bluuebunny/crossref_metadata_2025 huggingface dataset:
Traditional Chinese medicine for male sexual dysfunction and the risk of major adverse cardiovascular events: A population-based retrospective cohort study
Authors: Yang Wen-Chieh , Lin Heng-Jun
Published: July 2024

The study investigates the association between traditional Chinese medicine (TCM) use for male sexual dysfunction (SD) and the risk of major adverse cardiovascular events (MACE). Using data from Taiwan's National Health Insurance Research Database from 2001 to 2018, the study includes a random sample of 2 million individuals. Male patients aged 20–70 with newly diagnosed SD were classified as TCM users or non-TCM users. The risk of MACE was evaluated using Cox proportional hazards regression and Kaplan-Meier methods. Results show that among the 144 114 TCM users without SD and 144 114 non-TCM users without SD, TCM users exhibited a higher MACE incidence (9.93 vs. 9.08 per 1 000 person-years, adjusted hazard ratio [aHR]: 1.07). Among male patients with SD (n = 4 959) with otherwise similar baseline characteristics, the association between TCM use and an increased risk of MACE (aHR:1.23) appeared to be related to the presence of SD, particularly organic SD (aHR:1.24). In the TCM group, most MACE cases occurred in males over 40 years old. Individuals using selective serotonin reuptake inhibitors (SSRIs) and those with comorbidities such as hypertension, prostate issues, anxiety, and hyperlipidemia were more prone to MACE. The conclusion suggests that male patients with SD using TCM may encounter an increased risk of MACE. TCM practitioners should be cautious when prescribing Chinese herbal medicine (CHM) for male SD patients, considering potential cardiovascular risks.
Comparison of robotic and laparoscopic approaches in short- and long-term outcomes of lateral pelvic lymph node dissection for advanced rectal cancer: a Japanese multicenter study
Authors: Ishii Mitsutoshi , Tominaga Tetsuro , Nonaka Takashi , Takamura Yuma , Oishi Kaido , Hashimoto Shintaro , Shiraishi Toshio , Noda Keisuke , Ono Rika , Hisanaga Makoto , Takeshita Hiroaki , Fukuoka Hidetoshi , Oyama Shosaburo , Sawai Terumitsu , Matsumoto Keitaro
Published: July 2024

Background
Lateral pelvic lymph node dissection (LPND) is a challenging surgical technique with complex anatomy and narrow pelvic manipulation. The outcomes of robotic and laparoscopic surgery for LPND are still unclear.
Methods
We retrospectively reviewed 169 consecutive patients who underwent rectal cancer surgery with LPND between 2016 to 2023. Patients were divided into two groups according to whether LPND was performed by robotic surgery (R group, n = 40) or laparoscopic surgery (L group, n = 129). Clinicopathological feature and outcomes were compared between groups.
Results
Frequency of surgery with combined resection of adjacent structures (5.0% vs 19.4%, p = 0.023), frequency of patients with distant metastasis (5.0% vs 19.4%, p = 0.028), and estimated blood loss from bilateral LPND (74 mL vs 132 mL, p = 0.013) were all lower in the R group than in the L group. Type of surgical approach did not correlate with postoperative complications. Median follow-up was 31.0 months (range, 1.0–69.0 months). No patients in the R group experienced local recurrence, compared to 4.6% in the L group. Multivariate analysis revealed laparoscopic surgery (odds ratio 3.687, 95% confidence interval 1.505–6.033; p = 0.004) as an independent predictor of poor relapse-free survival.
Conclusions
Robotic surgery for LPND appears to have good prognostic value in some, but not all, oncologic cases. However, large prospective studies are desirable to validate these findings.
“It was time I could have spent better.” – the Barriers, Enablers and Recommendations for Improving Access to Financial Aid when a Child has Cancer
Authors: Lim Megumi , Cashion Christine , Senanayake Sameera , Cramb Susanna , Kularatna Sanjeewa , Bradford Natalie
Published: July 2024

Purpose
A child’s cancer diagnosis imposes both short-term and long-term stress on families. This study aimed to explore (1) the barriers and enablers in alleviating the financial impacts of a child’s cancer diagnosis and treatment, and (2) areas for improvement in financial aid as suggested by stakeholders.
Method
This qualitative study utilised semi-structured interviews with five hospital social work team members, three charity representatives, and eight parents of children treated for cancer. The interviews, which were conducted between April 2023 and January 2024, were analysed using content analysis with an inductive-deductive approach supported by Nvivo Software.
Results
Barriers to mitigating financial impacts included administrative difficulties (e.g., paperwork complexities, strict eligibility criteria, and limited support), community and psychosocial factors (e.g., cognitive burden, social and societal factors), and navigational issues (e.g., poor communication, fragmented support systems). Enablers included streamlined administrative processes, assistance with navigating and applying for financial aid, and community support for emotional refuge and respite. Suggested improvements included simplified application forms, offering automatic provision for certain financial aids upon diagnosis, providing infrastructure to support application processes, reallocating funds to increase navigator roles, providing tailored information through a centralised platform, and facilitating connections to parent support groups.
Implications for Cancer Survivors
The financial stress stemming from the uncertainty of a child’s cancer diagnosis can be overwhelming. Current support systems fall short in effectively mitigating this stress. This research provides empirical evidence for policy changes to enhance support for families, which is crucial to alleviate the multifaceted challenges they face.
Appropriate cardiopulmonary resuscitation duration and predictors of return of spontaneous circulation in traumatic cardiac arrest
Authors: Seo Dongmin , Heo Inhae , Jung Kyoungwon , Jung Hohyung
Published: July 2024

Purpose
Current evidence regarding appropriate durations of cardiopulmonary resuscitation (CPR) and life-saving procedures during traumatic cardiac arrest (TCA) remains debatable. Accordingly, we aimed to identify factors associated with the return of spontaneous circulation (ROSC) and appropriate CPR durations to achieve ROSC in patients with TCA.
Methods
We conducted a retrospective observational study using a single-centre trauma registry of adult patients with TCA between January 2021 and December 2023. Univariate analysis was conducted to identify differences in baseline and outcome variables between ROSC and no-ROSC groups, while multivariable logistic regression analysis identified factors independently associated with ROSC. We determined appropriate cutoffs for pre-hospital and total CPR duration for ROSC, i.e., CPR durations with maximum sensitivity and specificity for ROSC.
Results
Of the 422 patients with TCA included, 250 were eligible for analysis. ROSC occurred in 22.4% (n = 56) of patients, while trauma bay/emergency department and in-hospital mortalities occurred in 80.8% (n = 202) and 97.2% (n = 243), respectively. ROSC-related factors included alert mental status in the field, as indicated by a verbal response (odds ratio [OR], 0.07; 95% confidence interval [CI], 0.01–1.12; p = 0.06), pain response (OR, 0.03; 95% CI, 0.01–0.43; p = 0.009), and unresponsive (OR, 0.04; 95% CI, 0.01–0.44; p = 0.009), as well as non-asystolic initial rhythms, including pulseless electrical activity (OR, 4.26; 95% CI, 1.92–9.46; p < 0.001), shockable rhythm (OR, 14.26; 95% CI, 1.44–141.54; p = 0.023), pre-hospital CPR duration (OR, 0.90; 95% CI, 0.85–0.95), and total CPR duration (OR, 0.88; 95% CI, 0.84–0.92; p < 0.001). Upper limits of pre-hospital and total CPR durations for achieving a probability of ROSC < 1% were 23 and 30 min, respectively, while those for a cumulative portion of ROSC > 99% were 27 and 38 min, respectively.
Conclusions
CPR duration is independently and inversely associated with ROSC. To achieve ROSC, crucial time thresholds for pre-hospital and total CPR durations are 23–27 and 30–38 min, respectively. An alert mental status in the field and a non-asystolic initial cardiac rhythm are positive predictors of ROSC.
Study of triaxial loading of segregated granular assemblies through experiments and DEM simulations
Authors: Pola Venkata Rama Manoj , Annabattula Ratna Kumar
Published: July 2024

A simple position-dependent body force-based confinement for simulating triaxial tests using the Discrete Element Method is presented. The said method is used to perform triaxial simulations on mono-disperse and segregated assemblies of glass spheres. The macroscopic load response obtained in simulations is validated with experimental load response. A mesh construction algorithm is presented to check whether the confinement applied in the triaxial simulations is accurate. The particle displacement data obtained from triaxial simulations are used to obtain a particle-wise average strain tensor. This is further used to compare the strain localisation between the mono-disperse and segregated assemblies. It is observed that, in the segregated assembly, the interface between the two particle phases acts as a barrier for strain localisation, and the smaller particles preferentially undergo a higher degree of shear strain on average.
EEG microstates as an important marker of depression: A systematic review and meta-analysis
Authors: Zhang Si , Chi Ai-ping , Gao Li-quan
Published: July 2024

This study conducts a literature search through databases such as PubMed, Web of Science, CNKI (China National Knowledge Infrastructure), and the Cochrane Library to collect case-control studies on microstates in patients with depression. Conducting bias risk assessment using Review Manager 5.4, and meta-analysis is performed using Stata 18.0 and Stata 14.0 software. This study has been registered with Prospero, CRD42024543793. Our research results suggest that the increased duration and frequency of microstate A may serve as a potential biomarker for depression. An increase parameter in microstate B is also observed when individuals experience anxiety. The duration and coverage of microstate C are closely related to rumination levels. Abnormalities in microstate D among some patients with depression may indicate the presence of comorbid conditions such as overlapping mental disorders or attention and executive function deficits. This study provides important insights into identifying the symptoms and etiology of depression by examining differences in microstates between patients with depression and healthy individuals.
Perinatal depressive symptoms: Five aspects of stability
Authors: Li Yiran , Lu Yane , Wu Liuliu , Mao Fangxiang , Zhang Xuan
Published: July 2024

Objective: This conceptualized and examined five types of symptom stability: (a) form, (b) prevalence, (c) relative to the group, (d) relative to oneself, and (e) within-person changes.
Method: Pregnant women were recruited from outpatient centers of two comprehensive tertiary hospitals in Shandong Province (n = 465). The Edinburgh Postnatal Depression Scale (EPDS) was used to assess perinatal depressive symptoms at six time points: the first, second, and third trimesters and 42 days, three months, and six months postpartum.
Results: Symptoms of anxious depression were the most frequent and important to the depression construct during the perinatal period. Across pregnancy, four subtypes of depressive symptoms were identified, with a greater prevalence of depressive symptoms during the second and third trimesters than during the first trimester. Three subtypes of depressive symptoms were identified after delivery, with a higher prevalence at 42 days than that at three and six months. In addition, the depression construct became more coherent, there was an increase in stability relative to oneself and others, along with an increase in within-person stability.
Conclusion: The postpartum period is particularly vulnerable. Early interventions to prevent persistent or increased depressive symptoms during the perinatal period may prove promising.
Localised Astrocyte Ca2+ Activity Regulate Neurovascular Coupling Responses to Active Sensing.
Authors: Lind Barbara , Stelzner Jakob , Krogsgaard Aske , Kulkoviene Gabriele , Sperling Leonora
Published: July 2024

Neurovascular coupling (NVC) ensures sufficient and targeted blood flow during increased neuronal activity. Astrocytic participation in NVC has long been debated, likely due to the intricacy of the intracellular Ca2+ fluxes and the diversity of their regulatory capacities. As astrocyte signaling changes with brain states, we focused on their involvement in voluntary sensing in freely behaving mice. We used 2-photon microscopy to record cellular and vascular activity in the whisker barrel cortex of awake head-fixed animals. The NVC initiated by volitional whisking in the resting mouse was compared to the whisking preceding locomotion and experimenter-evoked whisker deflections. We developed an analysis method to detect early, subcellular astrocytic activity and found it corresponded with neuronal and vascular responses under all three conditions. After the depletion of noradrenaline (NA), the early astrocytic Ca2+ response to volitional whisking was only moderately reduced and primarily in astrocytic processes closest to the blood vessels. Meanwhile, the dilation of 1st order capillaries was also reduced. Together, these findings demonstrate significant disruptions in the focal regulation of cerebral blood flow, potentially limiting the sustenance of activated neurons. This disruption appeared to translate into behavioral aberrations, as NA-depleted mice exhibited an extended period of exploratory whisking prior to locomotion. Remarkably, NA-depletion did not alter cellular or blood flow responses to locomotion or experimenter-evoked whisking. Our study confirms an astrocytic contribution to NVC, which is relevant during volitional sensing. It also suggests that self-directed sensory processing depends on an appropriate NVC response, which itself depends on NA and astrocyte activity.
Artificial Intelligence (AI) Powered Detection and Identification of Pressure Vessel External Damage – YOLO-based Application
Authors: Seddik E. , Hewieg M. , Afify R.
Published: July 2024

Regular visual inspections of pressure vessels by qualified inspectors are vital in the oil and gas industry to ensure vessel integrity, prevent catastrophic failures, and avoid the consequences of misdiagnosis. In the present paper, a deep learning (DL) model is proposed to perform visual inspection of pressure vessels using the You Only Look Once (YOLO) v8 model. Initially, binary classification is developed to diagnose whether the pressure vessel's exterior shell is in excellent condition or includes damage using a training dataset of 5000 real shell surface on-site images from the Abu Madi gas field of the PETROBEL Company, Egypt. An additional model was trained on the same dataset of binary model for multi-class identification of external damages (i.e. corrosion, painting damage, mechanical damage, or brittle fracture). Three models were compared; namely YOLO v5, YOLO v8, and YOLO v9. The highest performance model was YOLO v8. Its detection accuracy reached 93% and 91.5% for binary classification and multi-class classification models, respectively. Implementing this solution in the inspection process will result in a cost reduction since it decreases the need for scaffolding and trained inspectors. This study provides a valuable roadmap for future research on image processing-based pressure vessel damage detection.
Heparin Rebound in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting Surgery：A Single-Center Retrospective Study
Authors: Xu Yang , Jiang Fei , Hu Shan-shan , Wang Jin-quan , Yao Yun-tai
Published: July 2024

Background
Heparin, an anticoagulant used in cardiac surgery, can result in heparin rebound (HR), where it returns postoperatively despite being neutralized with protamine. This study was designed to investigate the prevalence of HR in patients undergoing off-pump coronary artery bypass grafting (OPCAB) and evaluate the impact of HR on their short-term outcomes.
Methods
We analyzed 503 OPCAB patients aged 31–80 years from September 2019 to June 2022, who were categorized into HR (n = 56) and Non-HR (n = 447) groups. HR was defined by a 10% increase in activated coagulation time (ACT) after heparin neutralization with protamine, bleeding over 200 mL/h, and abnormal laboratory coagulation examination results. The primary outcome was postoperative bleeding volume. Secondary outcomes included the incidence of postoperative reoperation for bleeding, allogenic blood transfusion incidences and volumes, and laboratory variables. Data were analyzed using t-tests, Mann–Whitney U tests, and Pearson’s χ2 or Fisher’s exact tests.
Results
Significant differences were observed in preoperative platelet counts (P < 0.001) and the ACT measured 2 hours post-heparin neutralization (P = 0.012). The group HR exhibited higher 24-hour bleeding volumes, increased reoperation rates, and greater total bleeding volumes (all P < 0.001).
Conclusions
Postoperative HR was found to be prevalent in OPCAB patients and increased bleeding risks. These findings indicate the need for future randomized controlled trials to confirm the impact of HR and guide patient blood management.
Integrating Clinical and Microbiological Expertise to Improve Vaginal Candidiasis Management
Authors: Karakoyun Ayşe Sultan , Unal Nevzat , Sucu Mete , Bingöl Oğuzhan , Unal Ilker , Ilkit Macit
Published: July 2024

Vaginal candidiasis (VC) is a prevalent condition among women of reproductive age and poses a significant global public health challenge. However, the disease is often diagnosed and treated without mycological information. We aimed to investigate the epidemiology, laboratory diagnostics, and antifungal susceptibility of VC. We included 300 women (100 pregnant and 200 non-pregnant) from Çukurova University Obstetrics and Gynecology outpatient clinic in Adana, Türkiye. Participants underwent a health survey and provided vaginal swab samples for microscopic examination and fungal culture. The microscopic analysis involved wet-mount and gram-stained slides, whereas fungal identification involved CHROMAgar Candida, MALDI-TOF MS, and RT-PCR HRMA. Antifungal susceptibility tests were conducted at pH 7 and pH 4 using the CLSI document M44-A2. Of the 106 women with positive fungal cultures, 92 (86.8%) were diagnosed with VC, whereas 14 (13.2%) showed Candida colonization. Among those with VC, 55.4% had acute and 44.6% had recurrent VC; a family history of allergies significantly increased the risk for both types. We recovered 115 yeast isolates, predominantly C. albicans, C. glabrata, and C. krusei. Diagnostic accuracy of CHROMAgar Candida was 91.3% for the most common isolates, and HRMA was consistent in differential diagnosis. Antifungal resistance varied with pH; susceptibility to fluconazole, itraconazole, and ketoconazole decreased at pH 4, whereas susceptibility to miconazole increased. Our findings underscore the need for a diagnostic algorithm and enhanced collaboration between clinicians and microbiologists to improve VC management. Recommendations include using Gram staining, CHROMAgar Candida, MALDI-TOF MS, and antifungal susceptibility tests at both pH levels.
Analyzing the influencing factors of unplanned readmission within one year after cadaveric renal transplantation
Authors: Cao Weiwei , Zhong Minghuan , Sun Zhou , Liang Guofu , Yan Fu , Liu Chao , Ma Li , Zhu Kejing , Ding Bei , Niu Yulin
Published: July 2024

To investigate the factors influencing unplanned readmission within one year following cadaveric renal transplantation. Clinical data of kidney transplant recipients from the organ transplantation department of a tertiary general hospital in Guizhou Province, collected between April 2017 and December 2022, were retrospectively analyzed. Recipients were categorized into an unplanned readmission group and a non-readmission group based on whether unplanned readmission occurred within one year post-surgery. Univariate analysis and conditional backward stepwise regression was employed to identify variables, and binary logistic regression analysis was conducted to determine the independent influencing factors of unplanned readmission within one year after cadaveric renal transplantation. Unplanned readmission was observed in 183 out of 479 recipients (38.20%). Univariate analysis and conditional backward stepwise regression indicated that fall risk, albumin, total protein, serum creatinine, Cystatin C, medical insurance, length of stay, rejection reaction, blood transfusion during hospitalization, occupations, smoking history, drinking history and comorbidities were associated with unplanned readmission within one year after cadaveric renal transplantation. Binary logistic regression analysis revealed that rejection reaction(OR=2.323, 95%CI: 1.009-5.345), comorbidities greater than or equal to three (OR=1.887, 95%CI: 1.095-3.111), fall risk(OR=0.387, 95%CI: 0.162-0.927) , and on-the-job(OR=2.949, 95%CI: 1.789-4.862) were independent factors influencing unplanned readmission within one year after cadaveric renal transplantation.Consequently, upon discharge, medical staff should thoroughly assess the risk of unplanned readmission and develop individualized intervention plans based on these risk factors to reduce the incidence of unplanned readmissions, alleviate disease burden, and optimize the allocation of medical resources.
Cardiovascular disease management and healthcare delivery for people experiencing homelessness: a scoping review
Authors: Macklin Jillian , Samson Bethel , Zsager Alex , Ross Heather , Pinto Andrew , Gibson Jennifer L.
Published: July 2024

Background:People experiencing homelessness have increased prevalence, morbidity, and mortality of cardiovascular disease (CVD), attributable to several traditional and non-traditional risk factors. While this burden is well-known, mainstream CVD management plans and healthcare delivery have not been developed with people experiencing homelessness in mind nor tailored to their unique context. The overall objective of this work was to explore and synthesize what is known about CVD management experiences, programs, interventions, and/or recommendations specifically for people experiencing homelessness.
Methods: We conducted a mixed-methods systematic scoping review to combine qualitative and quantitative studies in a single review using the Arksey and O’Malley framework and lived experience participation. We performed a comprehensive search of OVID Medline, Embase, PsychINFO, CINAHL, Web of Science, Social Sciences Index, Cochrane, and the grey literature with key search terms for homelessness, cardiovascular disease, and programs. All dates, geographic locations, and study designs were included. Articles were analyzed using conventional content analysis.
Results: We included 37 articles in this review. Most of the work was done in the USA. We synthesized articles’ findings into 1) barriers/challenges faced by people experiencing homelessness and their providers with CVD management and care delivery (competing priorities, lifestyle challenges, medication adherence, access to care, and discrimination), 2) seven international programs/interventions that have been developed for people experiencing homelessness and CVD management with learnings, and 3) practical recommendations and possible solutions at the patient encounter level (relationships, appointment priorities, lifestyle, medication), clinic organization level (scheduling, location, equipment, and multi-disciplinary partnership), and systems level (root cause of homelessness, and cultural safety).
Conclusions: There is no ‘one-size-fits all’ approach to CVD management for people experiencing homelessness, and it is met with complexity, diversity, and intersectionality based on various contexts. It is clear, however, we need to move to more practically-implemented, community-driven solutions with lived experience and community partnership at the core. Future work includes tackling the root cause of homelessness with affordable housing, exploring ways to bring cardiac specialist care to the community, and investigating the role of digital technology as an avenue for CVD management in the homeless community. We hope this review is valuable in providing knowledge gaps and future direction for health care providers, health services research teams, and community organizations.
Characterisation and prognostic impact of ZRSR2 mutations in myeloid neoplasms
Authors: Al-Kali Aref , Yacout Mahmoud , Katamesh Bahga , Jabban Yazan , He Rong , VISWANATHA David , Jevremovic Dragan , Greipp Patricia , Bessonen Kurt , Palmer Jeanne , Foran James , Saliba Antoine , Hefazi Mehrdad , Begna Kebede , Hogan William , Patnaik Mrinal , Shah Mithun , Alkhateeb Hassan
Published: July 2024

The ZRSR2 gene is a member of the spliceosome gene family which are frequently mutated in myeloid neoplasms. ZRSR2 mutations (ZRSR2m) occur in less than 5% of MDS, CMML, and AML. Our study included 164 ZRSR2m patients (98.8% males) and 98 ZRSR2wt MDS control cohort. In the ZRSR2m group, there were 53 MDS (32%), 39 CCUS (24%), 33 MPN (20%), 23 MDS/MPN overlap (14%), 15 AML (9%), and 1 MPAL (0.6%). Most MDS patients were the low blast subtype (n=37, 70%). Twenty-seven MDS patients (51%), and 23 CCUS patients (59%) had absolute monocyte count ≥0.5 x109/L and 18 of 23 MDS/MPN overlap were CMML (78%). Mutations in ZRSR2 were spread across the entire gene. The median number of co-mutations was 2, with TET2 (51%) and ASXL1 (32%) being the most common. U2AF1 and SRSF2, previously described as mutually exclusive with ZRSR2, were found in 10.4% of patients. Median overall survival (OS) was 51 months, and significantly varied among MNs (p=0.004). ZRSR2m MDS patients had better mOS than the MDS control cohort with ZRSR2wt (35 vs 22 months, p=0.013). ZRSR2m patients with isolated TET2 co-mutation and higher hemoglobin showed improved survival, while patients with RUNX1m, higher WBC count showed worse OS.
Early vs. Late Time-restricted eating: The golden key to a leaner body, balanced metabolism, and restful sleep for healthy young adults
Authors: Abuduaini Zulihumaer , Liu Chao , Chen Guofang
Published: July 2024

This randomized crossover trial evaluated the effects of early (eTRE) and late (lTRE) time-restricted eating on healthy young adults' body weight, metabolism, and sleep. The study recruited healthy participants and rigorously controlled confounders to ensure accuracy and reliability. Both eTRE and lTRE facilitated weight loss and improved metabolic markers like blood pressure and glycemic control. Notably, eTRE showed greater weight and muscle mass reduction, while lTRE stabilized body fat content. These distinct effects highlight the need for tailored TRE approaches. Neither eTRE nor lTRE significantly influenced insulin, lipids, or inflammatory markers. Intriguingly, lTRE reduced blood glucose fluctuation, aligning with its cardiovascular benefits. This novel finding underscores TRE's potential in maintaining glycemic and cardiovascular health. In summary, this study provides valuable insights into TRE's effects on body composition, metabolism, and sleep, emphasizing the need to explore optimal TRE implementations further to maximize health benefits.
Management and Coping with Care for Older Adults: Tales of Family Caregivers in Enugu State, Nigeria
Authors: Ene Jacinta , Onyishi Nkechinyere , Lum Tanyi
Published: July 2024

Background: Often, ageing is associated with a decline in health conditions and changes in the dietary needs of older adults. It then follows that the most essential line of action is caregiving. This paper examines how family caregivers manage and cope with the caregiving roles for older adults in south-east Nigeria.
Method: We sought to adopt a qualitative research approach. Focus group discussions and in-depth interviews were utilized in collecting data from 54 participants aged 15-59 years who provide caregiving roles to older adults aged 60 years and above. Data were analyzed thematically.
Results: We found that participants experience challenges managing care for older adults. This was owing to older adults' age, health status, attitude, financial incapacitation and educational status of the family caregivers. Most of the participants cope through human and non-human relationships. Findings show that communal relationships in rural communities is gradually declining. It was found that participants who cope through non-human relationships adopt strategies including maintaining a positive outlook of life, observing spiritual relationship with God and spending time playing games and music. Few participants narrated how they cope through adequate ageing nutrition and unsafe hygiene practices. We observed that family caregivers are in dire need of assistance in care management for older adults. Participants showed little knowledge of social work engagement in care management for older adults.
Conclusion: We recommend that the Nigerian government should assist with health insurance schemes, security grants and payment to registered family caregivers. International organizations, indigenes in the diaspora and local humanitarian groups in collaboration with social workers can help develop care aid programs for older adults’ wellbeing in low-resource countries.
A cross-sectional investigation of a mobile health clinic run by undergraduate pharmacy students providing services to underserved communities
Authors: Maughan Emily , Richardson Charlotte , Nazar Hamde
Published: July 2024

Background
Mobile health clinics have been used to provide healthcare to underserved communities, especially during the COVID-19 pandemic. Student-led clinics, operated by undergraduate health students, offer valuable training while serving these populations.
Aim
This cross-sectional study investigates the demographic characteristics and services provided by a mobile health clinic run by undergraduate pharmacy students, assessing its impact on underserved communities.
Methods
The mobile health clinic operated from October 2023 to April 2024, staffed by 36 fourth-year pharmacy students. Services included cardiovascular disease risk screening and lifestyle advice. Data were collected using an electronic primary care system and analysed with descriptive statistics.
Results
The clinic served 716 users, with a demographic breakdown of 53.2% female and 46.8% male, predominantly aged 31–60 years. Users were ethnically diverse. Services provided included blood pressure (91.3%), BMI (91.3%), and diabetes risk assessments (54.9%). Many users reported low risk for smoking and alcohol consumption, but varied levels of physical activity. Referrals were made for cardiovascular disease risk and lifestyle support.
Conclusions
The mobile health clinic effectively reached a diverse, underserved population, providing essential health services and facilitating student training. Further research is needed to evaluate the long-term impact and cost-effectiveness of such clinics, and the follow-up care for referred patients.
Evaluation of the effects of gradual increases in intra-abdominal pressure on blood pressure in a patient undergoing laparoscopic cholecystectomy.
Authors: Abedinzade Mohamadreza , Taghavi Negin , Farsani Nafise Mohamadi
Published: July 2024

Backgrounds
Gallbladder stones are a common health problem in developed countries, and the laparoscopic surgical method is widely used for treatment. It is important to identify surgical techniques that can reduce complications during and after surgery.
Methods
This study included 100 patients, with 50 in the intervention group who underwent surgery with stepwise increased intra-abdominal pressure, and 50 in the control group who had surgery with 15 mmHg pressure. Demographic information was recorded, and hemodynamic changes during surgery and postoperative complications were documented. Data was compared using independent t-tests, ANOVA, and Chi-square tests.
Results
The results of our study showed that the intervention group had significantly more stable mean heart rate and blood pressure (systolic, diastolic, and mean arterial pressure) during surgery compared to the control group. The intervention group also had significantly lower frequency of nausea, mean pain, and administration of the analgesic Pethidine during recovery. However, there were no significant differences between the two study groups in mean arterial oxygen saturation during surgery, duration of hospital stay in recovery, frequency of vomiting, and headache.
Conclusion
Based on our findings, it is recommended to increase intra-abdominal pressure using the stepwise method employed in our study for all patients undergoing cholecystectomy. This can help achieve hemodynamic stability during surgery, reduce pain in patients, and improve the overall quality of treatment.
Deep Transfer Learning Hybrid Techniques for Precision in Breast Cancer Tumor Histopathology Classification
Authors: Gupta Muniraj , Verma Nidhi , Sharma Naveen , Singh Satyendra Narayan , Singh R. K. Brojen , Sharma Saurabh Kumar
Published: July 2024

Breast cancer is one of the most prevalent causes of cancer-related death globally. Preliminary diagnosis of breast cancer increases the patient's chances of survival and healing. In this paper, we propose a hybrid deep transfer learning model integrating xception with support vector classifier (XSV) and xception with random forest (XRF) along with pre-processing technique to classify breast cancer as cancerous (malignant) or non-cancerous (benign) along comparative analysis of prominent machine learning classifiers, such as Random Forest Classifier (RFC), Logistic Regression (LR), Support Vector Classifier (SVC), K-Nearest Neighbors (K-NN), and Ada-boost. In experiment all the models are implemented on two openly accessible datasets: BreakHis and Breast Histopathology Images Database (BHID) across various metrics such as accuracy, area under the receiver operating curve, precision, recall, f1-score, Matthew's correlation coefficient, classification success index, and kappa at different magnification levels of images. Our proposed model that utilized the fine tuning of xception model in conjunction with RFC and SVC, surpass existing breast cancer classification methodologies. Specifically, the XSV that achieved accuracies of 89.26%, 85.87%, 90.17%, and 88.98%, while the XRF attained accuracies of 87.78%, 84.78%, 88.98%, and 87.61% for BreakHis at 40X, 100X, 200X, and 400X magnifications, respectively. For BHID at 40X magnification, the XSV and XRF models achieved accuracies of 87.35% and 87.29%, respectively. Employing this study will aid our medical practitioners and researchers in choosing an accurate model for tumor classification and our results will help medical professionals to classify the disease with precision.
Assessing the Impact of Human Activities on Ecosystem Asset Dynamics in the Yellow River Basin From 2001 to 2020
Authors: Ming Lei , Wang Yuandong , Liu Guangxu , Meng Lihong , Chen Xiaojie
Published: July 2024

The intensification of human activities in the Yellow River Basin has significantly altered its ecosystems, challenging the sustainability of the region's ecosystem assets. This study constructs an ecosystem asset index for the period from 2001 to 2020, integrating it with human footprint maps to analyze the temporal and spatial dynamics of ecosystem assets and human activities within the basin, as well as their interrelationships. Our findings reveal significant restoration of ecosystem assets, mainly attributed to the conversion of farmland back into natural habitats, resulting in a 15,994 km2 increase in ecological land use. Notably, 45.88% of the basin has experienced concurrent growth in both human activities and ecosystem assets, with ecosystem assets expanding at a faster rate (22.61%) than human activities (17.25%). Areas with high-quality ecosystem assets are expanding, in contrast to areas with intense human activities, which are facing increased fragmentation. Despite a global escalation in threats from human activities to ecosystem assets, the local threat level within the Yellow River Basin has slightly diminished, indicating a trend towards dispersion. Results highlight the critical importance of integrating spatial and quality considerations into restoration efforts to enhance the overall condition of ecosystem assets, especially under increasing human pressures. Our work assesses the impact of human activities on the dynamics of ecosystem assets in the Yellow River Basin from 2001 to 2020, offering valuable insights for quality development in the region, may provide a scientific basis for general watershed ecological protection and sustainable management in a region heavily influenced by human activity but on a path to recovery.
DSC-YOLO: Non-Destructive Defect Detection of Tire X-Ray Images Based on Dynamic Snake Convolution
Authors: Xu Guangpeng , Li Aijuan , Wang Xibo , Xu Chuanyan , Chen Jiaqi , Zheng Fei
Published: July 2024

Tire X-ray nondestructive testing before leaving the factory is crucial for driving safety. Given the complexity of tire structures and the diversity of defect types, traditional manual visual inspections and machine learning methods face significant challenges in terms of accuracy and efficiency. This study proposes an innovative tire X-ray image nondestructive testing technique based on the YOLOv5 model, incorporating several advanced technologies to enhance detection performance. Specifically, we introduce Dynamic Snake Convolution (DSConv), which adaptively focuses on slender and curved features within tires. Additionally, we have designed a C3 module based on DSConv, specifically targeting slender defects such as cord-overlap and cord-cracking. To improve the detection accuracy of small defects, we redesigned the neck network structure and introduced the Scale sequence feature fusion module (SSFF) and the Triple feature encoding module (TFE) to integrate multi-scale information from different network layers. Furthermore, we developed the Convolution Block Attention Module, integrated into the SSFF, which effectively reduces the interference of complex backgrounds and focuses on defect recognition. In the post-processing stage, we employed the Soft-NMS algorithm to optimize the confidence of candidate detection boxes, enhancing the accuracy of box selection. The experimental results show that compared to the YOLOv5 benchmark model, the algorithm proposed in this study achieved a 5.9 percentage point increase in mAP0.5 and a 5.7 percentage point increase in mAP0.5:0.95, demonstrating superior detection accuracy compared to current mainstream object detection algorithms and effectively completing the nondestructive testing task of tire defects.
GPT-3.5 altruistic advice is sensitive to reciprocal concerns but not to strategic risk
Authors: Schmidt Eva-Madeleine , Bonati Sara , Köbis Nils , Soraperra Ivan
Published: July 2024

Pre-trained large language models (LLMs) have garnered significant attention for their ability to generate human-like text and responses across various domains. This study delves into the social and strategic behavior of the commonly used LLM GPT-3.5 by investigating its suggestions in well-established behavioral economics paradigms. Specifically, we focus on social preferences, including altruism, reciprocity, and fairness, in the context of two classic economic games: the Dictator Game (DG) and the Ultimatum Game (UG). Our research aims to answer three overarching questions: (1) To what extent do GPT-3.5 suggestions reflect human social preferences? (2) How do socio-demographic features of the advisee and (3) technical parameters of the model influence the suggestions of GPT-3.5? We present detailed empirical evidence from extensive experiments with GPT-3.5, analyzing its responses to various game scenarios while manipulating the demographics of the advisee and the model temperature. Our findings reveal that, in the DG, model suggestions are more altruistic than in humans. We further show that it also picks up on more subtle aspects of human social preferences: fairness and reciprocity. This research contributes to the ongoing exploration of AI-driven systems' alignment with human behavior and social norms, providing valuable insights into the behavior of pre-trained LLMs and their implications for human-AI interactions. Additionally, our study offers a methodological benchmark for future research examining human-like characteristics and behaviors in language models.
Cattle identification based on multiple feature decision layer fusion
Authors: Li Dongxu , Li Qi , Wang Yueming , Han Mingshuo , Yang Mei , Li Baoshan
Published: July 2024

In breeding farm cattle feeding and watering scenarios, the number of cattle is dense, resulting in complex scenes and spatial congestion, and traditional single-modal cattle identification methods often encounter problems such as susceptibility to occlusion and low identification accuracy. Consequently, this study proposes a decision layer fusion cattle identity recognition method with multiple features of cattle face, cattle muzzle pattern, and cattle ear tag. The image is segmented into cattle face, cattle muzzle pattern, and cattle ear tag by the SOLO algorithm. Cattle face, and cattle muzzle patterns adopt the FaceNet network model with different backbones, respectively, while the ear tag adopts the PP-OCRv4 network model. The experiment extracts the features of the three parts respectively, stores these features in the database while comparing them with the database, calculates the Euclidean distance and text similarity with the sample data, and extracts the Top 3 confidence levels. Then, it performs One-Hot encoding processing for each of these features, which are used as inputs to the decision-making layer. An integration approach is used in the decision fusion part, where different integration strategies combine multiple base classifiers and compare the best performance as the final decision fusion recognition model. The results show that using the multimodal decision fusion method makes the recognition accuracy reach 95.74%, 1.4% higher than the traditional optimal unimodal recognition accuracy. The verification rate reaches 94.72%, 10.65% higher than the traditional optimal unimodal recognition verification rate. This fusion method achieves individual recognition and accurate management of cattle in breeding farms, bringing an efficient and accurate solution for the animal husbandry industry.
Multi-ensemble Bayesian Analysis of Inclusion-based Rock-physics Models
Authors: Spikes Kyle T. , Sen Mrinal K.
Published: July 2024

A statistics-based approach to rock physics often includes the calculation of a series of simulations to fit data along with probability associated with the modeling to characterize uncertainty. We present a Bayesian approach to determine the most probable rock-physics model (e.g., inclusion based). Our results also feature combinations of highly probable model inputs from posterior distributions; these combinations result from using of many different sets of input values from a prior distribution where each set corresponds to an ensemble. Exhaustive sampling allows for the calculation of the full posterior distribution for each ensemble. We demonstrate this method using two inclusion-based rock-physics models, the self-consistent and differential effective medium models along with a carbonate laboratory data set. Results indicate that the latter of the two models is the most probable. Analyses of the underlying model inputs indicate multiple but distinct clusters among those inputs. The problem is computationally demanding and requires parallel computation for tractability. Results from this work are applicable to data sets with similar velocity-porosity trends. More generally, the method is applicable to any other data set and relevant rock-physics models of interest.
CiteSpace-based Knowledge Graph Visualization of Mendelian Randomization Studies in Cancer
Authors: Kaiyue Zhang , Lai Wei , Jiayu Xiu , Tingjun Wang , Yuanpeng Huang
Published: July 2024

Objective
This study aims to perform a visual analysis of the literature on Mendelian randomization in the field of cancer, summarizing its developmental trajectory, current research status, and hot topics to provide references for future research directions.
Methods
Literature on Mendelian randomization studies in the field of cancer was retrieved from the Web of Science Core Collection up until April 18, 2024. The analysis and visualization of publication trends, author and institutional collaboration networks, keyword co-occurrence, clustering, timeline graphs, and burst terms were conducted using CiteSpace6.3.R1.
Results
A total of 964 English-language articles were included, showing an increasing trend in the number of articles using MR for cancer-related research, with a sharp rise in recent years. Despite the large volume of publications, there has not yet been a large-scale formation of collaborative groups among authors and institutions. The research hotspots include cancers such as breast cancer, colorectal cancer, prostate cancer, and lung cancer. Discussions on key risk factors include macro indicators such as BMI, hematological micro indicators such as sex hormones, symptoms such as back pain, and other diseases such as obesity. Research methods are often used in conjunction with meta-analysis.
Conclusion
The field of cancer Mendelian randomization research is heating up, with research continuously deepening and improving. Future efforts should strengthen collaboration and communication between researchers and institutions, delve deeper into current research hotspots, and provide research directions and theoretical bases for disease prevention and the development of new therapies.
The Quest for Optimal Ketamine Dosing Formula in Treatment-Resistant Major Depressive Disorder
Authors: Kwaśna Julia , Cubała Wiesław Jerzy , Kwaśny Aleksander , Wilkowska Alina
Published: July 2024

Background
Emerging evidence indicates that intravenous ketamine is effective in managing treatment-resistant unipolar and bipolar depression. Clinical studies highlight its favorable efficacy, safety, and tolerability profile within a dosage range of 0.5-1.0 mg/kg based on actual body weight. However, data on alternative dosage calculation methods, particularly in relation to body mass index (BMI) and therapeutic outcomes, remain limited.
Methods
This retrospective analysis of an open-label study aims to evaluate various dose calculation strategies and their impact on treatment response among inpatients with treatment-resistant major depressive disorder (MDD) (n = 28). The study employed the Boer and Devine formulas to determine lean body mass (LBM) and ideal body weight (IBW), and the Mosteller formula to estimate body surface area (BSA). The calculated doses were then compared with the actual doses administered or converted to a dosage per square meter for both responders and non-responders.
Results
The findings support using actual body weight-based dose calculations for ketamine in treatment-resistant MDD.
Conclusions
This preliminary analysis does not endorse alternative ketamine dosing methods based on different body weight metrics. Incorporating body impedance analysis and waist-to-hip ratio measurements could improve the accuracy of ketamine dosing.