OBJECTIVE To establish and implement a women-centred continuity of midwifery care service specifically focused on urogynecological conditions. DESIGN Observational study was conducted. SETTING R. Guzzardi Hospital – Vittoria (Italy) POPULATION 441 women received midwifery care in the first 40 days after childbirth. The target population consisted of low-risk mothers and newborns who delivered in our hospital during January and December 2022. METHODS. 122 quantitative variables were extracted. A preliminary statistical analysis was conducted, allowing us to describe our sample of women and the results obtained during the first and second check-ups for comparison. Subsequently, using the statistical software, it was possible to correlate the variables, identifying those that were statistically significant. MAIN OUTCOME MEASURES Improved pelvic floor function, reduced urinary incontinence, and enhanced postnatal care continuity, particularly for immigrant women. RESULTS The cesarean section is associated with a high score in the pelvic-perineal assessment (p value = 0.0069). Higher values of lacerations and/or episiotomy were recorded in induced deliveries (p value= 0.0097). Urgency urinary incontinence, and stress urinary incontinence, are associated with a pelvic floor with poor tone and functionality (I assessment: p value = 0,00371) (II assessment: p value 8.843 e-06). Over 10% of women with urinary disorders at the first check-up achieved complete recovery, while the remaining 4% persisted with urogynaecology symptoms. The tone and functionality of the pelvic floor improved in 15% of cases initially marked by a low score. CONCLUSION Midwife-led care improves women’s well-being and empowerment, particularly in postpartum urogynaecological health, supporting recovery and personal development.

Cline theory has a central place in speciation studies. Cline locations delimit taxon boundaries, cline widths scale with barrier strength, and the shapes of clines (smooth or stepped) suggest whether species barriers are mono- or polygenic. How cline shapes vary along chromosomes therefore forms part of the genome species barrier landscape. Further, asymmetric moving clines (wave fronts) can mark adaptive introgression puncturing species barriers, potentially leading to their collapse or decay. Here we review the development of cline and wavefront models and relate this to the use of dispersal kernels in epidemiology and ecology. We contrast classical results to those for a thick-tailed kernel, showing how cline shape affects the speed of spatial process, including the widening of neutral clines and the spatial coalescent. We critique current cline models used for inference (both spatial and genomic clines) and address Barton’s question: Why (after decades of cline fitting) is there so little evidence of stepped clines? We suggest evidence is weak because stepped cline models are over-parameterised. We propose minimum parameter stepped cline models, and discuss non-parametric approaches, that may help resolve the issue. This broadens to a discussion of the future of, and alternatives to, cline fitting.

Neurodiversity has gained increasing recognition in contemporary literature, particularly in young adult (YA) fiction, which serves as a crucial platform for shaping societal perceptions. This study explores the representation of Autism Spectrum Disorder (ASD) in YA literature, analyzing how autistic characters are portrayed in terms of authenticity, diversity, and alignment with real-world experiences. Through a comparative literary analysis, the study examines recurring themes, narrative structures, and the impact of these representations on readers' understanding of ASD. Additionally, it investigates the extent to which these portrayals challenge or reinforce stereotypes, considering the role of authors' perspectives, publishing trends, and audience reception. Findings highlight the progress made in fostering inclusive storytelling while underscoring areas where representation can be further improved. This research contributes to ongoing discussions about neurodiversity in literature and its broader implications for inclusivity and social awareness.

This study explores the concept of liminality and transformation within the framework of Afrojujuism in My Life in the Bush of Ghosts by Amos Tutuola. Afrojujuism-a fusion of African spiritual cosmologies, folklore, and surrealist aesthetics-shapes the novel's character development and narrative structure, blurring the boundaries between the physical and metaphysical worlds. Through an analysis of Tutuola's use of mythic tropes, supernatural encounters, and fluid identity transitions, this paper examines how liminality functions as a transformative force in the protagonist's journey. The research highlights how Afrojujuism informs the novel's fragmented, episodic storytelling, reflecting the fluid and nonlinear nature of African oral traditions. Ultimately, the study underscores how Tutuola's work challenges conventional narrative forms and enriches the literary exploration of identity, exile, and metamorphosis.

This study explores the representation of characters with autism in classic and modern literature, examining how societal understanding and portrayals of autism have evolved over time. By analyzing key literary works, the research identifies recurring themes, narrative functions, and the depth of character development concerning autistic traits. The study contrasts early depictions-often marked by stereotypes or a lack of formal diagnosis-with contemporary portrayals that reflect greater awareness and nuanced representation. Additionally, the research investigates the impact of these depictions on public perception, inclusivity, and the broader literary landscape. Through this comparative approach, the study highlights shifts in narrative techniques, authorial intent, and cultural attitudes toward autism, contributing to ongoing discussions on neurodiversity in literature.

This study examines the concept of Afrojujuism as a literary device for articulating cultural hybridity and identity in Amos Tutuola's My Life in the Bush of Ghosts. Rooted in the fusion of African spiritual cosmologies, folklore, and modernist literary experimentation, Afrojujuism encapsulates a poetics of syncretism, where indigenous oral traditions, colonial legacies, and postcolonial realities converge. By analyzing the novel's narrative structure, linguistic style, and thematic concerns, this paper explores how Tutuola employs Afrojujuism to challenge rigid cultural binaries and reimagine identity as a fluid, dynamic process. The work highlights the interplay between Yoruba mythology, animist beliefs, and global literary forms, demonstrating how the novel constructs a liminal space where the material and spiritual worlds intersect. Ultimately, this study argues that Afrojujuism serves as a powerful aesthetic and ideological framework for expressing the complexities of postcolonial African identity.

Abstract

Population segregation catalyzes genetic differentiation and can lead to speciation. Population genetic structure is also critically important for population management, especially in species characterized by small, isolated populations. Sandhill Crane (Antigone canadensis) populations of the Pacific flyway are made up of breeding populations nesting west of the Rocky Mountains, and isolated by intermediate mountain ranges. Current management policy in British Columbia treats all Sandhill Cranes as a single population, whereas in the western United States subpopulations are subject to population specific management. Here, we analyze microsatellite markers, mitochondrial DNA sequences, and mitochondrial haplogroups, derived from 203 individual Sandhill Cranes to elucidate population genetic structure of cranes migrating along the Pacific Flyway to summer breeding habitat on the North and Central Coast of BC and southeast Alaska. STRUCTURE, AMOVA, FST, DAPC, and phylogenetic analyses reveal geographically separated crane populations along the west coast of North America show substantial genetic differentiation in the Pacific Flyway. These findings are consistent with behavioural and ecological evidence - divergent diets, flyways and breeding habitats. We conclude the unique characteristics of coastal Sandhill Crane populations deserve special management consideration relative to interior and southwestern Alaskan crane populations. The conservation of Pacific Flyway Sandhill Cranes depends on safeguarding the genetic diversity and adaptations within and between populations to protect these cranes from current and future climate scenarios, and by protecting the breeding, staging and wintering habitats of each population.

The Riemann hypothesis is considered and validated in this paper. For that purpose a multipoint Taylor series is used to obtain a series representation around the four inter-related zeroes. This series allows getting a new equation whose solutions are the searched zeroes. It is shown that this equation only has solutions on the critical line.

For breast conserving mammoplasty, the persistent problem of blue staining of the skin left after blue dye injection affects the overall aesthetics of the breast after the breast conservation procedure and causes distress to patients . Herein, through a case report, we proposed that for breast tumors adjacent to the nipple areola area, a double-ring incision could be used to remove the tumor and injecting blue dye into the skin within the double-ring incision subcutaneously to mark the sentinel lymph nodes could be considered as a satisfying method, because the blue skin could be removed intraoperatively by de-epithelializing and forming a new areola border with purse-string sutures.

Temperature significantly influences the physiology of poikilotherms. However, the effect of short-term cooling on their lipids remains unknown. We investigated how cooling (~4 hours) affects the lipidome of Diplostomum pseudospathaceum cercariae, a free-living stage of a common freshwater trematode. Samples of cercariae were either cooled (up to 0 °C) or uncooled during collection and then analyzed using high-performance thin-layer chromatography and gas chromatography. Cooling did not significantly affect the composition and quantity of lipid classes and fatty acids. Contrary to our hypotheses, cooling did not increase the levels of total lipids and polyunsaturated fatty acids. This suggests that cercariae lack the lipidomic adjustments to low temperatures for maintaining optimal membrane fluidity that characterize many other organisms. Lipid analysis revealed essential fatty acids (13% of sum), highlighting the potential nutritional importance of cercariae. Unlike other cercariae species, D. pseudospathaceum showed high levels of triacylglycerols and waxes (10% and 18% of total lipids, respectively). These findings enhance understanding of cercarial lipid metabolism and support using cooling for lipid sampling. In addition, we provide important data on the dry weight of cercariae and methodological recommendations for their sampling, aiming to facilitate future research on these understudied organisms.

Robust weighted fusion estimator for AR systems with mixed uncertainties is presented, where the mixed uncertainties include uncertain noise variances and missing measurements and multiplicative noises . The design approach of integrated parallel covariance intersection fusion predictor has three steps, which includes model conversion, the design of local and parallel covariance intersection fusion predictor and the confirmation of their robustness. By the state space and the fictious approach, the original system is converted into a multi-model system. According to the mini-max robust estimation principle and the parallel covariance intersection fusion algorithm, the local and fusion predictors are presented. The robustness and the robust accuracies of them are proved by matric conversion method. A simulation example verifies the correctness and effectiveness of the proposed results.

the Association Between Early Life Respiratory Syncytial Virus (RSV) Infection and the Development of atopic dermatitis: A meta-analysisHao-long Ran12 Jin-rui Zhang12De-zhao Bi12

During the nestling period, brood-parasitic birds stimulate host parents to provide food through complex visual and auditory signals, including emitting supernormal stimuli in the form of begging calls to increase the feeding frequency. However, whether the begging calls of brood-parasitic nestlings act as a universal type of supernormal stimulus signal and their effects on less common host species still require further research. In this study, we used playback recordings to verify the impact of the begging calls of Common Cuckoo nestlings on the parental care behaviour of host Barn Swallow parents. The results showed that male Barn Swallow parents, but not female parents, reduced their feeding frequency in response to both type of cuckoo nestling calls (the begging calls of cuckoo nestlings reared by common/uncommon hosts). Thus, the total feeding frequency in the two experimental groups was significantly lower than the control group. Additionally, brood size, temperature, and weather all affected the feeding frequency in the Barn Swallow. This study supports the idea that the supernormal stimulus of brood-parasitic nestling begging calls does not always work as a universal signal; the behavioural adaptations formed by parasitic birds in response to common hosts may lead to reduced fitness when utilising uncommon hosts, e.g., the Barn Swallow.

IntroductionImmune checkpoint inhibitors (ICIs) are human-derived monoclonal antibodies that enhance the anti-tumor immune response of T cells by inhibiting the the programmed cell death-1(PD-1)/programmed death-ligand-1 (PD-L1) pathway, thus producing anti-tumor immune effects. Tirelizumab is a PD-1 antibody inhibitor that has been shown to be effective in combination with chemotherapy for the treatment of squamous cell lung cancer, however, the subsequent immunotherapy-related adverse events (irAEs) have also been widely observed. It has been reported that among patients receiving anti-PD-1 / PD-L1 therapy, about 70 % had at least one irAE, 10 % had severe irAEs, and 0. 5 % had fatal irAEs [1].Stevens-Johnson syndrome (SJS) /toxic epidermal necrolysis(TEN) is a severe type of pleomorphic erythema and a rare adverse mucocutaneous reaction with a mortality rate of up to 50%[2-3]. The body surface area of the skin (BSA) is the main criterion to distinguish SJS and TEN: BSA<10% is classified as SJS, BSA>30% is classified as TEN, and BSA in between is classified as overlapping type SJS/TEN[4]. The main clinical manifestations of this disease are skin blisters, bullae, epidermal exfoliation, mucosal erosion, etc., and in severe cases, there are systemic poisoning symptoms and different degrees of involvement of internal organs[5]. Because of the difficulty in conducting randomized controlled trials in patients with such critical diseases, the standardized treatment of SJS/TEN is a major clinical challenge. The mainstream treatment measures include immediate discontinuation of suspected allergenic drugs, wound care and drug therapy. Although systemic application of glucocorticoids is currently the most common treatment method, some studies have shown that the use of high-dose glucocorticoids increases the risk of complications[6]. Other treatments such as intravenous immunoglobulin (IVIG), immunosuppressants, plasma exchange, etc., although clinically found to improve the condition to a certain extent, but there is no definite study to prove that it can effectively reduce the mortality of the disease [7].Therefore, there is an urgent need for new and effective treatments to improve the prognosis of the disease. In this report, we described the case of a patient with lung squamous cell carcinoma in whom multiple immune-related adverse events were induced by Tirelizumab.

Background Literacy promotion is central to child development, particularly for children with sickle cell disease (SCD) given patterns of neurocognitive involvement. Book ownership programs offer a unique strategy within pediatric healthcare. This study aimed to evaluate the implementation of a literacy promotion program within an outpatient pediatric subspecialty clinic. Procedure The Sickle Cell Story Club (SCSC) distributed books from March 2021 to December 2023 in an outpatient comprehensive SCD clinic. Families completed home literacy and feedback surveys when receiving a book. Books were provided regardless of data completion and could be refused at any time. Results 1,711 books were distributed to 386 patients (0-22 years), with an average of 4 books per patient (range=1-12 books). Most books were given by psychosocial team members (94.87%). Caregivers of young children (0-5 years) read more (68.8%) as a result of the SCSC and all found the program to be useful for reading development. Caregivers of school-aged children (6-12 years) observed a positive impact of the SCSC on their child’s reading confidence (86.8%). Caregivers of school children and adolescents (13+ years) agreed that the SCSC increased the frequency of reading behaviors as well as enjoyment towards reading. Nearly all families were likely to recommend the SCSC (90.1%). Conclusion Given the neurocognitive impact and known disparities in educational resources, patients with SCD are at a unique risk for differences in learning. Literacy promotion is imperative to child development and a chronic disease subspecialty clinic offers a unique opportunity to address this domain.

Accumulations of woody debris along bridge piers can cause localized scour of the streambed, which can compromise the structural integrity of the bridge and increases the likelihood of catastrophic failure. In-stream flow deflecting structures are a form of debris mitigation, and they work by deflecting debris-carrying flows away from piers so that they may pass unobstructed through the bridge. The efficacy of these structures has previously been demonstrated primarily through flume experiments; however, there is little field-based testing of these structures, and descriptions of the hydrodynamic and geomorphological interactions these structures induce in field settings are scarce. We investigated the use of an Acoustic Doppler Current Profiler (ADCP) and Large-Scale Particle Image Velocimetry (LSPIV) to monitor these interactions following the construction of flow-deflecting vanes in a large, urban river in Middletown, Ohio. We observed how the locations of greatest scour transitioned away from the banks and piers as a result of the construction process. Additionally, we found that the vanes increased flow velocities in the spans between piers and decreased velocities at the piers, which suggests proper deflection from these structures. However, we noted that the vanes had a weaker influence on flow patterns during high-flow events, which suggests that the functioning of these vanes are highly dependent on channel stage. Overall, we found our results from LSPIV to correlate well with our results from the ADCP, which suggests that LSPIV can serve as a low-cost alternative to ADCP for streamflow investigations.

A document by Yuhan Du. Click on the document to view its contents.

Fantastic statements that the Nobel-Prize-winning COVID-19 vaccines saved millions (and tens of millions) of lives are based on the theoretical scenarios of Watson et al. (2022), published in The Lancet Infectious Diseases. Watson et al. (2022) theoretically inferred massive mortality reductions distributed globally, occurring solely during vaccine rollouts. We calculated the quantitative consequences of Watson et al. (2022)’s low-value (14.4 million lives saved) theoretical scenario on all-cause mortality by time (by week or by month, 2020-2022) in 95 countries. Our calculations provide graphical proof that the theoretical proposals of Watson et al. (2022) are untenable, compared to measured all-cause mortality. Therefore, the characteristics of the COVID-19 vaccines (efficacies in preventing infection or serious illness, duration of protection, waning, etc.) and of COVID-19 spread input by Watson et al. (2022) must be invalid.

Introduction: Bipolar disorder is linked to elevated rates of suicidal behavior and death by suicide. The objective of this study was to examine the contribution of depressive symptoms and hazardous alcohol use to suicidal behavior within a predominantly low-income African American sample of individuals with bipolar disorder. Method: We recruited 204 patients with bipolar disorder from an urban public hospital’s outpatient clinic in the Southeastern U.S. Multiple regression examined associations between depressive symptoms, hazardous alcohol use, and suicidal behavior among past-year drinkers, controlling for gender. Results: The regression model revealed that gender, depressive symptoms, and hazardous alcohol use were significant predictors of suicidal behavior. Depressive symptoms exhibited the strongest association (β = 0.367, p < .001), followed by hazardous alcohol use (β = 0.171, p = .042) and gender (β = 0.227, p = .012). Collectively, these factors accounted for 24.1% of the variance in suicidal behavior (R 2 = 0.241), underscoring their role in suicide risk among individuals with bipolar disorder. Conclusions: Findings highlight significant associations between depressive symptoms, hazardous alcohol use, and suicide risk in low-income African American individuals with bipolar disorder. Clinical interventions should prioritize comprehensive screening and targeted approaches to address these interconnected risk factors.

Background Emerging evidence suggests that a combined approach with left atrial appendage occlusion (LAAO) and catheter ablation (CA) may be a safe, effective alternative for patients with atrial fibrillation (AF) at high risk of bleeding and stroke. Objective This review seeks to systematically evaluate the safety and efficacy of this combined approach, addressing gaps in the current evidence. Methods A systematic search of PubMed, Science Direct, and Cochrane Central Register of Clinical Trials (CENTRAL) was performed for studies that reported outcomes comparing CA and LAAO vs. CA without LAAO. The Review Manager 5.4 software was utilized to conduct a meta-analysis of the outcomes. Results Six studies of 3,770 patients with AF, of whom 1778 underwent LAAO after CA vs. 1992 CA, were analyzed. After a mean follow-up of 30 months, the combined approach was associated with a significantly lower risk of major bleeding compared to CA alone (OR 0.45; 95% CI 0.26-0.78; p <0.0001). There were no differences in stroke or systemic embolism rates between groups (OR 1.00; 95% CI 0.66–1.52; p = 0.91), and no significant difference was observed in all-cause mortality (OR 0.77; 95% CI 0.34–1.74; p = 0.35). Conclusion This meta-analysis suggests that a combined approach is associated with a reduction in major bleeding while demonstrating non-inferiority in thromboembolic events and mortality compared to CA alone. Further randomized clinical trials are needed to confirm these findings.

IoT cyberattacks are becoming more frequent and complicated, threatening individuals and organizations. IoT networks are vulnerable to internal and external cyberattacks because to their openness and self-configuration. DoS attacks are particularly destructive, stopping genuine users from accessing key services. Traditional anomaly detection approaches fail to identify complex temporal correlations and are inaccurate and not robust. This study introduces a feature extraction-based VGGNet model for time series anomaly detection using the Artificial Butterfly Optimization (ABO) algorithm for feature selection and a hybrid Capsule Network (CapsNet) deep learning model for accurate attack classification. VGGNet extracts hierarchical temporal features to improve representation quality, whereas ABO effectively picks the most relevant features to reduce computing cost. The hybrid CapsNet classifier captures spatial and hierarchical connections among selected characteristics to improve anomaly detection accuracy. Experimental results on MSL and PSM time series datasets show high classification accuracy, reduced false alarms, and improved precision-recall metrics, exceeding conventional methods. This scalable, adaptable approach detects anomalies in real time, enabling deep learning-driven cybersecurity solutions.

Abstract Semiconductor materials are an essential aspect of modern electronics. Crystallography is an important instrument that goes a long way in the understanding and enhancing of these materials. This paper discusses the role of crystallography in the enhancement of semiconductors pointing out its use in materials such as silicon, gallium arsenide, and other emerging materials. While materials gain from structure refinement, tools such as crystallography enhance their structure at atomic levels hence modifying silicon, computers, solar cells and LED’s to deliver improved functionality. Meanwhile, the paper covers developed areas in semiconductors such as 2D materials and quantum technologies. Lastly, it explores the new directions and problems in the area of research under concern and summarizes how crystal structures will aid the future of semiconductor engineering: more efficient and stronger electronic devices will be achieved.

Background: The seaweed Halimeda macroloba has been used in the pharmaceutical and nutraceutical industries, but no research has described its invivo activity. Therefore, the current study is done to explore the antidiabetic, hypolipidemic, and antioxidant properties of hydroalcoholic extract of H. macroloba (HME) in Wistar rats. Methods: HME was prepared using 70% alcohol as a solvent using maceration for 72 hours. Nicotinamide (i.p.,110mg/kg) and streptozotocin (i.p.,45mg/kg) were given to induce diabetes and the rats were screened for confirmation of diabetes after 72 hours. Following induction, the rats were randomly divided into seven groups and animals were treated with two doses of HME and conventional medications. Weekly monitoring of body weight and fasting blood glucose with monthly lipid profiles were measured and on the 90 th day, antioxidant parameters and HbA1c were measured. Histopathological analysis was performed on the renal liver and pancreatic tissues. Results: Significant improvements have been seen in body weight, Fasting Blood Glucose and reduction in HbA1c following treatment with HME (100mg/kg and 200mg/kg). Similarly, HME substantially raised HDL levels while lowering LDL, TC, and TG. Comparing the HME groups to the untreated diabetic rats, there was significant raising in the antioxidant levels of GSH, CAT and SOD. However, compared to diabetic rats, HME groups had lower levels of MDA. Comparably, HME reversed the histological alterations and restored the liver, kidney, and pancreas functions. Conclusion: The overall results show administering HME improved BW, HbA1c, and glycemic management. Additionally, the lipid profiles and antioxidant activities have been considerably enhanced.