bluuebunny/crossref_metadata_2025 huggingface dataset:
In Vitro Activity of “Last Chance” Antimicrobials against Klebsiella pneumoniae Complex.
Authors: Sękowska Alicja
Published: December 2023

Klebsiella pneumoniae complex is one of the most commonly isolated bacteria within human infections. These microorganisms are opportunistic pathogens that pose a serious threat to public health due to possibility of transmission in the human population. Resistance to carbapenems is one of the most important antimicrobials resistance mechanisms amongst them. In this situation therapeutic options are limited. Therefore, the aim of this study was to evaluate fosfomycin, colistin, ceftazidime-avibactam and meropenem-vaborbactam in vitro activity against multidrug-resistant K. pneumoniae complex strains. The study involved 160 strains of Gram-negative rods: K. pneumoniae – 138 and K. variicola - 22. Minimal inhibitory concentration of fosfomycin was estimated by agar dilution method and for colistin by microdilution method. The susceptibility to ceftazidime-avibactam and meropenem-vaborbactam was determined by gradient strip method. All of the analysed K. pneumoniae complex isolates produced extended-spectrum beta-lactamases and 60.0% carbapenemases. The most of the analysed strains were susceptible to fosfomycin and colistin (62.5%). Among pandrug-resistant K. pneumoniae complex isolates the most were susceptible to colistin (43.9%). Fosfomycin has good activity against ESBL- and VIM-positive isolates from this complex. In turn, colistin has satisfactory in vitro activity against KPC- and VIM-positive isolates from K. pneumoniae complex. Ceftazidime-avibactam has good activity against K. pneumoniae complex strains producing ESBL, KPC and OXA enzymes. In turn, meropenem-vaborbactam has satisfactory in vitro activity against ESBL- and KPC-positive isolates from this complex.
Bacteriophage St_134 and its Endolysin as a Potential Staphy-lococcus Biofilm-Removing Biological Agent
Authors: Golosova Natalia N. , Matveev Andrey L. , Tikunova Nina V. , Khlusevich Yana A. , Kozlova Yulia N. , Morozova Vera V. , Babkin Igor V. , Ushakova Tatiana A. , Zhirakovskaya Elena V. , Panina Elisaveta A. , Ryabchikova Elena I. , Tikunov Artem Y.
Published: December 2023

Bacteria of the genus Staphylococcus are a significant a challenge for medicine, as many species are resistant to multiple antibiotics and even to all of the antibiotics used. One of the approaches to develop new therapeutics to treat staphylococcal infections is the use of bacteriophages specif-ic to these bacteria or lysins of such bacteriophages capable to hydrolyze the cell walls of these bacteria. In this study, a new bacteriophage St_134 specific to Staphylococcus epedermidis was de-scribed. This small podophage belonging to the Andhravirus genus showed relatively wide host range and was able to infect more than 60 strain of Staphylococcus spp., including a clinical strain from the Staphylococcus aureus complex. Two genes encoding different phage lysins were identi-fied in the Ste134 genome. Both lysins LysSte134_1 and LysSte134_2 were produced in Escherichia coli cells. Endolysin LysSte134_1 was demonstrated catalytic activity against a wide panel of staphylococcal peptidoglycans (4 species, 6 strains), was active against S. aureus and S. epidermidis planktonic cultures and destroyed biofilms formed by clinical strains of S. aureus and S. epider-midis.
Relationships between Regenerating Qinghai Spruce Seedlings and Soil Stoichiometry across Elevations in a Forest in North-Western China
Authors: WU Xiurong , CHONG Peifang , XU Erwen , ZHAO Weijun , JING Wenmao , ZHAO Jingzhong , WANG Shunli , WANG Rongxin , MA Xuee
Published: December 2023

Qinghai spruce (Picea crassifolia) is a ecologically important species in the forest ecosystem of the Qilian Mountains region in China. Natural regeneration of this species is critical to maintaining forest ecosystem function. We here analyzed several biological indicators among naturally re-generating Qinghai spruce across several elevations in the Pailugou watershed. Specifically, seedling density, basal diameter (BD), and plant height were measured, as were soil physico-chemical parameters, at 2700 m, 3000 m, and 3300 m above sea level. Differences in the biological indicators and correlations between the indicators and soil parameters were then assessed at each elevation. The results showed that soil stoichiometry was more sensitive to changes in el-evation than seedling indicators were. Furthermore, seedling density was positively correlated with soil pH, whereas BD was positively correlated with the carbon to nitrogen ratio (C/N), the carbon to phosphorus ratio, and soil organic carbon (SOC) contents. None of the analyzed soil parameters had a significant impact on elevation-specific differences in seedling density. However, soil pH, SOC, and C/N significantly affected variations in seedling diameter at each elevation. Finally, soil pH, SOC, C/N, and the carbon to phosphorus ratio significantly affected variations in seed-ling height at each elevation. This study provides a strong theoretical basis for further under-standing of the mechanisms associated with Qinghai spruce regeneration, ulti-mately contrib-uting to rational protection and management strategies for this important natural resource.
Non-athletic Cohorts Addressed by Longitudinal Whole-Body Electromyostimulation Trials – an Evidence Map
Authors: Beier Miriam , Kohl Matthias , Schoene Daniel , Von Stengel Simon , Uder Michael , Kemmler Wolfgang
Published: December 2023

Whole-body electromyostimulation (WB-EMS) can be considered as a time-efficient, joint-friendly and highly customizable training technology that attracts a wide range of users. The present evidence map aimed to provide an overview of different non-athletic cohorts addressed by WB-EMS research. Based on a comprehensive systematic search according to PRISMA, eighty-six eligible longitudinal trials were identified that correspond with our eligibility criteria. In summary, WB-EMS research sufficiently covers all adult age categories in males and females. Most cohorts addressed (58%) were predominately or exclusively overweight/obese and in about 60% of them, diseases or conditions were inclusion criteria for the trials. Cohorts specifically addressed by WB-EMS trials suffer from cancer/neoplasm (n=7), obesity (n=6), diabetes mellitus (n=5), the metabolic syndrome (n=2), nervous system diseases (n=2), chronic heart failure (n=4), stroke (n=1), peripheral arterial diseases (n=2), knee arthrosis (n=1), sarcopenia (n=3), chronic unspecific low back pain (n=4), and osteopenia (n=3). Chronic kidney disease was an eligibility criterion in five WB-EMS trials. Finally, three studies included only critically ill patients, two further studies considered frailty as an inclusion criterion. Of importance, no adverse effects of the WB-EMS intervention were reported. In summary, evidence gaps of WB-EMS research were particular evident for cohorts with diseases of the nervous and cerebrovascular system.
A Consideration of Gradeless Learning in Higher Education
Authors: Amer Adan , Sidhu Gaganpreet , Srinivasan Seshasai
Published: December 2023

This article presents a brief overview of the purpose, implementation, and criticisms of the typical graded system 'used by most schools worldwide to assess students' academic performance. Letter and numerical grades serve many purposes, such as motivating students and allowing teachers or parents to track progress, yet this tool is quite unreliable for measuring knowledge acquisition. The overuse of grades to measure student success also impedes intrinsic learning outcomes, such as discovering interests or developing skills essential for transforming post-secondary students into lifelong learners. In contrast, gradeless learning systems that emphasize the application of knowledge and high-quality feedback can improve 'students' well-being and overall learning outcomes. Despite these benefits, switching away from grades is a tumultuous one given that students rely on them for motivation to perform well in school. Hopefully, implementing gradeless learning on a program or course level will be the first step in achieving this paradigm shift.
INTERGENERATIONAL HOUSING FORMS AS A CONSEQUENCE OF THE EVOLUTIONARY MODEL OF MULTI-GENERATION FAMILY LIFE IN THE CONTEXT OF SOCIETY AGING AND SOCIO-ECONOMIC CHANGES
Authors:   Faculty of Architecture Bialystok University of Technology, Poland, Magdziak Monika
Published: December 2023

The article discusses the phenomenon of intergenerational homes as an evolution of the traditional multigenerational household model. Intergenerational living refers to multiple generations of one family living alongside each other. It addresses contemporary challenges such as caring for older generations and providing affordable housing for the younger ones. In this paper the author defines trends in Poland, discusses the origins, and analyzes various intergenerational living forms. Using examples of the modernization of a cube house from the 1980s, the author examines the real-life manifestation of intergenerational homes and identifies the recurring functional strategies applied.
THE FUNCTIONAL AND SPATIAL MODEL (IN THE DEVELOPMENT STRATEGY) AS AN INSTRUMENT FOR PLANNING AND CONTROLLING TRANSFORMATIONS IN THE STRUCTURE OF THE CITY AND AGGLOMERATION
Authors:   Cracow University of Technology, Faculty of Architecture, Department of Spatial Planning, Urban and Rural Design, Poland Society of Polish Town Planners, Poland Spatial Planning Office of Krakow, Poland, Łasocha Marceli
Published: December 2023

The article, based on the example of Krakow and the Krakow metropolis, discusses the method of managing space through the Development Strategy document, and in particular the recently launched Functional and Spatial Structure Model. After analyzing three documents of the Strategy, conclusions are drawn regarding the shortcomings resulting from these documents and good practices related to them. The guidelines may be helpful for other metropolises and for improving the current economic and spatial planning system in Poland. The article also draws attention to the authors of individual documents, which is particularly important in times of depreciation of the urban planning profession.
DEFICIT OF PUBLIC PARKING SPACES IN HOUSING ESTATES ON THE EXAMPLE OF A STREET IN WARSAW
Authors:   Bialystok University of Technology, Poland Faculty of Architecture, Matyszewska-Fuszara Katarzyna
Published: December 2023

Warsaw of the 21st century is struggling with many problems in the context of urban planning, and one of them is the deficit of public parking spaces. The aim of the research is to assess newly built housing estates in Warsaw in terms of providing a sufficient number of public parking spaces. The study adopted the in situ inspection method and was supported by a diagnostic survey in the form of a questionnaire. The article analyzes two housing estates with service premises on the ground floor at Komputerowa Street in Warsaw's Mokotów district. The analyzed area is covered by the Local Spatial Development Plan, which would indicate a well-planned space, but the solutions confronted with reality turn out to be insufficient for the needs of a contemporary inhabitant of the capital. The article also examines nowadays pro-ecological methods of city planning, which introduce restrictions on car traffic, and analyzes the possibility of using them in the discussed housing estates.
EVALUATION OF THE POSSIBILITY OF INCREASING THE BIOLOGICALLY ACTIVE SPACE IN THE HIGHLY URBANIZED BUILT-UP AREA: A CASE STUDY OF THE "NIEBUSZEWO-BOLINKO" DISTRICT OF THE CITY OF SZCZECIN
Authors:   Uniwersytet Zielonogórski, Zielona Góra, Polska Wydział Budownictwa, Architektury i Inżynierii Środowiska Instytut Architektury i Urbanistyki, Piesik Jarosław
Published: December 2023

The Paris Agreement sets a goal of reducing air pollution emissions by 55% by 2030 compared to the 1990 levels. One way to achieve this is by increasing the biologically active areas in cities, where there is limited space. This article explores the possibility of using the vertical space on the walls of buildings, such as a housing estate in Szczecin, by planting vines. It also tries to determine the size of the area that can be used, which will result in an increase in the biologically active areas of cities.
FROM NARRATIVE TO EXPRESSION OF HISTORICAL VALUES. OBJECTIVIZATION OF EVALUATION OF TWIN VILLAS IN SOŁACZ, POZNAŃ
Authors:   Zachodniopomorski Uniwersytet Technologiczny w Szczecinie, Poland Wydział Architektury Katedra Projektowania Architektonicznego, Barełkowski Robert K.
Published: December 2023

The article explores the method of deriving historical values from the history of an object and place, in connection with people important to the object or place. This is a detailed analysis of the practical process of translating an integrated historical narrative used to recreate important components or carriers of historical values, based on the case of two semi-detached villas in Poznań's Sołacz district. The HeV method used in this case illustrates how to qualify individual historical factors that may be of great importance in themselves, but of little importance in relation to architecture.
SINOP CITADEL THROUGHOUT HISTORY
Authors:   Istanbul Technical University, Turkey Department of Architecture, Basel Nihan Zorlu
Published: December 2023

Sinop, a strategically important city in history, has felt the need to defend against the dangers of being a widespread settlement in almost every period. Even today, traces of defensive structures can be found in the city. For this reason, it is possible to see how the inner castle changed over the years and how it was shaped according to needs from the Hellenistic period to the Ottoman period. This study aims to examine how the structure changes according to periods.
OLD RURAL CHURCH CEMETERIES WITHIN THE CONFINES OF THE CONTEMPORARY CITY OF SZCZECIN
Authors:   West Pomeranian University of Technology in Szczecin, Poland Faculty of Environmental Management and Agriculture, Department of Landscape Architecture, Pilarczyk Aleksandra
Published: December 2023

The aim of this article was to indicate the transformations that have occurred and continue to occur within the space of the old rural church cemeteries located within the contemporary administrative boundaries of the city of Szczecin. By combining source materials and documentation regarding the history of the discussed cemeteries with an analysis of their current state, it was possible to identify which components of their historical landscape have survived to the present day and what their significant values are. The research results showed that within the areas of the former church cemeteries, few traces of their former function have survived. However, as long as the church is in use, there is a chance to preserve remnants of this heritage, although inevitable transformations arising from contemporary users' needs are also occurring
Between What They Are and What They Were: Power Dynamics and Knowledge Production in Fieldwork with Argentine Perpetrators
Authors: Goldentul Analia
Published: December 2023

This article reflects on fieldwork with Argentine perpetrators who were tried between 2015 and 2017 for crimes against humanity. The majority of these retired officials were interviewed while they were in prison, subject to widespread social condemnation, and no longer held positions of power. Consequently, this article focuses on how these conditions influenced the power dynamics between the interviewees and the researcher, the type of data collected, and the production of knowledge. Additionally, it examines how the emotions that emerged in the interaction with perpetrators affected the researcher and the course of the research.
Special Section on Perpetrators in Argentina: Introduction
Authors: Robben Antonius C. G. M. , Salvi Valentina
Published: December 2023

Introduction to the special section on Perpetrators in Argentina.
Vertebral Artery Dissection in the Setting of Unstable Os Odontoideum
Authors: Finkel Ryan A. , Narendran Nakul , Nilssen Paal K. , Skaggs David L. , Illingworth Kenneth D.
Published: December 2023

Update

This article was updated on February 23, 2024 because of a previous error. One author was left off of the author list. The updated author list is Ryan A. Finkel, MD, Nakul Narendran, BA, Paal K. Nilssen, BA, David L. Skaggs, MD, MMM, and Kenneth D. Illingworth, MD.

An erratum (JBJS Case Connect. 2024;14[1]:e23.00466ER) has been published for this article.

Case:

A healthy 5-year-old boy presented with a gradual onset of headaches and acute global right-sided weakness over 10 days. The work-up revealed unstable os odontoideum leading to multiple posterior circulation infarcts with vertebral artery dissection. He underwent antiplatelet therapy, cervical collar immobilization, and delayed occiput to C2 posterior spinal fusion and instrumentation with iliac crest autograft. At 2-year follow-up, the patient had a solid fusion mass, appropriate cervical alignment, and was without neurologic sequelae.

Conclusion:

This case adds to a sparse body of literature in the management of vertebral artery dissection with vertebrobasilar insufficiency secondary to unstable os odontoideum.
Empirical Vulnerability Analysis of Automated Smart Contracts Security Testing on Agricultural Blockchains
Authors: Ganguly Ankit , Dash Dipti , Mohapatra Priyabrata
Published: December 2023

This study endeavors to uncover and rectify potential vulnerabilities within smart contracts, specifically within the framework of an agricultural block-chain setting. The overarching goal is to bolster the security and credibility of agricultural smart contracts, thereby establishing a foundation of trust and dependability in block-chain-driven agricultural ecosystems. The study’s primary focus lies in the synthesis of two innovative techniques: the ABC-GOA optimization and ensemble learning model. ABC-GOA optimization methodically windows down optimal feature selections from the set of features, which are extracted by AST from smart contract dataset, ensuring that only the most pertinent attributes are considered. This step augments the precision and efficacy of subsequent processes. Complementing this, the ensemble learning model ingeniously amalgamates diverse individual models, culminating in a collective classification approach that is more robust, insightful, and proficient. The results offer a resilient shield against potential threats and vulnerabilities inherent to smart contracts in agriculture, thereby fortifying the reliability and safety of block-chain-powered agricultural systems. This research contributes significantly to advancing secure and efficient smart contract deployment in the dynamic realm of agricultural block-chain applications.
The role of machine learning methods in assessing the risk of neonatal Sepsis: A study of biochemical markers and genetic variants
Authors: Zhao Xiaofen , Yang Mifeng , Feng Xingxing , Zhao Pengna , Zhu Shuangyan , Liu Kai
Published: December 2023

Neonatal Sepsis is a life-threatening infection that affects neonates, and its morbidity and mortality rates remain high. There is currently no effective method for timely diagnosis and prevention of neonatal Sepsis. Using machine learning techniques, we aimed to analyze the risk factors of neonatal Sepsis, including biochemical indicators and genetic variants. We collected data from 107 neonates, 56 of whom were in the sepsis cohort and 51 were not. We classified the data using support vector machine (SVM) and random forest (RF) models and evaluated model performance and feature significance. PCT (calcitoninogen level), WBC (white blood cell count), and IL-6 (interleukin-6 level) were the characteristics most strongly associated with sepsis risk. We analyzed the association between genetic variants in CRP (C-reactive protein) and IL-10 and biochemical markers using the Kruskal-Wallis H test and linear regression. CRP gene variants were significantly associated with CRP levels, whereas IL-10 gene variants were substantially distinct from Hb (hemoglobin) levels. These findings shed light on potential biomarkers and genetic correlates of neonatal Sepsis, which will inform future clinical diagnosis and treatment.
Sequential structural evolution triggered by O-O dimerization in oxygen-redox reactions
Authors: Yamada Atsuo , Shi Xiang-Mei , Okubo Masashi
Published: December 2023

The participation of oxygen in electrochemical reactions increases the capacity of lithium-ion battery positive electrodes beyond conventional cationic-redox limits. However, structural degradation due to oxidized oxide ions significantly reduces the discharge voltage compared with that in the first charge, mostly with a capacity loss. In this study, we showed that O-O dimerization triggers transition-metal migration in an oxygen-redox positive electrode upon charging. First-principles calculations were performed to reveal the thermodynamic and kinetic energy landscapes of the full structural evolution of a typical lithium-rich oxide, i.e., Li1.2Ni0.13Co0.13Mn0.54O2. The oxygen oxidation process can be divided into three sequential steps: (i) generation of persistent oxidized oxide ion O−; (ii) peroxide formation; and (iii) transition-metal migration. The elusive use of O2−/O− while blocking O-O dimerization is the key to avoiding structural degradation due to transition-metal migration and realizing energy-efficient oxygen-redox reactions.
Using the GEPR model to predict outcomes of geriatric emergency general surgery
Authors: Xu Dequan , Zhou Haoxin , Rong Jie , Xie Xin , Hou Limin
Published: December 2023

Purpose
The present study aimed to develop artificial intelligence (AI)-based model and GEPR, derived from geriatric data, to predict the outcomes of geriatric EGS.
Methods
A retrospectively database of geriatric EGS patients who underwent emergency surgery was used for the development of the AI model and GEPR. The study employed a specialized algorithm, comprising of four sequential steps: scale prototype selection, clinical data collection and collation, AI model development, and GEPR development.
Results
In total, 1500 patients were enrolled with mean age of 69.8 years in the study.RandomForestClassifier algorithm outperformed the other AI models. Based on the feature importance, GEPR was derived with a total score range of 0–26. The GEPR has a c-statistic of 0.872 for mortality in hospital (95%CI 0.840–0.905). The observed probability of mortality in hospital gradually increased from 0% at a score of 0 to 63.3% at a score of 12 and 100% at a score of 15 .
Conclusion
Using patient-related and technical parameters, an GEPR derived from AI algorithms for prediction of surgical complications in geriatric EGS was developed. GEPR reliably predicts postoperative the mortality in hospital in geriatric EGS patients. Further prospective multicenter trials are needed to externally validate the model developed.
Triumph Over Adversity: A Case Report on Early Diagnosis and Effective Treatment of Progressive Acute Transverse Myelitis in the COVID-19 Era
Authors: Xiong Xudong , Chen Liyun , Xie Fang , Li Shufang
Published: December 2023

Introduction: Acute Transverse Myelitis (ATM) is a rare acute inflammatory disease. Currently, there are no data on the incidence rates in China or other Asian countries. ATM can occur due to various causes, including infections, autoimmune diseases, and demyelinating diseases. The incidence of ATM related to COVID-19 is even rarer, with few reports available. The aim of the current study is to report a rare case of transverse myelitis during COVID-19 infection.
Case presentation: A 65-year-old male patient developed fever, cough, and fatigue on December 25, 2022, and tested positive for COVID-19. After self-medicating, his fever subsided, but he soon experienced chest tightness and abdominal discomfort. Admitted to the emergency department on January 2, 2023, he quickly developed muscle weakness in his lower limbs, progressing to severe weakness (1/5 strength) and urinary retention. This weakness extended to his upper limbs, reducing his strength to 3-/5 and impairing his ability to use a mobile phone. Numbness also spread to his navel area. A positive Babinski sign was noted five days later. He showed significant improvement following timely diagnosis and pulse glucocorticoid therapy.
Discussion: Research increasingly recognizes ATM as a neurological complication of COVID-19, though the exact mechanism of SARS-CoV-2 causing ATM is unclear. The virus may affect the spinal cord through direct invasion, cytokine storms, or autoimmune responses. ATM rapidly progresses and can cause multi-organ failure if untreated.
Conclusion: No specific treatment or standard protocol exists for ATM, but corticosteroid pulse therapy, especially with methylprednisolone, has been effective in treating ATM by promoting nerve conduction and restoring neurological function.
Curcumin Loaded Poly(Lactic Acid) – Poly(Propylene Glycol) with Boc-Glycine End group Copolymer in Drug Delivery Applications.
Authors: G Kalaimagal , Devarajan S , Soundararajan S , Gajalakshmi D
Published: December 2023

Poly (lactic acid) , Poly (propylene glycol) with Boc-Glycine linked polymer was synthesized from lactic acid, Poly (Propylene glycol) with Boc-Glycine. The synthesized polymers were characterized by using Infrared (IR) , Thermo gravimetric analysis (TGA), Nuclear Magnetic Resonance spectroscopic Techniques (1H NMR) and also characterized by Stability, Anti-inflammatory and Drug delivery studies were conducted in Vitro environments. PLA-PPG with Boc-Glycine copolymer polymer may be used in potential Drug delivery Applications in Pharmaceutical fields.
Work-related stress among Nurses: a comparative cross- sectional study of two Government Hospitals in Ghana
Authors: Gmayinaam Vincent Uwumboriyhie , Nortey Abraham Norman , Sedode Saviour , Apedo Samuel Kwasi , Ananga Mark Kwame , Kyedodu Gideon , Kwabla Pearl , Osei Eric
Published: December 2023

Background
Occupational stress is increasing globally and affecting all workplaces and countries' health professionals. There is, however, a paucity of literature on the issue in Ghana. Besides, policymakers have not given it the needed much attention. We, therefore, examined the prevalence and causes of occupational stress among nurses working in a secondary care and tertiary hospitals in Ghana.
Methods
We conducted health facility-based cross-sectional study among 248 nurses from two hospitals (Volta Regional Hospital [VRH] and Ho Teaching Hospital [HTH]). The Perceived stress scale (PSS) and Weiman Occupational Stress Scale (WOSS) were used to measure the stress level and occupational stressors among the nurses. Descriptive analyses and t-test were performed, and statistical significance as measured at the 0.05 level.
Results
Majority of nurses 77.8% of experienced a moderate level of stress. The total individual mean score of the nurses from the two hospitals (VRH = 3.02 and HTH = 3.09) were 25% higher than the established WOSS. Nursing difficult patients (t=-1.1196, p = 0.037), Unfriendly relationship with superiors, colleagues, and subordinates (t=-2.3333, p = 0.020), working with incompetent staff (t=-1.3129, p = 0.037) were the statistically significant stressors among nurses in the HTH. However, long work hours (t = 2.0841, p = 0.038) and needle-stick injuries (t = 2.6669, p = 0.008) were the statistically significant stressors among nurses from the VRH. Headache (VRH = 73.8% and HTH = 97.9%), Fatigue (VRH = 68.9% and HTH = 83.5%), Frustration VRH = 50.5% and HTH = 68.3%) and Lack of Concentration (VRH = 81.6% and HTH = 80.0%) were the effects of occupational stress reported.
Conclusion
The study demonstrated increasing levels of occupational stress among nurses. To accelerate progress towards achieving the sustainable development goal (SDG) 3.4 of promoting mental health and wellbeing by 2030, the 2012 Mental Health Act of Ghana and the Occupation Health and safety regulations, should fully and effectively be implemented by health facilities across the country.
Massive penetrating brain injury combined with open skull fracture- response strategies for complex head injuries
Authors: Zheng Yun-Cong
Published: December 2023

Purpose: Penetrating traumatic brain injury (PTBI) is an extremely serious and fatal trauma. Proper primary evaluation and prompt surgical management will improve patient survival rates. However, this condition is rare in Taiwan, and there are no updated standards and guidelines to deal with this condition.Materials and Methods: A 67-year-old male, worker, fell from a height of 3 meters. His head was inserted into the metal structure at the site. The emergency medical technician cut off a piece of metal to deliver the patient to my emergency room under the protection of a neck collar. Brain CT in E1V1M5 status shows a metallic foreign body penetrating through the left high fronto-parietal lobe into Lt parietal lobe with associated open skull fracture, pneumocephalus, and adjacent intracerebral hemorrhage (ICH). Depressed skull pieces with traumatic subarachnoid hemorrhage complicated the neurological conditions. We provide experience with possible steps in setting up PTBI.Results: After initial resuscitation, emergency personnel prescribed ceftriaxone and metronidazole to control central nervous system infection. A loading dose of depakine is also given to prevent seizures. We arranged an emergency craniectomy to remove the foreign body, ICH, and bone fragments inserted into the brain parenchyma with a microscope. After bleeding control and debridement, a subdural drain was inserted as an intracranial pressure monitor. Following antibiotics control and anticonvulsant agent continued at neurosurgery intensive care unit. Cranioplasty was performed 2 weeks later. He was transferred to the rehabilitation department under E4V2M5 status with right hemiplegia. Now, the patient's coma scale has recovered to E4V3M6, and the muscle power of the right lower limb has recovered to 2 in the bottom of this September.Conclusions: In the era of the ongoing war between Ukraine and Russia, the possibility of PTBI occurring may continue to increase. As a neurosurgeon, you must be prepared for danger in times of crisis and know how to deal with PTBI efficiently. When faced with many injuries or a war situation, our cases can provide valuable experience.
Efficacy of MP-3 Microperimeter Biofeedback Fixation Training in Children with Eccentric Fixation Amblyopia
Authors: Wang Shaoyi , Wang Jiawei , Xi Ruijie , Chai Song
Published: December 2023

Background：To evaluate the efficacy of MP-3 microperimeter biofeedback fixation training (MBFT) in children with eccentric fixation amblyopia, including assessment of retinal sensitivity, fixation characteristics, and fixation stability.
Methods: This prospective study evaluated 11 amblyopic eyes of 11 children under 12 years old. All the patients presented to the Second Hospital of Hebei Medical University, China, from December 2020 to December 2022. All children were trained for three 20 minutes MBFT sessions per week for 8 weeks using the MP-3 microperimeter (NIDEK, Japan). Best corrected visual acuity (BCVA) was recorded pre- and post-training. The microperimeter automatically measured the mean retinal sensitivity, fixation stability [(including the percentage of fixation points located within 2° and 4° diameter circles, and calculated the area containing 68.2%, 95.4%, 99.6% of fixation points to construct the bivariate contour ellipse area (BCEA)] and fixation characteristics (percentage of fixation points within a 2° foveal diameter) pre- and post-training. The differences between mean retinal sensitivity, fixation stability, and fixation characteristics were compared pre- and post-training with P<0.05 indicating statistical significance.
Results：BCVA and mean retinal sensitivity improved significantly after training (P=0.0078, P=0.0071, respectively). The fixation stability at both 2° and 4° was significantly better after training (P=0.0020, P=0.0106, respectively). BCEAs encompassing 68.2%, 95.4%, 99.6% of fixation points decreased significantly after training (P=0.0377, P=0.0378, P=0.0377, respectively). The percentage of fixation points within the 2° foveal diameter increased significantly after training (P=0.0245).
Conclusions: MBFT with the MP-3 can effectively improve visual acuity, fixation characteristics, fixation stability and mean retinal sensitivity in children with eccentric fixation amblyopia, offering a new treatment for intractable cases.
Report of an intergeneric hybrid between the jandaya parakeet (Aratinga jandaya) and the beach parakeet (Eupsittula aurea) and a possible pairing between hybrid and parent
Authors: Leandro-Silva Victor , Queiroz Marney , Pereira Glauco Alves
Published: December 2023

Hybridization is relatively common and is underestimated due to the low level of knowledge about the reproductive biology of many bird species, especially neotropical ones. Here, we present a case of intergeneric hybridization in the Psittacidae family between the Jandaya Parakeet (Aratinga jandaya) and the Peach-fronted Parakeet (Eupsittula aurea). As well as reporting the hybrid, we also show a possible pairing between the hybrid and its parents. The plumage pattern of the recorded hybrid is similar to that of the Peach-fronted Parakeet, but with features that differ in the belly and head regions of the individual. Similarities in behavior and an almost complete overlap in the distribution of the species may have facilitated hybridization. Also, because they are illegally bred species (trafficking), we can't rule out the possibility that this individual came from captivity.
Evaluation of Post-Thrombolytic Events to Determine Appropriate ICU Monitoring Duration for Ischemic Stroke Patients
Authors: Reimer James , Wang Fajun , Ramiro Joanna , Welch Emily , Christopher Kara , Braun James
Published: December 2023

Background:
Alteplase, a tissue plasminogen activator, is the only FDA-approved medication for acute ischemic stroke (AIS). Current guidelines recommend monitoring patients in an intensive care unit (ICU) for 24 hours after thrombolytic therapy. However, recent studies have questioned the need for prolonged ICU monitoring. This retrospective cohort aims to identify potential candidates for early transition to a lower level of care by assessing risk factors for neurological deterioration, symptomatic intracranial hemorrhage (sICH), or need for ICU intervention within 24-hours post-thrombolysis.
Methods:
This retrospective cohort study included adult AIS patients 18 years and older who received thrombolysis in a tertiary care center. Patients were excluded if they were transferred to another facility, transitioned to comfort care or hospice care within 24 hours, or lacked imaging and National Institutes of Health Stroke Scale (NIHSS) score data. The primary endpoint was incidence of sICH between 0-12-hours and 12-24-hours. Secondary endpoints include the need for ICU intervention and rates of neurological deterioration.
Results:
The analysis included 204 patients who received the full dose of alteplase. Among them, 10 patients (4.9%) developed sICH, with the majority (n=7) occurring within 12 hours post-thrombolysis (p=0.350). Sixty-two patients required ICU interventions within 12 hours compared to 4 patients after 12 hours (p=0.022). Twenty-four patients had neurological deterioration within 12 hours and 7 patients after (p=0.415). Multivariable analysis identified mechanical thrombectomy and increased blood pressure at presentation as predictors of ICU need beyond 12 hours post-thrombolysis.
Conclusions:
Our study demonstrates that sICH, neurological deterioration, and need for ICU intervention rarely occurs beyond 12 hours after thrombolytic administration. These findings suggest that patients receiving thrombolysis for AIS, particularly those undergoing mechanical thrombectomy, may require 24 hours of ICU monitoring. Our results support the potential for early transition out from the ICU, leading to reduced hospital costs and optimized resource utilization.
Identifying obesogenic environment through spatial clustering of body mass index among adults
Authors: Wong Kimberly Yuin Yng , Moy Foong Ming , Shafie Aziz , Rampal Sanjay
Published: December 2023

Background
The environment plays a pivotal role in the increasing prevalence of obesity especially in developing countries due to globalization and nutrition transition. The tendency of body mass index (BMI) to cluster spatially indicates the presence of an obesogenic environment. However, spatial clustering analysis often requires lower regional data which are a challenge in developing countries. Therefore, this study aimed to determine the spatial clustering of BMI among adults in Malaysia through available point locations of national health survey respondents.
Method
This study utilized information of respondents aged 18 to59 years old from the National Health and Morbidity Survey (NHMS) 2014 and 2015 at Peninsular Malaysia and East Malaysia. Fast food restaurant proximity, district population density, and district median household income were determined from other sources. The analysis was conducted for total respondents and stratified by sex.
Results
Multilevel regression was used to produce the BMI estimates on a set of variables, adjusted for data clustering at enumeration blocks. Global Moran’s I and Local Indicator of Spatial Association statistics were applied to assess the general clustering and location of spatial clusters of BMI, respectively. Point locations of respondents and spatial weights of 8 km Euclidean radius or 5 nearest neighbours were applied. Spatial clustering of BMI independent of individual sociodemographic was significant (p < 0.001) in Peninsular and East Malaysia with Global Moran’s index of 0.12 and 0.15, respectively. High-BMI clusters (hotspots) were in suburban areas, whilst the main cities were low-BMI clusters (cold spots). Spatial clustering was greater among males with hotspots located closer to urban areas, whereas hotspots for females were in less urbanized areas.
Conclusion
Obesogenic environment was identified in suburban areas, where spatial clusters differ between males and females in some areas. Future studies and interventions on creating a healthier environment should be geographically targeted and consider gender differences.
A Universal Validation Method for Mitigating Machine Learning Extrapolation Risk
Authors: Yan Fangyou , Yu Mengxian , Zhou Yin-Ning , Wang Qiang
Published: December 2023

Machine Learning (ML) can provide decision-making advice for major challenges in science and engineering, and its rapid development has led to advances in fields like chemistry & medicine, earth & life, and communications & transportation. Grasping the trustworthiness of the decision-making advice given by ML models remains challenging, especially when applying them to samples outside the domain-of-application. Here, an untrustworthy application situation (i.e., complete extrapolation-failure) that would occur in models developed by ML methods involving tree algorithms is confirmed, and the root cause is revealed. Further, a universal extrapolation risk evaluation scheme, termed the extrapolation validation (EV) method, is proposed, which is not restricted to specific ML methods and model architecture in its applicability. The EV method quantitatively evaluates the extrapolation ability of 11 popularly applied ML methods and digitalizes the extrapolation risk arising from variations of the independent variables in each method. Meanwhile, the EV method provides insights and solutions for evaluating the reliability of out-of-distribution sample prediction and selecting trustworthy ML methods.
Establishment, operation and development of the electronic Pollen Information Network (ePIN) in Bavaria, Germany
Authors: Kutzora Susanne , Strasser Antje , Grenzebach Katharina , Ramona Gigl , Gebauer Robert , Weinberger Alisa , Szperalski Julia , Herr Caroline , Quartucci Caroline , Heinze Stefanie
Published: December 2023

Current data of actual airborne pollen concentrations is of high value for allergy sufferers and medical practitioners, as allergen avoidance is an important therapeutic approach to allergic rhinitis. In addition, pollen concentrations are important indicators for monitoring climate change, providing information on changes in plant growth, plant reactions to climate change and the immigration of neophytes. The importance of pollen monitoring as well as technical developments and the emergence of electronic pollen monitors led to the establishment of the electronic Pollen Information Network (ePIN) in Bavaria. ePIN is one of the first fully electronic pollen monitoring network worldwide that offers real-time pollen information to the public currently in three-hourly intervals. It consists of eight electronic pollen monitors in as well as four Hirst-type pollen traps. The ePIN data is public and free of charge. Consumers can access the information via a website or an app. This article describes ePIN, its establishment, operation and further development.
Evaluating Left Atrial Function Changes by Speckle Tracking Echocardiography in Type 2 Diabetes Patients in Central Vietnam: A Cross-Sectional Comparative Study
Authors: Dang Hai Nguyen Ngoc , Luong Thang Viet , Tran Toan Thanh
Published: December 2023

Background
Type 2 diabetes mellitus (T2DM) is a metabolic disorder that detrimentally affects multiple systems in the body, with a particular emphasis on the vascular and nervous systems. Despite its significant impact, limited studies have explored the influence of this condition on the left atrial (LA) function. To address this gap, our study utilized speckle tracking echocardiography (STE) to assess LA function in patients with T2DM in Central Vietnam.
Results
The cross-sectional comparative study enrolled 134 subjects involving 66 patients with T2DM and 68 healthy individuals meeting the selection and exclusion criteria of the study. In our study, healthy individuals demonstrated higher values for LA reservoir strain (LASr), LA conduit strain (LAScd), and LA contractile strain (LASct), measuring 38.75% ± 5.43%, 19.58% ± 5.91%, and 19.16% ± 4.98%, respectively. In contrast, the T2DM group exhibited lower values for LASr, LAScd, and LASct, which measured 31.2% ± 4.56%, 14.77% ± 6.3%, and 16.36% ± 4.82%, respectively (p < 0.05). Type 2 diabetes patients with normal LA volume index (LAVI) and normal left ventricular mass index (LVMI), LASr, LAScd, and LASct results were 32,07% ± 5,28%, 16,28% ± 6,95%, and 15,64% ± 5,32%, respectively.
Conclusions
STE of the LA reveals a noteworthy reduction in reservoir, conduit, and contractile functions within the T2DM group when compared to the control group (p < 0.05). Furthermore, these impaired functions persist in T2DM patients even in the absence of increased LAVI and LVMI.
Failure Patterns Analysis of Three-dimensional Radiation Therapy for Stage IV NSCLC Primary Tumors
Authors: zhang wei , liu jie , Wu Xin Yu , Ouyang Weiwei , Su Sheng Fa , ma zhu , Li qing song , yang Wengang , Chen Xiaxia , Lu Bing
Published: December 2023

Objective: To investigate the failure Patterns of three-dimensional radiotherapy to primary tumors combined with first-line systemic therapy and the influence of radiotherapy-related factors for stage IV non-small cell lung cancer (NSCLC). Methods: Seven hundred and forty-eight cases with the initial diagnosis of stage IV NSCLC that met the inclusion criteria were selected from 1509 cases registered from March 2003 to July 2021 for univariate analysis and failure Patterns test using the chi-square test. Kaplan-Meier survival analysis was performed with the log-rank test and Cox regression model for multi-factor prognostic analysis. P < 0.05 indicated a statistically significant difference.
Results: The failure incidence of first-line treatment was 72.3% in 748 cases and 33.6%, 38.8%, 19.4%, and 8.1% at ≤6 months, >6-12 months, >12-24 months, and >24 months, respectively. A significant difference was observed in the median survival time (MST), which was 7.2, 13.4, 22.2, and 37.6 months (X2 = 324.580, P < 0.000), respectively. The incidence of recurrence failure (RF) was 20.4%. A decrease was observed in the recurrence rate with the increasing dose of radiotherapy to the primary tumor, and no significant difference in the incidence of RF was observed between oligometastatic (OM) and non-oligometastatic (NOM) tumors. The incidence of metastatic failure (DF) was 89.4%, with the order of incidence as follows: brain > bone > lung > liver > pleural cavity > distant lymph nodes > adrenal gland > other body parts. The incidence of additional metastases (AM) was approximately 2/3, and the progression of synchronous metastases (PSM) was approximately 1/2 of the cases. The metastatic status, time of treatment failure, pathology type, gender, and ≥63 Gy during the same period of four to six cycles of chemotherapy were independent factors in the prediction of prognosis.
Conclusions: The failure Patterns of radiotherapy for primary tumors in stage IV NSCLC was different from that of first-line systemic therapy alone, with significantly lower local failure, predominant metastatic failure, and the highest incidence of brain metastases. The later treatment failure occurs, the longer will be the OS. OM, female sex, non-squamous cell carcinoma, the late occurrence of treatment failure, and ≥63Gy concurrent four to six cycles of chemotherapy were independent prognostic factors for prolonged survival.
A dosimetric comparison of brachytherapy sources for endometrial cancer: Iridium-192 and an electronic brachytherapy source with multichannel cylinders and a three-dimensional technique
Authors: Wang Wenhui , Wang Bei , Yu Lang , Zhen Hongnan , Zhang Yue , Feng Siqi , Chen Zhou , Qiu Jie , Zhang Fuquan , Hu Ke
Published: December 2023

Background and purpose
For patients with postoperative endometrial cancer (EC), Ir192 vaginal brachytherapy (IBT) was commonly used. We would devise a novel multi-channel vaginal applicator which could be equipped to an electronic brachytherapy (EBT) device. We aimed to explore the physical parameter differences between EBT and IBT.
Materials and Methods
This study retrospectively included 20 EC patients receiving adjuvant IBT from March 1, 2023 to May 1, 2023. The multi-channel vaginal cylinders were used and three-dimensional plans were performed. We designed a multi-channel vaginal applicator model and simulate a three-dimensional EBT plan.
Results
Twenty EBT plans were compared with 20 IBT plans. For mean dose of CTV, EBT was significantly higher (738.3 vs. 684.3cGy, p = 0.000). As to CTV coverage, there was no significant difference between EBT and IBT plan. For high-dose areas (V200% and V150%), EBT values were significantly higher. There were no significant differences in the maximum doses of vaginal mucosa between EBT and IBT, whether at the apex (median dose: 961.5 vs. 844.0cGy, p = 0.079) or in the middle segment. For bladder and rectum, both the low-dose area and high-dose area, values from EBT plans were significantly lower. For the conformity index, there was no significant difference between EBT and IBT plans. For the dose homogeneity index, EBT value was lower.
Conclusion
For patients who would use this novel multi-channel vaginal applicator and receive a three-dimensional radiotherapy plan, the target volume would get a higher dose while retaining the equivalent target coverage and organs at risk would get lower dose.