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High oestradiol levels during in vitro fertilization (IVF) fresh cycles have been linked to adverse obstetric outcomes, yet whether this is due to endometrial or oocyte effects remains unclear. Investigating subsequent frozen embryo transfer (FET) cycles can help clarify the origins of these effects. This study aimed to evaluate obstetric outcomes and placental histology in FET cycles for patients with elevated serum oestradiol levels during the ovarian stimulation cycle in which the embryos were created.
Methods:
A single centre retrospective cohort study of live singleton deliveries after IVF with programmed FET from 2009 to 2017. High oestradiol during ovarian stimulation was defined as ≥10,000 pmol/L. We compared obstetric outcomes and placental findings between pregnancies with high oestradiol levels in the preceding ovarian stimulation cycle and a control group.
Results:
We analyzed 114 deliveries in the high oestradiol group and 194 in the control group. Baseline demographics were comparable between groups. No significant differences were observed in obstetric outcomes, including low birth weight, preeclampsia and preterm delivery. The placental macroscopic and histopathological findings did not significantly differ between the groups as well.
Conclusion:
High oestradiol during the ovarian stimulation cycle used to create embryos is not associated with adverse obstetric outcomes or placental pathologies in pregnancies following FET. This is consistent with an endometrial effect of high oestradiol and thus support the practice of a freeze all approach in high oestradiol cycles.
Natural enemies serve a crucial role in crop protection through the regulation of pest population dynamics. Cyrtorhinus lividipennis is an important natural enemy of rice planthoppers. Fatty acid synthase (FAS), a multifunctional enzyme crucial for fatty acid biosynthesis, serves as a vital energy source for insect reproduction. However, the function of FAS in the reproductive processes of C. lividipennis remains incompletely understood. In this study, the ClFAS gene was successfully cloned from C. lividipennis. The open reading frame of ClFAS was 7224 bp, encoding a putative protein of 2407 amino acids. The expression levels of ClFAS were notably elevated in the fifth-instar nymphs, adults, as well as in the fat body and ovaries of female individuals. Silencing of ClFAS resulted in a reduction of 58.4%, 34.6%, and 49.0% in the expression levels of ClVg at 1-, 2-, and 3-days post-dsRNA injection, respectively. Furthermore, RNA interference (RNAi)-mediated depletion of ClFAS not only suppressed the Vg protein expression but also significantly impaired oocyte maturation and ovarian development. The fecundity of dsFAS-treated C. lividipennis females was markedly reduced by 49.5%, accompanied by significant decreases of 32.7% in oviposition duration and 26.3% in female adult lifespan. Our findings showed that ClFAS positively regulates the reproduction of C. lividipennis by promoting vitellogenesis and ovarian development, which provides valuable insights into how lipid metabolism governs fecundity in predatory insects.
Diagnostic stewardship of blood culture utilization is important to mitigate the risks associated with unnecessary culturing. Although blood culture algorithms have been studied previously, there is a lack of data on their application among solid organ transplant (SOT) recipients. This study aims to retrospectively apply a blood culture algorithm (initially developed for a non-immunocompromised population) to adult SOT recipients and assess its performance.
Methods:
We conducted a manual retrospective review of adult SOT recipients with a blood culture event (BCE) between February 2022 and January 2024 at a single academic medical center. BCEs were categorized as appropriate, inappropriate, or lacking documentation, according to a previously established institutional blood culture algorithm.
Results:
Of 737 BCEs among adult SOT recipients, 185 (25%) were inappropriate. Within the subset of inappropriate BCEs, 178 (96%) yielded negative cultures, while 7 (4%) were deemed contaminants. No true positives were identified. Inappropriate BCEs were most commonly triggered by isolated fever and/or leukocytosis (136, 74%), and lower urinary tract infection (17, 9%). 17 of 18 BCEs due to donor blood culture positivity at the time of organ transplantation resulted in a negative blood culture in the recipient.
Discussion:
Once applied retrospectively, our institutional blood culture algorithm did not miss any true positive bloodstream infections among adult SOT recipients. This study provides initial evidence supporting the cautious application of blood culture diagnostic algorithms in adult SOT populations. Further prospective investigations are warranted to validate these findings.
We examine the dispersion of prolate spheroidal microswimmers in pressure-driven channel flow, with the emphasis on a novel anomalous scaling regime. When time scales corresponding to swimmer orientation relaxation, and diffusion in the gradient and flow directions, are all well separated, a multiple scales analysis leads to a closed form expression for the shear-enhanced diffusivity, $D_{\it{eff}}$, governing the long-time spread of the swimmer population along the flow (longitudinal) direction. This allows one to organize the different $D_{\it{eff}}$-scaling regimes as a function of the rotary Péclet number (${\it{{\it{Pe}}}}_r)$, where the latter parameter measures the relative importance of shear-induced rotation and relaxation of the swimmer orientation due to rotary diffusion. For large ${\it{{\it{Pe}}}}_r$, $D_{\it{eff}}$ scales as $O({\it{{\it{Pe}}}}_r^4D_t)$ for $1 \leqslant \kappa \lesssim 2$, and as $O({\it{{\it{Pe}}}}_r^{ {10}/{3}}D_t)$ for $\kappa = \infty$, with $D_t$ being the intrinsic translational diffusivity of the swimmer arising from a combination of swimming and rotary diffusion, and $\kappa$ being the swimmer aspect ratio; $\kappa = 1$ for spherical swimmers. For $2 \lesssim \kappa \lt \infty$, the swimmers collapse onto the centreline with increasing ${\it{{\it{Pe}}}}_r$, leading to an anomalously reduced longitudinal diffusivity of $O({\it{{\it{Pe}}}}_r^{5-C(\kappa )}D_t)$. Here, $C(\kappa )\!\gt \!1$ characterizes the algebraic decay of swimmer concentration outside an $O({\it{{\it{Pe}}}}_r^{-1})$ central core, with the anomalous exponent $(5-C)$ governed by large velocity variations occasionally sampled by swimmers outside this core. Here, $C(\kappa )\gt 5$ for $\kappa \gtrsim 10$, leading to $D_{\it{eff}}$ eventually decreasing with increasing ${\it{{\it{Pe}}}}_r$, in turn implying a flow-independent maximum, at a finite ${\it{{\it{Pe}}}}_r$, for the rate of slender swimmer dispersion.
Cultural evolutionary models of bargaining can elucidate issues related to fairness and justice, and especially how fair and unfair conventions and norms might arise in human societies. One line of this research shows how the presence of social categories in such models creates inequitable equilibria that are not possible in models without social categories. This is taken to help explain why in human groups with social categories, inequity is the rule rather than the exception. But in previous models, it is typically assumed that these categories are rigid – in the sense that they cannot be altered, and easily observable – in the sense that all agents can identify each others’ category membership. In reality, social categories are not always so tidy. We introduce evolutionary models where the tags connected with social categories can be flexible, variable, or difficult to observe, i.e. where these tags can carry different amounts of information about group membership. We show how alterations to these tags can undermine the stability of unfair conventions. We argue that these results can inform projects intended to ameliorate inequity, especially projects that seek to alter the properties of tags by promoting experimentation, imitation, and play with identity markers.
CHD is a major risk factor for acute ischaemic stroke in paediatric patients due to endothelial changes from surgically manipulated vessels, prosthetic material, flow stasis in variable circulations, and hypercoagulability from chronic cyanosis. Stroke recognition in critically or chronically ill patients is challenging, yet rapid identification allows for mechanical thrombectomy to restore cerebral blood flow, particularly in those ineligible for thrombolysis or beyond its therapeutic window. We present a case series highlighting the importance of prompt stroke diagnosis and the role of mechanical thrombectomy in paediatric CHD patients, including children as young as four.
Methods:
We conducted a single-centre retrospective chart review of paediatric CHD patients who experienced thromboembolic stroke and underwent mechanical thrombectomy from July 2018 to March 2024. Data collected included age, stroke territory, maximum Paediatric NIH Stroke Scale (PedNIHSS) score, pre-thrombectomy neurological deficits, and post-thrombectomy outcomes using thrombolysis in cerebral infarction (TICI) scores.
Results:
Four CHD patients underwent mechanical thrombectomy for thromboembolic stroke (Table 1). They exhibited diverse cardiac anatomies, including two-ventricle and single-ventricle physiology, with a wide age range at presentation.
Conclusion:
Stroke presentation in CHD patients is variable, necessitating a high index of suspicion. Mechanical thrombectomy is safe and effective in patients as young as four, with no haemorrhagic complications in this series. Further research is needed to develop tailored stroke management guidelines for paediatric CHD patients, particularly younger children and those ineligible for thrombolysis.
Green/blue wellbeing is increasingly a focus of mental and physical healthcare in the United Kingdom, with green/blue space “prescribing” touted as providing a range of benefits. Attempts to explore the “how” and “why” of potential mental health improvements through these activities to date are primarily quantitative, and/or utilize medical/individualized models. Such approaches are situated within and can reinscribe a humanist, extractivist, one-way relationship with the natural world. Here, we draw on ecofeminist approaches to care to explore findings from our fieldwork with two wild swimming communities in Scotland, enabling us to consider human–nature interactions as relational. The wild swimming focus groups presented a complex picture in which the mental health benefits of swimming are entangled with relationships between group members, and embodied, sensory experiences of and relationships with blue spaces. By conceptualizing these groups as “ecologies of care,” we seek to embrace that intricacy, considering how wild swimming is a political act engaged with through deviant bodies or in deviant temporal/weather conditions, and how care is engendered through mutuality, space, and cold water. In conjunction with this complexity, the emergent nature of these groups has transformative implications for futurity, justice-to-come, and hyper-local ways of living within and alongside blue spaces.
This article presents an integrative literature review that explores citizens’ trust in the welfare state, distinguishing this sub-field from broader research on political trust. The review aims to systematise the factors that shape the experiences of vulnerable welfare users with social policy and so contribute to their (dis)trust in welfare. The first part of the article compares various meanings of trust at different levels of welfare state organisation, from user trust in frontline services to trust in the welfare state as a whole. The ambiguities arising from different operationalisations of ‘trust in the welfare state’ are shown. The second part presents key factors that influence such trust, including prevailing redistributive principles, managerial pressures, institutions’ perceived performance, distributive and procedural justice, and characteristics of frontline workers. The article concludes by linking these factors into causal mechanisms that reveal the tensions users face between bureaucratic procedures and personal interactions with frontline workers.
Although industrial modernization in Eurasia both preceded and outlived the Soviet project, in popular and scholarly imaginations, manufacturing cities located in the continent’s eastern regions are often understood as quintessentially ‘Soviet’. Yet, this perception tends to ignore the ways in which earlier urban developments were integrated with socialist innovations. This special issue seeks to decentre the concept of ‘Soviet urbanism’ by placing socialist forms into a longue durée perspective on industrial modernity and destabilizing popular equations of ‘post-socialism’ with ‘post-industrialism’. The collection’s contributions explore how modernist urbanism has intersected a variety of political and economic regimes over the past century and how evolving industrial processes continue to shape and reconfigure Eurasia’s urban landscapes.
In this clinical reflection, we report on stigma and ageism and their impact on those experiencing signs and symptoms of borderline personality disorder (BPD). We highlight the need for increased collaboration between those with lived experience of the disorder and healthcare providers. This is an important issue in BPD as the impact of structural stigma is significantly affecting the quality of life and short- and long-term trajectories of those with BPD, especially during adolescence.
Inertial sedimentation of a cloud of cylinders released within a confined fluid-filled cell is experimentally investigated. Various cylinder numbers, $N_c$, aspect ratios, $\xi$, solid-to-fluid density ratios, $\rho _c / \rho _{\!f}$, and settling velocities corresponding to moderate Reynolds numbers are examined. The parameters correspond to two distinct path regimes for isolated cylinders: oscillatory trajectories for higher-density cylinders and rectilinear sedimentation for lower-density cylinders. In both cases, we observe the formation of subgroups (termed objects of class $N$) composed of $N$ cylinders in contact, as well as their recombination due to splitting or merging. Depending on the parameters, specific distributions of class-$N$ objects are found. In addition, beyond the formation of individual objects, large-scale vertical columnar structures emerge, made of densely packed objects and alternating regions of ascending and descending fluid. These structures, driven by complex interactions between local clustering and global flow organisation, which persist throughout the sedimentation process, are highly sensitive to $\xi$. Despite its inner complex dynamics, the group is observed to sediment as a collective entity, with a constant velocity exceeding that of an isolated cylinder. This velocity may be predicted from multi-scale information. Fluctuating velocities of the objects are further analysed. Different mechanisms for horizontal and vertical components are identified. Horizontal fluctuations are related to intrinsic particle mobility, while vertical fluctuations are attributed to strong wakes and vertical streams. Both fluctuations are mainly influenced by the cylinders’ aspect ratio, which also affects the structural and spatial distribution of the objects.
Identifying self-similarity is key to understanding and modelling a plethora of phenomena in fluid mechanics. Unfortunately, this is not always possible to perform formally in highly complex flows. We propose a methodology to extract the similarity variables of a self-similar physical process directly from data, without prior knowledge of the governing equations or boundary conditions, based on an optimisation problem and symbolic regression. We analyse the accuracy and robustness of our method in five problems which have been influential in fluid mechanics research: a laminar boundary layer, Burger’s equation, a turbulent wake, a collapsing cavity and decaying turbulence. Our analysis considers datasets acquired via both numerical and wind tunnel experiments. The algorithm recovers the known self-similarity expressions in the first four problems and generates new insights into single length scale theories of homogeneous turbulence.
This article introduces the part-time cyborg as a Black feminist framework for navigating and resisting the demands of visibility, labor, and surveillance in digital and institutional spaces. Drawing on Donna Haraway’s cyborg theory and Black feminist thought, the part-time cyborg reclaims rest and refusal as strategies for survival and defiance. The article argues that mundane authoritarianism operates through small, everyday demands that normalize compliance, particularly for Black women, whose bodies have long been sites of scrutiny and control. By turning off a camera or withdrawing from hypervisibility, the part-time cyborg disrupts these systems, asserting autonomy in the face of extractive logics. In an era of intensifying surveillance and control, these micro-resistances are vital tools for imagining and building more just and equitable futures.
The trajectory of Mild Cognitive Impairment (MCI) to dementia within primary care is not well understood.
Objective
We investigated the 5-year trajectory of patients initially diagnosed with MCI, evaluated their risk of developing dementia considering age, sex, and Montreal Cognitive Assessment (MoCA) test scores and determined the annual conversion rate from MCI to dementia for patients assessed in a MINT (Multispecialty Interprofessional Team) memory clinic.
Methods
We conducted a longitudinal cohort study using a retrospective chart review of 751 patients assessed within a MINT memory clinic in Ontario, Canada. The conversion rate from MCI to dementia was estimated with the Kaplan-Meier method. Cox regression examined time to dementia diagnosis and the association between baseline MoCA scores and dementia risk.
Findings
The observed 5-year conversion rate from MCI to dementia was 28.0%, though with limited follow-up data. Accounting for missing data, the estimated 5-year conversion rate was 48.8% (39.5%, 59.2%) with an average annual rate of 9.8%. Each one-point increase in MoCA score at initial visit was associated with a 10% lower rate of conversion to dementia (aHR: 0.90, 95%CI: 0.85-0.96).
Discussion
Findings highlight the profile of patients assessed in MINT clinics, cognitive trajectory of those diagnosed with MCI, and the importance of primary care-based memory clinics in early detection and intervention.
Approaches to different listening practices rarely extend beyond human ears. During the nineteenth century, anatomists’ fascination with non-human hearing emerged in tandem with the professionalization of comparative anatomy. This existed in tension with the professionalization of European music criticism, where the only model for listening was human. Theories of sensationalism, developed particularly in Feuerbach’s and Marx’s writings on the human senses, grounded an anthropocentric outlook, yet numerous commentators considered animal hearing as materially related to that of humans. This article traces the process of decentring human listening. It uncovers a discourse on the materiality of the senses, and asks when did the penny drop that human hearing was neither the only aural reality, nor necessarily the ‘highest’ in the natural world.
Political science is useful for many things but especially for the suite of research methods that we teach our students that generalize to a wide range of careers. However, that training is often buried deep in the major and is not well integrated into further coursework except perhaps for senior research. In reaction to that model, we started a new program that frontloads quantitative research methods, beginning with data visualization and then modeling following an inquiry model. With their newfound independence, students are able to approach substantive upper-level courses ready to engage the worth of theory by evaluating and updating their empirical tests. This article describes the program and reports on survey results from a 2024 sample of political scientists that reveals broadscale support for the program and its operating assumptions.
Despite the long-standing proximity between Ottoman and Iranian reformists, the Young Turk policy toward Iran was notably reserved. The numerous tensions between Istanbul and Tehran during the constitutional period are often attributed to Young Turk pragmatism. Conversely, this study emphasizes the cultural factors in Irano-Ottoman relations and their influence on the Ottoman perception of Iran following the Ottoman Revolution of 1908. Drawing on the reports written by Hüseyin Hasib Efendi, Ottoman ambassador in Iran from 1909 to 1913, it argues that the multilayered nature of Ottoman modernity and the anxieties of the late Ottoman bureaucratic elite were crucial in shaping the Porte’s policy toward Iran. The article introduces the concept of entangled Orientalism to describe the process of Ottoman discursive adaptation to the West-dominated international order. Additionally, it aims to reassess the role of the Russian menace in the Ottoman understanding of regional politics.
Focusing on the case of Mongolia during the Cold War, this article analyses how the goals of resource extraction and socialist development shaped urban and regional planning in the country. The article examines the negotiations for development assistance between Mongolia, the Soviet Union, East Germany and Czechoslovakia since 1962, with a particular focus on the foundation of the mining city of Erdenet in 1973 as a key outcome of these negotiations. It demonstrates that mineral extraction was the central aspect of socialist assistance. The requirements and scale of mining infrastructure provided a distinct logic to urban and regional planning in the country. The article argues that in the socialist development vision, extraction was integral to urban thinking. The socialist approach to resource development in Mongolia employed a heavy-handed approach of extensive urbanization, contrasting sharply with post-socialist urban patterns shaped by investments from private extractive industries.