bluuebunny/crossref_metadata_2025 huggingface dataset:
Effectiveness and Safety of Anti-PCSK9 Treatment in Persons with Hyperlipidemia: A Register-Based Cohort Study
Authors: Andersen Michael , Andreasen Anne Helms , Bang Lia Evi , Solem Espen Jimenez , Petersen Tonny Studsgaard Petersen Studsgaard
Published: July 2023

Addressing dyslipidaemia, a condition involving abnormal amounts of lipids in the blood, is crucial due to its strong association with cardiovascular disease. Anti-proprotein convertase subtilisin/kexin type 9 (PCSK9) drugs like alirocumab and evolocumab offer promising therapeutic solutions. Here we show, from our register-based cohort study in the Capital Region of Denmark (2016–2022), the efficacy and safety of these drugs in 907 persons with dyslipidaemia. Upon treatment initiation, PCSK9 inhibitors showed a substantial 49% reduction in low-density lipoprotein cholesterol (LDL-C) levels. The mandated switch from alirocumab to evolocumab resulted in no significant difference in LDL-C levels or adverse clinical outcomes, such as major cardiovascular events or mortality. Thus, we conclude both alirocumab and evolocumab can be safely and effectively used interchangeably for treating dyslipidaemia.
Plant splicing factor U1C: Evolution and stress-response potential
Authors: Jia Zichang , Wang Junjie , Meng Xiangfeng , Tian Yuan , Wang Baohua , Chen Moxian , Yang Jingfang , Das Debatosh , Cao Yunying
Published: July 2023

Alternative splicing in all organisms proceeds via spliceosomal complex formation involving various small nuclear ribonucleoprotein (snRNP) proteins, and in its early stages, one of the components, called U1C, is deemed essential for 5′ splice site interaction with the U1 snRNP machinery via splice site recognition followed by base pairing. However, a systematic analysis of the U1C gene family in response to developmental cues and stress conditions in plants has not been performed. Basic bioinformatic analysis identified 114 U1C genes in 72 plant species. Comparisons of gene and protein structures, promoter motifs, and tissue- and stress-specific expression levels by phylogenetic analysis revealed their functional commonness or diversity in response to developmental cues such as embryonic expression or under stress treatments such as drought and heat. Moreover, fluorescence quantitative expression analysis showed that U1C gene expression levels changed under salt, low temperature, drought, and cadmium stress in rice seedlings; however, the performance of shoots and roots was not consistent under different stress conditions.
Quantification of Damage and Yield Losses and Management of Meloidogyne Exigua in Arabica Coffee Treated With Biofertilizers, Biopesticides and Chemical Nematicide
Authors: de Figueiredo Maiza Silva , Barbosa Dimmy Herllen Silveira Gomes , Moraes Willian Bucker , Xavier André da Silva , Dutra Íris Petronilia , Chagas Elcio do Nascimento , Júnior Waldir Cintra de Jesus , Alves Fábio Ramos
Published: July 2023

The objective of this work was to verify if biofertilizers, biopesticides and chemical nematicide reduced the population of M. exigua in coffee in 2019 and 2020. The treatments were: T1: Organic biofertilizer containing Bacillus subtilis, B. licheniformis and Lactobacillus sp. (Bio1); T2: Bio1 + Bio1; T3: Bio1 + 100% organic biofertilizer rich in organic matter, humic and fulvic acids (Bio2); T3: Bio1 + Bio2; T4: biopesticide based on B. subtilis and B. licheniformis (Bio3); T5: biopesticide based on Trichoderma harzianum (Bio4); T6: Fluensulfone; T7: Bio1 + Fluensulfone and T8: Control. The experiment was carried out in a field of arabica coffee cv. Catuaí in a randomized block design in an 8x6 factorial scheme (8 treatments x 6 collection periods) with four blocks. The evaluations were carried out at 0, 120, 180, 240, 360 and 420 days after application of the products (DAA). Yield losses and relative efficiency (RE) of the treatments was calculated. The treatment that most reduced the population of M. exigua in the roots was T7 (50.91) and in the soil was T6. The RE ranged from 34.77–45.04%. At 180 and 420 DAA we observed reduction of the nematode in the roots. The highest yields in 2019 were observed in plants treated with T1 and T5, whereas in 2020 it was in plants that received T2, T6 and T7. In 2019, except for T6, all treatments resulted in increased productivity. In 2020, the treatments that brought the most profit to the coffee grower were T6 and T7.
Layered plaques and coronary plaque vulnerability: an optical coherence tomography study
Authors: Yu Zening , Chen Qingjie , Li Xiaomei , Yang Yining
Published: July 2023

Background
Layered plaques are a subclinical sign of plaque rupture or erosion, with plaque vulnerability and can be detected by optical coherence tomography (OCT). The study designed to evaluate the prevalence, angiographic, OCT characteristics of layered plaques in patients with acute coronary syndrome (ACS).
Methods and results
Consecutive ACS patients with 126 coronary culprit lesions underwent coronary angiography (CAG) and pre-intervention optical coherence tomography examination in this study. Patients were divided into layered plaque group (n = 57) and non-layered plaque group(n = 69) based on OCT plaque morphology. Layered plaque is heterogeneous signal-rich layered tissue of different optical signal intensity that close to the luminal surface, clearly demarcated from the underlying components on OCT. Patients with layered plaque were higher statin uptake rate compared to patients with non-layered plaque(P = 0.037). Uric acid (368.613 ± 91.840vs.327.901 ± 76.232µmol/L, P = 0.009) and Indirect bilirubin (IBil) (9.873 ± 5.252vs.8.130 ± 4.039, P = 0.037) level is higher in layered plaque group compare to patient with non-layered plaque. Longer lesion length in the layered plaque group compared with the non-layered plaque group (10(8,12) vs.8(5.5,10.0), P = 0.004). Higher lipid index (1400(631.5,2257) vs.1080(577.5,1455), P = 0.02)), Macrophage accumulation (49.1%vs.33.3%, P = 0.035) and TCFA (68.4%vs. 40.6%, P = 0.002) in the layered plaque group compared with the non-layered plaque group. Results of multivariate analyses showed that Uric acid was independent risk factors of layered plaque in our cohorts (P < 0.05).
Conclusions
This study demonstrate that layered plaques are associated with plaque vulnerability and progression of atherosclerosis at culprit lesions in patient with ACS.
Initial usability evaluation training for clinical engineering students
Authors: Maeda Yoshitaka , Suzuki Satoshi
Published: July 2023

Background
We conducted usability evaluation training among clinical engineering students to determine user dissatisfaction with equipment that was difficult to use, and we verified the effectiveness of the training program.
Methods
We conducted a workshop in which 66 students evaluated the usability of appliances they normally use at home, and they commented on both the good and bad attributes. To verify the effectiveness of usability evaluation training, the comments of 61 students were categorized based on their descriptions, and their levels of comprehensiveness were verified. Additionally, we conducted text mining on 14 students’ comments regarding their impressions of the training program.
Results
Ninety percent of the students commented on the consistency and suitability of the presentation of information on the subject equipment. This represented a statistically significant higher number of comments than that for the other topics. However, the students were least likely to comment on the ease of listening to and viewing information on equipment displays, with 62% of the students commenting on this aspect. The students’ comments regarding their impressions of the training program included the lessons they had learned and specific plans on how they would apply their training in the future.
Conclusions
Students could use the target equipment and evaluate their usability while being aware of their cognitive characteristics and mental models throughout the training period. This training program also contributed to providing students with an interest in usability evaluation, its importance, confidence in usability evaluation, and renewed motivation to learn in the future.
Accuracy and Feasibility in Building A Personalized 3D Printed Femoral Pseudoaneurysm Model For Endovascular Training: A Promising Educational Tool
Authors: Chew Fatt Yang , Lee Suat Yee , Lee Pei Hua , Chew Shen Cheak Currina
Published: July 2023

Objectives:
This study aimed to evaluate the accuracy and feasibility of 3D printing in creating a femoral pseudoaneurysm model based on CT scans for endovascular training.
Methods:
A case of a left femoral pseudoaneurysm was selected, and the 3D model was created using DICOM files imported into Materialise Mimics 22.0 and Materialise 3-Matic software, then printed using vat polymerization technology. Two 3D-printed models were created, and a series of comparisons were conducted between the 3D segmented images from CT scans and these two 3D-printed models. Ten comparisons involving internal diameters and angles of the specific anatomical location were measured.
Results:
The study found that the absolute mean difference in diameter between the 3D segmented images and the 3D printed models was 0.179±0.145 mm and 0.216±0.143mm, respectively, with no significant difference between the two sets of models. Additionally, the absolute mean difference in angle was 0.986±0.649° and 1.003±0.914°, respectively, and the absolute mean difference in angle between the two sets of data was not significant. Bland-Altman analysis confirmed a high correlation in dimension measurements between the 3D-printed models and segmented images. Furthermore, the accuracy of a 3D-printed femoral pseudoaneurysm model was further tested through the simulation of a femoral pseudoaneurysm coiling procedure using the Philips Azurion7 in the angiography room.
Conclusions:
3D printing is a reliable technique for producing a high accuracy 3D anatomical models that closely resemble a patient's anatomy based on CT images. Additionally, 3D printing is a feasible and viable option for use in endovascular training and medical education. In general, 3D printing is an encouraging technology with diverse possibilities in medicine, including surgical planning, medical education, and medical device advancement.
Bombieri–Vinogradov and Barban–Davenport–Halberstam type theorems for special numbers
Authors: Wang Nanxiang , Dai Haobo
Published: July 2023

A number is called special if it has mutually distinct exponents in its canonical prime factorizaton for all exponents. In this paper, we prove Bombieri–Vinogradov and Barban–Davenport–Halberstam type theorems for special numbers. As applications, we get the asymptotic formulae for the Tichmarsh divisor problem for the special numbers and a binary quadratic Titchmarsh divisor problem for the special numbers.
Possibilities to Estimate the Sex of the Fetus in Very Early Pregnancy
Authors: Borowski Jacek , Bulsa Marek , Szczepańska-Przekota Anna , Borowska Julia
Published: July 2023

Background:Ultrasound examination of pregnant women to assess the anatomy and normal developmental parameters of the fetus has been the standard in obstetrics since the 1980s. There are medical situations in which the doctor overseeing the course of the pregnancy should know the sex of the fetus as early as possible. This is particularly true in the case of suspected cases of serious genetic and sex-linked diseases. Advances in medical diagnostics make it possible to diagnose the sex of the fetus as early in pregnancy as possible. However, some of the diagnostic methods used during this period are associated with risks of complications or high costs, which disqualify them as screening methods. This study is part of the current of research on the importance of physical fetal parameters in estimating fetal sex.
Methods: descriptive statistics, regression equations with t-tests and logistic regression model statistics were used. Fetal parameters were analyzed between 5 and 12 weeks of gestation. The sample consisted of 255 pregnant women.
Results: On the basis of CRL, FHR, FV and GSV parameters in 255 pregnant women between 5 and 12 weeks of gestation, attempts were made to build models for estimating the sex of the baby. The combination of gestational week (LMP) and fetal parietal length (CRL) gave the most promising, statistically significant results.
Conclusions: Early diagnosis of fetal sex is important especially in the context of X-chromosome-related genetic diseases. Such a diagnosis can be made with a sufficiently high probability on the basis of an ultrasound examination and the use of appropriate statistical models.
Exploring recent patterns of migration of doctors to the United Kingdom: A mixed-methods study
Authors: Brennan N , Langdon N , Gale T , Humphries N , Knapton A , Bryce M
Published: July 2023

Introduction

A shortage of doctors is currently one of the biggest challenges faced by the healthcare workforce in the United Kingdom (UK). While plans are in place to increase the number of medical school places, in the short-term this gap will need to continue to be filled by the international recruitment of doctors. The aim of this study is to identify key factors that explain the patterns of migration of doctors to the UK, in order to aid the development of policies to recruit and retain a sustainable workforce.

Methods

We analysed General Medical Council (GMC) secondary data on the patterns of migration of internationally trained doctors (2009-2019). Qualitative interviews were conducted with 17 stakeholders by videoconferencing which were audio-recorded, transcribed and thematically analysed using NVivo.

Results

In 2019, 34.5% of UK doctors were trained internationally mainly in India, Pakistan, Italy, Nigeria, Greece, Romania and Egypt. Most new registrations by internationally trained doctors from 2009-2019 did not have a specialty at the time of initial registration (96.2% in 2019). Only a relatively small number of these doctors go on to gain specialist or GP registration (11.6% within 5 years and 27.2% within 10 years of registration). The stakeholder interviews highlighted training opportunities and career progression as the main drivers of migration. The barriers internationally trained doctors face regarding specialty training included differences between UK and destination health systems, systematic bias, bureaucracy and selection processes not being accessible.

Conclusion

This study makes a contribution to the literature by identifying recent patterns in the migration of doctors to the UK. The UK’s dependence on internationally trained doctors has important global implications as source countries are losing skilled health workers which is undermining their health systems. In keeping with the WHO Global Code on the International Recruitment of Healthcare Personnel, policymakers need to consider how to reduce the UK’s reliance on internationally trained doctors, particularly from countries on the safeguard list whilst continuing the drive to increase medical school places. Additional support is required for internationally trained doctors, to ensure that they get on the training programmes they seek, enabling their career progression.
An operational risk assessment method for petrochemical plants based on deep learning
Authors: liu zhipeng
Published: July 2023

Petrochemical plants are an important guarantee for the development of people's lives, and the most important thing in petrochemical plants is the risk assessment method in operations. Based on the research of deep learning algorithms, this paper innovatively proposes a risk assessment method for petrochemical plants based on the combination of human motion simulation based on the micro-Doppler effect and fuzzy hierarchical analysis. The original monitoring image of the petrochemical plant is invoked to identify the target of human movement in the job site and generate the spectral diagram of human movement, and the operation safety risk of the petrochemical plant is assessed through the combination of fuzzy function and hierarchical analysis, which can effectively prevent the illegal actions of the on-site operators and provide protection for the personal safety of the on-site operators. This method plays an important role in improving the safety of petrochemical plants.
Addressing Domestic Violence in Antenatal Care Environments in Nepal (ADVANCE) – Study Protocol for a Randomized Controlled Trial Evaluating a Video Intervention on Domestic Violence among Pregnant Women
Authors: Chalise P , Manandhar P , JJ Infanti , Campbell J , Henriksen L , SK Joshi , Koju R , KD Pun , Rishal P , MR Simpson , Skovlund E , Swahnberg K , Schei B , Lukasse M
Published: July 2023

Background Domestic violence (DV) prior to, and during pregnancy is associated with increased risks for morbidity and mortality. As pregnant women routinely attend antenatal care this environment can be used to offer support to women experiencing DV. We have developed a video intervention that focuses on the use of behavioral coping strategies, particularly regarding disclosure of DV experiences. The effectiveness of this intervention will be evaluated through a randomized controlled trial (RCT) and a concurrent process evaluation.Methods All pregnant women between 12–22 weeks of gestation attending routine antenatal care at two tertiary level hospitals in Nepal are invited to participate. DV is measured using the Nepalese version of the Abuse Assessment Screen (N-AAS). Additionally, we measure participants’ mental health, use of coping strategies, physical activity, and food security through a Color-coded Audio Computer Assisted Self Interview (C-ACASI). Irrespective of DV status, women are randomized into the intervention or control arm using a computer-generated randomization program. The intervention arm views a short video providing information on DV, safety improving actions women can take with an emphasis on disclosing the violence to a trusted person along with utilizing helplines available in Nepal. The control group watches a video on maintaining a healthy pregnancy and when to seek healthcare. The primary outcome is the proportion of women disclosing their DV status to someone. Secondary outcomes are symptoms of anxiety and depression, coping strategies, the use of safety measures and attitudes towards acceptance of abuse. Follow-up is conducted after 32 weeks of gestation, where both the intervention and control group participants view the intervention video after completing the follow-up questionnaire. Additionally, a mixed methods process evaluation of the intervention will be carried out to explore factors influencing the acceptability of the intervention and the disclosure of DV, including a review of project documents, individual interviews, and focus group discussions with members of the research team, healthcare providers, and participants.Discussion This study will provide evidence on whether pregnant women attending regular antenatal visits can enhance their safety by disclosing their experiences of violence to a trusted person after receiving a video intervention.Trial registration The study is registered in ClinicalTrial.gov with identifier NCT05199935.
Spatio-temporal variation and future multi-scenario simulation of carbon storage in Bailong River Basin using GeoSOS-FLUS and InVEST models
Authors: Wang Wanli , Zhang Zhen , Ding Jing , Liu Xiaopeng , Sun Heling , Li Guolong , Deng Chao
Published: July 2023

By providing a scientific foundation for managing regional ecosystem carbon (C) pools, research on the spatial distribution characteristics of regional C stocks can assist in the development of policies on C emissions reduction and sequestration enhancement. Using the GeoSOS-FLUS and InVEST models and explorations of the Bailong River Basin in the past 20 years, the influence of three future scenarios of land use change—natural development (ND), ecological protection (EP) and arable land protection (ALP)—on C storage was modelled. Between 2000 and 2020, there was a gradual increase in C storage in the BRB with a total increase of 5.58 Tg (3.19%), showing notable spatial heterogeneity. The increase in C storage was attributed to land use conversion among woodland, arable land and grassland, with the conversion between woodland and arable land being the primary factor contributing to the increase in C storage. By 2050, C storage under the EP, ALP and NP scenarios was 183.915, 183.108 and 183.228 Tg, respectively. In 2050, C storage under the EP scenario increased by 0.37% compared with that in 2020, and decreased by 0.07% and 0.005% under the ALP and NP scenarios, respectively. In contrast to the other scenarios, the EP scenario prioritised the protection of the woodland and grassland C sinks, which has significant implications for future planning.
Tunnelling of electrons via the neighboring atom
Authors: Yang Weifeng , Zhu Ming , Tong Jihong , Liu Xiwang , Gong Xiaochun , Jiang Wenyu , Lu Peifen , Song Xiaohong , Wu Jian
Published: July 2023

As compared to the intuitive process that the electron emits straight to the continuum from its parent ion, there is an alternative route that the electron may transfer to and be trapped by a neighboring ionic core before the eventual release. Here, we demonstrate that electron tunnelling via the neighboring atomic core is a pronounced process in light-induced tunnelling ionization of molecules by absorbing multiple near-infrared photons. We devised a site-resolved tunnelling experiment using an Ar-Kr+ ion as a prototype system to track the electron tunnelling dynamics from the Ar atom towards the neighboring Kr+ by monitoring its transverse momentum distribution, which is temporally captured into the resonant excited states of the Ar-Kr+ before its eventual releasing. The influence of the Coulomb potential of neighboring ionic cores promises new insights into the understanding and controlling of tunnelling dynamics in complex molecules or environment.
Continuous shear wave measurements for dynamic cardiac stiffness evaluation in pigs
Authors: Caenen Annette , Keijzer Lana , Bézy Stéphanie , Duchenne Jürgen , Orlowska Marta , Steen Antonius F. W. , Jong Nico , Bosch Johan G. , Voigt Jens-Uwe , D’hooge Jan , Vos Hendrik J.
Published: July 2023

Ultrasound-based shear wave elastography is a promising technique to non-invasively assess the dynamic stiffness variations of the heart. The technique is based on tracking the propagation of acoustically induced shear waves in the myocardium of which the propagation speed is linked to tissue stiffness. This measurement is repeated multiple times across the cardiac cycle to assess the natural variations in wave propagation speed. The interpretation of these measurements remains however complex, as factors such as loading and contractility affect wave propagation. We therefore applied transthoracic shear wave elastography in 13 pigs to investigate the dependencies of wave speed on pressure-volume derived indices of loading, myocardial stiffness, and contractility, while altering loading and inducing myocardial ischemia/reperfusion injury. Our results show that diastolic wave speed correlates to a pressure-volume derived index of operational myocardial stiffness (R = 0.75, p < 0.001), suggesting that both loading and intrinsic properties can affect diastolic wave speed. Additionally, the wave speed ratio, i.e. the ratio of systolic and diastolic speed, correlates to a pressure-volume derived index of contractility, i.e. preload-recruitable stroke work (R = 0.67, p < 0.001). Measuring wave speed ratio might thus provide a non-invasive index of contractility during ischemia/reperfusion injury.
Construction and evaluation of a 180-day readmission prediction model for chronic heart failure patients based on sCD40L
Authors: Zhang Peng , Lin Hui , Meng Liping , Xing Yangbo , Peng Fang
Published: July 2023

Background
The high readmission rate of patients with chronic heart failure can cause waste of medical resources and economic losses. Establishing an effective heart failure readmission model can effectively alleviate medical pressure and improve the quality of treatment.
Methods
In this study, we conducted a comprehensive analysis of clinical and laboratory data from 248 patients with chronic heart failure who received treatment at our medical center between January 2021 to January 2023. We also measured sCD40L levels to determine their association with readmission due to heart failure during follow-up. To analyze the data, we employed various statistical methods including independent sample t-test, correlation analysis, univariate COX regression, and LASSO COX regression. Using these techniques, we organized the data and constructed a predictive model that was both trained and validated.
Results
We developed a nomogram to assess the likelihood of readmission within 180 days for patients with chronic heart failure. Our findings revealed that monocytes, creatinine, sCD40L, and hypertension history were all independent risk factors for 180-day heart failure readmissions. Additionally, our model's area under the curve was 0.731 in the training dataset and 0.704 in the validation dataset.
Conclusion
This study provides new insights for predicting readmission within 180 days for patients with chronic heart failure. And sCD40L is an important predictive indicator for readmission of heart failure patients within 180 days, and clinical doctors can develop appropriate treatment plans based on sCD40L.
Nurses’ Competency on Electrocardiography Interpretation in Adult Emergency Room: Addis Ababa, Ethiopia, 2021. Multicenter Cross-sectional Study
Authors: Belay Yegremew Haimanot , Gezahegn Demmelash , Melaku Birhanu , Tegegne ousman adal
Published: July 2023

Background: Electrocardiography is a graphic representation of the electrical activity of the heart. According to previous literature, nurses have poor knowledge and skills about basic electrocardiography interpretation. For instance, a previous survey conducted in Turkey showed that only 38.1 percent of nurses were able to recognize ventricular fibrillation, 54.3% myocardial infarction, and 33.3% third-degree atrioventricular block.
Objective: This study was aimed at assessing Nurses’ competency in electrocardiography interpretation in adult emergency rooms in Addis Ababa, Ethiopia, in 2021.
Method: An institutional-based descriptive, cross-sectional study design was used to conduct the study. A total of 175 nurses in five randomly selected hospitals with adult emergency rooms were included in this study. Semi-structured, self-administered questionnaires were used to collect the data. Data were entered into Epi data and analyzed using SPSS version 26. A Fisher’s exact test was used to identify the relationship between dependent and independent variables.
Results: Of 203 respondents, 175 actively participated, for a response rate of 86.2%. From those 175 nurses, 159 (90.9%) were not competent (scored < 65%), and the mean score was 6.82 ± 3.65 SD.
Conclusion: The overall level of competency of nurses in electrocardiography interpretation is low. This implies most nurses in the emergency room do not monitor and manage a patient's electrocardiography for manifestations of arrhythmias, electrolyte disturbance and other cardiac abnormalities. Level of education and training were a determinant factor to enhance their competency.
Biomimetic supramolecular protein matrix restores structure and properties of human dental enamel
Authors: Mata Alvaro , Hasan Abshar , Chuvilin Andrey , Teijlingen Alexander , Parmenter Christopher , Venturi Federico , Fay Mike , Greco Gabriele , Pugno Nicola , Ruben Jan , Edwards-Gayle Charlotte , Myers Benjamin , Dreveny Ingrid , Cowieson Nathan , Winter Adam , Gamea Sara , Walboomers X. Frank , Hussain Tanvir , Rodríguez-Cabello José Carlos , Rawson Frankie , Tuttle Tell , Elsharkawy Sherif , Banerjee Avijit , habelitz Stefan
Published: July 2023

The authors have requested that this preprint be removed from Research Square.
A National Audit of Facilities, Human and Material Resources for the Comprehensive Management of Diabetes Mellitus in Ghana-A 2023 Update
Authors: Yorke Ernest , Akpalu Josephine , Johnson Gwendolyn de-Graft , Atiase Yacoba , Reynolds Margaret , Laryea Ruth , Tetteh John , Yawson Alfred E. , Amoah Albert G. B
Published: July 2023

Background
It is expected that Sub-Saharan African countries are expected to experience the largest increases in the prevalence and complications of diabetes by the year 2045. However, the human and material resources as well as the systems for managing diabetes in Africa are inadequate.
Thus, this study or needs assessment, aimed at updating the human and material resources, identifying the gaps and unmet needs for comprehensive diabetes care in Ghana.
Methods: We conducted a national audit of 122 facilities in all 16 administrative regions of Ghana comprising 6 Teaching, 10 Regional, 100 Municipal/District Hospitals, and 6 private and quasi-government hospitals. Information obtained covered areas on personnel and multidisciplinary teams, access to medications, access to laboratory services, financing, screening services, management of diabetes complications, and availability/use of diabetes guidelines or protocols. Data was analysed using STATA version 16.1. P-values <0.05 were set as significant.
Results:
Only 85(69.7%) out of the 122 surveyed facilities had a dedicated centre or service for diabetes care. Twenty-eight (23%) had trained diabetes doctors/specialists; and whilst most centres had ophthalmic nurses and dieticians, majority of them did not have trained diabetes educators (nurses), psychologists, ophthalmologists, podiatrists, and foot/vascular surgeons. Also, 13.9% had monofilaments, none could perform urine dipstick for microalbumin; 5 (4.1%) and just over 50% could perform laboratory microalbumin estimation and glycated haemoglobin respectively. Access to and supply of human insulins was better than analogue insulin in most centres. Nearly 100% of the institutions surveyed had access to metformin and sulphonylurea with good to excellent supply in most cases, whilst access to Sodium Glucose Transporter-2 inhibitors and Glucagon-like peptide-1 analogues were low, and moderate for Dipeptidyl peptidase-4 inhibitors and thiazolidinediones.
Overwhelming majority of the health facilities (95.1%) offered NHIS as payment mechanism for clients, whilst 68.0% and 30.3% of the patients paid for services using out-of-pocket and private insurance respectively. Also, 91.8% surveyed used the National Treatment Guideline in their practice and 15 (12.3%) had Diabetes Support Groups in their locality and catchment areas.
Conclusion: Significant gaps remain in human and material resources, which requires urgent multisectoral collaboration to promote and achieve acceptable comprehensive diabetes care.
Unlocking Sub-Saharan Africa's Export Potential: A Reassessment of the Influence of Manufacturing Firms Access to finance
Authors: Oduola Musa Olanrewaju
Published: July 2023

Enhancing sub-Saharan Africa's manufacturing exports is an imperative necessity, given its numerous economic and developmental benefits. While significant scholarly contributions have explored the factors influencing firms' exporting activities, further research is needed to deepen our understanding of the access to finance perspective. Despite previous studies examining the link between access to finance and exporting activities, a lack of consensus persists in the existing literature. Moreover, the majority of these studies have focused primarily on formal finance, neglecting the role of informal finance. Therefore, this study fills this gap by investigating the impact of access to finance on the exporting activities of manufacturing firms in sub-Saharan Africa. The World Bank Enterprise Survey data for 38 sub-Saharan African countries is utilised to measure firm exporting, employing the extended probit regression model for empirical testing. The findings reveal a direct relationship between access to formal finance and manufacturing firms' exports, indicating that improved access to formal finance increases the likelihood of exporting for firms in sub-Saharan Africa. We found a similar result for the effect of access to informal finance. To ensure the robustness of our results, we employ alternative measures of firm exporting in terms of export value and apply instrumental variable Tobit and Heckman selection two-step regression models. The results remain consistent with our initial findings. Based on these findings, policy recommendations are provided to support and enhance manufacturing exports in sub-Saharan Africa.
JEL Classification: C36, D22, F14, G23, L60, M20
Exploring Nonlinear Optical Properties of Perylene Diimide Derivatives and Biomolecules: A Computational Supramolecular Study
Authors: Hussain Wajid , Iqbal Muhammad Shahid , Bashir Muhammad Rashid , Khan Maroof Ahmad , Ali Hafiz Saqib , Hanif muhammad
Published: July 2023

This study investigates the supramolecular interactions between perylene diimides (PDI) and nucleotides, specifically adenosine monophosphate (AMP) and cytidine monophosphate (CMP). The study uses five PDIs (L6, L7, L8, L9, L10) that were previously studied. Ten complexes (complex 1 (L-ala-PDI-AMP), complex 2 (B-ala-PDI-AMP), complex 3 (GLY-PDI-AMP), complex 4 (IMI- PDI -AMP), complex 5 (PYR-PDI-AMP, complex 6 (L-ala-PDI-CMP), complex 7 (B-ala-PDI-CMP), complex 8 (GLY-PDI-CMP), complex 9 (IMI-PDI-CMP), and complex 10 (PYR-PDI-CMP) labeled 1-10, were obtained using the B3LYP/6-31G basis set, and their weak interactions were studied through Density Functional Theory (DFT). The study aimed to optimize the supramolecular complexes formed between PDI and nucleotides by placing the molecules parallel to each other without bond formation before the optimization process. The study explores the properties of these complexes through various methods such as NMR, IR, UV, Hyperpolarizabilities, frontier molecular orbitals (FMOs), density of states (DOS), noncovalent interactions (NCI), Iso-surface analysis, atom in molecule (AIM), dipole moment (µ), electron density distribution map (EDDM), transition density matrix (TDM), Molecular electrostatic potential (MEP), and Electron-hole analysis (EHA) using DFT. The weak bonds formed among PDI and nucleotide in all ten complexes were visualized using Discovery Studio Visualizer. The electronic properties of the complexes were examined through Natural Bond Orbital (NBO) and Natural Population Analysis (NPA), leading to Non-Linear Optics (NLO) study. The study provides insight into the nature of weak interactions between PDI and nucleotide, as well as the electronic properties of these complexes, which could have implications for future studies in the field of supramolecular chemistry.
PMSM Sliding Mode Control Based on Improved Reaching Law
Authors: Wang Shijiao , jiang chengming , Tu Qunzhang , Zhu Changlin
Published: July 2023

This paper proposes a novel adaptive reaching law-based sliding mode control (SMC) method for maintaining favorable velocity control performance of permanent magnet synchronous motors (PMSMs) under internal and external perturbations. A new sliding mode reaching law (NSMRL) is designed, which contains adaptive terms and state variables of the sliding mode surface function. This augmented reaching law decreases the chatter of the control system and increases the rate at which the state variables of the system reach the sliding mode surface. Additionally, a Luenberger observer load torque (LOLT) is designed to observe the external load and provide feedback to the velocity controller, reducing the impact of load disturbances and improving the jamming performance of the controller. Simulation experiments confirm that NSMRL reduces buffeting, decreases overshoot, and shortens response time, demonstrating its advantages in PMSM control.
Physiological uptake characteristics of breast on 68Ga-FAPI-04 PET
Authors: Zhang Yue , Zhou Yushan , Tian Rong , Su Minggang
Published: July 2023

Purpose Gallium 68 (68Ga)-labeled fibroblast activation protein inhibitor (FAPI) PET is sensitive on breast cancer staging, but its clinical utility may be limited by the high physiological FAPI uptake in normal breast tissue that can obscure primary tumors. The aim of this study was to elucidate the characteristics of physiological 68Ga-FAPI-04 uptake in normal breast.Procedures A total of 143 consecutive women with 68Ga-FAPI-04 PET were reviewed retrospectively. SUVmax, density and thickness of breast gland, as well as SUVmax of nipple, were measured. Univariate and multivariate regression analyses were used to identify factors related to the breast and nipple SUVs.Results Twenty-eight premenopausal, 62 menopausal and 10 post-operative (after bilateral adnexectomy) women with 103 examinations were included. All had a diffuse, symmetrical uptake in breast gland. There was no difference in FAPI uptake between bilateral breasts (P = 0.253). Patients in menstrual status with expected high estrogen level (late follicular, ovulatory and mid luteal phases) had higher breast SUVs (median, 3.91) than those with expected moderate (early follicular, early luteal and late luteal phases; median, 1.57; P < 0.001) or low level (menopause and post-operation; median, 0.98; P < 0.001). Menstrual status was an independent predictors of breast SUV (r2 = 0.689, P < 0.001). All the patients had a focal, symmetrical uptake in nipples. Nipple SUV did not correlate with menstrual status (P = 0.913).Conclusion Physiological breast FAPI uptake levels are related to menstrual status. Premenopausal patients with breast lesions should be examined 68Ga-FAPI-04 PET during the perimenstrual period (five days before and during menstruation).
Research on preprocessing and recognition of surface defects of chip package
Authors: Wang Zhirui , Xu Lijun
Published: July 2023

In the process of chip production and transportation, the surface of the package body is prone to various defects, and these defects will have a certain impact on the quality of the chip. Therefore, in order to ensure the quality of the chip products and meet the needs of relevant industries, it is necessary to use certain technical equipment and algorithms to achieve efficient acquisition and processing of the chip image and timely and accurately identify the defects on the chip surface. In this study, a series of pre-processing including gray-scale, geometric correction, region segmentation and enhancement, threshold segmentation and noise reduction are carried out on the collected chip images. Secondly, an effective method of scratch determination and character segmentation is proposed to realize the feature extraction of scratch and character on the surface of the chip package. Then recognition of the position and size of the scratch is realized by using the centroid coordinates, boundary and roundness of the connected domain of the scratch binary image. Finally, convolutional neural network is used to establish the character data set, adjust the network frame and parameters, and train a model with a recognition rate of 90.63%. The research content and results of this paper have certain reference significance for ensuring chip quality.
Biosynthesis of Fe3O4 Nanoparticles mediated Allium cepa extract: Chemical characterization and antimicrobial applications
Authors: K. AL-Salman H. N. , Qasim Qutaiba A. , Abbas Basil A. , Hussein Adel J. , Shari Falah Hassan , Jabir Majid S. , Albukhaty Salim , Sulaiman Ghassan M. , Garadi Maged A. Al , Swelum Ayman A
Published: July 2023

Scientists have become more interested in the use of plant extracts as efficient capping and reducing agents for the environmentally friendly fabrication of nanoparticles. In the current study, the Iraqi onion extract (Allium cepa) was prepared and subsequently used as a reducing agent for the biosynthesis of Fe3O4 nanoparticles. UV-visible, FT-IR, XRD, TEM, FESEM, and EDS investigations were used to characterize nanoparticles. The in vitro cytotoxicity of both A. cepa extract and Fe3O4 NPs was evaluated in MDCK-SIAT cells using the MTT test, and the antiviral activity of Fe3O4 NPs was investigated using the Neuraminidase Assay Kit MAK12. The antibacterial activities of A. cepa extract and Fe3O4 NPs were investigated against S. aureus, and E. coli using a disk-diffusion approach. Our results showed the generation of stable, crystalline, and semi-spherical, 36 ± 1.23 nm-sized Fe3O4 nanoparticles, and had strong antibacterial, and antiviral activities, assuming that onion peel extract is an excellent choice for producing Fe3O4 nanoparticles, which may be utilized in the future for a range of therapeutic objectives.
Evaluating the impact of engaging older adults and service providers as research partners in the co-design of a community mobility-promoting program: A multi-method developmental evaluation study
Authors: MacNeil Maggie , Abelson Julia , Moore Caroline , Lindsay Shazelle , Adams Janet , Alshaikhamed Aref , Jain Kamal , Petrie Penelope , Ganann Rebecca
Published: July 2023

Background: Increasingly researchers are partnering with citizens and communities in research; less is known about research impacts of this engagement. EMBOLDEN is an evidence-informed, mobility-promoting intervention for older adults co-designed by a 28-person Strategic Guiding Council (SGC) of health/social service providers and older adult citizens. This study evaluated research partners’ perceptions of engagement strategies, the engagement context, strengths, areas for improvement, as well as the impacts of the guiding council on older-adult identified priority areas.
Methods: This study was guided by developmental evaluation, working in partnership with four older adult SGC members who helped to set evaluation priorities, decide methods, and adapt patient-centred evaluation tools. Data sources included a survey, focus groups and document analysis of meeting notes from 16 SGC meetings that took place between December 2019 and February 2022. A thematic approach to analysis guided the coding of focus group transcripts and SGC meeting notes.
Results: Of 26 SGC members, nine completed the evaluation survey, and five participated in focus groups. Around two thirds of the SGC commonly attended each meeting. EMBOLDEN’s SGC was structured to include a diverse group (across gender, ethnicity and discipline) of older adults and service providers, which was perceived as a strength. Engagement processes were perceived as inclusive and well-facilitated, which stimulated discussion at meetings. Advantages and disadvantages of engaging with the SGC virtually, as compared to in-person (as was the case for the first 3 SGC meetings) were also discussed. Impacts of the SGC were identified across preparatory, execution phase and translational stages of research. Impacts of SGC involvement on members were also described.
Conclusion: Older adult research partners played an important role designing, implementing, and evaluating co-design approaches in this study. Older adults and service providers can make important contributions to the design, delivery and sharing results of health research through their lived expertise and connections to community. This project contributes to the growing field of citizen and community engagement in research by offering a participatory approach to engagement evaluation that considers diversity, satisfaction, and impact.
A Simple AVX to PIM Vectorizer (SAPIVe)
Authors: Sokulski Rodrigo M. , Santos Paulo C. , Santos Sairo R. dos , Alves Marco A. Z.
Published: July 2023

The growing data demands in modern applications aggravated persistent problems in computer architecture, such as the Memory Wall. Processing-In-Memory(PIM) devices emerged as an alternative to mitigate these problems, approaching processing and storage units to reduce data traffic between processors and memory. Literature and industry proposed different PIM designs and a prominent approach aims to expose memory bandwidth by placing large Single Instruction-Multiple Data (SIMD) or vector units in memory. One method to use these new processing units is runtime binary translators. Simple AVX to PIM Vectorizer(SAPIVe) provides transparency to the users and specific software independence by adopting a hardware-based binary translator to convert the application’s vector instructions to PIM instructions. In this work, the authors expand SAPIVe evaluations, explanations, and discussions, seeking to deepen the description of the mechanism and improve the understanding of its behavior and performance.
Causal associations between type 2 diabetes mellitus and chronic hepatitis C: A bidirectional Mendelian randomization study of East Asians
Authors: ke jianji , Liu Feiqi , Ji Bai
Published: July 2023

Observational studies have shown a bidirectional relationship between type 2 diabetes mellitus (T2DM) and chronic hepatitis C (CHC). However, the causal relationship remains unknown. We explored the connection between T2DM and CHC in East Asians utilizing Mendelian randomization (MR). Two-sample bidirectional MR was applied to summarized statistics from genome-wide association studies. The inverse variance-weighted method, weighted-median method, MR-Egger regression, weighted mode, simple mode, heterogeneity test, pleiotropy test, and MR-PRESSO were employed for MR analysis. Results of various methods revealed an inverse relationship between T2DM and CHC, with an odds ratio (OR) (95% confidence interval [CI]) of 0.906 (0.858–0.957; P=0.00037), 0.825 (0.732–0.931; P=0.0025), 0.882 (0.808–0.962; P=0.00484), and 0.862 (0.772–0.961; P=0.00922) from inverse variance-weighted, MR-Egger, weighted median, and weighted mode, respectively. Further, no heterogeneity or directional pleiotropy was identified in Cochran’s Q test and Egger’s intercept. In the backward MR analysis, the P-values were all not statistically significant, indicating no detectable connection between CHC and T2DM. Finally, there was no proof of a connection involving blood sugar levels, hemoglobin A1c levels, and CHC risk. This large MR analysis revealed that T2DM had an inverse relationship with CHC, while CHC had no causality with T2DM.
Transforming Healthcare Systems with Artificial Intelligence: Revolutionizing Efficiency, Quality, and Patient Care
Authors: Ahmed Abatal , Adil Korchi
Published: July 2023

Artificial intelligence (AI) has revolutionized healthcare systems, offering oppor- tunities to enhance efficiency, improve quality of care, and optimize patient outcomes. This article explores the applications of AI in healthcare, focusing on medical imaging, predictive analytics, and personalized medicine. We discuss the potential benefits, challenges, and ethical considerations associated with AI integration. Additionally, we present real-world examples and case studies to demonstrate the impact of AI algorithms in healthcare. The findings highlight the ability of AI to improve diagnostic accuracy, streamline processes, and enable personalized treatment plans. This article contributes to the growing body of knowledge on AI in healthcare, emphasizing the transformative potential of AI technologies in enhancing healthcare systems.