bluuebunny/crossref_metadata_2025 huggingface dataset:
Traditional management of female infertility in Africa: a scoping review protocol
Authors: Mashaah Thokozile , Muziringa Masimba , Gomo Exnevia , Chideme-Maradzika Julita , Madziyire Mugove Gerald , January James
Published: November 2023

Introduction

Infertility adversely affects the sexual reproductive health and overall quality of life of people. Recent estimates show that about one in six people (both men and women) experience infertility in their lifetime. This scoping review will, therefore, map the existing evidence on traditional management of female infertility in Africa including the effectiveness of the traditional healthcare systems, to inform policy and practice.

Methods

The scoping review will be guided by the Arksey and O’Malley framework in conjunction with the Joanna Briggs Institute updated methodological guidance for scoping reviews. A search strategy will be developed, which will target the following databases: PubMed, Scopus, Embase, CINAHL, Google Scholar and Africa-Wide Information including grey literature. The screening of titles, abstracts and full text will be done by two independent reviewers. Data will be extracted, analysed numerically and thematically. The reporting of the scoping review will use the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews checklist.

Ethics and dissemination

This scoping review will not require ethical approval as this is secondary analysis of peer-reviewed articles. The findings of the review will be disseminated on various platforms including conferences, meetings to key stakeholders and in a peer-reviewed journal for wider sharing.
Comparison of relative change with effect size metrics in Alzheimer’s disease clinical trials
Authors: Goldberg Terry E , Lee Seonjoo , Devanand Davangere P , Schneider Lon S
Published: November 2023

Background

Per cent slowing of decline is frequently used as a metric of outcome in Alzheimer’s disease (AD) clinical trials, but it may be misleading. Our objective was to determine whether per cent slowing of decline or Cohen’s d is the more valid and informative measure of efficacy.

Methods

Outcome measures of interest were per cent slowing of decline; Cohen’s d effect size and number-needed-to-treat (NNT). Data from a graphic were used to model the inter-relationships among Cohen’s d, placebo decline in raw score units and per cent slowing of decline with active treatment. NNTs were computed based on different magnitudes of d. Last, we tabulated recent AD anti-amyloid clinical trials that reported per cent slowing and for which we computed their respective d’s and NNTs.

Results

We demonstrated that d and per cent slowing were potentially independent. While per cent slowing of decline was dependent on placebo decline and did not include variance in its computation, d was dependent on both group mean difference and pooled SD. We next showed that d was a critical determinant of NNT, such that NNT was uniformly smaller when d was larger. In recent AD associated trials including those focused on anti-amyloid biologics, d’s were below 0.23 and thus considered small, while per cent slowing was in the 22–29% range and NNTs ranged from 14 to 18.

Conclusions

Standardised effect size is a more meaningful outcome than per cent slowing of decline because it determines group overlap, which can directly influence NNT computations, and yield information on the likelihood of minimum clinically important differences. In AD, greater use of effect sizes, NNTs, rather than relative per cent slowing, will improve the ability to interpret clinical trial results and evaluate the clinical meaningfulness of statistically significant results.
Quantitative MRI outcome measures in CMT1A using automated lower limb muscle segmentation
Authors: O'Donnell Luke F , Pipis Menelaos , Thornton John S , Kanber Baris , Wastling Stephen , McDowell Amy , Zafeiropoulos Nick , Laura Matilde , Skorupinska Mariola , Record Christopher J , Doherty Carolynne M , Herrmann David N , Zetterberg Henrik , Heslegrave Amanda J , Laban Rhiannon , Rossor Alexander M , Morrow Jasper M , Reilly Mary M
Published: November 2023

Background

Lower limb muscle magnetic resonance imaging (MRI) obtained fat fraction (FF) can detect disease progression in patients with Charcot-Marie-Tooth disease 1A (CMT1A). However, analysis is time-consuming and requires manual segmentation of lower limb muscles. We aimed to assess the responsiveness, efficiency and accuracy of acquiring FF MRI using an artificial intelligence-enabled automated segmentation technique.

Methods

We recruited 20 CMT1A patients and 7 controls for assessment at baseline and 12 months. The three-point-Dixon fat water separation technique was used to determine thigh-level and calf-level muscle FF at a single slice using regions of interest defined using Musclesense, a trained artificial neural network for lower limb muscle image segmentation. A quality control (QC) check and correction of the automated segmentations was undertaken by a trained observer.

Results

The QC check took on average 30 seconds per slice to complete. Using QC checked segmentations, the mean calf-level FF increased significantly in CMT1A patients from baseline over an average follow-up of 12.5 months (1.15%±1.77%, paired t-test p=0.016). Standardised response mean (SRM) in patients was 0.65. Without QC checks, the mean FF change between baseline and follow-up, at 1.15%±1.68% (paired t-test p=0.01), was almost identical to that seen in the corrected data, with a similar overall SRM at 0.69.

Conclusions

Using automated image segmentation for the first time in a longitudinal study in CMT, we have demonstrated that calf FF has similar responsiveness to previously published data, is efficient with minimal time needed for QC checks and is accurate with minimal corrections needed.
Cancer advance care planning: development of a screening tool
Authors: Berlin Pia , Göggelmann Lena , Herzog Svenja , Pedrosa Carrasco Anna J , Hauck Johannes , Timmesfeld Nina , Kruse Johannes , Rief Winfried , Riera Knorrenschild Jorge , von Blanckenburg Pia , Seifart Carola
Published: November 2023

Objectives

Advance care discussions are a useful communication tools for medical preferences and beneficial for shared decision-making processes in hospital settings. The present study developed the first screening tool for need for advance care planning (ACP).

Methods

In phase 1 (n=92), items were evaluated using feasibility analysis and item reduction. In phase 2 (n=201), reduced screening items were analysed for predictive value of need for ACP. Statistical analysis included receiver-operating characteristics analysis (area under the curve>0.80), optimal cut-off based on sensitivity and specificity, interpretation of OR and construct validity using correlation with death anxiety, communication avoidance within families and trust based on the relationship with the treating physician.

Results

Participants in both phases were approximately 60 years old with non-curative prognosis. After item reduction, predictive values of four possible items with good item difficulty and discrimination were compared for mild, moderate and great levels of death anxiety. A two-item combination ofI am burdened by thoughts of an unfavourable course of the diseaseandI am burdened by the feeling of being ill-prepared for the end of lifeshowed best prediction of death anxiety and communication avoidance. Clinical cut-off at sum-score ≥6 was of high sensitivity (95%) and specificity (81%). Previous use of social support and readiness for ACP was related to higher chance of interest in ACP.

Conclusion

Screening for need of ACP is possible with two objective items and one subjective item. Positive screening therefore indicates when to offer ACP discussions and provides routine estimation of ACP need in clinical practice.
Nurse practitioner and physician end-of-life home visits and end-of-life outcomes
Authors: Scott Mary M , Ramzy Amy , Isenberg Sarina Roslyn , Webber Colleen , Eddeen Anan Bader , Murmann Maya , Mahdavi Roshanak , Howard Michelle , Kendall Claire E , Klinger Christopher , Marshall Denise , Sinnarajah Aynharan , Ponka David , Buchman Sandy , Bennett Carol , Tanuseputro Peter , Dahrouge Simone , May Kathryn , Heer Carrie , Cooper Dana , Manuel Douglas , Thavorn Kednapa , Hsu Amy T
Published: November 2023

Objectives

Physicians and nurse practitioners (NPs) play critical roles in supporting palliative and end-of-life care in the community. We examined healthcare outcomes among patients who received home visits from physicians and NPs in the 90 days before death.

Methods

We conducted a retrospective cohort study using linked data of adult home care users in Ontario, Canada, who died between 1 January 2018 and 31 December 2019. Healthcare outcomes included medications for pain and symptom management, emergency department (ED) visits, hospitalisations and a community-based death. We compared the characteristics of and outcomes in decedents who received a home visit from an NP, physician and both to those who did not receive a home visit.

Results

Half (56.9%) of adult decedents in Ontario did not receive a home visit from a provider in the last 90 days of life; 34.5% received at least one visit from a physician, 3.8% from an NP and 4.9% from both. Compared with those without any visits, having at least one home visit reduced the odds of hospitalisation and ED visits, and increased the odds of receiving medications for pain and symptom management and achieving a community-based death. Observed effects were larger in patients who received at least one visit from both.

Conclusions

Beyond home care, receiving home visits from primary care providers near the end of life may be associated with better outcomes that are aligned with patients’ preferences—emphasising the importance of NPs and physicians’ role in supporting people near the end of life.
Impact of bedside ultrasound on care in specialist palliative care units: a qualitative study
Authors: Moore Steven , Stoneham Bethany , Taylor Vanessa , Perkins Paul
Published: November 2023

Objectives

To explore the experiences of palliative care doctors regarding the clinical impact of ultrasound in specialist palliative care units (SPCUs).

Methods

The study adopted a qualitative research design using semistructured interviews and a reflexivity journal. Six participants were recruited through purposive and snowball sampling. Findings were analysed using framework analysis.

Results

Analysis used four predetermined themes: (1) practicalities, (2) clinical indications, (3) impact on patient care and service provision and (4) governance and training. Analysis identified a relationship between procedural confidence and use of ultrasound.

Conclusions

Our study provides information for understanding the current use and limitations of ultrasound in SPCUs. Ultrasound leads to safer practice, especially when performing invasive procedures such as paracentesis. Development of standards around the use of, and training of staff undertaking ultrasound in specialist palliative care, are recommended.
Hemodynamic effects of the blood flow on aneurysm rupture risk: Geometrical aspects
Authors: Raheem Al-Behadili Faisal , Farqad Rand Otbah , Aminian Saman , Dabis Hasan Khalid , Ghane Golnar , Hassanvand Amin , Bahramkhoo M.
Published: November 2023

This study provides comprehensive information about the impact of the parent vessel’s shape on the risk of cerebral aneurysm rupture. It focuses on internal carotid artery (ICA) aneurysms with varying parent vessel sizes, analyzing different aspects of blood flow dynamics. By comparing various hemodynamic factors such as wall shear stress (WSS), oscillatory shear index (OSI) and pressure distribution, the researchers aim to establish a meaningful relationship between the parent vessel’s mean diameter and these significant hemodynamic parameters.
Thermal and structural analysis of laser beam machining process on a Dual Phase 780 (DP780) workpiece
Authors: Mishra Rajat , Aneesh T. , Hotta Tapano Kumar , Mohanty Chinmaya P. , Shaik Saboor , Gupta Manoj
Published: November 2023

This study highlights the development of an intelligent thermo-structural model for precise prediction of responses such as the width of heat-affected zone (HAZ), equivalent stress and total deformation for laser beam machining (LBM) process while machining a novel Dual Phase 780 (DP780) workpiece. The numerical model is analyzed through response surface Box–Behnken design to study the consequences of input parameters such as voltage ([Formula: see text]), current ([Formula: see text]) and cutting speed ([Formula: see text]) on the above-mentioned response parameters. The results achieved through the numerical model are validated by comparing them with experimental results. Furthermore, a careful parametric study along with line and surface plot analysis is conducted to evaluate both linear and quadratic relationships between the input and the response parameters, respectively. The results indicate that the HAZ can be reduced significantly through efficient laser processing with optimum input parameters. The process parameters are optimized by developing an objective function for each of the response parameters through regression analysis. An extremum model is used to obtain the ideal values of HAZ, equivalent stress and total deformation. These results are also validated by conducting a confirmative test using the numerical simulation model which is validated through experiments.
Photonuclear reaction in 67Zn
Authors: Kahane Sylvian , Moreh Raymond
Published: November 2023

Mono-energetic [Formula: see text]-beams ([Formula: see text][Formula: see text]eV) based on thermal neutron capture, in a nuclear reactor, using the Mn([Formula: see text]) reaction were utilized for generating a fast neutron source from Zinc, via the [Formula: see text]Zn([Formula: see text]) reaction. One of the incident [Formula: see text]-lines of the Mn source at [Formula: see text][Formula: see text]keV, photoexcites by chance a resonance level in [Formula: see text]Zn, with subsequent emission of neutrons at an energy of 191[Formula: see text]keV. The cross-section for this process was measured and found to be [Formula: see text][Formula: see text]mb with an intensity of the order of 104[Formula: see text]n/s. The angular distribution of the 191[Formula: see text]keV neutron group was also measured.
Novel solitonary solutions of (2+1)-dimensional variable coefficient NLS equations
Authors: Wang Shaofu
Published: November 2023

The objective of this paper is to obtain some solitary solutions of (2+1)-dimensional variable coefficient nonlinear Schrödinger (NLS) equations through computerized symbolic computation. By applying the [Formula: see text]-expansion and homogeneous balance method, two soliton solutions are constructed for the NLS equations, which provide a model of the interaction between two waves. Consequently, the solitary solutions are obtained in different forms of dynamical structures. Moreover, the propagation behavior of the resulting solitonary solutions is discussed. The results have rich physical structures that are helpful to explain the nonlinear soliton phenomena in nonlinear optics and plasma physics.
Compressive Behavior of Concrete Subjected to High Rate of Loading Using SHPB
Authors: Khan M. M. , Kamran  , Iqbal M. A.
Published: November 2023

Concrete is the most widely used construction material for strategic structures which are subjected to high rate of loading (impact and blast loading). Hence, the study of the concrete material becomes essential day by day for the structural engineers for the analysis and design of the concrete structures for safety and security purposes. This paper focuses on investigating the dynamic compressive response of the standard concrete (M35) and high-strength concrete (M60) under impact loading by using the newly developed split Hopkinson pressure bar setup (SHPB) apparatus. First, the calibration of SHPB performed at a 4.90[Formula: see text]ms[Formula: see text] impact velocity generates almost similar incident and transmission trapezoidal profile waves with minor reflection showing accuracy. Second, the dynamic compression tests were performed on the standard concrete (SC) and high-strength concrete (HSC) specimens of 29.5[Formula: see text]mm in diameter and [Formula: see text][Formula: see text]mm in length with an aspect ratio of about 1([Formula: see text]) and a comparative study of strain rate effect and quasi-static compressive strength on the material properties has been investigated. The dynamic compression behavior of SC and HSC thus studied under varying strain rates has been presented in terms of the compressive strength, dynamic increase factor, stress–strain relationship, material failure, and fragmentation. Compressive strength increments of 114% and 41% were observed in SC and HSC as the loading condition changed from quasi-static to dynamic. In addition, the HSC described the [Formula: see text]% and [Formula: see text]% higher compressive strength corresponding to 290[Formula: see text]s[Formula: see text] and 131[Formula: see text]s[Formula: see text] strain rate as compared to SC describing that the HSC is more sensitive to the strain rate. The dynamic mechanical properties increased with an increase in the strain rate, and the DIFs were found to vary in the range of 1.42–2.14 and 1.07–1.41 for SC and HSC, respectively. The critical strain and ultimate strain were also found to be sensitive to strain rate and increased with increase in strain rate for both grades of concrete. Moreover, strain rates exert a noteworthy influence on fragmentation, leading to an increase in the percentage weight of fine fragments and a decrease in the percentage weight of large fragments as the strain rate increases. Additionally, there is an overall increase in the quantity of fragments for both SC and HSC specimens under these conditions. The flaky, elongated, angular, and irregular shape fragments were observed but their quantity and size varied significantly with strain rate.
Power cocentralizing generalized derivations on left ideals of prime rings
Authors: Liu Cheng-Kai , Tsai Yuan-Tsung
Published: November 2023

Let [Formula: see text] be a prime ring with center [Formula: see text], let [Formula: see text] be a nonzero left ideal of [Formula: see text] and let [Formula: see text] be two generalized derivations of [Formula: see text]. In this paper, we completely characterize the structure of [Formula: see text] and all possible forms of [Formula: see text] such that [Formula: see text] for all [Formula: see text], where [Formula: see text] are fixed positive integers. With this, several known results can be either deduced or generalized. Moreover, our result can be regarded as the one-sided ideal version of the theorem obtained by Lee and Zhou in [An identity with generalized derivations, J. Algebra Appl. 8 (2009) 307–317].
Governing Online Rumor: An Uncertain Intervention Timing Model for Online Rumor Propagation from the Perspective of Government
Authors: Jin Meiling , Liu Fengming , Ning Yufu , Zhou Jian
Published: November 2023

In view of different types of online rumors, when the governance institutions (government departments) intervene to achieve the least cost and the best effect is a core issue of rumor governance. Based on the perspective of the government, under the premise of limited human, material and financial resources, and considering the different impacts of government intervention opportunities on the spread of different types of rumors, this paper establishes an uncertain multi-objective network rumor transmission intervention timing model, so as to achieve the optimal allocation of government intervention opportunities for different types of online rumors, minimize the total cost and maximize the inhibition effect of rumor spreading. Then, the equivalent form of the model is given, and the model is solved. In addition, numerical experiments are conducted on three types of rumors during the COVID-19 pandemic. The experimental results show that when the types of online rumors and the focus of government departments on cost and governance effect are different, the optimal time for intervention will change. Finally, combined with the experimental results, corresponding countermeasures and suggestions are put forward for the supervision of online rumors by government departments.
Soft Disemigraphs, Degrees and Digraphs Associated, and Their AND and OR Operations
Authors: George Bobin , Jose Jinta , Thumbakara Rajesh K.
Published: November 2023

A soft set is a classification of elements of the universe with respect to some given set of parameters. It is an approach for modeling vagueness and uncertainty. Soft semigraphs are used to provide a parametrized point of view for semigraphs. The theory of soft semigraphs is a fast-developing area in semigraph theory due to its capability to deal with the parametrization tool. In this paper, we introduce soft disemigraph by applying the concept of soft set in disemigraph and the concepts of degrees and digraphs associated with a soft disemigraph. Also we introduce AND and OR operations on them and investigate some of their properties.
Fe3O4@Co3S4 Nanocatalyst: Enhanced Activation of Peroxymonosulfate for Acetaminophen Degradation
Authors: Guan Xiaotong , Jiang Yu , Meng Liang
Published: November 2023

How to accelerate the electron transfer to promote the circulating efficiency of Fe[Formula: see text]/Fe[Formula: see text] is a key problem to be solved, so that magnetic particles can activate peroxymonosulfate well to efficiently degrade acetaminophen (ACE). Herein, a Fe3O4@Co3S4 catalyst was prepared by modifying Co3S4 nanosheets on the surface of magnetic Fe3O4 particles. The Co[Formula: see text] in the modified layer Co3S4 accelerates the rate of electron transfer between Fe[Formula: see text] and Fe[Formula: see text], thus promoting the circulating efficiency of Fe[Formula: see text]/Fe[Formula: see text]. Fe3O4@Co3S4/PMS system can degrade over 95% of ACE within 5[Formula: see text]min. Quenching experiment and ESR tests prove that non-radical 1O2 and [Formula: see text] played predominant roles in the advanced oxidation process. And after six cycles, the degradation rate could still be higher than 50%.
Enhancement in Efficiency of Methyl Ammonium Tin Iodide-Based Perovskite Solar Cell Using SCAPS-1D
Authors: Sharma Divya , Mehra Rajesh , Raj Balwinder
Published: November 2023

Perovskite solar cells came to limelight owing to their simple fabrication processes, cost-effectiveness, better optoelectronic characteristics and outstanding power conversion efficiencies (PCEs). These solar cells have simply outpaced their rival cells since the alteration from aqueous hole transport layers (HTLs) to solid HTLs. Various layers of a perovskite cell viz. light absorber layer, electron transport layer (ETL) and HTL play a decisive role in ascertaining its performance. Today, various types of organic and inorganic HTLs are available but inorganic HTLs have gained an upper hand over their organic counterparts in terms of stability, cost, fabrication and material properties which represent them as a prospective candidate for optimum perovskite device. Copper antimony sulfide (CuSbS[Formula: see text] is a common HTL available in abundance with the benefit of an adequate bandwidth of 1.54[Formula: see text]eV. In addition, CuSbS2 possesses substantial band aligning and electron inhibiting features. This research paper elaborates a relative study of two perovskite solar devices possessing discrete inorganic hole transport layers, i.e., cuprous iodide (CuI) and copper antimony sulfide (CuSbS[Formula: see text], and discrete perovskite layers, i.e., MAPbI[Formula: see text]Cl[Formula: see text] and MASnI3, using the same negative charge transport layer, i.e., Cd[Formula: see text]Zn[Formula: see text]S, through numerical simulation employing SCAPS-1D. The effects of thickness, defect density and doping concentration with respect to absorbing layer on the efficiency and other parameters of perovskite layers are also discussed. By employing CuSbS2 with MASnI3 in the proposed device, the solar cell parameters are efficacious enough demonstrating the [Formula: see text] of 1.10[Formula: see text]V, PCE of 31.11%, fill factor (FF) of 83.05% and [Formula: see text] of 33.75[Formula: see text]mA[Formula: see text]⋅[Formula: see text]cm[Formula: see text].
Unitary connections on Bratteli diagrams
Authors: Das Paramita , Ghosh Mainak , Ghosh Shamindra , Jones Corey
Published: November 2023

In this paper, we extend Ocneanu’s theory of connections on graphs to define a 2-category whose 0-cells are tracial Bratteli diagrams, and whose 1-cells are generalizations of unitary connections. We show that this 2-category admits an embedding into the 2-category of hyperfinite von Neumann algebras, generalizing fundamental results from subfactor theory to a 2-categorical setting.
Selection of thin-film-integrable substrates for THz modulator
Authors: Liu Tong , Ran Jia , Dong Wen , Sun Qiushuo , Yu Xiao , Chen Long , Zhang Guangzu , Luo Wei , Fu Qiuyun , Jiang Shenglin
Published: November 2023

The integrable substrate for THz modulation directly influences both the quality of films and THz absorption. Currently, the available THz substrate candidate library is still not clear. Here, we have carried out a systematic investigation of commonly used commercial substrates, including Si, quartz SiO2, MgO, Al2O3, GdScO3 and TbScO3 in the range of 0.4–1.6[Formula: see text]THz. It is found that low resistance Si, TSO and GSO are certainly not appropriate for THz light modulation due to their relatively higher absorption and dielectric constant, while the rest show better THz transmittance, low refractive index and loss. However, the dielectric constant and refractive index of high resistance Si are generally two times larger than quartz SiO2, Al2O3 and MgO. Compared with Al2O3 and MgO, quartz SiO2 shows at least 50% lower dielectric constant, refractive index and absorption, making it the best candidate. Our research is believed to build the rich substrate candidate library for THz range light modulation.
Does Random Auction Ending Curb Stock Price Manipulation?
Authors: Lin Yiping , Michayluk David , Zou Mi
Published: November 2023

This paper examines the effect on stock market efficiency and potential market manipulation of introducing a random ending time for the call auctions that start and end continuous trading on three equity markets. We find that the probability of a price dislocation at the end of the auction declines, indicating a lower risk of market manipulation. In addition, the variance ratio and market-adjusted return volatility measures decrease, suggesting a more efficient and less volatile price discovery process. We confirm a behavioral change in order submissions by observing the timing of order entry, amendments, and deletions on one of the exchanges for which we have access to order data. Overall, our results indicate that adding a random auction ending time can reduce the risk of stock market manipulation and improve price efficiency.
Component-distinguishable Co-location and Resource Reclamation for High-throughput Computing
Authors: Zhao Laiping , Cui Yushuai , Yang Yanan , Zhou Xiaobo , Qiu Tie , Li Keqiu , Bao Yungang
Published: November 2023

Cloud service providers improve resource utilization by co-locating latency-critical (LC) workloads with best-effort batch (BE) jobs in datacenters. However, they usually treat multi-component LCs as monolithic applications and treat BEs as “second-class citizens” when allocating resources to them. Neglecting the inconsistent interference tolerance abilities of LC components and the inconsistent preemption loss of BE workloads can result in missed co-location opportunities for higher throughput.

We present
Rhythm
, a co-location controller that deploys workloads and reclaims resources rhythmically for maximizing the system throughput while guaranteeing LC service’s tail latency requirement. The key idea is to differentiate the BE throughput launched with each LC component, that is, components with higher interference tolerance can be deployed together with more BE jobs. It also assigns different reclamation priority values to BEs by evaluating their preemption losses into a multi-level reclamation queue. We implement and evaluate
Rhythm
using workloads in the form of containerized processes and microservices. Experimental results show that it can improve the system throughput by 47.3%, CPU utilization by 38.6%, and memory bandwidth utilization by 45.4% while guaranteeing the tail latency requirement.
Malnutrition Is Associated with Diabetic Retinopathy in Patients with Type 2 Diabetes
Authors: Wei Wen , Lin Ruiyu , Li Shihai , Chen Zheyuan , Kang Qianqian , Lv Fenyan , Zhong Wenying , Chen Hangju , Tu Mei
Published: November 2023

Background. The relationship between malnutrition and diabetic retinopathy (DR) is still unclear. The purpose of this study is to investigate the relationship between malnutrition and DR in type 2 diabetic patients. Methods. A cross-sectional study was conducted on 612 patients with type 2 diabetes mellitus. Four malnutrition assessment tools: Global Leadership Initiative on Malnutrition (GLIM) criteria, controlling nutritional status (CONUT), nutritional risk index (NRI), and prognostic nutritional index (PNI), were applied to assess the nutritional status of the study population. The association between malnutrition and DR was examined using multivariable logistic regression and ordered logistic regression. Results. The proportion of malnutrition varied from 10.0% to 34.3% in total patients and from 16.3% to 45.1% in DR patients across the assessment tools. DR patients were more likely to be malnourished than patients without DR. The adjusted odds ratios (aOR) and 95% confidence interval (CI) for DR of malnutrition defined by different tools were 1.86 (1.01-3.14) for GLIM criteria, 1.67 (1.04-2.70) for NRI, and 2.24 (1.07-4.69) for PNI. The aOR and 95% CI for the severity of DR of malnutrition defined by different tools were 1.99 (1.12-3.51) for GLIM criteria, 1.65 (1.06-2.58) for NRI, and 2.51 (1.31-4.79) for PNI. Conclusions. Malnutrition was common in DR patients, and it was closely linked to the presence and severity of DR. Diabetic patients with DR should undergo nutritional assessment and early treatment of malnutrition to prevent the onset or progression of DR.
Analysis of the Application and Benefits of Aircraft Electric Wheel Systems during Taxi and Take-Off
Authors: Sun Shuang , Liao Yu , Ding Shuo , Lei Yinte , Li Song , Hu Zhijie , Dong Hualong
Published: November 2023

An electric wheel hybrid power system is designed for driving a large single-aisle passenger aircraft during the take-off and ground taxi phases, which consists of an APU, an energy storage system, and a motor. In the taxi phase, the electric wheel hybrid power system works alone, and the turbofan engine does not work, reducing fuel consumption and pollution emissions. During the take-off rolling phase, the electric wheel hybrid power system and turbofan engine work together to reduce the thrust requirement of the turbofan engine. This article establishes an aircraft kinematic model, hybrid power system model, and a mechanical wheel model. The feasibility of the collaborative work of the electric wheels and the turbofan engines is verified by simulations. By utilizing the established hybrid system of electric motor wheels, the fuel consumption can be reduced, and the emissions of CO, HC, and NOX can also be diminished to varying degrees. The input of motor power leads to lower turbine inlet temperature, thereby enhancing the turbofan engine’s service life by approximately 4.3% and saving operational costs.
The Importance of Acromegaloid Physical Features for Clinical Practice
Authors: Perić Ivona , Zamolo Gordana , Bezak Boris , Klen Jasna , Jurišić-Eržen Dubravka
Published: November 2023

Acromegaly and gigantism are hormonal disorders which develop as a consequence of chronic growth hormone hypersecretion. The prefix pseudo- is used to describe a certain clinical condition without a clearly proven characteristic of pathophysiological mechanism and basic biochemical features; pseudoacromegaly or acromegaloidism match the definition from above. In this case reports, we will try to provide a concise overview of diagnostic evaluation of acromegaloid physical appearance, while discussing two cases of patients who have similar clinical acromegaloid features as the first sign of the disease but have completely different etiologic backgrounds of their acromegalic appearance. The first case is of a 57-year-old male who presented with a marked acral growth and coarse facial features, but the diagnosis of secondary amyloidosis caused by multiple myeloma was confirmed just after biopsy of tongue and buccal mucosa. The second case is that of a 63-year-old male with an acromegaloid appearance caused by ectopic secretion of GH secreting lung carcinoma. The early diagnosis of ectopic acromegaly and pseudoacromegaly is still a challenging process. The key task is to confirm the GH axis abnormalities and establish the underlying disease, as a crucial step for faster treatment and need to avoid unnecessary therapeutic procedures to decreased mortality and improved quality of life.
The Benefits of Low-Carbohydrate, High-Fat (LCHF) Diet on Body Composition, Leg Volume, and Pain in Women with Lipedema
Authors: Jeziorek Małgorzata , Chachaj Angelika , Sowicz Monika , Adaszyńska Agnieszka , Truszyński Aleksander , Putek Justyna , Kujawa Krzysztof , Szuba Andrzej
Published: November 2023

This study aimed to assess the potential benefits of a low-carbohydrate, high-fat (LCHF) diet on body composition, leg volume, and pain reduction in women with lipedema compared to overweight or women with obesity. The study included 113 female participants, 56 with lipedema and 57 with overweight/obesity (BMI >25 kg/m2) without lipedema. All subjects were prescribed a low-carbohydrate, high-fat (LCHF) diet with anti-inflammatory properties to adhere to for a duration of 7 months. Measurements of anthropometry, body weight, composition, and pain (VAS) were conducted at the study’s commencement and conclusion. 52 participants completed the study. Both groups experienced a similar weight reduction, amounting to 12.9% compared to the baseline (−10.8 kg vs. −11.9 kg; p = 0.14, for lipedema and women with overweight/obesity, respectively). The most reduction was in body fat mass. Improvements in various parameters were observed, except for ankle circumferences, which decreased more in the lipedema group. Lipedema participants showed significantly reduced pain levels following the LCHF diet (4.6 ± 2.6 vs 3.0 ± 2.3;

p
 
<
 
0.001

). The LCHF diet holds promise for weight loss, body fat reduction, leg volume management, and pain alleviation in women with lipedema. These findings provide valuable insights into potential therapeutic strategies for lipedema management.
Dyslipidemias: Prevalence and Associated Factors among Lactating Women in a Lower- and Middle-Income Country, Ghana
Authors: Helegbe Gideon Kofi , Abdullah Saeed Jabactey , Mohammed Baba Sulemana
Published: November 2023

Background. Dyslipidemia, an abnormally high level of lipids in the blood, has a negative impact on the health status of the individual and has lately emerged as a major public health concern, especially for low- and middle-income countries (LMIC) globally, including Ghana. However, it is still unclear what the burden and drivers of these lipid abnormalities are, especially among lactating women in the Upper West of Ghana. Thus, this study is aimed at determining the prevalence of dyslipidemia and its associated factors among lactating mothers in the Wa Municipality of Ghana. Methodology. A cross-sectional study was conducted from May to June 2020 in 8 health facilities within the Wa Municipality. Multistage and simple random sampling methods were used to select the facilities and the 200 study subjects. Sociodemographic data were collected using questionnaires, while blood samples were taken to determine the lipid profile of participants. Dietary patterns were also assessed using the Food Frequency Questionnaire (FFQ). Data were processed and analyzed using SPSS 17 software (SPSS, Inc., Chicago, IL). The chi-square test and multiple regression analysis were performed to determine the predictors associated with the various types of dyslipidemia, with statistical significance set at a

p

value < 0.05. Results. The prevalence of hypercholesterolemia (LDL-C), hypo-HDL-cholesterolemia, and hypertriglyceridemia (TG) was 57%, 59%, and 22%, respectively. Chi-square and multinomial regression analysis revealed that duration of lactation (

X

2

=
3.95

,

p
=
0.047

), religion (

AOR
=
0.375

, 95% CI 0.144–0.978,

p
=
0.045

), low income (

AOR
=
0.116

, 95% CI 0.026–0.514,

p
=
0.005

), middle income (

AOR
=
0.163

, 95% CI 0.044–0.600,

p
=
0.006

), and alcohol intake (

AOR
=
6.312

, 95% CI 1.108–35.949,

p
=
0.038

) were associated with LDL-C, while age (

AOR
=
0.963

, 95% CI 0.910-1.019,

p
<
0.001

) and educational status (

AOR
=
0.365

, 95% CI 0.140–0.954,

p
=
0.040

) predicted HDL status. Conclusion. Dyslipidemia is common among lactating mothers of Wa Municipality, and it is predicted by lifestyle factors. Furthermore, future research to look at a larger sample size on dyslipidemia during lactation is recommended.
A Novel Multiplex LAMP Assay for the Rapid and Accurate Diagnosis of Visceral Leishmaniasis Caused by Leishmania infantum from Iran
Authors: Samsami Sahar , Namavari Sahar , Ataei Saeed , Ghasemian Abdolmajid , Yazdanpanah Ava , Sepahi Neda , Hatam Gholamreza , Faramarzi Hossein , Mirzaei Hadi , Ranjbar Razie , Ghanbariasad Ali
Published: November 2023

Visceral leishmaniosis (VL) is one of the neglected tropical diseases despite being responsible for serious clinical symptoms, some of which lead to fatal outcomes. Thus, there is a need to apply accurate, rapid, and specific diagnostic measurements in order to control the disease and reduce the mortality rate. We aimed to develop and validate a multiplex LAMP assay for the diagnosis of VL caused by Leishmania infantum (L. infantum). Moreover, a thorough assessment was conducted to determine the effectiveness of multiplex LAMP in identifying various Leishmania species, such as Leishmania tropica (L. tropica) and Leishmania major (L. major) in comparison to Leishmania infantum (L. infantum). The diagnostic performance of the multiplex LAMP method for VL was compared to each LAMP assay, real-time polymerase chain reaction (RT-qPCR), and nested PCR technique. Two separated primers were set and used in a multiplex LAMP assay which was designed based on the ITS2 (internal transcribed spacer II) and were selected on the basis of conserved and high copy number region. Multiplex LAMP primers were designed using an online tool available at https://www.primerexplorer.jp/e. The alignment was performed using MEGA5, and the primers were further adjusted utilizing GENE Runner software. All molecular methods were tested on the serial dilution of cloned plasmid containing ITS region from standard strains of L. infantum, L. tropica, and L. major. Moreover, multiplex LAMP assay was evaluated and compared based on both standard strains and 55 clinical samples from humans as well as dogs. Various approaches were applied to interpret the multiplex LAMP reaction which deciphered a higher sensitivity when compared to the RT-qPCR for L. infantum (one copy number of plasmid, equal to 0.85 femtograms (fg) of plasmid concentration, and 0.004 parasite DNA per μL) detection while these three standard strains of Leishmania were confirmed to contain 40 DNA copies using RT-qPCR. Additionally, the multiplex LAMP detection limit was approximately equivalent to RT-qPCR for L. major and L. tropica, which included 0.342 picograms (pg) and 342 femtograms (fg) of plasmid concentration, 4 × 103 and 4 × 102 copy number of plasmid, and 17.1 and 1.71 parasite DNA per μL for L. major and L. tropica, respectively. Nested PCR exhibited a lower detection limit for L. infantum of 4 × 106 plasmid copy number compared to multiplex LAMP and RT-qPCR. Multiplex LAMP has the potential for accurate and rapid detection of infectious disease, successful treatment, and finding and monitoring asymptomatic cases, especially in low-income countries.
Integration of Prenatal Cardiovascular Magnetic Resonance Imaging in Congenital Heart Disease
Authors: Desmond Angela , Nguyen Kim‐Lien , Watterson Christopher T. , Sklansky Mark , Satou Gary M. , Prosper Ashley E. , Garg Meena , Van Arsdell Glen S. , Finn J. Paul , Afshar Yalda
Published: November 2023

Standard of care echocardiography can have limited diagnostic accuracy in certain cases of fetal congenital heart disease. Prenatal cardiovascular magnetic resonance (CMR) imaging has potential to provide additional anatomic imaging information, including excellent soft tissue images in multiple planes, improving prenatal diagnostics and in utero hemodynamic assessment. We conducted a literature review of fetal CMR, including its development and implementation into clinical practice, and compiled and analyzed the results. Our findings included the fact that technological and innovative approaches are required to overcome some of the challenges in fetal CMR, in part due to the dynamic nature of the fetal heart. A number of reconstruction algorithms and cardiac gating strategies have been developed over time to improve fetal CMR image quality, allowing unique investigations into fetal hemodynamics, oxygenation, and growth. Studies demonstrate that incorporating CMR in the prenatal arena influences postnatal clinical management. With further refinement and experience, fetal CMR in congenital heart disease continues to evolve and demonstrate ongoing potential as a complementary imaging modality to fetal echocardiography in the care of these patients.
An Ethical Approach to Creating Gardens Inspired by Qurʾānic Narratives
Authors: Kolkailah Naiyerah
Published: November 2023

Much of the literature on “Islamic gardens” focuses on artistic and architectural features or religious symbolism attributed to the influence of Islamic beliefs and civilization. This study seeks to expand the scope of intellectual inquiry beyond traditional motifs and recurrent features to investigate the potential influence of Islamic ethical values on creating gardens. Following a brief overview of the history of “Islamic gardens” and a short survey of Qurʾānic terms denoting earthly and paradisiacal gardens, this research highlights theological and ethical principles derived from four Qurʾānic narratives featuring earthly gardens, natural landscapes and non-human creation. These principles are, then, incorporated into a holistic ethical framework for creating gardens that harmonizes theocentric, anthropocentric, and ecocentric priorities. This framework prioritizes faithfulness to God while upholding both serving humanity and safeguarding natural habitats and ecosystems as ethical imperatives and mutually reinforcing investments with spiritual consequences in this life and the hereafter. This study also presents several garden models (particularly botanic gardens and community gardens) considered suitable for adopting and applying the proposed tripartite framework. The last section of this study explores how Islamic institutions, including mosques and charitable organizations, can utilize the tripartite framework to create gardens and green spaces that contribute to fulfilling a range of spiritual, social and environmental objectives.
Ukraine, Participation and the Smartphone at War
Authors: Ford Matthew
Published: November 2023

Digitisation is redefining the battlefield. Whereas once only soldiers and embedded journalists had privileged access to the battlefield, now war is everywhere, brought to us by civilians and their smartphones. People produce, publish and consume media on the same device. They can be at the frontlines or on the other side of the world. Digital individuals may willingly participate in war or they may participate by virtue of being connected to the grid. In this sense it is participative in that everyone has the potential to be involved through the data they create. This produces dynamic information flows that amplify and accelerate both war and its representation bringing the relationship between the military targeting and media production cycles into alignment. In the process, the bystander has been removed from war and instead collapsed the relationship between audience and actor, soldier and civilian, media and weapon.
Modeling staged and simultaneous evacuation during a volcanic crisis of La Soufrière of Guadeloupe (France)
Authors: Gillet Olivier , Daudé Éric , Saval Arnaud , Caron Clément , Taillandier Patrick , Tranouez Pierrick , Rey-Coyrehourcq Sébastien , Komorowski Jean-Christophe
Published: November 2023

The seismic and fumarollic activity of La Soufrière de Gaudeloupe increased in 1992. Continuing unrest led the Observatoire volocanologique et sismologique of Guadeloupe (OVSG-IPGP) to recommend in July 1999 to the authorities that the volcano alert be set to “Vigilance” (yellow). The OVSG-IPGP has been particularly vigilant and reinforced its monitoring following another significant increase of unrest in 2017 that culminated in magnitude 4.1 felt earthquake and a probable failed phreatic eruption. Volcanic activity remains difficult to forecast precisely, so the only way to stay safe, in case of an impending eruption, is to move away from the threatened area. This can be a major problem for the authorities and the population. In the French overseas departments, despite the presence of several volcanoes, there is limited experience in managing volcanic emergencies, especially in areas with a high population density and strategic assets, such as the Basse-Terre region of Guadeloupe. Therefore, it is crucial to devise and assess an emergency management strategy to identify potential problems and dangers that may arise during a mass evacuation. Crisis exercises can be planned to prepare the authorities and the population, but they are rarely carried out due to the human and resource costs involved. A series of evacuation scenarios are evaluated through simulations. The scenarios model staged and simultaneous evacuations with different speeds of individual response times. The aim of this research is to evaluate the two main evacuation strategies defined in the current volcano emergency response plan for La Soufrière of Guadeloupe, revised in 2018 by the authorities. This paper describes a calibrated agent-based model of mass evacuation and its exploration focusing on the potential staged evacuations of the southern Basse-Terre area. The overall objectives of this research are to: (1) test the evacuation strategy of the current emergency plan, and (2) provide relevant information to stakeholders. The results of these simulations suggest that there is no significant difference between the two evacuation strategies. It is estimated that 95% of the population will be evacuated within 20 h with a simultaneous or a staged evacuation. Whatever the scenario, the simulation results show high levels of road congestion. However, the staged evacuation will significantly reduce the number of vehicles on the network during the peak time of the evacuation and therefore reduce dangerous situations and the potential for adding crises within a volcanic crisis.