bluuebunny/crossref_metadata_2025 huggingface dataset:
A Novel Virtual Reality-Based Educational Module to Address Gaps in Morphine Titration Training among Medical Students
Authors: Limonta Laura , Martinez Valeria
Published: September 2024

Introduction:
Effective intravenous morphine titration is critical for managing severe pain, particularly during the ongoing opioid crisis. However, current medical curricula often lack adequate practical training in this area.
Methods
This study evaluated fifth-year medical students' theoretical knowledge and practical experience of intravenous morphine titration and developed a virtual reality simulation module to address educational gaps. Initially, students' self-perceived knowledge, practical skills, and confidence were assessed through subjective questionnaires, followed by an objective and quantitative questionnaire to evaluate theoretical knowledge. Based on identified gaps, a VR teaching module was developed using the Uptale platform, aligned with the second-cycle curriculum, and designed to enhance engagement and provide a realistic learning experience.
Results
Significant knowledge gaps were identified among the 167 students tested: 80.83% reported understanding morphine titration, only 24.70% reported knowing how to perform it, and a mere 4% felt confident. The quantitative assessment highlighted deficiencies in knowledge regarding dilution, administration frequency, and monitoring of morphine titration. The VR teaching module, tested by 48 students, was developed to address these needs, featuring four progressively difficult patient scenarios covering key curriculum points for second-cycle students. The immersion questionnaire revealed high levels of spatial presence, affordance, and enjoyment in the VR environment. Most students agreed that the VR simulation effectively captured their attention and provided a realistic learning experience.
Conclusions
The study highlights substantial deficiencies in practical training for morphine titration in medical education. VR simulations may offer an immersive and engaging platform to bridge these gaps, allowing students to practice safely. Future research should explore the long-term impact of VR-based training on clinical performance and patient outcomes.
Ixodes ricinus in Ireland: exploring the links between environmental factors, host species activity and tick abundance in an area of Europe with limited potential vertebrate hosts
Authors: Walsh Ríona , Gormally Mike , Williams Christopher , Hamilton Orla , Carbeck Belle , Carlin Caitríona
Published: September 2024

Background:
Ixodes ricinus (Linnaeus 1758) vectors several important diseases in Europe, and the nymphal abundance in an area is an important factor determining tick bite risk. While interactions between abiotic, habitat, and vertebrate host factors and this tick species are generally well understood in continental Europe, this is not the case in Ireland, a highly fragmented and vertebrate depauperate region of Europe. This study examines the abiotic, habitat and host factors predicting nymphal abundance in such a setting. Our findings may provide insights for possible future changes in I. ricinus vector ecology on continental Europe given current predictions of future vertebrate diversity loss.
Methods:
15 woodland sites in Ireland were surveyed over three years (2020-2022) wherein abiotic and habitat factors were determined and tick abundance recorded. Concurrently, mammal and birdsong activity data were collected for each site across multiple visits. Generalised linear mixed models were used to identify the most important factors predicting I. ricinus abundance.
Results:
Nymphal I. ricinus abundance was driven by seasonality, with peak abundance occurring in April. Abiotic and habitat factors featured less than expected in models predicting nymphal abundance, but mean minimum winter temperature was found to have an inverse predictive relationship with adult tick abundance. While I. ricinus nymphs were significantly more abundant at sites where deer were present, at visit level, there was an inverse predictive relationship between deer activity events the week of a site visit and nymphal abundance. Modelling individual host species as predictors of nymphal abundance also identified increased mean robin birdsong events for the previous year to be a predictor of decreased nymphal abundance.
Conclusions:
Seasonality predicted nymphal tick abundance more robustly than any other abiotic variable. Seasonality was also the driving factor behind the relationships seen between deer activity and nymphal abundance. This highlights the importance of understanding the seasonal changes in dynamics between I. ricinus abundance and host activity, a less well-studied area. Furthermore, the identification of European robin as a predictor of nymphal abundance in woodland sites confirms the important relationship between passerine bird species and I. ricinus in Ireland.
The Effect of Receiving Preventive Health Care on Self-Rated Health Status among Adults and Elders in Turkiye
Authors: MANAVGAT Gökçe , DEMİRCİ Ayhan
Published: September 2024

Background
Preventive healthcare is crucial in timely detection of risk factors or symptoms associated with diseases, contributing significantly to reducing treatment expenses in health economics by mitigating potential disease risks at the health level. The aim of this study is to examine the sociodemographic factor and the utilization of preventive healthcare services associated with self-rated health status among adult groups and the elderly in Turkey.
Methods
We conducted statistical difference test analyses to assess the frequency of preventive health service utilization for the perceived health across different age groups. We utilized multilevel ordered probit regression models to scrutinize the self-rated health status, considering factors associated with sociodemographic variables and receipt of preventive healthcare among adult groups and elders by using Turkiye Health Survey (HS) Micro Dataset (2022). Thus, we observed model coefficients and their significances, especially concerning age, within the perceived health levels reflecting individuals' health statuses.
Results
This study highlights a clear and positive association between self-rated health status and preventive health services, particularly in consultations with general practitioners, blood pressure measurements, and blood sugar tests. Notably, regular utilization of these services within past year positively influences health status. This relationship is more pronounced with age, especially among young adults and middle-aged adults. Typically, tobacco and alcohol use have a negative impact on health for each age group, while education level has a positive effect. Additionally, affordability constraints on accessing healthcare services and medication clearly have a negative impact.
Conclusion
Subsidizing primary healthcare, screenings, and expanding healthcare services are essential for effective policy implementation. It is crucial to enhance the accessibility and affordability of preventive healthcare interventions to encourage regular check-ups, particularly among young adults and adults, encompassing gender-based considerations.
Effectiveness of Ethnomathematics-Based Learning on Students' Mathematical Literacy: A Meta-Analysis Study
Authors: Pratama Ryan Angga , Yelken Tuğba Yanpar
Published: September 2024

This study aims to determine the effectiveness of ethnomathematics-based learning on students' mathematical literacy through a meta-analysis study. Primary studies were collected from Google Scholar and ERIC databases based on the inclusion criteria. The results of the literature review obtained 16 studies, either from theses, proceedings, or journal articles. Furthermore, the effect sizes were combined according to the Random Effects Model (REM) and data analysis using CMA v3 and R Studio (Meta Package). The calculation results obtained an overall effect size (1,163; 𝐶𝐼 95% [0,719; 1,607]; 𝑝 < 0,001) which indicates that ethnomathematics-based learning has a “strong” effect on students' mathematical literacy when compared to conventional learning. As a result of the moderator category analysis, it was found that the effect sizes differed significantly according to students' regional demographics (𝑄=33,867; 𝑝=0,000), independent variables (𝑄=24,412; 𝑝=0,002), and subject matter (𝑄=67,754; 𝑝=0,000). However, it does not show significant differences when based on the duration of the meeting (𝑄=1,97, 𝑝=0,1601), education level (𝑄=3,743; 𝑝=0,291), sample size (𝑄=3,62, 𝑝=0,0569), and the type of publication (𝑄=4,381; 𝑝=0,112). Thus, it can be said that ethnomathematics-based learning can be an effective learning model for increasing students' understanding of mathematical literacy, especially in the Kalimantan Island region, recommended to be integrated with the Ethnomathematics Pop Up Book and Visual Thinking learning model, and Probability & Sets and 2D & 3D Geometry materials are recommended to be taught through this learning model.
Formative research identifying lung health and screening programming needs among firefighters
Authors: Kang Augustine , Gautreau Marc , D'Souza Peter , Lui Natalie
Published: September 2024

Purpose
Firefighting professionals are exposed to several job-related dangers, many of which have carcinogenic properties, escalating their risk of respiratory disease. Despite this, there are no specific guidelines dedicated to lung health assessments for this occupation. Given rising instances of fires, particularly wildland fires because of climate change, it is imperative to assess the viability of a lung health program for firefighters.
Approach:
This is a qualitative study using focus groups involving firefighters, senior firefighting personnel (lieutenants, captains, and chiefs), and medical practitioners affiliated with fire departments in the San Francisco Bay Area. These sessions aimed to assess participants’ views on the respiratory health threats firefighters face and the logistics needed to establish a lung health program. Two independent reviewers used thematic analysis to extract themes and codes from the transcripts and subsequently develop a joint codebook.
Results
We conducted a total of 4 focus groups: 2 sessions with firefighters, 1 with senior firefighting personnel, and 1 with physicians. These discussions spanned between 52 to 71 minutes. The study revealed four primary themes: (1) promising organization climate for enhancing lung health; (2) unique occupational risks; (3) advocacy of increased lung health screening for firefighters; and (4) opportunities for enhancing health care delivery, training, and equipment. The study also found unique issues, such as fires in homeless encampments that introduce distinct health threats (like specific toxins and bio-risks).
Discussion
This study documented unique occupational risks and identified opportunities for building a lung health program for firefighters.
A rare case of single umbilical artery aneurysm diagnosed by ultrasound: a case report
Authors: Liu Qiong , Quan Ying lan , Tao Yaping , Kou Changmei , Nie Sisi , Cui Guihua , Li Ning
Published: September 2024

Background: Single umbilical artery aneurysms are extremely rare vascular malformations associated with the prenatal fetus. These occur where the umbilical cord enters the placenta on the proximal side of the fetus, and are associated with increased perinatal morbidity, including intrauterine growth restriction and increased fetal mortality.
Case presentation: This article reports a rare case of single umbilical artery aneurysm, which was detected by ultrasound at 22 weeks and 1 day of gestation. The fetus was successfully delivered by emergency cesarean section at 37 weeks and 2 days of gestation. The newborn showed mild asphyxia and was hospitalized in the neonatal intensive care unit with subsequent discharge after 19 days of treatment. Pathological analysis of the placenta confirmed expansion of the end of the umbilical artery due to a blood clot.
Conclusion: Single umbilical artery aneurysm formation is a rare pregnancy complication associated with high fetal mortality rates.Therefore, elective cesarean delivery can reduce the risk of fetal death by avoiding intrauterine distress and death.
Effect of Breathing Phase Number on the 4D Robust Optimization for Pancreatic Cancer Intensity Modulated Proton Therapy
Authors: Fan Xiaoying , Wang Shuting , Li Weijie , Li Tengxiang , Dai Tianyuan , Yin Yong
Published: September 2024

Purpose
Respiratory movement, as one of the main challenges in proton therapy for pancreatic cancer patients, could not only lead to harm to normal tissues but also lead to failure of the tumor control, resulting in irreversible consequences. Including respiratory movements into the plan optimization, i.e. 4D robust optimization, may mitigate the interplay effect. However, 4D robust optimization considering images of all breathing phases is time-consuming and less efficient. This work aims to investigate the effect of the breathing phase number on the 4D robust optimization for pancreatic cancer intensity modulated proton therapy (IMPT) by examining plan quality and computational efficiency.
Methods
A total of 15 pancreatic cancer patients were retrospectively analyzed. For each patient, five four-dimensional (4D) robust treatment planning strategies with different numbers of respiratory phases and one three-dimensional (3D) treatment plan were created. Optimization of the plans were performed on all ten phases (10phase plan), two extreme phases (2phase plan), two extreme phases plus an intermediate state (3phase plan), six phases during the exhalation stage (6Exphase plan), six phases during the inhalation stage (6Inphase plan) and 3D Computed Tomography (CT) scan image (3D plan), respectively. 4D dynamic dose (4DDD) was then calculated to access the interplay effect by considering respiratory motion and dynamic beam delivery. Plan quality and dosimetric parameters for the target and organs at risk (OARs) were then analyzed.
Results
Compared to the 4D plans, 3D plan only showed lower maximum dose of the small intestine while performing worse on all other aspects. All five 4D treatment planning strategies showed similar protection of the OARs. Both the 6Exphase and 6Inphase plans demonstrated similar performance as the 10phase plan in target coverage, outperforming the other three plans. Compared with the 10phase plan, the average decline rates of the optimization time of the five plans of 2phase, 3phase, 6Exphase, 6Inphase, and 3D were 73.26 ± 6.54%, 65.80 ± 7.89%, 42.14 ± 13.57%, 37.72 ± 11.70% and 75.52 ± 8.21%, respectively. With the decrease of the number of phases selected for optimization, the decline rates increased, while the other dosimetry parameters generally showed a deterioration trend.
Conclusion
This study highlighted that the dosimetric performances of the 6Exphase and 6Inphase plans closely aligned with that of the 10phase plan. These plans offered a feasible alternative to 10phase optimization by reducing optimization time while maintaining dose coverage of the target and protection of OARs.
Examining the After-School Study Burden and Well-Being of Chinese Secondary School Students Following Burden Reduction Policies: A Sociological Analysis
Authors: Ran Yunfang , WU XI , Wang Yitao , Zhou Zhiying , Yin Yuan
Published: September 2024

Background
To address the significant issue of students’ heavy after-school study burden, many countries have enacted relevant policies and made efforts to promote students’ well-being. However, the effects of policy implementation are not always desirable. This study is informed by an analysis of how dominant social imaginaries and discourses in China—emphasizing accountability, performativity, competitiveness, and capital accrual—contribute to students’ burdens.
Methods
This case study investigated the after-school study burden of Chinese junior secondary school students following the implementation of burden reduction policies. It involved one-on-one semi-structured interviews with 15 students, 9 parents, and 3 teachers. Additionally, informal individual or group discussions were conducted to explore more in-depth topics. Furthermore, the researchers spent nearly three months immersing themselves in the research site, during which they observed students’ learning status and extracurricular activities. They also reviewed internal documents, including assignments, learning and school extracurricular records, and teachers’ reflexive journals.
Findings:
This study found conflicts between the more humanistic goals of burden reduction policies and the demands of the dominant social imaginary and discourses in China oriented towards pragmatic educational goals. Participants—students, parents, and teachers—were influenced by the dominant social imaginary and discourses, feeling compelled to prioritize academic performance over holistic development and well-being. Consequently, students continued to face heavy after-school study burdens and emotional pressures from various sources such as school assignments, tutoring, and additional exercises assigned by parents or themselves.
Conclusion
The study suggests that all stakeholders should reflect on their responsibilities and collaborate to pursue humanistic objectives in education. This involves striving to meet students’ diverse learning needs, promoting holistic development, and enhancing well-being, rather than solely focusing on pragmatic goals as defined by dominant social imaginary and relevant discourses.
Durable complete response of advanced hepatocellular carcinoma using cannabis oil. A report of two cases.
Authors: Berg Pieter F. van den , Heide Frans van der , Ruiter Simeon J.S. , Slangen Jules J.G. , de Groot Derk Jan A. , Hoogwater Frederik J.H. , Nijkamp Maarten W.
Published: September 2024

Background.
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related mortality worldwide with a grim prognosis. Current treatment options for advanced HCC are limited, and a large proportion of patients is not amenable to any form of treatment, with best supportive care as the only remaining option. Meanwhile, the use of cannabis-derived products is rising in oncological patients who are seeking symptom relief. Cannabinoids, similar to endogenous endocannabinoids, have shown promise in recent preclinical cancer research due to their ability to interact with various signaling pathways and molecular mechanisms of interest.
Case presentation.
In this report, we present two patients with advanced HCC with a high tumor burden who demonstrated durable and complete regression after use of cannabis oil for symptom relief. The observations in this report build on previous (pre)clinical research highlighting the potential anti-tumor qualities of cannabinoids and stress the need for clinical trials investigating the anti-tumor effects of cannabinoids in cancer patients.
Conclusion.
Based on the two cases presented here, we call for further research into the potential beneficial effect of cannabinoids in patients with advanced HCC.
Patient Reported Health Related Quality of Life Outcomes After Viable Cryopreserved Umbilical Tissue Placement Directly Over Spared Neurovascular Bundles After Robotic Assisted Radical Prostatectomy
Authors: Shah Mit , Kennedy Aidan , Geisenhoff Alexander , Kraemer Samantha , Dave Chirag , Sun Fiona , Shetty Sugandh , Seifman Brian , Hafron Jason , Meah Sabir , Johnson Anna
Published: September 2024

Introduction
Incontinence and sexual dysfunction remain common side effects from robotic-assisted radical prostatectomy (RARP) despite nerve sparing (NS) and bladder neck reconstruction techniques. Placing growth factors and anti-inflammatory substances over neurovascular bundles is an emerging technique to enhance recovery of continence and potency. Viable cryopreserved umbilical tissue (vCUT) is FDA-approved for surgery. The objective is to determine if vCUT use in NS-RARP accelerates return of continence and sexual function.
Methods
A retrospective cohort of 176 patients undergoing NS-RARPs with and without vCUT from 2015-2020 was identified through the Michigan Urological Surgery Improvement Collaborative (MUSIC). Return to social urinary continence at 3, 6, and 12 months postoperatively was evaluated using MUSIC patient-reported outcomes (PRO), a validated questionnaire assessing urinary and sexual quality of life at baseline and post-treatment. A distinct cohort of 65 patients undergoing NS-RARP with and without vCUT was assessed for erections firm enough for intercourse at 12 and 24 months post-operatively using MUSIC-PRO. The association between vCUT use and social continence at 3 months was assessed via multivariable logistic regression. A descriptive analysis among patients with quality erections prior to surgery assessed the association between vCUT use and erection quality.
Results
Continence was achieved by 3 months post-op in 86% (99/115) of vCUT patients versus 74% (45/61) in non-vCUT patients (p=0.044). In a multivariable analysis, although not reaching conventional statistical significance, vCUT patients were more likely to achieve continence than non-vCUT patients (OR=2.21, p=0.073). At 24 months post-op, 32% of vCUT patients reported good sexual function versus 33% in non-vCUT patients (p=0.9).
Conclusions
vCUT use during NS-RARP is associated with quicker return to social urinary continence. However, no differences were seen in return of potency. Further studies with longer follow-up and larger sample sizes may further evaluate effectiveness of vCUT in accelerating return of postoperative continence and potency.
Trial registration: N/a
Mendelian randomization analysis does not reveal a causal influence between lipoprotein(A) and immune-mediated inflammatory diseases
Authors: Li Jingyuan , Qin Xiaoning , Hu Yang , Xu Yuru , Zhao Qingzhao , Bu Peili , Ti Yun
Published: September 2024

Observational studies have reported an association between lipoprotein(a) (Lp(a)) and immune-mediated inflammatory diseases (IMIDs). Here, we aimed to explore causal relationship between Lp(a) and IMIDs by Mendelian randomization (MR) analysis. We performed a two-sample mendelian randomization analyses based on genome-wide association study (GWAS) summary statistics of Lp(a) and nine IMIDs, specifically celiac disease (CeD), Crohn’s disease (CD), ulcerative colitis (UC), inflammatory bowel disease (IBD), multiple sclerosis (MS), psoriasis (Pso), rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), type 1 diabetes (T1D), and summary-level data for lipid traits. We performed bidirectional and multivariable MR (MVMR) to examine the causal relationship of Lp(a) with IMIDs analysis and its independence after controlling other lipid traits, namely high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) and triglycerides (TG). The results indicated no causal relationship between Lp(a) and the risk of IMIDs in univariable and multivariable MR analysis (with all IVW P values > 0.05). In multivariable MR, genetically predicted HDL (ORMVMR 0.80(0.68–0.95); P = 0.011) and TG (ORMVMR 0.80(0.66–0.98); P = 0.033) linked to higher risk of type 1 diabetes, and genetically predicted LDL linked to higher risk of psoriasis (ORMVMR 0.80(0.64–0.99); P = 0.045). This MR study found no evidence suggesting a causal link between lipoprotein(a) and IMIDs, which is contrary to the results of many observational studies. The identification of potential mechanisms underlying the observed associations in observational studies necessitates further investigation.
A Comparative Study of Veterans' Sexual Trauma Experiences Over Time
Authors: Karuvannur Shyamala , Dun Danielle N.
Published: September 2024

Military sexual trauma (MST) is a prevalent issue with many concomitants. In the last 25 + years there has been an increase in VA policies aimed to support recovery of MST victims, but there is limited research investigating their success. There have also been military policies enacted to prevent sexual assault and improve the care of personnel reporting sexual assault but no research on their effectiveness. We aimed to compare a sample of Veterans in 2004–2006 to a sample of Veterans in 2017–2023 to see if these policies have improved recovery in the VA system or improved effectiveness in the military. Study 1 included 110 Veterans with MST (19–79 yo; 85% F) from the Northport VA between 2004–2006; Study 2 included 100 Veterans with MST (20–71 yo; 91% F) from the San Diego VA between 2017–2023. Physical and psychological concomitants were assessed with self-report questionnaires. Physical concomitants did not improve between studies. In fact, Study 2 subjects were more likely to report chronic pain (X2[1,N = 199] = 7.71, p = .005), pelvic pain (X2[1,N = 202] = 8.45, p = .004), migraines (X2[1,N = 199] = 10.59, p = .001), and panic attacks (X2[1,N = 199] = 32.24, p < .001) than Study 1 subjects. Most psychological concomitants did not improve except lifetime drug use (X2[1,N = 209] = 14.97, p < .001) and consumption of 3 + drinks per day (X2[1,N = 207] = 25.67, p < .001). Subjects in Study 2 were more likely to report a psychiatric diagnosis (X2[1,N = 200] = 13.40, p < .001). Most physical and psychological concomitants associated with MST have not improved between the studies suggesting that MST-focused policies implemented between 2006–2017 have not significantly improved recovery. A re-evaluation of these policies is needed.
Deliberate Practice: A Framework for boosting pre-clerkship clinical skills
Authors: Xu Min , Shi Hongmei , Zhang Youren , Lei Hong , Yang Miao
Published: September 2024

Background
Clinical skills performance is a core competence for medical students, yet many pre-clerkship students encounter significant challenges in applying clinical skills effectively during their transition to clinical rotations. This study aims to explore effective training frameworks and pedagogical approaches that enhance clinical skills performance, thereby facilitating the transition from preclinical to clinical clerkship and fostering the development of clinical competence.
Methods
A total of 157 pre-clerkship students graded in the 4th year were enrolled in this study. All the students underwent two-week enhanced performance training in clinical skills which focusing on medical history-taking, physical examination, and essential procedural skills. Two competence-based evaluations in the form of objective structured clinical examination (OSCE) were implemented before (OSCE-2) and after (OSCE-3) the enhanced performance training for the students. Additionally, OSCE scores of clinical diagnostic curricula (OSCE-1) which conducted two years ago were referred for comparison.
Results
The medical history-taking performance of pre-clerkship students demonstrated fine skills retention in the pre-training OSCE examination [79.50 (9.50) in OSCE-1 vs 79.50 (9.50) in OSCE-2, q = 1.767, p = 0.424]. However, both performance of physical examination [95.10 (5.80) in OSCE-1 vs 85.00 (8.00) in OSCE-2, q = 15.840, p < 0.001]and essential procedural skills [93.00 (10.00) in OSCE-1 vs 88.00 (14.00) in OSCE-2, q = 5.284, p < 0.001] showed a significant decay with time. Skills performance in medical history-taking [83.50 (7.25) in OSCE-3 vs 79.50 (9.50) in OSCE-2, q = 7.028, p < 0.001], physical examination [90.25 (7.38) in OSCE-3 vs 85.00 (8.00) in OSCE-2, q = 7.430, p < 0.001], and essential procedural skills [95.00 (4.63) in OSCE-3 vs 88.00 (14.00) in OSCE-2, q = 9.247, p < 0.001] all showed significant improvement after the enhanced skills performance training.
Conclusion
The enhanced clinical skills performance training curriculum contributed to facilitate the transition from preclinical to clinical clerkship with improving skills performance. The aligned framework of deliberate practice and advanced teaching modalities showed significant effectiveness in the enhanced clinical skills performance training for pre-clerkship students, which providing reference to peers for best practices in evidence-based medicine education.
HU Coefficient: A Clinically Oriented Metric to Evaluate Contour Accuracy in Radiation Therapy
Authors: Hu Harold Yang , Hu Shaw Yang , Yang Min , Hu Yanle
Published: September 2024

Purpose
To propose a clinically oriented quantitative metric, the HU coefficient, to evaluate contour quality, gauge the performance of auto contouring methods, and aid effective allocation of clinical resources.
Materials and Methods
Publicly available pelvic CT data from the Cancer Imaging Archive was used to demonstrate the clinical utility of the HU coefficient in contour evaluation. The bladder was selected as the organ of interest. It was contoured by a certified medical dosimetrist and reviewed by a certified medical physicist. This contour served as the ground truth contour. From this contour, we simulated two contour sets. The first set had the same Dice similarity coefficient (DSC) but different HU coefficients, whereas the second set kept a constant HU coefficient while exhibiting different DSCs. Four individuals were asked to adjust the simulated contours until they met clinical standards. The corresponding contour modification times were recorded and normalized by individual’s manual contouring times from scratch. The normalized contour modification time was correlated to the HU and DSC to evaluate their suitability as quantitative metrics assessing contour quality.
Results
The HU coefficient maintained a strong correlation with the normalized contour modification time when both sets of simulated contours were included in analysis. The correlation between the DSC and normalized contour modification time, however, was weak. Compared to DSC, HU is more suitable for evaluating contour quality.
Conclusions
We demonstrated that the HU coefficient correlated well with the average normalized contour modification time. Clinically, contour modification time is the most relevant factor in allocating clinical resources. Therefore, the HU coefficient is better suited than DSC to assess contour quality from a clinical perspective.
Relationship between IgM deposition intensity in renal tissue and 5-year renal prognosis in immunoglobulin A nephropathy
Authors: Gao Li , Zhang Xuan , Yu Dongrong , Jiang Mengjie , Yu Can , Li Xiaohong , Zhu Qin
Published: September 2024

[Objective] This study aimed to examine both the clinical and renal tissue humoral immunodeposition profiles in immunoglobulin A nephropathy (IgAN) and identify factors influencing its prognosis. [Methods] A retrospective analysis was conducted on clinicopathological data from 774 patients with primary IgAN, confirmed via renal biopsy, at Hangzhou Hospital of Traditional Chinese Medicine between January 1, 2016, and December 31, 2018. Patients were categorized into end-event and non-end-event groups based on whether they reached the renal composite endpoint, defined as a ≥ 50% decline in eGFR or progression to end-stage renal disease (ESRD). Risk factors for adverse renal outcomes were evaluated using univariate and multivariate Cox regression models. Patients were further divided into three groups based on IgM deposition levels in the glomerular mesangial area: IgM-negative, low (IF ≤ 2+), and high (IF > 2+). Comparative analyses of clinical and histopathological characteristics, along with treatment regimens, were performed across these groups. [Results] The high IgM deposition group exhibited significantly lower serum albumin and eGFR levels, alongside higher cholesterol, 24-hour urine protein, and blood immunoglobulin M levels compared to the IgM-negative and low deposition groups. Multivariate Cox regression analysis identified immunosuppressant use as an independent protective factor for IgAN prognosis, while low serum albumin, T2 lesions, and nephropathological IgM deposits were recognized as independent risk factors for the 5-year prognosis of IgAN. Kaplan-Meier survival curves revealed that patients with high IgM deposition had markedly poorer prognoses compared to those with negative or low deposition. [Conclusion] Besides low serum albumin and T2 lesions, IgM deposition in the mesangial region emerged as an independent risk factor for the 5-year prognosis of IgAN.
Study on apoptosis of human melanoma cell Induced by solanine in vitro and its mechanism
Authors: Feng Sen , Ren Mingyuan , Chen Sijia , Wang Bin , Zhang Yajun , Zhang Guoqiang
Published: September 2024

Objects:
Melanoma (malignant melanoma, MM) is a highly aggressive tumor, ranking as the third most common cutaneous malignancy, characterized by high metastatic potential, mortality, and poor prognosis. Solanine is a major steroidal alkaloid found in potatoes, and its anticancer benefits have been widely reported. However, its inhibitory effects on melanoma cells have been less studied. The aim of this study was to observe the effects of solanine on the proliferation, apoptosis and related apoptotic proteins of melanoma A375 and A2058 cells, and then to investigate the possible anti-tumor mechanism of solanine.
Methods
The morphological changes of apoptosis induced by varying concentrations of solanine in melanoma A375 and A2058 cells were observed using an inverted microscope. The proliferation inhibition rate of melanoma cells was examined using CCK-8 proliferation assay. DAPI staining was employed to observe cell growth and morphological alterations. Gene and protein expression levels of apoptosis-related genes (Caspase-3, Bcl-2 and Bax) were detected by quantitative real-time polymerase chain reaction (RT-qPCR) and western blot analysis.
Results
Within a certain concentration and time range, solanine can inhibit the viability of A375 and A2058 cells significantly in a time-dose-dependent manner (P < 0.05). Apoptosis induced by solanine was confirmed through DAPI staining. Notably, there was a marked decrease in the anti-apoptotic protein Bcl-2, alongside a significant increase in the expression of Bax and Caspase-3 at both the mRNA and protein levels (P < 0.05).
Conclusion
Our data demonstrated the inhibiting proliferation and inducing apoptosis of solanine in melanoma A375 and A2058 cells, and revealed it may be associated with the mitochondrial apoptotic pathway.
Integrated Technique of Natural and Artificial Texts Authorship Verification in the Academic Environment
Authors: Romanov Aleksandr , Shelupanov Alexander , Kurtukova Anna , Fedotova Anastasiia
Published: September 2024

The issue of text plagiarism in academic and educational environments is becoming increasingly relevant every year. The quality of research articles and works is declining due to students copying fragments of others' works and using modern generative models for text and source code creation. The article proposes an integrated technique for authorship verification of both natural and artificial language texts, based on a combination of statistical methods, machine learning, and deep neural networks. The presented technique addresses several related tasks: assessing text homogeneity, detecting plagiarism when solving closed-set authorship attribution problems, and identifying texts and fragments created by generative models. Experimental data include a multi-domain dataset of natural language texts consisting of research articles on natural and technical sciences, PhD dissertations, and artificially generated texts on related topics. To evaluate the effectiveness of the technique in relation to artificial language texts, a multilingual program dataset was used, consisting of source codes for programs of technical students as well as artificially generated program codes. The experimental results demonstrate the effectiveness of the proposed technique for plagiarism detection and copyright protection in the educational process. The accu-racy of identifying heterogeneous fragments in text or code is 93–94%, authorship attribution ac-curacy is 89–99% depending on the number of co-authors, and verification accuracy is 97.5–99.4%.
The solvent effect in regulating the antioxidant activities of Curcumin and its metal complexes- An insight into the mechanism of action using DDPH assay
Authors: Breitener Priya , P.V Mohanan , Nair Balachandran. , Jawahar Lalitha , AlNeyadi Shaikha S.
Published: September 2024

IC50 values from DPPH assay using different polarity solvents are used to confirm the antioxidant mechanisms of curcumin and its complexes with metals. The antioxidant activity varies with the solvent. The protic solvent exhibits the maximum activity with the lowest IC50 value. The polar aprotic medium displays a comparably low activity with a larger IC50 value. The least activity been exhibited by nonpolar solvent with the highest IC50 value. Curcumin's IC50 value varies with solvent, indicating that it follows a distinct molecular route. The antioxidant activity showed a regular increasing trend with non-polar, polar aprotic and protic solvents. The trend suggests an unrelated mechanistic pathway SPLET (sequential proton loss electron transfer), SET-PT (sequential electron transfer-proton-transfer) and HAT (hydrogen atom transfer) operating in solvent used for the study. Curcumin metal complexes antioxidant activity are compared to curcumins to study the influence of groups such as o-methoxy, phenolic, and di-keto in determining their activity. The antioxidant activity of Curcumin-1 and its metal complex with enol center blocked by complexation were comparable suggestive of negligible involvement of enol center in deciding the efficiency and emphasizing on importance of phenol center. The activity of Curcumin-1 was maximum in all the solvents used, followed by the II and III fractions. The trend observed agree with the number of the o-methoxy group present in the substituent.
Advanced Ac-dc Power Flow Analysis: Evaluating the Impact of Control Parameters on System Performance
Authors: Yadaraju Vijay Prashant , M Siva Kumar
Published: September 2024

The paper addresses the challenges posed by the increasing integration of Direct Current (DC) transmission lines and system controllers into power systems. It presents a novel AC-DC load flow methodology designed to resolve the limitations of traditional AC-only models. This new approach integrates established AC load flow techniques with the specific requirements of DC systems, aiming to improve the analysis of mixed AC-DC networks. The proposed methodology, utilizing the Newton-Raphson algorithm, systematically evaluates performance by comparing it with conventional AC-only models and other hybrid methods through detailed test cases. The results show that the AC-DC load flow method significantly enhances both the accuracy and computational efficiency of power flow calculations. By effectively addressing the complexities of integrating AC and DC components, this method offers a robust and innovative solution for modern power system analysis, representing a notable advancement in the field.
Renal pseudohypoaldosteronism type 1 – an adult case series including a novel gene variant
Authors: Calissendorff Jan , Falhammar Henrik
Published: September 2024

Purpose
Renal pseudohypoaldosteronism type 1 (PHA1) is a rare disease affecting infants. Symptoms are failure to thrive, vomiting and weight loss. It is caused by gene variants in NR3C2 by which the mineralocorticoid receptor is dysfunctional, and patients develop hyponatremia, elevated plasma aldosterone and renin but have normal blood pressure. Little is known about PHA1in adults. We present four adults with PHA1, their clinical, biochemistry and genetic data.
Methods
Clinical and biochemical data were collected from the medical files and clinical examination of the participants. Genetic testing was performed.
Results
Two adult dizygotic twins and their mother, as well as an adult man were included. One of the sisters and the man had had severe hyponatremia and been admitted several times as young infants, treated with sodium chloride and fludrocortisone. All had as adults elevated plasma aldosterone and normal potassium. The females now had normal plasma renin, but it was increased in the male. A novel genetic variant in NR3C2 were found in the twins and their mother (c.1816T > C, p.(Cys606Arg)). All had normal blood pressure and were asymptomatic.
Conclusion
In adulthood PHA1 seems to be asymptomatic and long-term consequences favorable.
Geographical accessibility and inequalities in access to childbirth care in the Grand Conakry metropolitan area, Guinea: a spatial modelling study
Authors: GROVOGUI Fassou Mathias , Dioubate Nafissatou , Manet Hawa , Kpogomou Pepe , Millimouno Tamba Mina , Semaan Aline , Beňová Lenka , Delamou Alexandre , Macharia Peter
Published: September 2024

We modelled geographic accessibility, coverage, and wealth-based inequalities for childbirth care in Grand Conakry, Guinea. We assembled boundaries, health facilities, wealth index, road network, elevation, landcover, and geo-traced travel speeds. Using least-cost path algorithm, we computed travel times to the nearest facility by level and sector. We quantified the coverage (% of women of childbearing age) within 15, 30, and 60-minutes of the nearest facility and its variation by wealth index. Average travel speeds ranged from 14 to 28 km/h. Travel to any facility took 8-minutes, increasing to 22 for public hospitals (range from 5 to 33-minutes across communes). Coverage was 100% within 30-minutes of any facility, dropping to 82% for public hospitals, varying across communes. Slower speeds due to traffic substantially increased travel time and reduced coverage. Pro-rich inequalities emerged, especially in peri-urban communes with longer travel times. Targeted interventions are needed to reach equitable access to childbirth care.
Synthesis of Novel Graphene Oxide-Chitosan-Silicon Dioxide Embedded Polysulfone Membrane for Oily Water Treatment
Authors: Yasir Ahmed T. , Alshaibi Nadeen , Ndame Nchwa , Youssef Hind Ben , Ba-Abbad Muneer M. , Benamor Abdelbaki
Published: September 2024

Large quantities of produced water are generated during oil and gas exploration activities as for each barrel of oil, three barrels of produced water is generated. Due to their hydrophobic nature, conventional hydrophobic polymeric membranes struggle to effectively separate oil from produced water. In this work an innovative strategy is suggested by employing a hydrophilic/super-oleophobic nanocomposite to develop novel polymeric membranes able to effectively separate oil content from produced water without negatively affecting the other membrane properties such as the total flux and fouling. Graphene oxide-Chitosan-silicone oxide (GO-CH-SiO2) nanocomposite was synthesized by functionalizing graphene oxide (GO) with chitosan (CH) and silicon dioxide (SiO2). To improve the membrane flux, anti-fouling propensity and oil rejection, the synthesized nanocomposites were doped in the polysulfone membranes matrix. The effect GO-CH-SiO2 concentration, GO:CH ratio and GO-CH:SiO2 ratio on the performances of developed membranes were experimentally assessed and morphology of the synthesized membrane were investigated using appropriate characterization techniques. The experimental results showed that the membrane with GO:CH of 1:2 and GO-CH: SiO2 ratio of 1:6.5 showed the highest pure water permeation flux of 28.35 LMH/bar with a comparable flux recovery rate of 76% and oil rejection efficiency of 98.5%.
Effect of Wheat Bread Incorporated with Chamomile and Wild Thyme on Glycemic and Insulin Responses, Antioxidant Status and Inflammation in Type 2 Diabetic Individuals
Authors: Khan Imran , Ahmad Imtiaz , Johnson Stuart , Ahmad Jamil , Almajwal Ali Madi
Published: September 2024

Previous studies suggest that bread incorporated with chamomile and wild thyme powder exhibit lower starch digestibility and higher antioxidant activity in vitro and hence its intake may suppress postprandial blood glucose and enhance antioxidant status in humans. The present study determined the effect of bread incorporating chamomile and wild thyme on blood glucose, insulin, antioxidant status and inflammation in type 2 diabetic individuals. Sixteen male subjects consumed either control bread (CB) or bread incorporated with 3 % chamomile and wild thyme powder in two separate sessions. Blood glucose was measured by finger-prick method at fasting and then postprandially for 2 h. Plasma insulin, antioxidant and inflammatory markers were measured at fasting and 2 h after consumption. A non-significant decrease in blood glucose while a non-significant increase in insulin was observed after the consumption of chamomile and wild thyme-containing bread (CWB) compared to CB. Compared to baseline, the consumption of CWB increased total polyphenols, total antioxidant capacity (TOAC) and superoxide dismutase (SOD) activity by 6%, 20% and 15%, respectively. Similarly, CWB non-significantly decreased thiobarbituric acid reactive substances (TBARS) by 27% and C-reactive protein (CRP) by 12% compared to CB. In conclusion, the consumption of bread incorporated with chamomile and wild thyme resulted in an improvement in blood glucose and plasma insulin levels, a beneficial increase in polyphenols, TOAC, SOD activity and a reduction in TBARS and CRP levels in type 2 diabetic individuals. Further studies are now warranted with large sample sizes and larger doses to achieve significant clinical results.
Paschen-Back Effect-Driven Coordination Modulation of SO₄²⁻ Hydration for Dendrite-Free Zn Ion Batteries via Magnetized Electrolyte
Authors: Wang Zhi , Yao Xiayan , Guo Jianwei , Qian Guoyu , Wang Hongchen , Gong Xuzhong , Wang Dong
Published: September 2024

Tuning the anionic solvation structure and dynamic processes at solid‒liquid interfaces are critical yet challenging for stabilizing Zn metal anodes in Zn ion batteries. Here, we demonstrate that highly hydrated SO42− can be modulated under a strong magnetic field (MF) via the Paschen-Back effect on the O-H stretching mode, which reorients individual water molecules to manipulate Zn²⁺ solvation and protonated water clusters (H3O+). This high level of hydration was confirmed through Raman spectroscopy, molecular dynamics (MD) simulations, and ¹⁷O/¹H nuclear magnetic resonance (NMR) with coaxial insert tubes. Our findings reveal that the MF disrupts the hydrogen-bonded water structure (DDAA), leading to charge redistribution and localization onto the SO42− -4H₂O (DDA) complex, inhibiting the intra-molecular Fermi resonance of free O-H stretch water (DAA-OH) and suppressing the Zn2+-6H₂O interaction. Additionally, MD simulations and electrochemical characterizations show that these hydrated SO42−-H₂O complexes favor Zn2+ nucleation and deposition on the (002) plane, with the preferential adsorption of oxygen on Zn (002) inhibiting 2D Zn2+ diffusion. Combined with density functional theory (DFT) analysis, we demonstrate that magnetically treated ZnSO4 electrolytes exposed to a 3 T MF for 25 minutes can disrupt the Grotthuss proton-transport mechanism, suppressing H2 evolution and achieving 100% dendrite-free growth. This work highlights the critical role of magnetization pretreatment in enhancing the stability of electrochemical interfaces, offering insights for the molecular design of interfacial water in various aqueous Zn-based batteries.