bluuebunny/crossref_metadata_2025 huggingface dataset:
Study on the Near‐Distance Object Following Performance of a 4WD Crop Transport Robot: Application of 2D LiDAR and Particle Filter
Authors: Pak Eun-Seong , Kim Byeong-Hun , Lee Kil-Soo , Cha Yong-Chul , Kim Hwa-Young
Published: November 2024

In this paper, the development and performance evaluation of a 4WD robot system designed to follow near-distance moving objects using a 2D LiDAR sensor are presented. The study incorporates identifier (ID) classification and a distance-based dynamic angle of perception model to enhance the tracking capabilities of the 2D LiDAR sensor. A particle filter algorithm was utilized to verify the accuracy of object tracking. Furthermore, a Proportional-Derivative (PD) controller was designed and implemented to ensure the stability of the robot during operation. Experimental results demonstrate the potential applicability of these approaches in various industrial applications.
Epidemiological Insights: Unraveling Drug Resistance in Leishmania Species through Comprehensive Studies
Authors: Ghousepeer Gajala Deethamvali , Rani Mansi , Kumar Aman , Singh Shubhankar Kumar , Priyadarshini Anjali , Singh Shailja , Raj V. Samuel , Basu Subhajit , Pandey Ramendra
Published: November 2024

Leishmaniasis, a neglected tropical disease caused by the protozoan parasite Leishmania, remains a significant public health concern in endemic regions. This disease manifests in various forms like cutaneous, mucocutaneous, and visceral leishmaniasis, each associated with specific Leishmania species and influenced by host immune responses. Over the past few decades, treatment for leishmaniasis has relied on a limited range of drugs, including Pentavalent Antimonials, Amphotericin B formulations, Miltefosine, and Paromomycin. However, widespread drug resistance has emerged, particularly in visceral leishmaniasis, threatening treatment efficacy and leading to increased cases of treatment failure. This review provides a comprehensive overview of the mechanisms underlying Leishmania drug resistance, including changes in parasite uptake and efflux, intracellular sequestration, and stress response modulation. Additionally, we examine the impact of environmental factors, such as arsenic exposure in endemic areas, on resistance development, and review recent studies exploring molecular and genomic markers associated with resistance. The review highlights the urgent need for new therapeutic strategies and emphasizes a multi-faceted approach to tackle resistance through surveillance, molecular insights, and global collaborations.
Enhanced Oil Recovery in Low-Permeability Reservoirs: Water Block Remediation by Interfacial Tension Reduction and Wettability Alteration
Authors: Guessoum Hadil , Abdallah Ahlam
Published: November 2024

The water trapping after drilling, completion, and reconditioning operations in a low-permeability reservoir, critically impacts hydrocarbon production by creating capillary barriers for oil flow to the wellbore. Water flow and its influence on oil threshold pressure were evaluated with constant pressure injection at a given reservoir pressure gradient (1173 hPa) will be generated. Compounds encompassing alcohols and surfactants were strategically employed to mitigate the undesirable impact of heightened water saturation. These agents were chosen for their efficacy in diminishing water saturation, reducing capillary pressure through the modulation of interfacial tension, and inducing alterations in rock wettability via adsorption mechanisms. Each treatment performance was evaluated by The Amott method and stalagmometric analysis which revealed that ethylene glycol decreased interfacial tension by up to 38.5% at 60% concentration, Propanol to 29,08 mN/m at the same concentration, and butanol reversed the rock wettability to an oil-wet state, evidenced by a wettability index of -0.159. The highest oil displacement efficiency was demonstrated by butanol, achieving a 72.6% rate of water recovery at 20% concentration.
Assessment of the Utility of Selected Inflammatory Markers in Correlation with Magnetic Resonance Enterography (MRE) Findings in the Diagnosis of Crohn’s Disease
Authors: Lorenc-Góra Justyna , Waniczek Dariusz , Czuba Zenon , Lorenc Zbigniew , Muc-Wierzgoń Małgorzata , Kryj Mariusz
Published: November 2024

Crohn’s Disease (CD) is a chronic inflammatory bowel disease affecting the gastrointestinal tract. The search continues for new markers for assessing the activity of CD. Among them, pro-inflammatory and anti-inflammatory cytokines appear promising.We performed the analysis of cytokine concentrations in blood serum using the Bio-Plex Multiplex system (Bio-Rad) and their correlations with radiological parameters assessed by magnetic resonance enterography (MRE), fecal calprotectin levels measured quantitatively by ELISA and clinical evaluation according to the Crohn’s Disease Activity Index (CDAI). Our study has found that measuring cytokine serum concentrations can be a valuable tool in the diagnosis and treatment of CD. Positive correlations were reported between contrast enhancement on DCE-MRE and the concentrations of PDGF-BB and RANTES. Also, a positive correlation was found between delayed-phase of DCE and IL-10 concentration, a strong negative correlation between delayed-phase of DCE and IL-12 concentration, and a strong positive correlation between delayed-phase of DCE and RANTES concentrations. A strong positive correlation was also observed between the thickness of the intestinal wall on T2-weighted images and RANTES concentration. Therefore, concentrations of PDGF-BB, RANTES, IL-10 and IL-12 are promising markers of CD activity. The study also demonstrated significant correlations between the severity of disease activity assessed by the CDAI and the concentrations of IL-5, IL-8, and IL-9, as well as positive correlations between the levels of fecal calprotectin and the concentrations of IL-1RA and VEGF. Therefore, the levels of IL-5, IL-8, IL-9, VEGF and IL-1RA may be useful markers in the diagnosis and clinical assessment of disease activity.
Genomic Diversity and Virulence Factors of Clostridium perfringens Isolated from Healthy andNecrotic Enteritis–Affected Broiler Chicken Farms in Quebec Province
Authors: Heidarpanah Sara , Li Kevin , Thibodeau Alexandre , Meniaï Ilhem , Parreira Valeria R. , Quessy Sylvain , Segura Mariela , Fittipaldi Nahuel , Gaucher Marie-Lou
Published: November 2024

Avian necrotic enteritis due to the Gram-positive bacterium Clostridium perfringens has re-emerged following the ban on antibiotic growth promoters in many poultry producing countries. The limited number of previous studies has left important gaps in our understanding of the genetic diversity and virulence traits of the pathogen. To address these knowledge gaps, in this study, we sequenced the genomes of 41 Clostridium perfringens isolates recovered from commercial broiler chicken flocks in Quebec, Canada, including isolates from healthy birds and those affected by necrotic enteritis. We sought to understand the pangenome diversity and interrogated the genomes for key virulence factors involved in necrotic enteritis pathogenesis. On average, the genomes had a GC content of 28% and contained 3,206 coding sequences. A variable presence of toxins, degradative hydrolytic enzymes, and collagen-binding proteins was also found. Through pangenome analysis, we revealed a total of 10,223 genes, 652 (6.4%) of which formed the core genome. Additionally, we identified 17 different plasmids, 12 antibiotic resistance genes, and nine prophage regions. Overall, our results demonstrated a relatively high genetic diversity among chicken Clostridium perfringens isolates collected from the same geographical location, offering new insights into potential virulence mechanisms and adaptation of the pathogen within poultry populations.
Initial Outcomes of Physician-Modified Inner-Branched Endovascular Repair for Distal Aortic Arch Aneurysm
Authors: Tsushima Shingo , Shibata Tsuyoshi , Iba Yutaka , Nakajima Tomohiro , Nakazawa Junji , Miura Shuhei , Arihara Ayaka , Mukawa Kei , Iwashiro Yu , Kawaharada Nobuyoshi
Published: November 2024

Background/Objectives: Although acceptable initial outcomes after physician-modified inner-branched endovascular repair (PMiBEVAR) for thoracoabdominal aortic aneurysm have been reported, few clinical studies have reported on PMiBEVAR for aortic arch aneurysm. Herein, we evaluate the initial outcomes of six cases of proximal landing zone 2 PMiBEVAR. Methods: This retrospective study analyzed data from six patients who underwent zone 2 PMiBEVAR for aortic arch aneurysms at a single center between October 2021 and June 2024. The outcomes were 30-day mortality and postoperative complications. Results: The median follow-up period was 12.5 (7.3–25) months. The patients had a median age of 78.5 (76.5–79.0) years, and the median aneurysm diameter was 56 (50–61) mm. Technical success was achieved in 5/6 (83.3%) cases. The median modification and operative times were 56 (45–60) min and 92 (79–308), respectively. Open abdominal surgery was required in one patient due to access vessel bleeding. Postoperatively, delayed type Ia endoleak and vascular access-site complication occurred in one patient each. However, no patients experienced stroke, spinal cord ischemia, or other complications. The median hospital stay was 10 (7–41) days, and no deaths or reinterventions occurred after 30 days. During post-discharge follow-up, the aneurysm diameter remained “unchanged” in four patients, including the one with delayed type Ia endoleak, while two patients experienced aneurysm diameter shrinkage. Ultimately, one patient died due to respiratory failure. Conclusions: PMiBEVAR for distal aortic arch aneurysm might be effective in improving postoperative outcomes; however, further studies are required to confirm these results.
Enhancing Air Suction Efficiency: A Comparative Study of Venturi Devices with Four Distinct Manifold Configurations
Authors: Tumur Seyhmus , Bagatur Tamer
Published: November 2024

Dissolved oxygen content is a paramount indicator of water quality. The quality of water and its remediation are directly linked to the dissolved oxygen concentration within it. A higher dissolved oxygen level signifies better water quality. Aeration processes are employed to enhance dissolved oxygen levels in water treatment. Aeration is achieved through natural methods or hydraulic structures that increase the interfacial area between water and air. This study investigates the aeration efficiencies of pressurized flow systems equipped with Venturi devices of two different orifice diameters connected to four distinct manifold pipe systems. The findings indicate that the orifice diameters of these hydraulic structures (Venturi devices) significantly influence aeration efficiency.
Saponins Effect on Human Insulin Amyloid Aggregation
Authors: Mari Eleonora , Vilasi Silvia , Moretti Paolo , Mangione Maria Rosalia , Giorgini Giorgia , Galeazzi Roberta , Ortore Maria Grazia
Published: November 2024

Misfolding and amyloid aggregation of proteins have attracted scientific interest from a few decades, due to their link with several diseases, in particular neurodegenerative diseases. Proteins can assemble and result in insoluble aggregates that, together with intermediate oligomeric species, modify extracellular environment. Many efforts have been and are devoted to the search of cosolvents and cosolutes able to interfere with amyloid aggregation. In this work we intensively study the effect of saponins, bioactive compounds, on human insulin aggregation. To monitor the kinetic of amyloid aggregation following secondary structure changes we performed fluorescence and UV-Visible absorption spectroscopies, using Thioflavin T and Congo Red as amyloid specific probes, and Circular Dichroism. To study the overall structural features and size of aggregates we performed Synchrotron Small Angle X-ray Scattering and Dynamic Light Scattering experiments. The morphology of the aggregates was assessed by Atomic Force Microscopy. To deepen the understanding of saponins interaction with insulin, a Molecular Dynamics investigation was performed, too. Reported data demonstrate that saponins interfere with the amyloid aggregation by inducing a strong inhibition on the formation of insulin fibrils, likely through specific interactions with insulin monomers. A dose dependent effect is evident and amyloid inhibition is already clear when saponins are just 0.01 % w/w in solution. We suggest that saponins, which are natural metabolites present in a wide range of foods ranging from grains, pulses, and green leaves to sea stars and cucumbers, can be promising metabolites to inhibit human insulin aggregation. This basic research work can pave the way to further investigations concerning insulin amyloidosis, suggesting the use of saponins as amyloid inhibitors and/or stabilizing agents in solution.
Electronic Health Literacy, Health Literacy, and Predictors of Self-Care Behavior Among Risk Groups of Hypertension and Diabetes Mellitus in Chang Klang Community,
Nakhon Si Thammarat, Southern Thailand
Authors: Raksanam Buppha , Sornkaew Wittaya , Thirarattanasunthon Phiman , Ruangrattanatrai Wilailuk , Mudchiew Thanarat , Sriwisit Sukhumaporn , Sayoungkul Panupong , Chantra Sasipa
Published: November 2024

Electronic health literacy, health literacy, and self-care behaviors among at-risk populations for diabetes and hypertension are crucial areas of study. Additionally, there is a lack of concrete research on this issue in the Chang Klang community. The objectives of this cross-sectional study were to: 1) explore Electronic Health Literacy, health literacy, and self-care behavior, 2) examine the relationships between Electronic Health Literacy, health literacy, and self-care behavior, and 3) identify predictors of self-care behavior among individuals at risk for diabetes and hypertension in the Chang Klang community, Nakhon Si Thammarat Province, southern Thailand. The study was conducted between October and November 2024, using a proportionate stratified sampling method to recruit 472 risk group participants. Data were analyzed using percentages, means, standard deviations, Pearson product-moment correlation, and stepwise multiple regression analysis. The results revealed that mean scores for Electronic Health Literacy, self-care behavior, participation in health education activities, and learning from observing health role models were at a moderate level (3.44 ± 0.88, 3.56 ± 0.68, 3.44 ± 0.94, and 3.56 ± 0.71, respectively). Overall health literacy was at a high level (3.77 ± 0.67), with the highest score observed in the dimension of accessing health information and services (3.91 ± 0.76) and the lowest in understanding self-care information (3.67 ± 0.76). A statistically significant positive correlation (p < 0.001) was found between Electronic Health Literacy, health literacy, participation in learning activities, learning from health role models, and self-care behavior. These variables accounted for 40% of the variance in self-care behavior (R² = 0.40). The findings indicated that while risk groups can access health information, they struggle to understand and apply it. Effective communication, role models, and participation in health activities are key to fostering sustainable behavior change.
Pengaruh Media Pembelajaran Powerpoint Morph dalam meningkatkan Kreativitas Belajar peserta didik di SMP Negeri 18 Palembang
Authors: Firli Muhammad Robi , Fatihah Husnul
Published: November 2024

Abstrak
Keberadaan teknologi saat ini dinilai sangat penting dalam pendidikan. Tenaga pendidik harus mampu mengasah keterampilannya dalam menguasai  teknologi melalui media pembelajaran. Media pembelajaran yang cocok untuk meningkatkan kreativitas belajar peserta didik adalah media pembelajaran yang memiliki unsur visual, audio maupun audio visual. Media pembelajaran PowerPoint Morph merupakan media yang berfokus terhadap unsur visual, audio maupun audio visual. Penelitian ini bertujuan untuk mengetahui pengaruh media pembelajaran powerpoint morph dalam meningkatkan kreativitas belajar peserta didik. Penelitian ini menggunakan jenis penelitian pre-experimental design dalam bentuk one-grup pretest-posstest design. Dengan populasi seluruh kelas VII dengan sampel kelas VII.8 yang berjumlah 36 orang diambil menggunakan teknik purposive sampling. Berdasarkan hasil analisis dan pembahasan dapat disimpulkan bahwasanya penerapan media pembelajaran powerpoint morph dapat meningkatkan kreativitas belajar peserta didik. Hal ini dapat dibuktikan melalui hasil uji hipotesis menggunakan uji paired t-test didapatkan nilai sign sebesar 0,01 ˂ 0,05, artinya hipotesis kerja (Ha) diterima dan H0 ditolak. Jadi dapat ditarik kesimpulan bahwa terdapat pengaruh dari penerapan media pembelajaran powerpoint morph dalam meningkatkan kreativitas belajar peserta didik pada kelas VII SMP Negeri 18 Palembang.
Kata kunci : kreativitas belajar, media pembelajaran, powerpoint morph
The Effectiveness of Group Guidance Services with Symbolic Modeling Techniques to Increase Empathy of Santri at Ma'had Al-Khoirot MAN 2 Jember
Authors: Rahmah Unzilatur , Maghfiroh Nasruliyah Hikmatul , Rahmawati Weni Kurnia
Published: November 2024

The Effectiveness of Group Guidance Services with Symbolic Modeling Techniques to Increase Empathy of Santri at Ma'had Al-Khoirot MAN 2 Jember. The study examined the effectiveness of group guidance services using symbolic modeling techniques to foster empathy in santri of Al-Khoirot Islamic Boarding School MAN 2 Jember. This study is important because it offers an innovative approach to improving empathy in students through group guidance with symbolic modeling techniques. The research approach uses a quantitative method with a pre-experimental design methodology of the one group pretest-posttest type. The data collection method used was the Wilcoxon Test. The population of the study was santri of Al-Khoirot Islamic Boarding School MAN 2 Jember with a total of 39 students, with a sample of 6 students. The results of this study indicate that group guidance services using symbolic modeling techniques are effective in improving empathy in santri of Al-Khoirot Islamic Boarding School MAN 2 Jember. Before being given treatment, the level of empathy in students had an average of 229.5, but after being given treatment and posttest 4 times, there was a significant increase of 282.5. Analysis using the Wilcoxon test produced an Asymp value. Sig. (2-tailed) of 0.028, shows a significant influence between pretest and post-test, so that the research hypothesis can be accepted. The conclusion is that the symbolic modeling method is able to foster empathy in santri of Al-Khoirot Islamic Boarding School MAN 2 Jember, so that this therapy can be used as an alternative guidance strategy for developing empathy characters in Islamic boarding schools.
Keywords: Group Guidance, Symbolic Modeling Techniques, Empathy Santri
Behavior Counseling Uses Assertive Exercise Techniques in Dealing with Adolescent People Pleasers
Authors: Iskandar Isak , Muzayan Muzayan , Fauzi Anis , Salim Ahmad Aris
Published: November 2024

Someone who has people pleaser problems likes to get carried away by their friends, because they are unable to say "no," they tend not to be able to refuse. Because if you refuse, you will feel anxiety and guilt. This phenomenon is a bad behavior and must be handled, by changing the behavior and replacing it with new, better behavior. The purpose of this study is to understand the ins and outs of the implementation of behavioral counseling in adolescents. This study uses a qualitative approach method, this descriptive research tries to provide ideas systematically and carefully on the actual facts and characteristics of a particular population, the approach plan is through case studies. The results of this study show that there are differences in behavior in adolescents in Serang City between before and after implementing a behavioral approach using assertive techniques in dealing with people pleaser problems. The results of role-playing and homework assignments given to respondents are increasingly visible and can be seen from those who have begun to understand assertive behavior and the importance of eliminating bad behavior and replacing it with good behavior.
Impacto del sentido de pertenencia del analista en la relación terapéutica
Authors:   Instituto de Psicoterapia Relacional, Castaño Catalá Rosario , Gallego Luis Ricardo ,   Instituto de Psicoterapia Relacional
Published: November 2024

Relational Psychoanalysis has involved a shift towards a bipersonal and intersubjective conception of psychological phenomena, and some of the consequences of this is that analysts are increasingly aware of the loneliness of our profession, and of the need to develop and build a sense of belonging, a common place that allows us a greater understanding and connection with the vulnerability of the human condition. The search for belonging is a central core of the human being that is associated with mental health. During the period of confinement by COVID-19 we conducted a study among Spanish psychotherapists to find out how the pandemic had impacted our mental health. Some of the conclusions were that "connection with friends and family was the most valued and supportive activity" and also that "unwanted loneliness was associated with a negative impact on mental health".
Encontrando un hogar en el cambio. Cuando terapeuta y paciente migran
Authors:   Instituto de Psicoterapia Relacional, Román Mendoza Paulina
Published: November 2024

This paper seeks to expose the personal experience that, during a flight back to my city, I found myself reflecting on whether I could define myself as a relational psychoanalyst. This introspection led me to question my role as a therapist and to consider how my own experience of migration has influenced my practice.
Migration, an emotionally complex process, has transformed my understanding of the therapeutic
relationship. Through intersubjective connection, I have learned that both therapist and patient evolve in this shared space.
A significant case was that of D., a patient who, like me, was facing the uncertainty of a life change. As we worked together, our migration experiences became intertwined, revealing the importance of sustaining vulnerability and creativity in the therapeutic process. The pandemic further complicated our relationship, but it also provided an opportunity to explore new forms of connection.
The relational approach, as Margaret Black (2021) suggests, moves us away from the omniscient analyst and toward a process of co-creation. In this context, therapy becomes a space where both therapist and patient can find an emotional home, even in the midst of turbulence.
Plantar cutaneous sensation is independently associated with postural balance and lower limb motor function in older adults: The Shizuoka study
Authors: Kato Michitaka , Kito Kazuya , Nakano Satoko , Nakano Wataru , Kurita Yasunari , Tanaka Yoshihiro , Kuriyama Nagato , Seto Kazuya , Ozaki Etsuko , Tabara Yasuharu
Published: November 2024

Purpose: A relationship between decreased plantar cutaneous sensation and impaired balance function has been reported in patients with peripheral neuropathy and diabetes. This cross-sectional study aimed to investigate the relationship between plantar sensation and postural balance, as well as the association between plantar sensation and sarcopenia-related motor function in community-dwelling older adults.
Methods: The participants included 1,659 community-dwelling older adults with a mean age of 74 ± 5 years, of which 43% were male patients. Plantar cutaneous sensation thresholds were assessed using an automatic plantar sensation testing device. Postural balance was measured using one-leg standing (OLS) time. Grip strength, five-times sit-to-stand (STS) time, and normal gait speed were measured as components of muscle strength and physical function related to sarcopenia. The skeletal muscle mass index (SMI) and leg phase angle were obtained using bioelectrical impedance analysis.
Results: Age, sex, body mass index, and leg phase angle, but not SMI and grip strength, were independently associated with the plantar sensation threshold. Plantar sensation threshold was independently associated with the OLS time (P = 0.001) and STS time (P =0.001) after adjusting for potential confounders. No significant association was found between plantar sensation threshold and normal gait speed (P =0.741).
Conclusion: Plantar sensation was independently associated with postural balance and lower limb function in community-dwelling older adults. The assessment of plantar sensation could be useful for identifying factors contributing to poor postural balance and lower limb motor function.
Understanding Fundamental Differences in Symptomatic Outcomes of Hiatal versus Paraoesophageal Hernia Robotic Repairs
Authors: Aslam Arham , Hubka Michal , Sternbach Joel , Kuppusamy Madhan
Published: November 2024

Background: Hiatal hernia (HH), or type I paraoesophageal hernias (PEH), can commonly be grouped along with types II-IV PEHs. The fundamental operation performed for repair is similar for all types. We question whether the clinical outcomes following surgical repair differ. The objective of this study is to determine the differences in clinical outcomes when comparing robotic assisted surgical repair of HH versus types II-IV PEHs.
Design: This is a retrospective study analyzing 602 consecutive patients that underwent robotic assisted repair of a PEH between August 2018 and June 2024. Data was retrieved from an IRB approved database (IRB21-014).
Setting: Tertiary referral center.
Participants: Eligibility criteria included patients with objective findings of a PEH on diagnostic testing. 184 patients were excluded due to: emergent operation, repeat operations, conversion to open operation, patients pending follow up, patients lost to follow up. Patient demographics were consistent with a population-based sample.
Interventions: All patients underwent robotic assisted laparoscopic PEH repair with a fundoplication using the Da Vinci Xi robotic system (Intuitive Surgical, Sunnyvale, CA). No mesh implantation was used.
Measurements: The primary study outcome was postoperative symptomatic improvement when comparing HH repairs versus types II-IV PEH repairs. Secondary outcomes included other perioperative outcomes. The hypothesis was formulated before data collection started.
Results: Patients in the HH cohort showed significant reflux symptom improvement postoperatively (98% vs 12.2%, p<0.01). PEH patients also showed similar improvements in reflux symptoms (84.8% vs 25%, p<0.01). Symptomatic improvement of dysphagia was found to be significant only in the PEH cohort (54% vs 17.8%, p<0.01)
Conclusion: HHs and PEHs are two distinct entities that present with different symptoms; however, the fundamental operation is similar. Symptomatic outcomes differ between the two patient populations, even with the same surgical management.
Metagenomic analysis of human, animal, and environmental samples identifies potential emerging pathogens, profiles antibiotic resistance genes, and reveals horizontal gene transfer dynamics
Authors: Napit Rajindra , Gurung Anupama , Poudel Ajit , Chaudhary Ashok , Manadhar Prajwol , Sharma Ajay Narayan , Raut Samita , Pradhan Saman Man , Joshi Jyotsna , Poyet Mathilde , Groussin Mathieu , Rajbhandari Rajesh M. , Karmacharya Dibesh B.
Published: November 2024

Antimicrobial resistance (AMR) is a rapidly emerging global health crisis, projected to cause 10.2 million deaths annually by 2050. The unregulated and indiscriminate use of antibiotics is driving the swift emergence and spread of AMR, a problem worsened by the release of untreated wastewater from high-risk sources, such as hospitals, into rivers. Bacteria often acquire resistance through horizontal gene transfer, and specific environments, like the human gut or soil, can serve as hotspots for the emergence of novel antimicrobial resistance genes (ARGs) and multi-drug resistant (MDR) pathogens. Shotgun metagenomics can be used to profile the AMR of a given microbiome and help detect MDR bacteria that might otherwise go unnoticed. However, current AMR reporting is largely based on clinical cases, offering limited insights into specific pathogens and their associated AMR genes. Our study aims to advance the understanding of the natural distribution and dissemination of AMR. In particular, we focused on the presence of AMR mutations and gene transfer dynamics in human, animal, and environmental samples collected from a temporary settlement in Kathmandu, Nepal, using a One Health approach. Twenty-one samples were collected from a temporary settlement in Thapathali, Kathmandu, including fecal samples from birds (n = 3), humans (n = 14), and the environment (n = 4). Prevotella spp. was the dominant gut bacterium in human samples. A diverse range of phages and viruses were detected, including Stx-2 converting phages. In total, 72 virulence factors and 53 antimicrobial resistance gene (ARG) subtypes were identified, with poultry samples showing the highest number of ARG subtypes. Using a One Health-based metagenomics approach, we identified various pathogenic bacteria and virulence genes in both human and avian samples, underscoring the interconnectedness of antimicrobial resistance (AMR) across different domains. Heavy antibiotic use in poultry and clinical settings likely contributes to the spread of antimicrobial resistance genes (ARGs). Our analysis indicates frequent horizontal gene transfer, with gut microbiomes serving as key reservoirs for ARGs. Despite certain challenges, metagenomics shows significant potential for advancing our understanding of AMR dynamics. We emphasize the need for a One Health approach and robust global surveillance systems to enable the early detection and control of AMR, safeguarding public health.
Acceptance of Artificial Intelligence in Medical Practice Among Iranian Physicians and Medical Students: A Cross-Sectional Survey
Authors: Hajesfandyari Javad , Abbasinejad Shaghayegh , Oladi Niousha , Taghavi Tohid , Lavasani Eiliya Navaee , Jafari Atieh , Baghani Matin , Akhlaghdoust Meisam
Published: November 2024

Background
The integration of Artificial Intelligence (AI) into healthcare is rapidly advancing; however, research on its acceptance among medical professionals in Iran remains limited. This study aimed to assess the acceptance of AI in medical practice among Iranian physicians and medical students.
Methods
A cross-sectional survey was conducted between January and June 2023 at multiple medical institutions in Iran. The study included 535 participants (351 medical students and 184 physicians) who completed an online questionnaire assessing awareness, experience, attitudes, and willingness to adopt AI in clinical practice.
Results
Medical students reported significantly higher use of AI-based decision support systems (89.5%) than physicians (45.1%) (p = 0.038). Both groups frequently encountered AI errors (physicians: 65.1%, students: 68.5%). Attitudes toward AI were generally positive, with no significant differences based on gender or surgical specialty. However, years of medical experience significantly influenced attitudes (p = 0.02), with less experienced professionals showing more positive attitudes.
Conclusions
This study revealed a generational shift in AI adoption, with medical students showing higher acceptance rates. Although the attitudes were generally positive, the high prevalence of AI errors highlights the need for improved system reliability and targeted training programs. These findings have important implications for medical education, healthcare institutions, and AI developers in the evolving landscape of AI integration in Iranian healthcare.
The clinical characteristics and response at head-up tilt test of patients with micturition syncope:single center experience in China
Authors: Li Jing , Xiao Xuan , He Shunzhi , Sun Haitao
Published: November 2024

Objective The study compared clinical characteristics and response at head-up tilt test (HUTT) between micturition syncope (MS) and typical vasovagal syncope (VVS).
Methods Consecutive patients who underwent nitroglycerin-potentiated HUTT were retrospectively dichotomised into two groups: those with a history of MS and those with a history of VVS. The patients with MS were further subdivided into patients with MS alone and with MS and at least one episode of VVS.
Results 2637 patients were enrolled:204 had MS (MS alone in 103 and MS+VVS in 101),216 had typical VVS. Patients with MS were older (38.6±13.1vs 36.3±18.5, P=0003) and more likely males (66.2% vs 48.1%, P＜0.001). At multivariable analysis, smoking habit (OR 2.16, p<0.0001), history of traumatic syncope (OR 2.24, p=0.0001) and drinking alcohol before syncope (OR 2.63, p<0.0001) were independently associated with MS. HUTT was positive in 141 (69.1%) patients with MS and in 144 (66.7%) patients with VVS (p=0.592). Patients with MS showed more mixed (46.1% vs 28.2%, p<0.001) and vasodepressor forms (15.2% vs 7.9%, p=0.013) and less cardioinhibitory responses compared with others (7.4% vs 30.6%, p<0.001).
Conclusions Compared with VVS, patients with MS have different clinical characteristics and drinking alcohol was an important recipitating factor for MS. The positivity rate of HUTT is high and similar to that of VVS, although patients with MS show a higher prevalence of hypotensive responses
Comparing the bowel cleansing effects between sodium picosulfate and 2L polyethylene glycol: A real-world study
Authors: Su Yang , Luo Dan , Jiang lin , zhang chen , Liu Yifeng , Sun Xiaobin , Shan Jing
Published: November 2024

Background: This study aimed to compare the bowel cleansing efficacy, adverse reactions, and patient compliance of two low-volume bowel preparation regimens, sodium picosulfate (PICO) and 2L polyethylene glycol (2L PEG), in a "real-world" setting.
Methods: This single-center, observational trial was conducted at the Gastrointestinal Endoscopy Center of The Third People's Hospital of Chengdu between May and October 2023. Patients undergoing colonoscopy were enrolled, with the primary outcome being the rate of adequate bowel cleansing, as assessed by the Boston Bowel Preparation Scale (BBPS). Secondary outcomes included polyp detection rate, adverse reactions, and patient compliance.
Results: A total of 5423 patients were included, divided into the PICO group (n=739) and the 2L PEG group (n=4684) based on the bowel preparation regimen used. Both groups achieved an adequate bowel cleansing rate exceeding 90% (92.2% vs. 91.3%, P=0.437), with comparable polyp detection rates (42.2% vs. 45.5%, P=0.096) and high willingness to repeat the procedure (99.2% vs. 99%, P=0.588). Notably, total colon and right colon cleansing were more effective in the PICO group compared to the 2L PEG group [(6.90 ± 1.19) vs. (6.81 ± 1.14), P=0.016; (2.15 ± 0.53) vs. (2.11 ± 0.51), P=0.005]. Adverse reactions differed between the groups, with the PICO group experiencing less nausea (5.7% vs. 11.7%, P<0.001) but more sleep disturbances (24.5% vs. 14.6%, P<0.001).
Conclusion: In this real-world study, both PICO and 2L PEG regimens achieved adequate bowel preparation and comparable polyp detection rates. Despite differing adverse reaction profiles more nausea in the 2L PEG group and more sleep disturbances in the PICO group nearly all patients expressed willingness to repeat the same regimen. Thus, both PICO and 2L PEG are safe and effective options for bowel cleansing in the Chinese population.
Revealing mechanism of pore defect formation in laser directed energy deposition of aluminum alloy via in-situ synchrotron X-ray imaging
Authors: Liu Wei , Li Yuxiao , Zhang Bingbing , Yao Chunxia , Zhang Dongsheng , Sun Darui , Wu Yu , Chen Sen , Wang Jun , Wang Han , Luo S. N. , Lu Lei , Tao Ye
Published: November 2024

Laser metal additive manufacturing technology is capable of producing components with complex geometries and compositions that cannot be realized by conventional manufacturing methods. However, a large number of pores generated during the additive manufacturing process greatly affect the mechanical properties of the additively manufactured parts, and the mechanism of such pore generation has not been revealed by direct observation clearly. Here, we report the mechanism of pore generation in the laser direct energy deposition process as revealed by {\it in-situ} high-speed high-resolution synchrotron X-ray imaging. We found that dissolution and re-precipitation of external gases and precipitation of metal vapors are the two main mechanisms of pore formation. We further explored the effects of different process parameters on the generation of pores and optimized the process to suppress pore generation. This work provides important insights into the formation of porosity defects during laser metal additive manufacturing, and can provide guidance for related process optimization.
To compare patient's compliance and efficacy of intestinal cleanser alternately used with PEG-ELS and iced tea drink with the mixture of PEG-ELS and iced tea drink: a prospective randomised controlled study
Authors: Xu Qin , Zhang Min , Gu Shuiqin , Xu Jianping
Published: November 2024

Colonoscopy is considered as a standard procedure for early detection and prevention of colorectal cancer. Adequate intestinal preparation is a prerequisite for high-quality colonoscopy, which is closely related to the diagnostic accuracy and treatment safety of colonoscopy. Adding PEG-ELS into sports drinks to adjust the taste can improve patients' compliance and the quality of intestinal preparation. From October2023 to June 2024, a single-center, blind, randomized controlled trial of endoscopists has been implemented. 300 patients over the age of 18 underwent colonoscopy, and the patients were randomly assigned to warm water group (N= 100), mixed group (N =100) or alternate group (N=100) before receiving 3 L PEG-ELS solution combined with colonoscopy. Results The drinking amount of PEG -ELS solution, vomiting and the taste of intestine-clearing agent in group C were significantly better than those in group A and group B (P<0.01). Compared with Group A, Group B also performed better in these aspects. Group C also performed well in the quality of intestinal preparation, willingness to re-examine, clear intestinal vision and presence of polyps, which were significantly higher than those in the other two groups (P<0.05). Taking compound polyethylene glycol electrolyte powder and iced tea beverage alternately before colonoscopy has high compliance and curative effect, and it is recommended to be popularized in clinic.
Can Energy Development Strategy Actions Boost Green Technology Innovation? Quasi-Natural Experimental Evidence from China
Authors: Wu Yongchao , Gao Xinyu
Published: November 2024

Regarding the National Clean Energy Demonstration Province Construction Program (NCEDPCP) initiated by the Chinese government as a quasi-natural experiment, this article examines the effects and influencing mechanisms of the NCEDPCP on GTI based on China's provincial panel data from 2000 to 2020. The results show that the NCEDPCP strongly promoted GTI, leading to a 33.6% increase in the GTI level in the construction region. Mechanism tests indicate that the NCEDPCP promotes regional GTI mainly by strengthening environmental regulation. In contrast, the mediating role of R&D investment is not obvious. Furthermore, the NCEDPCP shows a strong touting color; the central and western regions and less economically developed regions obtain more policy dividends than their counterparts.
RETRACTED: Exploring the English Language Needs of Undergraduate Students in Mozambique
Authors: Caramba Bernardo José , Çavuşoğlu Çise , Akşit Zeynep , Kurt Mustafa
Published: November 2024

The authors have requested that this preprint be removed from Research Square.
Male breast cancer simulating multiple myeloma on 18F-FDG PET/CT: a case report
Authors: Chen Wenkun , Yao Shuzhan , Xu Shuaishuai
Published: November 2024

Background: Male breast cancer is a rare cancer that comprises less than 1% of breast cancer cases. Early detection is uncommon in men as they often do not notice breast lumps or seek medical attention until the lumps are large.
Case presentation: A 53-year-old male patient was referred due to left axillary lymphadenopathy for 3 years, and chest and back pain for 2 months. 18F-FDG PET/CT found multiple PET-positive lesions with underlying lytic lesions across the whole-body skeleton, and multiple enlarged lymph nodes showing high glycometabolism in left axilla. The diagnosis of multiple myeloma accompanied by extramedullary lymph node involvement was made. Subsequent rib biopsy confirmed metastatic breast infiltrating ductal carcinoma. Upon reevaluating the 18F-FDG PET/CT scans, the left mammary tissue appeared slightly fuller and exhibited greater glucose uptake compared to the right.
Conclusions: The earlier onset of lymph node lesions, compared to bone lesions, pointed more toward a diagnosis of bone metastases rather than MM.
Management of anti-NMDAr encephalitis in the Intensive Care Unit: a case report
Authors: García Beatriz Martínez , Maza Susana Sainz de la , Barragán Nuria García , Corral Íñigo Corral , García Juan Luis Chico
Published: November 2024

Background
Anti-NMDA receptor encephalitis has become a growing concern in young people. It usually manifests with rapid psychiatric and neurological symptoms. ICU admission is frequent, requiring a multidisciplinary approach for informed decision-making. While first-line treatments are standardized, there is no clear guideline for when to escalate to ovarian surgery or second-line immunotherapy, though early intervention is often recommended.
Case Presentation
A 31-year-old woman presented with a one-week history ofanxiety and insomnia. She developed speech dysfunction and disorganized behaviour. Normal diagnostic tests were followed by cerebrospinal fluid analysis showing lymphocytic pleocytosis and mildly elevated proteins. Her condition deteriorated with generalized seizures and decreased level of consciousness, requiring ICU admission and mechanical ventilation. Empirical immunotherapy was initiated, and right oophorectomy revealed a mature cystic teratoma. NMDAR antibodies in CSF analysis confirmed the diagnosis. Rituximab was administered, leading to full recovery within nine months.
Discussion
Anti-NMDAR encephalitis should be considered in young patients with acute psychiatric symptoms. Rapid diagnosis can be challenging due to overlapping symptoms with infections and psychiatric disorders. EEG and CSF analysis are pivotal for diagnosis. Ovarian teratomas, found in some cases, may accelerate recovery post-removal. Treatment involves early first-line immunotherapy and second-line treatments like rituximab, particularly in severe or refractory cases.
Conclusion
Early identification and treatment of anti-NMDAR encephalitis are crucial for recovery. Multidisciplinary care and timely immunotherapy, along with surgical intervention for teratomas, offer the best outcomes. More research is needed to establish clearer guidelines for second and third-line therapies.
Factors Affecting Performance of Diesel Engine Using DEE as an Ignition Enhancer by varying EGR and Intake Air Temperature
Authors: Bidir Michael Gebreyesus , Millerjothi K. , Annamalai K. , Porpatham E.
Published: November 2024

The rapid depletion of fossil fuels worldwide has prompted energy researchers to develop alternative energy sources using advanced technologies that maximize energy utilization. Effective use of fossil fuels can be achieved by fully extracting available energy before depletion. In this context, researchers have developed Homogeneous Charge Compression Ignition (HCCI) to optimize energy extraction during combustion. This study investigates the performance of a direct injection diesel engine using diethyl ether (DEE) as an ignition enhancer combined with liquefied petroleum gas (LPG) as fuel. The experimental setup also incorporates Exhaust Gas Recirculation (EGR) technology and intake air preheating to assess the impact on blended fuel performance. The study evaluates fuel performance under various load conditions, finding a 1.5% improvement in thermal efficiency at 15% EGR and 50°C air preheat when DEE is blended with LPG. Significant reductions in smoke (85%) and particulate emissions (90%) were observed. The analysis further highlights the superior performance of intake air preheating and EGR techniques.
Mitigating opinion polarization in social networks using adversarial attacks
Authors: Ichinose Genki , Ninomiya Michinori , Chiyomaru Katsumi , Takemoto Kazuhiro
Published: November 2024

In recent years, the spread of social networking services (SNS) has made it easier to connect with people who have similar opinions. Accordingly, similar opinions are shared within a group, while the frequency of exposure to different opinions tends to decrease. As a result, the polarization of opinion among groups is more likely to occur. Some studies have been conducted to identify the conditions under which opinion polarization occurs by simulating opinion dynamics, but specific methods for mitigating it have been poorly understood. Recently, it was found that even a few artificial perturbations inspired by the adversarial attack reverse the result in voter models, where a minority opinion becomes dominant through these perturbations. In this study, we conducted numerical simulations to determine whether it is possible to mitigate opinion polarization by adding such perturbations to the network in opinion dynamics models. The results show that opinion polarization can be mitigated by strategically generating perturbations to the weights of network links, and the effect increases as the perturbation strength parameter increases. Moreover, our analysis reveals that the effectiveness of this polarization mitigating method is enhanced in larger networks. Our results propose an effective way to prevent polarization of opinion in social networks.
Advancing Sustainable Farming: Development and Evaluation of a Battery-Operated Leafy Vegetable Harvester
Authors: kalluri Praveen , Shrivastava Atul Kumar
Published: November 2024

This paper addresses a self-propelled battery-operated harvester to harvest the green leafy vegetables through the conceptualization, analysis, and testing of the developed machine. This harvester seeks to mitigate this problem by providing an efficient and easy to use system that is cheaper compared to the conventional technique, which greatly reduces labour costs while increasing efficiency. The design incorporates certain agronomical and ergonomic parameters and agrees the harvester to be adjusted to the field condition and comfortable to use by the operators. Laboratory assessments and field estimates were conducted to measure the harvester's performance in terms of power management, cutting efficiency and speed control. Results indicate that the harvester operates optimally at a forward speed of 1.857 km/h with a conveyor speed of 0.86 m/s, utilizing a 558 mm pulley. The harvester's power desires and operational efficiency were analyzed using advanced statistical models, demonstrating significant reductions in energy consumption compared to manual harvesting. By integrating battery technology, the harvester influences to sustainable agricultural practices, supporting with global efforts to minimize carbon emissions. This innovative attempt provides a viable solution for smallholder farmers, developing agricultural productivity and supporting the transition to more sustainable farming methods.