Elastic flow of curves with partial free boundary

We consider a curve with boundary points free to move on a line in $\R^2$, which evolves by the $L^2$--gradient flow of the elastic energy, that is a linear combination of the Willmore and the length functional. For such planar evolution problem we study the short and long--time existence. Once we establish under which boundary conditions the PDE's system is well--posed (in our case the Navier boundary conditions), employing the Solonnikov theory for linear parabolic systems in H\"older space, we show that there exists a unique flow in a maximal time interval $[0,T)$. Then, using energy methods we prove that the maximal time is actually $T= + \infty$

Perceived abortion stigma and psychological well-being over five years after receiving or being denied an abortion.

OBJECTIVE:To prospectively assess perceptions of abortion stigma after receiving or being denied an abortion over 5 years, the factors associated with perceived abortion stigma, and the effects of perceived abortion stigma on psychological well-being. METHODS:We recruited people seeking abortion from 30 facilities across the US, and interviewed them by phone one week post-abortion seeking, then semiannually for 5 years. We used adjusted mixed effects regression analyses to examine the abortion stigma trajectories of those who obtained an abortion near a facility's gestational age limit (Near-limits) compared to those denied an abortion because they were just over the limit and carried their pregnancies to term (Turnaway-births). RESULTS:Of the 956 people recruited, we removed 28 due to ineligibility or missing data, leaving a final sample of 928. In unadjusted analyses, at one-week post-abortion seeking, over half of those seeking abortion perceived that if others knew they had sought an abortion, they would be looked down upon at least "a little bit" by people close to them (60%) or by people in their community (56%). In longitudinal adjusted analyses, people denied an abortion and who carried their pregnancies to term (Turnaway-birth group) reported significantly lower baseline perceived abortion stigma from people close to them (-0.38; 95% CI, -0.59, -0.16) and from people in their community (0.30; 95% CI, -0.52, -0.08), than Near-limits, differences that remained statistically significant for 1.5 years. Overall perceived abortion stigma declined significantly (p < .001) for both study groups. High perceived abortion stigma at baseline was associated with higher odds of experiencing psychological distress years later (adjusted Odds Ratio, 3.98; 95% CI, 1.39, 11.37). CONCLUSIONS:Most people considering abortion perceive some abortion stigma, which is associated with psychological distress years later

Stability for the Surface Diffusion Flow

We study the global existence and stability of surface diffusion flow (the normal velocity is given by the Laplacian of the mean curvature) of smooth boundaries of subsets of the $n$--dimensional flat torus. More precisely, we show that if a smooth set is ``close enough'' to a strictly stable critical set for the Area functional under a volume constraint, then the surface diffusion flow of its boundary hypersurface exists for all time and asymptotically converges to the boundary of a ``translated'' of the critical set. This result was obtained in dimension $n=3$ by Acerbi, Fusco, Julin and Morini (extending previous results for spheres of Escher, Mayer and Simonett and Elliott and Garcke in dimension $n=2$). Our work generalizes such conclusion to any dimension $n\in\mathbb N$. For sake of clarity, we show all the details in dimension $n=4$ and we list the necessary modifications to the quantities involved in the proof in the general $n$--dimensional case, in the last section

Perceived stress and emotional social support among women who are denied or receive abortions in the United States: a prospective cohort study.

BackgroundExamining women's stress and social support following denial and receipt of abortion furthers understanding of the effects of unwanted childbearing and abortion on women's well-being. This study investigated perceived stress and emotional social support over time among women who were denied wanted abortions and who received abortions, and compared outcomes between the groups.MethodsThe Turnaway Study is a prospective cohort study of women who sought abortions at 30 abortion facilities across the United States, and follows women via semiannual phone interviews for five years. Participants include 956 English or Spanish speaking women aged 15 and over who sought abortions between 2008 and 2010 and whose gestation in pregnancy fit one of three groups: women who presented up to three weeks beyond a facility's gestational age limit and were denied an abortion; women presenting within two weeks below the limit who received an abortion; and women who received a first trimester abortion. The outcomes were modified versions of the Perceived Stress Scale and the Multidimensional Scale of Perceived Social Support. Longitudinal mixed effects models were used to assess differences in outcomes between study groups over 30 months.ResultsWomen denied abortions initially had higher perceived stress than women receiving abortions near gestational age limits (1.0 unit difference on 0-16 scale, P = 0.003). Women receiving first-trimester abortions initially had lower perceived stress than women receiving abortions near gestational age limits (0.6 difference, P = 0.045). By six months, all groups' levels of perceived stress were similar, and levels remained similar through 30 months. Emotional social support scores did not differ among women receiving abortions near gestational limits versus women denied abortions or women having first trimester abortions initially or over time.ConclusionsSoon after being denied abortions, women experienced higher perceived stress than women who received abortions. The study found no longer-term differences in perceived stress or emotional social support between women who received versus were denied abortions

Non-alcoholic fatty liver disease in lean individuals or another rare differential diagnosis - a clinical case

Въведение: Неалкохолната Мастна Чернодробна Болест (НАМЧБ) е значим обществен здравен проблем, засягаща  близо един милиард хора по цял свят. НАМЧБ е най-честата причина за чернодробно увреждане в световен мащаб и представлява чернодробна изява на метаболитния синдром. НАМЧБ е основно свързана със затлъстяването и свързаните му коморбидности, но също така би могло да се наблюдава и при индивиди с нормален или граничен BMI. Това е т.н. НАМЧБ „при слаби“ и представлява субфенотипна изява на Неалкохолната мастна чернодробна болест. Слабите индивиди с НАМЧБ показват по-леки признаци на Метаболитния синдром, сравнено с тези със затлъстяване, но са с по-висока честота на метаболитни промени, като дислипидемия, артериална хипертония, инсулинова резистентност и диабет сравнено със здрави контроли. Поставянето на диагнозата на НАМЧБ изисква изключване на вторични причини за чернодробна стеатоза, както и изключване на дневна алкохолна консумация ≥ 30 гр. абсолютен алкохол за мъже и ≥ 20 гр. абсолютен алкохол за жени.Клиничен случай: Представяме клиничен случай на мъж на 29 години, постъпил в клиниката с оглед диагностично уточняване във връзка с ехографски данни за изразена чернодробна стеатоза, съпроводена с лекостепенна хепатоспленомегалия. Липсват данни за известен Захарен диабет, ХБ или затлъстяване. Пациента е с наднормено тегло, но без затлъстяване: ръст 187 см, телесно тегло 108 кг, BMI – 30, коремна обиколка 111 см. От лабораторните изследвания нормална ПКК, CRP, нормални АСАТ, АЛАТ, АФ  и билирубин, леко повишен ГГТ, нормална синтетична чернодробна функция. Изследването на липидната обмяна показва повишени нива на LDL холестерол и ниско ниво на HDL холестерол. Проведен е лабораторен хепатологичен скрининг, при който са изключени – хронични вирусни хепатити, Болест на Уилсън и хемохроматоза, автоимунна чернодробна болест. Неинвазивните cкоровете за доказване наличие на стеатоза показаха високи стойности. NAFLD fibrosis score: -3,35 и FIB-4 index: 0,52, отхвърлят наличието на значима  фиброза. При ехографското изследване данни за изразена чернодробна стеатоза – 3 ст, горно-граничен размер на черния дроб и лекостепенна спленомегалия. Фиброскан еластографията показва нормална плътност на черния дроб – 4,8 кРа, при САР – 304 db/m, което доказва наличие на високостепенна стеатоза. Имайки предвид физикалните данни, категоричните резултати от неинвазивните скорове за стеатоза,  ехографското изследване, данните от фиброскан еластографията и след изключване на алкохолна консумация и на други по-чести причини за стеатоза се прие диагноза Неалкохолна мастна чернодробна болест при слаби.  Направи се и изследване на суха капка кръв  за лизозомални ензими, при което се изключи Болест на Гоше. Установи се ниско ниво на кисела сфингомиелиназа, което е индикация за Niemann Pick A/B болест, която представлява рядка наследствена автозомно-рецесивна болест засягаща липидния метаболизъм.Заключение: Клиничният случай представя пациент без затлъстяване, с категорични лабораторни, ехографски и фиброскан данни за Неалкохолна мастна чернодробна болест. В диференциално диагностичен план установихме данни за рядка наследствена болест – Болестта на Niemann Pick, протичаща с нарушение в обмяната на мазнините. Клиничният случай доказва широкия спектър от диференциални диагнози при слаби пациенти с НАМЧБ.abstractIntroduction:    Non-alcoholic    fatty    liver    disease    (NAFLD)  is  a  significant  health  problem  in  society  and it affects around a billion people on a global scale. NAFLD is the most common reason for liver damage worldwide and is considered the hepatic manifestation of the metabolic syndrome.. Nonalcoholic fatty liver disease (NAFLD) is generally associated with obesity and the related comorbidities but it can also develop in subjects with a normal body mass index (BMI). This sub-phenotype of NAFLD is so-called “lean” NAFLD. Lean subjects with NAFLD have milder features of the metabolic syndrome when compared with obese patients. Nonetheless they have a higher prevalence of metabolic alterations (e.g.,dyslipidemia, arterial hypertension, insulin resistance, and diabetes) compared with healthy controls. The diagnosis of NAFLD requires the exclusion of both secondary causes and of a daily alcohol consumption ≥ 30 g for men and ≥ 20 g for women.Clinical case: We present the clinical case of a 29-year-old man, who was admitted to the hospital because of diagnostic evaluation of ultrasound findings of severe liver steatosis accompanied with mild hepatosplenomegaly. No evidence of known Diabetes mellitus, Hypertensive disease or Obesity. The patient is overweight but without obesity: height – 187 sm., weight – 108 kg, BMI - 30, waist circumference – 111 sm. Laboratory examination revealed: normal blood count, normal level of CRP, AST, ALT, AF, total bilirubin, mild elevation of GGT and normal synthetic liver function tests. Lipid profile showed elevated level for LDL cholesterol and low HDL cholesterol. Underlying chronic viral hepatitis, autoimmune liver diseases, Wilson's disease and Hemohromatosis were ruled out. Calculated non-invasive scores for steatosis were high. NAFLD fibrosis score: -3,35 and FIB-4 index: 0,52, ruled out presence of significant fibrosis. Abdominal ultrasound examination showed liver steatosis grade 3, upper limit of normal size, mild splenomegaly. Liver transient elastography (TE) with fibroscan revealed normal liver stiffness - 4,8 kPa and CAP – 304 db/m, that proved presence of severe steatosis. Based on physical examination data, definite results of non-invasive scores for steatosis, ultrasound examination and fibroscan elastography, and after excluding of alcohol consumption and other common causes for steatosis we established the diagnosis „lean“ Non-alcoholic fatty liver disease. We performed an examination for Lysosomal Enzymes from dried blood, that rule out classical Gaucher disease. Low activity of acid sphingomyelinase was found, which is indicative of Niemann Pick disease A/B – rare inherited autosomal recessive condition involving lipid metabolism.Conclusion: Clinical case represents a patient without obesity, with definite laboratory, ultrasound and fibroscan data for Non-alcoholic fatty liver disease. As a differential diagnosis we found a rare inherited condition - Niemann Pick disease, characterized with impaired lipid metabolism. Our clinical case proves the broad spectrum of differential diagnosis of patients with NAFLD. Introduction:  Non-alcoholic  fatty  liver  disease  (NAFLD) is a socially significant health problem and it affects around a billion people on a global scale. NAFLD is the most common reason for liver damage worldwide and is considered the hepatic manifestation of the metabolic syndrome. Non-alcoholic fatty liver disease is generally associated with obesity and the related comorbidities, but it can also develop in subjects with a normal body mass index (BMI). This sub-phenotype of NAFLD is called lean NAFLD. Lean subjects with NAFLD have milder features of the metabolic syndrome when compared with obese patients. Nonetheless, they have a higher prevalence of metabolic alterations (e.g., dyslipidemia, arterial hypertension, insulin resistance, and diabetes) compared with healthy controls. The diagnosis of NAFLD requires the exclusion of both secondary causes and of a daily alcohol consumption ≥ 30 g for men and ≥ 20 g for women.Clinical Case: We present the clinical case of a 29-year-old man, who was admitted to the hospital because of diagnostic evaluation of ultrasound findings of severe liver steatosis accompanied with mild hepatosplenomegaly. There was no evidence of diabetes mellitus, hypertensive disease or obesity. The patient was overweight but without obesity: height – 187 cm., weight – 108 kg, BMI – 30, waist circumference – 111 cm. Laboratory examination revealed: normal blood count, normal level of CRP, AST, ALT, AF, total bilirubin, mild elevation of GGT and normal synthetic liver function tests. The lipid profile showed elevated level for LDL cholesterol and low HDL cholesterol. Underlying chronic viral hepatitis, autoimmune liver diseases, Wilson's disease and hemochromatosis were ruled out. The calculated non-invasive scores for steatosis were high. The NAFLD fibrosis score: -3.35 and FIB-4 index: 0.52, ruled out presence of significant fibrosis. Abdominal ultrasound examination showed liver steatosis grade 3, upper limit of normal size, mild splenomegaly. Liver transient elastography (TE) with fibroscan revealed normal liver stiffness – 4.8 kPa and CAP – 304 db/m that proved the presence of severe steatosis. Based on physical examination data, definite results of non-invasive scores for steatosis, ultrasound examination and fibroscan elastography, and after excluding alcohol consumption and other common causes for steatosis, we established the diagnosis lean non-alcoholic fatty liver disease. We performed an examination for lysosomal enzymes from dried blood that ruled out classic Gaucher disease. Low activity of acid sphingomyelinase was found, which was indicative of Niemann-Pick disease A/B – rare inherited autosomal recessive condition involving lipid metabolism.Conclusion: The clinical case presents a patient without obesity, with definite laboratory, ultrasound and fibroscan data for non-alcoholic fatty liver disease. As a differential diagnosis we found a rare inherited condition – Niemann-Pick disease, characterized by impaired lipid metabolism. Our clinical case proves the broad spectrum of differential diagnoses of patients with NAFLD

Uniform Sobolev, interpolation and geometric Calder\'on-Zygmund inequalities for graph hypersurfaces

In this note, our aim is to show that families of smooth hypersurfaces of $\mathbb R^{n+1}$ which are all $C^1$--close enough to a fixed compact, embedded one, have uniformly bounded constants in some relevant inequalities for mathematical analysis, like Sobolev, Gagliardo-Nirenberg and ``geometric'' Calder\'on-Zygmund inequalities. This technical result is quite useful, in particular, in the study of the geometric flows of hypersurfaces

Risk of violence from the man involved in the pregnancy after receiving or being denied an abortion.

BackgroundIntimate partner violence is common among women having abortions, with between 6% and 22% reporting recent violence from an intimate partner. Concern about violence is a reason some pregnant women decide to terminate their pregnancies. Whether risk of violence decreases after having an abortion, remains unknown.MethodsData are from the Turnaway Study, a prospective cohort study of women seeking abortions at 30 facilities across the U.S. Participants included women who: presented just prior to a facility's gestational age limit and received abortions (Near Limit Abortion Group, n = 452), presented just beyond the gestational limit and were denied abortions (Turnaways, n = 231), and received first trimester abortions (First Trimester Abortion Group, n = 273). Mixed effects logistic regression was used to assess the relationship between receiving versus being denied abortion and subsequent violence from the man involved in the pregnancy over 2.5 years.ResultsPhysical violence decreased for Near Limits (adjusted odds ratios (aOR), 0.93 per month; 95% Confidence Interval (CI) 0.90, 0.96), but not Turnaways who gave birth (P < .05 versus Near Limits). The decrease for First Trimesters was similar to Near Limits (P = .324). Psychological violence decreased for all groups (aOR, 0.97; CI 0.94, 1.00), with no differential change across groups.ConclusionsPolicies restricting abortion provision may result in more women being unable to terminate unwanted pregnancies, potentially keeping them in contact with violent partners, and putting women and their children at risk

Plataforma de optimización de la movilidad del STC Metro de la Ciudad de México mediante un ensamble de búsqueda local

En este Proyecto de Investigación se aborda la problemática de la movilidad del Sistema de Transporte Colectivo(STC) Metro de la Ciudad de México, mediante un ensamble de búsqueda local; con el cual se buscó el poder ofrecer al usuario posibles rutas que representen una menor probabilidad de contagio ante el Covid-19 y que proporcionen menor tiempo de traslado. Actualmente, la movilidad de la Ciudad de México no cuenta con alguna base de datos que nos permita almacenar y analizar la información obtenida del STC Metro. Por lo que el primer paso y el más importante en el desarrollo de este trabajo fue la recolección de datos, los cuales conforman nuestra Base de datos llamada Mobidas-CDMX (por su acronimo en ingles Mobility Data Bases), cuya finalidad es categorizar cada una de las estaciones que conforman al STC Metro de acuerdo al tipo de riesgo que puedan llegar a representar ante el Covid-19. Esto se realizó mediante el uso de los algoritmos del Aprendizaje maquinal K − medias y la clasificación mediante tablas de decisión. Con cada una de las estaciones categorizadas, el siguiente paso fue el desarrollo de diferentes algoritmos de búsqueda local para la obtención las posibles rutas entre las cuales se pueda seleccionar la mejor ruta, los algoritmos implementados fuerón los siguientes: Algoritmos de búsqueda no informada • BFS Algoritmos de búsqueda informada • UCS • Dijkstra • A* • A*Mejorado Estos Algoritmo nos permitieron la construcción de un ensamble de mezcla de expertos, en el cual mediante algunas reglas de decisión se establece la evaluación de cada una de las rutas mediante el uso del modelo epidemiológico de la viruela de Bernoulli y la formula del movimiento rectilíneo uniforme, dando paso al análisis y selección de las diferentes rutas obtenidas y con ello, obtener la mejor ruta correspondiente a la opción seleccionada por el usuario. El usuario tiene la posibilidad de seleccionar entre dos diferentes opciones para la generación de una ruta, estas son: Ruta que proporcionen al usuario una menor probabilidad de contagio. Ruta que proporcionen al usuario un menor tiempo de traslado. Finalmente con el ensamble de mezcla de expertos, se desarrolló el primer prototipo de la plataforma de movilidad del STC Metro de la Ciudad de México

ALat Pendeteksi, Penghisap dan Penyaring Asap Rokok

Asap Rokok menghasilkan banyak efek negatif saat terhirup masuk kedalam tubuh yang dapat terjadi pada perokok aktif maupun perokok pasif. Pemerintah telah berusaha mengadakan ruangan atau area khusus untuk merokok di area publik tetapi kurang efektif dalam mengurangi masalah asap rokok karena tidak ada kesadaran kedisiplinan perokok aktif saat merokok. Hal ini sangat merugikan bagi perokok pasif yang terpapar asap yang dihasilkan oleh perokok aktif. Oleh karena hal tersebut, dirancang alat yang mampu mendeteksi gas Carbon Monoxide (CO) yang terdapat didalam asap rokok. Alat menggunakan sensor  MQ7 yang mampu mendeteksi gas Carbon Monoxide (CO). Gas CO yang terdeteksi oleh sensor, dalam bentuk data diolah Arduino Nano kedalam satuan ppm untuk mengaktifkan sistem penghisap dan penyaring. Alat melakukan 3 tahap penyaringan yaitu ESP filter, HEPA filter dan Carbon Aktif filter. LED indikator warna hijau menandakan udara bersih dengan nilai = 20 ppm. Alat dapat berfungsi dengan baik, mampu untuk mendeteksi, menghisap, dan menyaring gas CO asap rokok, dengan nilai gas CO sebelum penyaringan ≥ 20 ppm dan nilai gas CO setelah penyaringan 3,1 ppm