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Objective: To examine what factors impact college students in the United States who are deciding to initiate or continue mental health services. Participants: Spring 2021 undergraduate students (N = 453) at a large urban university. Methods: Online, cross-sectional survey with mental health service experience as the independent variable and social support, accessibility, attitudes toward mental health, mental health literacy, and trust of mental health professionals as the dependent variables, as well as thematic analysis of reasons to discontinue services. Results: Individuals with lower levels of social support and higher levels of mental health literacy were more likely to have received therapy. Participants tended to discontinue services because of negative experiences, accessibility problems, negative attitudes toward services, or they felt better. Conclusions: Mental health literacy, social support, and accessibility are significant predictors of college student service use and should be taken into consideration by university administration. [ABSTRACT FROM AUTHOR]

This paper examines how multiseason drama serials, including those characterized as 'quality' or 'complex' television, deliver their continuation across multiple seasons. It proposes 'desperation' as a distinctive storytelling modality in which continuation itself and the narrative means by which continuation is managed are brought to the fore, charting how this is deployed by many shows which use season-long stories and/or stories which run for the lifetime of the show. Dramas derived from literary sources are examined alongside those where original narratives are drafted while they are already underway, and the relationship among continuation, seriality, adaptation, and literary/story-telling models is considered. Finally, through discussion of 'show bibles' and 'pitch bibles' it contends that continuing dramas effectively adapt themselves through the manner in which earlier seasons generate models and possibilities for those that follow. [ABSTRACT FROM AUTHOR]

Yudai Fujimoto,1,2 Yoshimi Yuri,2 Miki Fujii,1 Hironari Tamiya1,3 1Department of Rehabilitation, Osaka International Cancer Institute, Osaka, Japan; 2Graduate School of Health Sciences, Morinomiya University of Medical Sciences, Osaka, Japan; 3Department of Orthopaedic Surgery (Musculoskeletal Oncology Service), Osaka International Cancer Institute, Osaka, JapanCorrespondence: Yudai Fujimoto, Department of Rehabilitation, Osaka International Cancer Institute, 3-1-69 Otemae, Chuo-ku, Osaka, 541-8567, Japan, Tel +81-6-6945-1181, Fax +81-6-6945-1900, Email yuudai.fujimoto@oici.jpPurpose: This study aimed to determine the combination of factors associated with continuity of care in outpatients with cancer-related edema six months after the initial visit.Patients and Methods: A total of 101 outpatients were divided into two groups: continuation (n=65) and non-continuation (n=36) groups. Details regarding age, body mass index, sex, affected extremities (upper or lower), site of edema (unilateral or bilateral), International Society of Lymphology (ISL) classification, presence of distant metastasis, and overall score on the lymphedema quality of life questionnaire (LYMQOL) were obtained before initial lymphedema care. In this study, we performed a decision tree analysis using a classification and regression tree (CART) to detect the combination of factors associated with the continuity of edema care for cancer-related edema.Results: Significant differences were observed in the site of edema (unilateral or bilateral) and distant metastasis between the two groups. In the decision tree using CART analysis, the factors selected to influence the possibility of continuation were the side of edema as the first layer, and body mass index of 23.0 and distant metastasis (with/without) as the second layer. Outpatients with unilateral edema and a body mass index higher than 23.0 were most likely to be able to continue care. In contrast, outpatients with bilateral edema and distant metastasis had greater difficulty in continuing care.Conclusion: In this study, factors that were suggested to influence the continuity of cancer-related edema care were the side with edema, body mass index higher than 23.0, and distant metastasis. This information may be helpful for developing care strategies and improving patient adherence.Keywords: cancer-related edema, continuation, decision tree analysis, outpatient, predicted factor

Background: Major randomized clinical trials have shown that biological therapy can reduce the exacerbation rate and oral corticosteroid (OCS) dosage in patients with severe eosinophilic asthma. However, data on the continuation, efficacy, and safety of biological therapy in older patients with asthma are limited. Therefore, the aim of this study was to evaluate the differences in the continuation rate, efficacy, and safety of biological therapy between older (≥ 65 years) and younger (< 65 years) patients with asthma. Methods: In this single-center retrospective observational study, we collected clinical data of patients with asthma who were administered biological drugs such as omalizumab, mepolizumab, benralizumab, and dupilumab between April 2009 and August 2022. We comparatively analyzed the continuation, efficacy, and safety of biological therapy between older (age = 65 years) and younger patient (age < 65 years) groups. The reasons for discontinuation or switching of biological drugs were also evaluated. Results: Sixty-two (31 older and 31 younger) patients were treated with 91 biologics during the observational period. The mean age of older patients was 74.3 ± 5.1 years and that of younger patients was 48.0 ± 14.0 years. The continuation rate of biological therapy was not significantly different between the groups. Social background was the most common reason for discontinuation of biological therapy in both groups, and insufficient effect was the most common reason for switching to biological drugs. Asthma exacerbations decreased in both groups within the first 12 months of biologic therapy. The dosage of OCS tended to decrease in the older group and significantly decrease in the younger group. Conclusion: Biologic therapy for older patients with asthma can be continued, with efficacy and safety similar to those in younger patients with asthma. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate long-term continuation rates, adverse events of ring pessary use at a minimum of 5 years follow-up, and factors associated with discontinuation in symptomatic pelvic organ prolapse (POP). Methods: Women with symptomatic POP who were treated with vaginal ring pessary and had successful fittings were included. Adverse events and reasons for discontinuation of pessary use were recorded. Patients who were lost to follow-up were defined as discontinuation. Results: During 12 year-period, 239 of 329 POP patients (72.6%) had successful fittings with ring pessary. The mean age was 67.8 ± 8.9 years (range 27–86) and 70% of patients had advanced stage. The cumulative probability of continued ring pessary use was 84.1%, 64.4%, 49.3%, and 33.5%, at 1, 3, 5, and 10 years, respectively. Most common reason for discontinuation was frequent expulsion (21.6%), followed by vaginal erosion (16.5%), no prolapse improvement (12.4%), and inability or inconvenience to do self-care (9.3%). However, 9 patients (9.3%) had improvement of prolapse and were able to discontinue pessary insertion. Age above 70 years, wide introitus, and incapability of self-care are independent factors associated with long-term discontinuation. Adverse events occurred in 23.4% of patients, 18.8% of them had vaginal erosion, 11.7% vaginal discharge/infection, and 18.4% de novo SUI. However, no statistical significance existed between those who continued and discontinued pessary use due to these adverse events. Conclusion: Ring pessary is an effective treatment in symptomatic POP, with acceptable long-term continuation rates and minor adverse events. Self-care of pessary is very important aiming to minimize adverse events. Advanced age, wide introitus and incapability of self-care were associated factors for long-term discontinuation. [ABSTRACT FROM AUTHOR]

Introduction: Highly effective long‐acting reversible contraceptive (LARC) methods reduce unintended pregnancy rates; however, these methods are underutilized. The LOWE trial intervention provided structured contraceptive counseling resulting in increased uptake of LARC. This longitudinal follow up of the LOWE study assessed the long‐term impact of the intervention by investigating the contraceptive use at 12 months with a focus on continued use of LARC. Material and methods: In the cluster randomized LOWE trial, abortion, youth, and maternal health clinics were randomized to provide either structured contraceptive counseling (intervention) or standard contraceptive counseling (control). The intervention consisted of an educational video on contraceptive methods, key questions asked by the health care provider, a tiered effectiveness chart and a box of contraceptive models. Women ≥ age 18, who were sexually active or planned to be in the upcoming 6 months, could participate in the study. We assessed self‐reported contraceptive use at three, six and 12 months. Contraceptive choice and switches were analyzed with descriptive statistics. Contraceptive use at 12 months and continued use of LARC were analyzed using mixed logistic regressions, with clinic included as a random effect. Analysis with imputed values were performed for missing data to test the robustness of results. Results: Overall, at 12 months, women in the intervention group were more likely to be using a LARC method (aOR 1.90, 95% CI: 1.31–2.76) and less likely to be using a short‐acting reversible contraceptive (SARC) method (aOR 0.66, 95% CI: 0.46–0.93) compared to the control group. Women counseled at abortion (aOR 2.97, 95% CI: 1.36–6.75) and youth clinics (aOR 1.81, 95% CI: 1.08–3.03) were more likely to be using a LARC method, while no significant difference was seen in maternal health clinics (aOR 1.84, 95% CI: 0.96–3.66). Among women initiating LARC, continuation rates at 12 months did not differ between study groups (63.9% vs. 63.7%). The most common reasons for contraceptive discontinuation were wish for pregnancy, followed by irregular bleeding, and mood changes. Conclusions: The LOWE trial intervention resulted in increased LARC use also at 12 months. Strategies on how to sustain LARC use needs to be further investigated. [ABSTRACT FROM AUTHOR]

Periodic orbit families around asteroids serve as potential trajectories for space probes, mining facilities, and deep space stations. Bifurcations of these families provide additional candidate orbits for efficient trajectory design around asteroids. While various bifurcations of periodic orbit families around asteroids have been extensively studied, period-multiplying bifurcations have received less attention. This paper focuses on studying period-multiplying bifurcations of periodic orbit families around asteroids. In particular, orbits with periods of approximately 7 and 17 times that of the rotational period of asteroid 216 Kleopatra were computed. The computation of high-period orbits provides insights into the numerical aspects of simulating long-duration trajectories around asteroids. The previous literature uses single-shooting and multiple-shooting methods to compute bifurcations of periodic orbit families around asteroids. Computational difficulties were encountered while using the shooting methods to obtain period-multiplying bifurcations of periodic orbit families around asteroids. This work used the Legendre–Gauss collocation method to compute period-multiplying bifurcations around asteroids. This study recommends the use of collocation methods to obtain long-duration orbits around asteroids when computational difficulties are encountered while using shooting methods. [ABSTRACT FROM AUTHOR]

A method is proposed to generate an initial guess for impulsive trajectory design in the circular restricted three-body problem. The method uses acceleration-based switching surfaces to obtain near-impulsive solutions. A numerical continuation is performed on the maximum acceleration value to find near-impulsive solutions. A nonlinear programming problem is formulated by providing primer vector based analytical gradients. The solution space is narrowed down to aid the optimizer with the use of the near-impulsive solutions. The proposed method is used for the trajectory design of four different maneuvers between L1 and L2 Halo orbits in the Earth–Moon system. The results demonstrate the utility of the proposed method in generating extremal impulsive trajectories. [ABSTRACT FROM AUTHOR]

Background: Previously, we reported SMR (skeletal muscle radiodensity) as a potential prognostic marker for colorectal cancer. However, there have been limited studies on the association between SMR and the continuation of adjuvant chemotherapy in colorectal cancer. Methods: In this retrospective study, 143 colorectal cancer patients underwent curative surgery and adjuvant chemotherapy using the CAPOX regimen. Patients' SMRs were measured from preoperative CT images and divided into low (bottom quarter) and high (top three quarters) SMR groups. We compared chemotherapy cycles, capecitabine and oxaliplatin doses, and adverse effects in each group. Results: The low SMR group had significantly fewer patients completing adjuvant chemotherapy compared to the high SMR group (44% vs. 68%, P < 0.01). Capecitabine and oxaliplatin doses were also lower in the low SMR group. Incidences of Grade 2 or Grade 3 adverse effects did not differ between groups, but treatment discontinuation due to adverse effects was significantly higher in the low SMR group. Logistic regression analysis revealed Stage III disease (odds ratio 18.09, 95% CI 1.41–231.55) and low SMR (odds ratio 3.26, 95% CI 1.11–9.56) as factors associated with unsuccessful treatment completion. Additionally, a higher proportion of low SMR patients received fewer than 2 cycles of chemotherapy (50% vs. 12%). Conclusion: The low SMR group showed higher treatment incompletion rates and received lower drug doses during adjuvant chemotherapy. Low SMR independently contributed to treatment non-completion in colorectal cancer patients. [ABSTRACT FROM AUTHOR]

In 2022, Indonesia began the energy conversion pilot project from Liquefied Petroleum Gas (LPG) stoves to induction stoves in Surakarta. Before the program is scaled up, it is vital to conduct an in-depth analysis of the technology readiness, technology acceptance, and user satisfaction to assess program continuity. This research aims to identify what configuration of aspects of technology readiness, technology acceptance, and satisfaction will produce continuance intention and the necessary conditions of continuance usage intention. This study involved 412 conversion program participants in five districts in Surakarta, Indonesia. Utilizing fuzzy-set qualitative comparative analysis (fsQCA), four solution configurations that lead to high continuance intention and four for low continuance intention were obtained. Generally, nearly all conditions must be maintained at a positive level to produce high continuance intention, especially innovativeness, and satisfaction. The research has theoretical and practical implications, including satisfaction having the greatest impact on configurations and the quality of the conversion program, in which the induction stove and its service program must become the main focus to ensure satisfaction. Clear policies and wider socialization must be conducted to enhance people's awareness and trust. To boost sustainability and continuity, synergistic cooperation between stakeholders and the creation of a better environment for induction stove implementation must also be established. Future research should conduct a longitudinal study approach to strengthen the analysis of a long-term induction stove conversion program. [ABSTRACT FROM AUTHOR]

Pseudo-arclength continuation is a scheme used to generate a set of solutions for nonlinear equations and has been applied in numerous fields. In continuation schemes, solutions are obtained by tracking a parameter associated with the system as it varies, thereby creating a solution path. Pseudo-arclength continuation employs the nullspace vector, which is tangent to the path, as an approximation of the arclength in order to determine the direction of variation at each point on the path. However, the nullspace vector has both positive and negative solutions that are equally valid, leading to uncertainty in the direction of travel along the path at each location. Selecting the wrong nullspace vector can result in returning to a previously located solution instead of continuing the mapping of the solution path. Techniques to ensure consistent path direction have been developed; however, their efficacy does not extend to all scenarios. This paper addresses this gap by introducing a "flipping condition" to track previously determined path directions and ensure continuous following of the same path direction. A clear description of the process used to incorporate the flipping condition into the pseudo-arclength continuation scheme, practical implementation of the scheme, and examples demonstrating its application to the nonlinear circular restricted three-body problem (CR3BP), is provided. The inclusion of the flipping condition ensures a consistent direction of travel along the solution path and allows for families of solutions to be developed. • Pseudo-arclength continuation develops solutions to nonlinear equations along a path. • Uncertainty in path direction comes from equally valid signs of the nullspace. • Previously-located solutions are repeatedly found without a consistent path direction. • Implementation process for pseudo-arclength continuation to track path direction. • Application to periodic orbits families in the circular restricted three-body problem. [ABSTRACT FROM AUTHOR]

Background. Paliperidone palmitate 3-monthly (PP3M) has been tested in 1-year controlled studies. The aim of this study was to examine the relapse outcomes with PP3M monotherapy at 3 years in patients with schizophrenia. Methods. This was an observational, non-interventional study of patients started on PP3M according to their clinical need. All patients had a diagnosis of schizophrenia (ICD-10 F20) and were between 18 and 65 years of age. The study took place in a mental health facility in South East London, UK. Results. Among the 166 patients who started PP3M, 97 (58%) met inclusion criteria and were observed for 36 months. In total, five patients (5%) experienced a relapse (defined as step-up in clinical care) while on PP3M. There were no relapses between months 18 and 36. Of the original 97 patients, 56 (58%) remained on PP3M monotherapy at 3 years, and 71 (73%) remained on either PP3M or paliperidone palmitate one-monthly. Reasons for discontinuation of PP3M included patient refusal (n = 11, 33% of discontinuations) and adverse effects in (n = 8, 24%). Conclusion. PP3M is a highly effective monotherapy treatment for reducing relapse in people with schizophrenia. [ABSTRACT FROM AUTHOR]

In the work presented in this paper, a study for a class of space-time fractional Langevin diffusion equations with two different time-fractional derivatives and a spatial fractional Laplacian was conducted. Firstly, we investigate the well-posedness and regularity of the mild solutions for a nonlocal problem by using several distinctly different approaches in the following three cases with the source term f: if f is a linear source term, then some properties of the Mittag-Leffler functions, the techniques of Laplace transform and eigenfunctions expansion will be utilized to obtain our main results in this case; if f is a globally Lipschitz and uniformly bounded nonlinear source term, then the method in this case is based on the Picard approximation; if f is a locally Lipschitz and uniformly bounded nonlinear function, then the Banach fixed point theorem will be the main tool for dealing with this case. Next, for the corresponding Cauchy problem, the issues on the continuation, global existence or finite-time blowup of mild solutions are also discussed. [ABSTRACT FROM AUTHOR]

Abstract Background Paliperidone palmitate 3-monthly (PP3M) has been tested in 1-year controlled studies. The aim of this study was to examine the relapse outcomes with PP3M monotherapy at 3 years in patients with schizophrenia. Methods This was an observational, non-interventional study of patients started on PP3M according to their clinical need. All patients had a diagnosis of schizophrenia (ICD-10 F20) and were between 18 and 65 years of age. The study took place in a mental health facility in South East London, UK. Results Among the 166 patients who started PP3M, 97 (58%) met inclusion criteria and were observed for 36 months. In total, five patients (5%) experienced a relapse (defined as step-up in clinical care) while on PP3M. There were no relapses between months 18 and 36. Of the original 97 patients, 56 (58%) remained on PP3M monotherapy at 3 years, and 71 (73%) remained on either PP3M or paliperidone palmitate one-monthly. Reasons for discontinuation of PP3M included patient refusal (n = 11, 33% of discontinuations) and adverse effects in (n = 8, 24%). Conclusion PP3M is a highly effective monotherapy treatment for reducing relapse in people with schizophrenia.

Periodic orbit families around asteroids serve as potential trajectories for space probes, mining facilities, and deep space stations. Bifurcations of these families provide additional candidate orbits for efficient trajectory design around asteroids. While various bifurcations of periodic orbit families around asteroids have been extensively studied, period-multiplying bifurcations have received less attention. This paper focuses on studying period-multiplying bifurcations of periodic orbit families around asteroids. In particular, orbits with periods of approximately 7 and 17 times that of the rotational period of asteroid 216 Kleopatra were computed. The computation of high-period orbits provides insights into the numerical aspects of simulating long-duration trajectories around asteroids. The previous literature uses single-shooting and multiple-shooting methods to compute bifurcations of periodic orbit families around asteroids. Computational difficulties were encountered while using the shooting methods to obtain period-multiplying bifurcations of periodic orbit families around asteroids. This work used the Legendre–Gauss collocation method to compute period-multiplying bifurcations around asteroids. This study recommends the use of collocation methods to obtain long-duration orbits around asteroids when computational difficulties are encountered while using shooting methods.

Algebraic structures such as the lattices of attractors, repellers, and Morse representations provide a computable description of global dynamics. In this paper, a sheaf-theoretic approach to their continuation is developed. The algebraic structures are cast into a categorical framework to study their continuation systematically and simultaneously. Sheaves are built from this abstract formulation, which track the algebraic data as systems vary. Sheaf cohomology is computed for several classical bifurcations, demonstrating its ability to detect and classify bifurcations. [ABSTRACT FROM AUTHOR]

Whirl flutter is an aeroelastic instability that affects aircraft with propellers/rotors. With their long and flexible rotor blades, tiltrotor aircraft are particularly susceptible. Whirl flutter is known to have destroyed aircraft and in the best case it constitutes a fatigue hazard. The complexity of whirl flutter analysis increases significantly with the addition of nonlinearities, due to the more complex dynamical behaviours that emerge as a result. Most whirl flutter stability analyses in current literature are grounded in linear theory, preventing the full discovery of the nonlinearities' effects. Continuation and bifurcation methods (CBM) may instead be used to fully appreciate and analyse the effects of the presence of nonlinearities. Previous CBM-based work on nonlinear gimballed hub rotor-nacelle models, representing those found on tiltrotor aircraft, are capable of whirl flutter in parametric regions declared safe by linear analysis. Furthermore, it was found that they are capable of complex behaviours including limit cycle oscillations, quasi-periodic behaviour and even chaos, though the whirl flutter implications of such behaviours has not been explored. This paper investigates the impact of a smooth structural nonlinearity on the whirl flutter stability of a basic gimballed rotor-nacelle model, compared to its baseline linear stiffness version. A 9-DoF model with quasi-steady aerodynamics, a flexible wing and blades that can move both cyclically and collectively in both flapping and lead-lag motions, producing gimbal flap-like behaviour, was adopted from existing literature. A smooth stiffness nonlinearity was introduced in the blade flapping stiffness and CBM was used to find the new whirl flutter behaviours created by the presence of the nonlinearity. Time simulations, Poincaré sections and spectral analysis were then used to investigate the various behaviours found. This in turn allowed recommendations to be made concerning preferable and/or hazardous parameter combinations of use to the tiltrotor designer. [ABSTRACT FROM AUTHOR]

Abstract Background Maternal folate may not reach an optimal level to prevent neural tube defects if supplementation commenced post-conception or took place pre-conception only. Our study aimed to investigate the continuation of folic acid (FA) supplementation from pre-conception to post-conception during peri-conceptional period and to examine its differences in FA supplementation between the subgroups taking the initiation timing into consideration. Methods This study was conducted in two community health service centers in Jing-an District of Shanghai. Women accompanying their children to pediatric health clinics of the centers were recruited and asked to recall information concerning their socioeconomic and previous obstetric characteristics, utilization of healthcare and FA supplementation before and/or during pregnancy. The continuation of FA supplementation during peri-conceptional period were categorized into three subgroups: Supplementing with FA pre- and post-conception; supplementing with FA preconception only or post-conception only; no FA supplements pre-conception and post-conception. The relationship between FA continuation and couples’ characteristics were examined as setting the first subgroup as the base reference. Results Three hundred and ninety-six women were recruited. Over 40% of the women started FA supplementation after conception and 30.3% of them supplemented with FA from pre-conception to the first trimester of their pregnancy. Compared to this one-third of participants, women who didn’t supplemented with any FA during peri-conceptional period were more likely to have no utilization of pre-conception healthcare ( $$OR$$ OR = 2.47, 95% $$CI$$ CI : 1.33–4.61) or antenatal care ( $$OR$$ OR = 4.05, 95% $$CI$$ CI : 1.76–9.34), or who had a lower family socioeconomic status ( $$OR$$ OR = 4.36, 95% $$CI$$ CI : 1.79–10.64). Women who supplemented with FA pre-conception only or post-conception only were more likely to have no utilization of pre-conception healthcare ( $$OR$$ OR = 2.94, 95% $$CI$$ CI : 1.79–4.82), or to have no previous pregnancy complication ( $$OR$$ OR =1.80, 95% $$CI$$ CI : 0.99–3.28). Conclusion Over two-fifth of the women started FA supplementation and only one-third of them had an optimal supplementation from pre-conception to the first trimester. Maternal utilization of healthcare before or during pregnancy together with maternal and paternal socioeconomic status may play a role in the continuation to FA supplementation pre- and post-conception.

The dynamics of hydrodynamically unstable premixed flames are studied using the nonlinear Michelson–Sivashinsky (MS) equation, modified appropriately to incorporate effects due to gravity. The problem depends on two parameters: the Markstein number that characterises the combustible mixture and its diffusion properties, and the gravitational parameter that represents the ratio of buoyancy to inertial forces. A comprehensive portrait of all possible equilibrium solutions are obtained for a wide range of parameters, using a continuation methodology adopted from bifurcation theory. The results heighten the distinction between upward and downward propagation. In the absence of gravity, the nonlinear development always leads to stationary solutions, namely, cellular flames propagating at a constant speed without change in shape. When decreasing the Markstein number, a modest growth in amplitude is observed with the propagation speed reaching an upper bound. For upward propagation, the equilibrium states are also stationary solutions, but their spatial structure depends on the initial conditions leading to their development. The combined Darrieus–Landau and Rayleigh–Taylor instabilities create profiles of invariably larger amplitudes and sharper crests that propagate at an increasingly faster speed when reducing the Markstein number. For downward propagation, the equilibrium states consist in addition to stationary structures time-periodic solutions, namely, pulsating flames propagating at a constant average speed. The stabilising influence of gravity dampens the nonlinear growth and leads to spatiotemporal changes in flame morphology, such as the formation of multi-crest stationary profiles or pulsating cell splitting and merging patterns, and an overall reduction in propagation speed. The transition between these states occurs at bifurcation and exchange of stability points, which becomes more prominent when reducing the Markstein number and/or increasing the influence of gravity. In addition to the local bifurcation characterisation the global bifurcation structure of the equation, obtained by tracing the continuation of the bifurcation points themselves unravels qualitative features such as the manifestation of bi-stability and hysteresis, and/or the onset and sustenance of time-periodic solutions. Overall, the results exhibit the rich and complex dynamics that occur when gravity, however small, becomes physically meaningful. [ABSTRACT FROM AUTHOR]

Background and Aim: The aim of this study was to elucidate the continuous use of antithrombotic medications during the peri‐colorectal endoscopic submucosal dissection (ESD) period. Methods: This study included 468 patients with colorectal epithelial neoplasms treated by ESD, consisting of 82 under antithrombotic medications and 386 patients without the medications. Among patients taking antithrombotic medications, antithrombotic agents were continued during the peri‐ESD period. Clinical characteristics and adverse events were compared after propensity score matching. Results: Before and after propensity score matching, post‐colorectal ESD bleeding rate was higher in patients continuing antithrombotic medications (19.5% and 21.6%, respectively) than in those not taking antithrombotic medications (2.9% and 5.4%, respectively). In the Cox regression analysis, continuation of antithrombotic medications was associated with post‐ESD bleeding risk (hazard ratio, 3.73; 95% confidence interval, 1.2–11.6; P < 0.05) compared with patients without antithrombotic therapy. All patients who experienced post‐ESD bleeding were successfully treated by endoscopic hemostasis procedure or conservative therapy. Conclusions: Continuation of antithrombotic medications during the peri‐colorectal ESD period increases the risk of bleeding. However, the continuation may be acceptable under careful monitoring for post‐ESD bleeding. [ABSTRACT FROM AUTHOR]

Rotating machinery supported on journal bearings is affected by forces due to rotating unbalance and pressure gradients in the oil film. The interaction of these forces can evoke nonlinear behaviour, including asynchronous motion and even chaos. This work attempts to characterise the sub-synchronous motion of the rigid rotor supported on cylindrical journal bearings due to the abovementioned interaction. The analysis focuses on the rotor behaviour at the rotor speeds lower than the threshold speed for oil whirl, associated with sub-synchronous vibration of magnitude equaling the bearing clearance. It is shown that the sub-synchronous vibration can occur well before reaching the threshold speed and that the underlying period-doubling bifurcation depends on the amount of the rotating unbalance. The rotor response and stability are analysed using a numerical continuation method employing the infinitely short journal bearing model. Continuation results are further validated by time simulations which utilise the finite difference method to compute the hydrodynamic forces. The validation process employs bifurcation diagrams, Poincaré sections and numerical estimates of the largest Lyapunov exponents. [ABSTRACT FROM AUTHOR]

In this paper, the periodic solutions of nonlinear mechanical systems are studied starting from the nonlinear state-space model estimated using the nonlinear subspace identification (NSI) technique. In its standard form, NSI needs the input–output data from a nonlinear structure undergoing broadband excitation and requires the prior knowledge of the locations and kind of nonlinearities to be estimated. The method allows the estimation of the nonlinear features of the system and the indirect study of its periodic solutions using a single broadband excitation, without the need of feedback control loops. To this end, the nonlinear frequency response curves of the system are estimated merging the harmonic balance method with the NSI technique and using a continuation approach. Then, a monodromy-based stability analysis is developed in the nonlinear state-space framework to study the stability of the periodic solutions of the system and to track its bifurcations. The method is validated considering conservative nonlinearities on two numerical examples and one experimental application, the latter comprising a double-well oscillator with period-doubling phenomena. The effects of noise and nonlinear modeling errors are also evaluated. [ABSTRACT FROM AUTHOR]

While increase in institutional deliveries brings an opportunity to counsel women for postpartum family planning (PPFP), its uptake remains low. Reasons for poor acceptance of postpartum intrauterine contraceptive device (postpartum-IUD), and its relation with the timing of counselling need to be investigated. Women attending the antenatal clinic, reporting in labour, and within 48 h of delivery respectively were invited to participate. Eligible women were asked about awareness and choice for PPFP. After counselling, acceptance for PPFP was compared with the baseline. Acceptance and continuation of postpartum-IUD were compared between women counselled in the antenatal, intrapartum, and postpartum periods. Only 23% of 360 women were aware of postpartum-IUD. After counselling, acceptance for PPFP increased from 14% to 97% and for postpartum-IUD, from 0.5% to 33.9%. Acceptance of postpartum-IUD among women counselled in the antenatal, intrapartum and postpartum period was 45%, 35% and 21.7% respectively. Acceptance was higher among the antenatal-counselling group than the postpartum-counselling group (OR 0.45; CI 0.22–0.94; p = 0.03). Counselling, irrespective of its timing, improves acceptance for PPFP. Acceptance and continuation of postpartum-IUD are higher following counselling in antenatal period. All eligible women should be counselled irrespective of 'when' they approach the facility. Acceptance for postpartum-IUD is maximum when women are counselled in the antenatal period. With a surge in institutional deliveries, the opportunity to counsel women in the intrapartum and postpartum period should not be missed as this also increases acceptance for PPFP and postpartum-IUD. [ABSTRACT FROM AUTHOR]

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ObjectivesTo evaluate if a simple method for characterizing vaginal bleeding patterns in etonogestrel contraceptive implant users can predict subsequent patterns and bleeding-related discontinuation over the first 2 years of use.Study designWe reanalyzed phase 3 study bleeding data for non-breastfeeding participants from the United States, Europe, Russia and Chile during the first 2 years of implant use to characterize and correlate bleeding patterns. We used 90-day reference periods with period 1.1 starting at Day 29 and ending at Day 118. We dichotomized bleeding patterns as "favorable" (amenorrhea, infrequent bleeding and normal frequency bleeding without prolonged bleeding) or "unfavorable' (prolonged and/or frequent bleeding) and tracked user groups based on these bleeding patterns in reference period 1.1 through Year 1 and from Year 1 through Year 2, respectively.ResultsWe evaluated data from 537 and 428 women with up to 1 and 2 years use, respectively. Of the 325 (60.5%) women with favorable bleeding in reference period 1.1, 275 (84.6%) reported favorable bleeding also in reference period 2, 197 (60.6%) reported favorable bleeding throughout Year 1, and favorable bleeding in 75-85% of reference periods in Year 2. Among 212 (39.5%) women with unfavorable bleeding in reference period 1.1, 118 (55.7%) continued with unfavorable bleeding in reference period 2, while about 40%-50% reported favorable patterns in RP 2, 3 and/or 4. Initial favorable bleeding resulted in lower discontinuation rates than initial unfavorable bleeding in years 1 (3.7% vs 12.7%, p≪.0001) and 2 (2.5% vs 16.5%, p≪.0001).ConclusionImplant users with favorable bleeding in the first reference period are likely to continue with favorable bleeding over the next 2 years. Initial bleeding patterns predict overall continuation rates in years 1 and 2. Implications Statement When evaluating vaginal bleeding in any 90-day reference period over 2 years of etonogestrel implant use, approximately 80% of women with favorable and 40% with unfavorable bleeding patterns will have favorable bleeding in the next reference periods. These findings can facilitate counseling regarding bleeding for women using the etonogestrel implant.

Abstract Background The breastfeeding initiation rate in Israel is approximately 90%, yet exclusive breastfeeding drops sharply in the early postnatal period. The study objective was to assess early postpartum professional breastfeeding support, its association with breastfeeding success and identification of risk factors for early breastfeeding discontinuation. Methods As part of a post-discharge newborn follow-up study, a convenience sample of 868 mothers attending Maternal and Child Health Centers (MCHCs) up to three months post-partum were interviewed using a 26-item questionnaire. Breastfeeding-related questions covered demographic variables, pregnancy and birth details; breastfeeding duration, lactation support in hospital and post-discharge; and problems experienced. Results Most mothers, 797 (91.8%), initiated breastfeeding in hospital. All women who initiated breastfeeding in the hospital reported exclusive breastfeeding; by two weeks postpartum, 70 women (13.2%) were supplementing with formula (partial breastfeeding). Kaplan–Meier Survival Analysis revealed an estimated mean duration of exclusive breastfeeding in the sample population of 66.8 ± 1.5 days. This duration was shorter for women with preterm births, low birthweight infants (LBW), cesarean births, and hospitalizations in neonatal intensive care units (NICU). A total of 472 (59.3%) breastfeeding mothers reported receiving in-hospital guidance. Of these, 290 (61.3%) were observed breastfeeding. Of all women who initiated breastfeeding, 280 (35.1%) attended MCHC follow-up within 72 h of hospital discharge. A higher proportion of women experiencing breastfeeding difficulties attended an MCHC within 72 h (131/297, 44.1%) compared to women not experiencing difficulties (148/499, 29.7%). The most frequently reported problems were mechanical (55.2%) or milk supply concerns (18.5%). First-time mothers were more likely to report problems, as were Jewish (vs Arab) mothers. Conclusions Even in a population with high initiation rates of breastfeeding, breastfeeding duration, both exclusive and partial, is less than recommended. As much of this drop-off occurs during maternity leave, it is likely related to breastfeeding challenges other than employment. Breastfeeding support needs of women are currently not adequately met; staffing and time for both in-hospital and community-based counseling needs to be funded as well as mandated. Counseling hours should be tailored to assure adequate coverage of high-risk groups such as women after cesarean delivery and newborns requiring intensive care.

A continuation strategy which exploits the proposed optimization formulation to search periodic solution is presented for bifurcation tracking. The proposed optimization correction scheme integrated with the prediction-correction strategy is characterized by the minimization of the pseudo arclength equation with the imposition of optimization constraints on the harmonic balance equations and bifurcation conditions. Stability and sensitivity analysis are carried out in the frequency domain by making use of the Floquet theory. The derivatives of the stability factor with respect to the Fourier coefficients, vibration frequency, and bifurcation parameters are given in the explicit form. Finally, the effectiveness of the proposed methodology is illustrated by three numerical examples which include a Duffing oscillator, a nonlinear energy sink, and a Jeffcott rotor, respectively. Numerical results have demonstrated that the proposed method offers a convenient scheme to trace bifurcation solution. [ABSTRACT FROM AUTHOR]

The purpose of this study was to investigate the importance of motivational climate for the satisfaction of psychological needs and dropout in recreational, intermediate and elite volleyball. Seven thousand nine hundred thirty six volleyball players from all 321 volleyball clubs across Denmark were invited to participate in the study. Three thousand three thirty answered the questionnaire and 2150 were included in the analysis. Dropout from Volleyball was measured as the proportion of players that had stopped playing volleyball over the last year. The coach-created motivational climate was measured using the Motivational Climate Scale for Youth Sports. The satisfaction of players' psychological needs was measured using an adapted version of the basic psychological needs in exercise scale. The psychometric scales were validated and showed good model fit. For volleyball players of all levels, the degree of mastery climate predicted the satisfaction of the players' basic psychological needs satisfaction during volleyball which was, in turn, associated with lower dropout rates. Performance climate had a weak negative association with the satisfaction of psychological needs on the intermediate level only. When adjusting the models for the negative association between performance climate and mastery climate this negative association became nonsignificant and a weak positive association to needs satisfaction emerged for players at the elite level. Findings confirm that the coach-created mastery climate in volleyball teams is important for the satisfaction of players' basic psychological needs and continuation within the sport across the recreational, intermediate and elite levels. Coach-created mastery climate in volleyball teams was positively associated with the satisfaction of the players' basic psychological and negatively associated with dropout. These associations between coach created climate, need satisfaction and dropout were similar across different sporting levels. Performance orientation had little influence and seemed mainly problematic if it was at the expense of mastery climate. [ABSTRACT FROM AUTHOR]

Introduction: In 2020, Kenya had 19,000 new HIV infections among women aged 15+ years. Studies have shown sub‐optimal oral pre‐exposure prophylaxis (PrEP) use among sub‐populations of women. We assessed the uptake and continuation of oral PrEP among women 15–49 years in two health facilities in Kisumu County, Kenya. Methods: A retrospective cohort of 262 women aged 15–49 years, initiated into oral PrEP between 12 November 2019 and 31 March 2021, was identified from two health facilities in the urban setting of Kisumu County, Kenya. Data on baseline characteristics and oral PrEP continuation at months 1, 3 and 6 were abstracted from patient records and summarized using descriptive statistics. Missing data in the predictor variables were imputed within the joint modelling multiple imputation framework. Using logistic regression, we evaluated factors associated with the discontinuation of oral PrEP at month 1. Results: Of the 66,054 women screened, 320 (0.5%) were eligible and 262 (82%) were initiated on oral PrEP. Uptake was higher among women 25–29 years as compared to those 15–24 years (77% vs. 33%). Oral PrEP continuation declined significantly with increasing duration of follow‐up; 37% at month 1, 21% at month 3 and 12% at month 6 (p<0.05). In the adjusted analysis, women 15–24 years had lower adjusted odds of continuing at month 1 than women ≥25 years (adjusted odds ratio [aOR]: 0.41, 95% CI: 0.21–0.82). There was no association between being sero‐discordant and continuation of oral PrEP at month 1 (aOR; 1.21, 95% CI 0.59–2.50). Women from the sub‐county hospital were more likely to continue at month 1 of follow‐up compared to women enrolled in the county referral hospital (aOR 5.11; 95% CI 2.24–11.70). Conclusions: The low eligibility for oral PrEP observed among women 15–49 years in an urban setting with high HIV prevalence calls for a review of the screening process to validate the sensitivity of the screening tool and its proper application. The low uptake and continuation among adolescent girls and young women underscores the need to identify and address specific patient‐ and facility‐level barriers affecting different sub‐populations at risk for HIV acquisition. [ABSTRACT FROM AUTHOR]

STUDY QUESTION Is it possible to design an ART Treatment Planning and Continuation Intervention (TPCI) that is considered acceptable and feasible to patients and healthcare professionals (HCPs)? SUMMARY ANSWER HCPs and patients responded positively to the TPCI prototype and perceived it as an acceptable intervention to support patients to stay engaged with planned treatment, but some concerns were raised about the feasibility of using it in practice. WHAT IS KNOWN ALREADY People discontinue ART due to its psychological burden. Digital tools to support people undergoing ART are available but typically focus only on practical support rather than psychological support. Research about treatment continuation and multi-cycle planning indicates that cognitive factors (expectations, intentions, efficacy beliefs) should be targets of interventions designed to help patients engage with and continue treatment to meet their personal treatment plans and goals. However, it is not known whether this form of psychological support would be acceptable for HCPs and patients or feasible to implement in practice. STUDY DESIGN, SIZE, DURATION Qualitative cognitive interviews with HCPs and patients (May 2021). Patients were eligible if they had had a consultation to start a first/repeat stimulated IVF/ICSI cycle in the 8 weeks prior to recruitment, were aged 18 or older (upper age limit of 42 years for women) and fluent in English. Eligible HCPs were those employed by a fertility clinic who were responsible for delivering treatment planning consultations to patients. PARTICIPANTS/MATERIALS, SETTING, METHODS HCPs and patients were asked to think aloud while being exposed to and exploring the TPCI in one-to-one online cognitive interviews. The TPCI was designed to reduce treatment discontinuation via cognitive factors namely formation and maintenance of multi-cycle ART intentions and efficiency of decision-making during treatment, and continuation of treatment after an unsuccessful cycle (when recommended). To impact cognitive factors the TPCI comprised of two components: an expectation management and reasoning checklist for HCPs to use during planning consultations (TPCI Checklist) and a multi-feature cognitive support mobile application (TPCI App) for patients to use prior to and during treatment. After participants thought aloud while being exposed to the TPCI prototype (both components) they were asked open questions concerning their perceptions of the core components and activities on eight acceptability dimensions (e.g. acceptability, demand, integration). Interviews lasted between 40 and 90 min, were recorded, transcribed verbatim and analysed using thematic analysis. MAIN RESULTS AND THE ROLE OF CHANCE Thirteen HCPs and 13 patients participated in 25 online interviews. Thematic analysis using inductive and deductive coding generated 180 codes, grouped into 22 categories and synthesized into 9 themes. The themes showed that HCPs and patients provided positive feedback about the TPCI, perceiving it as a needed, acceptable and potentially effective way to forewarn patients of the possible need for multiple cycles, to provide patients with a sense of patient–clinic collaboration and support, and to bolster treatment intentions, all of which were perceived to contribute to reduced treatment discontinuation. HCPs perceived implementation of the TPCI Checklist to be challenging in its current length due to time pressures and clinic workload. Suggestions for enhancing the TPCI Checklist and App were provided, but none required critical changes to its core components or activities. LIMITATIONS, REASONS FOR CAUTION All patients were women recruited from social media websites, mainly associated with patient support groups, who may be highly committed to their fertility treatment. HCPs were predominantly from private fertility clinics. WIDER IMPLICATIONS OF THE FINDINGS The findings suggest there is demand for digital support geared towards motivational aspects of undergoing ART. The TPCI is an acceptable support tool to meet that need according to HCPs responsible for delivering planning consultations and patients undergoing fertility treatment. Future research is needed to develop the prototype and examine the feasibility of implementation of the TPCI in clinics. STUDY FUNDING/COMPETING INTEREST(S) This research was financially supported by Merck Serono Ltd, an affiliate of Merck KGaA, Darmstadt, Germany. 'Merck KGaA, Darmstadt, Germany reviewed the manuscript for medical accuracy only before journal submission. The authors are fully responsible for the content of this manuscript, and the views and opinions described in the publication reflect solely those of the authors' J.B. reports personal fees from Merck KGaA, Darmstadt, Germany, Merck AB an affiliate of Merck KGaA, Darmstadt Germany, Theramex, Organon JJC, Ferring Pharmaceuticals A/S, research grant from Merck Serono Ltd, grants from ESHRE outside the submitted work and that she is co-developer of Fertility Quality of Life (FertiQoL) and MediEmo app. S.G. reports consultancy fees from TMRW Life Sciences and Ferring Pharmaceuticals A/S, speaker fees from Access Fertility, SONA-Pharm LLC, Meridiano Congress International and Gedeon Richter. C.H. declares no conflicts of interest. TRIAL REGISTRATION NUMBER N/A. [ABSTRACT FROM AUTHOR]

Background: Maternal folate may not reach an optimal level to prevent neural tube defects if supplementation commenced post-conception or took place pre-conception only. Our study aimed to investigate the continuation of folic acid (FA) supplementation from pre-conception to post-conception during peri-conceptional period and to examine its differences in FA supplementation between the subgroups taking the initiation timing into consideration. Methods: This study was conducted in two community health service centers in Jing-an District of Shanghai. Women accompanying their children to pediatric health clinics of the centers were recruited and asked to recall information concerning their socioeconomic and previous obstetric characteristics, utilization of healthcare and FA supplementation before and/or during pregnancy. The continuation of FA supplementation during peri-conceptional period were categorized into three subgroups: Supplementing with FA pre- and post-conception; supplementing with FA preconception only or post-conception only; no FA supplements pre-conception and post-conception. The relationship between FA continuation and couples' characteristics were examined as setting the first subgroup as the base reference. Results: Three hundred and ninety-six women were recruited. Over 40% of the women started FA supplementation after conception and 30.3% of them supplemented with FA from pre-conception to the first trimester of their pregnancy. Compared to this one-third of participants, women who didn't supplemented with any FA during peri-conceptional period were more likely to have no utilization of pre-conception healthcare ( OR = 2.47, 95% CI : 1.33–4.61) or antenatal care ( OR = 4.05, 95% CI : 1.76–9.34), or who had a lower family socioeconomic status ( OR = 4.36, 95% CI : 1.79–10.64). Women who supplemented with FA pre-conception only or post-conception only were more likely to have no utilization of pre-conception healthcare ( OR = 2.94, 95% CI : 1.79–4.82), or to have no previous pregnancy complication ( OR =1.80, 95% CI : 0.99–3.28). Conclusion: Over two-fifth of the women started FA supplementation and only one-third of them had an optimal supplementation from pre-conception to the first trimester. Maternal utilization of healthcare before or during pregnancy together with maternal and paternal socioeconomic status may play a role in the continuation to FA supplementation pre- and post-conception. [ABSTRACT FROM AUTHOR]

Around the world each year, large sums of money are expended in helping students access higher education institutions (HEIs), but there is remarkably little evidence to show whether this investment is effective or not. Here we use data from a UK university to investigate the relationship between financial support and the continuation of students beyond their first year of study. As a result of changing scholarship policies over the course of three years, a natural experiment was created that allowed us to investigate the effect of financial support on the rates of withdrawal of students from households with different incomes. Controlling for multiple demographic and attainment factors (age, gender, ethnic grouping, disability, nationality, household income, prior educational attainment, and local Higher Education participation rates), the data suggest that scholarships improved student retention, but principally for those students from households with low and intermediate incomes. Interestingly, the value of the scholarships, which varied from £500 to £3,000, did not have a measurable effect on withdrawal. We also found that some students who appeared to be eligible for a scholarship and would likely have benefited from it did not receive one, and we discuss the reasons why this might be so. These results have important implications for scholarship policies in Higher Education internationally; to maximise impact, scholarships should be awarded to those most in financial need. [ABSTRACT FROM AUTHOR]

OBJECTIVES:In 2015, private healthcare providers in Nigeria introduced DMPA-SC (depot medroxyprogesterone acetate administered subcutaneously) into the method mix. We aimed to [1] examine the sociodemographic predictors of continued DMPA-SC use after 3 months, and [2] characterize the additional influences of contraceptive counseling quality and experiences of side effects on continuation. STUDY DESIGN:From March to August, 2016, we conducted phone interviews with a convenience sample of women obtaining DMPA-SC from selected providers to survey them about their experience obtaining an initial dose of DMPA-SC. Study coordinators contacted women again about 3 months later after when they were due for reinjection. We used logistic regressions to examine the likelihood of having obtained a subsequent dose of DMPA-SC at follow-up as predicted by sociodemographic characteristics, a quality of counseling indicator based on responses to a 14-item scale, and reports of side effects experienced. RESULTS:Of the 541 DMPA-SC users who completed the first survey, 311 were reached again via phone after 3 months to conduct a second survey. Multivariate results for sociodemographic predictors of continued DMPA-SC use show that those with some college education or more (OR=2.79; 95% CI: 1.09-7.14), and those with four or more children (OR=2.89; 95% CI: 1.09 0 7.67) were more likely to obtain another dose. Our summary quality measure showed that women overall rated the quality of their initial counseling session high. Logistic regressions indicated that higher quality during the initial counseling session is related to the likelihood of getting another dose of DMPA-SC (OR=2.04; 95% CI: 1.12-3.47) whereas experiencing more bleeding reduced the likelihood of continuation after 3 months (OR=0.15; 95% CI: 0.07-0.34). CONCLUSIONS:Among urban Nigerian women, both counseling quality and experiencing side effects were important factors in predicting continued use of DMPA-SC after 3 months. These findings are consistent with previous studies of DMPA and injectable contraception continuation. IMPLICATIONS:New contraceptive methods that are designed for increased access and ease of use, combined with high quality provision, have potential to increase contraceptive use in settings with low levels of contraceptive prevalence. Higher quality counseling can help encourage women's continuation of a new injectable contraceptive method at 3 months.

Abstract Introduction In 2020, Kenya had 19,000 new HIV infections among women aged 15+ years. Studies have shown sub‐optimal oral pre‐exposure prophylaxis (PrEP) use among sub‐populations of women. We assessed the uptake and continuation of oral PrEP among women 15–49 years in two health facilities in Kisumu County, Kenya. Methods A retrospective cohort of 262 women aged 15–49 years, initiated into oral PrEP between 12 November 2019 and 31 March 2021, was identified from two health facilities in the urban setting of Kisumu County, Kenya. Data on baseline characteristics and oral PrEP continuation at months 1, 3 and 6 were abstracted from patient records and summarized using descriptive statistics. Missing data in the predictor variables were imputed within the joint modelling multiple imputation framework. Using logistic regression, we evaluated factors associated with the discontinuation of oral PrEP at month 1. Results Of the 66,054 women screened, 320 (0.5%) were eligible and 262 (82%) were initiated on oral PrEP. Uptake was higher among women 25–29 years as compared to those 15–24 years (77% vs. 33%). Oral PrEP continuation declined significantly with increasing duration of follow‐up; 37% at month 1, 21% at month 3 and 12% at month 6 (p

The article "The Early Neolithic Cultural Transformation in the Targowisko Settlement Region, SE Poland" deals with the cultural change in the early Neolithic settlement region of Targowisko in southeastern Poland. The study examines various aspects such as settlement phases, the function of "pseudo-ditches," and the organization of the settlement space. Fundamental cultural changes have been identified, particularly in terms of symbolism, while continuity mainly concerns everyday objects. The results suggest a connection between the late Linearbandkeramik (LBK) and the Middle Culture (MC). The study shows that there was continuity of settlement in the region, although sociocultural and genetic aspects changed. Remains of cereal crops were also found, indicating continued agricultural activity. The results demonstrate that the cultural change in the Targowisko settlement region was complex and requires further investigation. [Extracted from the article]

Stand-alone deep-space CubeSats are the future of the space sector. For limited budget reasons, these spacecraft need to follow operational-compliant (OC) trajectories: transfers with thrusting and coasting periods imposed at pre-defined time instants. Traditional trajectory optimisation algorithms exhibit convergence problems when handling discontinuous constraints. In this work, a homotopic direct collocation approach is presented. It employs a continuation algorithm that maps the classical bang-bang trajectory of a fuel-optimal low-thrust problem into an OC solution. M-ARGO CubeSat mission is considered as case study for validation, including a realistic thruster model with variable specific impulse and maximum thrust. The trajectories computed with the developed algorithm are compared with non-operational-compliant solutions. Our algorithm produces transfers similar to the optimal solutions with no operational constraint, both in terms of thrusting profile and propellant mass. [ABSTRACT FROM AUTHOR]

Plain language summary The hormonal IUD is a popular contraceptive method choice where it is available. While the method has been around for decades it remains out of reach for many populations in low- and middle-income countries. The hormonal IUD offers both highly effective protection from pregnancy as well as non-contraceptive benefits that appeal to users in the US and Europe, but there is limited evidence available to explore the acceptability and use of this method among users in lower resource settings. This research looks at the profile of users who chose to use the hormonal IUD during a pilot introduction in Madagascar, Nigeria, and Zambia. Over a period of 12 months, researchers followed up with these users to understand who continued to use the method over time and their satisfaction with the method. Findings show that the hormonal IUD was broadly appealing in these settings among users from multiple demographic segments, including among users who had not used other methods of contraception in the past. When followed-up at 3 and 12 months, satisfaction with the method was high and most users in all three countries were still using the method. The findings suggest that the hormonal IUD could be well received and may contribute to greater uptake of voluntary modern contraception in lower resource settings.

The ability to match one's movements to an external beat and maintain that rhythm in the absence of the beat suggests sophisticated, well-developed neural control. Children (aged 5-10 years) were compared with adults (aged 18-30 years) during a repetitive reaching task to determine development of this control. Children as young as 5 years exhibited this control. The mean rate of reaching did not differ between groups nor did it differ during the two phases, suggesting an overall ability to internalize and continuously repeat a given pace. Children aged 5-8 years were significantly more variable than children aged 9-10 years and adults, likely attributable to variability in central control processes. We found a possible transition period of temporal control. Children aged 9-10 years begin to exhibit more adult-like levels of variability with respect to temporal consistency and movement effort. [ABSTRACT FROM AUTHOR]

Background: The breastfeeding initiation rate in Israel is approximately 90%, yet exclusive breastfeeding drops sharply in the early postnatal period. The study objective was to assess early postpartum professional breastfeeding support, its association with breastfeeding success and identification of risk factors for early breastfeeding discontinuation. Methods: As part of a post-discharge newborn follow-up study, a convenience sample of 868 mothers attending Maternal and Child Health Centers (MCHCs) up to three months post-partum were interviewed using a 26-item questionnaire. Breastfeeding-related questions covered demographic variables, pregnancy and birth details; breastfeeding duration, lactation support in hospital and post-discharge; and problems experienced. Results: Most mothers, 797 (91.8%), initiated breastfeeding in hospital. All women who initiated breastfeeding in the hospital reported exclusive breastfeeding; by two weeks postpartum, 70 women (13.2%) were supplementing with formula (partial breastfeeding). Kaplan–Meier Survival Analysis revealed an estimated mean duration of exclusive breastfeeding in the sample population of 66.8 ± 1.5 days. This duration was shorter for women with preterm births, low birthweight infants (LBW), cesarean births, and hospitalizations in neonatal intensive care units (NICU). A total of 472 (59.3%) breastfeeding mothers reported receiving in-hospital guidance. Of these, 290 (61.3%) were observed breastfeeding. Of all women who initiated breastfeeding, 280 (35.1%) attended MCHC follow-up within 72 h of hospital discharge. A higher proportion of women experiencing breastfeeding difficulties attended an MCHC within 72 h (131/297, 44.1%) compared to women not experiencing difficulties (148/499, 29.7%). The most frequently reported problems were mechanical (55.2%) or milk supply concerns (18.5%). First-time mothers were more likely to report problems, as were Jewish (vs Arab) mothers. Conclusions: Even in a population with high initiation rates of breastfeeding, breastfeeding duration, both exclusive and partial, is less than recommended. As much of this drop-off occurs during maternity leave, it is likely related to breastfeeding challenges other than employment. Breastfeeding support needs of women are currently not adequately met; staffing and time for both in-hospital and community-based counseling needs to be funded as well as mandated. Counseling hours should be tailored to assure adequate coverage of high-risk groups such as women after cesarean delivery and newborns requiring intensive care. [ABSTRACT FROM AUTHOR]

In this paper we investigate the effect of nonlinear damping on the Lugiato–Lefever equation i ∂ t a = - (i - ζ) a - d a xx - (1 + i κ) | a | 2 a + i f on the torus or the real line. For the case of the torus it is shown that for small nonlinear damping κ > 0 stationary spatially periodic solutions exist on branches that bifurcate from constant solutions whereas all nonconstant stationary 2 π -periodic solutions disappear when the damping parameter κ exceeds a critical value. These results apply both for normal ( d < 0 ) and anomalous ( d > 0 ) dispersion. For the case of the real line we show by the Implicit Function Theorem that for small nonlinear damping κ > 0 and large detuning ζ ≫ 1 and large forcing f ≫ 1 strongly localized, bright solitary stationary solutions exist in the case of anomalous dispersion d > 0 . These results are achieved by using techniques from bifurcation and continuation theory and by proving a convergence result for solutions of the time-dependent Lugiato–Lefever equation. [ABSTRACT FROM AUTHOR]

Periodic orbits in gravitational many–body problems have been fundamental special solutions for analyzing phase–space flows not only in autonomous systems but also in time–dependent non–autonomous systems. The growing interest in cislunar space may require deeper understandings of periodic orbits in the Earth–Moon system beyond the simplified dynamics in the circular restricted three–body problem. The present paper deals with two mechanisms of the generation of multiple families of synodic resonant periodic orbits in the bicircular restricted four–body problem through numerical examples adopting planar and three–dimensional retrograde periodic orbits around the Earth. The first part of the paper reveals complex interplays between a synodic resonant periodic orbit and multi–revolutional orbits originated from period–multiplying bifurcations. Extensions of continuation curves beyond the usual limit find another 12 : 11 synodic resonant planar retrograde periodic orbit around the Earth in addition to the one already found in the previous work. The second part shows that a doubly symmetric periodic orbit in the circular restricted three–body problem can generate four families of synodic resonant periodic orbits in the bicircular restricted four–body problem. This work identifies linearly stable, 1 : 1 synodic resonant, three–dimensional retrograde periodic orbits around the Earth and indicates their substantially large stability regions under solar gravitational perturbations. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Arts & Social Sciences (JASS) is the property of Sultan Qaboos University and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)