Obstetric management for pregnant women with Klippel–Trenaunay syndrome: a UK case report and review of the literature

Klippel–Trenaunay Syndrome (KTS) is a rare congenital vascular disorder characterized by extensive capillary and venous malformations that pose unique challenges during pregnancy. This case report discusses the successful management of a 34‐year‐old pregnant woman with KTS who had two caesarean sections, resulting in the birth of two healthy babies. Despite the lack of evidence‐based guidelines for obstetrical management in KTS, a multidisciplinary team collaborated to devise a high‐risk thrombosis management plan, involving the use of compression stocking and low molecular weight heparin prophylaxis. The patient's elevated risk of thrombosis, exacerbated during pregnancy, informed the decision of caesarean sections, aligning with finding that in most KTS pregnancies, this method of delivery based on obstetric indications and arteriovenous malformations is chosen. This case highlights the importance of systematic and patient‐centered care, advocating for comprehensive obstetric management guidelines to address the unique challenges posed by KTS during pregnancy. Further research is warranted to enhance our understanding and refine guidelines for individuals with vascular abnormalities linked to KTS.</p

Josephine Butler’s reconsideration of female saints: eschatological conceptions of history and the dismantling of structural evil

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Educational affordances of music video games and gaming mobile apps

The rapid advancement of mobile and computing technologies has made the enjoyment of music in the video gaming experience more accessible and affordable, and has raised the interest of educators in the affordances of music-related games for informal music learning. This study aimed to examine the educational affordances of music-related games through content analysis. User reviews of music gaming mobile apps and video games were collected from two major digital distribution platforms and analysed to identify patterns and meanings related to their educational affordances and learning design. The findings reflected a sense of competence, autonomy and engagement resulting from playing video games, which motivated players to become self-directed learners in the context of informal learning. Several bias and limitations were identified, suggesting that an overreliance on video games may lead to unbalanced musical growth and incomprehensive musicianship training.</p

A family of process-based models to simulate landscape use by multiple taxa

Context: Land-use change is a key driver of biodiversity loss. Models that accurately predict how biodiversity might be affected by land-use changes are urgently needed, to help avoid further negative impacts and inform landscape-scale restoration projects. To be effective, such models must balance model realism with computational tractability and must represent the different habitat and connectivity requirements of multiple species. Objectives We explored the extent to which process-based modelling might fulfil this role, examining feasibility for different taxa and potential for informing real-world decision-making. Methods We developed a family of process-based models (*4pop) that simulate landscape use by birds, bats, reptiles and amphibians, derived from the well-established poll4pop model (designed to simulate bee populations). Given landcover data, the models predict spatially-explicit relative abundance by simulating optimal home-range foraging, reproduction, dispersal of offspring and mortality. The models were co-developed by researchers, conservation NGOs and volunteer surveyors, parameterised using literature data and expert opinion, and validated against observational datasets collected across Great Britain. Results The models were able to simulate habitat specialists, generalists, and species requiring access to multiple habitats for different types of resources (e.g. breeding vs foraging). We identified model refinements required for some taxa and considerations for modelling further species/groups. Conclusions We suggest process-based models that integrate multiple forms of knowledge can assist biodiversity-inclusive decision-making by predicting habitat use throughout the year, expanding the range of species that can be modelled, and enabling decision-makers to better account for landscape context and habitat configuration effects on population persistence.</p

Neurodynamic approaches to cardinality-constrained portfolio optimization

This book addresses the growing need for a comprehensive guide to the application of machine learning in financial analytics. It offers a valuable resource for both beginners and experienced professionals in finance and data science by covering the theoretical foundations, practical implementations, ethical considerations, and future trends in the field. It bridges the gap between theory and practice, providing readers with the tools and knowledge they need to leverage the power of machine learning in the financial sector responsibly.</p

Meaningful life changes following hearing aid use: A qualitative user perspective

Objective: This study aimed to explore meaningful life changes due to hearing aid use in adult users. Design: A cross-sectional survey design was used with open-ended questions analyzed using inductive qualitative content analysis. Study Sample: US-based adult hearing aid users (n=653) from the Hearing Tracker website community and Lexie Hearing database. Results: Participants had a mean age of 65.4 years (13.6 SD), including 61.2% males, 38.3% females (0.5% other). Analysis of 2122 meaning units from responses identified two broad domains: 'meaningful benefits' (n=1709; 80.5%) and 'remaining difficulties' (n=413; 19.5%). The meaningful benefits domain included five categories (27 sub-categories): (a) psychosocial benefits, (b) improvements in hearing, (c) personal benefits, (d) hearing aid features and connectivity, and (e) situational benefits. Participants reported enhanced relationships and improved occupational functioning as key benefits. The remaining difficulties domain contained four categories (25 sub-categories): (a) hearing aid limitations, (b) hearing and communication issues, (c) situational difficulties, and (d) personal issues. Notable difficulties included hearing aid design issues and challenges in noisy environments. Conclusion: Hearing aid users reported diverse benefits and persistent challenges related to device use, illustrating the complexity of their lived experiences. These findings can inform empathetic, effective rehabilitation strategies and user-centric hearing aid technologies.</p

Association of soda drinks and fast food with allergic diseases in Korean adolescents: a nationwide representative study

Introduction: A high consumption of carbonated soft drinks (i.e., soda drinks) and fast food is potentially asso?ciated with the observed global rise in adolescent allergic diseases. Thus, our study aimed to examine the potential associations between the consumption of soda drinks and fast food and allergic conditions, identifying specific re?lationships across subgroups and each allergic condition (asthma, allergic rhinitis, and atopic dermatitis). Methods: This study uses large-scale data from the Korea Youth Risk Behavior Web-Based Survey (total n = 865,614). Soda drinks and fast food were defined by a self-reported questionnaire and allergic conditions by physician-diagnosed within Jinyoung Jeong, Hyesu Jo, and Yejun Son contributed equally as first authors. Edited by: Angela Haczku, Sacramento, CA. [email protected] www.karger.com/iaa © 2024 The Author(s). Published by S. Karger AG, Basel Correspondence to: Jaeyu Park, qkrwodb980 @ gmail.com Selin Woo, dntpfls @ naver.com This article is licensed under the Creative Commons Attribution- Dong Keon Yon, yonkkang @ gmail.com NonCommercial 4.0 International License (CC BY-NC) (http://www. karger.com/Services/OpenAccessLicense). Usage and distributionfor commercial purposes requires written permission. Downloaded from http://karger.com/iaa/article-pdf/doi/10.1159/000539518/4247630/000539518.pdf by Anglia Polytechnic University user on 26 July 2024 1 year. Multivariable logistic regression was used to analyze the weighted odds ratios (ORs), along with 95% confidence intervals (CIs), for allergic diseases associated with the intake of soda drinks and fast food. Results: Among 865,614 adolescents in grades 7–12 (male, 51.40%), pa?tients with asthma, allergic rhinitis, and atopic dermatitis were 18,568 (2.15%), 153,536 (17.74%), and 59,014 (6.82%), respectively. Current asthma was associated with soda drinks (OR, 1.07; 95% CI, 1.03–1.12) and fast food con?sumption (1.25; 1.17–1.33). Interestingly, stronger associ?ations were observed for female high schoolers, compared to male high schoolers and middle schoolers, in relation to the consumption of soda drinks (1.31; 1.19–1.44) and fast food (1.46; 1.26–1.69) with asthma. Current allergic rhinitis and atopic dermatitis had no significant association with fast food consumption and soda drinks. Conclusion: This first large-scale study suggests that fast food and soda drinks consumption are potentially associated with current asthma, with stronger associations observed in females than males, underscoring the need for sex-specific allergy prevention programs </p

The Round Letters of Percy Grainger

This thesis comprises the transcription, editing and critical commentary of thirty-nine selected letters—known as the Round Letters—of the Australian-born composer Percy Aldridge Grainger (1882–1961). The edited collection is intended to form a valuable contribution to the growing body of Grainger’s letters brought into the public domain, but otherwise not readily accessible.Drawing on a range of archival resources, this edition of the Round Letters includes an extended essay, detailed footnotes, a chronology of events, biographical sketches of principal characters, a glossary of Blue-eyed English, and a number of appendices of previously unpublished writings by Grainger intended to provide a framework for a critical reading of the letters.A key feature of the letters is Grainger’s use of ‘Blue-eyed English’, a sustained attempt at English language reform that sought to replace words of Latin or Greek origin with Anglo-Saxon equivalents. A critical consideration of Grainger’s word usage sheds light on his conceptions of race, nature, individual and societal behaviours, and notions of democracy that were integral to his identity as a musician. Grainger’s life-long progress towards the realisation of ‘Free Music’, music that is reflective of the natural world, and which is unrestricted by adherence to metrical rhythms or fixed pitches, also features prominently in the Round Letters and provides the second focus for investigation.I argue that Grainger’s use of language, and specifically ‘Blue-eyed English’, far from being an expression of eccentricity as many commentators have claimed, was both central to the articulation of his world-view and informed his approach to composition. ‘Blue-eyed English’, as an expression of Grainger’s ideas of democracy, is further found to lead to ‘Free Music’, a concept that is offered as a lens through which to read his compositional output as a whole.</p

National trends of allergic diseases and pandemic–related factors among individuals with obesity in South Korea: A nationwide representative serial study, 2005–2021

Background Although obesity is known to be related to allergic diseases, few studies have investigated the prevalence of allergic diseases in individuals with obesity, especially during the COVID–19 pandemic. Thus, this study aimed to analyze national trends of allergic diseases among individuals with obesity and sociodemographic factors. Methods This study used data from the Korea National Health and Nutrition Examination Survey to examine the prevalence of allergic diseases among individuals with obesity in South Korea from 2005 to 2021. A nationally representative sample of 118,275 participants aged over 2 years or above was divided into six groups for analysis. This study used weighted multivariate regression analysis to examine the estimates of related factors. It assessed the weighted odds ratios or β–coefficients for these factors across different categories, including age, sex, region of residence, education level, household income, and body mass index for the entire population. Results All allergic diseases showed a general upward trend from 2005 to 2021, but each disease showed different prevalence trends when compared by age. Before the pandemic, those aged ≤39 years had an increasing trend for asthma and AD, but those aged ≥40 years had a decreasing trend. For asthma, β–coefficients were 0.629 (95% CI, 0.299 to 0.958) for 19–39 years, –0.245 (–0.450 to –0.040) for 40–59 years, and –0.668 (–1.024 to –0.313) for ≥60 years. For AD, β–coefficients were 2.514 (1.258 to 3.769) in those aged 2–18 years, 0.630 (0.173 to 1.086) in those aged 19–39 years, –0.458 (–0.648 to –0.268) in those aged 40–59 years, and –0.253 (–0.454 to –0.052) in those aged ≥60 years. However, for both asthma and AD, there were no significant changes in prevalence during the pandemic. In the case of AR, trends were different from those of asthma and AD. Before the pandemic, AR showed an increasing trend in those aged ≤39 years and those aged ≥40 years: β–coefficients were 3.067 (2.344 to 3.790) in 19–39 years, 2.051 (1.609 to 2.493) in 40–59 years, and 1.173 (0.820 to 1.526) in ≥60 years. During the pandemic, there was an increasing trend only among those aged 40-59, with no significant changes in other age groups: β–coefficients were 1.438 (0.065 to 2.811) in 40–59 years. Conclusions From 2005 to 2021, all allergic diseases (asthma, AD, and AR) increased overall, but with different age-related trends. No significant link was found between COVID–19 and allergic diseases, possibly due to preventive measures like mask-wearing and social distancing. Anxiety about accessing healthcare during the pandemic likely contributed to a decline in allergy diagnoses, highlighting the need for comprehensive strategies to manage and prevent allergic diseases.</p

Simulation in Nursing Education: An Evidence Base for the Future

Executive summary: The purpose of this research project was to investigate how simulated learning can transform practice learning by comparing existing learning approaches with emerging simulated and technologyenhanced learning approaches. The project also maps the ability of simulation to meet the NMC (2018) future nurse standards of proficiency for registered nurses. Methods • Phase one – A systematic review of primary studies and regulatory and national standards. • Phase two – A cross-sectional survey to explore organisational readiness for simulation-based education (SBE) and opportunities and challenges of SBE in pre-registration nursing courses in the UK. • Phase three – A case study involving two self-reporting student surveys and a focus group with academic staff acting as practice supervisors. • Phase four - Focus groups with Council of Deans of Health (CoDH) members who have NMC approval for SPL to capture their experiences in the delivery of SPL in pre-registration nursing programmes. Findings and Conclusion This report provides an evidence base demonstrating how simulated learning can transform practice learning in nursing education and meet the NMC (2018) future nurse standards of proficiency for registered nurses. The findings emphasise the significant contribution of simulated practice learning (SPL) in the delivery of pre-registration nursing programmes. The systematic review indicated that, on average, SBE is more effective than traditional clinical education in improving nurse assessment outcomes. The cross-section survey of higher education institutions (HEIs) with pre-registration nursing programmes highlighted their commitment to SBE with the recognition that infrastructure, commitment by faculty leadership, access to facilities, resources and funding were critical for ensuring success and sustainability. SPL was acknowledged as an effective method that complements learning in clinical placements and enables attainment of the future nurse standards of proficiency for registered nurses. This research highlighted the difficulties HEIs face when delivering SPL. There was a strong desire for clarity and a benchmarking tool to ensure consistency in the approach of HEIs. In addition, the planning, design and delivery of simulation was viewed as an advanced skill for academic staff and thus they require sufficient training. There is a need to develop the evidence base of SPL and measure the impact and benefit on student learning and achievement of proficiencies. Creating a standardised tool to evaluate the outcomes of SPL would provide a benchmark for all HEIs to use. It would also be useful for the NMC to monitor the impact of the new definition of SPL. This research has been undertaken after several HEIs have already incorporated SPL into their programmes. In line with ambitions in the NHS England Long Term Workforce Plan, there is now an opportunity to expand the number of HEIs integrating SPL into their pre-registration nursing programmes. The findings provide an important bedrock of evidence for future decisions such as regulatory and financial support for simulated learning. Relevant stakeholders may take a range of positions on this subject, but this evidence base will further inform the conversations ahead.</p