bluuebunny/crossref_metadata_2025 huggingface dataset:
Stabilization of the Proximal Ulnar Stump in the Sauvé-Kapandji Procedure by Reconstructing Distal Oblique Bundle
Authors: Shanqing Yin , Chenxi Zhang , Yaopeng Huang , Chuan Chen , Jiadong Pan , Xin Wang , Liu Xiaodong
Published: July 2024

Background
The most common Sauvé-Kapandji (S-K) postoperative complication is instability of the proximal Ulnar Stump. The distal oblique bundle (DOB) is a stable tissue used to stabilize the distal radioulnar joint. we have applied a method to stabilize the proximal ulnar stump by using an improved extensor carpi ulnaris to fix the ulnar stump and reconstruct the DOB to achieve a combination of dynamic and static stable tissue.
Methods
15 patients who underwent the S-K operation after partial ulnar wrist extensor tendon fixation of the ulnar stump and reconstruction of DOB to stabilize the proximal ulnar stump were recruited. After surgery, the patients' wrist pain was evaluated with a visual analog scale (VAS). The Mayo scoring system was used to evaluate total function. The imaging findings included the ulnar and radial distances and the palmar/dorsal displacement distance of the proximal ulna stump.
Results
All 15 patients were followed up for an average of 32.5 months (ranging from 9 to 60 months). The wrist pain of all patients improved from an average of 6.5 ± 2.5 points before the operation to 2.4 ± 2.1 points after the operation. The grip strength increased from 4.5 (4.3) kg before surgery to 7.5 (3.5) kg after surgery, and the forearm rotation activity improved from 61 (16)° before surgery to 81 (13)° after surgery. The average radius of the ulna decreased from 11 mm to 9 mm, but there was no significant difference among the 12 patients. Lateral X-ray imaging revealed no instability of the proximal Ulnar Stump.
Conclusion
Extensor carpi ulnaris fixation of the ulnar stump and reconstruction of the DOB can achieve the combination of dynamic and static stable tissue, which is an effective method for preventing instability of the proximal ulnar stump
Type of study/level of evidence Therapeutic IV.
Electronic Continuing Professional Development (e-CPD) to Improve Competencies of Indonesian Clinical Nurses: An exploratory action research study protocol
Authors: Sari Novita Kurnia , Prihatiningsih Titi Savitri , Lusmilasari Lely
Published: July 2024

Background.
The CPD programs available for nurses in Indonesia need an organized structure to align with individual nurses' specific career trajectories. The distribution of opportunities for CPD is inequitable, posing problems for nurses engaging in CPD activities. These challenges arise from insufficient financial support, a lack of time, and constraints due to work schedules. These programs should be designed in accordance with fundamental principles, advancements in educational technology, cost-effectiveness, ease of access, and the advantages they offer for career advancement and the development of competencies. Study aims to explore and develop the e-CPD model as it is applied on clinical nurses in Indonesia.
Methods.
Research design used Exploratory action research. Data collection will occur in two primary stages: exploration and acting. During the exploration stage, the research team conducted Focus Group Discussions (FGDs) with three distinct groups of participants. Simultaneously, inside the acting stage’s scope, instructional design development, e-CPD platform creation, and user testing will be undertaken.
Discussion.
The e-CPD is a ward-based learning activity that facilitates self-directed learning by providing information resources such as protocols and literature. The inherent nature of this model promotes the distribution of concise segments of essential content presented in platform formats that facilitate engagement among peers and mentors, interactivity, user-friendly digital learning opportunities, and support from peers and mentors. This study offers new light on how an e-CPD might be used as an alternative CPD model for clinical nurses.
Trial Registration.
This trial is registered under ClinicalTrial.gov with identifier number NCT06047652 on September 14, 2023.
Randomized controlled trial evaluating the efficacy of the "Water on Tray" anesthesia technique compared to the Halsted tecnique
Authors: Hosseini Hadi , Haradasht Sadra Amirpour , Khazaei Amir Hossein , Parhizkar Sepehr , Dehabadi Farnaz
Published: July 2024

Objective
With respect to the high failure rate of conventional IANB technique and other associated disadvantages, in this study we focused on an alternative called Water on Tray technique and assessed the efficiency of this method compared to the conventional technique.
Materials and Methods
This single-blind, single center randomized controlled trial was carried out among 90 individuals referred to the dental clinic of the International Branch of Guilan University of Medical Sciences (IB-GUMS) from November to December of 2017. The patients were randomly assigned into two groups. Injection pain was assessed using Numeric Rating Scale (NRS) and patients were asked to report any tingling sensation on the lip and tongue on the side of injection. Electric pulp test (EPT) and the stick test were also performed. If no numbness was report within 15 minutes, the injection was deemed unsuccessful. SPSS software version 25 was used with the significance level of p < 0.05
Results
The WOT technique demonstrated a significantly higher success rate of achieving adequate anesthesia on the first attempt (p < 0.05). Additionally, the WOT technique exhibited other significant advantages, including no instances of positive aspiration, rapid onset of action coupled with lingual nerve block, and reduced pain during injection.
Conclusion
The Water on Tray is a favorable technique to achieve inferior alveolar nerve block due to its ease and high success rate compared to the conventional technique.
Clinical Relevance:
This technique allows dentists to achieve a higher success rate with inferior alveolar nerve blocks and reduce injection pain in patients.
Anal fissure treatment in 2022 - A global snapshot audit conducted by the International Society of University Colon and Rectal Surgeons (ISUCRS)
Authors: Dulskas Audrius , Nunoo-Mensah Joseph , Fortunato Richard , Huneidy Majid , Bugra Dursun , Lohsiriwat Varut , Aukstikalnis Tomas , Samalavicius Narimantas
Published: July 2024

Background
An anal fissure is a longitudinal tear in the mucosa of the anal canal, distal to the dentate line. It is usually situated in the posterior midline but can occur in any quadrant. This condition affects both genders and is associated with pain, bleeding, anal discomfort, amongst other symptoms.
Aim
The aim of this study is to evaluate the global treatment and follow-up of patients with anal fissures in different countries and continents.
Method
A prospective cohort audit database was created with the cooperation of fifty-six doctors from twenty-one different countries. The patients were evaluated according to the type of anal fissure they had, treatment they underwent and results of 8-week post-treatment.
Results
Overall, 302 patients were included, with 106 (35%) diagnosed with an acute anal fissure and 196 (65%) a chronic anal fissure. Leading symptoms were painful defecation (n = 280, 92.7%) followed by anal bleeding (n = 194, 64.2%) and painful bleeding during defecation (n = 182, 60.2%). A total of 111 (36.8%) underwent surgical treatment. Out of the 264 (87%) who underwent follow-up at 8-weeks, 116 patients (44%) were cured, 86 (32.6%) showed marked improvements, 46 patients (17.4%) showed some improvement, 16 (5.0%) reported no change and one patient (0.3%) had worsened symptoms. Complications arising after treatment was recorded in 18 (6%) patients, with 15 (83%) complaining of headaches, 2 (5%) indicated hypotension, perineal sepsis, anal bleeding and/or allergies to medications used during treatment. Comparing pre-treatment and post-treatment Wexner Incontinence Scores, no patients had worsening fecal incontinence, 95.7% showed stable scores, while 13 (4.3%) showed improved scores.
Conclusion
The majority of surgeons chose a non-surgical approach as a first line treatment for anal fissures whether acute or chronic. Overall, 94% of all patients had resolution or improved symptoms, with none of the surgically treated patients developing fecal incontinence afterwards.
Predictive Factors for Post-Stroke Dysphagia in Patients after endovascular thrombectomy for Anterior Circulation Large Vessel Occlusion: A Retrospective Cohort Study
Authors: Yang Shu-Mei , Wu Hao-Wei , Hsueh Hsueh-Wen , Lin Yen-Heng , Lai Ting-Ju , Lin Meng Ting
Published: July 2024

Purpose
To identify the predictive variables for post-stroke dysphagia (PSD) among anterior circulation large vessel occlusion (LVO) stroke patients who underwent endovascular thrombectomy (EVT).
Methods
This retrospective cohort study enrolled hospitalized patients with anterior LVO stroke who underwent EVT between January 1, 2018 and October 31, 2022. PSD was defined as the unsuccessful removal of the nasogastric (NG) tube. Factors such as premorbid characteristics, laboratory results, EVT, rehabilitation-related parameters, and neuro-imaging were analyzed for correlations to PSD at 4 and 12 weeks.
Results
The study enrolled 136 patients and found that lower albumin, lower body mass index (BMI), higher initial and 24-hour post-EVT National Institute of Health Stroke Scale (NIHSS) scores, stroke-associated pneumonia, poor initial sitting balance and ability to sit up, insula or frontal operculum lesions, and bilateral hemisphere involvement were all associated with PSD at both 4 and 12 weeks in the univariate logistic regression. Moreover, the multivariate analysis revealed that lower BMI, insular lesions, and bilateral hemisphere involvement were significant predictors of PSD at both time points.
Conclusions
In patients with anterior LVO following EVT, PSD was associated with lower BMI, higher NIHSS scores, poor initial sitting balance and sitting ability, insular lesions, and bilateral hemisphere involvement.
Coronary Angiography and Interventions in a Sub-Saharan African Country: A 6-year Retrospective Review at Korle-Bu Teaching Hospital.
Authors: Agyekum Francis , Akumiah Florence , Ganatra Khushali , Nguah Samual , Doku Alfred , Adadey Martin , Ampofo Eugene , Asamoah Kofi , Akamah Joseph
Published: July 2024

Background
Coronary artery disease (CAD) is the leading cause of death globally, with unique challenges in Sub-Saharan Africa. This study examines the clinical profile, angiographic severity, and in-hospital outcomes of percutaneous coronary interventions in a Teaching Hospital in Ghana.
Methods
We retrospectively reviewed coronary angiography and percutaneous coronary interventions performed at Korlebu Teaching Hospital between January 2017 and December 2022. This included demographic data, atherosclerotic cardiovascular disease (ASCVD) risk factors, clinical presentation, lesion severity, type of intervention, and in-hospital outcomes.
Results
463 patients were analyzed, with a median age of 60 years. The most prevalent ASCVD risk factors were hypertension (81.4%), old age (61.9%), dyslipidemia (39.6%), diabetes mellitus (35.5%), and obesity (25.8%). Most of the patients had three or more ASCVD risk factors. 127 patients (27.5%) had normal coronary angiograms, 74 (16.0%) had mild non-obstructive CAD, 90 (19.5%) had single-vessel disease, 70 (15.2%) each had two-vessel disease, and three-vessel disease respectively. Thirty-one patients (6.7%) had significant left-main disease. Twice more males than females had severe three-vessel and left-main disease. Although Akans comprised the majority, Ga-Adangbe had more three-vessel and left-main diseases. Six patients (1.3%) died, five of whom were males. The in-hospital mortality rate was higher in emergency cases than in elective cases (6.6% versus 0.3%, p-value < 0.001)
Conclusion
Many patients referred for coronary angiography had multiple ASCVD risk factors. Many of the patients had obstructive coronary artery disease and underwent successful PCI in a resource-constrained center. PCI outcomes were better in elective than emergency cases.
Habitat use by nomadic ibis and spoonbills post-dispersal from breeding sites
Authors: McGinness Heather M. , Lloyd-Jones Luke R. , Robinson Freya , Langston Art , O’Neill Louis G. , Rapley Shoshana , Jackson Micha V. , Hodgson Jessica , Piper Melissa , Davies Micah , Martin John M. , Kingsford Richard , Brandis Kate , Doerr Veronica , Nally Ralph Mac
Published: July 2024

Context
Nomadic waterbirds are highly mobile across a range of spatial and temporal scales, which makes it difficult to monitor, quantify, and predict their habitat use with traditional methods, especially between breeding events when individuals and flocks can move over vast areas.
Objectives
This study aimed to provide accurate information on habitat use to improve strategic conservation management of these species, particularly the provisioning of environmental water.
Methods
To overcome the challenges of distance and remoteness, we analysed a 7-year GPS satellite telemetry dataset from 141 individuals. We quantified habitat selection post-dispersal from breeding sites, and predicted habitat preference for two wading waterbird species of the Threskiornithidae family that frequently nest together at the same sites: straw-necked ibis (Threskiornis spinicollis) and royal spoonbill (Platalea regia).
Results
Both long-term and short-term landscape-scale habitat associations differed between species. Royal spoonbills used fewer and more restricted habitat types than straw-necked ibis. Spoonbills displayed strong preferences for reservoirs, marshes and permanent wetlands, while ibis used both aquatic and terrestrial habitat, including areas of intensive animal production, modified pasture, and woodlands. Analysis of nocturnal versus diurnal space use showed that roosting and foraging habitat requirements for both species are distinct.
Conclusions
Analysing over 1 million telemetry points revealed species-level variability in habitat use, informing resource allocation for environmental water management. Royal spoonbills are more vulnerable to habitat change due to water regime alterations, highlighting the need for focused conservation management. Differences in day and night habitat use indicate the necessity of considering roosting habitats alongside foraging habitats for effective conservation. This comprehensive understanding of waterbirds' spatiotemporal interactions with their environment is crucial for long-term management aimed at increasing waterbird numbers and maintaining diversity.
Prevalence trends, population characteristics and treatment outcomes of tuberculosis combined with diabetes in southwest China: a register-based retrospective study
Authors: Kong Deliang , Shui Yichao , Zhang Ting , Wang Xiangliu , Wu Chengguo , Hao Mo , Li Chengyue , Zhong Jiyuan , Pu Chuan
Published: July 2024

The global situation regarding the prevention and control of pulmonary tuberculosis (PTB) remains challenging. With the ongoing aging population and the increasing prevalence of chronic diseases, the epidemic of comorbid PTB and diabetes mellitus (PTB-DM) presents challenges to PTB control .This study aims to explore the epidemiological trends of PTB-DM in Southwest China and identify risk factors associated with adverse treatment outcomes, providing evidence to enhance TB prevention and control measures and improve patient treatment outcomes.This retrospective study used PTB case data from the PTB Information Management System within the China Information System for Disease Control and Prevention (CISDP). The trend in PTB-DM incidence was analyzed using the Joinpoint regression model, and population and clinical characteristics of patients were described using frequencies (n) and percentages. Group comparisons utilized chi-square tests, and risk factors for adverse treatment outcomes were explored using multivariable logistic regression models with stepwise backward selection based on Wald tests.The Joinpoint analysis revealed a declining trend in PTB incidence in Southwest China (AAPC = -10.22%, 95% CI: -11.49%~-8.94%), contrasting with a rapid increase in PTB-DM incidence (AAPC = 14.25%, 95% CI: 11.35% ~17.23%). The proportion of PTB-DM among PTB cases increased significantly from 2.96% to 12.28%, indicating a pronounced increase in the comorbidity prevalence of PTB-DM. PTB-DM patients were characterized by a higher proportion of males and elderly individuals, multiple positive aetiological results, and lower rates of proactive medical consultation. Among PTB-DM patients, successful outcomes accounted for 80.85% , while unsuccessful outcomes accounted for 19.15%.Although the number of PTB-DM patients with successful treatment outcomes increased overall (AAPC = 12.22%, 95% CI: 10.30% ~14.16%), the failure rate showed a gradual upward trend (AAPC = 14.18%, 95% CI: 6.53% ~27.67%). Analysis of factors associated with adverse treatment outcomes showed that advanced age, retreatment, referral, and positive aetiological results were risk factors for PTB-DM patients.Therefore, it is imperative to strengthen early screening and standardized treatment for key populations, such as the elderly population, and to implement more comprehensive and effective treatment and management measures for patients.
in situ Observation of dynamic supported bilayer formation on solid surface by unilamellar vesicles
Authors: Sakai Takaya , Inoue Shigeto
Published: July 2024

Bilayer formation on solid substrates by unilamellar vesicle fusion in water has attracted considerable attention in biological, medical, and industrial fields. However, the actual dynamic process to spontaneously form highly ordered bilayer films occurs on the nanoscale and within a very short period of time such that it cannot be clearly observed even with the most advanced technology. Therefore, the essential mechanism remains hypothetical, and various models have been proposed. In this study, using high-speed atomic force microscopy, we succeeded for the first time in observing bilayer formation from N,N-dioctadecyl-N,N-dimethylammonium bromide (DODAB) unilamellar vesicles on a mica surface in situ with nanoscale 3D information. Furthermore, when another cationic surfactant, which was more cohesive in water than DODAB, was used, significant differences were observed in the initial process of domain formation on the surface. This study revealed that the spherical vesicles instantly transitioned from tetralayer to bilayer domains on the substrate, and then a uniform bilayer membrane was formed by fusion between the domains on the substrate.
Identification of a New Susceptibility Gene ALX4 in Non-syndromic Orofacial Cleft
Authors: Zhang Si-Di , Ge Bin , You Yue , Shi Bing , Jia Zhong-Lin
Published: July 2024

Objectives
Muscle is one of the important tissues that constitute the structure of lip and palate and its development might play some role in the formation of non-syndromic orofacial cleft (NSOC), a congenital orofacial malformation. This study was aimed to identify new susceptibility genes in NSOC.
Materials and Methods
We collected 18 candidate genes involved in the process of muscle and performed a two-stage case-control association analysis in western Han Chinese population. Then we extracted RNA from the lip tissue of NSCLO patients to perform RNA sequencing and confirmed the up-regulation of differentially expressed gene and microRNA with Real-time quantitative PCR. Bioinformatic analysis and dual luciferase reporter assay were sed to explore the transcriptional regulation of microRNA.
Results
ALX4 was most significant in the discovery phase and replication analysis further confirmed its association with NSOC subtypes. RNA sequencing found that ALX4 and has-miR-455-3p were both differentially up-regulated in NSCLO patients. Bioinformatics analysis and validation study proved that ALX4 is transcriptionally regulated by has-miR-455-3p as its target gene.
Conclusion
This study identified that ALX4 was a new susceptibility gene for NSOC in western Han Chinese population. The up-regulation of ALX4 transcription level in NSCLO patients might be regulated by has-miR-455-3p.
Viable bacterial communities in freshly pumped human milk and their changes during cold storage conditions
Authors: Pivrncova Eliska , Bohm Jan , Barton Vojtech , Klanova Jana , Linhartova Petra Borilova
Published: July 2024

Background
Human milk harbors diverse bacterial communities that contribute to infant health. Although pumping and storing milk is a common practice, the viable bacterial composition of pumped milk and the impact of storage practice on these bacteria remains under-explored.
Aim
This study aims to characterize viable bacterial communities in freshly pumped human milk and its changes under different storage conditions.
Methods
We conducted a metagenomic observational study in lactating mothers (n = 12) who provided freshly pumped milk samples. These samples were stored under various conditions (refrigeration for 24 h, 48 h, or freezing for six weeks) and treated with propidium monoazide (PMA) to selectively identify viable cells. The extracted DNA from individual samples was subsequently analyzed using 16S rRNA amplicon sequencing on the Illumina platform.
Results
Fresh milk samples treated with PMA had significantly lower median sequencing depth, diversity indices, and number of amplicon sequence variants than untreated samples (p < 0.05 for all). Moreover, the relative abundance of the bacterial genus Streptococcus was significantly reduced in PMA-treated samples when compared to those without PMA treatment (p < 0.05). The significant difference in the sequencing depth, amplicon sequence variants, and diversity indices between the paired PMA-untreated and PMA-treated human milk samples (p < 0.05) was observed at each storage interval. Also, significant changes in these parameters were observed between fresh human milk samples and their paired frozen samples (p < 0.05), while no differences were found between fresh and refrigerated samples (p > 0.05). Of specific genera, only PMA-treated samples stored at -20°C for six weeks (but not refrigerated samples) showed a significant decrease in the relative abundance of the genus Streptococcus (p < 0.05) and, contrary, increase in the relative abundance of the genus Staphylococcus (p < 0.05) in comparison to fresh PMA-treated samples.
Conclusions
The study demonstrated that the bacterial profiles significantly differed between human milk samples treated with PMA, which represent only viable bacteria, and those untreated. While two-day storage at 4°C did not significantly alter the overall diversity and composition of viable bacteria in human milk, freezing notably affected the viability and relative abundances of some bacterial genera.
Facile recovery of terephthalic acid from PET bottles via acid hydrolysis with nitric acid and applications in synthesis of cobalt MOFs
Authors: Seabra Victor , Gonçalves João M. R. , Moura Ana L. S. , Luna Vinícius G. , Santiago Pedro H. O. , Ellena Javier , Lima-Neto Benedito S.
Published: July 2024

Poly(ethylene terephthalate) (PET) taken from postconsumer commercial water bottles was subjected to acid hydrolysis with HNO₃ to recover terephthalic acid (H₂TPA). The H₂TPA was submitted to mono-nitration with HNO₃/H2SO4 to produce 2-nitro-terephthalic acid (NO₂-H₂TPA) in good yield. Both compounds were well characterized by NMR (¹H; ¹³C; ¹H-¹³C HSQC). These two molecules were used as ligands for the syntheses of two new cobalt-based Metal-Organic Frameworks (MOFs) via solvothermal methodology, in dimethylformamide (DMF) or dimethylacetamide (DMA). The MOFs Co-TPA-DMA (1) and Co-(NO₂-TPA)-DMF (2) were obtained and characterized by single crystal X-ray diffraction (SCXRD), powder X-ray diffraction (PXRD) and scanning electron microscopy with energy dispersive spectroscopy (SEM-EDS).
Unsupervised Learning of Spatially-Resolved ARPES Spectra for Epitaxially Grown Graphene via Non-negative Matrix Factorization
Authors: Imamura Masaki , Takahashi Kazutoshi
Published: July 2024

This study proposed an unsupervised machine-learning approach for analyzing spatially-resolved ARPES. A combination of non-negative matrix factorization and k-means clustering was applied to spatially-resolved ARPES spectra of the graphene epitaxially grown on a SiC substrate. The Dirac cones of graphene were decomposed and reproduced fairly well using non-negative matrix factorization (NMF). The base and activation matrices obtained from the NMF results reflected the detailed spectral features derived from the number of graphene layers and growth directions. The spatial distribution of graphene thickness on the substrate was clearly visualized by the clustering using the activation matrices acquired via NMF. Integration with k-means clustering enables clear visualization of spatial variations. Our method efficiently handles large datasets, extracting spectral features without manual inspection. It offers broad applicability beyond graphene studies to analyze ARPES spectra in various materials.
Household and Environmental Determinants That Influence the Prevalence Atopic Dermatitis Among Young Rural Children, in Mpumalanga Province, South Africa
Authors: Mbonane Thokozani P
Published: July 2024

Aim: This study aimed to evaluate and determine the prevalence of atopic dermatitis, as well as the factors that contribute to its development, particularly household and environmental determinants, in young children residing in a rural area in South Africa.
Subject and Methods: A cross-sectional analytical study was conducted, wherein caregivers and children were purposefully recruited as participants. Data collection involved the utilization of an adapted version of the International Study of Asthma and Allergies in Childhood questionnaire, which was then analyzed using Stata MP version 18. The study included a total of 881 caregivers, with a majority of the child participants being boys (n=477, 54.14%).
Results: The prevalence rates of historical and current atopic dermatitis were found to be 13.96% and 18.62%, respectively. Natural birth was found to be a protective factor in the study for both historical (Adjusted Odds Ratio [AOR]: 0.094, 95% Confidence Interval [CI]: 0.039-0.224) and current atopic dermatitis (AOR: 0.098, 95% CI: 0.042-0.231). The use of a traditional grass broom for sweeping the floor, exposure to household environmental tobacco smoking, and undergoing renovations were associated with both historical and current atopic dermatitis. Moreover, having an indoor domestic cat (AOR: 2.166, 95% CI: 0.931-5.036) was found to be associated with current atopic dermatitis.
Conclusion: These findings demonstrate that the prevalence of atopic dermatitis in rural areas is similar to that in urban areas among children. Consequently, there is a need to provide primary health care services, particularly for skin diseases, which are currently limited in rural areas. Additionally, environmental health services could play a crucial role in the management and control of atopic dermatitis and similar conditions in rural areas.
General practice utilization for adults with neurological disability who are National Disability Insurance Scheme Participants in Australia
Authors: Douglas Jacinta , Winkler Di , McLeod Adam , Oliver Stacey , Ramme Robin , Kondiboyina Avinash , Gardner Karina , Weeding Stephen , Pearce Chris
Published: July 2024

Background
Most adults with neurological disability rely on general practitioners for the management and early intervention of health needs. Understanding the frequency and patterns of service use across neurological disability subgroups is vital to inform effective practice and policy initiatives. This study analysed the patterns of general practice service utilisation of National Disability Insurance Scheme (NDIS) participants with Acquired Brain Injury, Cerebral Palsy, Multiple Sclerosis, Spinal Cord Injury, and Stroke and compared these patterns with those of the rest of the population.
Methods
This is a retrospective data linkage study using de-identified general practice electronic medical records from Victoria, Australia that have been linked with de-identified NDIS data. Patient records span July 2017 to February, 2023. To gain insight into patients’ utilisation of general practice services, we looked at: 1) frequency of clinic activities and general practitioner activities, 2) number of different general practice clinics visited and 3) number of distinct general practitioners seen.
Results
The study sample comprised 818,456 adult patients (2,104 NDIS participants with neurological disability; 816,352 rest of population). Our results indicate a consistent pattern of high general practice service utilisation among adults with neurological disabilities wherein service utilisation rates of all investigated neurological disability cohorts were approximately 2 times higher than rates found in the rest of the population (incidence rate ratio (IRR) 1.84 to 2.12, confidence interval (CI) range [1.84 to 2.33]). In further comparison to the rest of the population, a slightly lower rate of accessing different general practice clinics was found for participants with Cerebral Palsy (IRR = 0.85, CI [0.80, 0.90]). However, results suggest that adults with neurological disability consult multiple general practitioners and visit different clinics over available record years.
Conclusions
Findings from this administrative health data provides a valuable foundation and demonstrates that adults with neurological disability in Australia use general practice services more frequently than the rest of the population. Investigating the factors that influence general practice service utilization, as well as the quality of consultations and continuity of care experienced by adults with neurological disability, remains a critical area for future research.
Effectiveness of Retrograde Wide Pedicle Double-Blood Supply Flaps from the Medial Lower Leg in Reconstructing Foot and Ankle Soft Tissue Defects
Authors: Wang Wei , Shi Xianqing , Yang Miaomiao , Deng Xiaowen , Shen Weiwei , Li Wenbo , Zhang Yaqiang , Shi Jie , Xue Yun , Gao Qiuming
Published: July 2024

This study evaluated the clinical efficacy of a retrograde wide pedicle double-blood supply flap from the medial aspect of the lower leg, which includes nutrient vessels from the saphenous nerve and the medial malleolus perforating branch of the posterior tibial artery, in reconstructing soft tissue defects in the foot and ankle area. A retrospective analysis was conducted on 15 patients, ranging in age from 27 to 49 years, who had undergone this surgical technique between March 2018 and July 2022 due to injuries from car accidents or heavy object impacts. These patients experienced various types of soft tissue defects, including those with and without associated bone fractures. During the postoperative follow-up, which averaged 12 months, it was observed that two patients experienced initial complications such as flap swelling and skin discoloration, which were effectively managed with conservative treatments such as pedicle suture removal, manual massage, and limb elevation. By the end of the follow-up period, the majority of cases showed excellent results with good flap appearance and texture, no reported surgical pain, and high patient satisfaction. Furthermore, the functionality of the ankle was significantly improved, with restored range of motion in both dorsiflexion and plantar flexion. The results suggest that the retrograde wide pedicle double-blood supply flap is highly effective for reconstructing soft tissue defects in the foot and ankle regions, providing a stable blood supply and good venous return without the necessity for vascular anastomosis. This makes it a valuable option for surgical reconstruction in complex cases where tissue viability and functional recovery are paramount.
Inferring community structure in attributed hypergraphs using stochastic block models
Authors: Nakajima Kazuki , Uno Takeaki
Published: July 2024

Hypergraphs represent complex systems involving interactions among more than two entities and allow the investigation of higher-order structure and dynamics in real-world complex systems.
Stochastic block models have been employed to investigate community structure in networks.
Node attribute data, often accompanying network data, has been found to potentially enhance the learning of community structure in dyadic networks.
In this study, we develop a statistical framework for incorporating node attribute data into the inference of community structure in a hypergraph, employing a stochastic block model.
We demonstrate that our model, referred to as HyperNEO, enhances the inference of community structure in hypergraphs when node attributes are sufficiently associated with the communities.
We also showcase the use of stochastic block models, including our model, for projecting the nodes in a hypergraph into a two-dimensional vector space.
We found that this projection simplifies the identification of a set of nodes with similar community memberships in empirical hypergraphs.
We expect our framework to broaden the investigation and understanding of higher-order community structure in complex systems.
Decoding Study of Polar Coded-OFDM Systems in Multipath Fading Channel
Authors: Yu Yi , Wu Mingbao , Wan Fangying , Lin Yanhua , Li Yong , Zheng Zhian
Published: July 2024

In this paper, we investigate the decoding performance and corresponding decoding strategies for polar-coded orthogonal frequency division multiplexing (OFDM) systems operating under multipath fading channels. Multipath fading channels lead to frequency selective fading of the OFDM signal, resulting in varying levels of noise interference across different subcarriers after equalization. Furthermore, frequency selective fading induces burst errors in the equalized information, thereby significantly degrading the decoding performance. To address these issues, we propose two schemes in this paper to enhance the decoding performance of polar-coded OFDM systems. Firstly, we integrate the channel state information of each subcarrier into the generation of soft information for the polar decoder, in order to alleviate the degradation of decoding performance caused by variations in signal-to-noise ratio (SNR) across subcarriers during OFDM demodulation. Secondly, we introduce a packet interleaving design after the polar encoder to enhance the robustness of polar codes against burst errors. Simulation results demonstrate that the combined application of these two decoding strategies significantly outperforms the conventional scheme in terms of transmission performance over multipath fading channels.
Close association of systemic immune-inflammation index with hepatic steatosis than fibrosis: evidences from NHANES 1999–2018
Authors: Tu Zhanwen , Duan Lijuan , Duan Shuyin , Tu Runqi
Published: July 2024

Background
Several studies have demonstrated that systemic immune inflammation index (SII) has a positive relationship with hepatic steatosis. However, it is lack of system evidence for the correlation between SII and hepatic fibrosis. The objective of this study was to evaluate the relationships between SII and hepatic steatosis or hepatic fibrosis.
Methods
A cross-sectional analysis was performed of 21833 subjects aged over 20 from the National Health and Nutrition Examination Survey (NHANES). Fibrosis-4 index (FIB-4), NAFLD fibrosis score (NFS) and hepamet fibrosis score (HFS) were the indicators for hepatic fibrosis; fatty liver index (FLI), NAFLD liver fat score (LFS) and Framingham steatosis index (FSI) were the indicators for hepatic steatosis. Pearson’s test, generalized linear model (GLM) and restricted cubic splines (RCS) were used to analyze associations of SII with hepatic fibrosis and hepatic steatosis.
Results
Pearson’s test and GLM revealed that there were negative relationships between SII and hepatic fibrosis (FIB-4, NFS and HFS), while positive relationships between SII and hepatic steatosis (FLI, LFS and FSI). The corresponding β (95%CI) of SII and hepatic fibrosis were − 0.35(-0.46, -0.24), -0.67(-0.71, -0.63) and − 0.10(-0.12, -0.09), respectively. The corresponding β (95%CI) of SII and hepatic steatosis were 6.12(4.75, 7.50), 0.22(0.12, 0.31) and 0.27(0.20, 0.34), respectively. Statistically significant non-linear association were found in SII with hepatic fibrosis and hepatic steatosis in RCS model (all P < 0.001).
Conclusion
There was a negative significant association between SII and hepatic fibrosis, while a positive significant association between SII and hepatic steatosis.
Does combining two evidence-based exercise programs in elderly people with incontinence have a triple effect on incontinence symptoms, balance and functional status?
Authors: SEÇER Melda BAŞER , TOSUN Özge ÇELİKER , AKBAYRAK Türkan , İLÇİN Nursen , TOSUN Gökhan
Published: July 2024

Background: Improving pelvic floor muscle training (PFMT), balance and functional activity is recommended in the treatment of ürinary incontinence(UI) in the elderly. The aim of this study is to examine whether PFMT combined with Otago exercises is effective on symptoms, balance and functional status in elderly people with UI, compared to PFMT alone.
Methods: This study is an assessor‐blinded, randomized controlled trial. Participants with UI aged 65 and over living in a nursig home were randomly assigned to intervention (IG) and control group (CG). The intervention group attended an exercise program that included Otago exercises combined with PFMT. The control group was included in the PFMT program with different positions. Duration of exercise for both groups was 45-60 minutes per session three times a week for 12 weeks. UI symptoms and severity (Pelvic Floor Distress Inventory-20, bladder diary), PFM muscle function (superficial electromyography), balance (Berg Balance Scale), functional status (Senior Fitness Test) and fear of falling (Falls Efficacy Scale) was measured at baseline and after the intervention.
Results: The median age of the IG (n:22) and CG (n:21) was 73.5 and 77, respectively. At baseline and after the intervention within the group, a significant improvement was observed in the PTDE-20 score (IG and CG, p:0.00) and the 2-minute step test in the IG (p:0.02) and CG (p:0.01). A significant decrease was found in the 2.45m get up and go test, PFM work MVC, PFM work average onset, and PFM rest MVC EMG values ​​(p:0.01, p:0.02, p:0.01, p:0.00) in the IG. PFM rest average value was decreased (p:0.04) in the CG.
Conclusion: Considering the fact that functional type (stress and urge type) incontinence is common in the elderly people, both incontinence and functional mobility can be improved more effectively by combining two proven practices in the treatment of incontinence.
miR-144 regulates bovine skeletal muscle satellite cell proliferation and differentiation by targeting the NACC1 gene
Authors: Ding yanling , Zhang Yanfeng , Zhou Xiaonan , Li Chenglong , Su Zonghua , Xu Junjie , Shi Yuangang , li congjun , kang xiaolong
Published: July 2024

miRNAs are encoded by eukaryotic genomes and are characterized by tissue-specific and temporal expression, suggesting that miRNAs play multiple roles in different tissues and developmental periods of a species through a variety of regulatory pathways. miR-144 regulates cell development in other species, but its regulatory mechanism in bovine skeletal muscle satellite cells (BSMSCs) is unknown. So, this experiment was designed to elucidate the function of miR-144 in BSMSCs development. It was found that miR-144 promoted the proliferation of BSMSCs, but it plays an inhibitory role in the differentiation process. After transfection of the miR-144 mimic, 476 differentially expressed genes (DEGs) were detected by RNA-seq, and these DEGs mainly regulate adrenergic, MAPK, and PI3K-AKT signaling pathways. Further studies revealed that bta-miR-144 targets binding to the NACC1 gene; whereas NACC1 regulates BSMSCs in a manner opposite to bta-miR-144. These findings suggest that miR-144 negatively regulates BSMSCs development by targeting the NACC1gene.
Autosomal dominant stromal corneal dystrophy associated with a SPARCL1 missense variant
Authors: Hardcastle Alison , Braddock Freddie , Gardner Jessica , Bhattacharyya Nihar , Sanchez-Pintado Beatriz , Costa Marcos , Zarouchlioti Christina , Szabo Anita , Lišková Petra , Cheetham Michael , Young Robert , Thaung Caroline , Davidson Alice , Tuft Stephen
Published: July 2024

Corneal dystrophies are phenotypically and genetically heterogeneous, often resulting in visual impairment caused by corneal opacification. We investigated the genetic cause of an autosomal dominant corneal stromal dystrophy in a pedigree with eight affected individuals in three generations. Affected individuals had diffuse central stromal opacity, with reduced visual acuity in older family members. Histopathology of affected cornea tissue removed during surgery revealed mild stromal textural alterations with alcianophilic deposits. Whole genome sequence data was generated for four affected individuals. No rare variants (MAF <0.001) were identified in established corneal dystrophy genes. However, a novel heterozygous missense variant in exon 4 of SPARCL1, NM_004684: c.334G>A; p.(Glu112Lys), which is predicted to be damaging, segregated with disease. SPARC-Like protein 1 (SPARCL1) is a secreted matricellular protein involved in cell migration, cell adhesion, tissue repair, and remodelling. Interestingly, SPARCL1 has been shown to regulate decorin. Heterozygous variants in DCN, encoding decorin, cause autosomal dominant congenital stromal corneal dystrophy, suggesting a common pathogenic pathway. Therefore, we performed immunohistochemistry to compare SPARCL1 and decorin localisation in corneal tissue from an affected family member and an unaffected control. Strikingly, the level of decorin was significantly decreased in the corneal stroma of the affected tissue, and SPARCL1 appeared to be retained in the epithelium. In summary, we describe a novel autosomal dominant corneal stromal dystrophy associated with a missense variant in SPARCL1, extending the phenotypic and genetic heterogeneity of inherited corneal disease.
Structural Characterization of Disulfide-Linked p53-Derived Peptide Dimers
Authors: DiGiorno Magdalena C. , Vithanage Nisansala , Victorio Clara G. , Kreitler Dale F. , Outlaw Victor K. , Sawyer Nicholas
Published: July 2024

Disulfide bonds provide a convenient method for chemoselective alteration of peptide and protein structure and function. We previously reported that mild oxidation of a p53-derived bisthiol peptide (CTFANLWRLLAQNC) under dilute non-denaturing conditions led to unexpected disulfide-linked dimers as the exclusive product. The dimers were antiparallel, significantly α-helical, resistant to protease degradation, and easily reduced back to the original bisthiol peptide. Here we examine the intrinsic factors influencing peptide dimerization using a combination of amino acid substitution, circular dichroism (CD) spectroscopy, and X-ray crystallography. CD analysis of peptide variants suggests critical roles for Leu6 and Leu10 in the formation of stable disulfide-linked dimers. The 1.0 Å resolution crystal structure of the peptide dimer supports these data, revealing a leucine-rich LxxLL dimer interface with canonical knobs-into-holes packing. Two levels of higher-order oligomerization are also observed in the crystal: an antiparallel “dimer of dimers” mediated by Phe3 and Trp7 residues in the asymmetric unit and a tetramer of dimers mediated by Trp7 and Leu10. In CD spectra of Trp-containing peptide variants, minima at 227 nm provide evidence for the dimer of dimers in dilute aqueous solution. Importantly, and in contrast to the original dimer model, the canonical leucine-rich core and robust dimerization of most peptide variants suggests a tunable molecular architecture to target various proteins and evaluate how folding and oligomerization impact various properties, such as cell permeability.
Paraphilic Sexual Fantasies in a Sample of University Students from Southern Brazil
Authors: Furian Gabriel , Schwarz Karine , Canto Gustavo do , Jordani João , Marchi Nino , Beier Klaus Michael , Amelug Till , Lobato Maria Inês
Published: July 2024

Purpose: This study aims to investigate the frequency and the possible correlation between paraphilic fantasies, hypersexuality, childhood trauma, and self-declared sexual orientation in a sample of university students from public and private institutions in Southern Brazil.
Methods: An online questionnaire, through the Google Docs hosting platform, was adapted from the inventory of paraphilic interests and disorders of the Troubled-Desire website. Childhood Trauma Questionnaire, Hypersexual Disorder Screening Inventory was assessed, both in the Brazilian version.
Results: The sample consisted of 572 students, 64% with 18–24 years; 56.5% reported female biological sex and 43.5% male. Regarding gender identity, 55.8% were female, 42.8% male, 1.4% nonbinary, and 0.7% transvestite; 53.1% of the participants declared themselves heterosexual, 31.1% bisexual, and 13.1% homosexual. About 2.4% of the participants defined themselves as pansexual, demisexual, asexual, "I don't know," "doubt," "questioning," and queer. 42.6% of the women declared themselves as bisexual and 6.7% as homosexual, whereas 18% of the men self-declared as bisexual and almost 31% as homosexual; 3.2% of male participants presented diagnoses criteria for hypersexual disorder. The difference in the frequency of hypersexual disorder in men and women was statistically significant (p=0.012). Women were more associated with masochistic sexual fantasy, whereas men were more associated with frotteurism, voyeurism, sadism, pedophilia, and cross-dressing.
Conclusion: This research brings light to the presence of paraphilic fantasies in a sample of university students of Southern Brazil, which was very high, and to the absence of self-declared impairment or suffering, showing that these fantasies may not indicate a mental disorder.
Nutrition Transition Patterns in the Context of Global Food Systems Transformation
Authors: Carducci Bianca , Chen Yixin , Luo Hanqi , Webb Patrick , Fanzo Jess
Published: July 2024

The idea of nutrition transition was critical to conceptualizing patterns of the global burden of malnutrition in line with demographic and epidemiological transitions of the 20th century. However, earlier typologies are less reflective of the nuances which characterize today’s nutrition reality. This analysis presents a new paradigm for conceptualizing nutrition transition that better aligns with food system transitions and with evolving population dynamics. Examining seven nutrition indicators (under-5 stunting, wasting and overweight, adult overweight, anemia in women of reproductive age, adult diabetes and adult raised blood pressure) with national-level estimates between 2013-2023, we explore how food system typologies cluster across 108 countries and identify three distinct population-level patterns which describe a triple burden of malnutrition that manifests differently across the globe. The findings suggest that while Cluster 1 encompasses a large proportion of less industrialized countries from a food systems perspective, Clusters 2 and 3 represent a mosaic of typologies experiencing similar nutrition burdens in middle- and higher-income nations. Therefore, the forces shaping global and local food systems are dynamic and interactive, resulting in outcomes that are less linear and distinct than previous concepts allowed for.