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Optics Express Apr 2024The applications of rate-compatible low-density parity-check (RC-LDPC) codes are investigated for a 16 quadrature amplitude modulation (16QAM) signal and coherent...
The applications of rate-compatible low-density parity-check (RC-LDPC) codes are investigated for a 16 quadrature amplitude modulation (16QAM) signal and coherent detection system. With rate-compatible signals, we can provide the flexible net data rate between 135.5 Gb/s and 169.7 Gb/s in a passive optical network (PON) link. Based on the LDPC codes defined in the IEEE 802.3ca standard, we construct two sets of RC-LDPC codes with a fixed and variable information bit length. Since the puncturing operation may degrade the performance of LDPC codes, we apply the protograph-based extrinsic information transfer (PEXIT) technique to optimize the puncturing positions to mitigate the degradation. Additionally, we explore four low-complexity LDPC decoding algorithms (min sum, offset min sum, variable weight min sum, and relaxed min sum with 2 min emulation) to investigate the relationship between the computational complexity and decoding performance. Simulation results indicate that the constructed codewords exhibit good performance in the waterfall region across a range of code rates. Finally, we conduct an experimental setup in a dual-polarization 25 GBaud 16QAM coherent PON to verify the effectiveness of the constructed LDPC codes with four decoding algorithms. The experimental results show maximal 4.8 dB receiver sensitivity differences, which demonstrate the feasibility of the method for constructing RC-LDPC codes in future high-speed flexible coherent PON.
PubMed: 38859194
DOI: 10.1364/OE.522106 -
Optics Express May 2024The intriguing photonic spin Hall effect (PSHE) of reflected Laguerre-Gaussian (LG) beams can be exhibited on the systems with optical anti-parity-time (Anti-PT)...
The intriguing photonic spin Hall effect (PSHE) of reflected Laguerre-Gaussian (LG) beams can be exhibited on the systems with optical anti-parity-time (Anti-PT) symmetry. During the reflection, the left/right circularly polarized (LCP/RCP) components of reflected LG beams are considered. By controlling parameters of the Anti-PT systems, the PSHE of reflected LCP/RCP can be identical and symmetrical with respect to incident-reflected plane (IRP). Due to gain/non-Hermitian effects of designed Anti-PT systems, special PSHE near the strong gain points (SGP) and exceptional points (EPs) can be obtained simulatively. Through analyses in PSHE of reflected LCP on four similar Anti-PT systems, specific conclusions that can even be extended to more general cases. Moreover, simulations of PSHE by simultaneously varying the incident angles * and imaginary/real dielectric constants Im/Re[ε] of the Anti-PT systems, specal PSHE and other novel optical phenomena with real applications can be revealed. So Anti-PT systems not only provide novel ways to regulate the PSHE of reflected LG beams, but also offer possibilities for new optical characteristics of devices.
PubMed: 38859107
DOI: 10.1364/OE.523432 -
Optics Express May 2024The practical application of integrated gyroscopes in engineering has not yet been fully realized due to the linear correlation between the Sagnac effect and dimensions....
The practical application of integrated gyroscopes in engineering has not yet been fully realized due to the linear correlation between the Sagnac effect and dimensions. In recent demonstrations, gyroscopes operating near exceptional points (EPs) under parity-time (PT) symmetry have shown significant potential in enhancing their response to rotational rates. However, constructing higher-order EPs with refined physical properties poses a considerable challenge. Additionally, current methods for constructing higher-order EPs with robustness primarily rely on passive cavities, with almost no reports on constructing robust EPs using PT-symmetric systems that encompass both gain and loss. Here, we propose a robust design for a scalable fabrication of higher-order EP gyroscopes with PT-symmetric structure. We investigate the influence of perturbations on the frequency splitting of the higher-order EP gyroscope and demonstrate that it is possible to achieve a resonance splitting eight orders of magnitude higher than that obtained through the classical Sagnac effect. In comparison to the previously proposed PT-symmetric gyroscope, our solution allows a tunable frequency splitting by adjusting the phase shift, making it more measurable at the output power spectrum.
PubMed: 38859053
DOI: 10.1364/OE.522766 -
Cureus Jun 2024Background The prevalence of gestational diabetes mellitus (GDM) is increasing globally. When diet and lifestyle modifications are inadequate for control, managing GDM...
Time-in-Range With Insulin Versus Metformin in Gestational Diabetes Mellitus Using Continuous Glucose Monitoring: A Randomized Control Study at a Tertiary Care Centre in South India.
Background The prevalence of gestational diabetes mellitus (GDM) is increasing globally. When diet and lifestyle modifications are inadequate for control, managing GDM often involves insulin or metformin. Metformin's oral administration option improves patient compliance and acceptance, but concerns about its use persist, necessitating careful evaluation. Comparative studies between insulin and metformin in GDM are scarce. In pregnancies complicated by diabetes, precise glucose control is crucial for maternal-fetal well-being, and continuous glucose monitoring (CGM) plays a valuable role in achieving recommended targets. CGM provides comprehensive glucose profiles, including postprandial glucose excursions and details about time spent in hypoglycemia, euglycemia, and hyperglycemia. The time-in-range (TIR) metric, when used alongside A1C, offers more actionable information than A1C alone. To the best of our knowledge, no published trials compare TIR in GDM with metformin or insulin aspart/detemir, specifically focusing on CGM metrics. This randomized controlled trial (RCT) aims to assess TIR in women with GDM treated with either metformin or insulin. Materials and methods This study was a non-inferiority randomized control trial evaluating TIR in GDM using continuous glucose monitoring with metformin or insulin. Forty-four women with GDM were enrolled. The diagnosis of GDM was based on the International Association of Diabetes and Pregnancy Study Groups (IADPSG) criteria. CGM readings were collected for 14 days after sensor activation. Results In our study, 44 women with GDM completed the protocol, with 22 in the Metformin group and 22 in the Insulin group. Baseline characteristics did not differ between the groups. Age, BMI pre-gravid, BMI at 28 weeks, parity, family history of diabetes mellitus, previous history of GDM, glycated hemoglobin (HbA1c), oral glucose tolerance tests (OGTT) at zero hours, one hour, and two hours, as well as gestational weeks, did not significantly differ between the two groups. The metformin and insulin groups did not differ significantly in CGM metrics, including TIR, time above range, time below range, mean glucose, and glucose management indicator. Conclusion Based on our findings, the metformin and insulin groups did not differ in CGM metrics, including TIR, time above range, time below range, mean glucose, and glucose management indicator. In clinical practice, CGM metrics complement fasting blood glucose, postprandial glucose, and HbA1c as appropriate and useful clinical targets and outcome measurements. Metformin's oral administration option offers advantages such as improved patient compliance and acceptance in women with GDM.
PubMed: 38855483
DOI: 10.7759/cureus.61849 -
Journal of Cognition 2024Certain stimuli can automatically trigger different behaviors in a stimulus-driven manner. To investigate whether mathematical equations automatically trigger the...
Certain stimuli can automatically trigger different behaviors in a stimulus-driven manner. To investigate whether mathematical equations automatically trigger the tendency to engage in arithmetic processing, we asked whether the presentation of multiplication equations in an irrelevant dimension can trigger the automatic task of arithmetic processing and if so, which processes are involved. To that end, we employed a color-naming task in which participants had to name the color of different stimuli, such as: mathematical equations (e.g., 4 × 6 = 24), neutral-symbols (e.g., ####), neutral-words (e.g., building), and same-number strings (e.g., 11111), which appeared as one of four different colors. We found that mathematical equations and regular words in the irrelevant dimension triggered more task conflict (i.e., color naming's reaction time was longer) as compared to same-number strings. In addition, we found evidence for the automatic activation of different numerical processes; such that large-size equations (7 × 9 = 63) triggered more conflict as compared with small-size (2 × 3 = 6) equations and same-parity incorrect equations (3 × 2 = 8) triggered more conflict as compared to different-parity incorrect equations (4 × 2 = 9). We found no evidence indicating a distinction between the correct and incorrect equations. We discussed the relevance of the findings to the automaticity of arithmetic abilities and other domains in numerical cognition.
PubMed: 38855092
DOI: 10.5334/joc.372 -
Cureus May 2024Background Transdermal nitroglycerin (NTG) is a potent smooth muscle relaxant acting as a tocolytic agent by acting on the uterine muscles. The transdermal patch allows...
Background Transdermal nitroglycerin (NTG) is a potent smooth muscle relaxant acting as a tocolytic agent by acting on the uterine muscles. The transdermal patch allows for continuous and controlled release of NTG through the skin into the bloodstream. This method offers the advantage of sustained drug delivery over a prolonged period. Objective of the study The study aimed to evaluate the efficacy of NTG patches for the arrest of preterm labor. Materials and methods This retrospective study comprised 100 patients admitted to our tertiary care center, ranging from 27 to 35 weeks of gestation, exhibiting preterm labor, uterine contractions, effacement, and dilatation of the cervix, without comorbidities and complications. Results In this study, it was observed that the incidence of preterm labor was higher among women aged 21-25 years. Pregnancy duration was extended by an average of approximately 28.63 days in our study cohort, with 90% of patients experiencing a prolongation of pregnancy to 48 hours after the application of a transdermal NTG patch. Parity distribution showed 50% of patients having a parity of G2-G4 and 30% being primigravida. However, 40% of the participants reported experiencing side effects, including headaches (15%) and local reactions (25%), while 60% did not experience any adverse effects. Conclusion In this study we found that the application of transdermal NTG patches led to a mean prolongation of pregnancy by 28.63 days, allowing time for the administration of steroids and fetal maturation. The inhibition of preterm contractions was successful, with an efficacy rate of 92%. These findings suggest the potential effectiveness of transdermal NTG patches as a tocolytic agent in managing preterm labor. However, the occurrence of side effects highlights the importance of careful monitoring and management during treatment.
PubMed: 38854168
DOI: 10.7759/cureus.59982 -
Research Square May 2024A significant number of women die from pregnancy and childbirth complications globally, particularly in low- and middle-income countries (LMICs). Receiving at least four...
BACKGROUND
A significant number of women die from pregnancy and childbirth complications globally, particularly in low- and middle-income countries (LMICs). Receiving at least four antenatal care (ANC) visits may be important in reducing maternal and perinatal deaths. This study investigates factors associated with attending ≥ 4 ANC visits in Sarlahi district of southern Nepal.
METHODS
A secondary analysis was conducted on data from the Nepal Oil Massage Study (NOMS), a cluster-randomized, community-based longitudinal pregnancy cohort study encompassing 34 Village Development Committees. We quantified the association between receipt/attendance of ≥ 4 ANC visits and socioeconomic, demographic, morbidity, and pregnancy history factors using logistic regression; Generalized Estimating Equations were used to account for multiple pregnancies per woman.
RESULTS
All pregnancies resulting in a live birth (n=31,867) were included in the model and 31.4% of those pregnancies received 4+ ANC visits. Significant positive associations include socioeconomic factors such as participation in non-farming occupations for women (OR=1.52, 95% CI: 1.19, 1.93), higher education (OR=1.79, 95% CI: 1.66, 1.93) and wealth quintile OR=1.44, 95% CI: 1.31, 1.59), nutritional status such as non-short stature (OR=1.17, 95% CI: 1.07, 1.27), obstetric history such as adequate interpregnancy interval (OR=1.31, 95% CI: 1.19, 1.45) and prior pregnancy but no live birth (OR=2.14, 95% CI: 1.57, 2.92), symptoms such as vaginal bleeding (OR=1.35, 95% CI:1.11, 1.65) and awareness of the government's conditional cash transfer ANC program (OR=2.26, 95% CI: 2.01, 2.54). Conversely, belonging to the lower Shudra caste (OR=0.56, 95% CI: 0.47, 0.67), maternal age below 18 or above 35 (OR=0.81, 95% CI:0.74, 0.88; OR=0.77, 95% CI: 0.62, 0.96)), preterm birth (OR=0.41, 95% CI: 0.35, 0.49), parity ≥ 1 (OR=0.66, 95% CI: 0.61, 0.72), and the presence of hypertension during pregnancy (OR=0.79, 95% CI: 0.69, 0.90) were associated with decreased likelihood of attending ≥ 4 ANC visits.
CONCLUSIONS
These findings underscore the importance of continuing and promoting the government's program and increasing awareness among women. Moreover, understanding these factors can guide interventions aimed at encouraging ANC uptake in the most vulnerable groups, subsequently reducing maternal-related adverse outcomes in LMICs.
TRIAL REGISTRATION
The clinicaltrial.gov trial registration number for NOMS was #NCT01177111. Registration date was August 6, 2010.
PubMed: 38853894
DOI: 10.21203/rs.3.rs-4467441/v1 -
Industrial Psychiatry Journal 2024The coronavirus disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has detrimental effects on physical and mental...
BACKGROUND
The coronavirus disease (COVID-19) pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has detrimental effects on physical and mental health. Patients with severe mental illness are at higher risk of contracting the virus due to social determinants of health. Vulnerable populations include the elderly, people with pre-existing conditions, and those exposed to SARS-CoV-2. Unfortunately, only a few countries have updated vaccination strategies to prioritize patients with mental illnesses. Therefore, we aimed to explore whether individuals with mental disorders are prioritized in vaccine allocation strategies in different world regions. They are often neglected in policymaking but are highly vulnerable to the threatening complications of COVID-19.
METHODS
A questionnaire was developed to record details regarding COVID-19 vaccination and prioritizations for groups of persons with non-communicable diseases (NCDs), mental disorders, and substance use disorders (SUDs). were defined according to the WHO as chronic diseases that are the result of a combination of genetic, physiological, environmental, and behavioral factors such as cardiovascular diseases, cancer, respiratory diseases, and diabetes.
RESULTS
Most countries surveyed (80%) reported healthcare delivery via a nationalized health service. It was found that 82% of the countries had set up advisory groups, but only 26% included a mental health professional. Most frequently, malignancy (68%) was prioritized followed by diabetes type 2 (62%) and type 1 (59%). Only nine countries (26%) prioritized mental health conditions.
CONCLUSION
The spread of the coronavirus has exposed both the strengths and flaws of our healthcare systems. The most vulnerable groups suffered the most and were hit first and faced most challenges. These findings raise awareness that patients with mental illnesses have been overlooked in immunization campaigns. The range of their mortality, morbidity, and quality of life could have widened due to this delay.
PubMed: 38853796
DOI: 10.4103/ipj.ipj_54_22 -
Annals of Saudi Medicine 2024Medical treatment, expectant approaches, and surgical treatment options are available in the treatment of ectopic pregnancy. Regardless of the treatment, in addition to...
BACKGROUND
Medical treatment, expectant approaches, and surgical treatment options are available in the treatment of ectopic pregnancy. Regardless of the treatment, in addition to its effectiveness, the main concern is to limit the risk of relapse and preserve fertility.
OBJECTIVES
Determine the impact of medical or surgical treatment for ectopic pregnancy on future fertility.
DESIGN
Retrospective.
SETTING
Department of obstrtrics and gynecolgy at Ankara Etlik Zübeyde Hanım Women's Health Training and Research Hospital, Ankara, Turkey.
PATIENTS AND METHODS
Patients who were treated for ectopic pregnancy between June 2016 and November 2019 were allocated into two groups. Expectant approach or medical treatment by methotrexate constituted the conservative treatment group while salpingectomy by laparoscopy indicated the surgical treatment group.
MAIN OUTCOME MEASURES
Fertility rates within two years following treatment were evaluated according to treatment options.
SAMPLE SIZE
202 patients.
RESULTS
Of the 202 patients, 128 had medical treatment and 74 patients had surgical treatment for ectopic pregnancy. Of 272 diagnosed with ectopic pregnancy, 70 were excluded for various reasons. Parity and unemployment rate was significantly higher in the surgical treatment (=.006 and =.12, respectively). Moreover, ectopic mass size and serum β-hCG levels were significantly higher in the surgical treatment group (<.001 and <.001, respectively). There were no significant differences between the conservative and surgical treatment groups in time to pregnancy (17.0 months vs 19.0 months, =.255). Similarly, there was no significant difference between the conservative and surgical treatment groups with respect to history of infertility (=.12). There were no significant differences between the conservative and surgical treatment groups in terms of live birth (51.6% vs 44.6%) and ectopic pregnancy (2.3% vs 1.4%) (=.72 for both). There was no significant difference between the conservative and surgical treatment groups with respect to infertility rate (35.9% vs 41.9%, =.72) and admittance to the IVF program (3.9% vs 6.8%, =.39) following ectopic pregnancy treatment.
CONCLUSIONS
Reproductive outcomes did not differ significantly in women undergoing expectant management, medical treatment, and surgery for ectopic pregnancy. This finding suggests that clinicians should not hesitate to act in favor of surgical treatment for ectopic pregnancy even if there were concerns for future fertility.
LIMITATIONS
Retrospective study.
Topics: Humans; Female; Pregnancy; Retrospective Studies; Adult; Methotrexate; Salpingectomy; Conservative Treatment; Pregnancy, Tubal; Laparoscopy; Abortifacient Agents, Nonsteroidal; Turkey; Fertility; Chorionic Gonadotropin, beta Subunit, Human; Fertility Preservation
PubMed: 38853473
DOI: 10.5144/0256-4947.2024.141 -
Turkish Journal of Obstetrics and... Jun 2024To evaluate the clinical outcomes of laparoscopic and hysteroscopic surgical approaches for treating symptomatic isthmocele and identify their associated factors.
OBJECTIVE
To evaluate the clinical outcomes of laparoscopic and hysteroscopic surgical approaches for treating symptomatic isthmocele and identify their associated factors.
MATERIALS AND METHODS
Forty-six patients with symptomatic isthmocele diagnosed using transvaginal saline infusion sonohysterography were enrolled in this prospective cohort study. Patients underwent either laparoscopic or hysteroscopic isthmoplasty based on their residual myometrial thicknesses and fertility desires and were subsequently followed by clinical and ultrasonographic examinations.
RESULTS
Twenty-two patients underwent laparoscopy and 24 underwent hysteroscopic surgery. At baseline, there was no significant difference in the mean age and years since the last cesarean section between the two groups. However, the hysteroscopy group had a higher mean parity and previous cesarean sections (p=0.00, 0.03). The most common symptoms were abnormal uterine bleeding, infertility, and dysmenorrhea. The mean baseline residual myometrial thickness was significantly higher in the laparoscopy group (p=0.00), and only laparoscopic surgery led to a significant increase in residual myometrial thickness in patients (p=0.00). Both procedures significantly reduced abnormal uterine bleeding (p=0.00), but only laparoscopy reduced infertility (p=0.00) and hysteroscopy reduced dysmenorrhea (p=0.03). Hysteroscopy showed better symptom resolution in younger patients (p=0.01), whereas age did not affect laparoscopy outcomes.
CONCLUSION
Both approaches showed similar effectiveness in resolving abnormal uterine bleeding, with laparoscopy excelling in infertility resolution and hysteroscopy excelling in dysmenorrhea resolution.
PubMed: 38853455
DOI: 10.4274/tjod.galenos.2024.54006