bluuebunny/crossref_metadata_2025 huggingface dataset:
Fault-Tolerant Multi-Level Converter Architecture for Resilient Offshore Hydrogen Energy Storage Systems
Authors: Diabate Massiagbe , Krishnamoorthy Harish S. , Shi Jian
Published: April 2024

This paper proposes an offshore Hydrogen Energy Storage System (HESS) to interface with subsea oil and gas production systems and offshore renewable energy sources (like wind, floating solar, etc.). Such a HESS will provide a stable energy supply for an extended period, reducing the need for carbon-heavy backup systems such as diesel generators, thereby resulting in a much cleaner energy future. The proposed offshore architecture is modeled using a Hydrogen Energy Storage System (HESS) along with offshore renewables (primarily wind energy), subsea loads (such as drives for pumps, compressors, etc.), and a medium voltage DC (MVDC) grid. Each unit of the HESS is constructed using an electrolyzer to produce hydrogen from electricity, a hydrogen tank to store the fuel, and a fuel cell to transform hydrogen back into electrical energy. Each unit has separate converters to step up/down the voltage. These units are further interconnected through a multi-level cascaded bridge architecture to achieve a 6 kV output. The multi-level cascaded bridge architecture ensures the reliable operation of the system by re-balancing the energy storage electrically between the cascaded mode and protecting the system from any misshape that happens in the system. Suppose a fault occurs in one of the fuel cell units. In that case, the cascaded bridge architecture disconnects that unit from the system. It compensates for that unit by recovering the difference voltage from the other units to maintain the 6 kV DC output voltage.
Horizontal Closed Loop Geothermal Well Solution for Energy Production
Authors: Rasmussen J. P. , Maver K. G. , Vestavik O. M. , Hanna C.
Published: April 2024

A new horizontal geothermal well solution can be used to harvest geothermal energy by producing a heated fluid circulated in a closed loop completion. Typical wells are drilled to a vertical depth of 2-4 km depth depending on the temperature requirement with a 2-5 km horizontal section. Each well will be completed with the patent-pending vacuumized dual tubing completion technology. The circulation fluid is heated when flowing down the well between the lower completion liner and tubing in the horizontal section of the well. The circulation fluid is returned to the surface in the vacuumized dual completion tubing with a minimal heat loss and a temperature below 100°C after some time providing a power output of 1-3 MW.

The closed loop horizontal well solution does not require certain petrophysical properties of the geological formation needed for a conventional doublet geothermal well solution. The closed loop well therefore has a universal application and can be drilled in significantly more locations than a doublet geothermal well solution. Furthermore, as there is no maintenance of downhole equipment and very limited corrosion issues will make it possible for the closed loop solution to last more than 50 years.

Geothermal energy from a closed loop solution can be used for district heating and cooling as well as different industrial usages with nearly zero CO2 emissions.

By utilizing oilfield technology and expertise for drilling and completion in horizontal wells it will be possible to expand the use of geothermal energy creating a demand for many thousands or maybe even tens of thousands of wells worldwide.
CCUS Operational Challenges: Lessons Learned from the World's Largest Offshore Carbon-Capture, Utilization and Storage Initiative in the Oil and Gas Industry
Authors: Almeida B. R. F. , Ziglio C. M. , Batello D. A. , Lorenzeti J. F. C. , Musse A. P. S. , Lopreato L. G. R. , Aimoli C. G.
Published: April 2024

To incorporate an effective CCUS strategy in the already challenging reality of offshore oil and gas production, a broad range of multidisciplinary technologies with seamless interconnections have been required to successfully ensure highly efficient and safe operations in the Brazilian pre-salt reserves. Taking advantage of the flexible conception of topside facilities, tailormade EOR strategies could be established. Water-alternating-gas and design of gas composition and volume injected are typically employed to maximize oil and gas production throughout the exploration period.

Carbon capture through CCUS-anchored solutions have been playing a key role since the beginning of the exploratory efforts in the pre-salt layer of the Brazilian coast. Since the conceptual phase of the first projects in the area, the cutting-edge production strategy in pre-salt fields with CO2 content anticipated a much-needed boost in the CCUS technologies developments.

Several CCUS initiatives made possible to achieve the milestone of 40.8 million tons of CO2 reinjected, cumulatively (2008 – 2022), into the pre-salt reservoirs associated with EOR and contributed to place the greenhouse gases (GHG) production intensity in the pre-salt fields in the first quartile of the industry. Solely, in 2022 Petrobras reinjected 10.6 MtCO2 back into reservoirs. Therefore, the CCUS project developed by Petrobras is one of the main enablers of the development of the gigantic deepwater oil fields in the pre-salt Santos Basin - the first of its kind.
Static and Dynamic Properties of US Atlantic Outer Continental Shelf Cohesionless Soils for Offshore Wind Farm Design
Authors: Long Xiaoyan , Adhikari Sudarshan , Dow Jack , Hargrave Deanne
Published: April 2024

Soil behavior assessment is an essential part for the design of offshore wind farm foundations, especially for those situated nearshore with layered soil profiles. This paper presents the key results and study findings of an offshore geotechnical site investigation campaign conducted for a large wind farm development project along the US Atlantic Outer Continental Shelf (OCS) offshore New Jersey, specifically focusing on the cohesionless soils encountered at the study site. As indicated by Andersen, et al., (2023), the static, cyclic, and dynamic soil parameters for offshore wind turbine foundation design include static and cyclic shear strength, deformation parameters, initial shear modulus, Gmax, consolidation and deformation characteristics, effective stress (drained) strength parameters, and damping. In this paper, the conventional index and physical properties for the cohesionless soils are discussed together with the stress history (overconsolidation ratio, OCR), deformation (static secant modulus, E50), and permeability characteristics and dynamic initial shear modulus (Gmax)evaluated from the in situ cone penetration tests (CPTs) and onshore laboratory testing. The undrained and drained shear strength parameters (effective peak friction angles, residual friction angles, and dilation angles) and strength anisotropy from direct shear (DS), direct simple shear (DSS), and triaxial tests of the cohesionless soils are addressed.Results of the soil/steel interface residual strength measured from a suite of ring shear tests on reconstituted cohesionless samples using a Bishop apparatus are detailed herein. Additionally, soil erosion function apparatus (EFA) tests were performed on selected cohesionless samples to investigate the threshold seabed stress (τcr) and scour rates for the use of sediment mobility potential assessment. The EFA test results are compared and discussed with empirical shields diagram and correlations.This paper provides a thorough overview of the static and dynamic soil properties of the US Atlantic OCS cohesionless soils for offshore wind farm foundation design. Comparisons of the soil properties with those published for the soils in other regions also are included.
Elimination of Saturation Diving Activities Through Changes in ESDV Control Systems
Authors: Oliveira F. L. M. , Hofmann A. C. H. , Santana A. L. B. , Lacerda E. , Passos P. P. S.
Published: April 2024

This work presents changes made to the control systems of Emergency Shutdown Valves (ESDV) located around Mexilhão Platform, whose main objective was to eliminate PETOBRAS' demand for saturation deep diving in maintenance activities and their related safety risks. Due to the risk of permanently damaging current structures, planning operations were challenging. Risk analyses and simulated operations were carried out to identify gaps and project improvements, aiming for safe execution in the field. Tools and assembly components were specially designed for this demand and were previously tested in the simulated operation. The methodology described in this work adopted disruptive solutions, which have been successfully implemented in PETROBRAS assets since May 2018. A secondary delivery of this project is the minimization of production downtime due to the gain in agility in maintenance activities.
The Economics of the Disability Poverty Trap
Authors: Jennings Madison
Published: April 2024

This paper examines how the structure of existing public assistance, such as Supplemental Security Income (SSI) in the United States, created the current disability poverty trap. SSI creates barriers to saving with the implementation of low asset tests while at the same time establishing disincentives for work. As a result, the program fails to improve the quality of life for disabled people who need the benefits and prevents them from ever transitioning off the program. The inability to achieve a critical mass of income with limited benefits and low asset tests results in a poverty trap. Analyzing this dilemma utilizing behavioral economics, leisure demand and labor supply curves, income and substitution effects, and savings vs. consumption models reveals how public assistance programs systemically reinforce the disability poverty trap. Such reinforcement is done through limits on financial agency and failures to account for the socioeconomic role of disability in someone’s life. This analysis concludes that low monthly benefits and limitations on savings in public assistance programs fail to account for the extra costs of living with a disability and barriers to employment. Future policy solutions should increase the monthly benefits recipients receive on SSI, increase asset test limits, create more robust transitional periods off the program, and expand work opportunities.
High Medical Costs and Homelessness Vulnerability Among Older Adults in Washington, DC: A Policy Analysis
Authors: Parashar Jaya
Published: April 2024

The increasing risk of homelessness among older adults in Washington, DC, fueled predominantly by soaring medical expenses, represents a pressing societal concern. Despite notable reductions in overall homelessness rates, the number of older adults experiencing homelessness remains unchanged. As the demographic of older adults grows, the urgency to address this issue escalates. This article examines the complex nexus of high medical costs, poverty, and homelessness among the elderly community in Washington, DC. The article proposes, evaluates, and recommends five policy alternatives geared toward addressing this multifaceted predicament. After employing a rigorous policy analysis approach, alternative two, which focuses on expanding Medicare coverage by lowering eligibility criteria from 65 to 63 years of age, is the recommended policy choice. This proposed recommendation not only aims to ameliorate immediate financial vulnerabilities but also endeavors to democratize access to indispensable healthcare services. Through a blend of empirical analyses, this measure best mitigates the risk of homelessness among the elderly populace in the nation's capital. In synthesizing empirical insights, theoretical perspectives, and policy pragmatism, this article seeks to catalyze informed dialogue and efficacious action toward safeguarding the dignity and security of older adults in Washington, DC, and beyond.
Alloclita recisella Staudinger, 1859 (Cosmopterigidae, Antequarinae). Specie confermata per la fauna italiana della Sardegna e della Sicilia
Authors: Timossi Giovanni , Morin Lucio , Longo Turri Giuseppe
Published: April 2024

Viene confermata, per la fauna italiana, Alloclita recisella Staudinger, 1859, reperita in Sardegna e Sicilia. Vengono forniti dati geografici di distribuzione e informazioni utili all’identificazione delle specie. Viene aggiornata la checklist dei Cosmopterigidae italiani.
New Anillini from South Africa
Authors: Giachino Pier Mauro
Published: April 2024

The author describes the following new species: Microdipnus papafrancisci n. sp. from Pirie State Forest (Eastern Cape, RSA), Caeconannus silvanae n. sp. from Garden Route N.P. (Western Cape, RSA), C. confusus n. sp. from Riversonderend Mts., Olifantsbos Forest (Western Cape, RSA), C. giovanniboanoi n. sp. from Langeberge Mts., Garcia N.R. (Western Cape, RSA), C. brunobasoloi n. sp. from Riviersonderend, Oudebos Forest (Western Cape, RSA), C. mariozuninoi n. sp. from Kogelberg NR, Oudebos Forest (Western Cape, RSA), C. montaguensis n. sp. from Montagu pass Forest (Western Cape, RSA) and C. gigas n. sp. from Cata Forest (Eastern Cape, RSA). Additional data on the distribution of already known Caeconannus species are provided. The genus Caeconannus is currently confirmed to be endemic to South Africa.
Evaluation of moral distress and moral intelligence among medical residents
Authors: Isfahani Mehdi Nasr , Pari Fatemeh Asghari , Pakravan Fahimeh , Esmailian Mehrdad
Published: April 2024

Background: Medical ethics is necessary in the medical field to protect patient rights, enhance professional conduct, manage complex situations, prevent malpractice, and advance healthcare policy. Aim: This study aimed to examine the levels of moral distress and moral intelligence among medical residents and explore the relationship between these two concepts. Methods: This descriptive-analytical cross-sectional study was performed on 221 medical residents in 2021. The participants were recruited by census sampling method. Data were collected by two standard questionnaires, including Corley’s moral distress scale (2001) and Lennick and Kiel’s moral intelligence scale (2005). Statistical analyses were conducted using both parametric and non-parametric methods. All analyses were performed by SPSS-22 software. Results: Of participants, 140 (63.4%) were non-surgical and 81 (36.6%) were surgical assistants. Moral distress was significantly higher in surgical than non-surgical disciplines, (P<0.05). Further, according to the moral distress classification, 51.8% of surgical residents and 15.8% of non-surgical residents had severe moral distress. Moral intelligence was also higher in surgical than in non-surgical disciplines, but the difference was not statistically significant (P>0.05), and moral intelligence was moderate to high. There was a significantly negative correlation between moral intelligence (and its four subscales) and moral distress (P <0.001, r =-0.410). Conclusion: The results showed high moral distress and an inverse correlation between moral distress and moral intelligence among medical residents. The study highlights the importance of addressing issues related to moral distress and moral intelligence in medical education and training programs
Il concetto di maschera e la relazione medico-paziente: suggestioni da una (ri)lettura dei Sei personaggi in cerca d’autore di Luigi Pirandello
Authors: Giardina Simona , Refolo Pietro , Spagnolo Antonio G.
Published: April 2024

Il presente articolo ha come obiettivo fondamentale quello di approfondire il tema della “maschera” e la sua applicazione al contesto medico-scientifico, con particolare riferimento all’argomento della relazione medico-paziente. Principale riferimento per l’analisi sarà l’opera di Luigi Pirandello Sei personaggi in cerca d’autore (1921), che è portatore di valori universali, come pure alcuni esempi tratti dall’arte figurativa. Quel che emerge è l’esigenza da parte del malato che si autorappresenta mediante il mezzo artistico di narrare se stesso attraverso una maschera che diviene luogo del suo vissuto interiore e, dunque, delle emozioni.
Il pilastro fatiscente. Considerazioni etiche sulla medicina nell’era dell’IA
Authors: Pianca Filippo
Published: April 2024

Le promesse sull’introduzione dell’intelligenza artificiale in medicina, prospettando una pratica meno negligente e più efficace, sembrano lasciare poco spazio alla discussione filosofica. In realtà, tra aspettative, esperimenti in silico e prime implementazioni, i sistemi medici di IA hanno già iniziato a sollevare questioni di natura etico-antropologica. Al di là delle consuete preoccupazioni legate alla privacy e alla sicurezza dei sistemi, con la “medicina algoritmica” si profila lo stravolgimento dell’identità del medico e, in parallelo, la ridefinizione del rapporto medico-paziente. La crescente accuratezza dimostrata da diversi software clinici mette in discussione l’autorità epistemica del medico, con l’IA che risulta sempre più “fidata”. La relazione di cura, da diade, si trasforma in una triade, comportando una doppia traslazione di fiducia: sia il medico sia il paziente finiscono per dipendere dai risultati algoritmici. Riappare così il paternalismo, questa volta automatizzato, con il medico lasciato come terzo incomodo e relegato al ruolo di esecutore passivo dei verdetti computazionali. Se, come sostiene Karl Jaspers, la medicina poggia su due pilastri (quello tecno-scientifico e quello umanitario), l’introduzione clinica dell’IA non solo consolida il primo, delegato ai sistemi digitali, ma rischia anche di indebolire e spersonalizzare il secondo. Una valutazione critica del futuro della medicina è essenziale non solo per comprendere la direzione che questa pratica sta prendendo sotto l’influenza dell’industria digitale, ma anche per identificare i valori che devono essere rafforzati per evitare la perdita del significato umanitario inerente alle sue origini e al suo scopo.
Beauchamp and Childress’ principlism: theoretical reasons of some persistent conceptual issues
Authors: Furlan Enrico
Published: April 2024

Beauchamp and Childress’ principlism is probably the most influential model for justifying bioethical judgements at the international level. Despite its widespread adoption and influence, it is frequently subject to misunderstanding and oversimplification. Given its enduring relevance, the prevalence of a superficial grasp of its current structure, and the likelihood that the latest edition will be the final one, this paper seeks to achieve the following two objectives: a) clarify the current theoretical framework of principlism, demonstrating its ability to address most criticisms effectively; b) spotlight unresolved theoretical flaws and delve into their philosophical underpinnings. I will then conclude by suggesting a research direction for overcoming these persistent issues.
Risk factors and outcome of antenatally diagnosed congenital diaphragmatic hernia following in-utero transfer in a busy public-sector tertiary care center in North India
Authors: Joglekar Abhay , Roy Choudhury Subhasis , Vibhash Chandra , Kumar Manisha , Gupta Amit
Published: April 2024

We analyzed the risk factors and outcomes of antenatally diagnosed congenital diaphragmatic hernia (CDH) from a tertiary-care children’s hospital following in-utero transfer. A total of 41 antenatally detected cases of CDH were included; 30 were live-born and 11 were still-born. The primary outcome was postnatal survival. The secondary outcome was the probable factor affecting survival. No medical termination of the pregnancy was done. The mean gestational age at diagnosis was 23 weeks. The diagnostic accuracy of antenatal ultrasonography was 40/41 (97.5%). Lung-to-head ratio (LHR) was <1 in 20 cases (survived 2), LHR was >1 in 10 cases (survived 8), and LHR was not recorded in 11 cases (survived 4). Overall survival was 14/41 (34.1%). Survival in fetuses with polyhydramnios was 0% (n=3; survived 0), associated anomalies were 33.3% (n=3; survived 1), and liver herniation was 22.2% (n=9; survived 2). Postnatally, significant risk factors included a low Apgar score, the need for ventilation, and neonatal intensive care unit (NICU) management. Survival in live-born cases was 14/30 (46.6%) and in operated cases was 14/19 (73.6%). We concluded that antenatal ultrasound had a high accuracy rate for detecting CDH. Antenatal risk factors affecting outcomes were low LHR, maternal polyhydramnios, liver herniation, and associated malformations. Postnatal risk factors included a low Apgar score, NICU admission, and a need for ventilation. The overall survival rate, as well as the survival rates for live-borns and those undergoing surgery, were 34.1%, 46.6%, and 73.6%, respectively. This data will guide clinicians in counseling the families of antenatally diagnosed CDH.
Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in a Child with Myelodysplastic Neoplasm with Complex Karyotype and ETV6 Variant: Challenges in Treatment
Authors: Almeida Antônio de Kós Elaiza , Lamim Lovatel Viviane , Barbosa Tavares Rita de Cássia , Moura Ferreira Gerson , Evangelho Gomes Bernadete , Silva Bueno Ana Paula , Sobral da Costa Elaine , de Souza Fernandez Teresa
Published: April 2024

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only treatment with the potential for cure in patients with myelodysplastic neoplasm (MDS). Nevertheless, disease relapse is the main cause of treatment failure. Due to the rarity of childhood MDS (cMDS), there are few studies showing the impact of cytogenetic alterations and genetic variants on outcomes of allo-HSCT, mainly focusing on clonal chromosomal evolution (CCE) during relapse post-transplant. Here, we describe a 3-year-old boy with cMDS-IB, who evolved to MDS/AML. At diagnosis, the patient showed a complex karyotype with chromosomal abnormalities not yet reported together in the same clone, and likely a pathogenic variant in the ETV6 gene. The patient was treated with HLA-matched sibling HSCT, but unfortunately relapsed after HSCT with clonal cytogenetic evolution. This unfavorable outcome suggests that the treatment of pediatric MDS associated with predictive factors of poor prognosis, such as complex karyotype and ETV6 variant remains a challenge.
-uShukela: A history of the growth and development of the sugar industry in Zululand: 1905 to the presen
Authors: Cubin Tony
Published: April 2024

No abstract available.
The British presence in the Transorange 1845-1954
Authors: Le Roux C.P.J.
Published: April 2024

No abstract available.
Postmasburg: 'n eeu onder plaaslike bestuur, 1893-1993
Authors: Le Roux C.J.P.
Published: April 2024

No abstract available.
Building Railways and ‘Building Character’: The Model Villages in Northern Natal, c. 1935-1939
Authors: Taylor Judith
Published: April 2024

No abstract available.
Housing in late 19th and early 20th century Port Elizabeth
Authors: Appel Andrê
Published: April 2024

No abstract available.
Road building and the environment
Authors: Goetze Tim
Published: April 2024

Met die tegnologiese vooruitgang wat die industriële revolusie meegebring het, is die mens se beskouing van die natuur met die loop van tyd verander. Soos wat die samelewing verander het, moes die natuur dadelik aanpas en het die omgewing die knie moes buig voor die mens se kapitalistiese en industrialisasiebehoeftes. Die bou van paaie en treinspore teen die einde van die negentiende eeu het byvoorbeeld getoon hoe geweldig het die mens se beskouing van die natuur verander om aan te pas by die diktering van die industriële ontwikkeling. 'n Vergelykende studie van die bou van paaie deur twee omgewingsensitiewe, areas in twee verskillende gedeeltes van die wêreld: die Glenwood Canyon in Colorado in die VSA en die Tuinroete in die Suid-Kaap in Suid-Afrika, lewer verskeie interessante insigte, veral omdat beide snelweë opgegradeer is in 'n tydperk toe omgewingsake 'n sleutelrol in infrastruktuurontwikkeling begin speel het. Uit die navorsing blyk dit duidelik dat die verskerpte omgewingsbewustheid 'n leidende rol gespeel het in die beplanning van albei die paaie. Daar Ie 'n verpligting op historici om hul stem te voeg by die van andere uit ander dissiplines om die omgewingsdebat te stimuleer. 'n Bestudering en beskrywing van die geskiedenis van mense en gebeure is onherroeplik gekoppel aan die omgewing waar dit plaasgevind het. 'n Dokumentering van sodanige geskiedenis is om 'n stem te gee aan die stemlose omgewing
High-intensity focused ultrasound strategies for treating prostate cancer
Authors: Wu Xiaobo , Wu Yupeng , Ng Chi-Fai , Yee Chi-Hang , Chiu Peter Ka-Fung
Published: April 2024

Prostate cancer (PCa) is a significant health concern globally, necessitating effective treatment options. Typical treatment methods for early stage, particularly localized PCa, encompass radical procedures, such as radical prostatectomy (RP) and radiotherapy (RT), and nonradical focal therapy (FT). FT is a focused approach mainly used for treating small lesions limited to a specific zone of the prostate. Its objective is to achieve cancer control when minimizing damage to benign tissue. High-intensity focused ultrasound (HIFU) is one of the most used modalities in FT for the management of PCa. The progress in HIFU technology showcases continuous advancements, offering clinicians a variety of strategies to cater to diverse patient requirements. The advancements include the development of transrectal and transurethral HIFU machines that offer enhanced treatment distances, magnetic resonance imaging (MRI) fusion capabilities, real-time monitoring, and precise ablation. These improvements contribute to increased treatment effectiveness and better outcomes for patients. This narrative review aims to summarize the use of HIFU technology and its evolution, offering diverse options to clinicians, and explores the safety, effectiveness, and quality of different HIFU strategies, such as whole-gland ablation, hemigland ablation, and focal ablation. We conclude that nonwhole-gland HIFU offers similar cancer control with better short-term functional outcomes and fewer complications compared to whole-gland ablation. Combining HIFU with transurethral resection of the prostate (TURP) improves urinary function and reduces catheterization time. Focal ablation and hemigland ablation show promise in achieving cancer control when preserving continence and potency.
From Waves to Diagnoses: Decoding Electrocardiogram for Improved Cardiac Care
Authors: Varaganti Sharanya , Manisha Rajaputana Lakshmi , Muvvala Sudhakar
Published: April 2024

The electrocardiogram (ECG) is a fundamental tool in cardiology, providing invaluable insights into cardiac physiology and detecting various abnormalities. This review article presents a comprehensive overview of ECG interpretation, focusing on the procedure, application, and methodology. The placement of electrodes, ECG paper speed, and measurements of intervals and blocks are discussed in detail. The article emphasizes the importance of a systematic approach to ECG interpretation, highlighting six main sections: determination of heart rhythm, calculation of heart rate, assessment of intervals and blocks, analysis of atrial depolarization patterns, assessment of ventricular depolarization complexes, and delving into the intricate characteristics of ST segments and exploration of the electrocardiographic T-wave manifestations. Specific criteria for identifying abnormalities in each section are provided, along with their associated etiologies and clinical implications. Furthermore, the limitations of ECG as a diagnostic tool are acknowledged, emphasizing the need for clinical correlation and consideration of additional tests. The abstract encapsulates the breadth and depth of the review, conveying the relevance and the profound significance of ECG interpretation in the realm of clinical practice and scientific inquiry.
Pachymic acid exerts antitumor activities by modulating the Wnt/β-catenin signaling pathway via targeting PTP1B
Authors: Zhang Hao , Zhu Kun , Zhang Xue-Feng , Ding Yi-Hui , Zhu Bing , Meng Wen , Ding Qing-Song , Zhang Fan
Published: April 2024

Objective:

To determine the inhibitory effects of pachymic acid on lung adenocarcinoma (LUAD) cells and elucidate its underlying mechanism.

Methods:

CCK-8, wound healing, Transwell, Western blot, tube formation, and immunofluorescence assays were carried out to measure the effects of various concentrations of pachymic acid on LUAD cell proliferation, metastasis, angiogenesis as well as autophagy. Subsequently, molecular docking technology was used to detect the potential targeted binding association between pachymic acid and protein tyrosine phosphatase 1B (PTP1B). Moreover, PTP1B was overexpressed in A549 cells to detect the specific mechanisms of pachymic acid.

Results:

Pachymic acid suppressed LUAD cell viability, metastasis as well as angiogenesis while inducing cell autophagy. It also targeted PTP1B and lowered PTP1B expression. However, PTP1B overexpression reversed the effects of pachymic acid on metastasis, angiogenesis, and autophagy as well as the expression of Wnt3a and β-catenin in LUAD cells.

Conclusions:

Pachymic acid inhibits metastasis and angiogenesis, and promotes autophagy in LUAD cells by modulating the Wnt/β-catenin signaling pathway via targeting PTP1B.
Ethyl acetate fraction of Sargassum pallidum extract attenuates particulate matterinduced oxidative stress and inflammation in keratinocytes and zebrafish
Authors: Kim Chul Wook , Park Ji-Won , Yun Bohyun , Lee WonWoo , Choi Kyung-Min , Lee Seung-Hong
Published: April 2024

Objective:

To evaluate the effect of the ethyl acetate fraction derived from Sargassum pallidum extract against particulate matter (PM)-induced oxidative stress and inflammation in HaCaT cells and zebrafish.

Methods:

HaCaT cells and zebrafish were used to evaluate the protective effects of the ethyl acetate fraction of Sargassum pallidum extract against PM-induced oxidative stress and inflammation. The production of nitric oxide (NO), intracellular ROS, prostaglandin E2 (PGE2), and pro-inflammatory cytokines, and the expression levels of COX-2, iNOS, and NF-κB were evaluated in PM-induced HaCaT cells. Furthermore, the levels of ROS, NO, and lipid peroxidation were assessed in the PM-exposed zebrafish model.

Results:

The ethyl acetate fraction of Sargassum pallidum extract significantly decreased the production of NO, intracellular ROS, and PGE2 in PM-induced HaCaT cells. In addition, the fraction markedly suppressed the levels of pro-inflammatory cytokines and inhibited the expression levels of COX-2, iNOS, and NF-κB. Furthermore, it displayed remarkable protective effects against PM-induced inflammatory response and oxidative stress, represented by the reduction of NO, ROS, and lipid peroxidation in zebrafish.

Conclusions:

The ethyl acetate fraction of Sargassum pallidum extract exhibits a protective effect against PM-induced oxidative stress and inflammation both in vitro and in vivo and has the potential as a candidate for the development of pharmaceutical and cosmeceutical products.
Fertility, family planning methods and autonomy among women in Delhi
Authors: Sharma Kirti , Kumar Naveen , Kshatriya Gautam K. , Deb Roumi
Published: April 2024

Background:

Women’s autonomy is defined as the ability to regulate one’s environment with the help of social and material resources. This autonomy is intricately linked to various reproductive health outcomes, including reduced fertility, increased contraceptive usage and access to prenatal care. It can be understood as the ability of women to oversee and manage their surroundings independently, allowing them to make decisions about their lifestyle, irrespective of societal opinions.

Aims and Objectives:

This study explored the association between fertility, family planning methods (FPMs) and autonomy amongst women in Delhi.

Materials and Methods:

The data for the present study were collected from 400 married women aged 15–45 years old residing in Delhi. A face to face interview was conducted using a semi structured schedule to collect quantitative and qualitative data.

Results: The findings revealed that the autonomy level of women was found to be low (13.75%), medium (56.5%) and high (29.75%). Respondents with low autonomy status (47.27%) were illiterate or had a primary level of education. Women with low autonomy have a more significant number of conceptions than medium and high autonomy women, resulting in increased live births amongst low autonomy women. In addition, participants with low levels of autonomy were less aware of FPMs. The study underscored the influence of women’s social position, as reflected in factors such as education, occupation and the economic status of the family, on fertility and contraceptive usage.

Conclusion:

The findings of this study indicate that women exhibiting lower autonomy levels tend to possess lower educational attainment, experience a higher frequency of conceptions, demonstrate limited knowledge about contraception and show lower rates of employment.
Buyang Huanwu Decoction Alleviates Atherosclerosis by Regulating gut Microbiome and Metabolites in Apolipoprotein E-deficient Mice fed with High-fat Diet
Authors: Yu Qun , Zhang Yilin , Zeng Wenyun , Sun Yingxin , Zhang Xiaolu , Guo Lin , Zhang Yue , Yu Bin , Guo Maojuan , Wang Yu , Li Huhu , Suo Yanrong , Jiang Xijuan , Song Lili
Published: April 2024

The traditional Chinese herbal prescription Buyang Huanwu decoction (BHD), effectively treats atherosclerosis. However, the mechanism of BHD in atherosclerosis remains unclear. We aimed to determine whether BHD could alleviate atherosclerosis by altering the microbiome-associated metabolic changes in atherosclerotic mice. An atherosclerotic model was established in apolipoprotein E-deficient mice fed high-fat diet, and BHD was administered through gavage for 12 weeks at 8.4 g/kg/d and 16.8 g/kg/d. The atherosclerotic plaque size, composition, serum lipid profile, and inflammatory cytokines, were assessed. Mechanistically, metabolomic and microbiota profiles were analyzed by liquid chromatography-mass spectrometry and 16S rRNA gene sequencing, respectively. Furthermore, intestinal microbiota and atherosclerosis-related metabolic parameters were correlated using Spearman analysis. Atherosclerotic mice treated with BHD exhibited reduced plaque area, aortic lumen occlusion, and lipid accumulation in the aortic root. Nine perturbed serum metabolites were significantly restored along with the relative abundance of microbiota at the family and genus levels but not at the phylum level. Gut microbiome improvement was strongly negatively correlated with improved metabolite levels. BHD treatment effectively slows the progression of atherosclerosis by regulating altered intestinal microbiota and perturbed metabolites.
Uncommon case of isolated conjunctival histoplasmosis: A rare clinical entity
Authors: Shanthi Radhakrishnan , Monalisa Deori , Rameshkumar Gunasekaran , Lalitha Prajna
Published: April 2024

We report an unusual case of isolated conjunctival histoplasmosis in a healthy immunocompetent patient. A 62-year-old male presented with a gradually progressing, painless, fleshy mass in both eyes for 2 months. On examination, a diffuse, raised, vascularized, and nontender mass was noted on the entire bulbar conjunctiva. On incisional biopsy, the histopathologic report confirmed a causative agent of Histoplasma capsulatum. He was then treated with topical itraconazole and intravenous amphotericin B, the lesion exhibited signs of regression. When confronted with an unusual conjunctival mass, it is imperative to do a detailed microbiological and histopathological work-up of a patient.
Periorbital emphysema following dental procedure: A case report with literature review
Authors: Doğruya Suzan
Published: April 2024

We aimed to present a case of periorbital emphysema after tooth extraction in private dental practice. A 20-year-old female patient with the left maxillary first molar tooth extracted under local anesthesia was referred to the ophthalmologist with complaints of swelling and pain around the left eye 6 hours after the procedure. The best visual acuity was logMAR 0.0 in both eyes on visual examination. In the slit-lamp examination, there was periorbital swelling in the left eye, free eye movement, and a light reaction. The right eye followed naturally. Fundus examination of the bilateral optic nerve was normal. On palpation, crepitation was detected in the left periorbital region. A rapid assessment of airway obstruction was made. Diffuse air was observed in the left orbital soft tissue in orbita computed tomography. Prophylactic penicillin-derived antibiotics and nonsteroidal antibiotics were started. The light reaction was followed closely. Periorbital swelling decreased 24 hours after the procedure. During the surgical removal of impacted teeth, air through the air-operated handpiece may cause spread from the periapical region to the periorbital space along the subperiosteal region and fascial planes. Care should be taken to avoid this rare complication after dental procedures.
Application of 18F-FDG PET/CT imaging radiomics in the differential diagnosis of single-nodule pulmonary metastases and second primary lung cancer in patients with colorectal cancer
Authors: Yu Yu , Zhu Jing , Sang Shibiao , Yang Yi , Zhang Bin , Deng Shengming
Published: April 2024

Objective:

It is crucially essential to differentially diagnose single-nodule pulmonary metastases (SNPMs) and second primary lung cancer (SPLC) in patients with colorectal cancer (CRC), which has important clinical implications for treatment strategies. In this study, we aimed to establish a feasible differential diagnosis model by combining18F-fluorodeoxyglucose positron-emission tomography (18F-FDG PET) radiomics, computed tomography (CT) radiomics, and clinical features.

Materials and Methods:

CRC patients with SNPM or SPLC who underwent18F-FDG PET/CT from January 2013 to July 2022 were enrolled in this retrospective study. The radiomic features were extracted by manually outlining the lesions on PET/CT images, and the radiomic modeling was realized by various screening methods and classifiers. In addition, clinical features were analyzed by univariate analysis and logistic regression (LR) analysis to be included in the combined model. Finally, the diagnostic performances of these models were illustrated by the receiver operating characteristic (ROC) curves and the area under the curve (AUC).

Results:

We studied data from 61 patients, including 36 SNPMs and 25 SPLCs, with an average age of 65.56 ± 10.355 years. Spicule sign and ground-glass opacity (GGO) were significant independent predictors of clinical features (P= 0.012 andP< 0.001, respectively) to build the clinical model. We achieved a PET radiomic model (AUC = 0.789), a CT radiomic model (AUC = 0.818), and a PET/CT radiomic model (AUC = 0.900). The PET/CT radiomic models were combined with the clinical model, and a well-performing model was established by LR analysis (AUC = 0.940).

Conclusions:

For CRC patients, the radiomic models we developed had good performance for the differential diagnosis of SNPM and SPLC. The combination of radiomic and clinical features had better diagnostic value than a single model.
Efficacy and safety of neoadjuvant therapy in gastroenteropancreatic neuroendocrine neoplasms: A systematic review and meta-analysis
Authors: Yan Yu , Wu Danzhu , Wang Weizhen , Lv Yajuan , Yang Liyuan , Liu Yinglong , Dong Peng , Yu Xinshuang
Published: April 2024

Objective:

To determine the effectiveness and safety of neoadjuvant therapy in gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) and provide evidence-based suggestions for clinical treatment.

Methods:

The Cochrane Library, Embase, PubMed, and Web of Science were searched for articles published that analyzed the effectiveness and safety of GEP-NEN-targeted neoadjuvant therapy before March 2023. A confidence interval (CI) of 95%, a subgroup analysis, heterogeneity, and effect size (ES) were analyzed, and a meta-analysis of the literature was performed using the Stata BE17 software.

Results:

A total of 417 patients from 13 studies were included in this meta-analysis. The primary variables comprised the objective response rate (ORR), disease control rate (DCR), surgical resection rate, and R0 resection rate with ES values of 0.42 (95% CI: 0.25–0.60), 0.96 (95% CI: 0.93–0.99), 0.67 (95% CI: 0.50–0.84), and 0.60 (95% CI: 0.54–0.67), respectively. The secondary variables were the incidence rates of treatment-related adverse events (TRAEs), Grade 3 or higher TRAEs, and surgical complications with ES values of 0.29 (95% CI: -0.03–0.21), 0.13 (95% CI: -0.07–0.33), and 0.35 (95% CI: 0.27–0.44), respectively.

Conclusion:

Neoadjuvant therapy is an effective and safe treatment method for GEP-NENs. However, further studies are required to determine the optimal regimen for this therapy in these tumors.
Outcomes, responses, and prognostic analyses of intrathecal combined treatment for leptomeningeal metastasis from lung adenocarcinoma
Authors: Huang Sijie , Kang Xun , Wang Ce , Zhang Weichunbai , Jiang Jing , Kang Zhuang , Yang Shoubo , Chen Jinyi , Chen Feng , Li Wenbin
Published: April 2024

Background:

Leptomeningeal metastasis (LM) is a severe lung cancer complication, with potentially fatal consequences. The use of intrathecal therapy (IT) combined with systemic therapy has shown promise as a treatment approach for LM. Thus, this study aimed to evaluate the features and responses to IT combined therapy and identify determinants affecting patients with leptomeningeal metastasis resulting from lung adenocarcinoma (LM-LA).

Methods:

A retrospective analysis of medical records from our hospital database was performed, covering from April 2018 to August 2022, for 37 patients diagnosed with LM-LA and treated with IT combined therapy. Patients who received IT combined therapy for LM-LA were evaluated for demographic characteristics, treatment efficacy, survival, and variables that impacted them.

Results:

The median overall survival (mOS) of 37 patients was 16.0 months, and the survival rates at 6 and 12 months were 75.7% and 35.1%, respectively. Among the 21 patients with LM-LA who received IT combined with tyrosine kinase inhibitors (TKIs), the mOS was 17.0 months, which was significantly longer than that of patients treated with IT combined with chemotherapy (7.0 months, P = 0.010) and the best supportive care (6.0 months, P = 0.001). However, no significant survival benefit was observed in patients treated with IT combined with TKIs when compared with those treated with IT combined with PD-1 (5.0 months, P = 0.249). Multivariate analysis indicated that the combination of TKIs was an independent favorable prognostic factor for patients with LM-LA.

Conclusion:

Combination treatment is regarded as an additional option for patients with LM-LA. Compared with other combination therapies in our study, IT combined with TKI therapy provided a better survival outcome for patients with LM-LA.
Stem-like CD8 T cells in stage I lung adenocarcinoma as a prognostic biomarker: A preliminary study
Authors: Sang Jing , Liu Peng , Wang Meixiang , Xu Fengkuo , Ma Ji , Wei Zhigang , Ye Xin
Published: April 2024

Objectives:

This study aimed to investigate the presence of stem-like CD8 T (CD8 TSL) cells in lung adenocarcinoma (LUAD) and explore their relationships with the clinical outcomes.

Methods:

Multiplex immunofluorescence (mIF) was performed to identify CD8 TSL and antigen-presenting cells (APC) in 76 LUAD patients. Differences in the number of CD8 TSL cells based on tumor stage and the spatial relationships between CD8 TSL cells and APC niches were determined. The optimal cutoff value of CD8 TSL cells for predicting survival in patients with stage I LUAD was calculated.

Results:

CD8 TSL cells were present in all tumors, and their numbers were significantly higher in stage I patients than in stage III patients (P = 0.010); CD8 TSL cells located in the APC niches accounted for 69.7% (53/76) of the hotspot fields. The optimal cutoff value for the number of CD8 TSL cells required to predict the overall survival (OS) in patients with stage I LUAD was 2.5 per 10000 μm2. The median OS and progression-free survival (PFS) in the high-level group (>2.5) were significantly (P < 0.001) longer than those in the low-level group (≤2.5). The number of CD8 TSL cells was an independent prognostic factor for stage I LUAD. Patients with more CD8 TSL cells had a lower risk of death and disease progression than those with less CD8 TSL cells.

Conclusion:

CD8 TSL cells were observed in patients with stages I–III LUAD and might serve as prognostic biomarkers for stage I LUAD.
Effect of stability of PTEN on hepatocellular carcinoma
Authors: Hu Yilin , Mei Hongliang , Luan Tianji , Sun Huiling , Lu Qiping , Liu Rong
Published: April 2024

Background:

As an antioncogene gene, phosphataseandtensinhomolog (PTEN) is closely related to tumorigenesis. However, after mutation, PTEN will lose its function and no longer exert a tumor suppression effect. Through this research, we explored the impact of PTEN mutation on hepatic carcinoma (HCC) and the mechanism of PTEN for regulating HCC.

Methods:

First, bioinformatics was used to analyze the prognosis of PTEN in HCC. PTEN-related genes were then further analyzed by the LinkedOmics database, and GO and KEGG functional enrichment analysis were performed. Next, databases were utilized to predict the mutation and mutation frequency of PTEN. Eventually, CRISPR-Cas12a was applied to detect the R130Q mutation on PTEN in clinical samples of HCC. Finally, the fact that miR-92a-3p targets PTEN was identified by dual luciferase reporter gene assays, RT-qPCR, western blot, and rescue experiments.

Results:

Bioinformatics analysis indicated the high mutation frequency of R130Q/G/L* site on the PTEN gene. Through CRISPR-Cas12a, R130Q mutation was detected on PTEN in 26 out of 40 clinical samples of HCC.

Conclusions:

On the one hand, our study revealed that CRISPR-Cas12a might play an important role in the screening and prognosis of HCC as a new clinical method to detect PTEN mutation.
Development of accreditation modules based on hospital types in Iran: Protocol for a mixed methods study
Authors: Ghaffarian Ali , Cheraghi Azam , Ferdosi Masoud
Published: April 2024

BACKGROUND:

Among different tools, accreditation is widely used worldwide to improve the quality and safety of hospital services. In Iran, as in many other countries, the same accreditation standards apply to all hospitals, regardless of their size and type of activity. This has given rise to many problems for hospitals.

MATERIALS AND METHODS:

We will conduct this study in three phases: In the first phase, relevant individuals are interviewed to identify challenges caused to hospitals by applying the same standards for all types of hospitals and clarify issues that could be removed or changed in small hospitals. In the second phase, a scoping review is conducted on the literature about accreditation models worldwide. The first and second phases are conducted simultaneously, and a new accreditation model for Iran hospitals is derived by combining their results. In the final phase, using the Delphi technique, the obtained model and accreditation modules are verified during Delphi rounds.

DISCUSSION:

A more appropriate accreditation model that matches the characteristics of the target hospitals could be the output of this study. It is expected that the model could improve the process of evaluating the quality of hospital services through the accreditation tool.