Search

Abstract Small topographic depressions are ubiquitous in the glaciated terrain of the Northern Prairies characterized by a cold semiarid climate. Groundwater recharge in this region is focused in topographic depressions, which receive lateral inputs of snowmelt runoff in addition to vertical inputs of precipitation. The response of depression‐focused recharge to climate change is largely unknown due to the difficulty of representing the complex interaction between depressions and surrounding uplands in hydrological models. This study evaluates climate change effects on recharge using a process‐based hydrological model and the pseudo‐global warming (PGW) approach representing a climate of 2092–2100, which has a higher mean annual temperature (+4.9 °C) and precipitation (+135 mm or +27%) compared with the present climate. The recharge model is conditioned using field data from an instrumented grassland site in the Canadian Prairies. Under the present climate, snowmelt runoff occurred in March–April over frozen soil, which accounted for the majority of water transfer from the upland to the depression. Under the PGW scenario, the amount of snowmelt runoff in March–April decreased due to lower snow accumulation and shorter periods of frozen soil. Instead, runoff occurred in midwinter and also in summer months due to increased intensity and duration of summer storms. Despite the increased precipitation, mean annual recharge rates decreased from 10.2 to 3.2 mm yr–1, indicating the importance of considering the complex effects of warmer and wetter climate on hydrological processes in cold semiarid regions.

Brief Background: The paper presents a case of external root resorption combined with a periapical abscess following an untreated Ellis Class II type of injury to the maxillary permanent central incisors and its subsequent management. Materials and Methods: Based on the history, clinical and radiographic examination, a diagnosis of external root resorption and a periapical abscess with 21 and apical periodontitis with 11 subsequent to trauma was made. Discussion: Factors increasing the susceptibility to dental injury, particularly excessive overjet, use of calcium hydroxide to initiate mineralization and to bring about apical closure and barrier formation as well as treat infected pariapical lesions through the root canals, etc., form the subject of discussion. Summary and Conclusions: The case underlines the importance of periodic evaluation and timely restorations of fractured teeth. [ABSTRACT FROM AUTHOR]

This paper provides an early career researchers (ECRs) perspective on major challenges and opportunities that arise in the study and understanding of, and the provision of regional information for Climate, Weather and Hydrological (CWH) extreme events. This perspective emerged from the discussions of the early career 3-day Young Earth System Scientists - Young Hydrologic Society (YESS-YHS) workshop, which was conjointly held with the Global Energy and Water Exchanges (GEWEX) Open Science Conference. In this paper we discuss three possible ways forward in the field: a stronger interaction between Earth system scientists and users, a collaborative modeling approach between the different modeling communities, and an increased use of unconventional data sources in scientific studies. This paper also demonstrates the important role of ECRs in embracing the above outlined pathways and addressing the long-standing challenges in the field. YESS and YHS networks encourage the global community to support and strengthen their involvement with ECR communities to advance the field of interdisciplinary Earth system science in the upcoming years to decades.

We show that the distribution of elements H in the Hessian matrices associated with amorphous materials exhibit singularities P(H)∼|H|^{γ} with an exponent γ

We study the early-time and coarsening dynamics in the light-heavy model, a system consisting of two species of particles (light and heavy) coupled to a fluctuating surface (described by tilt fields). The dynamics of particles and tilts are coupled through local update rules, and are known to lead to different ordered and disordered steady-state phases depending on the microscopic rates. We introduce a generalized balance mechanism in nonequilibrium systems, namely, bunchwise balance, in which incoming and outgoing transition currents are balanced between groups of configurations. This allows us to exactly determine the steady state in a subspace of the phase diagram of this model. We introduce the concept of irreducible sequences of interfaces and bends in this model. These sequences are nonlocal, and we show that they provide a coarsening length scale in the ordered phases at late times. Finally, we propose a local correlation function (S) that has a direct relation to the number of irreducible sequences, and is able to distinguish between several phases of this system through its coarsening properties. Starting from a totally disordered initial configuration, S displays an initial linear rise and a broad maximum. As the system evolves toward the ordered steady states, S further exhibits power-law decays at late times that encode coarsening properties of the approach to the ordered phases. Focusing on early-time dynamics, we posit coupled mean field evolution equations governing the particles and tilts, which at short times are well approximated by a set of linearized equations, which we solve analytically. Beyond a timescale set by an ultraviolet (lattice) cutoff and preceding the onset of coarsening, our linearized theory predicts the existence of an intermediate diffusive (power-law) stretch, which we also find in simulations of the ordered regime of the system.

We explore phase separation and kinetic arrest in a model active colloidal system consisting of self-propelled, hard-core particles with nonconvex shapes. The passive limit of the model, namely cross-shaped particles on a square lattice, exhibits a first-order transition from a fluid phase to a solid phase with increasing density. Quenches into the two-phase coexistence region exhibit an aging regime. The nonconvex shape of the particles eases jamming in the passive system and leads to strong inhibition of rotations of the active particles. Using numerical simulations and analytical modeling, we quantify the nonequilibrium phase behavior as a function of density and activity. If we view activity as the analog of attraction strength, the phase diagram exhibits strong similarities to that of attractive colloids, exhibiting both aging, glassy states and gel-like arrested states. The two types of dynamically arrested states, glasses and gels, are distinguished by the appearance of density heterogenities in the latter. In the infinitely persistent limit, we show that a coarse-grained model based on the asymmetric exclusion process quantitatively predicts the density profiles of the gel states. The predictions remain qualitatively valid for finite rotation rates. Using these results, we classify the activity-driven phases and identify the boundaries separating them.

During the past three decades, sea water level (SWL) in the Caspian Sea has declined by about 2 m and sea area has decreased by about 15 000 km ^2 . This has affected coastal communities, the environment and economically important gulfs of the sea (e.g. Dead Kultuk). To assess the effects of coastline change and evaluate zones vulnerable to desiccation, we simulated SWL using total inflow from feeder rivers and precipitation and evaporation over the sea. We determined potential vulnerable areas of the sea over the past 80 years by comparing the minimum and maximum annual water body maps (for 1977 and 1995). We then determined the linear regression between SWL rise and covered potential vulnerable area (CVA), using annual Normalised Difference Water Index (NDWI) maps and SWL data from 1977 to 2018. Combining SWL-CVA regression and SWL simulation model enabled us to determine desiccated areas in different regions of the Caspian Sea due to changes in precipitation, evaporation and total inflow. The results showed that 25 000 km ^2 of the sea is potentially vulnerable to SWL fluctuations in terms of desiccation, with 70% of this vulnerable area located in Kazakhstan. Potential vulnerable area per kilometre coastline was found to be 6 km ^2 in Kazakhstan, 4 km ^2 in Russia and whole of Caspian Sea, 1.5 km ^2 in Iran, 1 km ^2 in Azerbaijan and 0.5 km ^2 in Turkmenistan. The results also indicated that SWL in the Caspian Sea is sensitive to evaporation and that e.g. a 37.5 mm decrease in mean annual net precipitation would lead to a 1875 km ^2 decrease in the sea area, while a 1 km ^3 decrease in mean annual inflow would lead to a 1400 km ^2 decrease in the sea area. Thus the developed framework enabled the spatial consequences of changes in water balance parameters on sea area to be quantified. It can be used to assess future changes in SWL and sea area due to anthropogenic activities and climate change.

Hierarchical aggregation is generally viewed as a kinetic phenomenon governed by kinetic growth laws, such as in the Smoluchowski equation, and modeled using diffusion or reaction limited kinetic growth models. Some aggregates, especially those controlled by surface grafting or surfactants, display reversible stability. For these equilibrated aggregates a simple thermodynamic model is proposed to describe the size distribution and the enthalpy and entropy of aggregation. The model uses the average degree of aggregation, z_{i(i−1)}, as the central quantifying parameter. Here i is an index reflecting the hierarchical level of structure in an aggregate, for instance, composed of crystals (i=0), clustered primary particles (i=1), aggregates (i=2), and agglomerates of aggregates (i=3). A change in Gibbs free energy for aggregation is given by ΔG_{i(i−1)}=−RTln(1/z_{i(i−1)}) for each level (i>0). This expression is advantageous since the degree of aggregation is directly determined in small-angle neutron and x-ray scattering, by transmission electron microscopy, simulation, or through spectroscopy. The atomistic hierarchical model enables an understanding of the mechanism of equilibrium aggregation since it provides expressions for entropy and enthalpy of aggregation at each structural/thermodynamic level. The model can be extended to describe pseudoequilibrium for industrially relevant materials such as condensation polymers. Applications in organic pigments and wormlike micelles are also briefly demonstrated.

Systematic crises may disrupt well-designed nutrition interventions. Continuing services requires understanding the intervention paths that have been disrupted and adapting as crises permit. Alive & Thrive developed an intervention to integrate nutrition services into urban antenatal care services in Dhaka, which started at the onset of COVID-19 and encountered extraordinary disruption of services. We investigated the disruptions and adaptations that occurred to continue the delivery of services for women and children and elucidated how the intervention team made those adaptations. We examined the intervention components planned and those implemented annotating the disruptions and adaptations. Subsequently, we detailed the intervention paths (capacity building, supportive supervision, demand generation, counselling services, and reporting, data management and performance review). We sorted out processes at the system, organizational, service delivery and individual levels on how the intervention team made the adaptations. Disruptions included decreased client load and demand for services, attrition of providers and intervention staff, key intervention activities becoming unfeasible and clients and providers facing challenges affecting utilization and provision of services. Adaptations included incorporating new guidance for the continuity of services, managing workforce turnover and incorporating remote modalities for all intervention components. The intervention adapted to continue by incorporating hybrid modalities including both original activities that were feasible and adapted activities. Amidst health system crises, the adapted intervention was successfully delivered. This knowledge of how to identify disruptions and adapt interventions during major crises is critical as Bangladesh and other countries face new threats (conflict, climate, economic downturns, inequities and epidemics)., (© 2024 The Author(s). Maternal & Child Nutrition published by John Wiley & Sons Ltd.)

Cardiovascular disease is the leading cause of mortality in the US. Studies suggest a role for environmental exposures in the etiology of cardiovascular disease, including exposure to arsenic through drinking water. Arsenic exposure during pregnancy has been shown to have effects on offspring, but few studies have examined impacts on maternal cardiovascular health. While our prior work documented the detrimental effect of arsenic on the maternal heart during pregnancy, our current study examines the effect of gestational arsenic exposure on the maternal heart postpartum. Timed-pregnant wild-type (C57BL/6J) mice were exposed to 0, 100 or 1000 µg/L sodium arsenite (NaAsO2) via drinking water from embryonic day 2.5 (E2.5) until parturition. Postpartum heart structure and function was assessed via transthoracic echocardiography and gravimetric measurement. Hypertrophic markers were probed via qRT-PCR and western blot. Isolated cardiomyocyte Ca 2+ -handling and contraction were also assessed, and expression of proteins associated with Ca 2+ handling and contraction. Interestingly, we found that exposure to either 100 or 1000 µg/L sodium arsenite increased postpartum heart size at P12 vs. non-exposed postpartum controls. At the cellular level, we found altered cardiomyocyte Ca 2+ -handling and contraction. We also found altered expression of key contractile proteins, including α-Actin and cardiac myosin binding protein C (cMyBP-c). Together, these findings suggest that gestational arsenic exposure impacts the postpartum maternal heart, possibly inducing long-term cardiovascular changes. Furthermore, these findings highlight the importance of reducing arsenic exposure during pregnancy, and the need for more research on the impact of arsenic and other environmental exposures on maternal heart health and adverse pregnancy events., New & Noteworthy: Gestational exposure to sodium arsenite at environmentally relevant doses (100 and 1000 µg/L) increases postpartum heart size, and induces dysregulated Ca 2+ homeostasis and impaired shortening in isolated cardiomyocytes. This is the first study to demonstrate that gestational arsenic exposure impacts postpartum heart structure and function beyond the exposure period.

Purpose: The genetic underpinning of neurodevelopmental disorders (NDDs) in diverse ethnic populations, especially those with high rates of consanguinity, remains largely unexplored. Here, we aim to elucidate genomic insight from 576 well-phenotyped and highly consanguineous (16%) NDD cohort., Methods: We used chromosomal microarray (CMA; N:247), exome sequencing (ES; N:127), combined CMA and ES (N:202), and long-read genome sequencing to identify genetic etiology. Deep clinical multivariate data were coupled with genomic variants for stratification analysis., Results: Genetic diagnosis rates were 17% with CMA, 29.92% with ES, and 37.13% with combined CMA and ES. Notably, children of consanguineous parents showed a significantly higher diagnostic yield (P < .01) compared to those from nonconsanguineous parents. Among the ES-identified pathogenic variants, 36.19% (38/105) were novel, implicating 35 unique genes. Long-read sequencing of seizure participants unresolved by combined test identified expanded FMR1 trinucleotide repeats. Additionally, we identified 2 recurrent X-linked variants in the G6PD in 3.65% (12/329) of NDD participants. These variants were absent in large-population control cohorts and cohort comprising neurodevelopmental and neuropsychiatric populations of European descendants, indicating a possible associated risk factor potentially resulting from ancient genetic drift., Conclusion: This study unveils unique clinical and genomic insights from a consanguinity rich Bangladeshi NDD cohort, highlighting a strong association of G6PD with NDD in this population., Competing Interests: Conflict of Interest Corresponding author, Mohammed Uddin owns share of GenomeArc. All other authors declare no conflicts of interest., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Breast implant illness (BII) has become a contentious subject in recent years. Although some studies have reported associations between breast implants and autoimmune diseases, others have failed to establish a definitive link., Objectives: The objective of this study was to provide a comprehensive, up-to-date evaluation of the literature surrounding BII, with an emphasis on identifying patient-related factors that may be associated with BII., Methods: A systematic review was performed following PRISMA guidelines by searching the PubMed (MEDLINE), Embase, and Cochrane databases for relevant studies published in the last 20 years., Results: Thirty-one studies were included, which covered 39,505 implant patients with a mean [standard deviation] age of 44.2 [9.30] years. Fifteen studies reported implant explantation status, with 72.4% patients choosing to remove their implants. Among these, 9 studies reported symptom improvement in 83.5% patients. Fifty-three percent of patients undergoing explantation had total capsulectomy. Twenty-eight studies documented total numbers of patients experiencing symptoms related to BII, with 31.3% patients reporting such symptoms. Among these, 16 studies of 4109 BII patients distinguished whether the reason for implantation was cosmetic augmentation or reconstruction. When specified, more patients experiencing BII-related symptoms received implants for "cosmetic" vs "reconstructive" reasons (cosmetic, 3864/4109 [94.0%] vs reconstruction, 245/4109 [5.96%]; P < .001)., Conclusions: This review provides an overview of the current state of knowledge regarding BII. The study highlights a potential relationship between BII and indication for implants (cosmetic vs reconstructive) among other variables, offering valuable insight on factors associated with BII and directions for future research., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Aesthetic Society. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Fetal macrosomia, marked by excessive birth weight, is a significant public health issue in developing countries, yet it has received less attention compared to low birth weight. This study aims to determine the prevalence of fetal macrosomia in Bangladesh and its associated factors., Methods: The study utilized data from 4,754 women with complete birth weight information of their children from the Bangladesh Multiple Indicator Cluster Survey (MICS) -2019, defining fetal macrosomia as newborns with a birth weight ≥4,000 g regardless of gestational age. Bivariate logistic regression assessed associations between independent variables and fetal macrosomia, presenting adjusted odds ratios (AOR) and a 95% confidence interval (CI), while controlling for potential confounders such as women's age, wealth index, education, healthcare utilization, comorbidities, newborn sex, and place of residence., Results: The prevalence of fetal macrosomia was 11.6%. Significant associations with fetal macrosomia included higher maternal age group (30-34 years) (AOR = 1.36, 95% CI = 1.07-1.74), secondary level of mother's education (AOR = 1.95, 95% CI = 1.43-2.66), experienced physical attacks (AOR = 1.41, 95% CI = 1.06-1.88), hypertension during pregnancy (AOR = 1.54, 95% CI = 1.15-2.07), and rural residence (AOR = 1.25, 95% CI = 1.15-1.49). Female infants had 18% lower odds of being macrosomic compared to male infants (AOR = 0.82, 95% CI = 0.72-0.93)., Conclusion: One in ten infants in Bangladesh are born with macrosomia, necessitating a multi-faceted approach involving improving maternal nutrition, promoting healthy lifestyles, enhancing access to quality prenatal care, and addressing socioeconomic, residential, and healthcare system challenges, underlining the importance of further community-based research to expand the study's scope., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2024 Islam, Chowdhury, Billah, Rashid, Kabir, Hasan and Kader.)

Human Activity Recognition (HAR), alongside Ambient Assisted Living (AAL), are integral components of smart homes, sports, surveillance, and investigation activities. To recognize daily activities, researchers are focusing on lightweight, cost-effective, wearable sensor-based technologies as traditional vision-based technologies lack elderly privacy, a fundamental right of every human. However, it is challenging to extract potential features from 1D multi-sensor data. Thus, this research focuses on extracting distinguishable patterns and deep features from spectral images by time-frequency-domain analysis of 1D multi-sensor data. Wearable sensor data, particularly accelerator and gyroscope data, act as input signals of different daily activities, and provide potential information using time-frequency analysis. This potential time series information is mapped into spectral images through a process called use of 'scalograms', derived from the continuous wavelet transform. The deep activity features are extracted from the activity image using deep learning models such as CNN, MobileNetV3, ResNet, and GoogleNet and subsequently classified using a conventional classifier. To validate the proposed model, SisFall and PAMAP2 benchmark datasets are used. Based on the experimental results, this proposed model shows the optimal performance for activity recognition obtaining an accuracy of 98.4% for SisFall and 98.1% for PAMAP2, using Morlet as the mother wavelet with ResNet-101 and a softmax classifier, and outperforms state-of-the-art algorithms.

The study investigated mental health status of the students of public and private universities, their willingness to take vaccine against COVID-19, and its association with fear, anxiety, and depression. A cross-sectional electronic survey was conducted from July 26 to September 15, 2021, using a well-structured questionnaire among 504 university students. The average age of the participants was 22.92 ± 2.28 years and 76.98% of them were willing to vaccinate against COVID-19. The fear of COVID-19 was found mild, and depression level was demonstrated moderate among the students irrespective of the university types. Moreover, Masters/MPhil/PhD students and the students living in semi-urban areas had the highest rate of willingness to vaccinate. The study demonstrated that level of fear, anxiety, and depression was directly associated with increased willingness to vaccinate among the tertiary level students in Bangladesh. The outcome of this study sketched a positive association of knowledge and education with better management of pandemic in a society., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: Hearing loss and diminished visual acuity are associated with poorer cognition, but the underlying mechanisms are not understood. The apolipoprotein (APOE) ε4 allelic variant may drive the associations. We tested whether APOE-ε4 allele count (0, 1, or 2) was associated with declines in memory, executive function, pure-tone hearing threshold averages, and pinhole-corrected visual acuity among participants in the Canadian Longitudinal Study on Aging (CLSA)., Methods: Multivariable linear mixed regression models were utilized to assess associations between APOE-ε4 allele count and each of the outcome variables. For each main effects model, interactions between APOE-ε4 and sex and age group (45-54-, 55-64-, 65-74-, and 75-85 years) respectively, were analyzed., Results: Significant associations were not observed in main effects models. Models including APOE-ε4 * age (but not APOE-ε4 * sex) interaction terms better fit the data compared to main effects models. In age group-stratified models, however, there were minimal differences in effect estimates according to allele count., Conclusion: APOE-ε4 allele count does not appear to be a common cause of sensory-cognitive associations in this large cohort., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Studies focusing on the safety and common side effects of vaccines play a crucial role in enhancing public acceptance of vaccination. Research is scarce regarding the usage of COVID-19 vaccines and the side effects experienced by health professions students in India and other countries. This study aimed to document self-reported side effects associated with COVID-19 vaccination among medical and dental students of six medical and dental colleges and teaching hospitals in four states (Tamil Nadu, Madhya Pradesh, Gujarat, and West Bengal) of India. A cross-sectional survey using purposive sampling of medical and dental students was conducted from 26 April to 26 May 2021. Data was collected using a Google Forms questionnaire capturing information regarding receiving COVID-19 vaccines, side effects and symptoms, onset and duration of symptoms, use of treatment to alleviate symptoms, awareness of haematologic risks associated with vaccination, and side effects from previous (non-COVID-19) vaccinations. The majority (94.5%) of participants received both doses of the Covishield/AstraZeneca COVID-19 vaccine. Among participants ( n  = 492), 45.3% ( n  = 223) reported one or more side effects. The most frequently reported side effects were soreness of the injected arm (80.3%), tiredness (78.5%), fever (71.3%), headache (64.1%), and hypersomnia (58.7%). The two most common severe symptoms were fever (14.8%) and headache (13%). Most side effects appeared on the day of vaccination: soreness of the injection site (57%), fever (43.1%), and tiredness (42.6%). Most reported symptoms persisted for one to three days-soreness of the injection site (53%), fever (47.1%), and headache (42.6%). Logistic regression showed that women were almost 85% less likely to report side effects. The study's findings corroborate the safety of the Covishield/AstraZeneca vaccine's first dose, evidenced by the relatively minor and transient nature of the side effects. However, the study underscores the necessity for ongoing research to assess the long-term impacts of COVID-19 vaccines, especially in the context of booster doses, thereby contributing to the global understanding of vaccine safety and efficacy., Competing Interests: Russell Kabir is an Academic Editor for PeerJ. The other authors declare that they have no competing interests., (©2024 Majumder et al.)

Purpose: Nipple-areolar complex (NAC) viability remains a significant concern following prepectoral tissue expander (TE) reconstruction after nipple-sparing mastectomy (NSM). This study assesses the impact of intraoperative TE fill on NAC necrosis and identifies strategies for mitigating this risk., Methods: A chart review of all consecutive, prepectoral TEs placed immediately after NSM was performed between March 2017 and December 2022 at a single center. Demographics, mastectomy weight, intraoperative TE fill, and complications were extracted for all patients. Partial NAC necrosis was defined as any thickness of skin loss including part of the NAC, whereas total NAC necrosis was defined as full-thickness skin loss involving the entirety of the NAC. P < 0.05 was considered statistically significant., Results: Forty-six patients (83 breasts) with an average follow-up of 22 months were included. Women were on average 46 years old, nonsmoker (98%), and nondiabetic (100%) and had a body mass index of 23 kg/m2. All reconstructions were performed immediately following prophylactic mastectomies in 49% and therapeutic mastectomies in 51% of cases. Three breasts (4%) were radiated, and 15 patients (33%) received chemotherapy. Mean mastectomy weight was 346 ± 274 g, median intraoperative TE fill was 150 ± 225 mL, and median final TE fill was 350 ± 170 mL. Partial NAC necrosis occurred in 7 breasts (8%), and there were zero instances of complete NAC necrosis. On univariate analysis, partial NAC necrosis was not associated with any patient demographic or operative characteristics, including intraoperative TE fill. In multivariable models controlling for age, body mass index, mastectomy weight, prior breast surgery, and intraoperative TE fill, partial NAC necrosis was associated with lower body mass index (odds ratio, 0.53; confidence interval [CI], 0.29-0.98; P < 0.05) and higher mastectomy weight (odds ratio, 1.1; CI, 1.01-1.20; P < 0.05). Prior breast surgery approached significance, as those breasts had a 19.4 times higher odds of partial NAC necrosis (95% CI, 0.88-427.6; P = 0.06)., Conclusions: Nipple-areolar complex necrosis following prepectoral TE reconstruction is a rare but serious complication. In this study of 83 breasts, 7 (8%) developed partial NAC necrosis, and all but one were able to be salvaged., Competing Interests: Conflicts of interest and sources of funding: none declared., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)

Objective: Cancer is a major cause of death globally, and places a substantial burden on both patients and their caregivers. Frequent stress among caregivers often affects their mental well-being. This study was aimed at assessing anxiety and depression levels among informal caregivers of patients with cancer treated at selected tertiary hospitals in Nepal. An additional aim was to identify socio-demographic factors associated with these mental health outcomes., Methods: In this cross-sectional study, 383 informal caregivers were surveyed with the Hospital Anxiety and Depression Scale (HADS). Statistical analyses, including descriptive analysis and binary logistic regression, were conducted to explore associations with socio-demographic variables., Results: The mean age of participants was 36.1 ± 13.1 years, and 56.1% were 12-36 years old. Most participants were married (81.5%), were unemployed (66.6%), and had primary to secondary education (66.6%). The prevalence of moderate to severe anxiety (52%) and depression (45%) among caregivers was notable. Caregivers of patients treated at non-governmental hospitals were six times more likely (OR 6.3, 95% CI: [3.62-10.95], P  = 0.001) to have anxiety and five times more likely (OR 5.3, 95% CI: [8.28-19.32], P  = 0.001) to have depression., Conclusion: People who take care of patients with cancer in Nepal often feel substantial stress. Determining the causes of these feelings can aid in the creation of programs to support caregivers' mental health. Caring for mental well-being among caregivers is critical to achieving better cancer care and quality of life., (© 2024 The Authors.)

Background: Nurses are essential members of the healthcare workforce and were among the first-line carers for patients in community and hospital settings during the COVID-19 pandemic. As a result, they were at a heightened risk of infection, resulting in several reported deaths among nursing staff. Several preventive measures were adopted to contain the spread of the COVID-19 virus. This study aims to explore the knowledge, attitudes, and practices (KAP) of nurses regarding hand hygiene, mask wearing, and social distancing measures in healthcare settings in Barbados during the COVID-19 pandemic., Method: An online survey of nurses working in public hospitals and polyclinics (public primary care clinics) in Barbados from March 2021 to December 2021 was conducted. A nonsystematic convenience sampling method was employed to recruit nurses who were readily available and willing to participate. A questionnaire captured the sociodemographic information and knowledge and practices related to hand hygiene, the use of face masks, and social distancing. Each correct response received one mark. Overall knowledge scores were categorized as poor (<60%), average (60-80%), or good (>80-100%)., Results: Of the 192 participants, the majority were female (82.8%) and had >5 years of experience (82%). The findings revealed that 45.8% had poor knowledge of hand hygiene, and that the knowledge of 43.8% of respondents was average. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 2.1 times increased odds (95% confidence interval 1.0, 4.2) of having good knowledge compared to other nursing categories. Regarding mask wearing, 53.6% of nurses had average knowledge, and 27.1% had good knowledge. Multivariable logistic regression showed that, after adjustment for age and gender, registered nurses had 3.3 times increased odds (95% confidence interval 1.5, 7.4) of having good knowledge compared to nursing assistants. A total of 68.6% of respondents followed the correct steps of handwashing every time, and 98.3% wore a mask in public places. More than half of the nurses (51.2%) kept a safe distance from others to avoid spreading SARS-CoV-2; one-third were in a crowded place(s) in the past three months, and 55.8% usually followed guidelines for social isolation as recommended by the WHO., Conclusions: The study identified knowledge deficiencies related to hand hygiene and wearing masks among nurses. It is imperative to provide additional training on infection control measures.

An optimized robot path-planning algorithm is required for various aspects of robot movements in applications. The efficacy of the robot path-planning model is vulnerable to the number of search nodes, path cost, and time complexity. The conventional A-star (A*) algorithm outperforms other grid-based algorithms because of its heuristic approach. However, the performance of the conventional A* algorithm is suboptimal for the time, space, and number of search nodes, depending on the robot motion block (RMB). To address these challenges, this paper proposes an optimal RMB with an adaptive cost function to improve performance. The proposed adaptive cost function keeps track of the goal node and adaptively calculates the movement costs for quickly arriving at the goal node. Incorporating the adaptive cost function with a selected optimal RMB significantly reduces the searches of less impactful and redundant nodes, which improves the performance of the A* algorithm in terms of the number of search nodes and time complexity. To validate the performance and robustness of the proposed model, an extensive experiment was conducted. In the experiment, an open-source dataset featuring various types of grid maps was customized to incorporate the multiple map sizes and sets of source-to-destination nodes. According to the experiments, the proposed method demonstrated a remarkable improvement of 93.98% in the number of search nodes and 98.94% in time complexity compared to the conventional A* algorithm. The proposed model outperforms other state-of-the-art algorithms by keeping the path cost largely comparable. Additionally, an ROS experiment using a robot and lidar sensor data shows the improvement of the proposed method in a simulated laboratory environment.

Women who are undocumented migrants in Europe encounter a variety of challenges while trying to access health services, including restricted access to antenatal care (ANC) despite the importance of ANC to the well-being of mothers and their infants. This study's aim was to examine the effect that limited access to antenatal care has on the pregnancy experiences and outcomes of undocumented migrant (UM) women in Europe. Systematic searches were done on PubMed, Ovid MEDLINE, Ovid EMBASE, EBSCO CINAHL Plus, and BioMed Central. From the search results, only primary research articles that reported on the pregnancy outcomes and experiences of undocumented migrants were selected. A meta-analysis was not possible because this review included information from both qualitative and quantitative studies. The data that was taken from the included publications was organised, analysed, using the Microsoft Excel programme, and then meta-synthesised. Twelve papers from seven different European nations-Belgium, France, Sweden, Denmark, Norway, Finland, and England-were included in this systematic review. Eight of the studies aimed to explore the access to and utilization of ANC by undocumented migrant women and the related pregnancy outcomes. Two of the included studies examined the pregnancy experiences of UMs and two examined the perinatal risks associated with living as a migrant with no legal status. Although heterogeneous in their specific findings most of the studies showed undocumented immigrants are more likely to experience unfavourable pregnancy outcomes and experience greater anxiety and worries due to a variety of factors than documented migrants and registered citizens. This review's conclusions demonstrate the pressing need for policy modifications and healthcare reforms in Europe to address the problems associated with undocumented migrants' restricted access to antenatal care. It also highlights the urgent need for structural changes that will give this vulnerable population's health and well-being a higher priority. It is not just an issue of health equality but also a humanitarian obligation to address the many obstacles and difficulties undocumented migrant women endure during pregnancy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (© 2024 Osuide, Parsa, Mahmud and Kabir.)

Exposure to inorganic arsenic through drinking water is widespread and has been linked to many chronic diseases, including cardiovascular disease. Arsenic exposure has been shown to alter hypertrophic signaling in the adult heart, as well as in utero offspring development. However, the effect of arsenic on maternal cardiac remodeling during pregnancy has not been studied. As such, there is a need to understand how environmental exposure contributes to adverse pregnancy-related cardiovascular events. This study seeks to understand the impact of trivalent inorganic arsenic exposure during gestation on maternal cardiac remodeling in late pregnancy, as well as offspring outcomes. C57BL/6 J mice were exposed to 0 (control), 100 or 1000 μg/L sodium arsenite (NaAsO 2 ) beginning at embryonic day (E) 2.5 and continuing through E17.5. Maternal heart function and size were assessed via transthoracic echocardiography, gravimetric measurement, and histology. Transcript levels of hypertrophic markers were probed via qRT-PCR and confirmed by western blot. Offspring outcomes were assessed through echocardiography and gravimetric measurement. We found that maternal heart size was smaller and transcript levels of Esr1 (estrogen receptor alpha), Pgrmc1 (progesterone receptor membrane component 1) and Pgrmc2 (progesterone receptor membrane component 2) reduced during late pregnancy with exposure to 1000 μg/L iAs vs. non-exposed pregnant controls. Both 100 and 1000 μg/L iAs also reduced transcription of Nppa (atrial natriuretic peptide). Akt protein expression was also significantly reduced after 1000 μg/L iAs exposure in the maternal heart with no change in activating phosphorylation. This significant abrogation of maternal cardiac hypertrophy suggests that arsenic exposure during pregnancy can potentially contribute to cardiovascular disease. Taken together, our findings further underscore the importance of reducing arsenic exposure during pregnancy and indicate that more research is needed to assess the impact of arsenic and other environmental exposures on the maternal heart and adverse pregnancy events., Competing Interests: Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests. Mark Kohr reports financial support was provided by National Heart Lung and Blood Institute. Nicole Taube reports financial support was provided by National Institute of Environmental Health Sciences. Haley Garbus reports financial support was provided by National Heart Lung and Blood Institute. Mark Kohr reports a relationship with National Heart Lung and Blood Institute that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)