bluuebunny/crossref_metadata_2025 huggingface dataset:
The Generalization of Muslim Wear to Modest Wear in 2010s Indonesia’s Fashion Trend
Authors: Ratuannisa Tyar
Published: August 2024

Indonesia is a country with the largest Muslim population in the world and with a diversity of languages, culture, and religious beliefs. From time to time, fashion trends in Indonesia are associated with the process of how an appropriate idea can be accepted and internalized through the filtration of Indonesian culture. Modest wear derived from Muslim wear does not only serve as a physiological fulfilment but also a need for identity. There are two types of modest wear users. The first ones are those who use it as an identity, they do not care about trends and will continue to use them. Meanwhile, the second ones are those who choose modest wear to keep up with the trend. This phenomenon raises an idea that, for a Muslim woman, the basis of clothing using modest wear is to use the hijab/jilbab/kerudung as part of the basic clothing. However, many also use head coverings temporarily and do not last long. Thus, this commitment to modest choices becomes a mere trend at one time or, in other words, the use of hijab does not represent their identity. This study investigates the change in Indonesia regarding hijab identity diachronically and the reinterpretation of modest wear in the 2010s accompanied by the determinant factors viewed from the synchronic aspects. It was revealed that modest wear was acceptable due to the dominant factors of trend drivers that are interconnected and interdependent, namely world events, economic conditions, social change, entertainment world, technological innovation, and fashion leaders in Indonesia.
Lyophilized amniotic membrane patches are a safe and effective treatment for rhegmatogenous lesions in combined tractional and rhegmatogenous retinal detachment: A prospective interventional study
Authors: Garcia Angel , Rojas Sergio , Ríos-Nequis Geovanni , Ramírez-Estudillo Abel
Published: August 2024

Objetives: This study was performed to evaluate the safety and effectiveness of a lyophilized amniotic membrane (LAM) as a patch for the treatment of retinal breaks and to describe the structural changes at the implantation site.
Design: prospective, interventional study.
Subjects: Patients with diabetic retinopathy and combined tractional and rhegmatogenous retinal detachment.
Methods: Patients were organized into 3 groups according to the number of rhegmatogenous lesions: those in group A had a single break, those in group B had two breaks, and those in group C had three or more breaks. The location of the break was also evaluated as either superior or inferior.
Main outcomes: Safety was evaluated and defined as a lack of adverse events or the absence of damage to the retinal tissue and intraocular structures. Efficacy was determined by evaluating SD-OCT images to assess whether complete coverage of the retinal break favouring the proximity of the edges and closure of the retinal break was achieved.
Results: Of a total of 23 eyes of 23 patients, 22 (95.6%) achieved retinal repair without associated complications. Patients with 2 or fewer rhegmatogenous lesions located inthe superior sector had a better anatomical result as they achieved 100% surgical success. The structural changes observed by SD-OCT showed adequate adaptation of the lyophilized patch and complete closure of the rhegmatogenous lesion with no alterations in the adjacent tissue.
Conclusions: The LAM patch seems to be safe and effective, as it promotes therapeutic closure of rhegmatogenous lesions without damaging the retinal architecture adjacent to the implantation site.
Best practices for methylome characterization in novel species: a case study in the microalgae Nannochloropsis
Authors: Steadman Christina , Small Eric , Banerjee Shounak , Twary Scott
Published: August 2024

Microalgae remain an important feedstock for the production of biofuels and bioproducts. Discovery of new species drives innovation for biotransformation, where bioengineering and other technological advances can significantly optimize performance. Production is predicated on deep knowledge of algal behavior predicted from genomic and phenotypic studies. However, prediction and manipulation of behavior, particularly for scale up, remains a challenge. Understanding the contribution of epigenetic processes to algal function provides another piece of this complex puzzle for achieving bioeconomy goals. Utilizing Nannochloropsis species as a model, we provide a methodological framework for investigating epigenetic processes, analysis of the limitations of state-of-the-art techniques, and best practices for discerning novel modifications, specifically focusing on variants of DNA methylation in new species. Further, we demonstrate specific forms of DNA methylation can be overlooked by traditional epigenetic analysis strategies. Using high-throughput, lower cost techniques, we provide several pieces of evidence demonstrating Nannochloropsis gaditana and N. salina lack the most ubiquitous forms of eukaryotic DNA methylation (5mC and 5hmC) and instead employ N6-adenine methylation (6mA), commonly found in bacteria, in their genomes. Interestingly, transcriptionally diverse physiological conditions do not elicit differential 6mA methylation in Nannochloropsis spp. Thus, the presence of 6mA may provide stability and protection of the genome. These collective discoveries illuminate not only a new, exciting avenue for improving feedstock genetic drift, stability, and culture health for bioproduction scale up but also an ideal model species to study other epigenetic processes.
Spatial Patterns and Optimization Policies of Low-Carbon Competitiveness of Urban Agglomerations in the Yellow River Basin under the Perspective of Complex Ecosystems
Authors: Ci Fuyi , Li Qinfang , Wang Zihan
Published: August 2024

This paper establishes a comprehensive evaluation index system for assessing the low carbon competitiveness of cities. It employs the kernel density estimation, Dagum Gini coefficient, and spatial autocorrelation analysis to explore the spatial patterns and optimization policies of low carbon competitiveness in urban agglomerations within the Yellow River Basin. The main innovations: (1) Improving the concept of urban low carbon competitiveness, the paper constructs a comprehensive evaluation index system comprising structural, functional, and potential indicators of urban low carbon development. Additionally, carbon circular economy indicators are introduced. (2) The research findings reveal that low carbon competitiveness in urban agglomerations within the Yellow River Basin exhibits a spatial distribution pattern of "downstream > midstream > upstream". The spatial connection pattern of low carbon competitiveness in urban agglomerations within the Yellow River Basin is observed to intensify from local to regional urban agglomerations, as well as from upstream to midstream to downstream urban agglomerations. Generally, absolute differences in low carbon competitiveness within urban agglomerations exhibit an increasing trend as one moves from upstream to midstream to downstream, and from local to regional levels.
Awareness and Acceptability of Assisted Reproductive Technology among Non-Medical Tertiary Students In a Low-resource Setting
Authors: Johnson-Ekeleba Abigail Charity , Sefogah Promise Emmanuel , Swarray-Deen Alim , Mumuni Kareem
Published: August 2024

Background Assisted Reproductive Techniques (ART) have significantly advanced infertility treatment worldwide. However, their availability and use in developing countries, including sub-Saharan Africa, remains limited although infertility is highly prevalent, with significant psycho-social challenges including stigma. This study assessed the awareness, attitudes, and perceptions of ART among non-medical tertiary students in Ghana.Method A cross-sectional study was conducted among non-medical students in tertiary institutions in Ghana. Pre-tested questionnaires were administered to both post-graduate and undergraduate students after obtaining informed consent. Ethical approval was obtained from the Review Board at Community Health Department of the University of Ghana Medical School. The data collected was analyzed using SPSS (version-27) and the results presented using frequency tables, graphs, and charts. significance was P-value below 0.05 was considered statistically significant.Results Overall, 196 participants from the two largest universities and other tertiary institutions in Ghana took part in this study. Majority (63.5%) of respondents demonstrated awareness on ART services, but 60.3% showed poor knowledge of the types of ART. Males generally exhibited lower knowledge of ART services compared to females, and knowledge of ART services showed an inverse relationship with age. In-vitro fertilization (IVF) was the most widely recognized and recommended ART technique, known by 65.1% of respondents who were aware of the types of ART. Most participants expressed reluctance to accept or recommend gamete donation due to religious reasons, fear of complications, and a preference for conventional means of procreation.Conclusion The majority of tertiary students in Ghana are aware of ART for infertility treatment; however, many are hesitant to donate their gamete, accept, or recommend donor gamete treatments. Fear of complications and related costs pose major barriers to considering ART among the respondents. Participants unanimously suggested government subsidies and the inclusion of ART under the national health insurance coverage package.
Impact of Resilience Policies on Cape Town's Water-Food Nexus: A System Dynamics Approach
Authors: Hofmann Viola S. , Egieya Jafaru M. , Parker Yumna , Gorgens Johann , Goosen Neill J.
Published: August 2024

Background
Climate change is increasingly affecting the supply of resources such as water and food. From 2015 to 2018, Cape Town endured its most severe drought on record. Yet, resource management often occurs in isolation, which contrasts with the holistic perspective provided by the nexus concept that recognizes the interdependence of resource sectors. This study employs system dynamics modelling, to examine the City of Cape Town’s (CoCT) water-food trade-offs and interactions using qualitative and quantitative approaches. It assesses various policies proposed by the CoCT, to improve system resilience and to boost future water supplies, examining their efficacy and potential drawbacks. These policies are tested against future scenarios including population growth and climate change predictions of different severities.
Results
The simulation results show an increase in food demand, which is mainly linked to population growth and a significant decrease in water availability. Without interventions, the CoCT is expected to experience serious water shortages within the 40-year simulation period.
Conclusions
The findings indicate that the CoCT’s strategies will effectively secure adequate water for its expanding population. However, a major concern was found to be the proposed intensification of aquifer exploitation. The model predicts that such an approach could lead to over-abstraction of some aquifers, compromising their sustainability.
The Application Research on Iris-clip intraocular lens implantation for Aphakia in Canine
Authors: Wu YuanHeng , Dong Yi , Liu Ying , Liu ZiChen , Wang YingYun , Bai Yang , Jin YiPeng
Published: August 2024

Objective
This study aimed to assess the clinical efficacy of Iris-clip intraocular lens (IOL) implantation for treating Aphakia in canines.
Method
Twelve dogs diagnosed with hereditary cataracts in both eyes were enrolled. Each dog's eyes were randomly assigned to either the control group or the operative group. Phacoemulsification was performed on both groups, with the operative group additionally receiving Iris-clip IOL implantation. Routine ophthalmic examinationst were conducted and compared between the two groups.
Results
In both groups, IOP gradually decreased post-surgery, with levels on the 3rd day being significantly lower than pre-surgery levels (P < 0.05). STT values initially decreased, then increased, with the operative group exhibiting lower values than normal between the 4th and 21st days post-surgery. Corneal edema and aqueous humor flare were higher in the operative group, requiring a longer recovery period. Visual acuity improved significantly in both groups, with the operative group showing superior results.
Conclusion
Iris-clip anterior chamber intraocular lens implantation may lead to early postoperative complications. However, with appropriate local drug treatment, these complications can be resolved, resulting in significant improvement in visual acuity in dogs with aphakic eyes. This study confirms the feasibility of this surgical approach for treating aphakia in dogs.
Causality of genetically determined metabolites and metabolic pathways on joint diseases: a two-sample mendelian randomization study
Authors: Zhang Binbin , Lu Chuan , Dou Bin , Yan Qi , Zhaxi Dawa , Wei Shuqing , Luo Xiang , Gu Wenzuo , Li Kewen
Published: August 2024

OBJECTIVE: Infectious arthropathies, inflammatory polyarthropathy, osteoarthropathies, and many other joint diseases are now prevalent worldwide. A large number of studies have suggested an association between metabolites and joint diseases, but due to the limitations of routine observational studies, its significance is not clear. In this paper, we used Mendelian randomization to assess potential causal associations between metabolites and a variety of joint diseases.
METHODS: By screening publicly available data from non-overlapping genome-wide association studies with 1400 metabolites as exposure data and 11 joint diseases as outcome data, the inverse-variance weighted (IVW) method was used as the study to assess the causal effect, MR-Egger, weighted median, weighted mode, and simple mode were used as supplementary methods, and Cochran's Q, MR-Egger- intercept, and MR-PRESSO for sensitivity analysis.
RESULTS: Positive correlations were found between N-formyl anthranilic acid levels and Arthropathies (PFDR=0.019) after FDR correction. Glycine levels (PFDR=0.016), N-acetylglycine levels (PFDR=0.010), Glycine to serine ratio (PFDR=0.018), Propionylcarnitine (c3) levels (PFDR=0.015) were positively correlated with Gonarthrosis. Cystine levels (PFDR=0.017), N-acetylglycine levels (PFDR<0.001), Glycine to serine ratio (PFDR<0.001), and X-24757 levels (PFDR=0.021) were positively associated with Gonarthrosis, primary, with knee surgery. Correlation.
There was a negative correlation between Taurine to cysteine ratio and Arthropathies (PFDR=0.035) and a negative correlation between Docosatrienoate (22:3n3) levels and Rheumatoid arthritis (PFDR=0.013). There was a negative correlation between taurine to cysteine ratio and Other joint disorders (PFDR=0.011). Cysteinylglycine to taurine ratio (PFDR=0.005), Adenosine 3',5'-cyclic monophosphate (cAMP) to adenosine 5'-monophosphate (AMP) ratio (PFDR=0.034) were negatively correlated with Other arthrosis. adenosine 5'-monophosphate (AMP) to histidine ratio (PFDR=0.024), and Glycohyocholate levels (PFDR=0.011) were negatively associated with Gonarthrosis, primarily, with knee surgery. Sensitivity analyses did not reveal the presence of heterogeneity as well as level pleiotropy (P>0.05), suggesting that the findings were not biased, and the leave-one-out method also suggested robust results. Six significant metabolic pathways were identified by metabolic pathway analysis.
CONCLUSION: This study provides new evidence of a causal relationship between metabolites and a variety of joint diseases. Metabolites are important markers in the progression of joint diseases, which is clinically important for the prevention and treatment of joint diseases.
Analysis of Factors Affecting the Population Growth Rate in Rural Areas of Khorasan Razavi Province Based on a MGWR Model
Authors: Aghajani Hossein , Sarkari Farnaz
Published: August 2024

Rural abandonment is a critical demographic issue that has impacted various countries across the world, including Iran, and specifically Khorasan Razavi Province. This research aims to pinpoint factors affecting rural population growth rates within this region. To overcome the limitations of the GWR model, its advanced form, known as Multiscale Geographically Weighted Regression, has been introduced. In this study, the average rural population growth rate of the province's districts between 2006 to 2016 was used as the dependent variable, and 38 variables across socio-demographic, environmental, and infrastructural sectors as independent variables. Results indicate a significant spatial autocorrelation within the rural population growth, suggesting that local regression models are more apt for examining spatial variable relationships. In analyzing local growth factors through MGWR, influencing variables included literacy rates, the average population of villages per district, and the percentage of rural health houses have had a positive impact, while variables included the percentage of the working-age population, the percentage of villages with fewer than 100 residents per district and distance from Wells have had a negative impact on rural population growth rate in the province.
Cellular angiofibroma of the female pelvic cavity: a case report
Authors: Chen Li , Zhang Gumuyang , Sun Hao
Published: August 2024

Background:
Cellular angiofibroma is a rare benign mesenchymal tumor that mostly occurs in the genital area. Its occurrence outside this region, particularly in the pelvis, is extremely rare. To our knowledge, this study reports the first case of cellular angiofibroma occurring in the pelvic cavity, except for one case reported in the retroperitoneum.
Case presentation:
A 25-year-old female patient with chronic, intermittent, dull pain in the lower abdomen that lasted for several months was referred to our clinic. Imaging studies revealed a tumor in the pelvic cavity anterior to the bladder. The radiographic characteristics of this tumor indicated a hypervascular nature, suggesting the possibility of a pheochromocytoma or a neuroendocrine tumor. The patient underwent surgical excision of the lesion. To date, no recurrence has been observed three months after excision.
Conclusions:
Cellular angiofibroma, although rare in the pelvic cavity, should be considered in the differential diagnosis of hypervascular pelvic space-occupying lesions. Immunohistochemical staining can help confirm the diagnosis of this condition. Treatment is generally straightforward, involving local excision of the tumor followed by postoperative monitoring.
Causal Relationship Among Intestinal Microbiota, Lipid Metabolites, and Cholangiocarcinoma: A Mendelian Randomization Study
Authors: Xu Sicheng , He Xing , Liu Liqiang , Ren Junkai , Zhou Qixian , Ye Huilin , Li Wenbin , Wang Haikuo
Published: August 2024

Background:
Cholangiocarcinoma (CCA) is an aggressive tumor with a poor prognosis. Numerous animal experiments and clinical studies have indicated an association between the gut microbiota (GM) and the incidence of CCA. Additionally, patients with CCA often exhibit metabolic disorders, but there is a lack of evidence regarding causality. Therefore, elucidating the causal relationships among GM, plasma metabolites, and CCA is crucial and can provide insights for the prevention and treatment of CCA.
Objective:
We utilized summary statistics from the largest available genome-wide association studies, including gut microbiota (GM) data from the MiBioGen consortium (n = 18,340), plasma metabolites from four distinct human metabolomics studies, and cholangiocarcinoma (CCA) patient data from the UK Biobank (cases n = 832 and controls n = 475,259). We conducted bidirectional Mendelian randomization analyses to explore the causal relationship between GM and CCA. Additionally, we performed two mediation analyses and a two-step Mendelian randomization (MR) to identify potential mediating metabolites, offering guidance for the clinical early detection and intervention of CCA.
Results:
In our analysis, we identified that two types of gut microbes (Enterobacteriaceae and Enterobacteriales) increase the risk of cholangiocarcinoma (CCA), while eight types of gut microbes, including Lachnospiraceae and Eggerthella, have protective effects. Additionally, we identified 31 plasma metabolites significantly associated with CCA, with lipid metabolism disorders being a key factor. Notably, four plasma metabolites, such as Intermediate-Density Lipoprotein Triglycerides (IDL_TG), mediate the relationship between gut microbiota and CCA, highlighting the role of plasma metabolites as intermediaries. These findings underscore the potential of targeting gut microbiota and plasma metabolites for the prevention and treatment of CCA.
Conclusion:
Our research demonstrates that plasma metabolites play a pivotal role in the pathogenesis of CCA induced by gut microbiota. This finding deepens our understanding of how gut microbiota dysbiosis contributes to the development of CCA by influencing plasma metabolites.
Empowering Alzheimer's Caregivers with Conversational AI: A Novel Approach for Enhanced Communication and Personalized Support
Authors: Hasan Wordh Ul , Zaman Kimia Tuz , Wang Xin , Li Juan , Xie Bo , Tao Cui
Published: August 2024

Alzheimer's disease and related dementias (ADRD) significantly impact patients and their caregivers, causing emotional stress, lack of training, and financial strain for the latter. Addressing the need for effective support, this research developed and validated ADQueryAid, a conversational AI system designed to empower ADRD caregivers. Built on a Large Language Model (LLM) and enriched with authoritative ADRD information through a knowledge graph, ADQueryAid uses Retrieval Augmented Generation (RAG) techniques to retrieve relevant information from both structured and unstructured data sources. Prompt engineering and conversation policies ensure the delivery of informative, empathetic, and personalized responses. Evaluated via a Blind Within-Subjects Design study with 20 ADRD caregivers interacting with both ADQueryAid and a baseline model (ChatGPT 3.5) in fictional caregiving scenarios, the system's usability was assessed using the Chatbot Usability Questionnaire (CUQ). Results showed ADQueryAid significantly outperformed the baseline model across all CUQ metrics, offering more contextually relevant information, accurate guidance, and emotional support, which enhanced the caregiving experience. This study highlights the potential of AI to support ADRD caregivers by providing personalized assistance, with future research focusing on expanding the knowledge base, refining conversational strategies, and exploring the long-term impact on caregiver well-being and patient outcomes.
Plasma mutation profile of precursor lesions and colorectal cancer using the Oncomine Colon cfDNA Assay
Authors: Reis Mariana Bisarro dos , Santos Wellington dos , de Carvalho Ana Carolina , Lima Adhara Brandão , Reis Monise Tadin , Santos Florinda , Reis Rui Manuel , Guimarães Denise Peixoto
Published: August 2024

Background
Colorectal cancer (CRC) is the second leading cause of cancer death worldwide. Early detection of precursor lesions or early-stage cancer could hamper cancer development or improve survival rates. Liquid biopsy, which detects tumor biomarkers, such as mutations, in blood, is a promising avenue for cancer screening.
Aim
To assess the presence of genetic variants in plasma cell-free tumor DNA from patients with precursor lesions and colorectal cancer using the commercial Oncomine Colon cfDNA Assay.
Material and Methods
Cell-free DNA (cfDNA) samples from the blood plasma of 52 Brazilian patients were analyzed. Eight patients did not have any significant lesions (five normal colonoscopies and three hyperplastic polyps), 24 exhibited precursor lesions (13 nonadvanced adenomas, ten advanced adenomas, and one sessile serrated lesion), and 20 patients with cancer (CRC). The mutation profile of 14 CRC-associated genes were determined by next-generation sequencing (NGS) using the Oncomine Colon cfDNA Assay in the Ion Torrent PGM/S5 sequencer.
Results
Thirty-three variants were detected in eight genes (TP53, PIK3CA, FBXW7, APC, BRAF, GNAS, KRAS, and SMAD4). No variants were detected in the AKT1, CTNNB1, EGFR, ERBB2, MAP2K1 and NRAS genes. All variants were considered pathogenic and classified as missense or truncating. The TP53 gene harbored the most variants (48.48%), followed by the KRAS gene (15.15%) and the APC gene (9.09%). It was possible to detect the presence of at least one variant in cfDNA in 60% of CRC patients (12/20) and 25% of precursor lesions (6/24), which included variants in three patients with nonadvanced adenoma (3/13–23.08%) and three with advanced adenomas (3/10–30%). No variants were detected in the eight patients with normal findings during colonoscopy. The detection of mutations showed a sensitivity of 60% and a specificity of 100% for detecting CRC and a sensitivity of 50% and a specificity of 100% for detecting advanced lesions.
Conclusion
The detection of plasma NGS-identified mutations could assist in early screening and diagnostic of CRC in a noninvasive manner.
Development and Validation of Newly Biopsy-Free Nomograms for Predicting Clinically Significant Prostate Cancer in Men with PI-RADS ≥4 Lesions
Authors: Wang Junxin , Chen Mingzhe , Xu Yong , Guo Shanqi , Jiang Xingkang
Published: August 2024

To develop and validate biopsy-free nomograms to more accurately predict clinically significant prostate cancer (csPCa) in biopsy-naïve men with Prostate Imaging Reporting and Data System (PI-RADS) ≥ 4 lesions. A cohort of 931 patients with PI-RADS ≥ 4 lesions, undergoing prostate biopsies or radical prostatectomy from January 2020 to August 2023, was analyzed. Various clinical variables, including age, prostate-specific antigen (PSA) levels, prostate volume (PV), PSA density (PSAD), prostate health index (PHI), and maximum standardized uptake values (SUVmax) from PSMA PET-CT imaging, were assessed for predicting csPCa. Model performance was evaluated using area under the receiver operating characteristic curve (AUC), calibration plots, and decision-curve analyses, with internal validation. The foundational model (nomogram 1) encompassed the entire cohort, accurately predicting csPCa by incorporating variables such as age, PSAD, PV, PSA ratio variations, suspicious lesion location, and history of acute urinary retention (AUR). The AUC for csPCa prediction achieved by the foundational model was 0.918, with internal validation confirming reliability (AUC: 0.908). Advanced models (nomogram 2 and 3), incorporating PHI and PHI + PSMA SUVmax, achieved AUCs of 0.908 and 0.955 in the training set and 0.847 and 0.949 in the validation set, respectively. Decision analysis indicated enhanced biopsy outcome predictions with the advanced models. Nomogram 3 could potentially reduce biopsies by 92.41%, while missing only 1.53% of csPCa cases. In conclusion, the newly biopsy-free approaches for patients with PI-RADS ≥ 4 lesions represent a significant advancement in csPCa diagnosis in this high-risk population.
Posaconazole enteric-coated tablets on the efficacy and tolerability of secondary antifungal prophylaxis in haploidentical allogeneic stem cell transplantation
Authors: wang xiaoning , Sun Chunhong , wang yuqi , Liu Ruimin , Ren juan , zhu huachao , He pengcheng
Published: August 2024

Background:
There are limited researches about posaconazole enteric-coated tablets on the efficacy and tolerability of secondary antifungal prophylaxis(SAP)for invasive fungal disease (IFD) in haploidentical allogeneic hematopoietic stem cell transplantation༈allo-HSCT༉.
Objective:
To investigate the plasma concentration of posaconazole enteric-coated tablets on the efficacy and tolerability of SAP and drug-drug interactions between posaconazole, cyclosporine A (CsA) and mycophenolate mofetil (MMF) in haploidentical allo-HSCT.
Methods:
We conducted a single-arm, open-label, prospective trial (ChiCTR2200059472, Date of Registration 30th April, 2022) to assess efficacy and tolerability of posaconazole enteric-coated tablets as SAP in haploidentical allo-HSCT patients. Plasma concentrations of posaconazole and mycophenolic acid (MPA,active metabolites of MMF) as well as CsA were monitored within 30 days post-transplantation. Additionally, the incidence of IFD was observed.
Results
Fourty-six patients previously with IFD were enrolled in the trial. The incidence of IFD was 4.35% at 100 days and 10.86% at 6 months. The primary cause of prophylaxis failure was gastrointestinal intolerance. The mean plasma concentrations of posaconazole were 0.48 ± 0.06ug/ml at week 1, 0.54 ± 0.07ug/ml at week 2, 0.75 ± 0.08ug/ml at week 3 and 0.90 ± 0.08ug/ml at week 4. The mean plasma concentrations of CsA were 133.04 ± 0.13ng/ml at week 1, 179.53 ± 11.19ng/ml at week 2, 225.02 ± 13.80ng/ml at week 3 and 278.61 ± 13.61ng/ml at week 4. The mean plasma concentrations of MPA during week 2, 3 and 4 were 0.41 ± 0.06mg/L, 0.84 ± 0.08mg/L and 1.08 ± 0.13mg/L, respectively. Posaconazole reached steady state concentrations by week 2 and MPA reached target concentrations at week 3.
Conclusion
Posaconazole enteric-coated tablets appears to be effective and tolerability for SAP of IFD after haploidentical allo-HSCT. When cyclosporine, MMF, and posaconazole are used in combination, the dosage of MMF does not need to be adjusted. The dosage of CsA needs to be personalized and adjusted based on therapeutic drug monitoring.
Alpha-Adrenergic Antagonists and Iris Dynamics: Challenges and Solutions in Cataract Surgery
Authors: Kaushik Jaya , Sharma Rishi , Goyal Sumit , Dangi Meenu , Jha Rakesh Kumar , Singh Ankita
Published: August 2024

Background: Alpha-1 adrenergic receptor antagonists (α1-ARAs) are frequently used in treatment of Hypertension and symptomatic benign prostatic hypertrophy (BPH). Numerous studies have demonstrated the association between α1-ARAs like Tamsulosin and increased surgical risks for patients undergoing cataract surgery. This study aims to identify and study the effects of α1-ARAs on iris parameters and the subsequent operative challenges encountered during cataract surgery.
Methods: A cross-sectional, prospective study involving 30 patients on α1-ARAs planned for cataract surgery and equal number of age and sex matched controls were subjected to evaluation of changes on iris parameters and subsequent challenges in cataract surgery.
Results: The study group had statistically significant lesser pupil diameter. Iris thickness at sphincter muscle region (SMR) was similar between groups (P = 0.53). Significantly lower values of iris thickness at dilator muscle region (DMR) found in treated subjects (P = <0.001). There was statistically significant difference between DMR/SMR ratio of two groups (P<0.001). Multiple regression analysis revealed longer duration of α1-ARAs treatment correlated with reduced DMR/SMR ratio (P = 0.001; r = 0.47).
Conclusion: α1-ARAs have implications for pupil size regulation and surgical procedures involving the eye. Tamsulosin is more potent than alfuzosin in inducing IFIS. Systemic α1-ARAs lower values of DMR thickness, DMR/SMR ratio and reduces pupillary diameter. Therefore, ophthalmologists, primary care physicians, urologists, and patients should be aware of the potential difficulties that these drugs pose for cataract surgery.
Screening and management of obstructive sleep apnea (OSA) and daytime sleepiness in professional drivers in Tunisia: A protocol study using machine learning
Authors: MSAAD Sameh , GARGOURI Rahma , KAMMOUN Nesrine , KHEMEKHEM Rim , ABID Narjes , FEHRI Sonia , KALLEL Kaouther , KAMMOUN Rim , GHARBI Leila DOUIK EL , Maalej Sonia , Bouhamed Heni , Abdelghani Ahmed , Aichaouia Chiraz , Turki Mohamed , KAMMOUN Samy
Published: August 2024

Background
Professional drivers have high rates of Obstructive Sleep Apnea (OSA). This study aims to determine the prevalence of OSA and Excessive Daytime Sleepiness (EDS) and identify their risk factors among a large representative sample of professional drivers in Tunisia. We will also evaluate the risk of accidents associated with OSA and EDS before and after treatment.
Methods
This will be a population-based and prospective study about 3000 professional drivers. Participants will receive a structured questionnaire to evaluate five main outcomes: the likelihood of OSA, EDS, drowsy driving, related sleepiness near misses and accidents, as well as work productivity. Validated self-report measures will be used to evaluate these outcomes.
Participants suspected of having OSA and/or EDS will undergo sleep laboratory investigations, including sleep study. Participants who have moderate-to-severe OSA combined with EDS will be recommended CPAP treatment. After one year of follow-up, all participants will be re-evaluated with self-report questionnaires. For those treated with CPAP, they will undergo the Maintenance of Wakefulness Test (MWT) and adherence, tolerance, and consistency of CPAP usage will be recorded.
We will also use machine learning models. Among the models we will evaluate: Random Forests (RF), XGBoost, and Deep Neural Networks (DNN). The data will be split into two sets: a training set and a test set. The training set will be used to train the machine learning models. The test set will be used to evaluate the models' performances. We will compare the performances of the different machine learning models using standard evaluation metrics such as accuracy, recall, and F1-score.
Conclusion
Our results will pave the way for the creation of a clinical screening instrument that can identify sleep-wake disturbances in professional drivers. This is likely to have a significant impact on the legal regulations concerning driving fitness and road safety.
Early thrombocytopenia at hospital admission predicts mortality in patients with non-isolated severe traumatic brain injury
Authors: Piñeiro Patricia , Calvo Alberto , Perez-Díaz Maria Dolores , Ramos Silvia , García-Ramos Sergio , Power Mercedes , Solchaga Isabel , Rey Cristina , Hortal Javier , Turégano Fernando , Garutti Ignacio
Published: August 2024

Background
Patients with severe traumatic brain injury (STBI) often experience an abnormal hemostasis that contributes to mortality and unfavorable neurological outcomes. We aimed to analyze epidemiologic, clinical and laboratory factors associated with mortality in patients with severe traumatic brain injury during the first 48 hours after in-hospital admission.
Methods
We performed an observational retrospective study of STBI patients with associated extracranial trauma [defined as Injury Severity Score (ISS) ≥ 16 with an Abbreviated Injury Scale (AIS) head and neck ≥ 3 and Glasgow Coma Scale (GCS) ≤ 8], admitted to a Level II trauma center over 7 years (2015–2021). Patients were divided in 2 groups: survivors and dead. We assessed differences regarding demographics, trauma severity, hemodynamics, disability, need of surgery, length of stay, transfusions, need of massive transfusion protocol and hemostatic laboratory parameters at different time points.
Results
134 STBI patients were included. Patients who died were older, mostly men and showed higher trauma severity and disability. Hemoglobin, platelets and clotting parameters deteriorated after admission to the emergency department (ED) with significant differences between groups within the first 24h after admission. Platelet count < 150 × 103/µL at ED arrival, Glasgow coma scale and age were independent risk factors for mortality.
Conclusions
Older age, Glasgow coma scale and platelet count at ED arrival were independent risk factors for mortality in STBI patients with associated extracranial trauma. Early thrombocytopenia < 150 × 103/µL at ED arrival may be used as a simple prognostic tool to early predict mortality between non-isolated STBI.
Effects of vitamin D3 supplementation on the recovery of hospitalized burn patients: a randomized double-blind controlled trial
Authors: Ghadimi Elahe , Rahbar Roozbeh , Jafarzade Elham , Mansoori Anahita
Published: August 2024

Background
Burn patients, due to their damaged skin, may not be able to synthesize vitamin D. In this study, we aimed to evaluate the effects of vitamin D supplementation on the recovery of hospitalized burn patients.
Methods
Fifty-four patients participated in a randomized controlled trial. Eighteen patients were randomly assigned to group C (control, received gelatin soft gel as placebo), 18 patients to group D1 (received 1000 IU/day vitamin D), and 18 patients to group D2 (received 3000 IU/day vitamin D). After supplementation, wound biopsy and blood samples were obtained from the patients. Weight, height, 25(OH)D level, wound healing, scar formation, quality of pain, and blood parameters were evaluated.
Results
There were no significant differences in the serum vitamin D levels between the groups at admission, and 81.5% of the participants were deficient. The Bates–Jensen Wound Assessment Tool demonstrated significant differences in wound healing between the C group and the D1 and D2 groups, and the supplemented groups experienced greater improvement. The D2 group showed significant differences in thickness and total score on the Vancouver scar scale up to three months after discharge (P = 0.03). Moreover, there was a notable decrease in insulin requirements and the number of injected insulin units in the supplemented groups compared with those in group C (P = 0.006 and P = 0.01, respectively). In addition, shorter hospitalization was observed in group D2 (P = 0.04).
Conclusion
Supplementation with vitamin D at doses of 1000 and 3000 IU/day improved wound healing and decreased scar thickness as well as exogenous insulin requirements. Overall, at 3000 IU/day, better results were achieved than at 1000 IU/day.
Systemic inflammation enhances metastatic growth in a syngeneic neuroblastoma mouse model
Authors: Mimura Kazuya , Fumino Shigehisa , Yamashi Kodai , Iguchi Masafumi , Inoue Maho , Takayama Shohei , Kim Kiyokazu , Aoi Shigeyoshi , Tajiri Tatsuro , Ono Shigeru
Published: August 2024

Background
We previously showed that total tumor resection enhances metastatic growth in a syngeneic metastatic mouse model of neuroblastoma. In this study, we further investigated which surgical factors contributed most to metastatic growth.
Methods
Tumor cells derived from MYCN transgenic mice were subcutaneously injected into wild-type mice. Mice were randomly assigned to receive partial resection (PR group), subcutaneous implantation of a sponge (Sp group), or observation (Obs group). The lymph node metastasis volume and frequency of lung metastasis were compared 14 days after assignment by measuring C-reactive protein (CRP) and interleukin-6 (IL-6) levels.
Results
The lymph node metastasis volume in the Sp group was larger than in the Obs group (148.4 [standard deviation {SD}: 209.5] vs. 10.2 [SD 12.8] mm3). The frequency of lung metastasis was greater in the Sp group than in the PR group (11.9 [SD 12.2] vs. 6.6 [SD 4.0] counts/slide). The CRP level in the Sp group was higher than in the PR group (2.3 [SD 0.5] vs. 1.5 [SD 0.4] µg/mL), and the IL-6 level in the Sp group was higher than in the PR or Obs groups (28.4 [SD 34.5] vs. 12.4 [SD 19.0] vs. 5.4 [SD 8.1] pg/mL).
Conclusion
Metastatic growth may be enhanced by systemic inflammation.
Pulmonary anthracosis in a free-ranging infant rhesus monkey (Macaca mulatta) in Bangladesh– A Case Report
Authors: Prank Md. Rasel , Ahasan ASM Lutful , Hossain Syed , Shil Subrata Kumar
Published: August 2024

Background: The study aims to describe a rare case of pulmonary anthracosis in a free-ranging infant rhesus monkey in Bangladesh.
Case presentation: An infant Rhesus monkey (Macaca mulatta) just under 1 year of age died suddenly in a veterinary hospital in Bangladesh under treatment period with clinical signs of loss of appetite, gradual weight loss, weakness, dehydration, depression, breathing difficulty, and mild nasal discharge. The experienced veterinarian performed the postmortem examination of the infant monkey, collected samples from different organs, and sent them to the Department of Anatomy and Histology at Chattogram Veterinary and Animal Sciences University (CVASU) for confirmatory diagnosis. A grossly considerable number of evenly distributed black spots were observed in the entire lungs. Moreover, both lungs were inflamed, firm, swollen, and discolored, but there were no nodules or fibrosis. Microscopically, black-colored carbon particles, inflammatory cells, edematous fluid, and brown color hemosiderin-laden macrophages were found in the interstitial space. Diffuse alveolar damage along with exudate and carbon particles were found in the alveoli.
Conclusion: The infant rhesus monkey died of cardiopulmonary failure due to chronic respiratory distress. The pulmonary anthracosis indicated that air quality was poor in the habitat and may pose a health risk to wild animals and humans.
Spectroscopic, Thermal and Electrical Properties of CNT Added PVC/PMMA Blends
Authors: Çelik Afşar , KARAGÖZ Mustafa Hamdi
Published: August 2024

This study investigated the effect of different ratios of CNT (carbon nanotube) additive on various properties of PVC/PMMA (poly (vinyl chloride/poly(methyl methacrylate)) blend. For this purpose, a nanocomposite was prepared by adding 0, 0.1, 0.5, and 1% CNT (carbon nanotube) to the PVC/PMMA blend, which was prepared by casting technique from a common solvent. Spectroscopic and thermal analyses were carried out on the prepared nanocomposite samples. SEM imaging showed that CNTs showed good distribution and interaction in the polymer matrix. XRD analyses showed the amorphous character of the structure, and CNT doping did not create any significant changes in crystallinity. The highest crystallinity was found in PVC40-1 at 15.24%. All the samples had similar Tg (Glass transition Temperature) values in the DSC analysis. The existence of CNT did not affect Tg values. CNTs helped to preserve the integrity of nanocomposite because the rate of degradation of nanocomposite without CNT reached its highest values (258.95–514.19W/min) in the DTG. TGA analysis showed that all the weight loss curves of the samples looked similar. Weight loss occurred at 194, 249, and 442°C and all of them were very similar. CNTs did not change the electrical conductivity of the nanocomposite. A fragility was observed in the structure of the nanocomposite.
Safety and Efficacy of Using Stapler Device for Wide Cystic Duct Ligation in Acute Setting of Laparoscopic Cholecystectomy
Authors: Alyami Rifan , Alotaibi Ahad , Alhoumaily Bader , Momen Ibrahim , Aljanfawe Hatem , Algoblan Marya
Published: August 2024

Introduction:
This research explores the challenges posed by variations in cystic duct anatomy during laparoscopic cholecystectomy and the potential use of stapler devices to address such complexities. It aims to assess the safety and efficacy of stapler devices, particularly in cases involving short, and wide cystic duct.
Methodology:
The study, conducted at King Abdulaziz Medical City in Riyadh, Saudi Arabia, between 2021 and 2023. The study design involved a retrospective cohort approach, and the sample size encompassed all cases meeting the inclusion criteria during the study period. Data was analyzed using SPSS program.
Results
The study involving 568 patients, with the predominant technique for ligation being clipping (89.3%). The primary indication for using the Endo GIA stapler was a wide cystic duct (6.2%). Analysis revealed a significant association between stapler device use and hypertension (p = 0.042), diabetes (p = 0.001), CKD (p = 0.011), and obstructive jaundice (p = 0.006). Multivariate regression demonstrated that older patients were 2.1 times more likely to use stapler devices (AOR = 2.125; p = 0.039), while those with obstructive jaundice had a 2.2 times higher likelihood (AOR = 2.168; p = 0.049).
Discussion
Throughout the years, metal clips have shown the best prognosis compared to any other method for securing the cystic duct during closure in laparoscopic cholecystectomy. However, to avoid incomplete sealing of wide, short, or inflamed ducts, other instruments have emerged as possible alternatives for such conditions.
Conclusion
Use of Endo-GIA is a safe and effective method for patients with wide, short cystic duct. Selective usage of endo-GIA is considered cost effective and may add a positive impact in decreasing post operative biliary leak.
Characterizing the need for childcare support for cancer patients through health care providers’ experiences: a qualitative study.
Authors: Preston Katherine , Li Zhang Hao Jim , MacDonald Mackenzie , Giuliani Meredith , Leung Bonnie , Ingledew Paris-Ann
Published: August 2024

Purpose
Approximately 1 in 5 newly diagnosed cancer patients are between the typical childrearing ages of 20 and 54. As such, a significant portion of cancer patients are also parents to young children (age < 18). This study aims to characterize the need for childcare support for cancer patients from the perspective of healthcare professionals providing care at a major Canadian cancer center.
Methods
Healthcare providers (HCP) were invited to partake in semi-structured telephone interviews, which were conducted using an interview guide. The interviews explored what specific benefits supportive childcare interventions could offer, as well as what might constitute optimal delivery. Interview transcript data was interpreted using thematic analysis.
Results
In total, 28 HCPs participated in interviews between April and May 2022. A wide range of providers were engaged, including physicians, nurses, and allied health professionals. Providers indicated that the introduction of supportive childcare services could have benefits including reduced stress for their patients, improved system efficiency and treatment compliance, and reduction of provider burnout.
Conclusion
These findings indicate that childcare issues are perceived by HCPs as a source of stress for cancer patients with children, and that benefits may be associated with the introduction of supportive childcare services. As such, cancer centers could consider the implementation of such services as a way of providing patient-centered care.
Biodiversity Assessment of Ground Beetles in Mount Nacolod Forest, Southern Leyte, Philippines
Authors: Abayon Myra Abit
Published: August 2024

A pioneer investigation about ground beetles was carried out within the forest of Mount Nacolod, a protected forest in Silago, Southern Leyte, Philippines. A comprehensive collection effort done for two months yielded a total of 2,315 individuals representing 26 species across 16 genera, 8 tribes, and 2 subfamilies were documented in the forests of Mount Nacolod. Table 1 provides a comprehensive list of these species, detailing their geographical distribution, habitat type, and conservation status. Among the recorded species, 11 are identified as Philippine endemics, with 4 specifically endemic to Leyte. These findings offer baseline data on the carabid beetles of Mount Nacolod. Notably, species such as Pheropsophus hassenteufeli, Pheropsophus lumawigi, and Tricondyla aptera punctipennis were recorded as the most abundant. emphasizing the significance of this study in expanding the understanding of local biodiversity. New additions in Leyte are Brachinus leytensis, Trigonotoma goeltenbothi, Pheropsophus lumawigi, Pheropsophus azoulayi, Pheropsophus uliweberi, and Pheropsophus taclobanensis. The last two species were discovered and identified in this study. The ecological characteristics, distribution, and occurrence of these species were also documented. Urgent conservation efforts are recommended, particularly for rare and endemic carabid beetle species found in specific forest habitats like Mount Nacolod. It is imperative to enhance protective measures in designated landscapes to mitigate threats such as mining, illegal logging, slash-and-burn agriculture, and human encroachment, safeguarding the biodiversity-rich ecosystems of Mount Nacolod and its surrounding forests.