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There is a paucity of data on the obstetrical outcomes of Canadian pregnant patients with epilepsy, which may differ from the average Canadian pregnancy and from other populations of pregnant patients with epilepsy.
Methods:
Pregnant patients with epilepsy were identified from a prospectively collected database of patients seen at the maternal-fetal medicine obstetrics program of Mount Sinai Hospital (Toronto, Canada) between January 1, 2014, and November 20, 2020. Pregnancy, delivery, and neonatal outcome data were retrieved from this database and described using 95% binomial confidence intervals. Comparisons of obstetrical outcomes over the same period among the Canadian population average, obtained from publicly available national health data, were done using one-proportion Z-tests for nominal variables and one-sample t-tests for continuous variables.
Results:
In total, 282 pregnancies, from 224 patients, were included, which resulted in 274 live births. Mean maternal age was 32.8 years (s.d. = 4.6; population average [μ] = 30.9; p < 0.01), and 53% were primiparous (CI95% = 49%–61%; μ = 43%; p < 0.01). The observed rates of obstetrical complications were gestational hypertension 9% (CI95%=6%–13%; μ=7%; p=0.19), gestational diabetes 5% (CI95% = 3%–8%; μ = 9%; p = 0.02), cesarean section 44% (CI95% = 38%–50%; μ = 28%; p < 0.01), postpartum hemorrhage 5% (CI95% = 3%–8%; μ = 0.5%; p < 0.01), stillbirth 1% (CI95% = 0%–2%; μ=1%; p > 0.99), and prematurity 9% (CI95% = 6%–13%; μ = 8%; p = 0.44).
Conclusion:
In this cohort of Canadian pregnant patients with epilepsy from an urban tertiary care center, observed rates of obstetrical complications were rare and no higher than in the Canadian population over the same period, with the exception of cesarean section and postpartum hemorrhage. Future prospective studies that include primary care and rural settings are needed to increase the generalizability of those results.
Being popular makes it easier for dictators to govern. A growing body of scholarship therefore focuses on the factors that influence authoritarian popularity. However, it is possible that the perception of popularity itself affects incumbent approval in autocracies. We use framing experiments embedded in four surveys in Russia to examine this phenomenon. These experiments reveal that manipulating information—and thereby perceptions—about Russian President Vladimir Putin’s popularity can significantly affect respondents’ support for him. Additional analyses, which rely on a novel combination of framing and list experiments, indicate that these changes in support are not due to preference falsification, but are in fact genuine. This study has implications for research on support for authoritarian leaders and defection cascades in nondemocratic regimes.
We demonstrate that the relative motion of horizontal parallel plates can be generated using patterned heating. This movement is driven by nonlinear thermal streaming associated with a pitchfork bifurcation. The propulsive effect is strongest when all the heating energy is concentrated in a single Fourier mode of the spatial heating pattern; it increases with a decrease in the Prandtl number and increases with the addition of a uniform heating component.
The critical effect of the windward interior angles of elastically mounted trapezoidal bodies on a galloping instability is numerically investigated in this paper using two methodologies of high-fidelity computational fluid dynamics simulations and data-driven stability analysis using the eigensystem realization algorithm. A micro exploration of the dynamical response is processed to understand the mechanism underpinning the structural amplification at the initial stage of the galloping instability and the competition between wake and structural modes. It is observed that very small changes in the windward interior angle of an isosceles-trapezoidal body can provoke or suppress galloping – indeed, a small decrease or increase (low to $1^\circ$) of the windward interior angle from a right angle ($90^\circ$) can result in a significant enhancement and complete suppression, respectively, of the galloping oscillations. This supports our hypothesis that the contraction and/or expansion (viz., fore-aft tapering and/or widening) of the cross-section in the streamline direction has potential influences on galloping triggering from the geometrical perspective. The data-driven stability analysis is also applied to verify and analyse this phenomenon from the perspective of modal analysis. The experimental measurements are also conducted in the wind tunnel to support this hypothesis.
In this paper, we study the linear stability of a two-dimensional shear flow of an air layer overriding a water layer of finite depth. The air layer is considered to be of an infinite extent with an exponential velocity profile. Three different background conditions are considered in the finite-depth water layer: a quiescent background, a linear velocity profile and a quadratic velocity profile. It is known that the cases of the quiescent water layer and the linear velocity profile allow for analytical treatment. We further provide an analytical solution for the case of the quadratic velocity field: we specifically consider a flow-reversal profile, although the result could be generalized to other quadratic profiles as well. The role of water layer depth on the growth rate of the Miles and rippling instabilities is studied in each of the three cases. Using asymptotic analysis, with the air–water density ratio being a small parameter, we obtain an analytical expression for the growth rate of the Miles mode and discuss the condition for the existence of a long-wave cutoff for these profiles. We provide analytical expressions for the stability boundary in the parameter space of inverse squared Froude number and wavenumber. In scenarios where a long-wave cutoff does not exist, we have carried out a long-wave asymptotic study to obtain the growth rate behaviour in that regime.
The educational mission of most western schools today includes the nurturing of children’s sexual upbringing, which many scholars see as a way of controlling their sexuality and forming them into “sexual citizens.” This article examines how official Swedish school guidelines and textbooks have mediated sexuality norms through education on masturbation. The professional discourse on masturbation started to change during the first half of the twentieth century, when masturbation shifted from being perceived as something harmful to something accepted as natural and harmless. This article focuses on a period following that shift in opinion: circa 1945-2000. The analysis shows that boys’ sexuality during this time received more attention than girls’, and a strong new norm about sex contributed to masturbation taking on less importance than heterosexual intercourse within a relationship. This article shows how state-controlled curricula have created norms about gender and sexuality, thus contributing to the development of a sexual citizenship.
Preeclampsia (PE) is a hypertensive disorder of pregnancy. PE patients were reported to have higher serum levels of C-reactive protein (CRP), interleukin-6 (IL-6) and tumor necrosis factor α (TNF-α) than those in healthy controls. However, whether the expressions of these inflammation biomarkers have a causal relationship with PE is unspecified. We applied the Mendelian randomization method to infer the causal relationship between inflammation biomarkers (e.g., CRP, IL-6, interleukin 1 receptor antagonist [IL-1ra] and TNF-α) and PE. Single nucleotide polymorphisms (SNPs) strongly related to inflammation biomarkers were used as instrumental variables. CRP, IL-1ra and IL-6 levels showed no significant effect on PE progression, while the genetic predicted higher level of TNF-α significantly increased the risk of PE (OR per 1-SD increase in TNF-α: 4.33; 95% CI [1.99, 9.39]; p = .00021). The findings suggest that pro-inflammatory activity of TNF-α could be a determinant for PE progression. More antenatal care should be given to those pregnant women with higher level of inflammation biomarkers, especially TNF-α.
Two first-order logic theories are definitionally equivalent if and only if there is a bijection between their model classes that preserves isomorphisms and ultraproducts (Theorem 2). This is a variant of a prior theorem of van Benthem and Pearce. In Example 2, uncountably many pairs of definitionally inequivalent theories are given such that their model categories are concretely isomorphic via bijections that preserve ultraproducts in the model categories up to isomorphism. Based on these results, we settle several conjectures of Barrett, Glymour and Halvorson.
This paper relies on nested postulates of separate, linear and arc-continuity of functions to define analogous properties for sets that are weaker than the requirement that the set be open or closed. This allows three novel characterisations of open or closed sets under convexity or separate convexity postulates: the first pertains to separately convex sets, the second to convex sets and the third to arbitrary subsets of a finite-dimensional Euclidean space. By relying on these constructions, we also obtain new results on the relationship between separate and joint continuity of separately quasiconcave, or separately quasiconvex functions. We present examples to show that the sufficient conditions we offer cannot be dispensed with.
This article offers a critical reading of Nuri Bilge Ceylan’s Ahlat Ağacı (The Wild Pear Tree) through an exploration and critique of the mythmaking and monumentalization surrounding the Gallipoli Battle and the multiple ways in which Ceylan’s film unsettles the foundational myths of the last century in Turkey. Ceylan’s scenes and characters are constructed in such a way that the male characters and particularly Sinan (the main character) refuse to succumb to hegemonic codes of masculinity. Through this cinematic refusal by an anti-hero (Sinan), the film addresses the crisis of hegemonic masculinities in their interconnectedness to militarism, nationalism, capitalism, and heteronormativity. Through Sinan’s quest for self-realization, the film signals not only the impotence and vanity of nationalist masculinities but also the caesuras and instabilities in national myths. As the last film of Nuri Bilge Ceylan’s new Land of Ghosts trilogy, which started with Once Upon a Time in Anatolia and Winter Sleep, Ahlat Ağacı seems to close the cycle with a final scene that bespeaks the possibility of unearthing lost others of national mythmaking, bringing fertility and hope to the lands in which collective amnesia reigns supreme.
We examine the equilibrium configurations of a nematic liquid crystal with an immersed body in two dimensions. A complex variables formulation provides a means for finding analytical solutions in the case of strong anchoring. Local tractions, forces and torques on the body are discussed in a general setting. For weak (finite) anchoring strengths, an effective boundary technique is proposed which is used to determine asymptotic solutions. The energy-minimizing locations of topological defects on the body surface are also discussed. A number of examples are provided, including circular and triangular bodies, and a Janus particle with hybrid anchoring conditions. Analogies to classical results in fluid dynamics are identified, including d'Alembert's paradox, Stokes’ paradox and the Kutta condition for circulation selection.
Marshall Sahlins claims that individuals with personal power, influence, networks, and control over their followers within the political sphere are actually “big-men” rather than “chiefs.” Big-men derive their authority from personal maneuvering, whereas “chiefs” obtain their authority from semi-hierarchical, formalized, and de-personalized rule. De Bruijne argues that those individuals who are perceived as “big men” in post-war Sierra Leone might be better understood as “chiefs.”
Vortex shedding in the wake of a cylinder in uniform flow can be suppressed via the application of a porous coating; however, the suppression mechanism is not fully understood. The internal flow field of a porous coated cylinder (PCC) can provide a deeper understanding of how the flow within the porous medium affects the wake development. A structured PCC (SPCC) was three-dimensionally printed using a transparent material and tested in water tunnel facilities using flow visualisation and tomographic particle image velocimetry at outer-diameter Reynolds numbers of $Re = 7 \times 10^{3}$ and $7.3 \times 10^{4}$, respectively. The internal and near-wall flow fields are analysed at the windward and mid-circumference regions. Flow stagnation is observed in the porous layer on the windward side and its boundary is shown to fluctuate with time in the outermost porous layer. This stagnation region generates a quasi-aerodynamic body that influences boundary layer development on the SPCC inner diameter, that separates into a shear layer within the porous medium. For the first time via experiment, spectral content within the separated shear layer reveals vortex shedding processes emanating through single pores at the outer diameter, providing strong evidence that SPCC vortex shedding originates from the inner diameter. Velocity fluctuations linked to this vortex shedding propagate through the porous layers into the external flow field at a velocity less than that of the free stream. The Strouhal number linked to this velocity accurately predicts the SPCC vortex shedding frequency.
To compute the maximum speed threshold for helicopters, we model the lift produced by the rotor blades. Using this model, we derive limits for each method traditionally used to alleviate dissymmetry of lift. Additionally, we find the minimum rotor angular velocity required to produce a prescribed lift at a given forward velocity. We derive conditions on the coefficient of lift for helicopter airfoils that maintain altitude. Further considerations are also made with regard to the properties of the air and its effect on helicopter dynamics.
During the last glacial period, rapidly changing environments posed substantial challenges to Neanderthal populations in Europe. Southern continental regions, such as Iberia, have been proposed as important climatic “buffer” zones during glacial phases. Contextualising the climatic and ecological conditions Neanderthals faced is relevant to interpreting their resilience. However, records of the environments and ecosystems they exploited across Iberia exhibit temporal and spatial gaps in coverage. Here we provide new evidence for palaeotemperatures, vegetation structure, and prey herbivore ecology during the late Pleistocene (MIS 5–3) in northern Spain, by applying multiple stable isotope tracers (δ18O, δ13C, δ15N, δ34S) to herbivore skeletal remains associated with Neanderthal occupations at Axlor Cave, Bizkaia. The results show little change over time and indicate stable climatic conditions and ecosystems across different occupations. Large within-layer isotopic variability in nitrogen and sulphur suggests the presence of a mosaic environment and a variety of isotopic ecotones that were exploited by Neanderthals and their prey. We implement a combination of carbonate and phosphate δ18O measurements to estimate palaeotemperatures using a cost-effective workflow. We show that the targeted use of phosphate δ18O measurements to anchor summer peak and winter trough areas enables high-precision seasonal palaeoclimatic reconstructions.