Using an electronic patient reported outcome measure (ePAQ-MPH) to assess potential harm for long-waiting patients in gynaecology.

Background: During the COVID-19 pandemic, outpatient waits for gynaecology appointments increased by 60% in the UK National Health Service (NHS). The aim of this study was to use the electronic Personal Assessment Questionnaire-Menstrual, Pain and Hormonal (ePAQ-MPH) electronic patient reported outcome measure (ePROM) to assess symptoms, impact and potential harm for patients waiting > 60 weeks for general gynaecology appointments at a teaching hospital.

Methods: 1070 patients waiting > 60 weeks for a new appointment (range 60-72 weeks) were invited to complete ePAQ-MPH online to measure gynaecological symptoms and health-related quality-of-life (HRQoL).

Paradoxical Uterine Rupture and Fetal Survival in Placenta Accreta: A Case Report.

We describe a case of uterine rupture in the presence of abnormally invasive placentation, with fetal survival despite a long rupture-to-delivery interval (19.5 hours). The patient had previously had an intrapartum stillbirth delivered via caesarean section with an atypical uterine incision at 34 weeks' gestation.

Mapping threatened Thai bovids provides opportunities for improved conservation outcomes in Asia.

Wild bovids provide important ecosystem functions as seed dispersers and vegetation modifiers. Five wild bovids remain in Thailand: gaur (), banteng (), wild water buffalo (), mainland serow () and Chinese goral (). Their populations and habitats have declined substantially and become fragmented by land-use change.

Affordance norms for 2825 concrete nouns.

Objects are commonly described based on their relations to other objects (e.g., associations, semantic similarity, etc.

Long Excited-State Lifetimes in Three-Coordinate Copper(I) Complexes via Triplet-Triplet Energy Transfer to Pyrene-Decorated Isocyanides.

There has been much effort to improve excited-state lifetimes in photosensitizers based on earth-abundant first-row transition metals. Copper(I) complexes have gained significant attention in this field, and in most cases, sterically driven approaches are used to optimize their lifetimes. This study presents a series of three-coordinate copper(I) complexes (-) where the excited-state lifetime is extended by triplet-triplet energy transfer.

Patient-initiated follow-up in gynaecology: Patient and clinician views.

Objectives: Follow-up appointments in the UK National Health Service account for up to two thirds of outpatient activity, but there is a significant resource impact in providing time fixed follow-up appointments. Increasingly patient initiated follow-up is being used, to make follow-up appointments work better for patients both in terms of timing and necessity, and to reduce unnecessary outpatient activity. The objective of this study was to use a modified questionnaire to evaluate patient and clinician views regarding Patient-Initiated Follow-Up (PIFU) in gynaecology services and identify subgroups suited to this pathway of care.

Vibrational Coupling Infrared Nanocrystallography.

Coupling between molecular vibrations leads to collective vibrational states with spectral features sensitive to local molecular order. This provides spectroscopic access to the low-frequency intermolecular energy landscape. In its nanospectroscopic implementation, this technique of vibrational coupling nanocrystallography (VCNC) offers information on molecular disorder and domain formation with nanometer spatial resolution.

Robustification of Bayesian-Inference-Based Gait Estimation for Lower-limb Wearable Robots.

Lower-limb wearable robots designed to assist people in everyday activities must reliably recover from any momentary confusion about what the user is doing. Such confusion might arise from momentary sensor failure, collision with an obstacle, losing track of gait due to an out-of-distribution stride, etc. Systems that infer a user's walking condition from angle measurements using Bayesian filters (e.

Effects of Personalization on Gait-State Tracking Performance Using Extended Kalman Filters.

Emerging partial-assistance exoskeletons can enhance able-bodied performance and aid people with pathological gait or age-related immobility. However, every person walks differently, which makes it difficult to directly compute assistance torques from joint kinematics. Gait-state estimation-based controllers use phase (normalized stride time) and task variables (e.

An Energetic Approach to Task-Invariant Ankle Exoskeleton Control.

Robotic ankle exoskeletons have been shown to reduce human effort during walking. However, existing ankle exoskeleton control approaches are limited in their ability to apply biomimetic torque across diverse tasks outside of the controlled lab environment. Energy shaping control can provide task-invariant assistance without estimating the user's state, classifying task, or reproducing pre-defined torque trajectories.

A national survey of UK practice for day-case vaginal prolapse surgery: Unrealistic expectations?

Objective: The UK NHS Getting It Right First Time report (2021) recommended that a significant proportion of native tissue vaginal prolapse operations should be undertaken as day-case procedures (target: 80% anterior compartment, 70% posterior compartment, 60% combined anterior/posterior compartment). The evidence for perioperative care, options for anaesthesia and outcomes of day-case vaginal prolapse surgery is limited. This study aimed to establish current practice amongst UK gynaecologists and explore perceived barriers to implementing day-case surgery for pelvic organ prolapse.

Early events in the mechanism of single-source chemical vapor deposition of zirconium and hafnium diboride: a computational investigation.

Chemical vapor deposition (CVD) of group 4 metal-diboride ceramics from a single source is a versatile technique that finds many applications from hypersonic flight to microelectronics. Though the kinetics of CVD have been studied extensively-allowing significant process improvements-a mechanistic understanding of the process has yet to be attained. Computations suggest two plausible reaction pathways-one higher-energy and the second lower-that correlate well with experimental results reported in the literature, explaining phenomena such as high-temperature deposition resulting in films overstoichiometric in boron.

Real-Time Gait Phase and Task Estimation for Controlling a Powered Ankle Exoskeleton on Extremely Uneven Terrain.

Positive biomechanical outcomes have been reported with lower-limb exoskeletons in laboratory settings, but these devices have difficulty delivering appropriate assistance in synchrony with human gait as the task or rate of phase progression change in real-world environments. This paper presents a controller for an ankle exoskeleton that uses a data-driven kinematic model to continuously estimate the phase, phase rate, stride length, and ground incline states during locomotion, which enables the real-time adaptation of torque assistance to match human torques observed in a multi-activity database of 10 able-bodied subjects. We demonstrate in live experiments with a new cohort of 10 able-bodied participants that the controller yields phase estimates comparable to the state of the art, while also estimating task variables with similar accuracy to recent machine learning approaches.

Enhanced Deep-Red Phosphorescence in Cyclometalated Iridium Complexes with Quinoline-Based Ancillary Ligands.

Compounds with good photoluminescence quantum yields (Φ) in the deep-red to near-infrared parts of the spectrum are desired for a variety of applications in optoelectronics, imaging, and sensing. However, in this region of the spectrum, quantum yields are usually modest, which is explained by the energy gap law and the inherently slower radiative decay rates for low-energy emitters according to the second-order perturbation theory. In this work, we outline a new direction in deep-red luminescence, introducing a new suite of bis-cyclometalated iridium complexes with efficient luminescence beyond 650 nm.

Examining the Implementation of Health-Related Social Need (HRSN) Screenings at a Pediatric Community Health Center.

Introduction: Social determinants of health (SDoH) influence health outcomes and screening for health-related social needs (HRSN) is a recommended pediatric practice. In 2018, Denver Health and Hospitals (DH) implemented the Accountable Health Communities (AHC) model under the Centers for Medicare and Medicaid Services (CMS) and began using the AHC HRSN screening tool during selected well child visits (WCVs) at a DH Federally Qualified Health Center (FQHC). The current evaluation aimed to examine the program implementation and identify key lessons learned to inform the expansion of HRSN screening and referral to other populations and health systems.

Chloride-dependent mechanisms of multimodal sensory discrimination and nociceptive sensitization in .

Individual sensory neurons can be tuned to many stimuli, each driving unique, stimulus-relevant behaviors, and the ability of multimodal nociceptor neurons to discriminate between potentially harmful and innocuous stimuli is broadly important for organismal survival. Moreover, disruptions in the capacity to differentiate between noxious and innocuous stimuli can result in neuropathic pain. larval class III (CIII) neurons are peripheral noxious cold nociceptors and innocuous touch mechanosensors; high levels of activation drive cold-evoked contraction (CT) behavior, while low levels of activation result in a suite of touch-associated behaviors.

Super-resolved time-frequency measurements of coupled phonon dynamics in a 2D quantum material.

Methods to probe and understand the dynamic response of materials following impulsive excitation are important for many fields, from materials and energy sciences to chemical and neuroscience. To design more efficient nano, energy, and quantum devices, new methods are needed to uncover the dominant excitations and reaction pathways. In this work, we implement a newly-developed superlet transform-a super-resolution time-frequency analytical method-to analyze and extract phonon dynamics in a laser-excited two-dimensional (2D) quantum material.

Diet-induced microbial adaptation process of red deer () under different introduced periods.

Insufficient prey density is a major factor hindering the recovery of the Amur tiger (), and to effectively restore the Amur tiger, red deer () was released into the Huangnihe National Nature Reserve of Northeast China as the main reinforcement. Differences in feeding and synergistic changes caused by the intestinal microbial communities could impact the adaptation of wildlife following reintroductions into field environments. We analyzed the foraging changes in shaping the intestinal microbial community of the red deer after being released to the Huangnihe National Nature Reserve and screened the key microbial flora of the red deer when processing complex food resources.

Three-Electron Nickel(I)/Nickel(0) Half-Bond.

An (N-heterocyclic carbene)nickel(I) cation precursor reacts with the corresponding nickel(0) complex to form a dinickel(I,0) monocation. The Ni···Ni distance in this cation is 0.93 Å shorter than in the analogous dinickel(0) complex.

Heteroleptic copper(I) charge-transfer chromophores with panchromatic absorption.

Four new heteroleptic bis-chelate Cu(I) complexes showing panchromatic visible absorption are described here. With this heteroleptic design, we demonstrate that the energy levels of the spatially separated HOMO and LUMO can be independently and systematically controlled ligand modification, with charge-transfer absorption bands throughout the visible and NIR regions that cover a wider range than typical Cu(I) chromophores.

Enhancing Voluntary Motion with Modular, Backdrivable, Powered Hip and Knee Orthoses.

Mobility disabilities are prominent in society with wide-ranging deficits, motivating modular, partial-assist, lower-limb exoskeletons for this heterogeneous population. This paper introduces the Modular Backdrivable Lower-limb Unloading Exoskeleton (M-BLUE), which implements high torque, low mechanical impedance actuators on commercial orthoses with sheet metal modifications to produce a variety of hip- and/or knee-assisting configurations. Benchtop system identification verifies the desirable backdrive properties of the actuator, and allows for torque prediction within ±0.