bluuebunny/crossref_metadata_2025 huggingface dataset:
Pengaruh Efikasi Diri dan Kualitas Kehidupan Kerja Terhadap Komitmen Organisasi pada Perusahaan bidang Telekomunikasi
Authors: Rangga Putra Firdaus  , Susita Dewi , Agung Wahyu Handaru
Published: April 2023

The aims of this study are: 1) To find out the description of self-efficacy, quality of work life and organizational commitment at company "X". 2) To determine the effect of self-efficacy on the organizational commitment of the company "X". 3) To determine the effect of the quality of work life on the organizational commitment of the company "X". This research was conducted on 113 employees of company "X". The data collection technique used a survey method through distributing questionnaires and processed using SPSS (Statistical Product and Service Solutions) version 25 as software for processing and analysis. This research uses descriptive analysis. The results obtained from the regression analysis show that there is a positive and significant effect between self-efficacy and quality of work life on organizational commitment. The self-efficacy model and the quality of work life simultaneously have a significant effect on organizational commitment to employees of Company "X" with a value of Fcount > Ftable 19,830 > 3,079 and the significance value obtained is smaller than 0.05, namely 0.000 < 0.05.

 

Tujuan penelitian ini adalah: 1) Untuk mengetahui deskripsi dari efikasi diri, kualitas kehidupan kerja dan komitmen organisasi pada perusahaan “X”. 2) Untuk mengetahui pengaruh dari efikasi diri terhadap komitmen organisasi perusahaan “X”. 3) Untuk mengetahui pengaruh dari kualitas kehidupan kerja terhadap komitmen organisasi perusahaan “X”. Penelitian ini dilakukan kepada 113 orang karyawan perusahaan “X”. Teknik pengumpulan data menggunakan metode survei melalui penyebaran kuesioner dan diolah menggunakan SPSS (Statistic Product and Service Solutions) versi 25 sebagai perangkat lunak dalam pengolahan dan analisis. Penelitian ini menggunakan analisis deskriptif. Hasil yang didapat dari analisis regresi menunjukkan terdapat pengaruh positif dan signifikan antara efikasi diri dan kualitas kehidupan kerja terhadap komitmen organisasi. Model efikasi diri dan kualitas kehidupan kerja berpengaruh signifikan secara simultan terhadap komitmen organisasi pada karyawan Perusahaan “X” dengan nilai Fhitung > Ftabel 19,830 > 3,079 dan nilai signifikansi yang didapat lebih kecil dari 0,05 yaitu 0,000 < 0,05.
Effectiveness of Zero Based Waste Management Policy in Realizing a Clean Gresik Regency
Authors: Hertati Diana , Nurhadi  , Tukiman
Published: April 2023

The development of the population in an area and the existence of socio-economic activities will have an impact on increasing the type and amount of waste that will threaten the regional ecosystem. The empirical facts still reflect that waste management is not optimal with the high amount of waste entering the Ngimpik TPST, so that effective waste management is needed in realizing Gresik Regency as a clean city. This study aims to describe the Effectiveness of Waste Management based on "Zero Waste" in Creating a Clean Gresik Regency. This type of research uses a qualitative descriptive approach. Sources of data in this research include primary data and secondary data. Qualitative analysis from Miles and Huberman is used to analyze the data which includes four components, namely: data collection, data condensation, data presentation and drawing conclusions. The results of this research show that the effectiveness of the zero waste-based waste management policy at the Ngimpik TPA is quite effective. Adjustment of needs with waste management innovations that continue to be improved so that problems can be resolved. The main obstacles are the inadequate facilities and infrastructure and the lack of public awareness to reduce waste generation so that waste can be controlled, and the landfill burden will be reduced.
Impact of a Simulation-based Education Approach for Health Sciences: Demo, Debrief, and Do
Authors: Orsega-Smith Elizabeth , Leonard Tara , Ruggiero Laurie , Amato Nicolette , O'Hara Jamie
Published: April 2023

Background:Skill-based practice is important for individuals to incorporate into students' learning and can be challenging in large classes. Simulation-based education (SBE) is a method where students can learn and practice skills to use in real world settings with assistance of peer coaching. The COVID-19 pandemic presented challenges to providing students with sufficient SBE. The purpose of this paper is to: a.) describe a SBE approach for health coaching referred to as “Demo, Debrief, and Do” (DDD), b.) discuss how this approach became important in COVID-19 classroom experiences, c.) describe the impact of DDD activity on students in a health sciences curriculum. DDD is a collaborative activity where graduate health coaching students demonstrate coaching skills, debrief their demonstration, and support undergraduate students to demonstrate (or do) their own coaching skills in a small virtual online setting.
Methods: Qualitative feedback from 121 undergraduate students enrolled in 3 sections of a behavior change strategies course and quantitative surveys to examine their confidence in applying the skills and overall satisfaction with DDD were gathered.
Results: The overall average confidence level following the lab was 31.7 (0-35). The average satisfaction level following the lab was 23.3 (0-25 range). The most common highlight described was observing the coaching demonstration followed by “debrief” and “do”.
Conclusion: The (DDD) simulation approach fulfilled an educational need during the COVID 19 pandemic and filled a gap in offering SBE opportunities for both graduate and undergraduate students while learning effective client-communication skills health coaching delivery.
Influence of Hall and Slip on MHD Reiner-Rivlin blood flow through a porous medium in a cylindrical tube
Authors: Yasin M. , Hina Sadia , Naz R.
Published: April 2023

The current study aims to scrutinize the peristalsis of magnetohydrodynamics Reiner-Rivlin fluid model in a cylindrical tube through porous medium. The basic equations, including momentum, heat, and concentration are tackled in the valuable presence of Hall current, Joule heating, viscous-dissipation, and Soret effects. Moreover, slip effect is also entertained. The considered system is simplified by approximating with long wavelengths and very low Reynolds numbers. Perturbation technique is chosen to obtain the closed form analytical solutions. The impact of influential parameters is presented through plots and physically discussed in detail. The main conclusions of this work are that the velocity and temperature fields exhibit opposite behavior for the Hartman number and Hall parameter. The slip parameter has minimizing impact on velocity distribution. The fluid velocity tends to increase when Reiner-Rivlin fluid parameter is incremented. The Darcy number has upgrading impact on fluid temperature. The solute concentration minifies when slip parameter is incremented. It can be visualized that size of trapped bolus becomes larger on increasing the value of Hall and slip parameter.
How to update a living systematic review and keep it alive during a pandemic: a practical guide
Authors: Heron Leonie , Buitrago-Garcia Diana , Ipekci Aziz Mert , Baumann Rico , Imeri Hira , Salanti Georgia , Counotte Michel Jacques , Low Nicola
Published: April 2023

Background
The covid-19 pandemic has highlighted the role of living systematic reviews. The speed of evidence generated during the covid-19 pandemic accentuated the challenges of managing high volumes of research literature.
Methods
In this article, we summarise the characteristics of ongoing living systematic reviews on covid-19 and we follow a life cycle approach to describe key steps in a living systematic review.
Results
We identified 97 living systematic reviews on covid-19, which focused mostly on the effects of pharmacological interventions (n = 46, 47%) or the prevalence of associated conditions or risk factors (n = 30, 31%). The scopes of several reviews overlapped considerably. Most living systematic reviews included both observational and randomised study designs (n = 45, 46%). Only one third of the reviews has been updated at least once (n = 34, 35%). We address practical aspects of living systematic reviews including how to judge whether to start a living systematic review, methods for study identification and selection, data extraction and evaluation, and give recommendations at each step, drawing from our own experience. We also discuss when it is time to stop and how to publish updates.
Conclusions
Methods to improve the efficiency of searching, study selection, and data extraction using machine learning technologies are being developed, their performance and applicability, particularly for reviews based on observational study designs should improve, and ways of publishing living systematic reviews and their updates will continue to evolve. Finally, knowing when to end a living systematic review is as important as knowing when to start.
WNT and VEGF/PDGF signaling regulate self-renewal in primitive mesenchymal stem cells
Authors: Mazzella Matteo , Walker Keegan , Cormier Christina , Kapanowski Michael , Ishmakej Albi , Saifee Azeem , Govind Yashvardhan , Chaudhry G. Rasul
Published: April 2023

Background
Therapeutic use of multipotent mesenchymal stem cells (MSCs) is hampered due to poor growth and limited self-renewal potential. The self-renewal potential of MSCs is also affected during propagation and changes are poorly understood. This study investigated the molecular mechanism involved in the self-renewal of primitive (p) MSCs.
Methods
pMSCs were cultured to low passage (LP), P3, and high passage (HP), P20, in fetal bovine serum medium (FM) and xeno-free medium (XM). The characteristics of LP and HP pMSCs were evaluated for morphology, expression of cell surface markers, doubling time (DT), colony forming efficiency (CFE), proliferation by BrdU assay, telomerase activity and trilineage differentiation. We then examined transcriptome and nucleosome occupancies using RNA-seq and MNase-seq, respectively analyses.
Results
pMSCs grown in FM gradually changed morphology to large elongated cells and showed a significant reduction in the expression of CD90 and CD49f, CFE, proliferation, and telomerase activity. In addition, cells had a greater propensity to differentiate into the adipogenic lineage. In contrast, pMSCs grown in XM maintained small fibroblastoid morphology, self-renewal, and differentiation potential. Transcriptomic analysis showed upregulation of genes involved in self-renewal, cell cycle, and DNA replication in XM-grown pMSCs. Whereas senescence genes were upregulated in cells in FM. MNase-seq analysis revealed less nucleosomal occupancies in self-renewal genes and senescence genes in pMSCs grown in XM and FM, respectively. The expression of selected genes associated with self-renewal, cell cycle, DNA replication, differentiation, and senescence was confirmed by qRT-PCR. These results led us to propose signaling pathways involved in the self-renewal and senescence of pMSCs.
Conclusion
We conclude that the self-renewal potential of pMSCs is controlled by WNT and VEGF/PDGF, but TGFβ and PI3K signaling induce senescence.
Unique Properties of Clinical Manifestation and Magnetic Resonance Imaging for Differential Diagnosis of Optic Nerve Hemangioblastoma
Authors: Liu Hongjuan , Yang Bentao , Chen Yue , Guo Sitong , jiang libin
Published: April 2023

Background
To investigate the unique properties of clinical manifestation and radiological imaging for differential diagnosis of optic nerve hemangioblastoma (ONH) from adult optic nerve glioma (ONG) prior to surgical resection.
Methods
ONH and adult ONG patients were recruited from 2012 to 2022.
Results
A total of seven ONH patients (8 eyes) and 23 adult ONG patients (24 eyes) were assessed. The median onset age of ONH patients (39 years) was older than that of adult ONG patients (27 years) (p = 0.007). 42.9% of ONH patients were closely associated with the diagnosis of VHL syndrome. Notably in MRI, the retrobulbar hemangioblastomas in all ONH patients were primarily intraorbital (100%) and canalicular (87.5%), and anterior intracranial (12.5%), especially concentrated in the orbital apex, with little posterior optic pathway involvement. Nearly all affected parts of optic nerve in the ONH group (6/8, 75.0%) presented with circumscribed cyst-solid components, characterized by cystic lesions in the front (peritumoral edema) and solid tumors in the back. The tumor presented typically with hypo- or isointense on the non-contrast T1-weighted images, and hyper- or isointense on the T2-weighted images (hyperintense pretumor cystic lesion, slight hyper-/isointense solid lesion), and the solid part appeared with significant heterogeneous enhancement.
Conclusion
Optic nerve tumors in those with older ages (> 30 years) or those diagnosed with VHL syndrome are more likely to be indicative of ONH. In the absence of associated VHL syndrome, MRI images presenting with circumscribed cyst-solid components (peritumoral edema and posterior solid tumor) especially concentrated in the orbital apex, with a heterogeneous enhancement of the solid part in the postcontrast study, is the unique property of ONH for differentiation.
Chromosomal polymorphisms and susceptibility to menstrual disorders: a retrospective analysis of 24,578 wemen
Authors: Cheng Ran , Luo Xiaoyan , Zhou Wenjie , Zhou Xiaoyang , Nie Ying , Qiao Xiaoyong , Yang Zhilan , Xu Liang zhi
Published: April 2023

Purpose To evaluate the association between the polymorphic variants of chromosomes and menstrual disorders.Methods The data from our previous retrospective, single-center cohort study were re-analyzed. Women with regular menstruation were included as controls. Women with menstrual cycle abnormalities were subgrouped according to reproductive causes. Frequency of chromosomal polymorphisms were compared between groups. Regression analysis were used to adjust for potential confounding variables.Result A total of 24,578 women composing of 8,062 women with regular cycles as the control group and 16,516 women as the menstrual cycle irregularity group were included. When compared with control group, the incidence of chromosomal polymorphisms in the total menstrual cycle irregularity group, Polycystic ovary syndrome group and Primary ovarian insufficiency group were significantly higher (4.49% versus 5.34%, P = 0.004, 4.49% versus 5.35%, P = 0.018 and 4.49% versus 5.94%, P = 0.002, respectively). The incidences of inv(9) in Primary ovarian insufficiency group were significantly higher than that in the control individuals (1.0% versus 1.6%, P = 0.024). Logistic regression analysis showed an effect of chromosomal polymorphisms on menstrual cycle irregularity (OR: 1.62, 95%CI: 1.234–2.187, P = 0.007; adjusted OR: 1.46, 95%CI: 1.153–1.819, P < 0.001). The result demonstrated an effect of chromosomal polymorphisms on Primary ovarian insufficiency group (OR: 2.52, 95%CI: 1.307–5.177, P < 0.001; adjusted OR: 2.61, 95%CI: 1.371–4.605, P < 0.001).Conclusion The study suggests chromosomal polymorphisms adversely affect female menstrual cycle irregularity.
Estimating and displaying population attributable fractions using the R package graphPAF
Authors: Ferguson John , O'Connell Maurice
Published: April 2023

graphPAF is a comprehensive R package designed for estimation, inference and display of population attributable fractions (PAF)s and impact fractions. In addition to allowing inference for standard PAFs and impact fractions, graphPAF facilitates display of PAFs over multiple risk factors using fan plots and nomograms, calculations of PAFs for continuous exposures, inference for PAFs appropriate for specific risk factor → mediator → outcome pathways (pathway-specific PAFs) and Bayesian network based calculations and inference for joint, sequential and average PAFs in scenarios where multiple risk factors are of interest. In summary, graphPAF extends and consolidates existing packages for PAF estimation in multiple ways. This article serves as a broad overview of theory and estimation approaches appropriate for attributable fractions, as well as a guide regarding how to use the graphPAF package in practice.
Lateral behaviour of unreinforced masonry walls with different types of opening and effect of strengthening measures: A computational approach
Authors: Debnath Pranoy , Dutta Sekhar Chandra
Published: April 2023

The present paper addresses a sophisticated numerical modeling technique using a plasticity-based simplified micro-model method and the extended finite element method (XFEM) for simulating the nonlinear behaviour of unreinforced masonry (URM) walls with different types of sizes and positions of openings. The validity of this model has been proven by comparing the results subjected to a similar loading obtained by the experimental approach. Thereafter, the validated computational model is used to study the behaviour of the 3D URM wall model with different opening percentages. The effect of the position of the openings is also studied. Further, the load-displacement curves are drawn to provide a clear idea about the load-carrying capacity of the same URM walls. The hysteretic behaviour obtained in each models under cyclic loading gives an idea about the energy dissipation capacity of each of the models studied. The same walls are analyzed by strengthening the walls with two cost-effective materials, wire mesh and polypropylene bands. Since the study on lateral behaviour of masonry walls, particularly regarding the effect of area and the position of the opening, is extremely terse, the present detailed study is believed to be helpful in reducing the seismic vulnerability of actual masonry structures, which always have openings with different sizes and positions.
Dynamics and embedded solitons of stochastic quadratic χ(2) and cubic χ(3) nonlinear susceptibilities with multiplicative white noise in the Itô sense
Authors: Li Zhao , Peng Chen
Published: April 2023

The main purpose of this paper is to study the dynamics and embedded solitons of stochastic quadratic χ(2) and cubic χ(3) nonlinear susceptibilities in the Itˆo sense. Firstly, two-dimensional dynamics system and its perturbation system are obtained by using travelling wave transformation. Secondly, phase portraits of two-dimensional dynamics system are plotted. What’s more, chaotic behaviors, two-dimensional phase portraits, three-dimensional phase portraits and sensitivity of the perturbation system are analyzed by using the Maple software. Finally, the embedded solitons of stochastic quadratic χ(2) and cubic χ(3) nonlinear susceptibilities are obtained. Moreover, three-dimensional and two-dimension of stochastic quadratic χ(2) and cubic χ(3) nonlinear susceptibilities are plotted.
Impact of Healthcare System and Patient Factors on Telemedicine Adoption
Authors: Cesar Trevor C. , Goharderakshan Nathan , Li Qiaowu , Tovar Stephanie , Chien Gary W.
Published: April 2023

Background:
Telemedicine has become one of the standards in healthcare delivery, particularly since onset of the COVID pandemic. However, healthcare disparities in telemedicine care delivery among historically disadvantaged groups remains unclear with most studies demonstrating its persistence. We aim to evaluate patient and healthcare system factors in telemedicine utilization in a large, diverse population.
Methods:
Retrospective study of patient visits across Kaiser Permanente Southern California between January 1, 2019, and June 30, 2021. Patient factors included age, gender, ethnicity, median household income, primary spoken/written language, marital status, and registration on kp.org. Healthcare factors included type of visit, provider age, gender, specialty, number of years in practice and primary language. Rates of utilization compared between office and virtual visits, prior to and after March 2020, with an interrupted time series and slope analysis.
Results:
There were 177,171,288 visits during the study period. There was a decrease in patient visits after March 2020 (lockdown), driven by a sharp decline in office visits. Within three months of lockdown, total visits increased until the end of study, at 2.8 million/month, compared to 2.5 million/month prior to lockdown, driven by office visits that approached pre-lockdown and high telemedicine visits. In a multivariate regression analysis, there were no significant differences in patient age, race, gender, income, marital status, language, and kp.org registration in telemedicine utilization. Providers with 6-10 years in practice, aged < 30 utilized the most telemedicine (p=.01). General surgery, medical specialties, OBGYN, pediatrics and psychiatry utilized more telemedicine compared to primary care, but podiatry and surgical specialties utilized less (p < 0.01).
Conclusions:
Our study of over 177 million patient visits in an integrated healthcare system of a large, diverse population shows sustained high utilization of telemedicine after the pandemic lockdown, with an increase of office visits, and overall increase of total patient visits. No significant healthcare disparities across various populations were found in telemedicine utilization, contrary to most current literature demonstrates. Results of this study may prompt more investigation to the role of telemedicine in various populations.
Prediction model of Gleason score upgrading after radical prostatectomy based on a Bayesian network
Authors: Wang Guipeng , Wang Xinning , Du Haotian , Wang Yaozhong , Sun Liguo , Zhang Mingxin , Li Shengxian , Jia Yuefeng , Yang Xuecheng
Published: April 2023

Objective To explore the clinical value of the Gleason score upgrading (GSU)prediction model after radical prostatectomy (RP) based on a Bayesian network.
Methods The data of 356 patients who underwent prostate biopsy and RP in our hospital from January 2018 to May 2021 were retrospectively analysed. Fourteen risk factors,including age, body mass index (BMI), total prostate-specific antigen (tPSA), prostate volume, total prostate-specific antigen density (PSAD), the number and proportion of positive biopsy cores, PI-RADS score, clinical stage and postoperative pathological characteristics, were included in the analysis. Data were used to establish a prediction model for Gleason score elevation based on the tree augmented naive (TAN) Bayesian algorithm. Moreover, the Bayesia Lab validation function was used to calculate the importance of polymorphic Birnbaum according to the results of the posterior analysis and to obtain the importance of each risk factor.
ResultsIn the overall cohort, 110 patients (30.89%) had GSU. Based on all of the risk factors that were included in this study, the AUC of the model was 81.06%, and the accuracy was 76.64%. The importance ranking results showed that lymphatic metastasis, the number of positive biopsy cores, ISUP stage and PI-RADS score were the top four influencing factors for GSU after RP.
ConclusionsThe prediction model of GSU after RP based on a Bayesian network has high accuracy andcan more accurately evaluate the Gleason score of prostate biopsy specimens and guide treatment decisions.
Evaluation of Welding Defects with X-ray Digital Laminography for NDT inspection of Carbon Steel Plate
Authors: Ghandourah Emad E. , Hamidi Shahfuan A.hanif , Salleh Khairul Anuar Mohd , Wahab Mahamad Noor , Banoqitah Essam Mohammed , Fallatah Othman A.
Published: April 2023

X-ray imaging Digital Laminography (DL) is a well-known Non-Destructive Testing (NDT) technique well suited for non-destructive examination of large and flat structures where traditional Computed Tomography (CT) is impractical. This technique provides 3D radiographic imaging and precise characterization with depth information of welding defects in welded components, ensuring component quality meets the standard criteria and safety purposes. Furthermore, determining the welding defect's location in fabrication, in-service, and maintenance is crucial for welding repair, resulting in the areas where the repair work needs to be started. This work highlights the characterization of welding defects by experimental digital radiographic testing (RT-D) and digital laminography (DL) techniques applied to welded carbon steel plates. A test specimen, specially prepared with artificial linear and volumetric flaws like lack of fusion, clustered porosities, and slag inclusions with varying dimensions, was tested, and the approaches were analyzed. Furthermore, a test phantom was fabricated with known geometry features that access the DL system's optimal detection accuracy to demonstrate a broad functionality and acceptance of the DL system for depth information in flat and plate structures. The digital laminography technique provides advantages for characterizing welding defects and testing phantom features with high contrast and acceptable image quality. The result is then confirmed by the advanced Ultrasonic Testing (UT) and RT-D. To ensure compliance with industry standards in RT-D, the exposure conditions, image sensitivity, and quality are analyzed according to ISO 17636-2.
A comprehensive evaluation on leaching of non-ferrous metals from polymetallic tailings
Authors: Javanshir Sepideh , Arasteh Aida , Mohebbi Mohsen , Gorgij Mahmood
Published: April 2023

There is a significant deficit between the supply and demand of critical metals, leading to look for new ways to get high-value elements from mine tailings. In this study, the atmospheric leaching method was applied to extract valuable elements, including copper, zinc, and copper oxide, from a polymetallic ore that was considered a tailing in the mining site. The sample contained 3.28% copper, 13.74% iron, 1.7% zinc, 5.71% lead, and 1.98% oxidized copper. The effect of time, stirrer speed, acid concentration, particle size, and temperature were investigated on the leaching of Cu, CuO, and Zn. The optimum recommended conditions for leaching of polymetallic ore were: acid concentration 0.5 mol L− 1, %solid 25%, and leaching time 1 h. Leaching recoveries of 63.5% for Cut, 97.5% for CuO, 1% for Fe, and 100% for Zn can be achieved under the optimum conditions. The results for the dissolution of metals agreed with mineralogical studies.
Mode-dependent magnonic noise
Authors: Furukawa Ryo , Eguchi Takuro , Sekiguchi Koji
Published: April 2023

The performance of magnonic devices, such as converters, switches, and multiplexers, depends significantly on the magnonic noise. Although a peculiar discrete magnonic noise has been reported, concrete magnon dynamics under high-magnon density conditions have not been clarified. Therefore, this study performs zero-span measurements of the spectrum analyser to accurately detect magnonic noise as a fluctuation of the spin-wave amplitude. The results of low-frequency magnonic noise demonstrated spin-wave mode dependency, indicating the existence of a peculiar magnon surface state. Furthermore, the energy thresholds of four-magnon scattering and auto-oscillation were determined using magnonic white noise. We believe the noise data presented here can help promote and accelerate theoretical and experimental research on magnons.
Determination of Attitudes and Knowledge Levels of Pediatricians About Pediatric Medicolegal Problems in Turkey
Authors: Kurt Nevin Cambaz , Doğramacı Yakup Gökhan , Hakeri Hakan
Published: April 2023

Introduction
In recent years, there has been an increase in allegations of medical errors, particularly related to issues of consent. The role of legal representatives in making decisions about children's medical treatment has resulted in various legal and ethical dilemmas. This study aimed to assess the knowledge and awareness of pediatricians on medicolegal issues.
Methods
The study was conducted prospectively and cross-sectionally. Participants were presented with 14 case examples and were asked 25 questions about their knowledge of the necessary information, consent, documents, and procedures required in each case. They were asked to score their adequacy on a scale of 1 to 5 points. Mann Whitney U and Kruskal Wallis tests were used statistically.
Results
A total of 209 pediatricians participated in the study, 66% of which are working in tertiary care hospitals. The results indicated pediatricians were unsure about their knowledge of necessary information, consent, documents, and procedures for children, with an average score of 3.19 out of 5. They also felt inadequate when faced with treatment refusal, with an average score of 2.77 out of 5. No significant differences were found in the results based on professional seniority or job title. Furthermore, only 2% of the pediatricians believed that children under 12 years old could understand their medical treatment options.
Conclusion
The study highlights that pediatricians need more knowledge on basic legal issues related to information, consent, and refusal of treatment. Legal education should be included in medical schools' curricula to prevent lawsuits and improve patient care, and pediatricians should receive legal training to enhance their knowledge of medicolegal issues.
Ameliorative effect of bofutsushosan (fangfengtongshengsan) extract on the progression of aging-induced obesity
Authors: Saeki Takafumi , Yamamoto Saya , Akaki Junji , Tanaka Takahiro , Nakasone Misaki , Ikeda Hidemasa , Wang Wei , Inoue Makoto , Manse Yoshiaki , Ninomiya Kiyofumi , Morikawa Toshio
Published: April 2023

This study aimed to compare fat accumulation in young and aged mice raised on a high-fat diet and to characterize the obesity-reducing effects of a traditional Japanese Kampo medicine, bofutsushosan (BTS; fangfengtongshengsan in Chinese). Aged mice fed a high-fat diet containing 2% BTS extract for 28 days exhibited a significant reduction in weight gain and accumulation of visceral and subcutaneous fat, which were greater degree of reduction than those of the young mice. When the treatment period was extended to two months, the serum aspartate aminotransferase and alanine aminotransferase levels and accumulation of fat droplets in the hepatocytes decreased. The mRNA expression of mitochondrial uncoupling protein 1 in the brown adipose tissue was significantly reduced in the aged mice compared to the young mice but increased by 2% in the BTS-treated aged mice. Additionally, the effect of BTS extract on oleic acid-albumin-induced triglyceride accumulation in hepatoblastoma-derived HepG2 cells was significantly inhibited in a concentration-dependent manner. Evaluation of the single crude drug extracts revealed that Forsythia Fruit, Schizonepeta Spike, and Rhubarb were the active components in BTS extract. These results suggest that BTS extract is effective against visceral, subcutaneous, and ectopic fats in the liver, which tend to accumulate with aging. Thus BTS extract is useful in preventing and ameliorating the development of obesity and metabolic syndrome.
Neurogenic pulmonary edema and Takotsubo cardiomyopathy in aneurysmal subarachnoid hemorrhage
Authors: Hwang Eui-Hyun , Koo Ja Ho , Lee Yeonhu , Song Ji Hye , Lim Yong Cheol
Published: April 2023

Objective: Neurogenic pulmonary edema (NPE) combined with Takotsubo cardiomyopathy (TCM) is a unique condition associated with aneurysmal subarachnoid hemorrhage (aSAH). Although several mechanisms have been proposed, the pathophysiology and management strategies are not yet fully established. We aimed to determine the radiological and clinical outcome of patients with NPE with TCM after aSAH and to propose management strategies.
Methods: We analyzed the data of 573 patients with aSAH recorded at a single medical center from February 2015 to July 2022. This study retrospectively investigated the incidence and demographics of SAH combined with both NPE and TCM and the clinical outcomes of the patients. Risk factors of NPE-TCM were also investigated.
Results: During the 7 years, 11 (1.9%) of 513 patients had NPE complicated with TCM after aSAH. All 11 patients had poor-grade SAH (Hunt–Hess Grade 3 to 5). Three of 11 patients had posterior circulation in the NPE-TCM group. The most prevalent treatment option was endovascular coil embolization except for one case of clip. Long-term outcomes were favorable in 6 of 11 patients, and there was one case of mortality. Age, troponin I level, and alveolar-arterial oxygen gradient were risk factors of NPE-TCM.
Conclusion: NPE combined with TCM is a unique finding in patients with aSAH, and severe clinical conditions may be independent predictors of a fatal outcome. Therefore, understanding the pathophysiology and appropriate management of this condition can improve outcome in patients with aSAH.
Use of Video-Assisted Thoracoscopy in the Treatment of Primary Spontaneous Pneumothorax in Children
Authors: Şahin Ceyhan , Ayyıldız H. Nihan Karaman , Mirapoğlu Semih , Güvenç F. Tuğba , Yıldız Zeliha Akış , Arpacık Mehmet , Kaymakçı Aytekin , İlçe Zekeriya
Published: April 2023

Purpose:This study aims to review the Primer Spontan Pneumothorax (PSP) patients we have treated as well as the literature and to present our approach to the treatment of PSP in pediatric patients and Video-Assisted Thoracoscopic Surgery (VATS).
Methods:The study was designed retrospectively and conducted at a tertiary referral university hospital between January 1, 2015 and May 1, 2021. Patients under the age of 18 years with a diagnosis of Pneumothorax (PTX) were included in the study. Medical records were analyzed in terms of clinical characteristics, demographic data, findings from imaging data, procedures performed, and course of the disease at hospital. Patients with no evidence of PTX on radiologic imaging (direct posteroanterior chest X-ray (PA CXR) or Thoracic computed tomography (CT)), incomplete medical records for follow-up, history of trauma, and neonatal pneumothorax were excluded from the study.
Results:
The study was conducted on a total of 98 PTX cases in 69 patients, 61 (88.4%) males and 8 (11.6%) females. The ages of the patients ranged between 13 and 17 years with a mean of 16.59 ± 0.95 years. While 48 (49%) PTX cases were treated with tube thoracostomy, 19 (19.4%) were treated with medical follow-up and 31 (31.6%) were treated with VATS. A total of 31 VATS procedures were performed in 28 patients. The follow-up period after VATS ranged from 3 to 78 months, with a mean of 31.5 ± 20.3 months and a median of 28 months.
Conclusion:If PSP is detected on PA CXR in a pediatric patient presenting with chest pain and respiratory distress, there is no need for CT scan. CT can be performed in recurrent PTX and in patients undergoing surgery. If the percentage of PTX detected in PA CXR is below 32%, medical follow-up should be applied, if it is above 32%, tube thoracostomy should be applied, and if it is above 72%, the patient should be considered as a candidate for VATS. If there is no decrease in O2 sat during medical monitoring, there is no need for additional O2 supplementation. If PTX does not start to shrink and lung expansion does not increase 60 hours after the start of medical follow-up and if PTX is progressive during follow-up, tube thoracostomy should be performed. VATS should be performed if there is no increase in lung expansion 18 hours after tube thoracostomy, if the pneumothorax is progressive, and if air leaks persist for more than 10 days despite increased lung expansion and if recurrent pneumothorax occurs. If pleurectomy is to be performed during VATS, partial pleurectomy should be preferred.
Risk Assessment of Mounded Storage Tanks
Authors: Du Chenyang , Liu Chang , Yuan Jun , Cheng Xin , Song Ce , Li Xiaowei
Published: April 2023

The Mounded Vessel is the third form different from the above ground and buried storage containers. In this paper, qualitative and quantitative assessment methods are comprehensively used for risk assessment of Mounded Vessel. Quantitative calculation method is used for failure probability, and qualitative calculation method is used for failure consequence. By comparing and evaluating the risk level of propylene Mounded Vessel and above ground propylene spherical tanks with similar parameters, it is concluded that the failure consequences of Mounded Vessel are smaller, the risk level is lower, and the safety is higher.
Touraine-Solente-Gole syndrome: pathogenic variant in SLCO2A1 presented with polyarthralgia and digital clubbing
Authors: Nicolau Rafaela , Beirão Tiago Melo , Guimarães Franscisca , Aguiar Francisca , Ganhão Sara , Rodrigues Mariana , Grangeia Ana , Brito Iva
Published: April 2023

Background: Primary Hypertrophic Osteoarthropathy (PHO), also known as Touraine-Solente-Gole Syndrome, is a rare, multisystemic autosomal recessive disorder caused by pathogenic variants in the HPGD or SLCO2A1 genes. However, autosomal dominant transmission has also been described in some families with incomplete penetrance. PHO usually starts in childhood or adolescence, presenting with digital clubbing, osteoarthropathy, and pachydermia. We described a complete form of the syndrome in a male patient with a homozygous variant in the SLCO2A1 gene (c.1259G>T).
Case presentation: A 20-year-old male was referred to our Pediatric Rheumatology Clinic with a five-year history of painful and swollen hands, knees, ankles and feet, prolonged morning stiffness and relief with non-steroidal antiinflammatory drugs. He also reported late onset facial acne and palmoplantar hyperhidrosis. Family history was irrelevant and parents were non-consanguineous. On clinical examination, he presented clubbing of the fingers and toes, moderate acne and marked facial skin thickening with prominent scalp folds. He had hand, knee, ankles and feet swelling. Laboratory investigation showed elevated inflammatory markers. Complete blood count, renal and hepatic function, bone biochemistry were normal, as well as immunological panel. Plain radiographs revealed soft tissue swelling, periosteal ossification and cortical thickening of the skull, phalanges, femur and toe acroosteolysis. Due to the absence of other clinical signs suggesting a secondary cause, we suspected PHO. A genetic study revealed a likely pathogenic variant, c.1259G>T (p.Cys420Phe), in homozygosity in the SLCO2A1 gene, thus confirming the diagnosis. The patient started oral naproxen with significant clinical improvement.
Conclusions: PHO should be kept in the differential diagnosis of inflammatory arthritis affecting children, most of the times misdiagnosed as Juvenile Idiopathic Arthritis (JIA). To the best of our knowledge, this is the first reported case of this pathogenic variant and it constitutes the second genetically confirmed case of PHO in a Portuguese patient (first variant c.644C >T), both made at our department.
Development of the Burnishing Process: Moving Towards Increasing the Quality and Surface Hardness of Aluminum alloy 2024
Authors: Najafabadi Akbar Hojjati
Published: April 2023

Because of the hard grind of some metals such as aluminum, copper and brass, burnishing can be very effective. Burnishing is a non-cutting process in which the surface of the workpiece is plastically deformed by hard work and pressure in the surface layers of the workpiece. In this study, the burnishing process is applied to 2024 aluminum alloy to improve the quality of the final surface and its increasing hardness. In this process, a roller-based tool was used for burnishing with the lathe. The parameters of spindle speed, feed rate and burnishing force were used in three stages, with two repetition phases and in the full factorial method in aluminum 2024 burnishing. Minitab software was used to determine the effects of the different parameters on surface roughness and hardness. Also, the regression method was used to predict the surface roughness and hardness under the influence of the parameters. The results showed that the optimum surface roughness (Ra = 0.05µm) was achieved at a feed rate of 0.11mm/rev, a spindle speed of 1000rpm, and a burnishing force of 1000N.
Childhood, adulthood, and cumulative traumatic events experienced from childhood to adulthood and dementia risk: a population-based cohort study
Authors: Xie Ziwei , Sun Huizi , Zhou Chunmiao , Fu Chunying , Wang Qi , Dong Caiyun , Hao Wenting , Zhen Xuemei , Zhu Dongshan
Published: April 2023

Objective
We aim to examine the associations of traumatic events experienced in childhood, adulthood, and cumulative traumatic events experienced from childhood to adulthood, with risk of all-cause dementia, including Alzheimer's disease (AD) and vascular dementia (VD), whilst considering the roles of sex.
Methods
We used data from the UK Biobank cohort study and 145,558 participants were included. Frequency of traumatic events (including emotional abuse, physical abuse, and sexual abuse) experienced in childhood and adulthood were collected. Cumulative number and type of traumatic events experienced from childhood to adulthood were also calculated. We used cox proportional hazards models to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for the association between traumatic events and risk of all-cause dementia. Sex-specific associations were also analyzed.
Results
Compared to people who did not experience traumatic events in their life course, those who often experienced emotional, physical, and sexual abuse in childhood were associated with a higher risk of all-cause dementia, with HRs (95% CI) of 2.23 (1.34, 3.71), 3.16 (1.81, 5.53) and 3.23 (1.52, 6.89), respectively. Corresponding HRs (95% CI) in people who experienced traumatic events in adulthood were 1.42 (1.11, 1.82), 1.96 (0.97, 3.98), and 3.13 (1.18, 8.27), respectively. After cumulative type of traumatic events were calculated from childhood to adulthood, we found that people who experienced both emotional and physical abuse in childhood had the highest risk of all-cause dementia in later life with HRs (95% CI) of 1.94 (1.00-3.78).
Conclusions
Both traumatic events experienced in childhood and adulthood were related to an increased risk of dementia. People who experienced both emotional and physical abuse in childhood had the highest risk of all-cause dementia.
A Proposal to Teach Medical Students How to Use Interpreters
Authors: Thomas Kyle , Jacobs Nicole , Silva Lizette , Teixeira Amir , Andrade Alejandro , Vera Alexandra Lopez
Published: April 2023

The necessity of trained medical interpreters is crucial to ensure fair and high-quality healthcare for patients with limited English proficiency. Despite this requirement, medical schools often do not adequately educate their students on how to work with interpreters. This study outlines a curriculum developed to tackle the deficiency of interpreter-use training for medical students. The interactive model used in the curriculum enabled students to practice patient interactions with interpreters and learn about the ethical, cultural, and legal aspects of interpreter use. Post-workshop surveys were conducted to determine student readiness for future clinical experiences that require the use of a medical interpreter. The effectiveness of the curriculum was confirmed in preparing students for interpreter use. The study's objective is to reduce healthcare disparities by training students to navigate cultural and linguistic barriers between themselves, limited English proficiency patients, and interpreters. By providing early training to medical students, they will be equipped to interact with limited English proficiency patients not only during clinical rotations but also throughout their medical careers. The study underscores the significance of incorporating language-discordant encounters with interpreters and corresponding health equity curricula in medical schools.
Rebound multi-system inflammatory syndrome in children (MIS-C): A case report of an extremely rare phenomenon
Authors: Alyasin Soheila Sadat , Johari Leila , Noeiaghdam Rafat , Moshfeghinia Reza , Mehdizadegan Nima
Published: April 2023

Background: Multi-system inflammatory syndrome in children (MIS-C) is a newly defined clinical syndrome characterized by systemic inflammation, fever, and multi-organ dysfunction related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. While MIS-C is familiar to most physicians, recurrent and rebound cases of MIS-C are extremely rare, with only two such cases reported to date.
Case presentation: Here, we report the case of a five-month-old boy diagnosed with rebound MIS-C (19 days apart), with the second episode being more severe and featuring a right coronary artery aneurysm. The immunodeficiency workup returned normal. Standard MIS-C treatment protocols were followed in both episodes, eventually yielding an excellent outcome. The patient remained well within 12 months of follow-up.
Conclusions: We conclude that longer and closer follow-ups of MIS-C patients may be needed, perhaps with a more aggressive treatment protocol to prevent a rebound or recurrence of the disease, though further studies are required to guide clinical decision-making.
A Symmetrical High Utilization Rate of Physical Sensors Array for Passive Direction Finding of Mixed Near-Field and Far-Field Signals
Authors: Du Bo , Cui Weijia , Jian Chunxiao , Du Yuxi , Lin Wei
Published: April 2023

Direction of arrival (DOA) estimation is an important branch in the field of array signal processing. In the research field of DOA estimation of mixed near-field (NF) and farfield (FF) signals, the traditional uniform linear arrays (ULAs) and sparse linear arrays (SLAs) have low utilization rate of physical array sensors and low degrees of freedom. For the purpose of improving the utilization rate of physical array sensors and improving the passive direction finding performance, a configuration method named symmetrical high utilization rate of physical sensors array (SHUA) is proposed in this paper. High utilization means that, under the constraint of array size, SHUA can reduce the redundancy during the generation process of consecutive lags by maximizing the utilization of the physical sensors, thus generating more consecutive lags. This configuration method innovatively reduces the redundancy of consecutive lags and enlarges the array aperture by solving a local optimal solution under the performance conditions limited by the computer. More consecutive lags and larger array aperture allow for more accurate estimation of DOA and range parameters. Simulation experiments show that, under the restriction of the same array size, compared with the common sensor array configurations, the SHUA can make better use of the physical array sensors and upgrade the passive direction finding performance.
The prevalence of dental caries and associated risk factors in Chinese children aged 7-9 years
Authors: Li Hui , Liu Xiaoyu , Xu Jianhui , Li Siwei , Wang Xueqin , Li Xin
Published: April 2023

Background
Dental caries is the most common oral health problem in school-age children caused by the interaction of microorganisms, substrates and teeth over time. The objective of this study was to evaluate the prevalence, severity, oral distribution, and associated risk factors of deciduous tooth caries in children aged 7–9 years in Jinzhou, China.
Methods
A total of 1,603 primary school students aged 7–9 years old from public and private schools in Jinzhou were recruited using multi-stage, stratified, and random sampling methods for cross-sectional studies. Deciduous teeth caries in school-age children were detected and recorded according to the World Health Organization standard, and a questionnaire was collected from a parent or guardian with information on the relevant risk factors for the child. Odds ratios and 95% confidence intervals of caries-related factors were estimated using binary logistic regression analysis.
Results
The prevalence of deciduous tooth caries was 74.5%, the average caries was 3.02,and dmft was 4.08 ± 2.74.There were 655 cases (77.1%) of caries in boys and 539 cases (71.6%) in girls, and the difference between them has statistical significance (P < 0.05). Binary Logistic regression analysis showed that the mother's education level, flossing, reason for last dental visit, and consumption of desserts, sweets, and soft drinks were associated with the prevalence of dental caries.
Conclusions
Deciduous teeth have a high incidence of dental caries in children aged 7–9 years, especially mandibular deciduous molars are the most common. Social demographic factors, socioeconomic status factors, oral hygiene habits, and dietary habits all play an important role in the occurrence of dental caries.