bluuebunny/crossref_metadata_2025 huggingface dataset:
Magnetic field normalization in residential premises located above built-in transformer substations 6(10)/0,4 kV power 100-400 kVA
Authors: Pelevin Dmytro
Published: December 2024

The purpose of the work is to define methods and means of screening, sufficient to reduce to a safe level the low frequency magnetic field in residential premises of old buildings, located above built-in transformer substations 6(10)/0,4 kV power 100–400 kVA at short distances to the premises. To achieve this goal, a modified method for synthesizing active shielding systems of the magnetic field for transformer substations at short distances from the substation to the floor of the premises, and its experimental verification was carried out on a full-scale physical model of a transformer substation power 100 kVA with a physical layout of the synthesized active shielding system. A synthesis of active shielding systems of magnetic field for transformer substations with a power of 100–400 kVA at short distances from the substation to the floor of the premises and an analysis of their effectiveness were carried out. It was determined that the normalization of the magnetic field on the floor surface for transformer substations with a power of 100 kVA using a synthesized active shielding system with one compensation winding is possible at distances of at least 1,15 m from the substation, and with two windings - at least 1,02 m. It was determined that normalization of the magnetic field on the floor surface for 400 kVA transformer substations using a synthesized active shielding system with two windings is possible only at a distance from the substation of at least 1,6 m. An analysis of the effectiveness of the combined use of active and passive shielding was conducted. It was determined that the combined use of synthesized two-channel active shielding systems and a passive flat electromagnetic shield made of 4 mm thick aluminum sheet allows reducing the magnetic field above the built-in transformer substation with a power of 100 to 400 kVA to the normative level while limiting the distance from the substation to the floor of the premises to at least 1,08 m and provides protection of public health from the effects of the low frequency magnetic field.
Development of the Physics Practicum Apparatus based on Microcontroller: A Prototype Constructed from Misconceptions of Basic Kinematics Concepts
Authors: Syamsiah Endah Nur , Taufani Muhammad Rizka , Aminudin Adam Hadiana , Pamungkas Rahadian Sri , Fadilla Reno Muhammad , Nabilah Fatih Najah
Published: December 2024

Critical thinking skills are fundamental in 21st-century teaching. This study aims to identify trends in research on critical thinking skills in physics in Indonesia, as reported in journal articles published between 2016 and 2022. This is meta-analysis research using the Prisma model. There were 36 articles that met the selection criteria. We performed the data analysis manually and used VOSviewer software. The indicators used for data analysis include the year, type of research, research subject, topic, treatment, data collection instrument, and the application of data analysis in each article. The analysis of article reviews reveals that the research trend for critical thinking skills in physics in Indonesia has increased, with more publications expected in 2020. Temperature and heat are the physics topics that have become the focus of research. High school students in grade X are the most frequently selected research subjects. Research on physics education typically employs quantitative methods, employs a quasi-experimental design, and utilizes a test as a data collection instrument. The most common method of data analysis in research is the t-test.
Integrated Three-Dimensional Structural and Petrophysical Modeling for Assessment of CO2 Storage Potential in Gas Reservoir
Authors: Shah Syed Yasir Ali , Du Jiangfeng , Iqbal Sayed Muhammad , Du Linze , Khan Umair , Zhang Baoyi , Tan Jingqiang
Published: December 2024

Carbon dioxide (CO2) storage in oil and gas reservoirs is one of the most effective methods for enhancing hydrocarbon recovery efficiency and mitigating climate change by securely storing CO2. However, building a realistic three-dimensional (3D) geological model for these storage reservoirs poses a significant challenge. To address this, employing a novel methodology combining 3D structural and petrophysical modeling, our study presents a pioneering effort to assess the CO2 storage potential of the faulted reservoir between the G- and E-sands of the Lower Goru Formation in the Kadanwari Gas Field (KGF), Middle Indus Basin (MIB), Pakistan. Analysis of seismic data revealed a complex reservoirs structure affected by normal faults oriented in a northwest–southeast direction. These faults partition the reservoir into several compartments and could serve as potential pathways for CO2 migration. Three-dimensional structural modeling unveiled complex features, for example horsts, grabens, and half-grabens, formed through multiple deformation stages. Petrophysical modeling indicated promising reservoir characteristics, that is high porosity and permeability in the desired zone. Three-dimensional property models were generated using sequential Gaussian simulation to represent the distribution of petrophysical properties, for example porosity, permeability, shale volume, and water saturation. Geological uncertainties were incorporated enabling the calculation of pore volume distribution and corresponding uncertainty. A novel technique was developed to assess the probable CO2 storage potential in the KGF, considering its distinctive features. The study revealed a storage potential ranging from 10.13 million tons (P10) to 101.54 million tons (P90), with an average potential of 53.58 million tons (P50). Our study offers a comprehensive approach to evaluating CO2 storage potential in complex geological zones, filling a knowledge gap in existing literature on carbon neutrality efforts in Pakistan. These findings lay the groundwork for future initiatives in geological CO2 storage in the MIB and support the country’s efforts to reduce carbon emissions.
Análisis bibliométrico de la producción científica de la calidad de vida relacionada con la salud en población peruana
Authors:   , Hidalgo Calderon Sergio Alfredo
Published: December 2024

Introducción: El constructo calidad de vida es multidimensional y subjetivo. Así mismo, desde 1948 se comenzaron a desarrollar los sistemas para evaluarla. En el Perú, se han realizado esfuerzos para estandarizar y aplicar pruebas que midan la calidad de vida debido a la relación directa con la salud de la población y el impacto que genera en la economía del país. Sin embargo, en el Perú no se tiene un registro sistematizado de los estudios realizados sobre este tema. Métodos: Se realizó un primer análisis exploratorio bibliométrico de la producción científica de la Calidad de Vida Relacionada con la Salud (CVRS) en población peruana en artículos primarios publicados en Scopus. La estrategia de búsqueda fue realizada mediante búsqueda avanzada, se realizó la búsqueda en términos Mesh. Se descargaron artículos originales de estudios primarios, revisiones en español, portugués e inglés desde la primera publicación. Se realizó el análisis de resultados y gráficos a través de página web de Scopus y en Vos Viewer 1.6.20, lo que nos permite observar un resumen de toda base de datos. Resultados: Se obtuvo un total de 342 documentos, de los cuales 287 (83.9%) fueron artículos, 284 (83%) fueron en inglés. Desde el año 2008 un crecimiento sostenido de artículos publicados sobre la calidad de vida relacionada con la salud en población peruana. Así mismo, es la Universidad Peruana Cayetano Heredia la institución con mayor cantidad de documentos por filiación. El documento más citado tuvo 171 citas. La revista con la mayor cantidad de documentos publicados fue Revista Peruana de Medicina Experimental y Salud Publica con 11 (3.2%). El autor con mayor cantidad de documentos publicados fue Alejandra Caqueo-Urízar con 13 (3.8%). Conclusiones: En conclusión, se observó un incremento sostenido en la producción científica anual desde el 2008 sobre calidad de vida relacionada…
Responsabilidad social empresarial y las acciones para la reducción de la huella de carbono de la Empresa Comercial en Lima - Chorrillos durante el año 2022
Authors:   , Villanueva Burgos Josefina , Criollo Collahuazo Cristina Grimenez
Published: December 2024

Este estudio pretendió determinar la relación entre la responsabilidad social empresarial y las acciones para la reducción de la huella de carbono en la empresa comercial en Lima – Chorrillos durante el 2022. La metodología empleada fue cuantitativa, correlacional, no experimental-trasversal. Se optó por usar la técnica de la encuesta y se aplicó 2 cuestionarios con escala de Likert, con un proceso de validación mediante juicio de expertos. Además se aplicó la prueba de confiabilidad de alfa de Cronbach, cuyos puntajes fueron de más de 0.7, lo que implica que ambos instrumentos son confiables. La empresa donde se realizó el estudio es una MYPE que cuenta con 52 trabajadores; se aplicó los cuestionarios a la totalidad de los empleados, por lo que se considera una muestra censal. Se concluyó que, si bien existe una correlación positiva débil, no hay una relación significativa entre la responsabilidad social empresarial (RSE) y la huella de carbono dentro de la empresa. Sin embargo, sí se logró determinar que existe relación significativa causal entre la dimensión de reducción de emisión directa de gases de efecto invernadero y la responsabilidad social. Se recomendó aplicar acciones de RSE más acordes a la reducción de emisiones indirectas de gases de efecto invernadero para mitigar la huella de carbono de la empresa.
Estado nutricional y su asociación con calidad de la dieta en pacientes con enfermedad renal crónica sometidos a hemodiálisis en un hospital público-Lima, 2022
Authors:   , Caspa Sanchez Grace Karoline , Garcia Brito Diana Liz
Published: December 2024

El objetivo de esta investigación fue determinar la asociación del estado nutricional frente a la calidad de la dieta en pacientes con enfermedad renal crónica sometidos a hemodiálisis en un Hospital Público de Lima. La metodología corresponde a un estudio descriptivo de tipo transversal en la cual se determinó el estado nutricional aplicando el sistema de puntuación cuantitativo e integral, denominado Puntuación Objetiva de Nutrición en Diálisis (OSND) que incluye mediciones antropométricas (el porcentaje de cambio de peso seco, el índice de masa corporal (IMC), el pliegue cutáneo tricipital y el perímetro braquial) y tres pruebas de laboratorio: niveles de albúmina, transferrina y colesterol; para determinar la calidad de la dieta se aplicó el índice de alimentación saludable (IAS). La muestra incluyó a 51 pacientes que llevaban su tratamiento dialítico en 3 sesiones Inter diarias a la semana (35 varones y 16 mujeres) con una edad media de 58 años de edad. Para la asociación se empleó la prueba estadística Tau -c- de Kendall. Los resultados mostraron un 51 % de con desnutrición moderada, 45% bajo y solo el 4 % un estado normal basado en la OSND. El índice de alimentación saludable (IAS) se calificó como 78 % nivel de calidad malo, 20 % regular y 2 % bueno. Así mismo se no se encontró asociación significativa del estado nutricional frente a la calidad de dieta (p valor>0.05). Se concluyó que, si bien no se encontró asociación entre las variables, se hallaron otros factores en el estudio que, si están relacionados con el desarrollo de la desnutrición, como patrón alimenticio monótono, circunferencia braquial, pliegue cutáneo tricipital y niveles bajos de transferrina.
WITHDRAWN: Isolation and Characterization of Plant Sterols from Saponified Paprika Oleoresin
Authors: Patel Vishwa
Published: December 2024

The full text of this preprint has been withdrawn by the authors due to author disagreement with the posting of the preprint. Therefore, the authors do not wish this work to be cited as a reference. Questions should be directed to the corresponding author.
Associations between types of physical activity, physical activity levels, and overactive bladder: a cross-sectional study based on 2007–2020 NHANES
Authors: Zhu Jiaxing , Luo Xueli , Wu Jianfa , Li Fangzhi , Liao Wencheng , Xu Kaixin , Li Yousheng , Xie Jiali
Published: December 2024

The aim of this study was to investigate the association between the types and levels of physical activity and overactive bladder (OAB) in a nationally representative population. Participants from the National Health and Nutrition Examination Survey (NHANES) 2007–2020 were included in this study. Weighted logistic regression analysis was employed to study the correlation between the risk OAB and physical activity types and levels. The reliability of the findings was assessed using subgroup analysis. The relationship between OAB and physical activity levels was investigated using a restricted cubic spline (RCS) model. After adjusting for potential covariates, vigorous recreational activity (OR: 0.68, 95% CI: 0.62–0.75, p < 0.001), moderate recreational activity (OR: 0.83, 95% CI: 0.78–0.88, p < 0.001) and physical activity levels (p < 0.001) were protective factors for OAB. The subgroup analysis revealed a consistent and significant correlation between OAB and vigorous and moderate recreational activities. Restricted cubic spline showed a nonlinear relationship between the physical activity levels and OAB (P-non-linear value < 0.001). In all kinds of physical activities, it was determined that vigorous recreational activities and moderate recreational activities possess a protective impact on OAB. Moderate increases in physical activity can be effective in preventing OAB.
The Impact of a Knee Osteoarthritis Clinician-Led Patient Specific Shared-Decision Making Tool in the Adult Reconstruction Clinical Setting: A Movement is Life Musculoskeletal Disparities Project
Authors: Romero Sebastian J. , Rancu Albert L. , Clemons Tiana L. , Dlott Chloe , Li Mengnai , Gibson David H. , Jones Lynne C. , O’Connor Mary I. , Wiznia Daniel H.
Published: December 2024

Background
The decision to undergo total knee arthroplasty (TKA) is complex, requiring patients to consider the risks and benefits of surgery. It is the clinician’s responsibility to educate patients on their treatment decisions. Patient decision-making aids are a tool for clinicians to utilize with their patients to improve their patients' understanding of their condition and treatment options. With increased emphasis on patient-centered healthcare, implementation of a shared decision-making aid in adult reconstruction clinical practice may help patients make better informed decisions.
Purpose
Given that the orthopaedic surgery clinic is the primary setting where a patient decides whether to pursue non-operative treatment versus surgery, patients and clinicians in this setting may benefit from the use of a shared decision-making tool (SDMT). The primary goal of this study was to evaluate the utility of a patient-specific SDMT on the patient’s decision regarding knee osteoarthritis (OA) management.
Methods
A randomized prospective clinical trial was conducted to evaluate the impact of a SDMT regarding treatment for knee OA. Patients were randomized to an intervention arm with the implementation of a patient-specific SDMT or a control arm with a standard of care (SOC) clinic appointment without the use of the tool. The impact of the SDMT was assessed by evaluating patients on Patient-Reported Outcome measures, and their attitudes towards non-operative and operative interventions.
Results
Both the patient-specific SDMT and control groups demonstrated a statistically significant increase in post-visit understanding of their disease progression. Patients in the SDMT group demonstrated a significant increase in the proportion of patients who would be “extremely likely” to pursue non-operative treatment post-visit. Comparisons between SDMT and control groups demonstrated a significant inclination for the SDMT cohort to enroll in non-operative, conservative management such as corticosteroid or hyaluronic acid injections.
Conclusion
Use of a patient specific customizable SDMT tool in an adult reconstruction clinic positively impacted patient attitudes toward receiving non-operative treatment for OA and, more importantly, patient understanding of disease post-visit.
Trial Registration:
This randomized controlled study (ID: NCT05411939, Registered 04/15/2023 at clinicaltrials.gov) was approved by the institutional review board at our university (HIC# 2000032637) and used the CONSORT checklist.
Sex Differences in Waiting Times for Cataract Surgery in Sweden, 2010–2022: Nationwide Analysis of 1.4 Million Patients
Authors: Stålhammar Gustav , Jute Philip
Published: December 2024

Background
Sex-based disparities in healthcare access and outcomes remain a challenge. Understanding differences in waiting times for cataract surgery between males and females can reveal inequities in care delivery.
Methods
This nationwide retrospective cohort study used data from the Swedish National Cataract Register, which covers > 93% of all cataract surgeries in Sweden. A total of 1,413,652 patients aged > 40 years who underwent first-eye cataract surgery between 2010 and 2022 were included. Exclusions were made for patients with waiting times > 24 months, those residing outside Sweden, and those with missing sex data. The primary outcome was waiting time, defined as the interval between preoperative assessment and surgery. Secondary analyses included stratification by visual acuity, regional variations, and the influence of demographic and clinical factors.
Results
The mean waiting time was 64 days for females (SD 126) and 60 days for males (SD 102), with a significant difference (P < 0.001). This disparity persisted across all visual acuity strata and regions. Multivariate Cox regression identified female sex, older age, specific comorbidities, and residence region as significant predictors of longer waiting times. Differences in comorbidities, including higher rates of pseudoexfoliation syndrome in females and endophthalmitis in males, were observed. Despite fluctuations in overall waiting times, the sex-based disparity remained consistent over the study period.
Conclusions
Persistent sex-based differences in waiting times for cataract surgery were identified in Sweden over 13 years. While small and unlikely to affect clinical outcomes, these differences highlight systemic inequities that merit further investigation and intervention to ensure equitable access to care.
Intensive Care Unit Dialysis Practice, Clinical Outcomes, and Associate Factors Among Critically Ill Patients at St.Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia: A Prospective Cohort Study Design
Authors: Getahun Zelalem , Demissie Dereje Bayissa , Sulan Menbeu , Tufa Muluneh Kidane , Laytin Adam , Mehari Maraki
Published: December 2024

Introduction: Acute kidney injury (AKI) is a common complication in critically ill patients, associated with increased morbidity and mortality. Despite its widespread use, there is limited research examining intensive care unit dialysis practice and clinical outcomes among critically ill patients. Objective: The aim of this study was to investigate intensive care unit dialysis practice, clinical outcomes, and associate factors among critically ill patients at St. Paul’s Hospital Millennium Medical College in Addis Ababa, Ethiopia 2024 Methods and Materials: Hospital based prospective quantitative cohort study was conducted in St. Paul Hospital Millennium Medical College over a period of seven month from December 1, 2023 - June 30, 2024. The study used a data abstraction checklist to collect data from patients' charts, which was processed using Kobo collect software and exported for further analyzed using SPSS version 25. Descriptive analysis was performed to describe study variables, and binary and multivariable logistic regression was used to identify significant factors at PV < 0.05, with a 95% CI for the final model. The clinical trial number is not applicable. Result A study involving 301 AKI patients admitted to the ICU, with 90% response rate, with a mean age of 34.3 ± 15.4 Years old. Females were the most frequently admitted patient 49 (54.4%). The study found that most patients with acute kidney injury (AKI) achieved good renal recovery, with 67.8% successfully weaned from ICU care and transferred to a general ward. Sepsis 46 (51.1%) and advanced age > 60 years old (10.0%) were the leading risk factors. This study identified factors significantly associated with patient outcomes were: patient who had Urea Reduction Ratio below 55–60% range were 6 times more likely to have increased mortality than a patient who has Urea Reduction Ratio of greater than 60% (OR = 6.04, 95% CI 1.09-33.318) and Patients with a higher APACHE II score were 2.7 times more likely to experience worsened ICU outcomes compared to those with lower score [AOR] = 2.7, 95% CI 1.086–17.879). Conclusion: The study revealed that 67.8% of acute kidney injury (AKI) patients successfully recovered from ICU care. This study found that sepsis was the most common cause of acute kidney injury (AKI) leading to dialysis in the study setting Intensive care unit. The severity of illness, as measured by the APACHE II score, was a strong predictor of mortality. Inadequate dialysis, characterized by a low urea reduction ratio, was also associated with increased mortality.
Effectiveness of Transdiagnostic Internet-Delivered Cognitive Behavioral Therapy for Symptoms of Adjustment Disorder: A Longitudinal Observational Study in a Routine Online Care Setting
Authors: Sapkota R. P. , Peynenburg V. , Dear B. F. , Titov N. , Hadjistavropoulos H. D.
Published: December 2024

Background: Trials of disorder-specific Internet-delivered cognitive-behavioral therapy (ICBT) for Adjustment Disorder (AD) show moderate effect sizes but may have limited scalability in routine care settings, where clients present with a range of concerns. Transdiagnostic ICBT, which addresses common emotional and behavioral concerns irrespective of diagnosis, could address the need for effective and scalable treatments for symptoms of AD.
Objective: This study aimed to evaluate the effectiveness of a transdiagnostic ICBT course for patients with high AD symptoms, and to investigate predictors of treatment outcomes, and treatment satisfaction.
Methods: 793 participants received a therapist-guided, transdiagnostic ICBT course. The study measured changes in AD symptoms from pre-treatment to post-treatment to 3-month follow-up using the Adjustment Disorder – New Module 8 (ADNM-8).
Results: The prevalence of high AD symptoms (defined as a score >23 on the ADNM-8) was 54.8% at pre-treatment. The study found large reductions in AD symptoms from pre-treatment to post-treatment (d = 1.29, 95% CI [1.13, 1. 45]) and from pre-treatment to the 3-month follow-up (d = 1.67, 95% CI [1.49, 1.85]). These effect sizes were comparable to those found in previous ICBT trials of AD-specific treatments. Approximately 70% of participants scored below clinical cut-off for high AD symptoms at post-treatment, and 79 % met this criterion at follow-up. Engagement in treatment and post-treatment satisfaction were similar between individuals with high AD symptoms and those without, with the majority (76.9%) completing four or more lessons and 81.7% reporting overall satisfaction.
Conclusions: The findings suggest that transdiagnostic ICBT is an effective and acceptable treatment for AD symptoms, with results comparable to those of AD-specific interventions. The high prevalence of AD symptoms and stressful life events among participants in a routine care setting underscores the importance of early identification of individuals with high AD symptoms.
A Retrospective Cohort Study of Chimeric Antigen Receptor T-Cell Therapy in Follicular Lymphoma Patients with or without Histological Transformation
Authors: Wang Jingjing , Zeng Liangyu , Ma Xiao , Wu Depei , Li Caixia , Xu Ting
Published: December 2024

Background: Follicular lymphoma (FL), one of the most common indolent lymphomas, is still classified as an incurable disease. Adverse outcomes in FL frequently occur in patients who experience early relapse or histological transformation to aggressive lymphoma. Chimeric antigen receptor T-cell therapy (CAR-T) has received approval for the treatment of relapsed/refractory B-cell lymphoma.
Methods: This retrospective study presents the clinical characteristics and treatment follow-up of 26 patients with transformed or relapsed/refractory FL who received CAR-T therapy. It evaluates the efficacy of CAR-T and assesses treatment lines, LDH levels, remission status before treatment, and the histological transformation of their prognostic impact.
Results: Among the 14 transformed FL patients, there was one treatment-related death, the overall response rate (ORR) was 92.0%, with a 2-year progression-free survival (PFS) rate of 66.7% and an overall survival (OS) rate of 73.3%. For the 12 relapsed/refractory FL patients, the ORR was 100.0%, with a 2-year PFS rate of 75.0% and an OS rate of 100.0%, which is lower than that for transformed FL. A favorable remission state before CAR-T treatment correlated with improved PFS (P =0.009). Compared to transformed patients, those with relapsed/refractory FL exhibited better OS following CAR-T treatment (P =0.04).
Conclusion: CAR-T therapy demonstrates significant efficacy and good safety for treating relapsed/refractory follicular lymphoma and transformed lymphoma. Further research should focus on identifying prognostic factors, extending remission duration, and preventing recurrence.
Design and Optimization of Miniaturized Co-planar Vivaldi Antennas for Enhanced Microwave Imaging in Brain Hemorrhage Detection
Authors: Zhang Weijia , Xie Jin , Somjit Nutapong , Cheng Xue , Jiang Yanrong , Sun Dongqin , Cai Shaomin
Published: December 2024

This paper presents an innovative design and optimization of a miniaturized coplanar Vivaldi antenna tailored for advanced microwave imaging applications in cerebral hemorrhage detection. Measuring just 80 × 80 × 1 mm³, the antenna integrates novel features such as curved radiating arms, optimized solder pads, and strategically placed metallized vias to address challenges in deep tissue imaging. These enhancements deliver outstanding broadband performance (1.6–8 GHz), exceptional impedance matching with a voltage standing wave ratio (VSWR) consistently below 1.5 in the critical 2–4 GHz range, and a reflection coefficient as low as -45 dB at 4 GHz. Notably, the gain peaks at 9.5 dB at 6.5 GHz, ensuring superior signal penetration and resolution. The innovation extends beyond design, employing ANSYS HFSS simulations and multi-layer cranial models to replicate real biological conditions. Comparative analysis of single, double, and 36-antenna arrays demonstrates the antenna's ability to achieve high-resolution imaging, even in complex tissue environments. Additionally, a novel application of real-time differential imaging and beamforming algorithms, including Delay-And-Sum (DAS) and Delay-Multiply-And-Sum (DMAS), enhances imaging clarity and detection sensitivity. The results show significant improvements in identifying hemorrhagic regions, offering crucial technical advancements for portable, non-invasive diagnostic systems. By combining miniaturization, performance optimization, and application-specific enhancements, this work establishes a transformative foundation for early stroke detection technologies.
Proving the Efficacy of Autologous Fat Grafting in the Treatment of Rectocele: A Retrospective Study
Authors: Dandin Ozgur , Ozturk Kamil , Vural Veli , Calis Hasan , Sabuncuoglu Mehmet Zafer , Zihni Ismail
Published: December 2024

Background
Rectocele, a prevalent condition linked with pelvic organ prolapse, affects many women postpartum, leading to symptoms like constipation, straining during bowel movements, and vaginal pressure, significantly impairing quality of life. Traditional surgical procedures for rectocele repair often lead to complications and symptom recurrence. Recently, autologous fat grafting (AFG) has emerged as a minimally invasive alternative. This retrospective study evaluates the efficacy and safety of AFG, using a stem cell-enriched approach for rectocele treatment.
Material and Methods
Conducted at Akdeniz University Faculty of Medicine, this study included female patients who underwent AFG for rectocele from January 2023 to January 2024. Inclusion criteria were patients diagnosed with rectocele, aged 18 or older, with a follow-up period of at least 6 months post-procedure. Data were collected on patient demographics, clinical characteristics, pre- and post-procedural symptoms, procedural details, and follow-up outcomes. Statistical analysis compared pre- and post-procedural variables using appropriate tests.
Results
The study included 65 patients, with a mean (± SD) age of 51,2 (± 12,41) years. Pre-procedural symptoms included rectal pain, constipation, and dyspareunia. Post-procedural outcomes demonstrated significant improvements in these symptoms, with a mean (± SD) follow-up period of 12,13 (± 4,29) months. The majority of patients reported symptom relief, particularly from rectal pain and constipation. Complications were minimal, with 25% of patients experiencing mild skin ecchymosis that resolved with treatment. Obstructive defecation, Quality of life, and constipation assessments showed significant improvements, with patients reporting higher satisfaction and improved functional outcomes.
Conclusion
AFG shows promise as an effective minimally invasive treatment for rectocele. It offers significant symptom relief and improved quality of life with minimal complications. The results suggest that AFG could be a valuable alternative to traditional surgical methods.
Tailored vertebral artery mobilisation in complex craniovertebral junction surgery- a blessing in disguise
Authors: Maurya Ved Prakash , Kumar Ashutosh , J Ananth Chaitanya , Dikshit Priyadarshi , Ranjan Ravi , Bhaisora Kamlesh Singh ,   7.	Kuntal Kanti Das, Rai Shreyash , Verma Pawan Kumar , Kanjilal Soumen , Mehrotra Anant , Jaiswal Awadhesh Kumar , Srivast Arun Kumar
Published: December 2024

Background: The surgical exposure of the complex craniovertebral junction (CVJ) requires manipulation of the neurovascular structures and the atlantoaxial joint (C1-C2 joint) to access the pathological region. To achieve adequate C1-C2 joint manipulation, the mobilization of the vertebral artery (VA) is mandatory. The present retrospective observational study aims to describe the surgical nuances and share the experience of tailored vertebral artery mobilization for efficient management of CVJ pathologies.
Methodology: All the operated cases of CVJ anomalies from January 2019 to December 2023 were included. The clinico-radiological scan, including their three-dimensional computerized tomography (3-D CT), was recorded with a VA angiogram course. The intraoperative details of these patients were collected from the neurosurgery operative records. The patients' details were obtained either by the outpatient department or by telephone.
Results: A total of 18 patients were analyzed with a mean age of 49.21±18.30 years. The median pre-operative Nurick's grade amongst the study population was 4 (IQR: 3,4 and Range: 3-5). Twelve patients underwent bilateral vertebral artery mobilization, whereas the remaining six underwent unilateral vertebral artery mobilization. After surgery, at three months of follow-up visit, the median post-operative Nurick's grade was 3 (IQR: 2,3 and Range: 2-5), which was statistically significant (P=0.002). The mean follow-up duration was 23.2 months without any procedure-related mortality.
Conclusions: Tailored vertebral artery mobilisation (VAM) is an excellent surgical strategy for negotiating through the atlantoaxial joint in a specific group of patients. It offers safe access to managing CVJ anomalies, keeping in mind the principles of micro neurosurgery.
Association of neutrophil percentage-to-albumin ratio with all-cause and respiratory disease-related mortality in US adults with asthma: results from NHANES 1999-2018
Authors: Wang Dan , Su Rui , Li Ruina , Li Xiaofeng , Zhao Hui
Published: December 2024

Background: Systemic inflammation and immune dysregulation may be associated with asthma onset and progression. Neutrophil percentage-to-albumin ratio (NPAR) is a novel marker of systemic inflammation. We aimed to investigate the association of NPAR with all-cause and respiratory disease-related mortality in adults with asthma through NHANES 1999-2018.
Methods:NPAR was calculated by neutrophil percentage (% of total white blood cell count) × 100/serum albumin (g/dl). Asthma was diagnosed by standardized questionnaire. Mortality was obtained by prospective matching with the National Death Index. Multivariate Cox proportional hazards regression analysis was used to explore these associations.
Results:A total of 5042 adults with asthma were included. After a median follow-up duration of 104 months, 697 participants died, of which 101 were respiratory disease-related deaths. In fully adjusted models, NPAR was significantly and positively associated with both all-cause and respiratory disease-related mortality (hazard ratios [HR] of 1.126 and 1.194, respectively, both p < 0.05). Compared to Q1, NPAR at Q4 was associated with significantly increased all-cause and respiratory disease-related mortality (all-cause: HR 2.112, p < 0.0001; respiratory disease-related: HR 2.595, p = 0.013). NPAR was nonlinearly associated with all-cause mortality, with an inflection point of 13.76. This association was significant only after the inflection point. The effect of NPAR on all-cause mortality was more pronounced in those <60 years of age.
Conclusions:Higher NPAR was associated with increased all-cause and respiratory disease mortality in US adults with asthma. Further exploration of the prognostic potential and underlying mechanisms of NPAR is needed.
Clinical trial number Not applicable.
Impact of Antiemetic Steroid Use on Survival in Small Cell Lung Cancer Patients Receiving Immune Checkpoint Inhibitors and Chemotherapy
Authors: Park Soh Mee , Jeong Jonghyun , Kim Yu Jung , Lee Ju-Yeun
Published: December 2024

Immune checkpoint inhibitors (ICIs) combined with conventional cytotoxic agents have become the new standard of care for extensive-stage small cell lung cancer (SCLC). The platinum-based agents in these regimens are highly emetogenic, necessitating prophylactic antiemetic steroids. This study evaluated the impact of prophylactic antiemetic steroid use on survival outcomes and efficacy in patients with SCLC undergoing combination therapy. Using data from the National Health Insurance Service of Korea database, patients treated with atezolizumab, etoposide, and carboplatin between 2020 and 2022 were categorized by antiemetic steroid dosage. Primary outcomes included overall survival (OS) and time to next treatment (TTNT), assessed using multivariate Cox proportional hazards models. After propensity score matching, 2,116 patients were categorized into low-dose (0–12 mg), moderate-dose (13–24 mg), and high-dose (25–36 mg) groups. Median OS was 10.2 months (interquartile range [IQR], 5.2–18.5), and median TTNT was 8.6 months (IQR, 4.8–15.5), with no significant differences among groups. Subgroup analysis revealed increased mortality associated with higher antiemetic steroid doses in patients concurrently receiving non-antiemetic steroids. Although antiemetic steroids did not significantly impact survival outcomes overall, reducing their dosage in patients already on steroid therapy for other indications is recommended.
Patient perspectives on telehealth access among people experiencing homelessness: A rapid review
Authors: Doherty Claire , Pepper Hayley , Jessup Rebecca , Hutton Jennie
Published: December 2024

Background

Telehealth services are rapidly expanding across the globe yet under-served populations, particularly people experiencing homelessness (PEH), are at risk of being further marginalised in society if focussed interventions to address telehealth access are not implemented.
The aim of this rapid review was to report on the patient experience of PEH when accessing telehealth services. Secondary objectives of the review were to summarise both the patient and health service outcomes that were reported.

Methods

This rapid review identified peer reviewed literature that explored patient experiences of telehealth for people experiencing homelessness. Databases searched were MEDLINE, Embase, APA PsychINFO and CINAHL. Study characteristics were extracted and during the second-phase, two authors independently extracted data from each paper using a framework for evaluating telehealth outcomes (access to care, cost, experience, effectiveness) with a third author reviewing the extracted data and finalising the results table.

Results

Twelve eligible studies were identified with publication dates between 2020 and 2024. Two were qualitative, nine were quantitative and one was a mixed-methods study design. A large variation was found across the literature in relation to participant experience of telehealth for PEH. Telehealth was shown to be an acceptable form of healthcare for PEH. It was more acceptable in settings where participants were accessing it with clinician support, in an environment that was familiar to the participant, where the participant was living in at least temporary accommodation. Furthermore, telehealth was accessible where the processes to access telehealth were not prohibitive and where the internet connection was reliable. However, significant adaptions to improve a participant’s experience of telehealth was identified as a need.

Conclusion

There is limited evidence available that explores the experiences of PEH when accessing telehealth. We have identified a number of simple factors that can be implemented to make telehealth services more accessible for PEH. Acknowledging that telehealth services are an accepted form of healthcare delivery across the globe, future research involving people experiencing primary homelessness and undertaking research utilising a digital inclusion framework would be of value.

Registration

The review was registered on the International prospective register of systematic reviews, (PROSPERO in October 2023 CRD42023466817).
Does Inflammatory Bowel Disease Elevate Infection Risk in Total Hip Arthroplasty? Insights from a nationwide study highlighting steroid use as the key determinant
Authors: Hong Seok Ha , Yu Yeon Ju , Han Seung Beom
Published: December 2024

Introduction
This study investigated the association between medication status and total hip arthroplasty (THA) complications in patients who have inflammatory bowel disease (IBD), considering varying illness severities.
Materials and Methods
This retrospective analysis of the National Health Insurance Review and Assessment Service database in South Korea, included patients undergoing unilateral THA between 2012–2022, specifically those diagnosed with IBD. Propensity score matching was used to adjust for baseline characteristics between IBD and non-IBD cohorts, with a matching ratio of 1:10.
Results
There was a significant difference between the IBD (n = 962) and non-IBD matched groups (n = 9,620) in terms of chronic periprosthetic joint infection (PJI) (2.1 vs 1.3%, P= 0.03) but not with acute PJI or other surgical complications (periprosthetic fracture, dislocation, and aseptic loosening). Medication use itself was not associated with PJI, except for corticosteroid use, significantly associated with PJI among IBD medications (OR: 2.79 [1.03–10.68], P = 0.04). Multivariable analysis indicated a significant increase in PJI risk with corticosteroid use within one year before THA (OR: 3.30 [1.21–10.86], P = 0.01). Patients not using steroids did not exhibit an inherent risk of IBD related complications.
Conclusions
This nationwide study confirmed that IBD increases the risk of chronic PJI. Preoperative corticosteroid use within the year before arthroplasty significantly increased the risk of PJI, particularly in patients with poorly controlled IBD and acute flares-up. Conversely, well-controlled IBD did not correlate with increased surgical complications. Attention should be directed towards recognizing the risk of steroid use, such as acute flares in cases of uncontrolled IBD, to optimize preoperative treatment for IBD undergoing arthroplasty.
Level of Evidence
Level III, Prognostic
The effect and safety of acupoint thread embedding in treatment of overweight and obese women: study protocol of a randomized controlled trial
Authors: Li Xiying , Zhao Yilin , Gunes Aylin , Li Guancheng , Xia Jingyu , Zheng Huimin , Jin Qi , Xu Wenqing , Xu Shifen , Yin Xuan
Published: December 2024

Background: Obesity is a major health concern over the world, affecting female’s physical and psychological health. Acupoint thread embedding (ATE) treatment is an innovative method based on Traditional Chinese Medicine (TCM) theories and can provide long term stimulation on acupoints. However, its efficacy for weight-loss among female patients remains questionable primarily due to insufficient high-level evidence.
Methods: This is a patient-assessor-blinded, randomized, sham controlled clinical trial that will conduct in a TCMhospital in Shanghai. A total of 132 eligible participants will be randomly assigned to either group, receiving ATE with health education or sham ATE with health education. Participants will receive 6 sessions of real or sham ATE intervention once in every 2 weeks for 12 weeks, with an additional 12 weeks of follow-upperiod. Primary outcome will be the change of body mass index between baseline and end of treatment. Secondary outcomes will include changes in the body weight, waist circumference, hip circumference, waist-to-hip ratio, waist-to-height ratio, body fat percentage measured by body composition analyzer, liver stiffness measured by liver elastography, self-rated questionnaires including Impact of Weight on Quality-of-Life-Lite Scale, Visual Analogue Scale of appetite,Well-Being Index and Hamilton Rating Scale for Anxiety, and blood tests results about glucolipid metabolism. All adverse events will be assessed by the treatment emergent symptom scale. Outcomes will be collected at baseline, week 6, week 12 and week 24 during the intervention and follow-up.
Discussion: This study will investigate the effect and safety of ATE in the treatment of overweight and obesity among female patients. The findings of this study will contribute to reveal the therapeutic benefits of ATE in losing weight.
Ethics and dissemination: This trial has received ethical clearance from the Ethics Committee of Shanghai Municipal Hospital of Traditional Chinese Medicine under the registration number 2024SHL-KY-10-01. All participants will provide their written informed consent prior to their enrolment. The findings will be disseminated through peer-reviewed publications and scholarly conferences.
Trial registration number: ClinicalTrials.gov ID: NCT06316310
Differences in Gastrointestinal Motility in Adults with Type 1 and Type 2 Diabetes Using Wireless Motility Capsule
Authors: Garg Samita , Syed Hareem , Elkin Baila , Shah Ravi , Valencia Sara , Bena James , Morrison Shannon , Cline Michael , Lembo Anthony
Published: December 2024

PURPOSE:
Gastrointestinal motility disorders are common in diabetes, though their prevalence and distribution are unclear. The Wireless Motility Capsule (WMC) assesses transit times and pressures of the entire gastrointestinal tract in a single study. This study aimed to evaluate the prevalence, patterns, and factors of gastrointestinal transit abnormalities using WMC in diabetes patients.
METHODS:
This retrospective observational study included Type 1 (T1D) and Type 2 Diabetes (T2D) patients who underwent WMC testing. Whole gut transit time (WGTT), gastric emptying time (GET), small bowel transit time (SBTT), and colon transit time (CTT) were analyzed. Univariate and multivariable analyses identified risk factors for delayed transit.
RESULTS:
A total of 482 patients (mean age of 54.2 years, 74% female) were included. Of these, 20.2% had T1D and 79.8% had T2D. Delayed transit was observed in 75.7% with delayed GET (58.8%) being the most common abnormality. In multivariable analysis, increasing BMI was associated with lower odds of delayed WGTT (OR 0.97 [0.94, 0.99]; p-value < 0.012), while increasing age (OR 1.03 [1.01, 1.04]; p-value < 0.001) and female gender (OR 0.53 [0.32, 0.86]; p-value < 0.011) were associated with increased odds of delayed CTT.
CONCLUSION:
This study highlights the high prevalence of gastrointestinal transit abnormalities in diabetes, with delayed gastric emptying being most common. Risk factors for delayed colonic transit include older age, female gender, and shorter diabetes duration. HbA1C levels were not significantly associated with transit delays. Identifying intestinal dysmotility in diabetes can guide early management strategies to improve outcomes.
Satisfaction survey of early clinical exposure in medical students: a cross-sectional study
Authors: Kachuei Maryam , Rezazadeh Mohammad , Hoseinzadeh Mohammad , Hashemi Akram , Mousavi Ashraf Sadat , Heidari Amirhossein
Published: December 2024

Introduction: Early clinical exposure (ECE), one type of vertical integration model between preclinical and clinical subjects, is a teaching-learning technique that improves early medical students' professionalism. Conventional medical training delays clinical exposure until later years, potentially diminishing students' motivation and confidence. This study aims to evaluate the satisfaction and perception of third-year medical students from the ECE program.
Method: A cross-sectional survey was conducted involving a convenience sample of 93 third-year medical students participating in an ECE program from December to March 2023 in the emergency ward. Data were collected using a validated semi-structured questionnaire, administered immediately after the program and three months later, after the students officially entered the clinical setting. Quantitative and qualitative analyses were conducted to assess students' satisfaction and perceptions.
Results: Out of 93 participants, 80 completed the questionnaire. Most of the students found ECE to be an effective program with a satisfaction rate of over 90% in terms of benefits for the clinical years, helping to adapt to the clinical environment, giving confidence to communicate with supervisors and patients, and taking medical history and physical examination individually or in groups of two or more people. However, results show a significant decrease in the attitude towards the ECE program after entering the hospital (P value = 0.001). Qualitative feedback highlighted the effectiveness of ECE in helping students adapt to the clinical environment, the need for prolonged interaction with supervisors, and the integration of ECE across all courses.
Discussion: The ECE program significantly improved students' initial confidence and adaptability to clinical environments. However, the observed decline in long-term satisfaction suggests a gap between the structured ECE experience and the complexities of real clinical practice. Continuous adaptation and integration of ECE throughout medical training are essential to sustain students' motivation and confidence as they transition to clinical roles.