bluuebunny/crossref_metadata_2025 huggingface dataset:
Harvesting Success: Strategy Development for Kampoeng Anggrek Agro-Tourism
Authors: Tsalits Askhaarina Aulia , Magfiroh Illia seldon
Published: September 2023

The research focuses on Kampoeng Anggrek Agritourism, a growing attraction in Kediri City that is seeing an increase in everyday visits, especially on weekends and holidays. The COVID-19 epidemic prompted a brief shutdown, which resulted in shifts in facility maintenance and employee attention, resulting in some deterioration. This study aims to evaluate Kampoeng Anggrek's present Business Model Canvas (BMC) and make recommendations for future improvements. Probability sample was used with the business model canvas approach, with ten participants from the internal and forty from the external aspects of Agrotourism Kampoeng Anggrek chosen using simple random sample. The research resulted in a comprehensive BMC framework, which provided proprietors with a clear picture of the company as well as the capacity to fine-tune each BMC aspect for operational optimization in agritourism operations. This study provides critical insights for stakeholders navigating the changing landscape of agrotourism firms in the face of dynamic external influences such as the COVID-19 pandemic
BLOODSTAIN PATTERN ANALYSIS AS SCIENTIFIC EVIDENCE IN THE JUDICIAL PROCESS. STATE OF THE MATTER IN SPAIN AND LEGE FERENDA PROPOSAL
Authors: Hernández Moreno María
Published: September 2023

El análisis de patrones de manchas de sangre brinda al proceso judicial la oportunidad de proporcionar, estudiar y evaluar pruebas veraces e imparciales, lo que facilita la toma de decisiones objetivas por parte del jurado.  

Sin embargo, existe un desconocimiento de la disciplina y de las normas legislativas relacionadas con la formación de expertos y sus informes en España. Esto complica el desarrollo de este tema y reduce su veracidad.

Con la intención de brindar medidas que faciliten su crecimiento de manera garante, se ha analizado la legislación, las sentencias relacionadas y los estándares de formación de los policías encargados de la investigación de patrones de manchas de sangre.

El propósito es el de probar el valor del análisis de patrones de manchas de sangre como disciplina. La importancia de la función auxiliar que ejercen los peritos en esta materia se pondrá de manifiesto también a través de los informes presentados en distintos procesos judiciales.
THE PRINCIPLE OF PRIMACY OF EUROPEAN UNION LAW: A COMPARATIVE APPROACH IN RELATION TO THE CONSTITUTIONAL LAW OF THE MEMBER STATES OF THE EUROPEAN UNION
Authors: SOTIRIOS KOLIBIRIS
Published: September 2023

At the supranational level of the European Union legal order, the Principle of Primacy of European Union Law holds a prominent position, as one of the general principles of European Union Law, in relation to the Constitutional Law of the Member States of the European Union. The objective of this scientific research is to scientifically highlight the reasons for the primacy of European Union Law in relation to the national Constitutional Law. The purpose of this scientific research is to cure the non-uniform implementation of Primary and Secondary European Union Law that arises in various affairs of citizens of the European Union by national Authorities in the interpretation of European Union Law. The methodology of writing the scientific research is based on the use of the current Primary European Union Law and the current jurisprudence of the Supreme Court of Justice of the European Union in conjunction with the recent scientific theory in the cognitive object of European Union Public Law. Emerges the nature of its Principle of Primacy of European Union Law emerges. For scientific analysis in the research field of Comparative Law, the scientific, modern and external comparative method of the macro-comparison is used. After reading of this scientific research, the readership will own the appropriate scientific tools which scientifically substantiate the primacy of European Union Law in relation to the Constitutional Law of the Member States of the European Union.
PocketFlow: an autoregressive flow model incorporated with chemical knowledge for generating drug-like molecules inside protein pockets
Authors: Yang Shengyong , Jiang Yuanyuan , Zhang Guo , You Jing , Zhang Hailin , Yao Rui , Xie Huanzhang , Xia Ziyi , Dai Mengzhe , Wu Yunjie
Published: September 2023

Identifying an active seed compound against a specific target protein is the first but challenging step for initiating a new drug development project. Newly emerging deep generative models (DGMs) providea rapid strategy to directly generate potential seed compounds inside protein pockets. However, the poor quality of generated molecules remains a major challenge, and whether these DGMs can generate bioactive molecules has not yet been wet-lab verified. We herein propose a new structure-based DGM, PocketFlow, which is an autoregressive flow model with chemical knowledge incorporated in molecular generation. PocketFlow can generate high-quality drug-like molecules with 100% chemical validity. In various evaluations, PocketFlow outperforms the current state-of-the-art DGMs. We applied PocketFlow to two new target proteins, HAT1 and YTHDC1, and successfully obtained wet-lab validated bioactive lead compounds. Overall, PocketFlow is the first wet-lab verified structure-based molecular DGM, highlighting the great potential of structure-based DGMs in drug discovery.
Falciform hernia following gastric bypass surgery case report
Authors: Ofoezie Frank Ejike , Courtney Michael , Mahawar Kamal , Marsh Ralph
Published: September 2023

Introduction:
Internal hernias are a possible complication following gastric bypass surgery. Falciform ligament hernias are a rare form of internal hernias which can be life threatening.
Case Presentation:
The case study describes a 59-year-old lady who presented with abdominal pain and bilous vomiting. She was found to have a falciform hernia following Roux-en-Y gastric by pass (RYGB). She underwent an emergency laparoscopy and division of the falciform ligament to release the bowel. She recovered and was discharged after 2 days.
Conclusion:
Given this occurrence, it is worth considering dividing the falciform ligament if any created defects or congenital defects are visualised during routine bariatric surgery. This will reduce the risk of falciform ligament herniation.
COVID-19 in a Dutch nursing home: a longitudinal retrospective care home level case study on infection rate, survival rate and daily functioning
Authors: Vries DD , Röhlinger DJM , Everink IHJ , Winkens B , Heffels JCF , Gordon AL , Schols JMGA
Published: September 2023

Background: During the pandemic nursing homes in the Netherlands were heavily affected by COVID-19. The goal of this study was to assess the impact of COVID-19 on infection rate, survival rate and daily functioning over the course of 2 years among residents of a small nursing home in the South of the Netherlands, which was amongst the first nursing homes to be affected by the pandemic.
Setting and methods: This retrospective study followed 70 residents from the start of the pandemic in March 2020 until March 2022. Data were collected on baseline characteristics of participants and the onset, duration, and sequelae of COVID-19 infections. Primary outcomes were mortality and infection rate. Secondary outcome was daily functioning using the Barthel index at intervals of six months over the course of the study.
Results: Within two years, 44 (62.9%) residents were diagnosed with COVID-19. During this study 72.7% (n=32) of the COVID-positive residents died, of which 22 deaths were related to the COVID-infection. The overall mortality was 60% (n=42) and the COVID-related mortality was 31.4% (n=22). COVID-19 and multimorbidity (> 3 morbidities) were independent risk factors for mortality. There was no significant difference in daily functioning over time between the Covid positive and Covid negative group measured using Barthel index by COVID-19 status.
Discussion/conclusion: A high COVID-19 infection rate was seen and was the most common cause of death. COVID-19 did not affect functional status over time.
Automating Poultry Farm Management with Artificial Intelligence: Real-time Detection and Tracking of Broiler Chickens for Enhanced and Efficient Health Monitoring
Authors: Depuru Bharani Kumar , Putsala Sreekanth , Mishra Pragya
Published: September 2023

The broiler industry plays a vital role in meeting the growing global demand for poultry meat. However, maintaining the health and well-being of broiler birds is crucial to ensure both optimal productivity and animal welfare. The increasing mortality rate of broiler chickens developed into an unavoidable issue that required attention. The major goal of this research is to monitor individual chickens for early disease identification, which will then allow for prompt isolation and treatment of sick birds, stopping the spread of pathogens and preserving the health of the flock as a whole. With an accuracy of 96%, the chosen model, YOLOv5s (You Only Look Once), performed the best. Based on their age, the algorithm was able to categorize broiler chickens. The model is converted to ONNX (Open Neural Network Exchange) format after custom training, and the centroid tracker is used for real-time tracking. After that, the output data is kept in a MySQL (My Structured Query Language) database for later use. The OpenCV (Open Source Computer Vision Library) library is used to deploy this model on a local machine. This model seeks to identify the broiler chicken in the video frame, classify them, and maintain track of them using the tracker. Based on their age, the birds are divided into categories. Since most monitoring is required between one and four weeks of age, they are divided into four age groups. The potential application of this model is in the detection of temperature, weight, flock behavior, etc.
The use of bilateral inter-semispinal plane block to effectively enhance the recovery pathway for posterior cervical surgery—A prospective randomized controlled study
Authors: Li Yafeng , Zhang Yang , Sun Wenjie , Li Qing , Zhang Hua
Published: September 2023

Background: Bilateral inter-semispinal plane (ISP) block can be used to alleviate postoperative pain in patients underwent posterior cervical surgery, this study aimed to determine if bilateral ISP block can promote recovery after surgery for patients undergoing posterior cervical surgery.
Methods: 100 patients were assigned randomly to either the control or ISP block group. The main outcome was the length of stay (LOS). The secondary outcomes include the Numerical Rating Scale(NRS) scores, times of PCIA press, and total consumption of rescue analgesic drugs. The patient’s postoperative life quality was evaluated using a 40-item quality of recovery score (QoR-40), time to first walk independently and oral intake. We also recorded postoperative negative outcomes.
Result: The mean LOS in the ISP group was significantly shorter than that in the control group (7.52 ±1.34 vs. 8.98 ±1.32 days, P = 0.014). Within 24 h postoperatively, pain scores in the ISP block group were lower than in the control group (P ＜ 0.001), however, the NRS scores at 48 h were not significantly different (P = 0.631). The PCIA press times and pentazocine consumption in the ISP group were significantly reduced compared with those in the control group (P ＜ 0.001). Postoperative total QoR-40 scores and its 4 dimensions were higher in the ISP group than in the control group (P < 0.001), except the independence. Oral intake and unassisted walking in the ISP group were shorter than those in the control group (P ＜ 0.001). Adverse effects were not different in neither group (P > 0.05).
Conclusion: Bilateral ISP block could significantly and safely promote recovery for patients undergoing posterior cervical surgery.
Trial registration: The trial was registered at the Chinese Clinical Trial Registry (www.chictr.org.cn) (No: ChiCTR2300069813); 27/03/2023
Maturity Model for Assessing the Medical Humanities: a Delphi study
Authors: Zhang Xin , Duan Zhiguang
Published: September 2023

Background: Becoming a first-level discipline in China means access to more educational resources. The development of medical humanities in China has been going on for more than 40 years, and most medical schools have set up master's and doctoral programs in medical humanities. The demand for medical humanities-related knowledge in China is also growing after COVID-19. However, medical humanities is only a second-level discipline and receives limited resources to meet the needs of society. This study aims to establish a system of indicators that can assess whether the medical humanities has a first-level discipline and provide a basis for its upgrading to a first-level.
Methods: A Delphi technique was used, with the panel of expert expressing their views in a series of two questionnaires. A coefficient of variation of less than 0.2 indicates expert agreement.
Result: A total of 25 experts participated in this Delphi study. Consensus was reached on 11 first-grade indices and 48 second-grade indices. The authoritative coefficient(Cr) of the experts was 0.804, which indicates that the experts have a high level of reliability.
Conclusion: This study provides a reliable foundation for the evaluation of medical humanities maturity.
Serological and RT-PCR evaluation of African yam bean (Sphenostylis stenocarpa(Hochst ex. A. Rich) Harms) accessions to viral resistance under field condition
Authors: Jeffrey Ihenacho , KEHINDE Iyabode , AYO-JOHN Emily , Bankole Paul , Abberton Michael , Lava Kumar , Adegboyega Taofeek , Oyatomi Olaniyi
Published: September 2023

Background
African yam bean (AYB) (Sphenostylis stenocarpa (Hochst ex. A. Rich.) Harms) an underutilized legume that produces nutritionally healthy seeds and tubers in some variety. The low yield of the crop is attributed to production constraints such as attacks by pest and disease causing organisms such as fungi, bacteria and viruses.
Result
In this study, one hundred AYB accessions were evaluated for resistance to viral infection. The AYB accessions were planted using a Randomized Complete Block Design on the experimental field at the International Institute of Tropical Agriculture (IITA) Ibadan Nigeria. Viral disease severity was assessed at 10, 12, 14, 16 and 18 weeks after planting (WAP) based on disease symptoms using disease severity index on visual scale of 1-5. Antigen–coated plate enzyme linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction was used to index diseased leaf samples collected from the field. Five virus species (Cowpea mild mottle virus, Cowpea mottle virus, Southern bean mosaic virus, Cowpea mosaic virus and Bean common mosaic virus) were detected in few accessions while mixed infections were observed in some accessions. TSs-552, TSs-577, TSs-580, TSs-560 and TSs-600 were devoid of viruses and could be resistant. There were no significant differences (p ≥ 0.05) in the mean disease incidence (DI) of viral diseases.However, at 18 weeks after planting,TSs-604 had the highest (100%) mean DI while TSs-584 had the lowest (13.33%) mean DI. Cluster analysis based on the AUDPC produced 6 main clusters, the clusters revealed grouping patterns in which AYB lines with similar resistance ratings were shown to form unique clusters.
Conclusion
The information generated from this study will contribute to the development of strategies in the management of virus diseases infecting AYB.
Importance about use of high-throughput sequencing in pediatric: case report a patient with Fanconi-Bickel syndrome
Authors: Abarca-Barriga Hugo Hernán , Laso-Salazar María Cristina , Tacuri Diego Orihuela , Saire Jenny Chirinos , Venero-Nuñez Anahí
Published: September 2023

Background
Fanconi-Bickel syndrome is characterized by hepatorenal disease caused by anomalous storage of glycogen. It occurs due to variants in SLC2A2 gene. We present a male patient of 2 years 7 months old, with failure to thrive, hepatomegaly, metabolic acidosis, hypophosphatemia, hypokalemia, hyperlactatemia.
Results
Whole exome sequencing identified the pathogenic variant NM_000340.2(SLC2A2):c.1093C>T (p.Arg365Ter), related with Fanconi-Bickel syndrome. He received treatment with bicarbonate, amlodipine, Schol´s solution, enalapril, alendronate and zolendronate, and nutritional management with starch, with which an improvement in weight and height was achieved by one standard deviation.
Conclusions
The importance of to know etiology in rare genetic disease is essential, not only to determine individual and familial recurrence risk, but also to establish the treatment and prognosis; in this sense, access to a new genomic technology in low- and middle-income countries is essential to shorten the diagnosis odyssey.
Neurological Manifestations of Long COVID: A Systematic Review
Authors: Boorle Naga Vijaya Lakshmi Divya , Kurra Nithin , Gandrakota Nikhila , Modi Karnav , Sudireddy Kavya , Irfan Shayan Ali , Jain Akhil , Parikh Priyanka , Jillella Dinesh
Published: September 2023

Background
Severe acute respiratory syndrome coronavirus-2 has been one of the most widespread and devastating global pandemics affecting more than 500 million people worldwide. After the cessation of active infection, the disease continues to have a disabling impact due to the persistence of fatigue, brain fog, anxiety, and depression, among the most common symptoms. This study explores the progression of neurological, neurocognitive, and neuropsychiatric symptoms over a period of 12 months or more following an initial diagnosis of COVID-19.
Methods
Through an electronic search of eligible studies from PubMed, Cochrane Trial register, and Google Scholar, a total of 10 studies that met the inclusion criteria were used for qualitative analysis. The systematic review highlights the similarities and differences in findings across the included studies.
Results
Olfactory dysfunction was prevalent in 0.9–51% of individuals, and taste impairment was observed in 1.1–21.3% of individuals. At 12 months, anxiety was more prevalent (3.5–29%) than depression (3.5–26%). Fatigue was the predominant neurocognitive complaint in 56% of individuals with severe COVID-19. Sleep difficulties were reported in 3.8–50% of individuals. Memory impairment followed by headaches and dizziness were also among the neurocognitive symptoms reported at 12 months.
Conclusions
From our study, we found that there is a significant neurological burden one year following the diagnosis of COVID-19. Further studies exploring the pathological mechanisms of neurological long COVID-19 are necessary to delineate better the mechanisms behind several long-term Neurological manifestations of COVID-19.
Effect of bar designs on peri implant tissues health: a systematic review
Authors: Omeish Nadine , Bessou Laure , Carra Maria-Clotilde , Tavernier Bruno , Porporatti André Luis
Published: September 2023

Different characteristics of bars (cross-sectional shape, diameter, distal extension etc) lead to different biomechanical behavior (retention and stress) with implants and peri-implant tissues. Aim: To evaluate the impact of bar designs in fully edentulous arch (in the maxilla and/or mandibula), with 4 implants or more, on the peri-implant soft and hard tissues.
Two reviewers searched for observational studies, RCT and in vitro studies, published on five main databases and three from the grey literature, without restrictions on February 2022.
Of the 2784 selected articles, 6 met the inclusion criteria. Three RCT evaluated peri-implant health tissues in full edentulous arches with 4 or 6 implants rehabilitated with implant bar overdentures. One prospective study with 5 years follow-up evaluated the success/survival rate of implants and implant bar overdentures. Overall, 231 subjects were enrolled in our systematic review with 936 implants. Overdentures’ survival rate was 100%. There was a trend that plaque indices and gingival indices were low in all of the studies, however no statistical analysis was done due to the lack of information.
There is data suggesting that distal extension, diameter of the bar, bar material, and cross-sectional shape do have an impact on the peri-implant bone stress. However, due to the lack of information in the included studies, we cannot confirm if bar characteristics affect the peri-implant tissues health.
Investigating the Structure under the Pingting Terrace from the Co-Seismic Deformation of the 2022 Guanshan Earthquake
Authors: Hsu Yi-Chun , Chang Chung-Pai , Yen I-Chin , Huang Shao-Yi , Yen Jiun-Yee
Published: September 2023

On September 17th and 18th, 2022, shallow earthquakes with magnitudes of 6.6 (ML) and 6.8 (ML) occurred in the eastern Taiwan Longitudinal Valley, which marks the collision zone between the Philippine Sea plate and the Eurasian plate, and led to noticeable surface deformation and ruptures within 70 km. This study primarily focuses on the southernmost section of the rupture zone - the Pingting Terrace. Surface rupture locations and behaviors correspond to changes in topography, providing mutual confirmation that the deformation behavior of Pingting Terrace is complex. Based on the distribution of surface ruptures and topography changes, this study roughly divides the Pingting Terrace into northern and southern segments, using the central concave feature as a boundary. The Riedel shear model analysis results show that the principal shear directions in the northern and southern segments are N-S trending and azimuth 20°, respectively. The maximum principal stress orientations are around 135° for the northern and 155° for the southern segments. These findings align with the fault mechanical investigation of the Lichi Mélange in the northern Muken River area of the Pingting Terrace. This suggests spatial changes in shear zone orientations within the Lichi Mélange, which contribute to developing pressure ridges due to transpressional forces. As a result, the Pingting Terrace experiences rapid uplift, causing the Luliao River to migrate southward into the Beinan River, while the eastern Beinan River turns to the eastward edge of the Pingting Terrace.
Ground Motion Shaking Predictions Based on Machine Learning and Physics-based Simulations
Authors: Monterrubio-Velasco Marisol , Callaghan Scott , Modesto David , Carrasco Jose Carlos , Badia Rosa M , Pallarés Pablo , Vazquez Fernando , Quintana Enrique , Pienkowska Marta , Puenta Josep de la
Published: September 2023

After large-magnitude earthquakes occur, a crucial task for impact assessment is to rapidly and accurately estimate the ground shaking intensities in the affected region. The intensity response can be obtained through computationally demanding simulations of wave propagation phenomena, which are accurate but still slow to produce timely results. To satisfy real-time constraints, ground shaking is traditionally evaluated with approximated Ground Motion Models (GMMs) that can drastically limit the accuracy of the estimated intensity map. In this work, one of the largest existent datasets (with more than 100M simulated seismograms), from CyberShake Study 15.4 developed by the Southern California Earthquake Center covering the Los Angeles basin region, was used to train and validate several Machine Learning (ML) strategies as an alternative to GMMs. Our predictions using the ML-based EStimator for ground-shaking maps (MLESmap) strategy outperform GMM solutions requiring similar evaluation times. We show a reduction in the median of the root mean square error (RMSE) up to 45\% for a set of unseen samples of the synthetic database, and a reduction in RMSE between 11\% and 88\% for real historical earthquakes relative to GMM predictions.
Realization of Higher-Order Topological Lattices on a Quantum Computer: A Route to Quantum Advantage
Authors: Lee Ching Hua , Koh Jin Ming , Tai Tommy Yingzhe
Published: September 2023

Programmable quantum simulators such as superconducting quantum processors and ultracold atomic lattices represent rapidly developing emergent technology that may one day qualitatively outperform existing classical computers. Yet, apart from a few breakthroughs, the range of viable computational applications with current-day noisy intermediate-scale quantum (NISQ) devices is still significantly limited by gate errors, quantum decoherence, and the number of high-quality qubits. In this work, we develop an approach that places NISQ hardware as a particularly suitable platform for simulating multi-dimensional condensed matter systems, including lattices beyond three dimensions which are difficult to realize or probe in other settings. By fully exploiting the exponentially large Hilbert space of a quantum chain, we encoded a high-dimensional model in terms of non-local many-body interactions that can further be systematically transcribed into quantum gates. We demonstrate the power of our approach by realizing, on IBM transmon-based quantum computers, higher-order topological states in up to four dimensions, which are exotic phases that have never been realized in any quantum setting. With the aid of in-house circuit compression and error mitigation techniques, we measured the topological state dynamics and their protected mid-gap spectra to a high degree of accuracy, as benchmarked by reference exact diagonalization data. The resources needed with our approach scale favorably with system size and lattice dimensionality compared to classical numerical computation in a general setting — our findings thus present a tantalizing route to useful quantum advantage.
Short-term outcomes of intracorporeal delta-shaped overlap versus extracorporeal anastomosis after laparoscopic colectomy: a propensity score-matched cohort study
Authors: Fujii Yoshiaki , Kobayashi Kenji , Sawai Hirozumi , Yamamoto Seiya , Uehara Shuhei , Miyai Hirotaka , Takahashi Hiroki , Takiguchi Shuji
Published: September 2023

Background
Laparoscopic colectomy methods, including intracorporeal anastomosis (IA), are commonly used in clinical practice and have become a research area. Previously, we described a novel IA technique, delta‑shaped overlap anastomosis (DOLA). This study aimed to describe detailed surgical tools for DOLA and their feasibility and safety by comparing short-term DOLA outcomes with those of conventional extracorporeal anastomosis (EA) after propensity score matching.
Methods
In total, 121 consecutive patients who underwent laparoscopic colectomy between June 2018 and August 2021 were retrospectively assessed. Linear staplers were used for all anastomoses. DOLA and EA groups included 46 and 74 patients, respectively. Propensity score matching analysis was conducted to compare matched groups based on clinicopathological characteristics, surgical and perioperative outcomes, complications, and postoperative inflammatory reactions. After matching, the DOLA and EA groups consisted of 35 cases each that were analyzed.
Results
Both groups had similar demographic characteristics, surgical procedures, histopathological outcomes, and postoperative complications. The DOLA group had significantly less blood loss than the EA group (10 versus 20 mL, p < 0.001). The DOLA group skin excision length (4 versus 6 cm, p < 0.001) and postoperative hospital stay length (6 versus 7 days, p < 0.001) were significantly shorter than those of the EA group. Increasing C-reactive protein (CRP) values at 1, 3, and 6 postoperative days were significantly lower in the DOLA group than in the EA group (p = 0.02, p = 0.03, and p = 0.04, respectively).
Conclusions
DOLA was significantly associated with lesser blood loss, shorter skin incision lengths, shorter postoperative hospital stays, and lower CRP level elevations than EA. DOLA is a safe, feasible technique that is potentially less invasive as compared to conventional EA.
The risk factors determined by four machine learning methods for the change of difference of bone mineral density in post-menopausal women after three years follow-up
Authors: Chang Ching-Yao , Peng Chung-Hsin , Chen Fang-Yu , Huang Li-Ying , Kuo Chun-Heng , Chu Ta-Wei , Liang Yao-Jen
Published: September 2023

Introduction:
The prevalence of osteoporosis has drastically increased recently. It is not only the most frequent but is also a major global public health problem due to its high morbidity. There are many risk factors associated with osteoporosis were identified. However, most studies have used the traditional multiple linear regression (MLR) to explore their relationships. Recently, machine learning (Mach-L) has become a new modality for data analysis because it enables machine to learn from past data or experiences without being explicitly programmed and could capture nonlinear relationships better. These methods have the potential to outperform conventional MLR in disease prediction. In the present study, we enrolled a Chinese post-menopause cohort followed up for 4 years. The difference of T-score (δ-T score) was the dependent variable. Information such as demographic, biochemistry and life styles were the independent variables. Our goals were:
1. Compare the prediction accuracy between Mach-L and traditional MLR for δ-T score.
2. Rank the importance of risk factors (independent variables) for prediction of δ T-score.
Methods:
Totally, there were 1698 postmenopausal women were enrolled from MJ Health Database. Four different Mach-L methods namely, Random forest (RF), eXtreme Gradient Boosting (XGBoost), Naïve Bayes (NB), and stochastic gradient boosting (SGB), to construct predictive models for predicting δ-BMD after four years follow-up. The dataset was then randomly divided into an 80% training dataset for model building and a 20% testing dataset for model testing. To ensure the accuracy of our results, 10-fold cross-validation technique for hyperparameter tuning was used. Models with the smaller mean error were considered as better models. After averaging the importance of the four Mach-L methods, the importance of each variable was obtained and rank 1 was the most critical and 22 as the least important variable.
Results:
For Pearson correlation, age, education, BMI, HDL-C, and TSH were positively and plasma calcium level, and baseline T-score were negatively correlated with δ-T score. All four Mach-L methods yielded lower prediction errors than the MLR method and were all convincing Mach-L models. From our results, it could be noted that education level is the most important factor for δ-T Score, followed by DBP, smoking, SBP, UA, age, and LDL-C.
Conclusion:
All four Mach-L outperformed traditional MLR. By using Mach-L, the most important six risk factors were selected which are, from the most important to the least: DBP, SBP, UA, education level, TG and sleeping hour. δ T score was positively related to SBP, education level, UA and TG and negatively related to DBP and sleeping hour in postmenopausal Chinese women.
“How are the registrars doing, especially the new ones”: International Medical Graduate Experiences of Medical Specialty Training at an African University
Authors: Baheir Baheir Masud , Tanjour Mazen , Ras Tasleem
Published: September 2023

Background: The lived experiences of International Medical Graduates (IMGs) pursuing medical specialist training at health sciences faculties in South Africa (SA) have not been documented despite the high numbers of IMGs choosing SA as the destination of choice for medical specialisation. This study addresses the following question: what are the experiences of IMGs pursuing medical specialisation in SA? The findings may help future IRs make informed decisions when choosing their study destination. It could also assist supervisors and program managers in anticipating some of the challenges that IMGs face.
Methods: A qualitative design using an interpretive phenomenological approach was employed. Semi- structured face-to-face interviews generated data directly from IMGs and were checked for accuracy using a focus group discussion.
Results: Two major themes were developed. Negative experiences were subdivided into 4 subsections: registration and administrative barriers; structural and policy-related challenges; challenges related to teaching, supervision and clinical training; and challenges related to life outside the university. The second theme documented positive experiences.
Conclusion: We described several important issues affecting externally funded IMGs arriving for medical specialist training at the study site. Some recommendations are made for practical implementation and future research.
Weekly Image Guidance in Patients with Cervical Cancer Treated with Intensity-Modulated Radiation Therapy: Results of a Large Cohort Study
Authors: Zeng Zheng , Wang Weiping , Liu Dingchao , Zhang Fuquan , Hu Ke
Published: September 2023

Background
Image guidance is recommended for patients undergoing intensity-modulated radiation therapy (IMRT) for cervical cancer. In this study, we evaluated the feasibility of a weekly image guidance pattern and analyzed the long-term outcomes in a large cohort of patients.
Methods
The study enrolled patients with stage IB-IVA cervical cancer who received definitive radiotherapy or concurrent chemoradiotherapy. IMRT was delivered at a dose of 50.4 Gy in 28 fractions, with weekly cone-beam computed tomography (CBCT). Physicians advised patients on rectum and bladder preparation to help them prepare on non-imaging guidance days. When significant tumor regression was observed, a second computed tomography simulation and re-planning were performed.
Results
The median follow-up periods were 63.4 months. The incidence rates of loco-regional and distant failure were 9.9% and 13.6%. The 5-year overall survival (OS), disease-free survival (DFS), loco-regional relapse-free survival (LRFS), and distant metastasis-free survival (DMFS) rates were 80.1%, 72.9%, 78.3%, and 74.8%, respectively. The 5-year OS, DFS, LRFS, and DMFS rates were statistically significant for patients with different stages. For patients with and without positive regional lymph nodes, the 5-year OS, DFS, LRFS, and DMFS rates were 64.5% and 86.0%, 56.8% and 78.8%, 62.7% and 84.3%, and 58.8% and 81.0%, respectively. Multivariate analysis showed that age, histology, tumor size, cancer stage, pretreatment squamous cell carcinoma antigen level, and para-aortic metastatic lymph nodes were independent prognostic factors of OS. Fifty-six (4.0%) patients experienced grade 3–4 chronic toxicities.
Conclusions
IMRT with weekly CBCT is an acceptable image guidance strategy in countries with limited medical resources.
Alkaline gelatinised cassia tora and locust bean gums as talc depressants: Adsorption and thermochemical aspect
Authors: Ngobeni Walter , Mulaba-Bafubiandi Antoine
Published: September 2023

Talc is a gangue mineral of most platinum group metals and base metals ores commonly found in the Southern African mineral repository. It is naturally hydrophobic, and invariably, the depression of talc is paramount and challenging in the flotation of these ores. This paper introduced cassia tora gum (CTG) and locust bean gum (LBG) as novel talc depressants. The adsorption densities, thermochemical, and talc depression of these depressants were studied using adsorption, zeta potential and microflotation studies. Talc flotability in the absence of the depressant was 89% this implied that the talc used in this study was naturally floatable. The adsorption studies revealed that CTG yielded the highest talc adsorption density, followed by LBG and CMC, and their adsorption densities were 5.8 mg/m2, 4.6 mg/m2 and 3.5 mg/m2, respectively. PGM flotation occurs at pH 9. Therefore, the zeta potential results at this pH were given more focus in the present study. The zeta potential values at pH 9 were -5.75 mV for LBG and CTG and -15 mV for CMC, respectively. In addition, the percentage of talc depression achieved in the microflotation studies decreased in the order LBG > CTG > CMC; their respective values were 72% > 56% > 51%. Therefore, the zeta potential values agree with the adsorption and microflotation studies results observed in this study, i.e., LBG and CTG depressed talc more effectively than CMC. Lastly, bench flotation results revealed that LBG yielded the highest talc depression at 100 g/t, while CTG yielded the highest talc depression at 25 g/t. Thus, these results agreed with thermodynamic theory, viz., a low molecular weight polymer is effective at low dosages where the surface is unsaturated. In contrast, a high molecular weight polymer is effective at high dosages as there is enough quantity to cover the surface adequately.
Unusual Presentation of Typhoid Encephalopathy: Case Reports
Authors: Alam Anggraini , Nurmawati Syndi , Hawani Dewi , Dewi Mia Milanti , Djauhari Hofiya , Parwati Ida , Kosasih Herman , Alisjahbana Bachti , DLH Dzulfikar
Published: September 2023

Background. Encephalopathy, associated with high mortality and prolonged sequelae, may be caused by Salmonella typhi infection. However, the similarity of symptoms and routine laboratory results with other infections, may hinder prompt diagnosis and treatment. Blood culture, which is the gold standard for typhoid, was not always performed. We presented two cases of typhoid encephalopathy that had been misdiagnosed as viral and TB meningitis. Proper awareness and blood culture in encephalopathy cases played an important part in diagnosing and, thus, treating these cases properly.
Case presentation. First case; a 13-year-old Sundanese male came to the hospital with seizure and fever. He was diagnosed with viral meningoencephalitis and treated with Acyclovir for five days. His fever continued and his condition worsened. Blood culture was found positive for S. typhi on day five of hospitalization. Subsequently, he was diagnosed with typhoid encephalopathy, given Ceftriaxone injection, and his condition improved. He recovered completely after six months. Second Case; a 12-year-old Sundanese male came with a decrease of consciousness and intermittent fever. He was diagnosed with tuberculosis meningitis and treated with first line antituberculosis drugs. IgM Salmonella was positive on the second day of hospitalization, and S. typhi was found through blood culture on his 4th day of hospitalization, leading to the diagnosis of typhoid encephalopathy. His condition improved after four days with ceftriaxone, and he recovered completely on 3 months follow-up.
Conclusions. Typhoid encephalopathy should always be considered as the cause of CNS infection in typhoid endemic areas. Blood culture is crucial in diagnosing encephalopathy cases.
Soil extracellular enzymes as drivers of soil carbon storage under nitrogen addition
Authors: Chen Ji , Chen Xiao , לֹשם ומחן , Sinsabaugh Robert , L. Moorhead Daryl , Bardgett Richard , Fanin Nicolas , Nottingham Andrew
Published: September 2023

Enhanced anthropogenic nitrogen (N) inputs to ecosystems may have substantial impacts on soil organic carbon (SOC) cycling. One way to link species-rich soil microorganisms with specific SOC cycling processes is via soil extracellular enzyme activities (EEAs). Here, by presenting a meta-analysis on the response of soil C-degrading EEAs to N addition, our results show that N addition increases hydrolytic C-degrading EEAs that target simple polysaccharides by 12.8%, but decreases oxidative C-degrading EEAs that degrade complex phenolic macromolecules by 11.9%. The net effect of N addition on SOC storage is determined by the balance between the two types of C-degrading EEAs, with impacts varying across different ecosystem types. Our results help identify changes in soil microbial C use strategies under N addition. Incorporating this enzymatic influence into Earth system models could improve the representation of microbial processes as well as predictions of SOC dynamics in a changing environment.
Comparison of different machine learning classification models for predicting deep vein thrombosis in lower extremity fractures
Authors: Wei Conghui , Wang Jialiang , Yu Pengfei , Li Ang , Xiong Ziying , Yuan Zhen , Yu Lingling , Luo Jun
Published: September 2023

Deep vein thrombosis (DVT) is a common complication in patients with lower extremity fractures. Once it occurs, it will seriously affect the quality of life and postoperative recovery of patients. Therefore, early prediction and prevention of DVT can effectively improve the prognosis of patients. Based on the predictive factors of DVT in patients with lower limb fractures, this study constructed a DVT prediction model with the help of different machine learning classification models to explore the effectiveness of different models in predicting DVT. The researchers conducted a retrospective analysis of DVT-related factors in patients with lower limb fractures from the Second Affiliated Hospital of Nanchang University from July 2017 to July 2023, and then calculated the incidence of DVT. Five prediction models were applied to the experiment, including Extreme Gradient Boosting (XGBoost) model, Logistic Regression (LR) model, RandomForest (RF) model, Multilayer Perceptron (MLP) model and Support Vector Machine(SVM) model. Afterwards, the performance of the obtained prediction models were evaluated by area under the curve (AUC), accuracy, sensitivity, specificity and F1 score. A total of 4,424 patients were included in this study, of which 207 patients had DVT. Theincidence rate of DVT was 4.68%. The prediction performance of the model based on machine learning: XGBoost model (AUC=0.730, accuracy=0.951), LR model (AUC =0.740, accuracy=0.712), RF model (AUC=0.703, accuracy=0.952), MLP model (AUC=0.571, accuracy=0.704), SVM model (AUC=0.488, accuracy=0.826). Although the LR model has the largest AUC, its accuracy is not as good as that of the XGBoost model. By comparing the AUC and accuracy, the XGBoost model performed the best. The DVT prediction model constructed by the XGB has high reproducibility, universality and feasibility. However, the model still needs external verification research before clinical application.
Targeting Bone Marrow Lipid Metabolism with Adiponectin Receptor Agonist for Diabetic and Postmenopausal Osteoporosis
Authors: Park Cheol Whee , LIM JI HEE , Kim Yaeni , Kim Min Young , Kim Eun Nim , Kim Tae Woo , Hong Yu Ah , Choi Bum Soon , Chung Sungjin , Lee Jeong-Hwa , Kim Hye Won , Park Ji Yong , Kim Jaemin
Published: September 2023

Osteoporosis is a malady of multiple cell types associated with the bone marrow (BM) fat accumulation. This study focused on understanding the role of adiponectin in osteoblast and osteoclast lipid metabolism in diabetic and ovariectomized mice with osteoporosis and exploring the effects of the adiponectin receptor (AdipoR) agonist, AdipoRon. AdopoRon prevented systemic bone resorption and oxidative stress, and excessive lipid accumulation in BM. AdipoRon activated AMPK and PPARɑ through AdipoR1 and AdipoR2, leading to a reduction in lipotoxicity-induced osteocyte apoptosis, oxidative stress, and inflammation with M1 polarization. All these changes increased osteogenic RUNX2/OPG/FOXO1 expression, decreased osteolytic RANKL/PPARγ expression, and preserved bony phenotypes and growth plate thicknesses in the lumbar vertebrae and femur. AdipoR1/R2 knockout in pre-osteoblasts and osteoclasts in high-glucose and palmitate media confirmed the positive action of AdipoRon on bone formation, which was achieved by activating AMPK and PPARɑ to the same degree through both AdipoR1 and AdipoR2. These activations were closely associated with the amelioration of osteocyte apoptosis, oxidative stress, inflammation, and autophagy induced by high-glucose and palmitate, which were controlled by regulating lipid metabolism. We revealed that AdipoRon may safeguard lipotoxicity in BM in diabetic and ovariectomized osteoporosis by modulating lipid metabolism in osteoclasts and osteoblasts.
Numerical simulation of two-dimensional cyclic water injection in rock fractures
Authors: Bai Zhenchao , Li Dong , Zhou Yue , Wang Feng , Li Weipeng , Ye Jiexian , Cao Xiong , Dang Wengang , Bai ZC.
Published: September 2023

Understanding the shear-seepage behaviors in rock fractures is crucial in excavation of tunnels through fractured surrounding rocks and mining explorations, however, the cyclic injection mechanism of fractures is not yet fully understood. This study utilized the COMSOL Multiphysics software to simulate the cyclic water injection in rock fractures with various injection amplitudes and frequencies. We documented that when subjected to cyclic water injection, the fluid flow in the rock fractures exhibited periodic fluctuations. As water injection amplitude increases, the flow pattern within the low-flow region become more turbulent, creating significant disturbances to the overall flow pattern. Additionally, the permeability of rock fractures varies periodically with the inlet flow rate, resulting in a permeability-flow rate relationship that forms an elliptical closed curve over time. Moreover, the amplitude of fluctuation in permeability increases as the water injection frequency and amplitude increase, illustrating that water injection within a specific range could enhance permeability in rock fractures. Furthermore, we proposed an approach to identify and quantify the primary channel and eddy flow areas.
Cytomegalovirus-specific T cell immunity reconstitution following allogeneic hematopoietic stem cell transplantation: a pilot stduy
Authors: Wang Luxiang , Li Su , Huang Jiayu , Zhang Zilu , Pan Zengkai , Jiang Chuanhe , Zhang Sujiang , Cai Xiaohong , Cai Gang , Hu Xiaoxia
Published: September 2023

Purpose
Reactivation of cytomegalovirus (CMV) leads to significant morbidity and mortality following allogeneic hematopoietic stem cell transplantation (allo-HSCT). The reconstitution of CMV-specific T cells plays a crucial role in the antiviral response after allo-HSCT. However, the impact of CMV reactivation on the recovery of CMV-specific T cells in the early stages after allo-HSCT, particularly haploidentical HSCT, remains undisclosed.
Methods
We retrospectively examined CMV-specific T-cell recovery in 78 allo-HSCT recipients to assess the influence of clinically significant CMV infection (CS-CMVi) on CMV-specific T-cell restoration.
Results
Patients in CS-CMVi group displayed higher absolute quantities of CMV-specific IFN-γ+ T cells on day 30 (CD4+ T cells: 1.40 vs. 0.07 cells/µL, p = 0.02; CD8+ T cells: 1.64 vs. 0.15 cells/µL, p = 0.11), but lower counts on day 180 (CD4+ T cells: 1.06 vs. 5.95 cells/µL, p < 0.01; CD8+ T cells: 3.70 vs. 55.36 cells/µL, p = 0.04). Among patients receiving letermovir prophylaxis (LTV group), the recovery of CMV-specific CD8+ T cells was significantly delayed compared to those receiving preemptive therapy (PET group) from day 60. The LTV group was more likely to experience late-onset CMV reactivation if their absolute counts of polyfunctional CMV-specific CD4+ T cells or CD8+ T cells was below 2.01 (AUC = 0.78, p = 0.003) or 0.90 cells/µL (AUC = 0.89, p < 0.001).
Conclusions
In conclusion, our pilot study provides direct evidence that early episodes of CS-CMVi impair the recovery of CMV-specific T cells after allo-HSCT. Additionally, insufficient polyfunctional restoration would lead to late-onset CMV reactivation in LTV group.