bluuebunny/crossref_metadata_2025 huggingface dataset:
Epidural Infusion of Dexmedetomidine Improves the Experience of Primiparas Undergoing Cesarean Section with Epidural Anesthesia: A Randomized Double‑Blinded Controlled Study
Authors: Liu Minghao , Chen Xuezi , Guo Dan
Published: January 2024

Background Dexmedetomidine has arousal sedation and analgesic effects. This study is to investigate the effect of 0.5µg/kg epidural dexmedetomidine combined with epidural anesthesia (EA) in parturients undergoing cesarean section.Methods A total of 92 parturients were randomly divided into Group R (receiveing epidural ropivacaine alone) Group RD (receiveing epidural ropivacaine with 0.5µg/kg dexmedetomidine). The primary outcome and second outcome will be intraoperative NRS pain scores and Ramsay Sedation Scale.Results All 92 parturients were included in the analysis. The NRS were significantly lower in Group RD compared to Group R at all observation timepoint (P > 0.05). Higher Ramsay Sedation Scale was found in Group RD compared to Group R (P < 0.001). No parturient has experienced sedation score of 4 and above. No significant difference regarding the incidence of hypotension, bradycardia and nausea or vomiting, Apgar scores and the overall satisfaction with anesthesia was found between Group R and Group RD (P > 0.05).Conclusion Epidural dexmedetomidine of 0.5µg/kg added slightly extra analgesic effect to ropivacaine in EA for cesarean section. The sedation of 0.5µg/kg epidural dexmedetomidine did not cause mother-baby bonding deficit. Satisfaction with anesthesia wasn’t significantly improved by epidural dexmedetomidine of 0.5µg/kg. No additional side effect allows larger dose of epidural dexmedetomidine attempt.Trial registration: This study was registered at www.chictr.org.cn (ChiCTR2000038853)
Characterization of arcing parameters in presence of graphite powder concentration in EDM of Ti-6Al-4V
Authors: Kuthe Yadnesh Abhaykumar , Rathod Yashraj , Prajapati Anshuman , Shetiye Er. Ganesh
Published: January 2024

Irrespective of the toughness, strength & hardness of any conductive material, Electric Discharge Machining (EDM) is a proven machining method. Selection of most favorable process parameters for machining is desirable to avoid excessive tool wear, damaged surfaces, and unwanted roughness. For this, the main reason could be the arcing while machining. Arcing results from successive electric discharges occurring at the interface of both the electrodes. Also, presence of powder concentration makes it more susceptible to occurring. This paper emphasizes identifying the combination of parameters that lead to arcing in the machining of titanium alloy Ti-6Al-4V using copper C100 electrode on Die Sinking EDM. Graphite powder concentration of 0%, 5% and 10% in SEO-45 EDM oil is used for the investigation. To identify arcing parameters, Taguchi parameter Design approach is used. Three stage process parameters are selected for finishing, intermediate and roughing stages to study arcing. Scanning electron microscopic (SEM) images of the machined surface tells that less surface crack density (SCD) has been formed on the machined surface. Discharge current, duty cycle and graphite powder concentration are the variables and effect of arcing on Material removal rate, Electrode wear rate and Surface roughness of Ti-6Al-4V is analyzed.
A pre-implementation study on the experience of ultrasound scanning in selected healthcare facilities of Lusaka, Zambia: the perspectives of pregnant women and male partners
Authors: Hamapa Arnold , Mweetwa Mudenda , Karen Imasiku , Agripa Lungu , Desire Kabamba , Mulaya Mubambe , Shown Haluzani , Abraham Kaluba , Catherine Mkandawire , Evarist Njelesani Kizito , Peter Mwaba , David Lissauer , Caren Chizuni , Beron Nsonga , Lydia Hangulu , Hamapa Arnold
Published: January 2024

Preterm birth and stillbirth are the main causes of the 5 million perinatal deaths worldwide annually. The World Health Organisation recommends that every woman must have an ultrasound scan before 24 weeks gestation. Ultrasound scanning by midwives in Maternal and Child Health (MCH) during antenatal care (ANC) clinics is a new intervention in Zambia. This study sought to determine the feasibility and acceptability of the ultrasound scanning intervention in 11 healthcare facilities drawn from Chisamba, Chongwe, Mumbwa, and Lusaka districts of Zambia. This was an exploratory qualitative study that used focus group discussions with 64 pregnant women and 29 male partners accessed from the ANC clinic through snowball sampling. All data were recorded, transcribed, coded using Nvivo 12, and thematically analysed. Participants expressed their eagerness to accept and use the ultrasound scanning services that would be provided by Midwives during antenatal care in MCH departments. Ultrasound scanning by Midwives in MCH departments is a positive, feasible, and acceptable intervention for pregnant women and male partners. Participants identified a number of barriers to the feasibility and acceptability of ultrasound scanning services, including insufficient infrastructure within MCH departments to conduct ultrasound scanning, unskilled midwives to provide ultrasound scanning services, a lack of ultrasound scanners and ultrasound scanning materials, and misconceptions about the side-effects of ultrasound scanning on the fetus. To address barriers to feasibility and acceptability of USS, there is need to conduct health education on the importance of ultrasound scanning services, provide ultrasound scanners and scanning materials, train midwives in basic ultrasound scanning, and create space for ultrasound scanning services as part of MCH services to improve birth outcomes.
Attitudes, knowledge and practices concerning delirium among paediatric intensive care unit nurses: A multisite cross-sectional study in Sichuan, China
Authors: Zhang YueEr , Xie JingYing , Tang MengLin
Published: January 2024

Background
Delirium is an acute mental state associated with poor outcomes. The incidence of delirium is high, especially in the paediatric intensive care unit (PICU). It is important for staff, particularly nurses, to understand delirium and implement interventions to prevent it. We performed a survey with the aim of evaluating and analysing the factors influencing the knowledge, attitudes and behaviour of PICU nurses towards delirium.
Methods
This cross-sectional descriptive study included 215 PICU nurses in 6 PICUs from five Grade 3A hospitals in Sichuan Province, China. Nurses were surveyed regarding their knowledge, attitudes/beliefs, and practices related to delirium care. The data were analysed using descriptive statistics; differences between groups were compared using t tests, ANOVA and rank-sum tests. Variables with a significance level of 0.05 in the univariate analysis were entered into the multivariable regression analysis to identify predictors.
Results
Only 14.4% of the nurses had a good understanding of delirium, and 40.9% had received relevant training. The mean knowledge score was 9.01 ± 3.86, and the overall passing rate of knowledge was 49.8%. The mean attitude and behaviour scores were 40.95 ± 5.62 and 40.33 ± 8.01, respectively. Among the hospitals, different delirium assessments for children and specific training were performed, explaining approximately 10% of the variability in knowledge scores (F = 6.152), approximately 10% of the variability in attitude/belief scores (F = 5.908), and approximately 17% of the variability in practice scores (F = 10.767).
Conclusions
PICU nurses have poor knowledge of delirium, particularly regarding its clinical manifestations, influencing factors and medications used, and they have adequate attitudes and confidence and good behaviour regarding delirium in children. To better prevent delirium, we suggest that PICU departments routinely assess delirium and conduct delirium training for nurses.
Trial registration
Not applicable
Development and Validation of A Diagnostic Nomogram Based on PET/CT and Clinical Characteristics: Differentiating mediastinal lymphomas from aggressive thymic epithelial tumors
Authors: Wei Maomao , Zhou Xin , Meng XiangXi , Kong Xiangxing , He QiuJun , Cui Yan , Liu Yang , Li Nan
Published: January 2024

Purpose
This study aims to establish and validate diagnostic nomogram integrating the PET/CT metabolic parameter with clinical features, to differentiate between aggressive thymic epithelial tumors(aTETs) and primary mediastinal lymphomas(PMLs).
Methods
A retrospective evaluation was conducted of 376 patients with anterior mediastinal masses treated at Peking University Cancer Hospital from January 2018 to December 2022. A total of 114 patients diagnosed pathologically with aTETs or PMLs were included. Of these, 79 patients were allocated to the training set and 35 to the validation set, in a ratio of approximately 7:3. Clinical and PET/CT data were collected. Univariate analysis and multivariate logistic regression analysis were conducted to identify clinical predictive factors and create diagnostic nomogram. Receiver Operating Characteristic (ROC)curves, calibration plots, and Decision Curve Analysis (DCA) were generated. The predictive accuracy and clinical value of the model were comprehensively evaluated using the validation set.
Results
Univariate analysis and logistic regression identified three key parameters associated with differentiating aTETs from PMLs, age(OR 0.75, 95%CI 0.65~0.87,P＜0.001),location(OR 35.66, 95%CI 2.44~521.98, P=0.009), and maximum standard uptake value(SUVmax)(OR 1.30, 95%CI 1.10~1.54, P=0.002). The ROC of the nomogram for the training and validation sets were 0.981 and 0.977, respectively, demonstrating excellent predictive capability and appropriate performance. Based on DCA, the clinical prediction model shows strong clinical utility in distinguishing between aTETs and PMLs.
Conclusion
Diagnostic nomogram based on SUVmax, age and location has been established and validated, which can be used to differentiate between patients with aTETs and PMLs.
Proximal Row Carpectomy with Interposition Arthroplasty using Both Capsular Flap and Acellular Human Dermal Matrix
Authors: Lee DaeHee , Seo JoongBae , Jung JaeUk , Yoo Jaesung
Published: January 2024

Background
In cases of wrist arthritis, proximal row carpectomy (PRC) has been widely utilized and shown favorable long-term outcomes. However, its applicability is limited in cases where arthritis extends to the lunate fossa or capitate. Recently, surgical approaches combining various methods of interposition arthroplasty have been introduced to overcome these drawbacks. The purpose of this study was to perform PRC and interposition arthroplasty with dorsal capsule and acellular dermal matrix(ADM),and analyze the clinical outcomes of these procedures.
Methods
Thirteen cases who underwent PRC and interposition arthroplasty with ADM were retrospectively recruited. The researchers assessed the patients' Visual Analog Scale (VAS) pain score, Disabilities of the Arm, Shoulder and Hand (DASH) scores, range of motion (ROM), retear, and radiocarpal distance (RCD).
Results
One year post-surgery, both the VAS pain scores, DASH scores, and ROM showed statistically significant improvement compared to before the surgery. Upon reviewing the radiological results, the postoperative mean RCD was 4.8 ± 0.8 mm and one year follow up mean RCD was 3.6 ± 0.5 mm at one year post-surgery. Moreover, in the one year follow-up, there was no observed failure of the allodermis graft in any of the cases
Conclusion
The PRC and interposition arthroplasty with ADM demonstrated significantly improved clinical outcomes after surgery, showing a maintain of RCD without graft failure effectively.
Comparison of the Pharmacokinetics of Gadolinium-Based and Iron Oxide-Based Contrast Agents inside the Lymphatic Structure using Magnetic Resonance Lymphangiography
Authors: Chae Yeon Ji , Kim Kyung Won , Kim Mi-hyun , Woo Chul-Woong , Kim Sang-Tae , Kim Ji-wook , Shin Tae-Hyun , Lee Do-Wan , Kim Jeong Kon , Choi Yoonseok , Woo Dong-Cheol
Published: January 2024

Purpose: Gadolinium (Gd)-based contrast agents are mostly used for contrast-enhanced magnetic resonance lymphangiography (MRL). However, overcoming venous contamination issues remains challenging. This study aims to assess the MRL efficacy of the newly developed iron-based contrast agent (INV-001, Inventera Pharmaceuticals Inc., Seoul, Korea) which is specially designed to mitigate venous contamination issues. This study further endeavors to explore the optimal dosage, including both injection volume and concentration, required to achieve successful visualization of the popliteal lymph nodes and surrounding lymphatic vessels.
Procedures: All animals utilized in this study were male Sprague-Dawley (SD) rats weighing between 250 and 300 g. The contrast agents prepared were injected intradermally in the fourth phalanx of both hind limbs using a 30-gauge syringe in SD rats. MRL was performed every 16 min on a coronal 3D time-of-flight (TOF) sequence with saturation bands using a 9.4-T animal machine.
Results: Contrary to Gd-DOTA, which exhibited venous contamination in the majority of animals irrespective of injection dosages and conditions, INV-001 showed no venous contamination. For Gd-DOTA, the popliteal lymph nodes and lymphatic vessels reached peak enhancement 16 min after injection from the injection site and then rapidly washed out. However, with INV-001, they reached peak enhancement between 16 and 32 min after injection, with prolonged visualization of the popliteal lymph node and lymphatic vessels. INV-001 at 0.45 μmol (15 mM, 30 μL) and 0.75 μmol (15 mM, 50 μL) achieved high scores for qualitative image analysis, providing good visualization of the popliteal lymph nodes and lymphatic vessels without issues of venous contamination, interstitial space enhancement, or lymph node enlargement.
Conclusion: In MRL, INV-001, a novel T1 contrast agent based on iron, enables prolonged enhancement of popliteal lymph nodes and lymphatic vessels without venous contamination.
Correlation between trophoblast cell-surface antigen-2 (Trop-2) expression and pathological complete response in patients with HER2-positive early breast cancer treated with neoadjuvant docetaxel, carboplatin, trastuzumab, and pertuzumab.
Authors: Gion María , García-Mosquera Juan José , Pérez-García José , Peg Vicente , Ruiz-Borrego Manuel , Stradella Agostina , Bermejo Begoña , Guerrero José Antonio , López-Montero Laura , Mancino Mario , Rodríguez-Morató José , Antonarelli Gabriele , Sampayo-Cordero Miguel , Llombart-Cussac Antonio , Cortés Javier
Published: January 2024

Purpose. The prognostic and predictive role of trophoblast cell-surface antigen-2 (Trop-2) overexpression in human epidermal growth factor receptor 2-positive (HER2-positive) breast cancer is yet unknown. We retrospectively analyzed Trop-2 expression and its correlation with clinicopathologic features and pathological complete response (pCR) in HER2-positive early breast cancer (EBC) patients treated with neoadjuvant docetaxel, carboplatin, trastuzumab, and pertuzumab (TCHP) in the PHERGain study.
Methods. Trop-2 expression at baseline was determined in formalin-fixed, paraffin-embedded primary tumor biopsies by immunohistochemistry and was first classified into expressing (Trop-2-positive) or not-expressing (Trop-2-negative) tumors. Then, it was classified by histochemical score (H-score) according to its intensity into low (0-9), intermediate (10-49), and high (≥50). The association between clinicopathologic features, pCR, and Trop-2 expression was performed with Fisher’s exact test.
Results. Forty-one patients with tissue evaluable for Trop-2 expression were included, with 28 (68.3%) Trop-2-positive tumors. Overall, 17 (41.46%), 14 (34.15%), and 10 (24.40%) tumors were classified as low, intermediate, and high, respectively. Trop-2 expression was significantly associated with decreased pCR rates (50.0% vs. 92.3%; odds ratio [OR] 0.05; 95% CI, 0.002-0.360]; p adjusted=0.01) but was not correlated with any clinicopathologic features (p≥0.05). Tumors with the highest Trop-2 H-score were less likely to obtain a pCR (OR 0.03; 95% CI, 0.001-0.290, p adjusted<0.01). This association was confirmed in univariate and multivariate regression analyses.
Conclusion. These findings suggest a potential role of Trop-2 expression as a biomarker of resistance to neoadjuvant chemotherapy plus dual HER2 blockade and may become a strategic target for future combinations in HER2-positive EBC patients.
A new combination of pulsed radiofrequency and platelet-rich plasma injections for management of grade I lumbosacral spondylolisthesis: A prospective study
Authors: Le Viet-Thang , Bui Dung Tuan Hoang , Do Phuoc Trong
Published: January 2024

Our study aimed to investigate the clinical benefits of combining pulsed radiofrequency (PRF) and platelet-rich plasma (PRP) techniques for treating chronic lumbosacral radicular (CLSR) pain resulting from grade I spondylolisthesis (G1SL). Ninety-six patients with CLSR pain between March 2021 and March 2023 were included in this study. Severity of pain was assessed using the Visual Analog Scale (VAS) score, which measured 6.75 ± 0.98 before procedure and decreased to 3.35 ± 0.78, 3.17 ± 0.56 and 3.03 ± 0.57 at 1, 3 and 6 months after procedure, respectively. Disability-related radicular pain was evaluated using the Oswestry Disability Index (ODI) score, which was 75.84 ± 8.49 before procedure and reduced to 30.19 ± 5.19, 26.01 ± 3.91 and 24.27 ± 3.77 at 1, 3 and 6 months after procedure, respectively. These improvements were statistically significant compared to before procedure (all p < 0.05). The effect was assessed according to the modified MacNab criteria, with 67 cases classified as having an excellent treatment effect. Based on these findings, a new treatment combining PRF and PRP applications appears beneficial in managing pain in regenerative medicine. So, further clinical studies are necessary to support and validate our preliminary findings.
Effect of Finite Spatial and Temporal Resolutions on Super-resolution Particle Tracking Velocimetry for Pressure-driven Flow in a Nanochannel
Authors: Tanaka Minori , Saeki Yo , Hanasaki Itsuo , Kazoe Yutaka
Published: January 2024

With developments of nanofluidics, understanding the behavior of fluids confined in nanospaces becomes important. Particle tracking is an efficient approach, but in nanospaces, it often suffers from the finite temporal resolution causing the Brownian displacement of nanoparticles and the finite spatial resolution due to the decreased signal-to-noise ratio of nanoparticle images, both of which are factors that can cause artifacts. Therefore, in the present study, we simulated nanoparticle tracking velocimetry based on the particle dynamics given by the Langevin equation to evaluate the artifacts. The results revealed that for measurement of the velocity distribution of pressure-driven flow in a 400 nm nanochannel utilizing 60 nm tracer nanoparticles, high-speed (temporal resolution: Δt ≤ 360 µs) and super-resolution (spatial resolution: Δz ≤ 25 nm) measurement is required for errors less than 10%, while insufficient resolution causes an artifact that results in a flattened velocity distribution compared with the original flow profile. The proposed resolutions were experimentally verified by defocusing nanoparticle tracking velocimetry developed by our group. As the simulation predicted, at longer temporal resolution and larger spatial resolution, the measured nanoparticle velocity distribution in the nanochannel indicated a parabolic flow profile but became flattened because of the artifacts. In contrast, at measurement resolutions within the proposed range, the velocity distribution close to the profile given by the Hagen-Poiseuille equation, which was considered to be the actual flow profile, was successfully obtained. This work provides a guideline for nanoscale flow measurements and will accelerate the understanding of specific transport phenomena in nanospaces.
MTA and Koedam Score Contributes to Cognitive Impairment in Probable Alzheimer, Vascular and Mixed Dementia: A Memory Clinic Study in Indonesia
Authors: Susianti Noor Alia , Prodjohardjono Astuti , Vidyanti Amelia Nur , Setyaningsih Indarwati , Gofir Abdul , Setyaning Cempaka Thursina Srie , Effendy Christantie , Setyawan Nurhuda Hendra , Setyopranoto Ismail
Published: January 2024

Background. Medial Temporal Atrophy (MTA) and Parietal Atrophy (Koedam score) have been used in clinical practice to help the diagnosis of Alzheimer’s disease. However, the role of this brain imaging marker in early detection of other type of dementia remains elusive. The study aims to investigate the association between MTA and Koedam scores with the cognitive function in dementia patients (Alzheimer, vascular and mixed dementia).
Method This was across-sectional study usingdata from a Memory Clinic in Dr. Sardjito General Hospital Yogyakarta, Indonesia. The data was collected from January 2020 until December 2022. We collected the data regarding demographic and clinical characteristics, including head MRI data and Montreal Cognitive Assessment (MoCA) score. The cut-off points of MTA score and Koedam score were determined by using Receiver Operating Curve (ROC) and Youden Index. Multivariate analysis was performed to investigate variables which were associated with the cognitive function.
Result From 61 dementia patients, 22.95% was probable Alzheimer’s disease, 59.01% was vascular dementia, and 18.03% was mixed dementia. Correlation test showed that MTA and Koedam score were negatively associated with Montreal Cognitive Assessment-Indonesian Version (MoCA-INA) score. A bivariate analysis supports the findings that patients with combination of MTA score ≥3 and Koedam score ≥2 was more likely to have poor cognitive function (OR= 11.33; p<0.05). Multivariate analysis showed higher MTA (≥3) and Koedam (≥2) scores were associated with poor cognitive function in dementia patients (OR= 13.54, 95% CI= 1.77-103.43, p=0.01 and OR= 5.52, 95% CI= 1.08-28.19, p=0.04)
Conclusion Higher MTA and Koedam score contribute to worse cognitive function in any type of dementia patients.
Effectiveness of Remdesivir for Hospitalized COVID-19 Patients Depending on the Severity of Respiratory Status: A Multicenter Retrospective Study in Japan
Authors: Yoshimoto Hidero , Yamakawa Kazuma , Tanaka Yoshihiro , Osawa Itsuki , Tagami Takashi , Endo Akira , Yamamoto Ryo , Hayakawa Mineji , Ogura Takayuki , Hirayama Atsushi , Yasunaga Hideo , Takasu Akira , Lee Sang-Woong
Published: January 2024

Remdesivir, approved for clinical use against COVID-19 worldwide, has varying effectiveness, depending on the respiratory failure status of patients. This retrospective observational study (the J- RECOVER) aimed to evaluate variations in remdesivir effectiveness by enrolling patients with COVID-19 from 64 institutions in Japan between January 1 and September 30, 2020. This study included patients aged ≥ 18 years who were administered with remdesivir within three days of admission. A total of 3,591 patients were eligible, and propensity score overlap weighting (OW) analysis was performed to compare in-hospital mortality as the primary outcome, depending on respiratory failure status, between the remdesivir-administered and control groups. The results exhibited the OW-adjusted odds ratio (OR) for mortality in overall cases (OR, 0.65; 95% confidence interval (CI), 0.36–1.19), mild cases without supplemental oxygen (OR, 0.11; 95% CI, 0.01–1.03), moderate cases requiring supplemental oxygen (OR, 0.82; 95% CI, 0.31–2.16), and severe cases requiring ventilation (OR, 0.78; 95% CI, 0.28 − 2.17). Remdesivir treatment may reduce the risk of in-hospital mortality among patients with mild respiratory distress. Additionally, the subgroup analysis suggests that remdesivir treatment may improve mortality in patients with an estimated glomerular filtration rate ≥ 60 mL/min per 1.73 m2 (P = 0.03).
Effectiveness of IoT and VR for Real-Time Teleoperation of Industrial Robots
Authors: Luu Toan , Nguyen Quang , Tran Thien , Tran Minh Quang , Ding Songlin , Kua Jonathan , Hoang Thuong
Published: January 2024

During the early stages of the Industry 4.0 era, teleoperation with human involvement in manufacturing processes and robot operation remained important. The existing teleoperation technologies have limitations in providing operator with spatial awareness and initiative control mechanism, making their applications difficult in tasks with high complexity and precision. This study implements the advancements from the Internet of Things (IoT) and Virtual Reality (VR) technology to improve the real-time teleoperation for industrial robots. The proposed design utilizes the benefits of the Message Queuing Telemetry Transport (MQTT) protocol in conjunction with a cloud broker, which has not been addressed significantly in previous studies for teleoperation. This setup enables the system to efficiently handle substantial amounts of data in short periods of time, allowing for an uninterrupted user experience while maintaining a consistent connection regardless of distance. Real-time robot control is accomplished by tracking the user's hand movements with a VR controller while providing the user with visual feedback from the VR environment. The incorporation of VR technology intends to improve the intuitiveness of controlling robot operations, provide more responsive feedback, and improve the quality of work performed by operators. Practical experiments are conducted with an industrial robot to observe the performance against the system under different internet conditions and different QoS setups. The evaluation criteria primarily concern latency and accuracy. The experiment aims to evaluate the effectiveness and scalability of the suggested system and to offer significant insight into its advantages and limitations relative to existing control system through systematic investigation.
Knowledge, Attitude and Practice of Radiation Safety Precautions among Orthopedic Residents and Consultants in Addis Ababa Burn, Emergency and Trauma Hospital and Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia
Authors: Mulat Kalkidan Ayalew , Tsehaye Milkyas , Akalu Gizachew Taddesse , Kebede Mebratu Abraha , Abate Kumlachew
Published: January 2024

Background
Fluoroscopy is widely used in orthopedic practice both for preoperative planning and operative interventions. Evidences show that there is increased risk of radiation exposure. It is reported that knowledge of radiation safety is very poor among orthopedic surgeons and residents. Junior residents and assistant surgeons are at higher risk for exposure than consultant surgeons. But still there has been also a significant gap in the knowledge, attitude and practice of orthopedic residents and surgeons towards radiation safety precautions.
Objective
to assess the knowledge, attitude and practices of orthopedic residents and surgeons towards radiation safety precautions in Addis Ababa Burn, Emergency and Trauma Hospital, and Tikur Anbessa Specialized Hospital.
Methodology
Institution based cross-sectional study was conducted from January 2020 to march 2020. The sample size was 114 and all eligible populations were included. Data was collected by trained orthopedic residents. It was entered into EPI INFO 7, processed and analyzed by using SPSS version 23. Both descriptive and analytic statistics was used to assess the variables. The Likert scale with a score out of 5 will be used to assess some of the variables.
Result
A total of 114 study participants were included which makes of 96.8% of response rate. Just 57.0% of them were age of less than 30 years with mean (SD) age of 29.8 (± 3.3). The majority the participants that account 101 (88.6%) were male. Orthopedic residents were the majority that accounts 103 (90.4%) of the participants. Regarding to the outcome variables, 48.2%, 52.6% and 43.9% of the Orthopedic Residents and Consultants had poor knowledge, negative attitude, and poor practice about radiation safety respectively. Training exposure was one of the explanatory variable which showed a statistically significant association with attitude (AOR; 10.96 (95%CI; 2.90, 41.39).
Conclusion
around half of the study participants have low level of knowledge, negative attitude and poor practice of radiation safety precautions. Therefore, awareness creation about radiation safety precaution should be given through training or other possible educational approach for orthopedic residents and consultants. Training on radiation safety and prevention should be given for all orthopedic residents and consultants.
Assessing Geomorphological Changes in Coastal lagoon using Geospatial Tools: a case study Moulay Bousselham Lagoon, Moroccan Atlantic Coast
Authors: Chahid Nouhaila Erraji , Bouchkara Mohammed , Joudar Imane , Benazzouz Aïssa , Zourarah Bendahhou , Khalidi Khalid El
Published: January 2024

This study aims to assess the morphodynamic changes undergone by an inlet, sandpits, and adjacent beaches of Moulay Bousselham lagoon (Morocco Atlantic coast), considered as a RAMSAR site of significant biodiversity. Firstly, a Digital Shoreline Analysis System (DSAS) is applied to monitor shoreline evolution for 72 years between 1949 and 2021, based on the EPR and LRR models, with the study area divided into south and north sides. Secondly, we mapped sandpit areas in the lagoon using recent satellite images and historical aerial photos within a GIS (Geographic Information System) environment. As a result, the average annual accretion rates on the north side, comprising 276 transects, are + 0.63 m/year (EPR) and + 0.55 m/year (LRR). Accretion is observed in 239 transects, while erosion is recorded in 37 transects. The south side, comprising 2211 transects, shows average annual erosion rates of -0.67 m/year (EPR) and − 0.82 m/year (LRR), with 1359 transects showing accretion and 872 transects indicating erosion. We show significant changes in the sandpit areas at the entrance and inside the lagoon, with the area of accumulation increasing from around 155662 m² in 1949 to 983823 m² in 2021. Accordingly, a Morphodynamical model is developed Based on the obtained results, which explains the main factors controlling the inlet evolution taking into account the dominant swell direction and energy. This article will help us to understand the relationship between the evolution of the coastline and its immediate influence on sediment supply to the lagoon.
TFRC, associated with hypoxia and immune, is a prognostic factor and potential therapeutic target for bladder cancer
Authors: Tang Runhua , Wang Haoran , Liu Jianyong , Song Liuqi , Hou Huimin , Liu Ming , Wang Jianye , Wang Jianlong
Published: January 2024

Background
Bladder cancer is a common malignancy of the urinary system, and the survival rate and recurrence rate of patients with muscular aggressive (MIBC) bladder cancer are not ideal. Hypoxia is a pathological process in which cells acquire special characteristics to adapt to anoxic environment, which can directly affect the proliferation, invasion and immune response of bladder cancer cells. Understanding the exact effects of hypoxia and immune-related genes in BLCA is helpful for early assessment of the prognosis of BLCA. However, the prognostic model of BLCA based on hypoxia and immune-related genes has not been reported.
Purpose
Hypoxia and immune cell have important role in the prognosis of bladder cancer (BLCA). The aim of this study was to investigate whether hypoxia and immune related genes could be a novel tools to predict the overall survival and immunotherapy of BLCA patients.
Methods
Firstly, we downloaded transcriptomic data and clinical information of BLCA patients from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases. A combined hypoxia and immune signature was then constructed on the basis of the training cohort via least absolute shrinkage and selection operator (LASSO) analysis and validated in test cohort. Afterwards, Kaplan-Meier curves, univariate and multivariate Cox and subgroup analysis were employed to assess the accuracy of our signature. Immune cell infiltration, checkpoint and the Tumor Immune Dysfunction and Exclusion (TIDE) algorithm were used to investigate the immune environment and immunotherapy of BLCA patients. Furthermore, we confirmed the role of TFRC in bladder cancer cell lines T24 and UMUC-3 through cell experiments.
Results
A combined hypoxia and immune signature containing 8 genes were successfully established. High-risk group in both training and test cohorts had significantly poorer OS than low-risk group. univariate and multivariate Cox analysis indicated our signature could be regarded as an independent prognostic factor. Different checkpoint was differently expressed between two groups, including CTLA4, HAVCR2, LAG3, PD-L1 and PDCD1. TIDE analysis indicated high-risk patients had poor response to immunotherapy and easier to have immune escape. The drug sensitivity analysis showed high-risk group patients were more potentially sensitive to many drugs. Meanwhile, TFRC could inhibit the proliferation and invasion ability of T24 and UMUC-3 cells.
Conclusion
A combined hypoxia and immune-related gene could be a novel predictive model for OS and immunotherapy estimation of BLCA patients and TFRC could be used as a potential therapeutic target in the future.
Long-term outcomes of gamma knife radiosurgery for cerebral cavernous malformations: 10 years and beyond
Authors: Myeong Ho Sung , Jeong Sang Soon , Kim Jung Hoon , Lee Jae Meen , Park Kwang Hyon , Park Kawngwoo , Park Hyun Joo , Park Hye Ran , Yoon Byung Woo , Lee Eun Jung , Kim Jin Wook , Chung Hyun Tai , Kim Dong Gyu , Paek Sun Ha
Published: January 2024

This study aimed to assess the long-term outcomes of Gamma Knife radiosurgery (GKS) for cerebral cavernous malformation (CCM) in 79 adult patients (96 lesions) with a mean follow-up of 14 years. The annual hemorrhage rate (AHR) for total CCM decreased from 21.4% (pre-GKS) to 2.3% (> 10 years post-GKS). Brainstem CCM AHR decreased from 27.2% (pre-GKS) to 3.5% (> 10 years post-GKS). Among patients with focal neurologic deficit (n = 35), 74.3% recovered, and seizures were controlled in eight (61.5%) of 13 patients. Symptomatic adverse radiation effects occurred in 6.4% of patients, and no mortality was observed. Most lesions decreased in size on the last follow-up MRI. Previous hemorrhage history (HR: 8.38, 95% CI: 1.07–65.88; P = 0.043) and brainstem location (HR: 3.10, 95% CI: 1.26–7.64; P = 0.014) were significant risk factors for hemorrhage. GKS for CCM demonstrated favorable long-term outcomes, particularly in cases with a history of hemorrhage or brainstem location.
Profession of Forensic Medicine in India: Current scenario and way forward
Authors: K Karthi Vignesh Raj , Ransing Ramdas , Sethi Satyranjan , Devraj Nilesh
Published: January 2024

Context:
Forensic Medicine and Toxicology/Forensic Medicine are among the subjects of the MBBS curriculum for undergraduates. Completing a postgraduate in this subject provides expertise in handling medicolegal cases.
Aims:
This study was conducted to determine the national and state-specific postgraduate trainee indices of FMT/FM subjects to highlight the postgraduate scenario of forensic medicine experts.
Settings and Design
This was a cross-sectional study.
Methods and Materials
On the official website of the National Medical Commission, data on postgraduate status in FMT/FM and postgraduate status in FMT/FM were obtained. The data available on this website through November 2023 were incorporated. The FMT/FM index was calculated at the national and state levels, and the states were graded based on the national FMT/FM index.
Results:
The national FMT/FM postgraduate trainee index was 0.054. Considering this value as a reference, the FMT/FM postgraduate trainee index had the highest grade (1.159 to 0.308), which was higher than that of the nation (0.054 but less than 0.308), lower than that of the nation (0.054 but higher than 0.00) and zero. Among all the states and UTs, Andaman and Nicobar, Arunachal Pradesh, Dadar and Nagar Haveli, J and K, Lakshadweep, Mizoram, Nagaland, Sikkim and Ladakh have zero FMT/FM-PG indices due to the nonavailability of any postgraduate seats for FMT/FM. In addition, 20 states had FMT/FM-PG indices higher than India’s FMT/FM-PG indices, followed by Pondicherry (1.159), Chandigarh (0.429) and Goa (0.308).
Conclusion:
The choice of any field as a profession is influenced by factors such as demand, job opportunities, field saturation, and monetary gain. Even though the FMT/FM-PG reveals a reduced saturation of experts in a few states, students are not choosing this subject professionally due to a lack of opportunity. In addition, the FMT/FM-PG index is determined by the intake capacity of qualifying professionals and associates.
Recommendation:
Corrective actions must be implemented, such as a revamp of the forensic medicine and toxicology curriculum, departmental faculty strength, and an approach of interdepartmental, intersectoral superpresence in the topic, to obtain fresh forms of work opportunities.
RETRACTED: Parental Bonding in the Developmental Period and Pathological Narcissism Phenotypes: The Mediating Role of Attachment Anxiety and Shame
Authors: Shahhosseini Saeid , Taqanaki Changiz Rahimi , Mohammadi Noorullah , Aflakseir Abdolaziz
Published: January 2024

The authors have requested that this preprint be removed from Research Square.
Genetic Associations and Functional Pathways in Parkinson's Disease: A Meta-Analytic Insight into LRRK2 Mutation Impact
Authors: A.Olanrewaju John , Oche Ambrose George , Arietarhire Leviticus , Afolabi Tolu , Olugbogbi Ezekiel , Joseph Enya , Somerekun Oladimeji , Irewoluwa Joel , Dario Alessi , Fasimoye Rotimi , Sammler Esther
Published: January 2024

Background: Parkinson's Disease (PD) is a complex neurodegenerative disorder with elusive pathophysiological mechanisms. Recent studies have highlighted the role of genetic variations and metabolic changes in PD progression.
Aim: This study aims to investigate the genetic disparities in PD, particularly focusing on LRRK2 mutations, and to analyze the associated metabolic pathway alterations.
Methodology: The study utilized R programming with MetaIntegrator for meta-analysis and ggplot2 for visualization. Datasets underwent preprocessing, and the MetaIntegrator package computed meta scores, effects, and ROC analysis. Differential gene expression and functional enrichment analyses provided insights into genetic associations and pathways in Parkinson's disease and LRRK2 mutations.
Results: Significant meta-score differences were observed in PD patients, especially in datasets GSE133347, GSE36321, and GSE100054, underscoring the impact of LRRK2 mutations. Genes like SKAP2 and IFNGR2 were significantly upregulated, implicating their role in neuroinflammation. Moreover, a shift in metabolic pathways, particularly carbohydrate kinase activity, was noted, indicating altered energy metabolism in PD cells.
Conclusion: The study reinforces the genetic heterogeneity of PD and highlights the potential therapeutic importance of targeting neuroinflammatory pathways and metabolic dysfunctions. These findings suggest new avenues for diagnostic and therapeutic strategies in PD management.
Assessing helminth infection in some reproductive colonies of Southern Giant Petrel (Macronectes giganteus) from Antarctica
Authors: Fusaro Bruno , Capasso Sofia , Lorenti Eliana , Panisse Guillermo , Fuentes Lautaro , Fornillo María Valentina , Libertelli Marcela , Ansaldo Martin , Diaz Julia I.
Published: January 2024

The host/parasite relationship is a key tool for understanding the role of parasitism in the feeding ecology of Antarctic seabirds. Especially, birds with extensive migratory routes through isolated regions are particularly sensitive to new infections. Although research on parasitic diseases in Antarctic birds is sparse and information is fragmentary, an increasing number of studies are currently underway in this area. The present study aims to provide new information on parasitic helminths in the Southern Giant Petrel Macronectes giganteus in some nesting areas, integrating different parasitological techniques. A total of 126 faecal samples, 16 regurgitates and six dead individuals (five adults and one chick) were analysed for helminth parasites. Members of four helminth groups (Cestoda, Digenea, Nematoda, Acantocephala) represented the parasitic diversity of the Southern Giant Petrel in the studied localities. All dead birds analysed (P = 100%) harboured helminth parasites, additionally P = 49.2% of the fecal samples and P = 0.06% of the regurgitated individuals presented at least one of the different helminth groups found in the viscera. The combination of three diagnostic techniques allowed us to determine the presence of nine adult helminth species (Cosmocephalus obvelatus, Stegophorus macronectes, Stegophorus diomedeae, Contracaecum sp., Parorchites zederi, Tetrabothrius heteroclitus, Diphylobotrium sp., Corynosoma shackletoni, and Renicolidae). In addition, juvenile specimens of Tetrameres sp. and Anisakis sp. were found in the eviscerated host. We discuss the trophic relationships of the hosts and their influence in the helminth infestations. This study provides new knowledge about the parasitic diversity of the Southern Giant Petrel in its nestling areas with new records of helminth species in Antarctica.
An Accurate Calculation Method for Inductor Air Gap Length in High Power DC-DC Converters
Authors: Zeng Xiaohui , Chen Wei , Yang Lei , Chen Qingbin , Huang Yuping
Published: January 2024

High-power inductors are fundamental components in high-power DC-DC converters, with their performance being a crucial metric of converter efficiency. This paper presents an in-depth analysis of a novel calculation method for the air gap length in such inductors. Taking into account the effects of air gap diffusion and the winding magnetic field, an expression for the air gap diffusion radius is derived, focusing on a distributed air gap structure. Furthermore, models for calculating the air gap and winding reluctance are developed, grounded in electromagnetic field theory. An equivalent magnetic circuit model, formulated based on Kirchhoff's second law, facilitates the proposed method for air gap length calculation. This study also involves the development of 3D models for both discrete and decoupled integrated inductors. The comparison between simulation outcomes and calculated air gap lengths indicates a maximum error of less than 5%, with the minimum error being as low as 0.54%. Additionally, the discrepancy between calculated values and experimental measurements is found to be 1.11%. These results validate the accuracy and applicability of the theoretical analysis and calculation method, underscoring their significance in the design and optimization of high-power DC-DC converters.
Investigation of Temperature Effects on Wide Steel Box Girder of Suspension Bridge Based on Long-Term Monitoring Data
Authors: Wang Yanru , Zhang Guoliang , Liu Lang , Wang Xu , Zheng Shuqin , Huang Jin , FU BIN , Zhou Lei
Published: January 2024

The time-varying temperature distributions on bridge structures may remarkably change structural performance, which may result in differential strain/stress responses on structural members compared with the design conditions. Therefore, it is crucial to have a comprehensive understanding of temperature distributions and its effects on bridges. In this study, taking advantage of structural health monitoring technology, one-year field monitoring data collected from a long-span suspension bridge were used to investigate the temperature distributions and their effects on the steel box girder. Specifically, the distributions and probability statistics of temperatures on the top and bottom plates were firstly analyzed. Based on which, the transverse and vertical temperature differences on the box girder were further examined, moreover, the representative values of temperature differences for various return periods were calculated by exceedance probability method. At end, a temperature prediction method was proposed to simulated the temperature field distributions during bridge life cycle, to provide substantial temperature data for estimating future operation condition. The results of this study were beneficial to structural evaluation of in-service bridges to ensure their serviceability and integrity in the life cycle.
Tri-UNet: A Brain Age Prediction Method Based on Different Scale Features of Magnetic Resonance Imaging
Authors: Pang Yu , Cai Yihuai
Published: January 2024

In the process of human aging, significant age-related changes occur in brain tissue. To assist individuals in assessing the degree of brain aging, screening for disease risks, and further diagnosing age-related diseases, it is crucial to develop an accurate method for predicting brain age. This paper proposes a multi-scale feature fusion method called Tri-UNet based on the U-Net network structure, as well as a brain region information fusion method based on multi-channel input networks. These methods address the issue of insufficient image feature learning in brain neuroimaging data. They can effectively utilize features at different scales of MRI and fully leverage feature information from different regions of the brain. In the end, experiments were conducted on the Cam-CAN dataset, resulting in a minimum Mean Absolute Error (MAE) of 7.46. The results demonstrate that this method provides a new approach to feature learning at different scales in brain age prediction tasks, contributing to the advancement of the field and holding significance for practical applications in the context of elderly education.
The Mediating Effects of Self-worth and Interpersonal Communication on the Relationship between Metacognitive Ability and Self-directed Learning Ability among Nursing Students: A Cross-Sectional Study
Authors: Yin xiumin , Pan Minghao , He Lang , Li Yuting , Zheng Wenkai , Liang Juan
Published: January 2024

Background: To explore the relationship between metacognitive ability and self-directed learning ability of nursing students, along with the mediating effect of self-worth and interpersonal communication between them.
Methods: A total of 905 nursing undergraduates from 6 universities in Shaanxi Province were selected as the survey objects by convenient sampling method, and 851（94.03%）were effectively responsed. Metacognitive Assessment Inventory, Adolescent Sense of Self-worth Scale, Supportive Communication Scale and Self-directed Learning Ability Scale were used to evaluate the metacognitive ability, self-worth, interpersonal communication ability and self-directed learning ability of nursing students.
Results: （1） The results indicated that the metacognitive ability, self-worth, and interpersonal communication ability were all positively correlated with the self-directed learning ability (all P<0 .001). （2）The mediating effects of self-worth and interpersonal communication on metacognitive ability and self-directed learning were significant (all P < 0.001). （3）Metacognitive ability could have an indirect effect on self-directed learning through the self-worth and interpersonal communication ability intermediary chain.
Conclusions: Improving the metacognitive level and self-worth of nursing students and cultivating good interpersonal communication ability are conducive to improving the self-directed learning ability of nursing students.