolcanoes embedded in waveguides, fabricated by soft-matter specific techniques. Propagate of the spin wave signal excited in yttrium iron garnet (YIG) with 3D self-standing microvolcanoes chambers on top filled by the magnetic nanoparticles was evaluated by Brillouin light scattering and microwave spectroscopy. The magnetic moment of the polymer microvolcanoes varied with the change of the magnetic field bias direction inside the YIG films, which was shown by 2D mapping of the outer surface of the films. The good correlation of micromagnetic modeling and experimental data of spin wave propagation in the multistructure as a function of the applied magnetic field was clarified by the convergence parameters of the obtained polymer 3D magnetic microvolcanoes fields and the standard theory of spin wave propagation. The uniqueness of the soft materials object—polymer magnetic 3D films on conductive YIG film—lies in the application of the magnon network properties, which may find application in biomedical high-sensitivity feedback sensors.

PCK1 and SLC22A2 gene variants associated with response to metformin treatment in type 2 diabetes

Type 2 diabetes (T2D) is a chronic disorder affecting 462 million worldwide, often managed with metformin as first-line treatment. However, metformin’s response varies among individuals, including up to 30% experiencing serious adverse drug reactions (ADRs) and 20-50% inefficacy. These differences may be due to various factors, including pharmacogenetic (PGx) variants. The PGx variants documented so far could affect both the safety and efficacy of metformin, but due to a lack of replication studies, none reached the clinical evidence-level needed to be used as a predictive marker for treatment response. Therefore, this study aims to evaluate the association between the presence of candidate PGx variants and metformin response in T2D subjects. We conducted an association study involving 108 T2D participants currently or previously treated with metformin. A characterization of their therapeutic response was carried out through questionnaires and pharmacological profile reviews. DNA samples were collected during their single visit to perform genotyping of 24 selected candidate PGx variants. Association analyses between candidate PGx variants and metformin response were performed. Among the subjects included in the analyses (n =  84), 25% were non-responders, and 58% experienced ADRs. At the time of study enrollment, 93.9% of non-responders continued to use metformin. The odds of being a non-responder to metformin are 5.6 times higher for homozygous carriers of the alternative allele of a variant within the PCK1 gene (rs4810083) compared to the other genotypes (95% interval confidence [1.9–16.6]). Two variants in perfect linkage disequilibrium within the SLC22A2 gene (rs316019 and rs316009) were associated with increase odds of having ADRs, where homozygous genotype carriers are 7.3 times more likely to have ADRs presentation (95% interval confidence [1.85–29.01]). This study identified associations between PCK1 and SLC22A2 candidate PGx variants and metformin response in T2D treatment. Additional genetic and functional studies are necessary to elucidate the variants’ impact in metformin’s pharmacological mechanisms.