Complete Separation Research Articles

Multifractal analysis of heart rate variability in pregnancy during sleep.

Understanding the complex dynamics of heart rate variability (HRV) during pregnancy is crucial for monitoring both maternal well-being and fetal health. In this study, we use the Multifractal Detrended Fluctuations Analysis approach to investigate HRV patterns in pregnant individuals during sleep based on RR interval maxima (MM fluctuations). In addition, we study the type of multifractality within MM fluctuations, that is, if it arises from a broad probability density function or from varying long-range correlations. Furthermore, to provide a comprehensive view of HRV changes during sleep in pregnancy, classical temporal and spectral HRV indices were calculated at quarterly intervals during sleep. Our study population consists of 21 recordings from nonpregnant women, 18 from the first trimester (early-pregnancy) and 18 from the second trimester (middle-pregnancy) of pregnancy. Results. There are statistically significant differences ( -value < 0.05) in mean heart rate, rms heart rate, mean MM fluctuations, and standard deviation of MM fluctuations, particularly in the third and fourth quarter of sleep between pregnant and non-pregnant states. In addition, the early-pregnancy group shows significant differences ( -value < 0.05) in spectral indices during the first and fourth quarter of sleep compared to the non-pregnancy group. Furthermore, the results of our research show striking similarities in the average multifractal structure of MM fluctuations between pregnant and non-pregnant states during normal sleep. These results highlight the influence of different long-range correlations within the MM fluctuations, which could be primarily associated with the emergence of sleep cycles on multifractality during sleep. Finally, we performed a separability analysis between groups using temporal and spectral HRV indices as features per sleep quarter. Employing only three features after Principal Component Analysis (PCA) to the original feature set, achieving complete separability among all groups appears feasible. Using multifractal analysis, our study provides a comprehensive understanding of the complex HRV patterns during pregnancy, which holds promise for maternal and fetal health monitoring. The separability analysis also provides valuable insights into the potential for group differentiation using simple measures such as mean heart rate, rms heart rate, and mean MM fluctuations or in the transformed feature space based on PCA.

Tutorial on Firth's Logistic Regression Models for Biomarkers in Preclinical Space.

Preclinical studies are broad and can encompass cellular research, animal trials, and small human trials. Preclinical studies tend to be exploratory and have smaller datasets that often consist of biomarker data. Logistic regression is typically the model of choice for modeling a binary outcome with explanatory variables such as genetic, imaging, and clinical data. Small preclinical studies can have challenging data that may include a complete separation or quasi-complete separation issue that will result in logistic regression inflated coefficient estimates and standard errors. Penalized regression approaches such as Firth's logistic regression are a solution to reduce the bias in the estimates. In this tutorial, a number of examples with separation (complete or quasi-complete) are illustrated and the results from both logistic regression and Firth's logistic regression are compared to demonstrate the inflated estimates from the standard logistic regression model and bias-reduction of the estimates from the penalized Firth's approach. R code and datasets are provided in the supplement.

Niacinamide Antimicrobial Efficacy and Its Mode of Action via Microbial Cell Cycle Arrest.

Niacinamide is a versatile compound widely used in the personal care industry for its ample skin benefits. As a precursor to nicotinamide adenine dinucleotide (NAD+), essential for ATP production and a substrate for poly-ADP-ribose polymerase-1 (PARP-1), studies have highlighted its roles in DNA repair, cellular stress mechanisms, and anti-aging benefits. Niacinamide was also studied for its antimicrobial activity, particularly in the context of host-infection via host immune response, yet its direct antimicrobial activity and the mechanisms of action remain unclear. Its multifunctionality makes it an appealing bioactive molecule for skincare products as well as a potential preservative solution. This study explores niacinamide's antimicrobial mode of action against four common cosmetic pathogens. Our findings indicate that niacinamide is causing microbial cell cycle arrest; while cells were found to increase their volume and length under treatment to prepare for cell division, complete separation into two daughter cells was prevented. Fluorescence microscopy revealed expanded chromatin, alongside a decreased RNA expression of the DNA-binding protein gene, dps. Finally, niacinamide was found to directly interact with DNA, hindering successful amplification. These unprecedented findings allowed us to add a newly rationalized preservative facete to the wide range of niacinamide multi-functionality.

Do we need another screw? Sacroiliac screw fixation in open-book pelvic ring injuries (APC type II).

To compare anterior plate fixation (SP fixation) both alone and in combination with an additional posterior sacroiliac screw (SP+SIS fixation) as a treatment for pelvic ring injuries with widening of the pubic symphysis and disruption to the anterior sacroiliac ligaments. To find studies with pelvic ring injuries (APC II; B2.3d) and SP or SP+SIS fixation, a systematic literature review was conducted by searching four databases. A protocol was published a priori at Open Science Framework (https://doi.org/10.17605/OSF.IO/3YHAV). Exclusion criteria included perineal injuries, chronic instability of the symphysis, complete sacroiliac separation, and pediatric patients (age <18 years). Primary outcomes of interest were defined as implant failure, health-related quality of life, and revision rate. Altogether, 1861 studies were screened, and 40 studies qualified for full-text analysis. In total, 14 studies (two surveys, six biomechanical studies, and six retrospective clinical studies) were included. The surveys revealed that surgeons who had more recently begun practicing were more likely to use posterior fixation (SP+ISS). The biomechanical studies were heterogenous and did not yield a uniform pattern. In clinical studies, 117 patients (45%) received SP fixation, and 142 patients (55%) received SP+SIS fixation. Complications occurred in 31 SP patients (30%) and in five SP+SIS patients (3.5%). A high risk of bias was uncovered, and reporting was found to be incomplete. SP+SIS may have the potential to improve outcomes, but the evidence remains too inconclusive to draw reliable recommendations.

Proximal humeral fractures with vascular compromise.

Vascular compromise due to arterial injury is a rare but serious complication of a proximal humeral fracture. The aims of this study were to report its incidence in a large urban population, and to identify clinical and radiological factors which are associated with this complication. We also evaluated the results of the use of our protocol for the management of these injuries. A total of 3,497 adult patients with a proximal humeral fracture were managed between January 2015 and December 2022 in a single tertiary trauma centre. Their mean age was 66.7 years (18 to 103) and 2,510 (72%) were female. We compared the demographic data, clinical features, and configuration of those whose fracture was complicated by vascular compromise with those of the remaining patients. The incidence of vascular compromise was calculated from national population data, and predictive factors for its occurrence were investigated using univariate analysis. A total of 18 patients (0.5%) had a proximal humeral fracture and clinical evidence of vascular compromise, giving an annual incidence of 0.29 per 100,000 of the population. Their mean age was 68.7 years (45 to 92) and ten (56%) were female. Evidence of a mixed pattern neurological deficit (brachial plexus palsy) (odds ratio (OR) 380.6 (95% CI 85.9 to 1,685.8); p < 0.001), complete separation of the proximal shaft from the humeral head with medial displacement (OR 39.5 (95% CI 14.0 to 111.8); p < 0.001), and a fracture-dislocation (OR 5.0 (95% CI 1.6 to 15.3); p = 0.015) were all associated with an increased risk of associated vascular compromise. A policy of reduction and fixation of the fracture prior to vascular surgical intervention had favourable outcomes without vascular sequelae. The classic signs of distal ischaemia are often absent in patients with proximal injuries to major vessels. We were able to identify specific clinical and radiological 'red flags' which, particularly when present in combination, should increase the suspicion of a fracture with an associated vascular injury, and facilitate early diagnosis and appropriate combined orthopaedic and vascular intervention.

Online monitoring of pre-crack initiation in carbon fiber-reinforced thermoplastic composites by an ultrasonic cutting tool using high-speed optical imaging and infrared thermography

The ultrasonic-assisted manufacturing process is a promising machining approach for composite materials as it exerts less force, making it ideal for the aerospace and automotive sectors. This work reports about the pre-crack initiation in carbon fiber reinforced (CF)/ poly-ether-ether-ketone (PEEK) composite under ultrasonic frequency at room temperature. An iron-based cutting tool matching the system’s resonance frequency (20 kHz) was used to perform the ultrasonic pre-cracking. In this novel work, the pre-cracking of CF-PEEK is considered as the initial step for a complete fiber layer separation, which holds the key for circularity options in high-performance aerospace composites. State-of-the-art high-speed camera and infrared thermography were combined to monitor the crack initiation and propagation. By online monitoring, the different stages involved in the pre-cracking process, its temperature evolution, and consequently the dissipated energy during pre-cracking under ultrasonic frequency were evaluated. The results showed that oscillation amplitude had a significant influence on the determined pre-crack depth and measured global temperature and energy compared to cutting force. The measured global temperature data indicates that pre-cracking occurred in the solid state with a temperature well below the glass-transition temperature of PEEK. However, the local temperature at the contact between the sample and sonotrode could have been much higher during ultrasonic cutting which needed further investigation. The computed global dissipated energy and temperature were only reliable at the pre-crack initiation site due to the limitation in the infrared thermography system.

Establishing carbon dots assisted high speed countercurrent chromatography and its application for efficient separation of rare earth element ions

Rare earth elements with unique magnetic properties and optical properties, known as the ‘industrial vitamin’, has a very high commercial value. As a secondary resource of rare earth elements, low-concentration solution includes mixed rare earth ions, which need to realize efficient separation and recovery urgently. High speed countercurrent chromatography is suitable for the separation and purification of rare earth element ions due to its advantages of large loading, good tolerance to samples, and simple pretreatment. In this study, a carbon dots assisted high speed countercurrent chromatography method was designed and established, the carbon dots were applied to the mobile phase of high speed countercurrent chromatography for the first time. The low concentration of REEs solution was enriched, and the effective separation of La (III), Ce (III), Gd (III) and Er (III) was successfully achieved. The complete separation of La (III), Ce (III), Gd (III) and Er (III) was achieved with a solvent system of 0.05 mol L−1 P507 (PE), 0.05 mol L−1 HNO3, and 0.1 mol L−1 CDs2 carbon dots (1:1:0.01, v/v/v), the upper phase as stationary phase, the lower phase as mobile phase. Density functional theory result showed that the binding energy of REEs (III)-CDs2 was larger than that of REEs (III)-P507, so the affinity of CDs2 to REEs (III) was stronger than that of P507. Therefore, with the addition of CDs2, the ability of mobile phase to elute REEs from the stationary phase was enhanced, and the separation effect was improved.

DMF-DM-seq: Digital-Microfluidics Enabled Dual-Modality Sequencing of Single-Cell mRNA and microRNA with High Integration, Sensitivity, and Automation.

Multimodal measurement of single cells provides deep insights into the intricate relationships between individual molecular layers and the regulatory mechanisms underlying intercellular variations. Here, we reported DMF-DM-seq, a highly integrated, sensitive, and automated platform for single-cell mRNA and microRNA (miRNA) co-sequencing based on digital microfluidics. This platform first integrates the processes of single-cell isolation, lysis, component separation, and simultaneous sequencing library preparation of mRNA and miRNA within a single DMF device. Compared with the current half-cell measuring strategy, DMF-DM-seq enables complete separation of single-cell mRNA and miRNA via a magnetic field application, resulting in a higher miRNA detection ability. DMF-DM-seq revealed differential expression patterns of single cells of noncancerous breast cells and noninvasive and aggressive breast cancer cells at both mRNA and miRNA levels. The results demonstrated the anticorrelated relationship between miRNA and their mRNA targets. Further, we unravel the tumor growth and metastasis-associated biological processes enriched by miRNA-targeted genes, along with important miRNA-interaction networks involved in significant signaling pathways. We also deconstruct the miRNA regulatory mechanisms underlying different signaling pathways across different breast cell types. In summary, DMF-DM-seq offers a powerful tool for a comprehensive study of the expression heterogeneity of single-cell mRNA and miRNA, which will be widely applied in basic and clinical research.

High-temperature heat treatment of hydrogen-reduced bauxite residue-calcite pellets for iron particles growth and separationTraitement thermique à haute température de boulettes de résidus de bauxite et calcite réduites à l’hydrogène pour la croissance et la séparation des particules de fer

ABSTRACT Bauxite residue characterised as a polymetallic source containing iron, alumina, titanium, calcium, silicon and rare earth elements offers an opportunity for reduced waste volume and the recovery of valuable metals. This study focuses on the agglomeration of bauxite residue with calcite, followed by hydrogen reduction at 1000°C. The resulting iron particles in the reduced pellets were initially very small distributed in a porous oxide matrix, posing challenges for physical separation methods. To address this issue, further heat treatments were conducted on the reduced pellets in an argon atmosphere, ranging from 1100°C to 1550°C. Phase analysis and microstructural examinations were performed using X-ray powder diffraction and scanning electron microscopy, respectively. Experimental findings indicate that the size of iron particles in the reduced pellets increases with higher heat treatment temperatures. Up to 1200°C, the oxide matrix remains a solid state, transitioning to a semi-molten and molten state above this heat treatment temperature and complete separation of iron from the oxide matrix above 1500°C. An alkali-leachable phase is present in the reduced pellets, initially in the form of calcium aluminate (mayenite), while above 1400°C, this phase dissociates to form monocalcium aluminate, and complete conversion at 1500°C. As observed in the microstructural analysis, there is an increase in the particle size of iron in both the solid and semi-molten states with an increasing in temperature from 1100°C up to 1300°C. This comprehensive study sheds light on the transformative effects of varying heat treatment temperatures on the composition and microstructure of bauxite residue-based materials.

Exploring barriers in the transition toward an established e-waste management system in Brazil: a multiple-case study of the formal sector

AbstractBrazil is the largest generator of electrical and electronic waste (e-waste) in Latin America but faces significant challenges with its management. This study investigates barriers to the growth of the formal sector in transitioning toward an established e-waste management system in the country. Driven by sustainability transitions research, it applies a transition management approach to e-waste management. The study presents the results of field studies conducted in four organizations with different levels of recycling operations. The results show several barriers, for instance, a lack of processes for the complete separation of metals, high reverse logistics cost, a lack of transparency throughout the supply chains, concern with data security, and a lack of financial incentives and policy integration. The study highlights various initiatives from the organizations that assist in tackling some of the identified barriers and shed light on possible transition pathways. The study provides a perspective from e-waste management organizations and policy insights to strengthen e-waste management in the country.

Moving horizon estimation and control of a binary simulated moving bed chromatographic processes with Langmuir isotherms

Simulated moving bed chromatographic (SMB) chromatographic processes are widely used for separations in pharmaceutical and biotechnological industries. In the present work, the control of such processes is proposed based on a semi-centralized control scheme that utilizes a combination of model predictive control (MPC) and classical PID control. The necessary information from the process, i.e. the internal concentration profiles, for the MPC is obtained by a moving horizon estimator (MHE) in real-time from the available limited measurements (the cycle-averaged concentrations of the extract and raffinate product streams and the dimensionless retention times of the concentration waves in the regeneration zones). As a test case study, the separation of a hypothetical system governed by the Langmuir isotherms in the nonlinear concentration range of the isotherms is considered. First, the stand-alone MHE is validated in open loop mode with no plant-model mismatch under deterministic and stochastic conditions. In the latter case, the true measurements are subject to random normally distributed noise. To evaluate the performance of the proposed control strategy, a reference tracking (change of the requirements for both the purities and the retention times) scenario is simulated. The investigated scenarios are: (i) no plant-model mismatch, (ii) MHE with ideal noiseless measurements and finally (iii) MHE under the influence of measurement noise. Results show that the controller is able to follow the change of the references from reduced purity to complete separation and vice versa closely.

Americanisation: The deterioration of British English

The study of the influence of American English on British English is necessary to understand both the short-term and long-term prospects for the development of global English in the world and the linguistic changes associated with the world’s national languages. The purpose of study was to examine the key differences in vocabulary, grammar, orthoepy, and spelling between American English and British English. The principal methods used in the study were comparative, analytical, synthetic, and statistical analysis, as well as elements of lexical, grammatical, orthoepic, and spelling analysis. The study examined the use of English in education in the context of the linguistic landscape of Europe, specifically Poland. Considering the statistical data, it was concluded that the americanization of the English-speaking space continues and leads to a gradual simplification of grammatical orthographic and orthoepic patterns of British English. Globalization and technological advancements today present two possible scenarios for the development of English: linguistic convergence between British and American English or complete separation of these varieties. The study noted that the influence of American English on the educational environment in Poland is high, but the study of the global language is based on British standards. In the long run, the impact of americanization will increase not only on British English, but also on national languages, which may lead to the spread of pidgin (American-Polish). This study can be used in the research of linguistic patterns in historical dynamics, Americanized regional varieties of English, and monitoring of the linguistic situation in the world

Highly Efficient Separation of BTEX via Amide Naphthotube Cavity-Confined Tandem C/N-H···π Interactions.

The separation of BTEX [benzene, toluene, ethylbenzene (EB), and xylene isomers] poses a huge challenge in the industry, attributed to their similar structures and physical properties. Supramolecular compounds show great promise for hydrocarbon separation. Herein, we designed two pairs of endo-functionalized amide naphthotubes with methyl and benzyl side chains, which were first employed as chromatographic separation materials and exhibited high shape-selectivity for BTEX. In particular, the amide naphthotubes with methyl side chains provided complete separation toward BTEX and anti-3a showed high selectivity for the p-xylene over other isomers with αPX/OX = 9.34, αPX/MX = 5.50, and αPX/EB = 4.30. The mechanism of BTEX separation originates from the synergistic effect of specially confined tandem N-H···π and C-H···π interactions toward aromatic compounds. The findings of this research show promise for practical applications in efficiently separating crucial aromatic isomers.

Binary classification with fuzzy logistic regression under class imbalance and complete separation in clinical studies

BackgroundIn binary classification for clinical studies, an imbalanced distribution of cases to classes and an extreme association level between the binary dependent variable and a subset of independent variables can create significant classification problems. These crucial issues, namely class imbalance and complete separation, lead to classification inaccuracy and biased results in clinical studies.MethodTo deal with class imbalance and complete separation problems, we propose using a fuzzy logistic regression framework for binary classification. Fuzzy logistic regression incorporates combinations of triangular fuzzy numbers for the coefficients, inputs, and outputs and produces crisp classification results. The fuzzy logistic regression framework shows strong classification performance due to fuzzy logic’s better handling of imbalance and separation issues. Hence, classification accuracy is improved, mitigating the risk of misclassified conditions and biased insights for clinical study patients.ResultsThe performance of the fuzzy logistic regression model is assessed on twelve binary classification problems with clinical datasets. The model has consistently high sensitivity, specificity, F1, precision, and Mathew’s correlation coefficient scores across all clinical datasets. There is no evidence of impact from the imbalance or separation that exists in the datasets. Furthermore, we compare the fuzzy logistic regression classification performance against two versions of classical logistic regression and six different benchmark sources in the literature. These six sources provide a total of ten different proposed methodologies, and the comparison occurs by calculating the same set of classification performance scores for each method. Either imbalance or separation impacts seven out of ten methodologies. The remaining three produce better classification performance in their respective clinical studies. However, these are all outperformed by the fuzzy logistic regression framework.ConclusionFuzzy logistic regression showcases strong performance against imbalance and separation, providing accurate predictions and, hence, informative insights for classifying patients in clinical studies.

Cyclic Ion Mobility of Isomeric New Psychoactive Substances Employing Characteristic Arrival Time Distribution Profiles and Adduct Separation.

Analysis of new psychoactive substances (NPS), which is essential for toxicological and forensic reasons, can be made complicated by the presence of isomers. Ion mobility has been used as a standalone technique or coupled to mass spectrometry to detect and identify NPS. However, isomer separation has so far chiefly relied on chromatography. Here we report on the determination of isomeric ratios using cyclic ion mobility-mass spectrometry without any chromatographic separation. Isomers were distinguished by mobility separation of lithium adducts. Alternatively, we used arrival time distribution (ATD) profiles that were characteristic of individual isomers and were acquired for protonated molecules or fragment ions. Both approaches provided comparable results. Calculations were used to determine the structures and collision cross sections of both protonated and lithiated isomers that accurately characterized their ion mobility properties. The applicability of ATD profiles to isomer differentiation was demonstrated using direct infusion and flow injection analysis with electrospray of solutions, as well as desorption electrospray of solid samples. Data processing was performed by applying multiple linear regression to the ATD profiles. Using the proposed ATD profile-based approach, the relationships between the determined and given content of isomers showed good linearity with coefficients of determination typically greater than 0.99. Flow injection analysis using an autosampler allowed us to rapidly determine isomeric ratios in a sample containing two isomeric pairs with a minor isomer of 10% (determined 9.3% of 3-MMC and 11.0% of 3-FMC in a mixture with buphedrone and 4-FMC). The proposed approach is not only useful for NPS, but also may be applicable to small isomeric molecules analyzed by ion mobility when complete separation of isomers is not achieved.

An improved Trizol method for extracting total RNA from Eleutherococcus senticosus (Rupr. & Maxim.) Maxim leaves.

High-quality nucleic acids are the basis for molecular biology experiments. Traditional RNA extraction methods are not suitable for Eleutherococcus senticosus Maxim. To find a suitable method to improve the quality of RNA extracted, we modified the RNA extraction methods of Trizol. Based on the conventional Trizol method, the modified Trizol method 1 and modified Trizol method 2 were used as the control for extraction of RNA from E. senticosus Maxim leaves. The modified Trizol method 1 added β-mercaptoethanol on the conventional Trizol method. After RNA was dissolved, a mixed solution of phenol, chloroform, and isoamyl alcohol was added to denature protein and inhibit the degradation of RNA. The modified Trizol method 2 adds PVPP to grind on the basis of modified Trizol method 1, so as to better remove phenols from leaves, and eliminates the step of incubation at -20°C to reduce extraction time and RNA degradation. Chloroform, CTAB, and CH3COONa were used instead of a phenol, chloroform, and isoamyl alcohol mixed solution to ensure complete separation of nucleic acid from plant tissues and to obtain high-purity RNA. The research results showed that the quality of RNA extracted by conventional Trizol method, modified Trizol method 1, was incomplete, accompanied with different degrees of contamination of polysaccharides, polyphenols, and DNA. The modified Trizol method 2 could better extract RNA from E. senticosus Maxim leaves. The ratio of A260/A280 was in the range of 1.8-2.0, and the yield of RNA was the highest, which was 1.68 and 1.15 times compared with that by conventional Trizol method and modified Trizol method 1 extraction, respectively. The reverse transcription cDNA was further tested through PCR with the specific primers. The amplified fragments are displayed in clear and bright bands in accordance with the expected size. The modified Trizol method 2 could better extract RNA from E.senticosus Maxim leaves. High-quality RNA has more advantages in molecular biology study of E.senticosus Maxim.

ROSES: The most Complete System for Endovascular Surgery

ROSES, an innovative Robotic System for Endovascular Surgery, features a unique mechanism that continuously measures the resistance encountered by catheters and guide wires as they advance within the body. This feature operates seamlessly without the need for additional specialized components. The system is comprised of a series of robotic actuators (up to three) arranged linearly on slides running along a rail, inclined toward the patient. Another slide, housing a pair of step motors, facilitates the adjustment of relative positions between the actuators, with the proximal actuator affixed to the motor slide by a lateral bar. A force transducer, linked to the motor slide via a wire, is responsive to the gravitational component of any object on the rail. Importantly, this force remains constant even as the actuators move. However, the force dynamically changes if an external obstruction hinders the progress of catheters and guide wires, serving as an alert to the attending physician. The system, uniquely, is also capable of guiding the introduction of the first catheter, even if it is pre-curved. This capability facilitates the complete separation of the doctor from the patient throughout the entire surgical procedure. The system employs compact, purely mechanical disposables designed for a wide range of interventions utilizing commercially available catheters and guide wires, including angioplasty, brain and carotid surgery (for aneurysms or thrombi), TAVI, and various lower and upper limb procedures. Future developments include the incorporation of animated catheters capable of altering their shape configuration under console control. As the system also records the penetration length of each device and transmits this data to a workstation along with X-ray images, it effectively becomes the "black box" of endovascular surgeries. This functionality allows for a complete separation between physicians and patients throughout the entire surgical procedure. The system is safeguarded by multiple pending international patent applications.

Primary Posterior Uterine Rupture in Labor: Case Report and Literature Review

Purpose: To report a rare case of primary posterior uterine rupture in a healthy term multigravida. Methods: Case report. Results: We present the case of an otherwise healthy 35-year-old gravida 4 para 3 with no reported medical or surgical history and three prior uncomplicated term vaginal deliveries who presented in labor at 39 weeks gestation. After four hours of oxytocin augmentation, the fetus was noted to have recurrent late decelerations and then became bradycardic with a baseline of 60 bpm. The patient’s cervix was found to be 7 cm dilated, 90% effaced, and -1 station. Standard resuscitative measures were undertaken at which point the patient’s cervix was rechecked and found to be 9 cm dilated, 90% effaced, and -1 station. Attempts at manually reducing the cervix while the patient pushed were unsuccessful. With the fetus still bradycardic with a baseline of 60 bpm, the patient was taken for an emergency Cesarean delivery. Within seven minutes of calling the emergency Cesarean delivery, surgery had started. However, there was difficulty with delivering the fetus, who had flipped to transverse back down. The fetus was rotated to breech before being delivered through a “T” incision made on the uterus to facilitate delivery of the head. Three tight nuchal cords were reduced at time of delivery. Examination of the uterus after delivery of the fetus revealed a full thickness, cruciate-shaped laceration in the posterior lower uterine segment extending ~9 cm in the vertical plane, involving the vagina, and ~5 cm in the transverse plane. The rupture was repaired, and the remainder of the surgery proceeded without further complication. Blood loss was estimated at 2500 mL, and she required transfusion of 4 units of packed red cells, 2 units cryoprecipitate, 1 unit fresh frozen plasma, and 1 unit of platelets. The infant was atonic upon delivery with a weight of 3785g and APGARs of 1/5/7. Umbilical artery blood gas analysis was normal with a pH of 7.19 and a base deficit of 7.9 mmol/L. The infant initially required intubation, but quickly improved and was extubated to room air at 1 hour of life. Imaging and neurological exams indicated possible moderate encephalopathy, and the infant underwent therapeutic hypothermia for four days at which point cooling was discontinued after improvement was noted. The remainder of his NICU stay was unremarkable and he was discharged on day nine of life. The mother required 2 additional units of packed red cells during the remainder of her postpartum course, but otherwise did well and she was discharged on post-op day five. Conclusion(s): Uterine rupture is the complete separation of all three layers of the uterus. It is a life-threatening event for both the fetus and the mother. Most uterine ruptures occur in a previously scarred uterus. Uterine rupture in a previously unscarred uterus (primary uterine rupture) is rare and estimated to occur in ~1:20,000 pregnancies. Over 90% of primary uterine ruptures occur in the anterior lower uterine segment. Although this patient did not have any reported medical or surgical history, her status as a multipara and being of advanced maternal age did pose a higher risk of primary rupture. This patient also underwent 3 ½ hours of oxytocin infusion at the time the Cesarean was called. Although she was not on oxytocin for long, its use is associated with primary uterine rupture more so than secondary rupture. Normal indicators of uterine rupture include non-reassuring fetal heart rate tracing, sudden unexplained abdominal pain, unexplained vaginal bleeding, and loss of fetal station. In this patient, fetal bradycardia was the only sign that her uterus was compromised. Although the uterine arteries were not involved in this patient’s rupture, blood loss was still profound due to the extensive uterine defect. This case highlights that, while rare, uterine rupture can occur in any patient, regardless of uterine surgical history and physicians must be prepared to intervene quickly.

Examination of Mandible in Morkaraman Sheep Using Geometric Morphometry Method

The aim of this study is to examine and analyze the mandible of Morkaraman sheep without any skeletal disorders using the geometric morphometric method. For this purpose, a total of 14 mandibles from male and female individuals were used in the study. The main components in multidimensional data sets were determined with Principal Component Analysis, used within the scope of the geometric morphometry method, and the differences between the samples were determined with Discriminant Function Analysis. Statistical and formal analyzes of these variances were also performed. A total of 12 principal components were obtained with 12 punctuations selected on a total of 14 mandibular (7 female, 7 male) images. Among these principal components, the first principal component (PC1) alone accounted for 30.409% of the total variation. The second principal component (PC2) alone accounted for 22.265% of the total variation, and the third principal component (PC3) alone accounted for 14.893% of the total variation. The first three of the variances obtained explained 67,567 of the shape differences. Discriminant Function Analysis (DFA) was used to objectively evaluate gender differences. In the discriminant function analysis, the p value was above 0.05 (p = 0.7). Although there was a complete separation between genders formally and statistically, no significant p value was obtained. In line with these analyses, information was obtained about the anatomical features and adaptations of the Morkaraman sheep mandible, which is one of the important economic resources of our country and is bred in a wide area, and it has become an exemplary study in this field.

Ice-Enabled Transfer of Graphene on Copper Substrates Enhanced by Electric Field and Cu2O.

Graphene films grown by the chemical vapor deposition (CVD) method suffer from contamination and damage during transfer. Herein, an innovative ice-enabled transfer method under an applied electric field and in the presence of Cu2O (or Cu2O-Electric-field Ice Transfer, abbreviated as CEIT) is developed. Ice serves as a pollution-free transfer medium while water molecules under the electric field fully wet the graphene surface for a bolstered adhesion force between the ice and graphene. Cu2O is used to reduce the adhesion force between graphene and copper. The combined methodology in CEIT ensures complete separation and clean transfer of graphene, resulting in successfully transferred graphene to various substrates, including polydimethylsiloxane (PDMS), Teflon, and C4F8 without pollution. The graphene obtained via CEIT is utilized to fabricate field-effect transistors with electrical performances comparable to that of intrinsic graphene characterized by small Dirac points and high carrier mobility. The carrier mobility of the transferred graphene reaches 9090 cm2V-1s-1, demonstrating a superior carrier mobility over that from other dry transfer methods. In a nutshell, the proposed clean and efficient transfer method holds great potential for future applications of graphene.