bluuebunny/crossref_metadata_2025 huggingface dataset:
Reconciliation of Thermodynamic and Mechanical Pressures and Development of a Frequency-Based Formula for Speed of Sound in Gases
Authors: Ogretim Egemen Ol
Published: January 2023

Discrepancy of the thermodynamic and mechanical pressures is a problem at the heart of the current theory of fluid mechanics. The fluid property that leads to this situation is the bulk viscosity, whose effects are zero for incompressible cases and are negligible for most other applications. Therefore, this discrepancy is conventionally ignored in phenomena other than acoustics and shock related ones. However, the flaw in the theory still persists since the late 19th century. In the present study, to improve the existing theory and to come up with a consistent structure in terms of mechanical and thermodynamic pressures, a novel fluid element model is proposed. Unlike the current fluid model that assumes a continuum of fluid, the present model proposes fluid elements that are separated from each other by a thin energy field that manifests itself as the mechanical pressure. Also, unlike the current efforts in explaining bulk viscosity effects through atomic level dynamics, the present model proposes a mesoscale analysis where bulk viscosity is integrated into the fluid element as a damper. Considering all these new features, each fluid element in this new model contains energy in both the wave form and the particle form. Of these two, wave energy is the cause of the thermodynamic pressure. In this manuscript, first, justifications of the mentioned aspects of the new fluid model are given. Then, a speed of sound expression is derived based on the new model involving the bulk viscosity effects. Resultant expression is, then, used for comparison with the findings of previous studies. The proposed formula can also be used to calculate the bulk viscosity of gases at different acoustic frequencies in a way that is more direct than those currently in use.
The Effect of COVID-19 on the Menstrual Cycle of Female Medical Staff: A Cross-sectional Survey in China
Authors: Sun Wenxi , Xia Liping , Ji Caifang , Wei Qianqian , Zhang Jun , He Sidi , Wang Xuqin , Shen Xueqin , Zhang Xiaobin , Li Chuanwei
Published: January 2023

Objective
Coronavirus disease 2019 (COVID-19) can affect women 's health. This study aimed to investigate the association between Menopathy, COVID-19 pandemic-related anxiety, sleep dysfunction and other factors among female medical staff.
Methods
A cross-sectional study was conducted via administrating online questionnaires to female medical staff in China from February to May 2022. The study includes 160 women aged between 18–45 years old. The questionnaires contain sociodemographic characteristics, medical and reproductive history, lifestyle information of participants, Rating Scale for Clinical Manifestation of Menopathy (SCMM), Self-Rating Anxiety Scale (SAS), and Sleep Dysfunction Rating Scale (SDRS). Data were analyzed using chi-square, t-tests, and linear regression analysis.
Results
A total of 160 female medical staff were randomly selected in this research, 7 of whom scored less than 3 points, 85 of whom scored more than 2 points and less than 12 points, and 68 of whom scored more than 11 points on the total score of SCMM. The score of dizziness and tinnitus was significantly higher during than before the COVID-19 pandemic, and scores of its following clinical symptoms of Menopathy: hypaphrodisia, dim complexion, abnormal urination, languidness, dim menstruation, thin menstruation, dysmenorrhea, and empty or saggy lower abdomen (p < 0.05). However, the score of vaginal bleeding quantity was significantly higher before than during the COVID-19 pandemic (p < 0.05). The score of vaginal bleeding quantity of the female medical staff was significantly lower in the cabin hospitals than others, and the same is true for vaginal bleeding duration (all p < 0.05). Besides, the findings of the univariable and multivariable linear regression analysis revealed a link between consistent exercise, the underlying illness, the SDRS score, the SAS score, and the total score of SCMM (p < 0.05).
Conclusions
In this study, we found that menstruation in female health staff was affected by the COVID-19 epidemic, where regular exercise and good physical condition were protective factors, while anxiety and insomnia were risk factors for regular menstruation.
Low Respiratory Quotient Correlates with High Mortality in Patients Undergoing Mechanical Ventilation
Authors: Shinozaki Koichiro , Yu Pey-Jen , Zhou Qiuping , Cassiere Hugh A. , John Stanley , Rolston Daniel M. , Garg Nidhi , Li Timmy , Johnson Jennifer , Saeki Kota , Goto Taiki , Okuma Yu , Miyara Santiago J. , Hayashida Kei , Aoki Tomoaki , Wong Vanessa , Molmenti Ernesto P. , Lampe Joshua , Becker Lance
Published: January 2023

Background
Oxygen consumption (VO2), carbon dioxide generation (VCO2), and respiratory quotient (RQ), which is the ratio of VO2 to VCO2, are critical indicators of human metabolism. To seek a link between the patient’s metabolism and pathophysiology of critical illness, we investigated the correlation of these values with mortality in critical care patients.
Methods
This was a prospective, observational study conducted at a suburban, quaternary care teaching hospital. Age 18 years or older healthy volunteers and patients who underwent mechanical ventilation were enrolled. A high-fidelity automation device, which accuracy is equivalent to the gold standard Douglas Bag technique, was used to measure VO2, VCO2, and RQ at a wide range of fraction of inspired oxygen (FIO2).
Results
We included a total of 21 subjects including 8 post-cardiothoracic surgery patients, 7 intensive care patients, 3 patients from the emergency room, and 3 healthy volunteers. This study included 10 critical care patients, whose metabolic measurements were performed in the ER and ICU, and 6 died. VO2, VCO2, and RQ of survivors were 282 +/- 95 mL/min, 202 +/- 81 mL/min, and 0.70 +/- 0.10, and those of non-survivors were 240 +/- 87 mL/min, 140 +/- 66 mL/min, and 0.57 +/- 0.08 (p = 0.34, p = 0.10, and p < 0.01), respectively. The difference of RQ was statistically significant (p < 0.01) and it remained significant when the subjects with FIO2<0.5 were excluded (p < 0.05).
Conclusions
Low RQ correlated with high mortality, which may potentially indicate a decompensation of the oxygen metabolism in critically ill patients.
Atypical Anti-Glomerular Basement Membrane Nephritis Occurring After SARS-CoV-2 Infection: A Case Report
Authors: Bağdatoğlu Oktay , Karakan Mine Şebnem , Süngü Nuran
Published: January 2023

Background
Atypical anti-glomerular basement membrane (GBM) disease, seronegative anti-GBM disease, is a variant where serum anti-GBM antibodies can not be identified in circulation although GBM is stained by Ig-G on an immunofluorescence microscope. We present a 19-year-old male patient who was previously healthy and developed the atypical anti-GBM disease after a SARS-CoV-2 infection.
Case presentation
The patient, who started to complain of hematuria and hemoptysis on the 3rd day of the negativity of the SARS-CoV-2 infection test, was referred to the hospital on the 15th day. The SerumAnti-GBM antibody of the patient who did not need hemodialysis was negative. Tubulointerstitial nephritis (TIN) was diagnosed in the kidney biopsy of the patient, and corticosteroid therapy was given. However, when the patient's complaints of hematuria and hemoptysis continued, a rebiopsy was performed. A diagnosis of atypical anti-GBM was made after linear IgG staining was detected in the glomerular basement membrane in the pathology of the patient whose serum anti-GBM antibodies were negative. Cyclophosphamide was given to the patient who was under corticosteroid treatment.
Conclusion
Although the classical anti-GBM disease is known to occur after SARS-CoV-2 infection, according to our knowledge, this case is the first case of atypical anti-GBM disease developed after SARS-CoV-2 infection.
Knowledge and Practical Attitudes of Caregivers Regarding Covid-19 at Sikasso Hospital in Mali in 2022
Authors: Sidi Haidara Dadé Ben
Published: January 2023

Background: Since the introduction of the coronavirus in Mali in March 2020, Sikasso Hospital was designated as a management center. The aim of this study was to determine the level of knowledge and practical attitudes of health care providers regarding covid-19.
Method / Results: This was a qualitative cross-sectional study conducted from December 10 to 12, 2020. Our sample was non-randomized for convenience, with 42 caregivers. Direct observation, questionnaire interview techniques were used. Data were analyzed on SPSS 23.0 and Excel 2017 software.
The average age was 42.3 ± 8.1 years; 85.7% of respondents were male versus 14.3% female; This population consisted of 31% Physicians/Pharmacists, 47.6% Nurses and 21.4% support staff.
The majority (69%) had a level of education that allowed them to make appropriate judgments about a health problem. All agents were informed about COVID-19 through the media, the department, their families or friends. The screening rate was 2.56 ‰. The majority of patients were health workers either (16.5%). The change in the status of the hospital as a center for the management of the disease, caused "fear, stress, panic" among the caregivers.
Conclusion: This study allowed us to determine the level of WTP of caregivers in the face of this disease at the hospital level.
Overexcitability and its Impact on Psychosomatic Disorders and the Role of "Cognitive Emotion Regulation" as a Mediating Variable
Authors: Alsaffar Khoula Fahad
Published: January 2023

Background
The current investigation examines TPD's assumption that bright people are overexcitable. The study will also reveal the impact of overexcitability on the degree of psychosomatic disorders among individuals regardless of talent. It was to examine what was assumed by the theory concerning the "amplified neurotic singularity" for the overexcitability and the possibility of improving their ability to be affected by psychological and physical orally. The study will also examine the "indirect influence" of positive and negative Cognitive Emotion Regulation as two mediating variables that control the effect of overexcitability on psychosomatic diseases.
Methodology
The descriptive analytical approach was utilized to test the study's assumptions using the Overexcitability Questionnaire II (OEQII), Cognitive Emotion Regulation Questionnaire (CERQ), and Patient Health Questionnaire PHQ-15 somatization on a sample of 269 students (male and female) (204 female).
Results
The study found that talented and normal pupils differed mainly in intellectual overexcitability (p=.044, 2.021T=). Track analysis demonstrated that emotional overexcitability and imaginative arousal have "direct favorable impacts" on psychosomatic diseases. P= 0.007- Z=2.681. Z=4.929 - P<.001. "Direct positive impacts" are for sensory and intellectual forms, negative effect on positive emotional regulation, direct negative effect for imaginational overexcitability, and positive effect of emotional overexcitability on negative emotional regulation.
Conclusions
Positive and negative emotional regulation as mediators showed no indirect connections between overexcitability and psychosomatic diseases. Considering the results, the study proposes future research on the effect of normal overexcitability on other psychological diseases and characteristics like attachment, social competence, and flexibility.
Delayed Onset of Neonatal Compartment Syndrome Associated with Compound Fetal Presentation
Authors: Manini Nicholas , Unno Hayato
Published: January 2023

Neonatal compartment syndrome, although rare, has a classic presentation with sentinel skin findings and subsequent development of swelling, erythema, and tenderness of the affected extremity. Neonatal compartment syndrome requires prompt surgical intervention to preserve the affected limb and ensure its normal growth and development. Our patient was born at term via vaginal delivery complicated by a compound presentation involving the left upper extremity. No physical exam abnormalities were noted at birth, but she developed signs of neonatal compartment syndrome by 15 hours of life. She was surgically treated at 22 hours of life and recovered well. At one year of age, she has normal growth and function of the affected extremity. Our case adds to the growing literature associating neonatal compartment syndrome with a compound fetal presentation.
Associations between Healthcare Costs and Care Experiences Among Older Adults with and Without Cancer
Authors: Allaire Benjamin , Zabala Diana , Lines Lisa M. , Williams Courtney , Halpern Michael , Mollica Michelle
Published: January 2023

Purpose
Care coordination and patient-provider communication are important for older adults with cancer, as they likely have additional, non-cancer chronic conditions requiring consultation across multiple providers. Suboptimal care coordination and patient-provider communication can lead to costly and preventable adverse outcomes. This study examines Medicare expenditures associated with patient-reported care coordination and patient-provider communication among older adults with and without cancer.
Methods
We explore SEER-CAHPS® linked data for differences in health care expenditures by care coordination and patient-provider communication experiences for beneficiaries with and without cancer. The cancer cohort included beneficiaries with ten prevalent cancer types diagnosed 2011-2019 at least 6 months before completing a CAHPS survey. Medicare expenditures were abstracted from Medicare claims data. Care coordination and patient-provider communication composite scores (range 0-100, higher scores indicate better experiences) were patient-reported in the CAHPS® survey. We estimated expenditure differences per one-point change in composite scores for patients with and without cancer.
Results
Our analysis included 16,778 matched beneficiaries with and without a previously diagnosed cancer (N=33,556). Higher care coordination and patient-provider communication scores were associated with significant reductions in expenditures among beneficiaries with and without cancer in the six months prior to survey response, ranging from $83 (SE=$7) to $90 (SE = $6) per month. Six months post-survey, reductions in expenditures of ranging $88 (SE =$6) to $106 (SE = $8) were found.
Conclusion
We found lower Medicare expenditures associated with higher care coordination and patient-provider communication scores. As the number of survivors living longer both with and beyond their cancer grows, addressing their multifaceted care and improving outcomes will be critical.
Analysis of the Profitability of Smallholder Farmers’ Eucalyptus Woodlot Production System in Wogera District, North Gondar, Ethiopia
Authors: Sete Yordanos , Alemu Asmamaw , Dagnew Abebe
Published: January 2023

Eucalyptus is one of the most planted genera of trees in the world, has been grown in East Africa for over a century. The area of Eucalyptus plantations has expanded greatly and the species dominates many rural and urban landscapes as it suits the limited resources of smallholder farmers, yields higher income than other tree crops and increasing demand for woodlot products. Smallholder farmers at the study area are converting their crop land to Eucalyptus plantation. Therefore there should need to deal the pushing factors and identify which investment was profitable. This study aims at identifying the factors influencing decision of land allocation for woodlot production, estimating the cash flows and profitability of smallholder Eucalyptus woodlot production, comparing profitability of Eucalyptus woodlots with alternative production systems (crop) and identifying the socioeconomic factors that affect profitability. Cross sectional data was collected through semi-structured interview schedule. Data analysis involved descriptive statistics, multiple linear regressions, cost-benefit analysis related to other cereal crops, Faustman model which compute the land expectation value (LEV) and SWOT analysis. The results of the household survey reveal that land degradation and neighbor influence are the main factors for smallholders’ land allocation decision for Eucalyptus plantation. The financial analysis with discounted cash flow shows that the smallholders’ Eucalyptus Woodlot production was more profitable than the alternative crop production. This could be one incentive and driver of crop land conversion to Eucalyptus woodlots. The econometric model also reveals that, age, family size, Eucalyptus plot size, literacy status, livestock holding and contractual agreement are factors that affect profitability significantly. Therefore, the result shows profitability of Eucalyptus at the end of five years is profitable than crop production for five year. Policy should intervene in the separate land management issue (cluster planting) to make aware smallholder farmers to plant either crop or Eucalyptus in appropriate way.
Duration of reproductive period and metabolic syndrome and its components: findings from the Henan Rural Cohort Study in menopausal women
Authors: Du Zhen , Wu Xueyan , Liao Wei , Hu Ze , Yang Jing , Dong Xiaokang , Zhao Hongfei , Liu Xiaotian , Wang Chongjian , Zhao Bing
Published: January 2023

Background
The purpose of this study was to investigate the relationship of duration of reproductive period with metabolic syndrome (MetS) and its components in rural population.
Methods
In all, 14596 menopausal women were enrolled from the Henan Rural Cohort study. Logistic regression and linear regression were used to evaluate the association between duration of reproductive period and MetS and its components (including central obesity, abnormal fasting plasma glucose (FPG), abnormal blood pressure (BP), abnormal triglycerides (TG) and abnormal high-density lipoprotein cholesterol (HDL-C). In addition, the mediation and interaction effects were performed by mediation analyses and generalized linear model.
Results
Each year of increase reproductive period correlated with an increased risk of MetS (OR = 1.031; 95% CI = 1.023–1.039; P < 0.05). This association changed slightly after adjusting for body mass index (BMI) and remained statistically significant (OR (95% CI): 1.012(1.003, 1.021)). A positive association between duration of reproductive period and central obesity, abnormal FPG, abnormal BP, abnormal TG, and abnormal HDL-C were revealed (all P < 0.05). The relationship with abnormal FPG (OR (95% CI): 1.009(1.000, 1.017)) and abnormal TG (OR (95% CI): 1.013(1.005, 1.021)) were attenuated after adjusting for BMI and remained statistically significant except for central obesity, abnormal BP and abnormal HDL-C. In addition, BMI mediated the relationship between duration of reproductive period and MetS and its components. The significant interaction of high fat diet was found in association between duration of reproductive period and MetS (P interaction = 0.011).
Conclusions
The longer duration of reproductive period might raise a woman's risk of MetS and its components. More importantly, the association was largely mediated by BMI. There is an interaction effect between duration of reproductive period and high fat diet on the risk of MetS.
MF-RISE : Benchmarking for Multifaceted Recommender System Engine
Authors: Mali Mahesh , Mishra Dhirendra , Vijayalakshmi M
Published: January 2023

The advent of the information age has led tothe availability of overwhelming choices of products to userswhich create need of various Recommendation Systems (RS). Recommendation System belongs to the methods of InformationRetrieval, Data Mining and Machine Learning algorithms. Multifaceted Recommendation System Engine (MF-RISE) helpthe users to get personalized recommendations, helps users to select correct product from wide range of products using userfeedback, ratings and reviews provided by users.
In real-world scenarios, recommenders have many non-functionalrequirements of technical nature and must handle huge amountdata. Evaluation of Multifaceted Recommendation System Enginemust take these issues into account in order to be producemaximum useful recommendations.
The many researchers have proposed a wide range of recommendationsystems algorithms. This study investigates there are threepopular existing types of recommendation systems algorithms, Collaborative Filtering (CF), Content-Based Filtering (CB), andHybrid Recommendation System. The MovieLens dataset with its3 variants was utilized for the purpose of this study. The studiedevaluation methods consider both quantitative and qualitativeaspects of algorithm with many evaluation parameters like meansquared error (MSE), root mean squared error (RMSE), Test Timeand Fit Time are calculated for each recommender algorithmimplementation. The study identifies the gaps and challengesfaced by every recommender algorithm. This study will alsohelp researchers to propose new recommendation algorithms by overcoming identified research gaps and challenges of existing algorithms.
HLA Identical (Related/Unrelated) Donor Hematopoietic Stem Cell Transplant for Hemoglobinopathies using Pre-transplant Immune Suppression and Post-transplant Cyclophosphamide: Does it Help Consolidate Our Gains?
Authors: Kharya Gaurav , Nirmal Garima , Shankar Ravi , Singh Saksham , Mishra Varsha , Bakane Atish , Sharma Bharti , Joseph Manju , Peters Sherin , Choetso Tsega , Chowdhry Mohit , Yadav Himshikha
Published: January 2023

Awaiting gene therapy, hematopoietic stem cell transplant (HSCT) is only curative treatment for Transfusion Dependent Thalassemia (TDT)/Sickle Cell Disease (SCD). Although conventional myeloablative conditioning (MAB) with calcineurin inhibitor (CNI) based graft-versus-host-disease (GvHD) prophylaxis in HLA identical donors (related/unrelated) (MSD/MRD/MUD) have shown good outcomes but are associated with increased regimen related toxicity (RRT), acute and chronic GvHD especially with use of peripheral blood stem cells (PBSC). We hereby report our experience of using (APOLLO protocol) for HLA identical donor HSCT for TDT/SCD. Thirty-two consecutive patients (TDT-16/SCD-16) were enrolled. Fourteen underwent MUD-HSCT whereas 18 received MSD/MRD. GvHD prophylaxis was with post-transplant cyclophosphamide (PTCY), sirolimus, and mycophenolate mofetil. All tolerated pre-transplant immune-suppression (PTIS) well and proceeded to HSCT. No significant RRT was seen in any of our patients. One patient developed acute grade II/IV GvHD (skin/liver) whereas none of the evaluable patients had chGvHD. Out of 32 evaluable patients at a median follow-up of 249.5 days (range 18–1074), 31 are alive and disease free, making an overall survival (OS) and disease-free survival (DFS) of 96.88 %. APOLLO protocol including PTIS, augmented John Hopkins conditioning and PTCY can safely be extended to HLA identical donors with minimal RRT, acute or chronic GvHD.
AiDHealth: An AI-enabled Digital Health Framework for Connected Health and Personal Health Monitoring
Authors: Memon Mukhtiar , Abbasi Suhni , Rahu Ghulam Ali , Magsi Habibullah
Published: January 2023

We live in a digitally connected world inspired by state-of-the-art ICT technologies and networks, inasmuch as the use of digital gadgets and apps is exponentially increasing in all domains of life. In parallel, artificial intelligence has evolved as an essential tool in all sorts of applications and systems such as healthcare systems. Healthcare is the key domain where the use of ICT infrastructure, technologies and artificial intelligence are playing a major role in providing connected and personalized digital health experiences. The vision is to provide intelligent and customized digital health solutions and involve the masses in personal health monitoring. This research proposes AiDHealth as an intelligent personal health monitoring framework based on artificial intelligence for healthcare data analytics and connectivity for personal health monitoring. AiDHealth relies on various machine learning and deep learning models for achieving prediction accuracy in healthcare data analytics. The extensive Pima Indian Diabetes (PID) dataset has been used for investigation. The findings of our experiments illustrate the effectiveness and suitability of the suggested MLPD model. AdaBoost classifier performance has the highest accuracy in prediction when calculated to the individual classifiers. The AdaBoost classifier produced the best accuracy i.e., 0.975%. The results reveal improvements to state-of-the-art procedures in the proposed model. Next, we trained the models and produced a 10-fold cross-validation illness risk index for each sample. Our findings suggest a need for greater experiments to compare the above-mentioned machine learning methods. We identified the AdaBoost classifier and Decision Tree classifiers with the best prediction with an average of 0.975% and a work Curve Area (AUC) of 0.994%. Thus, because the design of the AdaBoost classifier is superior, it can forecast the danger of type 2 diabetes more accurately than the existing algorithms and lead to intelligent prevention and control of diabetes.
Magnitude of Visual Impairment and associated factors among primary School Children of Ambo Town, West Shoa Zone, Oromia Region, Ethiopia,2021
Authors: Legese Nigist , Abdissa Bayisa , Begna Zenabu , Lemma Dereje
Published: January 2023

Background
Visual impairment is a functional limitation of the eye(s) or the visual system manifested as reduced visual acuity. Approximately 91 million children are estimated to be visually impaired worldwide and 90% of people with visual impairment have either preventable or treatable cause with cost- effective intervention.
Objectives
To assess the magnitude of visual impairment and associated factors among primary school children of Ambo Town, West Shoa Zone, Oromia Region, Ethiopia, 2021.
Methods
School-based cross-sectional study was conducted in the selected primary school of Ambo town. Simple random sampling was used to select schools and study participants. Data were collected using an interviewer-administered structured questionnaire. Data were entered in to Epidata version 3.1 and analyzed by using SPSS version 23. AOR with 95% CI at p-value < 0.05 in multivariable binary logistic regression analysis factors were identified as having statistically significant association with the visual impairment. The Hosmer-Lemeshow goodness of fit test was used to assess the fitness of the final model and the model is fit at p-value of 0.48.
Results
A total of 838 primary school children were enrolled to the study giving response rate of 93.07%. The magnitude of visual impairment was 69 (8.8%; 95%CI: 6.81–10.79). Refractive error was the main cause of the impairment in 46 (54.76%) students. Grade level of student (AOR = 2.375 95%CI: 1.079–5.226), Mobile exposure (AOR = 2.44 CI: 1.401–5.01), awareness of child eye problem (4.503 95%CI; 2.12–9.55) and family history (AOR = 2.41 95%CI; 1.071–5.42) were variables significantly associated with visual impairment among primary school children of Ambo Town.
Conclusion
Magnitude of visual impairment is high among school children of Ambo primary schools. High grade level, mobile exposure, awareness of child eye problem and family history were variables significantly associated with visual impairment.
Aortic Arch-clamping Technique in Total Arch Replacement and Frozen Elephant Trunk for Acute Type A Aortic Dissection
Authors: Luo Cheng , Jia Bo , Zhong Yongliang , Wang Chuan , Li Chengnan , Qiao Zhiyu , Hu Haiou , Ge Yipeng , Sun Lizhong , Zhu Junming
Published: January 2023

OBJECTIVES
Moderate hypothermic circulatory arrest (MHCA) with selective antegrade cerebral perfusion (SACP) is safe and efficient in total arch replacement and frozen elephant trunk (TAR and FET) for acute type A aortic dissection (ATAAD). But complications related to hypothermia and ischemia are inevitable. The aortic Arch-clamping technique is performed to elevate the lowest nasopharyngeal temperature to 28℃ and shorten the circulatory arrest time. The aim is to evaluate the efficacy of this new technique.
METHODS
From December 2019 to May 2022, the clinical data of patients with ATAAD who underwent TAR and FET was reviewed, including Arch-clamping in 54 cases and MHCA/SACP in 149 cases.
RESULTS
Circulatory arrest time was significantly decreased in the aortic Arch-clamping group (4.09 ± 1.696 min vs. 23.94 ± 6.738 min, P < 0.001). The composite endpoint was comparable in the two groups (24.1% for Arch-clamping group vs. 28.9% for MHCA/SACP, P = 0.503). In the Arch-clamping group, fewer patients developed high-grade acute kidney injury (AKI) according to a modified RIFLE criterion (14.9% vs. 46.9%, P = 0.022), and the hepatic dysfunction occurrence was decreased (7.4% vs. 22.8%, P = 0.013). Multivariable logistic analysis showed that the Arch-clamping technique is a protective factor for hepatic dysfunction (OR, 0.271; 95% CI, 0.091–0.803; p = 0.019), and Grade II & III AKI (OR, 0.393; 95% CI, 0.164–0.944; p = 0.037).
CONCLUSIONS
Arch-clamping technique shortens the circulatory arrest time significantly in TAR and FET. Available clinical data suggested that it has a certain protective effect on systemic organs and promotes postoperative recovery. Future large-sample studies are warranted to thoroughly examine this new technique.
Mixed chimaerism is associated with poorer long-term failure-free survival among aplastic anaemia patients receiving HLA-matched donor transplantation
Authors: Huang Xiao-Jun , Xu Zheng-Li , Xu Lan-Ping , Zhang Yuan-Yuan , Yifei Cheng , Mo Xiao-Dong , Han Tingting , Wang Feng-Rong , Yan Chen-Hua , Sun Yu-Qian , Chen Yuhong , Tang Fei-Fei , han wei , Wang Yu , Zhang Xiao-hui , Liu Kaiyan
Published: January 2023

The aim of this study was to evaluate the adverse effects of mixed chimaerism (MC) on survival outcomes and to assess the ability of different factors to predict MC in severe aplastic anaemia (SAA) patients after HLA-matched donor transplantation. A retrospective study was conducted in 103 consecutive SAA patients who received matched related (MRD) or unrelated donor (MUD) transplantation. The cumulative incidences of mixed chimaerism were 17.8 ± 0.2% and 25.0 ± 0.8% in the MRD and MUD cohorts, respectively (P = 0.432). Patients with mixed chimaerism had significantly poorer 10-year failure-free survival (FFS) than those with donor chimaerism (35.0% vs. 87.0%, P < 0.001). A multivariable model identified independent adverse predictors of mixed chimaerism, including patient age and ferritin level at transplantation. The incidences of mixed chimaerism were 62.5%, 30.8% and 5.4% in the high- (2 factors), intermediate- (1 factor) and low-risk (0 factor) groups, respectively (P < 0.001). The corresponding FFS rates were 37.5%, 75.3% and 83.6%, respectively (P = 0.018), at the final follow-up. Therefore, patients with mixed chimaerism suffered poorer long-term FFS, and patients with high-risk scores will be more likely to develop mixed chimaerism. Thus, more intensive conditioning might be recommended for these high-risk patients.
Point of care gastric ultrasound to predict aspiration in patients undergoing urgent endotracheal intubation in the emergency medicine department.
Authors: Asokan Reshma , Bhardwaj Bharat Bhushan , Agrawal Naman , Chauhan Udit , Pillai Aadya , Shankar Takshak , Lalneiruol D. J , Baid Himanshi , Chawang Hannah , Patel Sanket Mukeshkumar
Published: January 2023

Background:
One significant cause of morbidity and mortality in patients undergoing endotracheal intubation is the aspiration of gastric contents. Its prevalence is more in the emergency than in elective settings. Point-of-care gastric ultrasound (GUS) is a non-invasive bedside ultrasonogram that provides both qualitative and quantitative information about the stomach contents. The diagnostic accuracy of GUS in terms of gastric parameters (measured antral diameters, antral cross-sectional area, and calculated gastric volume) to predict aspiration is yet unknown. We aim to determine this in the patients undergoing urgent emergency intubation (UEI) in the emergency department.
Methodology:
A prospective observational study was conducted at the emergency department of a tertiary healthcare center in India. Patients requiring UEI were identified and a bedside gastric ultrasound was done in the right lateral decubitus position using low frequency curved array probe. The qualitative data and the antral diameters (anteroposterior and craniocaudal) were assessed. The patient's clinical parameters and history regarding the last meal were noted. The cross-sectional area of gastric antrum was calculated using CSA = (AP×CC) π/4. The gastric volume is estimated using Perla's formula: GV = 27.0 + 14.6(RLD CSA) − 1.28(age).
Results:
A hundred patients requiring urgent endotracheal intubation were enrolled in the study. Visible aspiration was more in participants with a distended gastric status (χ2 = 16.880, p = < 0.001). The median gastric volume in the patients who aspirated was 146.37mL, and it ranged from 111.59mL-201.01mL. Using ROC analysis, a cut-off of CC diameter ≥ 2.35cm (sensitivity 88%, specificity 91%) and AP diameter ≥ 5.15cm (sensitivity 88%, specificity 87%) predicts aspiration. A calculated USG CSA cut-off ≥ 9.27cm² (sensitivity 100%, specificity 87%) and an USG gastric volume ≥ 111.594mL (sensitivity 100%, a specificity 92%) predicts aspiration.
Conclusion:
Point-of-care gastric ultrasound is an useful non-invasive bedside tool for risk stratification for aspiration in busy emergency rooms. We present threshold gastric antral parameters that can be used to predict aspiration along with its diagnostic accuracy. This can help the treating ED physician take adequate precautions, decide on intubation techniques and treatment modifications to aid in better patient management.
Exploration of symptom clusters during hemodialysis and symptom network analysis of older maintenance hemodialysis patients: a cross-sectional study
Authors: Zhou Mingyao , Gu Xiaoxin , Cheng Kangyao , Wang Yin , Zhang Nina
Published: January 2023

Background
Symptom networks can provide empirical evidence for the development of personalized and precise symptom management strategies. However, few studies have established networks of symptoms experienced by older patients on maintenance hemodialysis. To examine the type of symptom clusters of older maintenance hemodialysis patients during dialysis and construct a symptom network to understand the symptom characteristics of this population.
Methods
The modified Dialysis Symptom Index was used for a cross-sectional survey. Network analysis was used to analyze the symptom network density and node characteristics, and factor analysis was used to examine symptom clusters.
Results
The symptom burdens with the highest scores were dry skin, dry mouth, itching, and trouble staying asleep. Five symptom clusters were obtained from exploratory factor analysis, of which the clusters with the most severe symptom burdens were the gastrointestinal discomfort symptom cluster, sleep disorder symptom cluster, skin discomfort symptom cluster, and mood symptom cluster. Based on centrality markers, it could be seen the feeling nervous and trouble staying asleep had the highest strength, and feeling nervous and feeling irritable had the highest closeness and betweenness.
Conclusions
Hemodialysis patients have a severe symptom burden and multiple symptom clusters. Dry skin, itching, and dry mouth are sentinel symptoms in the network model; feeling nervous, feeling irritable, and trouble staying asleep are core symptoms of patients; feeling nervous and feeling irritable are bridge symptoms in this symptom network model. Clinical staff can formulate precise and efficient symptom management protocols for patients by using the synergistic effects of symptoms in the symptom clusters based on sentinel symptoms, core symptoms, and bridge symptoms.
Assessment of Professional Identity Formation: A Transcultural Validation of the Professional Identity Essay for Brazilian Portuguese
Authors: Silveira Gabrielle Leite , Monson Verna , Poço Paula Cristina , Haydar Ahmed , Brenelli Sigisfredo Luis , Succi Fabiana Moreira Passos , Succi Guilherme de Menezes , Martins Milton de Arruda , Tempski Patrícia Zen
Published: January 2023

Introduction Professional identity formation (PIF) is recognized worldwide as an outcome of medical education grounded in the psychology of adult development and the literature on medical professionalism. However, instruments to assess and support PIF are scarce. The Professional Identity Essay (PIE) is an open-ended question assessment of PIF that elicits short narrative responses from learners and that can be analyzed to provide formative feedback and an overall stage of development. In this study, our aim was to translate and adapt the PIE to Brazilian Portuguese. Methods We followed a systematic procedure for the translation and cross-cultural adaptation of the instrument. A pilot study was conducted with medical students from the University of São Paulo. After providing individual formative feedback, we administered an online questionnaire to the Brazilian students to better understand the consequences of using the PIE. Content analyses of qualitative data were performed. Results Students found the instrument’s questions easy to interpret and self-reflective. It also gave students the opportunity to consider their PIF. The PIE was perceived as reliable and brought more awareness of the students’ own processes in addition to a sense of capability to foster their own development. In the same way, the students emphasized the importance of being helped in this process. Conclusion We found sufficient evidence of the validity of the PIE in terms of content, face validity, and consequences of use. The PIE enhances self-assurance in PIF through formative assessment and is sensitive to different cultures, making it a potential tool for educators.
A New Bin Size Index Method for Statistical Analysis of Multimodal Datasets from Materials Characterization
Authors: Jiang Tao , Luo Shengmin , Li Yucheng , Wu Yongkang , He Li , Zhang Guoping
Published: January 2023

This paper presents a normalized standard error-based statistical data binning method, termed “bin size index” (BSI), which yields an optimized, objective bin size for constructing a rational histogram to facilitate subsequent deconvolution of multimodal datasets from materials characterization and hence the determination of the underlying probability density functions. Totally 10 datasets, including 4 normally-distributed synthetic ones, 3 normally-distributed ones on the elasticity of rocks obtained by statistical nanoindentation, and 3 lognormally-distributed ones on the particle size distributions of flocculated clay suspensions, were used to illustrate the BSI’s concepts and algorithms. While results from the synthetic datasets prove the method’s accuracy and effectiveness, analyses of other real datasets from materials characterization and measurement further demonstrate its rationale, performance, and applicability to practical problems. The BSI method also enables determination of the number of modes via the comparative evaluation of the errors returned from different trial bin sizes. The accuracy and performance of the BSI method are further compared with other widely used binning methods, and the former yields the highest BSI and smallest normalized standard error. The advantages and disadvantages of the new method are also discussed.
A Novel Hybrid Multi-Verse Optimizer with Sine Cosine Algorithm for Global Optimization
Authors: PHAM VU HONG SON , DANG NGHIEP TRINH NGUYEN
Published: January 2023

MVO (multi-verse optimizer) and SCA (sine cosine algorithm) are stochastic optimization algorithms used in many scientific fields. SCA is a simple optimization algorithm that can exploit the search area and smoothly shift from exploration to exploitation. The SCA's undetermined search area exploitation mechanism results in simple local optimization. Moreover, MVO provides good exploration of the search area through the mechanisms of roulette wheel selection through white and black hole tunnels. SCA and MVO both fail to balance the exploration and exploitation mechanisms of the search area; furthermore, MVO is limited in its exploitation of the search area. This paper provides a hybrid algorithm (hMVO) between MVO and SCA to optimize the exploration and exploitation of the search area based on the advantages of each algorithm. Twenty-three test functions were used to evaluate the algorithm's optimality. The results indicate that the hMVO is competitive with the MVO, SCA, ant lion optimization (ALO), and the dragonfly algorithm (DA); this algorithm can also be applied to solve the discrete time–cost trade-off problem, demonstrating its stability and potential for global optimization.
CD16 CAR-T cells Enhance Antitumor Activity of CpG ODN-Loaded Nanoparticle-Adjuvanted Tumor Antigen-Derived Vaccine Via ADCC Approach
Authors: Zhang Xiaofei , Hu Qin , He Xuesong , Cui Xinyue , Liang Zhaoyan , Wang Li , Deng Xiongwei , Zhang Ze , Sheng Wang , Han Xiaodong D.
Published: January 2023

Background: Combinatorial immunotherapy strategies for enhancing the responsiveness of immune system have shown great promise for cancer therapy. Engineered nanoformulation incorporated toll-like receptor (TLR) 9 agonist CpG ODN has shown more positive results in suppressing tumor growth and can significantly enhance other immunotherapy activity with combinatorial effects due to the innate and adaptive immunostimulatory effects of CpG.
Results: In the present work, protamine sulfate (PS) and carboxymethyl β-glucan (CMG) were used as nanomaterials to form nanoparticles through a self-assembly approach for CpG ODN encapsulation to generate CpG ODN-loaded nano-adjuvant (CNPs), which was subsequently mixed with the mixture of mouse melanoma-derived antigens of tumor cell lysates (TCL) and neoantigens to develop vaccine for anti-tumor immunotherapy. The obtained results showed that CNPs was able to effectively deliver CpG ODN into murine bone marrow-derived dendritic cells (DC) in vitro, and remarkably stimulate the maturation of DC cells with proinflammatory cytokine secretion. In addition, in vivo analysis showed that CNPs enhanced anti-tumor activity of PD1 antibody and CNPs-adjuvanted vaccine based on the mixture antigens of melanoma TCL and melanoma-specific neoantigen could not only induce anti-melanoma cellular immune responses, but also elicit melanoma specific humoral immune responses, which significantly inhibited xenograft tumor growth. Furthermore, CD16 CAR-T cells were generated by expressing CD16-CAR in CD3+CD8+ murine T cells.
Conclusion: Our results eventually showed that anti-melanoma antibodies induced by CNPs-adjuvanted TCL vaccines were able to collaborate with CD16-CAR-T cells to generate an enhanced targeted anti-tumor effects through ADCC (antibody dependent cell cytotoxicity) approach. CD16 CAR-T cells has thus a great potential to be an universal promising strategy targeting on solid tumor synergistic immunotherapy via co-operation with TCL-based vaccine.
Efficient Distributed Dynamic Power Allocation and Beam-Forming In Underlay Cognitive Radio Networks
Authors: S PRABHAVATHI , v Saminadan
Published: January 2023

This paper explores an energy efficient spectrum allocation to unlicensed cognitive users with licensed primary users by a novel Distributed Dynamic Power Allocation (DDPA) and beam forming strategy in the multi user downlink Multiple Input Multiple Output (MIMO) underlay cognitive radio network with multi-objective constraints. Here the primary goal is to maximize total cognitive users' spectrum and energy efficiency while maintaining the intrusion power limit on primary networks under pre-defined thresholds with improved Quality of Communication (QoC). We proposed our resource allocation algorithm using dynamic optimization with enhanced reliability. The evaluation of the proposed system's performance of optimal approach is accessed and simulated with the Power Based Pricing Algorithm (PBPA) and Fractional Transmit Power Algorithm (FTPA).
Evaluation of organ dose using size-specific dose estimation (SSDE) and related cancer risk of chest CT scan during the COVID-19 pandemic
Authors: Robatjazi Mostafa , Moayed Mahdis , Baghani Hamid Reza , Molazadeh Mikaeil , Shomoossi Nematullah
Published: January 2023

This study aimed to estimate the individual patient’s lung and breast dose using the SSDE method as well as the effective dose in patients who underwent chest CT scans during the COVID-19 pandemic. The cancer risk incidence was estimated using excess relative risk (ERR), excess absolute risk (EAR), and lifetime attributable risk (LAR) models of biological effects of ionizing radiation report VII (BEIR-VII). The information of about 570 patients who underwent CT scans for COVID-19 screening was used for this study. Using the header of the CT images in a python script, SSDE and effective dose were calculated for each patient. The SSDE obtained by water equivalent effective diameter (wSSDE) was considered as lung and breast dose, and applied in organ-specific cancer risk estimation. The mean value of wSSDE for females (13.26 mGy) was a bit higher than the wSSDE value for males (13.08 mGy) but it was not statistically significant (P-value = 0.41). There was no significant difference in the calculated EAR, and ERR for lung cancer between males and females at the attained age of 5, and 30 years after exposure (P-value = 0.47, 0.46 respectively). There was no significant difference between lung cancer LAR values for females and males (0.48). The results also showed a decrease in the LAR values for both lung and breast cancers by increasing the exposure age. By considering the ALARA (as low as reasonably achievable) principle, the medical staff and the public should take the benefits of CT imaging in the detection of such infections. Besides, imaging medical physicists and CT scan experts have to optimize the imaging protocols and balance the image quality for detecting abnormalities versus the radiation dose based on the ALARA principle.
Mixed modeling of the effect of pharmaceutical pollution on the metamorphosis of amphibians from incomplete trajectory data
Authors: Ibrahimi Eliana , Miri Fundime , Porreca Annamaria , Aliko Valbona
Published: January 2023

In this paper, we aim to evaluate the potential of mixed models in assessing the impact of ibuprofen, fluoxetine, and a mix of them, on the Gosner stage development of Bufo bufo tadpoles, using incomplete trajectory data. We consider the mixed effects models as a good choice to deal with missing data, the within-subject correlations over time, and the feasibility to model time as a continuous covariate. We fitted several models with different random and fixed effects structures and compared them using the Likelihood Ratio (LR) test and Akaike Information Criteria (AIC). Influential analysis and multiple imputation are also performed to check the stability of the results. Mixed-effects models successfully modeled the Gosner stage incomplete longitudinal trajectories. Based on all fitted models, a significant difference in the evolution of the Gosner stage is observed between the group treated with a mix of pharmaceuticals and the other three groups (i.e., ibuprofen, fluoxetine, control).