High Weight Research Articles

Associations of High BMI and Excessive Gestational Weight Gain With Pregnancy Outcomes in Women With Type 1 Diabetes: A Systematic Review and Meta-analysis.

The increased risk of pregnancy complications in type 1 diabetes is mainly attributed to maternal hyperglycemia. However, it is unclear whether other potentially modifiable factors also contribute to risk in this population. We sought to assess whether high BMI and excessive gestational weight gain (GWG) are associated with perinatal complications in type 1 diabetes. We searched Medline, Embase, PubMed, Scopus, Web of Science, and Cochrane databases to January 2024. Studies examining associations between periconception BMI or GWG and perinatal complications in type 1 diabetes were included. We used a predesigned data extraction template to extract study data including year, country, sample size, participants' characteristics, exposure, and outcomes. We included 29 studies (18,965 pregnancies; 1978-2019) in the meta-analysis. A 1 kg/m2/1 kg increase in preconception BMI or GWG was associated with a 3% and 11% increase, respectively, in perinatal complications (BMI odds ratio [OR] 1.03 [95% CI 1.01-1.06]; GWG OR 1.11 [95% CI 1.04-1.18]). Preconception BMI ≥ 25 kg/m2 or excessive GWG was associated with a 22% and 50% increase, respectively, in perinatal complications (BMI OR 1.22 [95% CI 1.11-1.34]; GWG OR 1.50 [95% CI 1.31-1.73]). BMI was associated with congenital malformation, preeclampsia, and neonatal intensive care unit admission. Excessive GWG was associated with preeclampsia, cesarean delivery, large for gestational age, and macrosomia. Addressing maternal BMI prepregnancy and preventing excessive GWG should be key clinical priorities to improve outcomes in pregnant women with type 1 diabetes.

Association between high birth weight and dental caries at 4–5 years of age: a birth-cohort study

ObjectiveEarly childhood caries has become a globally crucial oral health problem over the decades. Most studies have discussed the association between low birth weight and early childhood caries; however, studies focusing on high birth weight have been relatively limited. This study aimed to assess the impact of high birth weight on the incidence and severity of dental caries in 4–5-year-old children.Subjects and methodsStudy subjects included 491 children from a birth cohort study at 4–5 years of age. Data on dental caries, prenatal and perinatal factors, and socio-demographic determinants were recorded. Logistic regression models adjusted for potential confounders were performed to analyze the data. Two-sided P-value < 0.05 was considered statistically significant.ResultsOf the 491 children, the prevalence of dental caries was 48.7%. High birth weight (≥ 4,000 g) was significantly associated with increased incidence of dental caries (OR, 2.000; CI 95% 1.062–3.765), and the relatively enhanced risk OR was further increased in subjects experiencing caries (dmft ≥ 3) (OR, 2.437; CI 95% 1.306–4.549) compared with the normal birth weight (2,500–3,999 g).ConclusionsHigh birth weight is a risk factor for early childhood caries. Particular attention should be paid to children with birth weight more than or equal to 4,000 g.

Episodic future thinking improves intertemporal choice and food choice in individuals with higher weight: A systematic review and meta-analysis.

Episodic future thinking (EFT) strengthens self-regulation abilities by increasing the perceived value of long-term reinforcements and reducing impulsive choice in delay discounting tasks. As such, EFT interventions have the potential to improve dietary and eating-related decision-making in individuals with obesity or binge eating symptoms, conditions associated with elevated delay discounting. Here, we meta-analyzed evidence from 12 studies that assessed whether EFT interventions improve delay discounting and real-world food choice compared to control interventions. Included studies involved 951 adults with overweight or obesity (body mass index [BMI] ≥25). There were no studies involving participants with binge eating disorder. EFT intervention pooled effects were significant, improving delay discounting with a medium effect, g = 0.55, p < 0.0001, and subsequent food choice outcomes with a small effect, g = 0.31, p < 0.01. Notably, our review is the first to analyze mechanisms of effect in this population, demonstrating that improvements were greater when temporal horizons of EFT episodes were aligned with delay discounting tasks and more distant horizons predicted far-transfer to subsequent dietary and eating-related choices. Our findings thus show that EFT is an effective intervention for individuals with higher weight at risk of adverse health consequences.

'It's Just Not Working', a Qualitative Exploration of the Weight-Related Healthcare Experiences of Individuals of Arab Heritage With Higher Weight in Australia.

Culturally and linguistically diverse population groups disproportionately experience higher weight and other non-weight-related discrimination in healthcare settings outside of their ancestral country. Little is known about the experiences of individuals with Arab heritage. This study aimed to qualitatively explore the intersectional weight-related healthcare experiences of individuals of Arab heritage with higher weight in Australia. A general inductive enquiry approach was used. Purposive, convenience and snowball sampling was used to recruit individuals of Arab heritage residing in Australia. Individuals were invited to participate in an online semistructured interview. Interviews were recorded, transcribedand thematically analysed. Fifteen participants took part in the study. Of these participants, 93% were female (n = 14), 80% were aged between 18 and 44 years (n = 12), 73% were university educated (n = 11), 53% were born outside of Australia (n = 8)and all were Muslim (n = 15). Four main themes were identified: (1) appearance-based judgement, (2) generalised advice and assumptions, (3) cultural responsivenessand (4) healthcare system constraints. Individuals of Arab heritage with higher weight in Australia, namely, females, often perceive their healthcare experiences as dismissive of their cultural and religious needs and driven by causality assumptions around weight. It is crucial that care delivered encompasses cultural humility, is weight-inclusiveand acknowledges systemic constraints. Cultural safety training benchmarks, healthcare management reformand weight-inclusive healthcare approaches are recommended to assist healthcare providers in delivering effective, holisticand culturally safe care. Insights gained from conversations with Arab heritage community members with lived experiences regarding weight-related healthcare encounters informed the study design and approach.

Childhood sexual abuse and IL6 mediated by change in BMI over an 18-year period: A growth curve model

BackgroundChildhood sexual abuse can increase both body weight and inflammation later in life. Higher weight or faster changes in weight, as measured by changes in body mass index (BMI), may mediate the relationship between childhood sexual abuse and inflammation, however, most studies to date have used a cross-sectional design limiting causal inferences. ObjectiveThe current study aimed to investigate the interrelationships between childhood sexual abuse, BMI, and C-reactive protein (CRP) and interleukin-6 (IL6).Participants and Setting.Data from 461 adults who participated in the Midlife in the United States (MIDUS) study were utilized. MethodsGrowth curve modeling was used to test initial levels of BMI and changes of BMI over an 18-year period as mediators linking childhood sexual abuse to CRP and IL6. ResultsSexual abuse was not significantly associated with the initial level of BMI; however, sexual abuse was associated with the slope of BMI (b = 0.072, p = .006). BMI intercept (b = 0.080, p = .001) and slope (b = 0.240, p = .002) predicted IL6 values whereas the slope of BMI (b = 0.398, p = .033) but not intercept predicted CRP values. The indirect effect from sexual abuse to IL6 through BMI slope was significant (b = 0.017, 95 % [CI.001, 0.033]) while the indirect effect from sexual abuse to CRP through BMI slope was not significant (b = 0.028, 95 % [CI -0.004, 0.061]). ConclusionChildhood sexual abuse was indirectly associated with IL6 through rates of change in BMI over time.

Evaluation of turbidity removal efficiency from Karun river water using polyaluminum chloride and chitosan

This study was conducted with the aim of evaluation of turbidity removal efficiency from Karun river water using polyaluminum chloride and chitosan. Chitosan is a linear cationic polyelectrolyte with high positive electron charge (one positive charge per glucose amine unit). Chitosan is used in water purification systems as coagulant along with common coagulants (alum, chlorferric). This biopolymer is also used as a primary coagulant. Chitosan has a higher ability to coagulate colloidal particles than synthetic polyelectrolytes, most of which lack the property of biological degradation in the short term, and some of them cause carcinogenesis and genetic mutation in humans. Therefore, the use of chitosan is preferable to artificial polyelectrolytes from an environmental point of view. This research was conducted on the laboratory scale using a jar test device at the water treatment plant in Ahvaz. In this study, various parameters such as pH, polyaluminum chloride concentration and chitosan concentration were present as variables. After preparing the samples and just before starting jar tests, in the rapid mixing cycle of 200 rounds per minute, the optimal pH to remove the turbidity obtained 8. Also, the optimal dosages of polyaluminum chloride and chitosan were selected as 4 ppm and 0.04 ppm, respectively. Also the main mechanism for destabilizing clots and removing turbidity was bridging between the particles. In this condition, the removal of turbidity showed the highest efficiency. On the other hand, chitosan created clots with a higher weight and, as a result, better settling ability. Therefore, chitosan was a suitable choice to remove turbidity from water.

The associations of early-life health and performance with subsequent dairy cow longevity, productivity, and profitability

Selecting and raising dairy animals that are more likely to reach their potential is a strategy to increase milk production efficiency and overall profitability. However, indicators are necessary for the early identification of animals that are less likely to perform well, allowing for their early culling and ensuring that resources are allocated to those with the highest potential. The objective of this study was to analyze the association between early-life animal health and performance with longevity, production, and profitability. After data cleaning, the following early-life measures (i.e., predictors) were available for 363 female calves born between June 2014 and November 2015 in eight dairy herds from New Brunswick, Canada (average: 45 calves/farm; standard deviation: 26.1 calves/farm; median: 42 calves/farm; range: 15 to 95 calves/farm): birth weight, weaning weight, weaning age, weaning average daily gain (weaning ADG), immunoglobulin G (IgG) serum concentration, the occurrence of navel infection, diarrhea, and pneumonia, and if animals received antibiotic treatment between birth and weaning. Their subsequent length of life (LL), length of productive life (LPL), lifetime cumulative energy-corrected milk (ECM), and lifetime cumulative milk value (i.e., response variables) were provided by the Canadian dairy herd improvement agency. Bayesian Additive Regression Tree models were trained for each response variable using 5-fold cross-validation. Models were evaluated using the RMSE and R2. The three most important predictors were identified using permutation, and the relationship between response variables and important predictors was assessed using accumulated local effect plots. The RMSE for LL, LPL, ECM, and milk value were 1.43 years, 1.37 years, 16 314.94 kg, and $CAD 11 525.68, respectively, whereas the R2 values were 0.30, 0.25, 0.29, and 0.29, respectively, indicating a moderate relationship between predictors and response variables. Non-linear relationships were found between the response variables and important predictors. Animals born with low or high birth weights were associated with decreased LL, LPL, ECM, and milk value. The highest LL, LPL, and milk value was observed for calves weaned between 1.9 and 2.0 months old, followed by a decline for calves weaned at older ages. The lowest LL and ECM were associated with weaning ADG of 0.786 kg/day, while 0.787 kg/day was associated with the lowest LPL. Lastly, both ECM and milk value were highest when serum IgG values were 1 659 mg/dL. These findings provide valuable insights for optimizing early culling decisions and enhancing the productivity and profitability of dairy farms.

Application of lightweight materials in automobiles: A review

Due to increasing challenges on carbon emissions, there is increased demand for more fuel economic vehicles; weight reduction, an attractive strategy for increasing fuel efficiency, has become prevalent in automobile design. This paper provides a review on weaved carbon fiber composites, long fiber carbon fiber composites, aluminum alloys, magnesium alloys, and glass fiber composites. They are assessed on strength, durability, corrosion resistance, and processing difficulty, to determine whether they can be used in lightweight automobile components. Numerous methods can be used to enhance the mechanical properties and ease of processing of these materials, to make them more appropriate for use. However, the materials all have their specific downsides like high weight, difficulties in processing, low corrosion resistance, or poor fatigue properties. We concluded that the materials are suitable for usage in automotives after undergoing specific Manufacturers should consider the relevance of these advantages and disadvantages to the application of materials in specific parts of the automobile.

Exposure to synthetic steroid hormones and precocious puberty in girls: A case-control study

Synthetic steroid hormones are an emerging class of environmental pollutants, but their influence on pubertal timing remains unclear. This case-control study explored the association between synthetic steroid hormone exposure and precocious puberty. Using ultrahigh performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS), synthetic steroid hormones were detected in urine samples from 229 Chinese girls, aged 6–9 years. Puberty status was assessed using Tanner staging by professional pediatricians. We conducted the least absolute shrinkage and selection operator (LASSO) regression combined with logistic regression. Besides, we evaluated the joint effects of steroid hormone mixture and identified the main contributor using the Weighted quantile sum (WQS) model and Bayesian kernel machine regression (BKMR) model. The logistic regression model reflected an inverse individual association between precocious puberty and halcinonide [OR (95 %CI): 0.20 (0.07, 0.46)], and budesonide [OR (95 %CI): 0.77 (0.62, 0.95)]. In the joint effects utilizing the WQS model, precocious puberty showed a marginal association with steroid hormone mixture, but was not significant [OR (95 %CI): 0.88 (0.75, 1.04)]. Prednisolone (0.31), fluorometholone acetate (0.24), and dexamethasone acetate (0.12) had the highest weight. Consistently, mixture exposure was not associated with precocious puberty in the BKMR model. In conclusion, precocious puberty was associated with halcinonide and budesonide exposure, but not steroid hormone mixture among girls. It highlighted the management of the residual synthetic steroid hormones in the environment and provided a direction for the prevention of precocious puberty.

An Experimental Investigation of Light Weight Concrete Using Pumice Aggregate for Short Wall Panel Under the Application of Axial Load

The project study with the special concrete such as light weight concrete by using pumice aggregate (Natural aggregate). One of the disadvantages of conventional concrete is having high self weight. This heavy self-weight will make it to some extent an uneconomical structural material. Light weight concrete having low density reduces dead load and increase the thermal insulation. The reduction in density is produced by using it as a replacement of coarse aggregate partially in concrete. In this Study an attempt has been made to find the compressive strength of light weight aggregate concrete using mix M25 with poly carboxyl ether admixture under the application of axial load on short wall panel. Light weight concrete is made by replacement of Coarse Aggregate of Pumice aggregates.

Оценка сортов сливы для специфических условий предгорий Кабардино-Балкарии

Abstract. The need for constant updating of the plum assortment in the foothills of Kabardino-Balkaria is caused by the imperfection of cultivated varieties. In this regard, we are conducting a variety study of varieties of homemade plum for the subsequent selection of the best of them. As a result, cultivars with the best in a number of valuable features and properties were identified. One of the important indicators for the comparative assessment of the studied plum varieties in the conditions of the region are the flowering time, yield and commercial qualities of fruits, as they characterize the resistance of the variety to adverse factors and its economic efficiency. Medium- and late-flowering varieties are considered more valuable, due to the fact that they escape the destructive effects of recurrent frosts and, as a rule, are characterized by regular fruiting. Milena, Early Hermenchik, Fortuna, October Sun, Top Hit, Byron Gold and the Grand Duke are among the studied cultivars with a late onset of flowering. In the middle term, they bloom – Big Prince, Kyrgyz excellent, Kuban comet, Kabardian early, Top Giant, Angelino, Black Star. All the studied varieties entered the period of full economic fruiting and began to yield high yields. In this regard, varieties with yields in terms of 1 ha are qualitatively distinguished: Kyrgyz excellent – 54 t/ha, Kabardian early – 35.3 t/ha, Top Giant – 34 t/ha, Byron Gold – 33.6 t/ha, Top Hit – 32.8 t/ha, Grand Duke – 32.1 t/ha, Chachak early – 31.9 t/ha, Big Hart – 31.5 t/ha, Ti chi san – 31.3 t/ha. A characteristic varietal feature is the size of the fruit, although to a large extent it depends on the growing conditions, the agricultural technology used, the age of the tree, the load of its harvest, rootstock and a number of other factors. Varieties have high fruit weight indicators: Ti chi san – 98,8 g, Angelina – 91,4 g, Top Giant – 90,1 g, Grosso de Felicio – 86,5 g, Byron Gold – 83,9 g, Oktouber San – 68,9 g, Kabardian early – 62,5 g, Yellow large – 56,4 g, Grand Duke – 52,6 g, Yellow Afaska – 42,3 g. Keywords: plum, varieties, adaptability, yield, commercial qualities of fruits

Evaluating Malnutrition Practices and Mother’s Education on Children Failure to Thrive Symptoms Using Entropy-Weight and TOPSIS Method

Background/Objectives: Failure to thrive (FTT) is mostly caused by insufficient consumption of nutrient-rich food, recurrent infections like diarrhea and intestinal worms, substandard caregiving practices, and limited availability of health and other vital services. Furthermore, there was a correlation between the educational level of mothers and the occurrence of FTT in children aged 6–12 months. Thus, the objective of the current research is twofold: (i) to investigate other factors related to FTT and (ii) to evaluate the impact of them on FTT in Sub-Saharan African countries and their urban areas. Methods: We used weight entropy and TOPSIS methods to approach the research question. In particular, the entropy-weight method is effective for precisely evaluating the relative significance of the selected criteria for TOPSIS computation. Thus, data were retrieved from the database of UNICEF for the year 2019 for nine Sub-Saharan countries, and based on the methods used, five criteria have been selected for consideration. Those of mothers in higher education were identified as having a higher weight, which means that this can affect positively the ability of mothers to mitigate the situation of FTT and protect their children. Results: The findings of the study highlight the factors of maternal education at a higher level and unhealthy habits as those with the greatest weight and impact on the FTT. Moreover, the results indicate that the association between maternal education, and especially higher education, and FTT is stronger in Ethiopia. Despite the limited amount of research on the specified relationship in Sub-Saharan countries, this study is among the initial ones to examine it. Conclusions: The current study can aid policymakers in devising appropriate policies and implementing effective measures to tackle FTT in Sub-Saharan Africa, like enhancing the number of mothers in these countries to be integrated into the educational system to help both themselves and their children mitigate or avoid the symptoms of FTT.

Evaluation of energy economic optimization models using multi-criteria decision-making approach

Achieving high performance in energy systems is crucial for sustainability. Energy economy optimization (EEO) models offer transparent analysis for energy policy decision-making. However, evaluating and benchmarking these models is a complex multicriteria decision making (MCDM) problem. Challenges include multiple criteria, data variation, and the importance of diverse criteria. This study develops an integrated MCDM approach to evaluate and benchmark EEO models. The methodology involves three phases. First, 12 commonly used EEO models and five evaluation criteria (software licenses, public source code, redistribution, public source data, and commercial software) are identified to create an evaluation decision matrix. Second, the fuzzy-weighted zero-consistency method (FWZIC) is used to evaluate and assign weights to the criteria. These weights are utilized in the benchmarking phase. Third, individual and group fuzzy decision by opinion score method (FDOSM) techniques are integrated to benchmark the EEO models based on the weights acquired. The FWZIC weighting reveals that the public source code criterion has the highest weight (0.3347), while redistribution has the lowest weight (0.1021). The group FDOSM results show that the OSeMOSYS model ranks first with the highest score (0.1595), while the DNE21+, MARIA, and MESSAGE models have the lowest score (0.0646), ranking them last. Systematic ranking, sensitivity ranking, and comparative analysis verify the proposed evaluation and benchmarking framework.

Reduced response to regadenoson with increased weight: an artificial intelligence based quantitative myocardial perfusion study

BackgroundThere is conflicting evidence regarding the response to a fixed dose of regadenoson in patients with high body weight. The aim of this study was to evaluate the effectiveness of regadenoson in patients with varying body weights using novel quantitative CMR perfusion parameters in addition to standard clinical markers. MethodsConsecutive patients with typical angina and/or risk factors for coronary artery disease (N=217) underwent regadenoson stress CMR perfusion imaging using a dual-sequence quantitative protocol with perfusion parameters generated from an artificial intelligence (AI) based algorithm. CMR was performed on 1.5T scanners using a standard 0.4mg injection of regadenoson. A cohort of consecutive patients undergoing adenosine stress perfusion (N=218) was used as a control group. ResultsAn inverse association of myocardial perfusion reserve and weight (mean decrease -0.05 per 10Kg increase, 95% CI -0.009/-0.0001, P=0.045) was noted in the regadenoson group but not in patients stressed with adenosine (P=0.77). Adjusted logistic regression analysis revealed a 10Kg increase resulted in 36% increased odds for inadequate stress response (OR= 1.36, 95% CI 1.10-1.69, P=0.005). Moreover, a significant interaction (OR=1.09, 95% CI 1.02-1.16, P=0.012) between stressor type (regadenoson vs adenosine) and weight was noted. This was also confirmed in the propensity matched subgroup (P=0.024) and was not attenuated after adjustment (P=0.041). BSA (P=0.006) but not BMI (P=0.055) was differentially associated with inadequate response conditional to the stressor used, and this association remained significant after adjustment for confounders (P=0.025). Patients in the highest quartile of weight (>93Kg) or BSA (>2.06m2) had substantially increased odds for inadequate response with regadenoson (OR=8.19, 95% CI 2.04-32.97, P=0.003 for increased weight and OR=7.75, 95% CI 1.93- 31.13, P=0.004 for increased BSA). Both weight and BSA had excellent discriminative ability for inadequate regadenoson response (ROC area under curve 0.84 and 0.83 respectively). ConclusionsUsing quantitative perfusion CMR in patients undergoing pharmacological stress with regadenoson, we found an inverse relationship between patient weight and both clinical response and myocardial perfusion parameters. A fixed-dose bolus approach may not be adequate to induce maximal hyperemia in patients with increased weight. Weight-adjusted stressors like adenosine may be considered instead in patients with body weight > 93Kg and BSA > 2.06m2.

Choices of measures of association affect the visualisation and composition of the multimorbidity networks

BackgroundNetwork analysis, commonly used to describe the patterns of multimorbidity, uses the strength of association between conditions as weight to classify conditions into communities and calculate centrality statistics. Our aim was to examine the robustness of the results to the choice of weight.MethodsData used on 27 chronic conditions listed on Australian death certificates for women aged 85+. Five statistics were calculated to measure the association between 351 possible pairs: odds ratio (OR), lift, phi correlation, Salton cosine index (SCI), and normalised-joint frequency of pairs (NF). Network analysis was performed on the 10% of pairs with the highest weight according to each definition, the ‘top pairs’.ResultsOut of 56 ‘top pairs’ identified, 13 ones were consistent across all statistics. In networks of OR and lift, three of the conditions which did not join communities were among the top five most prevalent conditions. Networks based on phi and NF had one or two conditions not part of any community. For the SCI statistics, all three conditions which did not join communities had prevalence below 3%. Low prevalence conditions were more likely to have high degree in networks of OR and lift but not SCI.ConclusionUse of different statistics to estimate weights leads to different networks. For exploratory purposes, one may apply alternative weights to identify a large list of pairs for further assessment in independent studies. However, when the aim is to visualise the data in a robust and parsimonious network, only pairs which are selected by multiple statistics should be visualised.

Research on Identification of the Capacity Influencing Factors of Youth Sports Clubs in China

Since the 1970s, nonprofit organizations have identified organizational capacity as the key to improving organizational effectiveness. Youth sports clubs have long been trapped in a predicament that makes it difficult for them to keep non-profit nature, operate independently and maintain high performance for a long time. This study investigates which influencing factors can act on the capacity of youth sports clubs to ensure their non-profit nature whilst achieving healthy and sustainable development. The organizational theory systems view emphasizes the relationship between open internal structures and the role of external environmental factors, therefore the capacity influencing factors of youth sports clubs can be comprehensively considered to achieve this by considering both the internal and external influencing components of organizational capacity. The focus of this study was obtained by searching 11 relevant policy documents, 21 papers, and in-depth interviews with 26 experts including youth sports club managers, coaches, and venue management personnel and scholars studying in the field of youth sports research or practice. The study revealed the internal and external influences on youth sports club capabilities, including strategic leadership, service innovation, resource acquisition, network relationships, policy, social media, and environmental uncertainty; and constructed a relationship between internal and external influences on youth sports club capabilities and organizational effectiveness. In addition, we found that Social media had the highest weight, policy had the lowest weight, and the rest of the influences did not differ significantly by the method of the weight calculation. We recommend that youth sports clubs increase the application of social media, stimulate employees&amp;apos; service and innovation ability, and cultivate the strategic leadership ability of leaders.

THE RELATIONSHIP OF MOTHER'S AGE AND NEWBORN'S WEIGHT WITH PERINEUM RUPTURE

Perineal rupture is an injury to the birth canal that occurs during birth due to tissue damage due to pressure on the baby's head and shoulders during the birth process. The aim of the research was to determine the relationship between maternal age and newborn weight with perineal rupture at the Independent Midwife Practice (PMB) Irma Suryani, Prabumulih City in 2023. The research method was analytical, using a cross sectional approach. The population of this study were all mothers giving birth at the Independent Midwife Practice (PMB) Irma Suryani, Prabumulih City. The sample taken in this study used the Random Sampling technique method, namely 149 people. The research instrument is a checklist. The results of the study based on univariate analysis showed that of the 149 respondents there were 64 respondents (43%) who were diagnosed with perineal rupture and 85 respondents (57%) who were diagnosed with not perineal rupture, there were 52 respondents (34.9%) who were of high risk age and 97 respondents (65 .1%) who had a low risk age, there were 35 respondents (23.5%) who had a high risk birth weight and 114 respondents (76.5%) who had a low risk birth weight. Of the 52 respondents with a high risk age, there were 38 respondents (25.5%) who were diagnosed with perineal rupture. Of the 97 respondents who had a low risk age, there were 26 respondents (17.4%) who were diagnosed with perineal rupture and of the 35 respondents who had a heavy newborn baby. At high risk births, there were 31 respondents (20.8%) who were diagnosed with perineal rupture, while of the 114 respondents who had low risk birth weights, there were 33 respondents (22.1%) who were diagnosed with perineal rupture. Conclusion: There is a significant relationship between maternal age and perineal rupture with a P value of 0.000 &lt; ? 0.05 and there is a significant relationship between the weight of the newborn and perineal rupture with a P value of 0.000 &lt; ? 0.05. Keywords : Perineal rupture incidence, maternal age, weight of newborn Bibliography : 18 (2017-2023)

Enhancing non-intrusive reduced-order models with space-dependent aggregation methods

AbstractIn this manuscript, we combine non-intrusive reduced-order models (ROMs) with space-dependent aggregation techniques to build a mixed-ROM, able to accurately capture the flow dynamics in different physical settings. The flow prediction obtained using the mixed formulation is derived from a convex combination of the predictions of several previously trained reduced-order models (ROMs), with each model assigned a space-dependent weight. The ROMs incorporated in the mixed model utilize different reduction methods, such as proper orthogonal decomposition and autoencoders, and various approximation techniques, including radial basis function interpolation (RBF), Gaussian process regression, and feed-forward artificial neural networks. Each model’s contribution is given higher weights in regions where it performs best and lower weights where its accuracy is lower compared to the other models. Additionally, a random forest regression technique is used to determine the weights for previously unseen conditions. The performance of the aggregated model is assessed through two test cases: the 2D flow past a NACA 4412 airfoil at a 5-degree angle of attack, with the Reynolds number ranging between $$1 \times 10^{5}$$ 1 × 10 5 and $$1 \times 10^{6}$$ 1 × 10 6 , and a transonic flow over a NACA 0012 airfoil, with the angle of attack as the varying parameter. In both scenarios, the mixed-ROM demonstrated improved accuracy compared to each individual ROM technique, while providing an estimate for the predictive uncertainty.

Acute Kidney Injury Requiring Dialysis After Pediatric Heart Transplant.

Acute kidney injury (AKI) is a common complication of pediatric heart transplant, with a subset of patients developing severe AKI requiring dialysis (AKI-D). We aimed to identify the epidemiology, risk factors, and outcomes of postoperative AKI-D in pediatric heart transplant recipients. We retrospectively identified all pediatric first-time, single-organ heart transplants at our institution from 2014 to 2022. Postoperative AKI was defined as AKI within 2 weeks of transplant. Unadjusted and adjusted logistic regression were used to identify characteristics associated with AKI-D, and unadjusted time-to-event analyses were used to determine the association between AKI-D and survival free of kidney failure. Among 177 patients included, 116 (66%) developed postoperative AKI of any stage, including 13 (7%) who developed AKI-D with median time from transplant to dialysis initiation of 6 days (IQR 3-13). In adjusted models, increased cardiopulmonary bypass time (OR 1.19, 95% CI 1.04-1.37, per 15 min increase in bypass time) and higher weight at transplant were associated with higher odds of AKI-D, whereas patient demographics and pretransplant kidney function were not associated with AKI-D. AKI-D was associated with greater mortality during initial hospitalization (46% vs. 1%, p < 0.001) and a lower rate of survival free of kidney failure. The incidence of AKI-D after pediatric heart transplant was 7%, with extended cardiopulmonary bypass time associated with postoperative AKI-D even in adjusted models. Further research is needed to improve the prediction and management of AKI-D in this population.

Optimization of the cold‐side heat exchanger design to improve the performance of the motorcycle exhaust thermoelectric generator

AbstractThis study optimizes the main parameters of the cold‐side heat exchanger (CHE) longitudinal fin, including fin quantity (Nf), fin thickness (Tf), and fin height (Hf), to enhance the performance of motorcycle exhaust thermoelectric generator units (TGUs) utilizing the computational fluid dynamics approach. The investigation shows that these parameters significantly affect the dissipation area of the CHE heat and the outside air velocity distribution in fin gaps, resulting in the fluctuation of TGU output power. The output power increases with respect to Hf; nevertheless, it first increases as Nf and Tf increase but decreases dramatically when Nf or Tf becomes too large. Besides, Hf significantly affects output power, and its impact is almost independent of Tf and Nf, and vice versa; meanwhile, Tf and Nf have a strong relation. This study proposes two Hf of 40 and 60 mm along with the optimal Tf of 1 mm and Nf of 29, providing significantly high output power, low weight, and compact size for TGU. This work contributes insight into the effect of CHE parameters on the TGU performance, and it is a crucial case study for selecting suitable heat sink parameters for TGU, considering practical requirements and conditions.