Ambulatory Cardiac Monitoring (ACM) is often used to evaluate pregnant patients with palpitations without structural heart disease; however, the diagnostic yield is not well defined. This single-center retrospective cohort study included pregnant patients without structural heart disease evaluated in a tertiary care cardio-obstetrics clinic between June 2023 and June 2024. The primary outcome was the detection of a clinically significant arrhythmia. Secondary outcomes included symptom–rhythm correlation and adverse maternal cardiac, obstetric, and fetal outcomes. Out of 124 patients identified, 49 (40%) completed ACM. Two patients had symptomatic clinically significant arrhythmias detected on ACM, including non-sustained ventricular tachycardia that did not alter management (n = 1), and symptomatic supraventricular tachycardia (SVT) resulting in medical therapy (n = 1). Palpitations occurred during monitoring in 35 of the 49 remaining monitored patients; of those, symptoms correlated with non-significant arrhythmias (premature atrial and ventricular contractions) in 11 (31%). No adverse cardiac events occurred in the remaining patients. Obstetric and fetal outcomes did not differ between monitored and unmonitored patients. In this small single center study, ACM in pregnant patients without structural heart disease has a low diagnostic yield. These findings could be used in shared decision-making for pregnant patients being evaluated for palpitations.
Narrowing the gap between energy demand and supply, while improving the efficiency of energy consumption, has become one of the central sustainability challenges addressed in global policy agendas. Implementing energy management systems in public institutions and organizations is important for achieving this balance. University campuses can be considered small cities, as they serve as living spaces for students. Therefore, since establishing an energy management system is a long-term process, its timely implementation and the creation of an effective system can only be achieved if the students actively using the campus understand and take ownership of the concept. This study explores the role of students as active participants in campus energy management, with a particular focus on integrating the ISO 50001 Energy Management System into higher education environments. A mixed-methods approach was used at Ankara Yıldırım Beyazıt University’s (AYBU) Etlik Campus, combining longitudinal building energy consumption data (2019–2023) with a face-to-face survey of 201 students from nine departments within the Faculty of Engineering and Natural Sciences. The survey assessed students’ knowledge, attitudes, and willingness to participate in energy efficiency and sustainability initiatives. The findings suggest that while students are generally aware of sustainability concepts, their technical familiarity with standards such as ISO 50001 and units such as ton of oil equivalent (TOE) remains limited. Notably, Energy Systems Engineering (ESE) students tended to report higher awareness and stronger support for forming volunteer, student-led energy management units. Based on the findings, student-led energy management units may serve as a participatory mechanism to improve energy-data transparency, strengthen operational energy literacy, and support sustainability-oriented campus practices. This approach offers a repeatable framework for higher education institutions seeking to align operational energy performance with student-led sustainability actions.
The mechanism of prostate cancer (PCa) progression and metastasis remains unclear. Spontaneous cancer cell fusion is one theory of etiology. This essay takes a reductionist approach to highlight spontaneous cancer cell fusion as the primary mechanism of PCa progression and metastasis. PCa cells can fuse with adjacent cancer cells or various bystander cells in the tumor microenvironment. The fate of the fusion hybrids is determined by the similarity of cell cycle timing between the fusing cancer cell and the cell being fused. A tumor cell with high proliferative activity, when fused with a non-proliferating neighbor, results in growth arrest. However, fusion with a proliferative cell may lead to abnormal hybrid cell division, causing the hybrid genome to undergo random recombination. This creates a hybrid derivative clone with a genotype and phenotype distinct from those of both the parental cancer cell and the cell being fused. The progression of tumor cell heterogeneity is dynamic, as the hybrid derivative clone can inherit the ability to fuse. Their fusion with various proliferative cells in the tumor microenvironment generates additional hybrid clones, each with a new genomic makeup and altered phenotype. The spontaneity of PCa cell fusogenicity enables an ever-changing tumor cell heterogeneity, which is the root cause of the pathological behavior of PCa progression and metastasis.
