Lutembacher syndrome with congenital atrial septal defect in an 18-year-old female: a rare case report

Introduction: Lutembacher syndrome (LS) is a rare condition with congenital atrial septal defect (ASD) and mitral stenosis (MS), often post-rheumatic illness. Diagnosis uses Doppler echocardiography, and treatment may involve surgery or percutaneous options. Case presentation: An 18-year-old female presented with worsening dyspnea, orthopnea, and potential undiagnosed rheumatic fever. Chest X-ray showed cardiomegaly. An echocardiogram revealed left atrial dilation and mitral stenosis with regurgitation, aortic valve showed thickening without stenosis, and the right ventricle was mildly dilated; an interatrial shunt was present. Mitral stenosis worsened left-to-right shunt. Discussion: LS results from the balance of ASD and MS. Factors influencing prognosis include pulmonary resistance, ASD size, and mitral stenosis severity. Echocardiography is essential for diagnosis, which revealed left atrial dilation, normal left ventricular function, severe mitral stenosis, and pulmonary valve changes. ECG indicated right ventricular hypertrophy. CXR showed left atrial enlargement and right ventricle enlargement. Treatment included an open heart surgery which replaced the mitral valve and closed the ASD. Conclusion: Lutembacher syndrome, a rare condition combining ASD and mitral stenosis, can cause cardiac failure and pulmonary hypertension if untreated. Given the patient’s stable condition in the early stages of the disease, early surgical or percutaneous intervention is advisable

Consideration of Statistical Approaches Within the Accelerated Assessment of Fatigue Properties of Metallic Materials

Understanding the fatigue behaviour of metallic materials is highly important when it comes to a reliable assessment of material degradation as a result of dynamic loading. Because the provision of such data is associated with great testing effort leading to increased time and cost requirements in terms of conventional methods, accelerated lifetime prediction methods are becoming increasingly important. However, the reduced number of fatigue specimens and tests complicates statistical validations of the obtained results. In this contribution, combinatorial approaches are used to estimate both lifetime prediction bands and virtually-determined S-N curves with a reduced number of specimens, displaying the material-related scatter due to microstructural inhomogeneities. In addition, a variable energy dissipation factor based on cyclic deformation curves is presented, which enables evaluation of materials that exhibit more pronounced scatter, for instance cast materials. An in situ evaluation of the cyclic deformation curves is provided via integration of non-destructive testing methods into the testing rig. Unalloyed SAE 1045 steel, low-alloyed 20MnMoNi5-5 steel, and the cast material EN-GJS-1050-6 are investigated in this research, as these materials posses gradually increasing complexity regarding their respective microstructures

Triangular Screw Placement to Treat Dysmorphic Sacral Fragility Fractures in Osteoporotic Bone Results in an Equivalent Stability to Cement-Augmented Sacroiliac Screws—A Biomechanical Cadaver Study

Background: Sacroiliac screw fixation in elderly patients with pelvic fractures remains a challenging procedure for stabilization due to impaired bone quality. To improve it, we investigated the biomechanical properties of combined oblique sacroiliac and transiliosacral screw stabilization versus the additional cement augmentation of this construct in a cadaver model of osteoporotic bone, specifically with respect to the maximal force stability and fracture-site motion in the displacement and rotation of fragments. Methods: Standardized complete sacral fractures with intact posterior ligaments were created in osteoporotic cadaver pelvises and stabilized with a triangle of two oblique sacroiliac screws from each side with an additional transiliosacral screw in S1 (n = 5) and using the same pelvises with additional cement augmentation (n = 5). A short cyclic loading protocol was applied, increasing the axial force up to 125 N. Sacral fracture-site motion in displacement and rotation of the fragments was measured by optical motion tracking. Results: A maximum force of 65N +/− 12.2 N was achieved using the triangular screw stabilization of the sacrum. Cement augmentation did not provide any significant gain in maximum force (70 N +/− 29.2 N). Only low fragment displacement was observed (2.6 +/− 1.5 mm) and fragment rotation (1.3 +/− 1.2◦ ) without increased stability (3.0 +/− 1.5 mm; p = 0.799; 1.7 +/− 0.4◦ ; p = 0.919) following the cement augmentation. Conclusions: Triangular stabilization using two obliques and an additional transiliosacral screw provides sufficient primary stability of the sacrum. Still, the stability achieved seems very low, considering the forces acting in this area. However, additional cement augmentation did not increase the stability of the sacrum. Given its lack of beneficial abilities, it should be used carefully, due to related complications such as cement leakage or nerve irritation. Improving the surgical methods used to stabilize the posterior pelvic ring will be a topic for future research

Adult ADHD predicts intimate partner violence perpetration and victimization irrespective of gender and age

Understanding the determinants of intimate partner violence (IPV) from perpetrator and victim perspectives has become a major objective of behavioral science. Empirical evidence suggests that adults at risk for Attention-Deficit/Hyperactivity Disorder (ADHD), compared to the general population, tend to have more conflictual partnerships, and the presence of ADHD increases the risk of aggressive behavior. Possible influences of gender have not been sufficiently investigated yet. Using data from an anonymous online survey, this study examined the relationship between ADHD and IPV in 316 male and female individuals with (n = 131) and without (n = 185) ADHD. Multiple linear regression analyses showed that adults at risk for ADHD had more frequently become both victims and perpetrators of IPV compared to the healthy control group. ADHD achieved significant incremental variance over gender and age. Thus, the presence of ADHD seems to be an important risk factor for IPV irrespective of gender and age. Accordingly, research and treatment approaches focusing on ADHD must not neglect the risk of IPV among patients but should offer specific psychological support

Preclinical Performance of a Novel Dental Implant Design Reducing Mechanical Stress in Cortical Bone

This animal study compared the healing performance of a novel implant design characterized by a shift in thread geometry and core diameter with two different surfaces with that of an apically tapered implant. Test Bioactive (n = 9), Test Porous (n = 7) and Control (n = 8) implants were placed in the mandibles of minipigs. Following healing, bone samples were harvested for determining bone-to-implant contact (BIC) and marginal bone loss (MBL). Comparative statistics were based on Levene’s test, Shapiro–Wilk tests, the Kruskal–Wallis test and Wilcoxon tests with Holm correction (α = 0.05). The mean undersizing of the osteotomy was 0.15 mm for Control, while in the test groups 0.33 mm and 0.34 mm were calculated. Insertion torques ranged from 61.5 Ncm (Control) to 76.1 Ncm (Test Bioactive). Maximum BIC was seen in Test Porous with 55.83%, while Test Bioactive showed only 48.11%. MBL was 4.1 mm in Test Bioactive, while Test Porous and Control exhibited 2.8 mm. No significant differences between the implant groups were observed (p > 0.05). Despite greater undersizing, the novel implant type performed comparably to the established Control implants. The rougher surface of the bioactive implants increased the insertion torque and led to more MBL

Modeling moist air effects and shape memory alloys in elastocaloric devices

Elastocaloric systems, which leverage shape memory alloys (SMAs) to achieve efficient, eco-friendly thermal management, offer a promising alternative to conventional air conditioning technologies. This study presents a simulationbased approach to modeling the effects of moist air and condensation phenomena within these systems. Here, we examine key factors affecting SMA performance, including mechanical behavior and the material’s latent heat characteristics. Moist air, particularly under conditions where temperatures fall below the dew point, introduces condensation and latent heat release, which can influence thermal output in elastocaloric systems. This work develops a comprehensive model that couples the thermomechanical behavior of SMAs with the thermodynamics of moist air, incorporating condensation heat transfer, mass balance, and moisture transport. Through simulations, we quantify the impact of condensation on device level and assess how ambient moisture conditions affect overall heat exchange. The findings enhance our understanding of elastocaloric system performance under real-world conditions, contributing to the advancement of sustainable and modern technologies

Examining major threats to valid measurement of sexual motivation: from basic research to implications for society and science

Sexual motivation plays a significant role in almost everyone’s life, influencing thoughts, feelings, behaviors, and decisions. Self-report measures are the primary means of unraveling the secrets of sexual motivation in the social sciences, allowing large-scale assessments of what goes on in people’s minds and behind closed doors. However, the validity of conclusions drawn from sexual self-report measures is controversial, particularly with regard to gender differences in sexual motivation. While the literature highlights various biases that could potentially threaten the valid measurement of sexual motivation, little is known about their actual impact. In this dissertation, I fill some of this gap by identifying and addressing critical threats to valid measurement of sexual motivation. Part I focused on how the measurement instrument affects validity. To date, most sexual motivation scales are vague in their conceptualization and lack a comprehensive validation process. In addition, most scales are regularly used for group comparisons (e.g., men vs. women) without demonstrating equivalent measurement properties across these groups. These factors lead to uncertainty about whether the scales measure sexual motivation and whether seemingly robust gender differences actually exist. We therefore developed and validated a novel scale of sexual motivation: the Trait Sexual Motivation Scale (TSMS). Across four preregistered studies, the theory-driven TSMS emerged as a reliable and valid measure of sexual motivation independent of gender and relationship status. Using this scale, we found higher male than female sexual motivation. This suggests that gender differences are not due to invalid group comparisons. Part II focused on social desirability bias as a threat to valid measurement and conclusions. Because of gendered sexual norms, previous research has expected men to overreport and women to underreport sexual experiences, which may account for much of the measured gender differences. However, support for these predictions is scarce and largely limited to laboratory research. In theory, the greater anonymity provided by online surveys promises more accurate responses, but little is known about whether this hope is justified for sexual self-reports. Here, we used the Item Sum Technique, an indirect questioning technique that maximizes people’s anonymity, to create conditions under which honest self-reports are particularly likely. In this item sum group, sexual motivation and gender differences in sexual motivation were not significantly different from those found in a standard online survey group. These results suggest that there is little evidence of social desirability bias in online surveys and argue against the notion that such bias explains higher self-reported sexual motivation in men than in women. Part III focused on the social norms that give rise to social desirability bias. Previous research predicted that sexual activity would be evaluated in opposite ways for women (socially punished) and men (socially rewarded), but this strong sexual double standard received little empirical support. We proposed an alternative model of sexual standards—the Similarities and Differences (S&D) model—that may explain the inconsistent findings by suggesting that male and female sexual norms are marked by both similarities and differences. Consistent with both models, participants perceived that high sexual activity is viewed more favorably for men than for women, while low sexual activity is seen more positively for women than for men. However, they also perceived that moderate levels of sexual activity, rather than very low or high levels, are viewed most favorably for both genders—a similarity predicted only by the S&D model. In sum, using the TSMS in online studies promises valid future measurement of sexual motivation. The lack of evidence that higher sexual motivation in men is due to invalid scales or self-presentation contributes to debates about gender differences. In the general discussion, I seek to reconcile these findings with research showing no gender differences, present a new model of flexible self-presentation, and discuss the TSMS and S&D model’s practical relevance. In doing so, I link basic research on sexual motivation with its broader scientific and societal implications.Sexuelle Motivation spielt im Leben fast aller Menschen eine wichtige Rolle. Sie beeinflusst Gedanken, Gefühle, Verhalten und Entscheidungen. Um umfassend zu ergründen, was in den Köpfen von Personen und hinter verschlossenen Türen vor sich geht, sind sexuelle Selbstberichte elementar. Gleichzeitig wird kontrovers diskutiert, inwiefern Befunden, die auf sexuellen Selbstberichten basieren, Vertrauen geschenkt werden darf. Während in der Literatur mehrfach Verzerrungen beschrieben wurden, welche die Validität sexueller Selbstberichte potenziell gefährden könnten, ist wenig darüber bekannt, ob diese tatsächlich zu falschen Schlussfolgerungen führen. Diese Dissertation zielt darauf ab, einen Teil dieser Lücke zu schließen, indem sie wesentliche Bedrohungen für die valide Erfassung sexueller Motivation identifiziert und untersucht. Teil I beschäftigte sich damit, welche Rolle das Messinstrument bei der validen Erfassung sexueller Motivation spielt. Aktuell kommen meist Skalen zum Einsatz, deren zugrundeliegende Konzeptualisierung vage und deren Validierungsprozess unvollständig ist. Zudem werden diese Skalen häufig für Gruppenvergleiche (z. B. zwischen Männern und Frauen) verwendet, ohne zu prüfen, ob sie für diese Gruppen vergleichbare Messeigenschaften aufweisen. Diese Versäumnisse führen zu Unsicherheiten darüber, ob die Skalen wirklich sexuelle Motivation erfassen und ob die scheinbar robusten Geschlechtsunterschiede tatsächlich existieren. Wir haben daher eine neue Skala sexueller Motivation entwickelt und validiert: die Trait Sexual Motivation Scale (TSMS). In vier präregistrierten Studien zeigte sich die theoriegeleitete TSMS unabhängig vom Geschlecht und Beziehungsstatus einer Person als reliables und valides Messinstrument sexueller Motivation. Unter Einsatz der TSMS fand sich eine höhere mittlere sexuelle Motivation bei Männern als bei Frauen. Dies deutet darauf hin, dass Geschlechterunterschiede nicht auf unzulässige Gruppenvergleiche zurückzuführen sind. Teil II beschäftigte sich damit, wie sozial erwünschtes Antwortverhalten die Validität sexueller Selbstberichte und darauf basierender Schlussfolgerungen beeinflusst. Aufgrund geschlechtsspezifischer sexueller Normen wurde in der bisherigen Forschung angenommen, dass Männer in ihren sexuellen Erlebnisberichten eher übertreiben und Frauen eher untertreiben. Diese Tendenzen könnten einen erheblichen Teil gefundener Geschlechterunterschiede erklären. Die Belege für diese Annahmen sind jedoch spärlich und stammen fast ausschließlich aus Laborstudien. Theoretisch sollte das hohe Ausmaß an Anonymität, das Online-Studien kennzeichnet, unverzerrte Selbstberichte begünstigen. Ob sich diese Hoffnungen erfüllen, ist für sexuelle Selbstberichte allerdings weitgehend ungeklärt. Hier wurde die Item Sum Technique verwendet, eine indirekte Befragungstechnik, welche die Anonymität der Teilnehmenden maximiert. Dadurch sollen Bedingungen geschaffen werden, unter denen wahrheitsgemäße Selbstberichte besonders wahrscheinlich sind. Die auf diese Weise erfasste sexuelle Motivation und entsprechende Geschlechterunterschiede wurden mit denjenigen aus einer Standard-Online- Befragung verglichen. Es zeigten sich keine signifikanten Unterschiede. Diese Ergebnisse liefern wenig Hinweise auf sozial erwünschtes Antwortverhalten in Online-Befragungen und stellen die Annahme infrage, dass diese Verzerrungen für die höhere gemessene sexuelle Motivation bei Männern im Vergleich zu Frauen verantwortlich sind. Teil III befasste sich mit sozialen Normen als Grundlage für sozial erwünschtes Antwortverhalten. Frühere Studien sagten voraus, dass sexuelle Aktivität bei Männern sozial belohnt und bei Frauen sozial bestraft wird. Für diese gegensätzlichen männlichen und weiblichen Sexualnormen, die als starker sexueller Doppelstandard bezeichnet werden, fanden sich jedoch nur wenige Belege. Wir haben ein alternatives Modell sexueller (Doppel-)Standards aufgestellt: das Similarities and Differences Model (S&D-Modell). Dieses sagt vorher, dass männliche und weibliche Sexualnormen sowohl Ähnlichkeiten als auch Unterschiede aufweisen und könnte so Inkonsistenzen in früherer Forschung erklären. Gemäß der Wahrnehmung der Studienteilnehmenden wird in der Gesellschaft ein hohes Ausmaß sexueller Aktivität bei Männern positiver beurteilt als bei Frauen und umgekehrt ein geringes Ausmaß sexueller Aktivität bei Frauen positiver beurteilt als bei Männern. Diese Befunde sind sowohl mit dem starken sexuellen Doppelstandard als auch mit dem S&D-Modell vereinbar. Allerdings nahmen die Teilnehmenden ebenfalls wahr, dass nicht besonders niedriges oder hohes, sondern ein moderates Ausmaß sexueller Aktivität bei beiden Geschlechtern am besten beurteilt wird – eine Ähnlichkeit männlicher und weiblicher Sexualnormen, die nur das hier präsentierte S&D-Modell erklären kann. Zusammenfassend verspricht der Einsatz der TSMS in Online-Studien eine valide Erfassung sexueller Motivation in zukünftiger Forschung. Für die Annahme, dass die höhere sexuelle Motivation von Männern im Vergleich zu Frauen auf die Verwendung nicht valider Skalen oder auf sozial erwünschtes Antwortverhalten zurückzuführen ist, konnten in unseren Studien keine Belege gefunden werden. Diese Ergebnisse liefern einen wertvollen Beitrag zur anhaltenden Debatte über Geschlechterunterschiede. In der allgemeinen Diskussion stelle ich die aktuellen Ergebnisse solchen Studien gegenüber, die keine Geschlechterunterschiede gefunden haben. Darüber hinaus stelle ich ein neues Modell der flexiblen Selbstpräsentation vor und diskutiere die praktische Relevanz der TSMS und des S&D-Modells. Auf diese Weise schlage ich eine Brücke zwischen der Grundlagenforschung zur sexuellen Motivation und ihren breiteren Implikationen für Wissenschaft und Gesellschaft

A screening setup to streamline in vitro engineered living material cultures with the host

Engineered living materials (ELMs), which usually comprise bacteria, fungi, or animal cells entrapped in polymeric matrices, offer limitless possibilities in fields like drug delivery or biosensing. Determining the conditions that sustain ELM performance while ensuring compatibility with ELM hosts is essential before testing them in vivo. This is critical to reduce animal experimentation and can be achieved through in vitro investigations. Currently, there are no standards that ensure ELM compatibility with host tissues. Towards this goal, we designed a 96-well plate-based screening method to streamline ELM growth across culture conditions and determine their compatibility potential in vitro. We showed proliferation of three bacterial species encapsulated in hydrogels over time and screened six different cell culture media. We fabricated ELMs in bilayer and monolayer formats and tracked bacterial leakage as a measure of ELM biocontainment. After screening, an appropriate medium was selected that sustained growth of an ELM, and it was used to study cytocompatibility in vitro. ELM cytotoxicity on murine fibroblasts and human monocytes was studied by adding ELM supernatants and measuring cell membrane integrity and live/dead staining, respectively, proving ELM cytocompatibility. Our work illustrates a simple setup to streamline the screening of compatible environmental conditions of ELMs with the host

The Case for Shared Religious Education

This paper conceptualises ‘shared religious education’ as a way for religious educators to reflect on how their subject might respond to a global need for cooperation and mutual understanding. In the context of migration, climate crisis and violent conflict, European societies are increasingly plural, yet subject to processes of individualization and competition which undermine people’s ability to cooperate and share across their respective cultural and ideological differences. We argue that there is an imperative for sharing and collaboration in response to the dangers we see in our increasingly fractured social worlds; and that education can play a key role in responding to this urgent need. Religious education, however, is subject to the sociological reality that it can separate as well as unite people. Through a critical discussion of the ‘shared education’ model, we make a case for shared religious education, identifying four core aims for those working in the fields of religious and worldviews education. Drawing on literature from religious education, we offer ideas and insights for how those working in the fields of religious and worldviews education may pursue these aims and so respond to the imperative for sharing