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Rheology of Concentrated Emulsions Prepared Using the Premix Membrane Emulsification...
Jophous Mugabi
Jae-Ho  Jeong

Jophous Mugabi

and 1 more

June 20, 2022
The rheological properties of emulsions gradually change to non-Newtonian fluid characteristics as the dispersed phase volume fraction increase. In premix membrane emulsification, a microporous membrane is used to prepare emulsions at higher production rates and higher volume fractions. The droplet size and droplet size distribution (span) can be precisely controlled, thus easier to study the rheological properties of emulsions. The influence of volume fraction, dispersed phase viscosity, and surfactant concentration were investigated. When the droplet size and span were controlled in a narrow range, the emulsion viscosity increased with dispersed phase viscosity due to energy loss to friction as the droplets become more rigid and less deformable, while the surfactant concentration had no significant influence on the emulsion rheology showing that surfactants mainly affect emulsion rheology through reduction of droplet size.
Online Machine Learning Modeling and Predictive Control of Nonlinear Systems With Sch...
Cheng Hu
Yuan Cao

Cheng Hu

and 2 more

June 20, 2022
This work develops a model predictive control (MPC) scheme using online learning of recurrent neural network (RNN) models for nonlinear systems switched between multiple operating regions following a prescribed switching schedule. Specifically, an RNN model is initially developed offline to model process dynamics using the historical operational data collected in a small region around a certain steady-state. After the system is switched to another operating region under a Lyapunov-based MPC with suitable constraints to ensure satisfaction of the prescribed switching schedule policy, RNN models are updated using real-time process data to improve closed-loop performance. A generalization error bound is derived for the updated RNN models using the notion of regret, and closed-loop stability results are established for the switched nonlinear system under RNN-based MPC. Finally, a chemical process example with the operation schedule that requires switching between two steady-states is used to demonstrate the effectiveness of the proposed RNN-MPC scheme.
Cervical Vagal schwannoma, a rare differential of a neck swelling: a case report
Ramesh Prajapati
Aakar Thapa

Ramesh Prajapati

and 7 more

June 20, 2022
Cervical vagal schwannoma is a rare clinical entity which requires different clinical approach than other neck swellings. Magnetic resonance Imaging is the preferred initial diagnostic test. Complications may arise due to vagal stimulation in unsuspecting open biopsies. Surgical excision with perioperative vagal monitoring is recommended for treatment of vagal schwannomas.
Stable blue food supply can enhance the resilience of cropland ecosystem against the...
Youzhu Zhao
Yangfan Li

Youzhu Zhao

and 1 more

June 20, 2022
Global changes in diets and frequent natural disasters have induced food production fluctuations, posing challenges to food security. The importance of blue food is attracting unprecedented attention, but research on its role in connection with terrestrial food and its mechanism is currently not available, especially there are significant challenges in how to carry out systematic food research on land and sea integration. Human demand for marine blue food affects cropland ecosystem through the food system and drives changes in its function and causes the loss of food security, while the interactions between land-sea food system and the response of cropland ecosystem resilience to terrestrial and marine food production have not been systematically studied. This study assesses the resilience of cropland ecosystem in coastal China based on early warning signal indicators calculated from net primary productivity (NPP), and analyzes the situation of shocks to production in the land-sea food sector to reveal the impact of green-blue food production on the resilience of cropland ecosystem. The results demonstrate that the marine food fluctuation had a significant impact on the resilience of cropland ecosystem in coastal China. Fujian and Guangdong provinces of China observed a significant decrease in cropland ecosystem resilience, with τ values of 0.27 and 0.07, respectively; the coefficient of variation of seafood production per capita as an essential influence on NPP resilience, with a contribution of 19.53%. The decoupling of blue food from green food in regions of increased cropland NPP resilience contributes to the land-sea food sector mutual complement through stable yields, and buffers the effects of food shocks on the resilience of cropland ecosystem. This study provides new perspectives on coordinating the balance between sustainable development of cropland ecosystem and human well-being.
Rethinking the nature of intraspecific variability and its consequences on species co...
Camille Girard-Tercieux
Isabelle Maréchaux

Camille Girard-Tercieux

and 11 more

June 20, 2022
Context Intraspecific variability (IV) has been proposed to explain species coexistence in diverse communities. Assuming, sometimes implicitly, that conspecific individuals can perform differently in the same environment and that IV blurs species differences, previous studies have found contrasting results regarding the effect of IV on species coexistence. Objective We aim at showing that the larg IV observed in data does not mean that conspecific individuals are necessarily different in their response to the environment and that the role of high-dimensional environmental variation in determining IV has been largely underestimated in forest plant communities. Methods and Results We first used a simulation experiment where an individual attribute is derived from a high-dimensional model, representing “perfect knowledge” of individual response to the environment, to illustrate how a large observed IV can result from “imperfect knowledge” of the environment. Second, using growth data from clonal Eucalyptus plantations in Brazil, we estimated a major contribution of the environment in determining individual growth. Third, using tree growth data from long-term tropical forest inventories in French Guiana, Panama and India, we showed that tree growth in tropical forests is structured spatially and that despite a large observed IV at the population level, conspecific individuals perform more similarly locally than compared with heterospecific individuals. Synthesis As the number of environmental dimensions that are typically quantified is generally much lower than the actual number of environmental dimensions influencing individual attributes, a great part of observed IV might be misinterpreted as random variation across individuals when in fact it is environmentally-driven. This mis-representation has important consequences for inference about community dynamics. We emphasize that observed IV does not necessarily impact species coexistence per se but can reveal species response to high-dimensional environment, which is consistent with niche theory and the observation of the many differences between species in nature.
New evidence for seed transmission of reptiles in arid areas of China
Zhenyuan Duan
Lei Shi

Zhenyuan Duan

and 1 more

June 20, 2022
Abstract: Diet and trophic niche of Teratoscincus roborowskii was analyzed by pellets analysis technique. A total of 263 pellets of Teratoscincus roborowskii were collected from the Turpan Botanic Garden in Turpan City from July to Octobor, 2016, . Food composition and proportion of Teratoscincus roborowskii were identified by comparative analysis. The number of food components in the fecal samples was identified, and the numeric frequency, biomass ratio and frequency of occurrence of each component were counted and then the monthly Shannon-wiener diversity index, Shannon evenness index and diet niche width were analyzed. The results show that the Teratoscincus roborowskii mainly feed on insects and caper fruit in the Turpan Botanic Garden. Insects are the most common food for the Teratoscincus roborowskii, the frequency of occurrence which in each month is the largest; caper fruit was the most food intake in July and August, and that of insects is the most one on September and October. There are some differences in the composition of food in different months, which may be related to changes of food availability. The results of the feeding habit analysis show that the Teratoscincus roborowskii may play an active role in the dispersal of caper seed.
Geometric morphometrics out-perform linear-based methods in the taxonomic resolution...
Pietro Viacava
Simone Blomberg

Pietro Viacava

and 2 more

June 20, 2022
Morphology-based taxonomic research frequently applies linear morphometrics (LMM) in skulls to quantify species distinctions. The choice of which measurements to collect generally relies on the expertise of the investigators or a set of standard measurements, but this practice may ignore less obvious or common discriminatory characters. In addition, taxonomic analyses often ignore the potential for subgroups of an otherwise cohesive population to differ in shape purely due to size differences (or allometry). Geometric morphometrics (GMM) is more complicated as an acquisition technique, but can offer a more holistic characterization of shape and provides a rigorous toolkit for accounting for allometry. In this study, we used linear discriminant analysis to assess the discriminatory performance of four published LMM protocols and a 3D GMM dataset for three clades of antechinus known to differ subtly in shape. We assessed discrimination of raw data (which are frequently used by taxonomists); data with isometry removed; and data after allometric correction. We found that group discrimination among raw data was high for LMM, possibly inflated relative to GMM when visualised in PCA plots. However, GMM produced better results in group discrimination after the size and allometry treatments. High measurement redundancy in LMM protocols appears to result in relatively high allometry but low discriminatory performance. These findings suggest that taxonomic measurement protocols might benefit from GMM-based pilot studies, because this offers the option of differentiating allometric and non-allometric shape differences between species, which can then inform on the development of the easier-to-apply LMM protocols.
Scale dependent niche conservatism found in a lake fish community
Tingyue Yang
Lan Zhu

Tingyue Yang

and 5 more

June 20, 2022
Investigations to niche evolution have received controversial results in recent times, leading to some confusions in ecological studies: competitive exclusion principle (CEP) predicts that closely related species should be adequately divergent; while niche conservatism (NC) predicts that closely related species should be ecologically most similar. In the present study, by using stable isotope to signify trophic niche, we analyzed niche divergences of 57 fishes from a lake (Poyang Lake, central China) at the phylogenetic scale, as well as niche divergences and overlaps of 7 fishes (same subfamliy) at 5 sites of this lake, and comprehensively investigated the concepts of NC and competitive exclusion principle (CEP). The results showed that, NC exists on a large scale (trophic differences showing positive relationships with genetic distances), but not at the local scale (sister species showing larger differences than closely related species, and almost no trophic overlap), where the CEP works better. Besides, trophic convergence was also found between some very distantly related species, leading to the possible limited divergence. We believe these findings will contribute to future theoretical and empirical niche explorations.
The “Airgap” and “Swirling Bubbles” signs in a Patient with Esophageal Carcinoma
Tiago Castro Pinto
Tiago Martins

Tiago Castro Pinto

and 3 more

June 20, 2022
Introduction: Pneumopericardium is a dreaded complication in esophageal carcinoma. Case description: We report a case of a 62 year old patient with past history of esophageal cancer with spontaneus pneumopericardium, without hemodynamic compromise. Admission echocardiogram that revealed a pneumopericadium with the presence of the “swirling bubbles” and the “air gap” sign. A small esophagopericardial fistula was postulated as the cause of the pneumopericardium. He underwent esophageal stent placement with resolution of the pneumopericardium. Discussion: Pneumopericardium is usually a sign of marked clinical deterioration in neoplasia and leads to patients’ death few weeks. Here we presented a case, in which a more fortunate and unusual outcome happened.
Is there a role for biogenic amine receptors in mediating trace amine-induced vascula...
Alex Voisey
Kenneth Broadley

Alex Voisey

and 2 more

June 20, 2022
Background and Purposes: Substantial evidence indicates trace amines can induce vasoconstriction independently of noradrenaline release. However, the mechanism underlying noradrenaline-independent vasoconstrictor responses to trace amines has not yet been established. This study evaluates the role of trace amine-associated receptor 1 (TAAR1) and other biogenic amine receptors in mediating trace amine-induced vasoconstriction. Experimental Approach: Vasoconstrictor responses to β-PEA and the TAAR1-selective agonist, RO5256390 were assessed in vitro in endothelium-denuded aortic rings and third-order mesenteric arteries of male Sprague Dawley rats. Key Results: β-PEA and RO5256390 induced concentration-dependent vasoconstriction of aortic rings but not third-order mesenteric arteries. Vasoconstrictor responses in aortic rings were insensitive to antagonists of 5-HT and dopamine. The murine-selective TAAR1 antagonist, EPPTB, had no effect on either β-PEA or RO5256390-induced vasoconstriction. The α1-adrenoceptor antagonist, prazosin, and the α2-adrenoceptor antagonist, yohimbine, induced a small but significant shift of the β-PEA concentration response curve that could not be ascribed to blockade of α1- or α2-adrenoceptors. Conclusion and Implications: Vasoconstrictor responses to trace amines are not mediated by classical biogenic amine neurotransmitter receptors. Although β-PEA vasoconstrictor responses were insensitive to ETTP, it has low affinity for rat TAAR1. Therefore, we propose that TAAR1 remains the most likely candidate receptor mediating vasoconstrictor responses to trace amines and that prazosin and yohimbine have some affinity for TAAR1.
Process evaluation of the SPPiRE trial: a GP delivered medication review of polypharm...
Caroline McCarthy

Caroline McCarthy

and 6 more

June 20, 2022
Background: The SPPiRE cluster randomised controlled trial (RCT) found that a GP delivered medication review that incorporated screening potentially inappropriate prescriptions (PIP), a brown bag review and a patient priority assessment, resulted in a significant but small reduction in the number of medicines and no significant reduction in PIP. Objective: To explore the experiences of GPs and patients engaged in the SPPiRE intervention and the potential for system wide implementation.Design: Mixed methods process evaluation; quantitative data was collected from the SPPiRE intervention website and qualitative data via semi-structured interviews.Setting and participants: 51 general practices throughout Ireland, and 404 participants with multimorbidity aged ≥65 years, prescribed ≥15 medicines participated in the RCT. Qualitative data was collected with purposive samples of intervention GPs (18/26) and patients (27/208).   Methods: Quantitative data was analysed descriptively, qualitative data thematically and both were integrated using a triangulation protocol.Results: The analysis generated three themes, intervention implementation, mechanisms of action, and both were underpinned by the theme of context. One fifth of patients had no review, primarily due to insufficient GP time. The brown bag review component resulted in the most medication changes, particularly stopping a medicine. GPs felt it easier to change medicines if the patient was well known to them, and patients were generally receptive to change. GPs identified lack of integration into practice software systems and resources as barriers to future implementation.Conclusion: Consideration of implementation of successful interventions is key to informing policy and integration into clinical practice. GPs and patients viewed the intervention positively, but implementation will depend on resourcing and integration into practice software systems.Trial registration number: ISRCTN12752680
The time course of acclimation to the stress of triose phosphate use limitation
Alan McClain
Jeffrey A. Cruz

Alan McClain

and 3 more

June 20, 2022
Triose-phosphate utilization (TPU) limits the maximum rate at which plants can photosynthesize. However, TPU is almost never found to be limiting photosynthesis under ambient conditions for plants. This, along with previous results showing adaptability of TPU at low temperature, suggest that TPU capacity is regulated to be just above the photosynthetic rate achievable under the prevailing conditions. A set of experiments were performed to study the adaptability of TPU capacity when plants are acclimated to elevated CO 2 concentrations. Plants held at 1500 ppm CO 2 were initially TPU limited. After 30 hours they no longer exhibited TPU limitations but they did not elevate their TPU capacity. Instead, the maximum rates of carboxylation and electron transport declined. A timecourse of regulatory responses was established. A step increase of CO 2 first caused PSI to be oxidized but after 40 s both PSI and PSII had excess electrons as a result of acceptor-side limitations. Electron flow to PSI slowed and the proton motive force increased. Eventually, non-photochemical quenching reduced electron flow sufficiently to balance the TPU limitation. Over several minutes rubisco deactivated contributing to regulation of metabolism to overcome the TPU limitation.
Intrapartum adrenalectomy for pheochromocytoma presenting in pregnancy: A case report
Paul Naseef

Paul Naseef

June 20, 2022
Pheochromocytoma occurs in 1 in every 50,000 hypertensive pregnant lady. Antenatal diagnosis is critical to reduce maternal and perinatal mortality rates. Here, we describe a patient diagnosed with pheochromocytoma at 35 weeks with an atypical presentation of right flank pain and seizures, her preoperative optimization and intra-partum surgical management.
Oil field power load prediction based on LSTM under abnormal data cleaning technology
Yang Yang
li wei

Yang Yang

and 1 more

June 20, 2022
In view of the massive load data ofoilfield distribution network contains various types of outliers, which is not conducive to load prediction, electric energy decision-making, dispatching and production, it is very necessary to identify and correct abnormal loads to improve the validity and reliability of load data and establish a safe, efficient and sustainable power system.Based on the above reasons, this paper proposes a data anomaly identification and scene generation method combining boxplot and generative adversance network (WGAN). This method firstly uses boxplot method to complete anomaly identification of active power, reactive power, current and other data of oilfield grid.Then, wasserstein-based generative Adversation network (WGAN) algorithm was used to achieve data fitting and generation, which provided data support for subsequent long-and-short Term Memory (LSTM) based load prediction model. Finally, the effectiveness of the proposed algorithm and model was verified by an example of an oilfield power grid.Through the intelligent identification, sequence generation and load prediction of oil field load data, the purpose of deep mining and analysis of oil field production behavior is realized.
Optimal control and cost-effectiveness analysis of an echinococcosis transmission mod...
Jianglin Zhao

Jianglin Zhao

and 1 more

June 20, 2022
A document by Jianglin Zhao. Click on the document to view its contents.
The location problem of emergency materials in uncertain environment
xiao jihe
Yuhong Sheng

xiao jihe

and 1 more

June 20, 2022
The hazards and unpredictability of emergencies have made people pay more and more attention to emergency response. A reasonable reserve of emergency materials can play an important role in post-disaster rescue. This paper uses the uncertain comprehensive evaluation method to grade the emergency materials, and establishes a location model for the uncertain emergency materials.The location of the reserve point is determined by maximizing the rescue satisfaction, the maximum number of service demand points under the maximum coverage, and pursuing the minimum sum of the distance from the demand point to the reserve point. Based on the uncertainty theory, the uncertain emergency materials location model is converted into an equivalent deterministic emergency materials location model, and the model is solved by a tabu search algorithm. Finally, a numerical experiment is given to illustrate the idea of the uncertain model.
INTRAOPERATIVE PUMP THROMBOSIS (PT) IN HEARTMATE (HM) III
Sathappan Karuppiah
Sudharsan Setty

Sathappan Karuppiah

and 3 more

June 20, 2022
Pump thrombosis is a rare and infrequent complication of HeartMate III left ventricular assist device (LVAD). While there are reports of pump thrombosis in the postoperative period, to our knowledge, there have been no prior reports on pump thrombosis in the intraoperative period. Here we present a case of a 24-year-old female who required HeartMate III LVAD implantation for progressive heart failure and the intraoperative period was complicated with pump thrombosis (PT). Managing PT in the intraoperative period is challenging and time-sensitive because of its rare occurrence and paucity of recommendations in diagnosing the PT.
Letter to the Editor: Management of aortic arch hypoplasia in neonates and infants
Maida Qazi
Satesh Kumar

Maida Qazi

and 2 more

June 20, 2022
Title: Letter to the Editor: Management of aortic arch hypoplasia in neonates and infantsArticle type : Letter to the Editor.Correspondence: 1. Maida QaziContact: 03332132159 Email: maidaqazi10@gmail.comInstitution: DOW University Of Health SciencesAddress: Bihar Colony, Al-Falah Road, Karachi.Co-authors : 2. Satesh KumarContact: +923325252902 Email: kewlanisatish@gmail.comInstitute: Shaheed Mohtarma Benazir Bhutto Medical College Liyari, KarachiAddress: Parsa citi, Garden East, Karachi
Sutureless bioprosthesis for aortic valve replacement: surgical and clinical outcomes
Ricardo Ferreira
Nuno Rua

Ricardo Ferreira

and 8 more

June 20, 2022
Aortic valve stenosis is the most common adult valve disease in industrialized countries. The ageing population and the increase in comorbidities urge the development of safer alternatives to the current surgical treatment. Sutureless bioprosthesis have shown promising results, especially in complex procedures and in patients requiring concomitant surgeries. Objectives: Assess the clinical and hemodynamic performance, safety, and durability of the Perceval ® prosthetic valve. Methods: This single center retrospective longitudinal cohort study collected data of all adult patients with aortic valve disease who underwent aortic valve replacement with a Perceval ® prosthetic valve between February 2015 and October 2020. Of the 196 patients included (mean age 77.20±5.08 years; 45.4% female; mean EuroSCORE II 2.91±2.20%), the majority had aortic stenosis. Results: Overall mean cross-clamp and cardiopulmonary bypass times were 33.31±14.09 and 45.55±19.04 minutes, respectively. Mean ICU and hospital stay were 3.32±3.24 and 7.70±5.82 days, respectively. Procedural success was 98,99%, as two explants occurred. 4 valves were reimplanted due to intra-operative misplacement. Mean transvalvular gradients were 7.82±3.62 mmHg. Pacemaker implantation occurred in 12.8% of patients, new-onset atrial fibrillation in 21.9% and renal replacement support was necessary in 3.1%. Early mortality was 2.0%.  We report no structural valve deterioration, strokes or endocarditis and one successfully treated valve thrombosis. Conclusions: Our study confirms the excellent clinical and hemodynamic performance and safety of a truly sutureless aortic valve, up to 5-year follow-up. These results were consistent in isolated and concomitant interventions, solidifying this device as a viable option for treatment of isolated aortic valve disease.
Evaluating the efficacy and safety of Thumper device for cardiac arrest: A systematic...
Luo Ding
Shuang Li

Luo Ding

and 6 more

June 20, 2022
Background:Cardiopulmonary resuscitation (CPR) is a major rescue measure for cardiac arrest (CA) patients, and chest compression is the key of CPR. The Thumper devices has been invented to solve the deficiency of manual compression.However, current randomized controlled trials (RCTs) provide controversial findings. Objectives: This meta-analysis aimed to compare the clinical benefits of using the Thumper devices with manual chest compressions during the provision of CPR of patients in CA. Methods: Relevant studies were retrieved from the Ovid, PubMed, Web of Science, EMBASE, Cochrane, CNKI etc.,electronic databases and by manually searching the reference lists of research and review articles. All RCTs published in either English or Chinese until June 31, 2020, were included in the meta-analysis. The odds ratios (ORs) and their 95% confidence intervals (95%CIs) for the return of spontaneous circulation (ROSC), survival rate (SR), and the incidence of rib fractures (RFs) were compared between the manual and Thumper chest compressions. Results: A total of 2164 records were identified, of which 16 were RCTs with an overall risk of bias ranging from low to medium classification.Following CPR, the hazard ratios for ROSC, SR, and RF were significantly better for the Thumper chest compression with ORs of 2.56, (95%CI 2.11-3.11, I2=0%), 4.06, (95%CI 2.77-5.93, I2=0%), and 0.24 (95%CI 0.14-0.41, I2=0%), respectively. Conclusions: The Thumper compression device improved the ROSC, SR and decreased the incidence of RFs in CA patients when compared with manual chest compression. Its use is, therefore, recommended during the resuscitation of CA patients.
Error estimates of a two-grid penalty finite element method for the Smagorinsky model
Yun-Bo Yang

Yun-Bo Yang

June 20, 2022
In the paper, we consider the penalty finite element methods (FEMs) for the stationary Smagorinsky model. Firstly, a one-grid penalty FEM is proposed and analyzed. Since this method is nonlinear, a novel linearized iteration scheme is derived for solving it. We also derived the stability and convergence of numerical solutions for this iteration scheme. Furthermore, a two-grid penalty FEM is developed for Smagorinsky model. Under $\varepsilon<
Outcomes of Lymphadenectomy for Early-Stage Mucinous Ovarian Cancer: A Retrospective...
Xiaqin Cheng
Zhen Zeng

Xiaqin Cheng

and 3 more

June 20, 2022
Objective: To evaluate the efficacy of lymphadenectomy for early-stage primary mucinous ovarian cancer (MOC). Design: Retrospective observation study Setting: Surveillance, Epidemiology, and End Results (SEER) database for 2000-2018 Population or sample: The study population comprised 1848 patients with early-stage MOC Methods: MOCs were divided into two groups according to lymphadenectomy. Propensity score matching were performed to correct for deviations. Independent risk factors for overall survival (OS) were determined by multivariate analysis using Cox regression. The role of lymphadenectomy was performed in different populations by stratified analysis applying interaction analysis. OS was calculated by Kaplan-Meier curves and compared by log-rank test. Main outcome measures: Overall survival Results: In the study, almost 65.8% (n = 1214/1848) experienced lymphadenectomy. Lymphadenectomy (HR = 0.692, 95% CI = 0.516-0.927, P = 0.009), age at diagnosis (HR = 3.028, 95% CI = 1.477-6.208, P = 0.002), and laterality (HR = 2.013, 95% CI = 1.145-3.54, P = 0.015) were found to be associated with OS. The role of lymphadenectomy varied by age group and tumor laterality, and the 5-year survival rates of patients with bilateral tumors who had experienced lymphadenectomy with sampling and dissection, or for MOC over age 50 and were higher than that of patients who did not undergo lymphadenectomy. Conclusion: Lymphadenectomy with sampling and dissection has little impact on OS in patients with early MOC. Lymph node therapy can be discontinued in patients younger than 50 years, and lymph node sampling is recommended for patients older than 50 years or with bilateral tumors.
Obstetric Outcome and Emotional Adjustment to Childbirth in Women with Dyspareunia: A...
Anna Padoa
Roni Tomashev

Anna Padoa

and 8 more

June 20, 2022
Objective: To assess obstetrical outcomes, perceptions of childbirth experience and emotional adjustment in women with dyspareunia. Design: Cross-sectional study. Setting: The maternity ward of a single medical center. Population: Four-hundred forty women, recruited within two days postpartum. Methods: We administered self-report questionnaires addressing demographic and reproductive background, dyspareunia, pain and perceived threat during delivery, sense of control during labour, perceived professional support, and maternal adjustment (i.e., perinatal dissociation, acute stress disorder (ASD), bonding, anticipated maternal self-efficacy depression and positive and negative affect). Obstetrical information was retrieved from clinical files. Main outcomes measures: Obstetrical outcomes and emotional adjustment to childbirth in women with dyspareunia versus comparisons. Results: Three-hundred eighty-eight women filled the dyspareunia questionnaire. The dyspareunia group included 71 women (18.3%) and the comparison group 317 (81.7%). Demographic data were similar between groups. No difference was observed in labour onset, analgesia, route of delivery and perineal tears. More participants with dyspareunia had premature delivery versus comparisons (14.1% vs 5.6%, p=0.02). Women with dyspareunia reported lower sense of control (p=0.01), lower perceived support (p<0.001), more perinatal dissociation (p<0.001), ASD symptoms (p<0.001), depression (p=0.02), negative affect (p<0.001), lower maternal bonding (p<0.001) and anticipated maternal self-efficacy (p=0.01). Women who experienced pain during pelvic exams were less likely to have spontaneous labor onset, more likely to need cervical ripening (p=0.02), and reported higher levels of negative affect (p=0.03). Conclusion: Dyspareunia was associated with more premature deliveries, more emotional distress and poorer maternal adjustment. Perinatal caregivers should be cognizant of such emotional reactions during prenatal care.
Takotsubo (Stress) Cardiomyopathy Induced by Acute Asthma Exacerbation in Elderly Wom...
Khaled Al Khodari
Raad  Alhaj Tahtouh

Khaled Al Khodari

and 3 more

June 20, 2022
A 73-year-old patient who was admitted secondary to acute asthma exacerbation that required frequent salbutamol and adrenaline nebulization. Takotsubo cardiomyopathy was diagnosed after new onset of chest pain with modest troponin elevation and normal coronary angiogram. Low ejection fraction and apical akinesia were completely resolved after her symptoms got improv
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