bluuebunny/crossref_metadata_2025 huggingface dataset:
Structured pre-briefing: the impact on medical students’ anxiety and learning experience in simulation
Authors: Mostafa Enase M. , Jaradat Ahmed A. , Khonji Sara A. , Alharbi Ghada M. , Khalil Nama A. , Eweida Rasha S. , Garadaha Prof. Taysir S.
Published: December 2024

Introduction: The expansion of simulation-based learning in undergraduate education is mounting, an approach that can reduce the anxiety of learners is emphasized. Methods: This study is conducted in the Medical Skills and Simulation Center (MSSC) to identify the effects of using structured pre-briefing (concept mapping) on final-year medical students’ anxiety levels and the relationship with perception after simulation. Design: Eighty-four fifth-year medical students in Arabian Gulf University on Jan 2021, over three months intervals. Students were divided into two groups: the interventional group of 44 students who received structured pre-briefing, including a concept map, and the control group, which included 40 students that received traditional pre-briefing. At the end of the session, each student completed a sheet of six items: State-Trait Anxiety Inventory (STAI-6) as a tool for measuring anxiety and a questionnaire to evaluate students’ perception (understanding) of simulation. Linear correlation coefficient was measured between anxiety level and students’ understanding or perception of experience. Results: Anxiety level measured by the STAI-6 score was higher in the control group than the interventional group of 48.9 ± 15.5 versus 34.9 ± 11.3, P < 0.001. The perception of experience was shown to be greater for the interventional group than for the control group of 46.5 ± 6.2 versus 41.7 ± 9.7, P,0.001. There was a significant negative correlation between the anxiety level and the students’ understanding (perception) of the pre-briefing (P = - r: 0.004). The implication of anxiety reduction was clear among medical students using the concept mapping as the awareness and perception of the elements of environments improved significantly. Conclusion: Structured pre-briefing using concept mapping decreases their anxiety level, which leads to improve the understanding and perception during simulated clinical experience.
Identification Of Pathogenic Mutations And Application Of Polygenic Risk Scores In Early-Onset Diabetes Patients
Authors: Atava Ivanna , Reščenko Raimonds , Brīvība Monta , Birzniece Līga , Elbere Ilze , Megnis Kaspars , Pečulis Raitis , Lauga-Tuņina Una , Kirillova Ināra , Konrāde Ilze , Dzīvīte-Krišāne Iveta , Kalniņa Ineta , Kloviņš Jānis
Published: December 2024

Background: Maturity-onset Diabetes of the Young (MODY) presents a diagnostic challenge, with a large proportion of cases lacking identifiable genetic mutations, which could lead to sub-optimal medical treatment and, subsequently, a decline in patients’ life quality. This study investigates the utility of polygenic risk score (PRS) in distinguishing monogenic diabetes from early-onset type 1 diabetes (T1D) and type 2 diabetes (T2D) cases to enhance diagnostic accuracy.
Methods: We investigated the genetic basis of early-onset diabetes in a Latvian cohort comprising 66 patients, contrasted with 174 non-diabetic controls, using whole-genome sequencing (WGS).
Results: We identified 22 causative mutations in three MODY genes (GCK, HNF1A, and HNF4A), eight of them being novel. We selected and tested the best-performing population specific T1D and T2D PRS models on the established diabetic cohort and controls. Patients without genetically confirmed MODY had a significantly higher risk for T1D compared to controls. A 75% centile of T1D-PRS included only 8.7% of the genetically confirmed MODY patients, compared to 34% of patients without mutations, providing good specificity for the identification of indicative T1D at this PRS range. While T2D-PRS was increased in the diabetic cohort, it did not demonstrate an ability to discriminate between MODY-positive and negative subgroups.
Conclusions: Our study demonstrates that the application of WGS improves diagnostic accuracy and highlights the potential of T1D-PRS as a critical tool for the stratification of MODY-suspected patients.
Preoperative role of MRI and CEM in breast cancer: Which one is more accurate?
Authors: Barrio-Piqueras Miguel , Urtasun-Iriarte Cesar , Mbongo-Habimana Carmen , Malmierca Patricia , Cordoba Jose Maria Nuñez , Perez Arlette Elizalde , Insausti Jose Luis Pina
Published: December 2024

Background
Breast-MRI is the main technique in preoperative assessment of breast cancer but has not been free of controversy. Contrast-enhanced-mammography (CEM) is an alternative.
Purpose
To evaluate CEM and MRI accuracy in preoperative staging of breast cancer and to determine which technique is more accurate measuring lesion size.
Material and Methods
Between September 2017 and November 2023, 139 histopathologically characterized lesions from 94 patients who underwent MRI and CEM were retrospectively studied. For both, BI-RADS categories and lesion diameters were reevaluated. Sensitivity, false-positive (FP), false-negative (FN) ratios, and area-under-curve (AUC) were calculated. Discrepancies between the lesion size measurements on MRI or CEM and histopathology were also assessed.
Results
94 women with breast cancer with 139 assessable lesions (23 benign and 116 malignant) were included. The global sensitivity was 96.6% for breast MRI vs 81.03% for CEM (p = 0.001). MRI provided 112 true-positives (TP) and 4 FN among 116 malignant biopsies; on the other hand, CEM reported 94 TP and 22 FN out of 116 confirmed malignant biopsies. Among the 23 negatives for malignancy biopsies, MRI showed 18 FP and 5 TN and CEM, 1 FP and 22 TN. AUC of 0.85 for MRI and 0.89 for CEM (p > 0.05). No significant differences in the tumor size assessment accuracy (p = 0.389) were found with a tendency to lesion size overestimation (MRI and CEM measured + 3.35 and + 4.04 mm respectively).
Conclusion
MRI was more sensitive than CEM in the detection of malignant lesions although the accuracy of both techniques was similar. CEM and MRI tend to overestimate the tumor size.
Optimized design and performance analysis of a centipede-like wheel-legged mobile robot
Authors: Zhang Tan , Ding Chen-jun , Wang Dong , Ma Teng-fei , Li Xin-bao , Zhang Jia-ning , Zhu Xue-hong
Published: December 2024

In order to improve the passability and motion flexibility of a mobile robot under unstructured terrain, a multi-drive module articulated mobile robot that can passively adapt to complex and variable obstacle terrains is developed by combining passive deformation wheels and flexible articulation devices, and the passive deformation wheels are optimised. Based on the study of the mechanism of passive deformation of wheels, a mechanical model of robot obstacle crossing is established, and the passability of the robot under different terrains is analysed. The experimental results under different terrains show that the robot has reasonable structural design, good obstacle-crossing performance and motion flexibility, and can passively adapt to complex and variable obstacle terrains.
Association of serum fatty acids with adverse long-term survival among cancer patients
Authors: Liu Fengyi , Cai Hengxuan , Lyu Kun , Li Lei , Zhang Yiying , Xu Wei
Published: December 2024

Background:
Evidence regarding the health effects of saturated fatty acids (SFAs), monounsaturated fatty acids (MUFAs), and total polyunsaturated fatty acids (PUFAs) is controversial. Our objective was to explore the associations between serum-free fatty acids and mortality among cancer survivors.
Methods:
The study included 6,575 participants with or without cancer diagnosis aged 20 years and older with or without a cancer diagnosis who were recruited before December 2014 and followed up through December 31, 2019. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by investigating weighted Cox proportional hazards regression models to assess the associations stratified by cancer status.
Results:
The weighted mean age was 49.6 years, 48.5% were male, and approximately 9.2% of the participants had a diagnosis of cancer. In total, there were 901 deaths over a median follow-up period of 8.74 years. After full adjustment for covariates, the positive associations between several subtypes of long-chain SFAs (C12:0-C16:0) and mortality risk were especially significant among cancer survivors (HRs per an increase of standard deviation 1.29–1.35, each p ≤ 0.022), while very-long chain SFAs (C22:0 and C23:0) were associated with reduced all-cause mortality only among adults without cancer (both p ≤ 0.029). There was substantial heterogeneity in the associations of individuals with different MUFAs with all-cause mortality stratified across cancer status. Omega-3 PUFAs were not related to mortality risk among adults with or without cancer (each p ≥ 0.086), while the individuals of omega-6 PUFAs (C18:2 n-6, C20:3 n-6, C22:4 n-6, and C22:5 n-6) were significantly associated with all-cause mortality risk among cancer survivors but not among those in the health population.
Conclusions:
We found that some subtypes of long-chain SFAs, MUFAs, and omega-6 PUFAs might be associated with increased all-cause mortality risk, while omega-3 PUFAs are not associated with reduced or increased mortality risk among cancer survivors.
The Maxillofacial Surgery Compendium: Insights from 1077 Microvascular Free Flap Reconstructions in the Head and Neck Area
Authors: Lampert Philipp , Fenske Jakob , Kreiker Henri , Steffen Claudius , Koerdt Steffen , Kreutzer Kilian , Rendenbach Carsten , Heiland Max
Published: December 2024

Purpose: This study aims to provide a comprehensive overview of patient demographics, treatment characteristics, and associated complications following microvascular free flap reconstructions in maxillofacial surgery, while also addressing the potential impact of fluctuating surgeon experience in a high-volume training center.
Methods: Adult patients who received a microvascular free flap between April 2017 and July 2023 were analyzed in this retrospective single-center study. Follow-up was recorded until July 2024. Fibula (FFF), scapula (SFF), deep circumflex artery (DCIA), radial forearm (RFF), anterolateral thigh (ALT) and latissimus dorsi (LDF) free flaps were included. Variables were stratified by flap type and the N-1 Chi2-test used to test for statistical significance of complication rates across years.
Results: 1077 patients met the inclusion criteria. DCIA flaps suffered the highest rates of early flap loss (11.1%; mean 3.0%) and wound infection (44.4%; mean 14.4%). SFFs had the highest rate of anastomotic revision (20.7%; mean 5.6%) and longest mean surgery duration (715 ± 183 min). Donor site complications were most common among RFFs (35.4%) and FFFs (33.6%). Overall, wound infection rates were higher among bony compared to soft-tissue flaps (32.3% vs. 10.9%). While complication rates varied significantly from year to year, the overall trends remained stable.
Conclusion: FFFs were associated with fewer recipient-site complications than SFFs and DCIA flaps, but donor site complications were higher. Among soft-tissue flaps, complication rates did not differ considerably. A well-structured resident training program mitigates the impact of experienced surgeons departing the team, though yearly fluctuations in complication rates should still be expected.
Global, regional and national burden of colorectal cancer and its risk factors, 1990-2021: a systematic analysis for the GBD 2021
Authors: Zeng Xuan , Chen Long , Liang Liang , Zhang XiaoYong , Liu Ning , Wang Jibo
Published: December 2024

Importance:
Colorectal cancer (CRC) represents a significant portion of the global cancer burden, underscoring the need for a detailed epidemiological assessment. This analysis is essential for informing targeted public health interventions and guiding strategic resource allocation.
Objective
The present study aims to conduct a comprehensive analysis of the global, regional, and national burden of CRC and its associated risk factors from 1990 to 2021, utilizing data from the Global Burden of Disease (GBD) 2021 study.
Methods
A comprehensive analysis was conducted to assess the distribution of CRC across 204 countries and territories, focusing on the burden in relation to age, gender, and geographic location. The study also evaluated the impact of key risk factors on disability-adjusted life years (DALYs) across 21 GBD regions. A Bayesian age-period-cohort (BAPC) model was employed to project the future trajectory of CRC over the next three decades.
Findings:
The 2021 global incidence of CRC is projected to be approximately 2,194,143 cases (95% uncertainty interval [UI], 2,001,272 to 2,359,390), with a prevalence of 11,679,120 (95% UI, 10,774,527 to 12,538,400) and 24,401,100 DALYs (95% UI, 22,689,369 to 26,161,518) worldwide. Significant regional variations in the burden of CRC were observed, with Central Europe experiencing the highest impact. The burden of CRC increases with age, peaking among the elderly population aged 84 to 94 years. From 1990 to 2021, the age-standardized incidence rate (ASIR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life years rate (ASDR) for CRC showed an upward trend, with a more pronounced burden observed in males compared to females. Future projections suggest a potential decrease in burden of CRC, with a more substantial reduction expected among females.
Conclusion
The study reveals regional disparities in the burden of CRC, with Central Europe being the most significantly affected region. Dietary risk factors were identified as primary contributing factor. These findings enhance our understanding of the global distribution and variation in CRC prevalence, providing valuable insights for cancer control planning.
Mediastinal A5: a novel artery variant of the pulmonary artery system: a case report
Authors: Li Gang , Gong Sheng , Wang Ning , Peng Yong , Yao Xiaojun
Published: December 2024

Background
Variations in the pulmonary artery require increased attention from thoracic surgeons prior to or during lobectomy to avoid serious intraoperative bleeding. Patients with intrathoracic adhesions typically experience more intraoperative bleeding and therefore require conversion to open thoracotomy. The inability to recognize variant pulmonary arteries in the context of adhesions may have a fatal impact on the patient, especially for patients with adhesions caused by pulmonary tuberculosis.
Case presentation
A 52-year-old man who presented with adhesions caused by pulmonary tuberculosis in the right upper lobe underwent video-assisted thoracic lobectomy in our department. The precise identification of a mediastinal A5 artery variant (an artery entering the lateral segment of the right middle lobe) originating from the proximal pulmonary artery trunk and then traveling between the branches of the superior pulmonary vein parallel to the right middle pulmonary artery trunk ensured a safe surgery. Right upper lobe lobectomy was performed following isolation of the mediastinal A5 variant without serious intraoperative bleeding.
Conclusion
Exact identification of mediastinal A5 variants can help surgeons safely perform right upper lobectomy.
Impact of Preoperative Frailty on Outcomes in Patients Subjected to Emergency Laparotomy: A Prospective Study
Authors: Isand Karl Gunnar , Aim Allan , Bahhir Artjom , Uuetoa Marit , Kolk Helgi , Saar Sten , Lepner Urmas , Talving Peep
Published: December 2024

Purpose
Emergency laparotomy (EL) is a high-risk procedure, especially in frail patients. This study investigates the prevalence of frailty in referral facilities, evaluates the impact of frailty on postoperative morbidity and mortality, and assesses the long-term effect of EL on patients’ functional status.
Methods
This prospective multicentre cohort study included patients aged 50 years and older who underwent EL. Frailty was assessed using the Clinical Frailty Scale (CFS). The primary outcome measure was the prevalence of frailty and its impact on the 180-day mortality rate after EL. Secondary outcomes were 30- and 90-day mortality, complications requiring invasive procedures, length of hospital stay (LOS), and changes in CFS and in living arrangement at six months post-operation.
Results
The study enrolled 251 patients with a median age of 73 years. Frailty was prevalent, with 57.8% of patients classified as frail (CFS 5–9). In Cox regression analysis, the hazard ratios of 180-day mortality with 95% confidence intervals were 2.4 (0.8–7.1) for CFS 4, 7.5 (2.8–20.0) for CFS 5, 14.4 (5.5–37.8) for CFS 6–8, and 28.7 (9.7–84.6) for CFS 9, compared to non-frail patients. Increasing frailty was also associated with higher 30 and 90- day mortality, increased risk of complications, and prolonged LOS. Additionally, at six months post-EL, patients experienced a further decline in functional status compared to their preoperative state.
Conclusion
The 180-day mortality after EL is significantly higher for patients on higher levels of frailty. Likewise, the preoperative frailty has a significant negative impact on postoperative outcomes both short- and long-term.
Design of a Slotted Patch Antenna for RF Energy Harvesting in the WiFi 6E band
Authors: Ahmed Md. Firoz , Alam Arshadul , Islam Md. Ashraful , Paul Pronab Kumar , Bashir Samiul , Uddin A. N.M. Shihab , Kabir M. Hasnat , Islam Md. Rashedul , Islam Md. Bipul
Published: December 2024

The increasing demand for wireless communication underscores the necessity for effective RF energy harvesting solutions, particularly within the burgeoning WiFi 6E spectrum (5.925–7.125 GHz). This paper details the design and evaluation of a compact slotted patch antenna with partial grounding specifically optimized for RF energy harvesting in this frequency range. The objective is to create a high-performance antenna with a wide bandwidth, making it ideal for integration into energy-harvesting devices. The antenna features a slotted patch configuration combined with a partial grounding approach and is constructed on an FR4 substrate measuring 9.18 × 9.18 × 1.6 mm³. This substrate has a dielectric constant of 4.3, a thickness of 1.6 mm, and a tangent loss of 0.025. A 50-Ohm microstrip line is used for feeding the antenna. Simulations performed using CST Microwave Studio reveal remarkable performance characteristics, including a reflection coefficient (S11) of -34.02739 dB, a Voltage Standing Wave Ratio (VSWR) of 1.040519, and a bandwidth of 2.22396 GHz, extending from 4.948941 GHz to 7.172901 GHz. Additionally, the antenna demonstrates a gain of 0.276 dBi, a directivity of 2.98 dBi, and an efficiency of-2.702 dB (53.68%). These findings indicate that the antenna is well-suited for energy-harvesting applications within the WiFi 6E band. Its compact dimensions, high efficiency, and broad bandwidth position it as a promising option for a variety of applications, including wireless sensor networks, wearable devices, and Internet of Things (IoT) systems, all of which depend significantly on energy harvesting for self-sustained operation.
Prevalence and associated factors of workplace violence among Chinese nurses in tertiary hospitals: a national cross-sectional study
Authors: Yuan Jianghao , Yang Jiaxin , Liu Yiting , Ning Meng , Yu Qiang , Li Xuting , Chen Zengyu , Huang Chongmei , Zhang Dan , Ren Zhenhui , Bin Chunhui , Li Yamin , Tian Yusheng
Published: December 2024

Background: Workplace violence (WPV) is a major issue for nurses worldwide, causing both physical and mental harm, and impairing their ability to work effectively. Several researches reported on the prevalence of WPV among nurses in China, ranging from 56.4–71%. However, little information is available about the correlates of different types of WPV among nurses across different departments in tertiary hospitals in China.Methods: A self-designed WeChat-based questionnaire was utilized, incorporating demographic and occupational factors. WPV was measured using the Chinese version Workplace Violence Scale. Two questions regarding career choices were employed to assess career satisfaction. Descriptive analyses, chi-square tests, and bivariate logistic regression analysis were conducted.Results: 122,237 participants were included in the analysis. 26.6% of them experienced at least one form of WPV in the past year. Male sex, shift work, postgraduate education, senior professional title, department, and working more than 50 hours per week were factors associated with WPV. Nurses encountered high levels of WPV were less likely to be satisfied with their nursing career.Conclusions: WPV is a special concern for Chinese nurses. Interventions to reduce WPV should be conducted by health authorities to create a zero-violence working environment for nurses, and to increase their career satisfaction.
SNRPB2 facilitates esophageal squamous cell carcinoma oncogenesis and progression via E2F4 stabilization
Authors: Xu Feng , Zhu Chen-cheng , Lu Chen , Ning Guang-yao , Zhang Ren-quan
Published: December 2024

Introduction:
Esophageal cancer (ESCA) has poor prognosis. Small nuclear ribonucleoprotein polypeptide B2 (SNRPB2) involves in pre-mRNA splicing a component of the spliceosome. However, the potential role of SNRPB2 in tumors remains poorly understood. This study aimed to determine the clinical relevance and prognostic value of SNRPB2 in patients with ESCA.
Methods
SNRPB2 mRNA expression levels and genetic alterations were analyzed using GEPIA2 and cBioPortal. The SNRPB2 protein were detected by immunohistochemical staining using paraffin-embedded tissue specimens of esophageal squamous cell carcinoma (ESCC). Cell experiments were performed to verify the role of SNRPB2 in ESCC cells. TIMER, GO, and GSEA analyses were performed to investigate potential biological functions of SNRPB2. Cycloheximide (CHX) chase was used to test protein stability.
Results
SNRPB2 mRNA was highly expressed in ESCA and associated with tumor progression and clinical prognosis. SNRPB2 protein was highly expressed in ESCC and significantly correlated with vessel carcinoma embolus, lymph node metastasis, clinical stage, and tumor grade. in vitro and in vivo experiments showed that the knockdown of SNRPB2 significantly suppressed proliferation, migration, and invasion. GSEA showed that SNRPB2 inhibits the Rb/E2F pathway. SNRPB2 positively correlates with E2F4 by increasing E2F4 protein stability. E2F4 overexpression dramatically eliminated the effects of SNRPB2 knockdown on ESCC tumor progression.
Conclusion
SNRPB2 promotes the proliferation, migration, and invasion of ESCC cells by increasing E2F4 protein stability. SNRPB2 has a prognostic role and immunoregulatory potential in ESCA, and is an important factor for prediction, evaluation, and individualized treatment.
Independent risk factors associated with Uric Acid Stone disease: A retrospective study
Authors: Huang Jinxing , Aizezi Xierzhati , Ge Xue , Wang Zheng , Ma Yuan , Li Jifu , Keremu Abuduweili
Published: December 2024

Objective
To find out the independent risk factors for uric acid stone formation through a retrospective single-center clinical analysis, to provide a scientific basis for the prevention and treatment strategies.
Methods
We reviewed 772 patients with urinary tract stones in our institution, divided into the uric acid stone and non-uric acid stone groups. We collected basic patient information and the results of blood and urine tests. We used descriptive statistics, t-tests, and chi-square tests for intergroup comparisons, and performed univariate analysis to screen significant variables, and multivariate Logistic regression to determine the independent risk factors for uric acid stone formation.
Results
Univariate analysis showed that males and patients with a history of hypertension were more likely to develop uric acid stones (P < 0.05). There were significant statistical differences in blood sodium, potassium, anion gap, creatinine, urea, uric acid, TG, LDL, VLDL, urinary calcium, uric acid, and pH between the groups (P < 0.05). Multivariate Logistic regression identified a history of hypertension (OR = 2.921, P < 0.01), abnormal blood uric acid (OR = 14.762, P < 0.01), low blood sodium levels (OR = 0.873, P = 0.014), low urinary pH (OR = 0.398, P = 0.001), and high urinary uric acid levels (OR = 1.00, P < 0.01) as independent risk factors for uric acid stone formation.
Conclusion
A history of hypertension, abnormal blood uric acid levels, low blood sodium levels, low urinary pH, and high urinary uric acid levels are independent risk factors for uric acid stone formation, providing diagnostic evidence for clinical practice and guidance for preventing and treating uric acid stones.
Digital Monitoring of Tai Chi Balance Training in Older Adults Using Wearable Sensors and Machine Learning
Authors: Corniani Giulia , Sapienza Stefano , Vergara-Diaz Gloria , Valerio Andrea , Vaziri Ashkan , Bonato Paolo , Wayne Peter
Published: December 2024

Tai Chi, an Asian martial art, is renowned for its health benefits, particularly in promoting healthy aging among older adults, improving balance, and reducing fall risk. However, methodological challenges hinder the objective measurement of adherence to and proficiency in performing a training protocol, critical for health outcomes. This study introduces a framework using wearable sensors and machine learning to monitor Tai Chi training adherence and proficiency. Data were collected from 32 participants with inertial measurement units (IMUs) while performing six Tai Chi movements evaluated and scored for adherence and proficiency by experts.
Our framework comprises a model for identifying the specific Tai Chi movement being performed and a model to assess performance proficiency, both employing Random Forest algorithms and features from IMU signals. The movement identification model achieved high accuracy (micro F1: 90.05%). Proficiency assessment models also achieved high accuracy (mean micro F1: 78.64%).
This study shows the feasibility of using IMUs and machine learning for detailed Tai Chi movement analysis, offering a scalable method for monitoring practice. This approach has the potential to objectively enhance the evaluation of Tai Chi training protocol adherence, learnability, progression in proficiency, and safety in Tai Chi programs, and thus inform training program parameters that are key to achieving optimal clinical outcomes.
Research title: Coping Skills and its Associated Factors Among Breast Cancer Women in Iraq: A Cross-Sectional Study
Authors: Alsdfan Rasha Mohammed , Kadir Azidah Abdul , Noor Norhayati Mohd , Al-jubour Mohammed Baqer Abbas
Published: December 2024

Coping skills play a vital role in managing the physical and psychological effects of breast cancer. Despite improvements in early detection and treatment, breast cancer survivors continue to face long-term challenges after diagnosis. This study aims to evaluate the coping skills employed by breast cancer women in Iraq and to identify the sociodemographic, clinical, and psychological factors associated with these coping behaviours. Methods: A cross-sectional study was conducted among 244 breast cancer women in the Medical City Teaching Oncology Hospital, Baghdad, Iraq, from August 2023 to October 2023. Coping skills and psychological factors were assessed using the BRIEF COPE-28 and Hospital Anxiety Depression scale, respectively. Sociodemographic and clinical characteristics were also taken. The associations between the coping skills and associated factors were evaluated using multiple linear regression analysis. Results: The mean (SD) coping skills for active coping, passive coping, and seeking support were 5.96 (1.31), 4.00 (1.10), and 7.58 (0.84), respectively. Multiple linear regression revealed hormonal therapy, anxiety, and depression were significant factors influencing active coping. The passive coping associated factors were the type of surgery and anxiety. The seeking support was notably affected by the stage of disease, duration since surgery, and anxiety. Conclusion: This study highlights the association factors influencing the coping skills among breast cancer women in Iraq, and the need for targeted psychological and clinical interventions to improve coping skills.
An EfficientNet-global attention mechanism model based on road pavement type identification for vehicles
Authors: Ni Zhe-Yuan , Wang Jun-Cheng
Published: December 2024

This study presents an enhanced road pavement-type identification method for vehicles to address the challenge posed by the complex texture characteristics of various road surfaces. First, a comprehensive dataset, including seven pavement types, i.e., dry and wet asphalt, immersed asphalt, dry and wet concrete, and icy and snowy roads, was constructed based on the existing open-source road surface classification dataset and road testing experiments. Second, an EfficientNet-GAM model was developed, and a global attention mechanism (GAM) was incorporated to streamline the model’s complexity while preserving the global feature representation. Then, label smoothing was applied to the cross-entropy loss function, and a cosine learning rate decay strategy was employed to accelerate model convergence to improve the model’s learning of similar pavement information. Finally, the experimental results demonstrate the model’s effectiveness in identifying various pavement types with high accuracy (98.11%) and computational efficiency.
Impact of Tele-Nursing on Maternal Self-Efficacy and Anxiety in Post-Discharge Epilepsy Care: an interventional study
Authors: Seif Marzieh , Khodahakhshi Mohammad reza , Roozbahani Reyhaneh , Dehghani Maryam , Hakimi Hamideh , Ranjbar Hadi , Fayyazi Afshin
Published: December 2024

Purpose
Epilepsy is one of the most common neurological disorders and one of the chronic childhood diseases that affects many children every year. Therefore, the present study was conducted with the aim of determining the effect of tele-nursing after discharge on the self-efficacy and anxiety of mothers with children with epilepsy.
Methods
In this experimental study, 90 mothers of children with epilepsy were selected by available sampling method and then randomly divided into two control and intervention groups. Demographic information questionnaire, Spielberger anxiety questionnaire and caregiver self-efficacy questionnaire were used to collect data. The intervention group was trained by telephone in the form of 10 telephone calls at regular intervals during two months. Data collected was analyzed using SPSS version 16.
Results
The results showed that the two control and intervention groups were similar in terms of mother's age, gender, mother's occupation, and parents' education. In addition, the anxiety scores of the two groups were similar before the intervention, and after the intervention the two groups had a statistically significant difference (P < 0.001). In terms of the self-efficacy score, the two groups had a statistically significant difference after the intervention (P < 0.001).
Conclusion
Tele-nursing after discharge caused a significant decrease in anxiety and increased self-efficacy of mothers in taking care of their children, therefore, it is recommended to use a comprehensive program in the form of tele-nursing according to parents' educational needs and wishes.
Multifunctional Cellulose-Based Adsorbent from Waste Wood Wool for Heavy Metal Removal and Bacterial Disinfection: Insights into Adsorption Behavior, and DFT Calculations
Authors: Bhardwaj Manisha , Jaiswal Shivangi , Misra Namita , Kumari Nirmala , Shukla Shruti , Dwivedi Jaya , Sharma Swapnil
Published: December 2024

The present study demonstrates the isolation of pure cellulose (CU) from Cedrus deodara (C. deodara) wood wool. Further, CU and modified mercaptobenzothiazole-functionalized CU (CU-MBT) were evaluated for adsorptive removal of Hg(II), Pb(II), Cd(II) ions and bacterial strains from water. Advanced characterizations through TGA, HR-TEM, FE-SEM, FTIR, XRD, EDX and XPS were performed to analyze the adsorbents. The adsorption kinetics of CU and CU-MBT followed the pseudo-second-order model with high regression coefficients (0.99) for Pb(II), Cd(II), and Hg(II). At pH 6 and pH 7, the thiol-functionalized CU-MBT displayed better adsorption capacities i.e. 185.18 mg/g, 178.57 mg/g, and 140.84 mg/g for Pb(II), Cd(II), and Hg(II) respectively. Several oxygen and sulphur-containing groups present at high densities in the CU-MBT are attributed to impressive adsorption properties towards Hg(II), Pb(II), Cd(II). Further, DFT calculations validated the stability and reactivity of CU and CU-MBT by utilizing their structural characteristics. Later, in the antibacterial analysis, the developed adsorbents revealed good antibacterial properties. In conclusion, CU-MBT has considerable calibre to act as an effective adsorbent in removing Pb(II), Cd(II), and Hg(II) as well as bacterial species from water, demonstrating its potential in water treatment.
Determination Of Stress Distribution in The Temporomandibular Joint Treated By Discectomy With And Without Disc Replacement Using Buccal Fat Pad By Finite Element Method
Authors: Pera Eren , Kıymet Ümit
Published: December 2024

Purpose
The aim of this study is to assess how discectomy affects stress distribution and peak values of the mandibular condyle and glenoid fossa and how the introduction of an interpositional free fat graft reduces stress in the above structures.
Materials and Methods
Stress analysis was conducted using 3D finite element models of a healthy joint, after disc removal and with interpositional material.
Results
The peak stress values of the condyle in the health joint model were approximately 8.19 Mpa in the condyle and 9.84 MPa in the glenoid fossa. After disc removal Von Misses stress were 158.5 MPa in the mandibular condyle and 109.7 MPa in the glenoid fossa. The model with free fat graft as a disk substitution showed a significant reduction in the Von Misses stresses; approximately 50–80% in the fossa and condyle, respectively.
Conclusions
Within the limitations of the present study, we concluded that the use of fat tissue as grafting material to replace the articular disc after discectomy can prevent excessive stress concentration and reduce peak values of the mandibular condyle and glenoid fossa.
Research on static error identification of three-axis machine tool based on multi-flexible system theory
Authors: Jiang Xiaogeng , Wang Yan , Wang Hao
Published: December 2024

In order to comprehensively consider the influence of geometric error caused by manufacturing defects and elastic error caused by the gravity of structural components on the static accuracy of machine tools, as well as the coupling relationship between them, this paper proposes an identification method of static error of three-axis machine tools. Taking the three-axis machine tool as the research object, the static error model of the machine tool is established according to the multi-flexible system theory and the homogeneous transformation matrix (HTM), and the geometric error component and the elastic error component in the static error are qualitatively analyzed. The Chebyshev polynomials are used to establish the parametric model of static error. Based on the three-axis linkage experiment of the Double ball bar (DBB), all the static errors are decoupled. Then, the finite element method is used to discretize the machine tool into three subsystems. Based on the spatial beam element, the stiffness model of each subsystem is established, and the elastic error component in the static error is quantitatively analyzed. The results show that the elastic error affected by gravity is mainly reflected in seven straightness errors and angle errors, and is generally greater than the corresponding static error. It shows that the machine tool offsets the influence of geometric errors from the perspective of elastomer compensation in the design stage, and proposes a simplified static error model of the machine tool.
The Influence of Regulatory Framework and Environmental Factors on Accounting Practices by Companies in Ghana
Authors: AMPEDU Raphael , AGYEI Bright ANTWI , Frank Peter Mang'ati , BOAKYE-BOATENG Gifty , MENSAH NII CORNELIUS ODOI , MENSAH RICHMOND , OFEIBEA Linda Nunoo , BOADI Joana ANKOBEA
Published: December 2024

This paper explores the influence of regulatory frameworks and environmental factors on the accounting practices of companies in Ghana. It emphasizes the critical role of a robust regulatory environment, maintained by bodies such as the Institute of Chartered Accountants, Ghana (ICAG), and the Securities and Exchange Commission (SEC), in ensuring transparency and consistency in financial reporting. The adoption of International Financial Reporting Standards (IFRS) has been pivotal in aligning Ghanaian accounting practices with global standards, although challenges remain in terms of implementation and compliance. Additionally, environmental factors such as economic conditions, technological advancements, sociocultural influences, and political stability significantly impact accounting practices. Economic stability encourages rigorous accounting standards, while technological advancements enhance the accuracy and efficiency of financial reporting. Sociocultural factors, including the education and professional development of accountants, and ethical standards, shape the quality of accounting practices. Political stability and effective legal systems are essential for enforcing accounting standards. This study provides valuable insights for regulators, policymakers, and practitioners, highlighting the need for continuous improvement in the regulatory framework and addressing environmental challenges to enhance the quality and reliability of financial reporting in Ghana.
Investigation of the Likelihood of Accessing Mental Health Treatment Between Immigrant and Nonimmigrant Adult Residents of the United States
Authors: Ejubovic Nihad , Alexander Jeffrey
Published: December 2024

Background
In the United States, immigrants are at higher risk of experiencing mental health problems and are less likely to seek professional treatment than nonimmigrants.
Objective
To investigate the likelihood of immigrant and nonimmigrant adult residents of the United States to access professional mental health treatment.
Methods
We used a quantitative, survey study design to evaluate the attitudes, perceptions, and likelihood of US adults seeking mental health treatment. Participants were recruited through social media platforms and completed an anonymous 15-question online survey (11 multiple-choice and 4 open-ended questions).
Results
Overall, 1053 adults completed the survey: 742 (70%) immigrants and 308 (29%) nonimmigrants. Most immigrants (689, 93%) and over half (188, 61%) of nonimmigrants reported experiencing mental health problems in the past 12 months. More immigrants (612/738, 82%) than nonimmigrants (219/298, 74%) were very likely or somewhat likely to seek professional mental health treatment (χ2 = 42.9, P < .001). There was also a small association between immigrant status and likelihood of seeking professional mental health treatment (φ = 0.20, P < .001).
Conclusions
Our findings suggested immigrants had more mental health problems than nonimmigrants and were more likely to seek mental health treatment. Future studies should investigate the impact immigration has on mental health perceptions, such as an individual’s age at immigration, and the likelihood of seeking mental health treatment.
Sperm DNA damage and disturbed chromatin condensation indexes (DFI and CMA3) in normozoospermic men with unexplained infertility problem
Authors: Abedinzadeh Mehdi , Abedinzadeh Sara , Sadeghi-Nodoushan Fatemeh , pourrajab Fatemeh
Published: December 2024

Purpose The quantitatively measured sperm DNA damage and disturbed chromatin condensation indexes (% DNA fragmentation index [DFI] and % high DNA staining index [HDS]) and their relationships with sperm quality in normospermic men with unexplained infertility were investigated. Methods In this retrospective study, conventional semen tests, including sperm motility and morphological evaluations and DNA fragmentation and disturbed chromatin condensation indexes (DFI, CMA3) were performed according to the World Health Organization 2021 criteria. DFI and CMA3 were evaluated using sperm chromatin dispersion (SCD) and chromomycin A3 (CMA3) staining assays and then correlation and regression analysis were done. Results By analyzing SCD and CMA3 results, notable differences were found in sperm parameters among different DFI and CMA3 groups (all P < 0.05). It was found that in the male fertility quality: sperm concentration, progressive/non-progressive motility, immobility, and morphology were significantly associated with sperm DFI and CMA3, but not with age (P < 0.05). Conclusions Sperm molecular index DFI and CMA3 negatively affect male fertility quality through semen parameters (sperm concentration, motility, and morphology).
Properties and Stability of Persistence Matching Diagrams
Authors: Gonzalez-Diaz Rocio , Torras-Casas Álvaro
Published: December 2024

We introduce persistence matching diagrams induced by set mappings of metric spaces, based on 0-persistent homology of Vietoris-Rips filtrations. Also, we present a geometric definition of the persistence matching diagram that is more intuitive than the algebraic one.In addition, we show that such matching diagrams encapsulate the information of persistence morphism images, kernels and cokernels induced by embeddings.The main result is a stability theorem for persistence matching diagrams induced by embeddings.At the end, we adapt our stability result for set injections (not embeddings) of finite metric spaces.
MSC Classification: 55N31
Modality-Aware Adaptive-Integration Guided Single-Stream Network for RGB-T Saliency Detection
Authors: Pang Yu , Zhang Longkun , Huang Yang , Yu Xiaosheng
Published: December 2024

RGB-T saliency detection becomes gradually a hot topic in saliency detection field recently. However, existing works (especially CNN based methods) usually use the two-stream structure to separately extract saliency cues from RGB and thermal infrared images, and then integrate them into the final detection result, this strategy greatly increases parameters scale while multi-modal fusion results are also very sensitive to two modalities’ quality. Based on above observation, we develop a novel Modality-Aware Adaptive-Integration Guided Single-Stream Network(MAANet), to detect salient objects from RGB-T image pairs. The feature pyramid network(FPN) is adopted as the basic structure of our MAANet. In order to tactfully fuse two supplementary modalities: (1)In the encoder: RGB and thermal infrared images are concatenated into 4-channel input of encoder structure in the proposed MAANet. (2)In the decoder: We propose a novel Modality-Aware Adaptive-Integration based Attention mechanism (MAAM) to enable the decoder to optimally perform the fusion of two modalities, and produce more accurate saliency predictions. (3)Finally: A novel coarse-and-refined bidirectional optimization(CRBO) method is proposed to suppress irrelevant background regions of saliency map generated by decoder structure. The proposed MAANet could better take both advantages of two modalities and is not sensitive to any one modality compared to previous RGB-T methods, meanwhile, MAANet is also more lightweight than previous works.Extensive experiments demonstrate that the proposed model performs favorably against most state-of-the-art RGB-T methods under different evaluation metrics, even outperforms than most RGB and RGB-D methods.
Optimizing Performance, Combustion and Emission characteristics of Mahua Biodiesel included GO and ZnO Nanoparticles: An ANN-RSM Approach
Authors: pala srinivasa reddy , Mohan Mangu Venkata Krishna , Vanthala Varaha siva Prasad
Published: December 2024

The present study focuses on the use of artificial neural networks (ANNs) and response surface methodology (RSM) with GO and ZnO nanoparticles placed in Mahua oil biodiesel blend (B20) are utilized to fuel direct injection diesel engines. These approaches are used to forecast the engine's operating characteristics. At a concentration of 75 ppm, GO and ZnO nanoparticles were taken into consideration. Additionally, a dispersant (TWEEN 80) and surfactant (CTAB) were mixed respectively at a ratio of 1:1. Using a spectrophotometer, stability analysis was carried out on a variety of nanofuel samples, and a study based on experiments was done on a diesel engine. The output factors that were examined at were BSFC, BTE, NHRR, CP, UHC, CO, NOx, and smoke visibility. These metrics were based on combustion, emissions and performance. Input parameters such as gasoline samples, injection pressure, and engine load were considered. The injection pressures were 200, 225, and 250 bars, whereas the loads were considered to be 5%, 50%, 75%, and 100%, respectively. When compared to other samples, the dispersion ZnO and GO nanoparticles in B20 shown amazing performance. The B20 + GO 75 ppm + TWEEN 80 75 ppm combination has shown a 5.293% decrease in BSFC and a 5.067% improvement in BTE at 250 bars. Furthermore, 3.13% and 43.50% improvements were made to combustion parameters including CP and NHRR, respectively. Smoke opacity, CO, UHC, and NOx were all reduced by around 38.55%, 11.07%, 37.63%, and 27.77%, respectively. Finally, the correlation coefficient (R2) for all parameters ranged from 0.93 to 0.99 using ANNs and RSM predictions.
Genetic variability correlation by biochemical seed compounds of a natural population ofAcrocomia aculeata (Jacq.) Lodd. ex Mart. (Arecaceae)
Authors: Alcantara Marcelo Augusto Mendes , Silvestre Marcela Aparecida Moraes , Rossini Bruno César , Friia Ana Carolina Souza , Batista Alef Carvalho , Moraes Mario Luiz Teixeira , Freitas Miguel Luiz Menezes
Published: December 2024

Acrocomia aculeata is a species widely found in the Brazilian Cerrado, with significant economic and environmental potential. It is used for biofuels, construction, human and animal nutrition, and recovery of degraded areas. Evaluating the genetic variability of natural populations is crucial for characterizing A. aculeata seeds through the selection and correlation of their chemical compounds, such as starch, carbohydrates, lipids, micronutrients (N, P, K, Ca, Mg, and S), and reserve proteins. Seeds were collected from 30 open-pollinated matrix trees in a degraded area of the former “Engenheiro Sergio Motta” Hydroelectric Power Plant construction site in Rosana, São Paulo, Brazil. Statistical analyses, based on a randomized block design with 30 progenies and four replications, examined 13 characteristics by mean, variance, and standard deviation. Genetic correlations, divergence by the Generalized Mahalanobis Distance (D²), grouping by the Tocher Optimization Method, and the Mulamba & Mock index were estimated, revealing five distinct groups of individuals (84% in the first group, 7% in the second, and 3% in each of the three subsequent groups). The Mulamba & Mock index indicated satisfactory results for selection aimed at increasing biochemical compounds, highlighting the genetic variability of the population and potential sources for future breeding and conservation programs.