bluuebunny/crossref_metadata_2025 huggingface dataset:
Temporal and Spatial Changes in Water Quality and Phytoplankton Populations in the lower St. Johns River, Florida
Authors: Bielmyer-Fraser Gretchen K. , Bowers Kaitlyn , Courville Julia M. , O’Keefe Samantha , Paulsen Sarah , Stoeber Luke , Wise Megan , Nienow James
Published: June 2023

The St. Johns River (SJR) is a dynamic system, spanning 310 miles of Florida’s eastern coast and provides ecological, recreational, and commercial benefit for the state. The lower SJR basin, located near Jacksonville, forms an estuarine environment where tidal flow from the Atlantic Ocean mixes with freshwater moving through the river toward the ocean. Anthropogenic influences, such as increased development, dredging, and wastewater discharge from a variety of sources has changed the water quality in the river over past years. In this study, a variety of water quality parameters and a suite of metals were measured in water samples collected from eight sites in the lower SJR from 2019 to 2022, continued from previous work which documented these parameters in the river from 2017 to 2019. Aquatic communities such as phytoplankton can be indicative of river health, therefore, phytoplankton were collected from each site and the diatom component identified. The total number of taxa in each sample ranged from 60 to 190, with 25 taxa accounting for the majority (64%). The species Thalassiosira wongii was first discovered in the lower SJR during this study, previously documented from southern Brazil and the North Pacific. Like water chemistry, seasonal fluctuations in phytoplankton abundance and diversity were observed, with a relative abundance of Skeletonema costatum and Skeletonema subsalsum in times of lowered diversity. Further, decreased phytoplankton diversity correlated with increased metal contamination in the lower SJR. This study provides new information about the impact of human disturbance on biotic communities.
Comparing the iLESSYS Delta and Endo-Surgi Plus trans-laminar approaches for single-segment disc herniation on neurological function: a randomised controlled trial
Authors: Lu Qi , Sun MaJi , Song Ting , Yuan Feng , Chen Hongliang
Published: June 2023

Objective
Comparison of the iLESSYS Delta with the Endo-Surgi Plus for PEID treatment of L5-S1LDH on neurological function.
Methods
In the period from August 2021 to August 2022, 80 patients with LDH in the L5-S1 segment were treated with PEID using the iLESSYS Delta system or the Endo-Surgi Plus system in combination with INOM and cervical EP monitoring. Patients were classified into two groups based on the endoscopy system employed. Of these,37patients were included in the Delta group and 43 patients in the Plus group.Patient demographics, perioperative indicators, IONM indicators, intraoperative EP and complications were analysed.Clinical outcomes were quantified using back and leg visual analog scale(VAS) scores, Oswestry Disability Index(ODI) and Japanese orthopaedic association(JOA) scores at the time points of follow-up.Patient satisfaction was assessed at the final follow-up according to the modified MacNab criteria.
Results
In the Plus group, the duration of surgery and the number of arthroplasties were less than those in the Delta group, with a statistically significant difference (p < 0.05). The rates of abnormal IONM indicators,cervical EP at the end of surgery and maximum intraoperative EP in the Plus group were less than those in the Delta group, with a statistically significant difference (p < 0.001). Compared to the preoperative period, the VAS score, ODI and JOA scores improved in both groups at all follow-up time points, and the difference was statistically significant (p < 0.001); The differences in pain VAS scores, ODI and JOA scores were not statistically significant when comparing the two groups (p > 0.05).
Conclusion
Both the iLESSYS Delta and Endo-Surgi Plus surgical systems achieve satisfactory early clinical results in the treatment of LDH with the Endo-Surgi Plus surgical shaping being more efficient, with less intraoperative impact on neurological function and safer.
Shaking table tests of the one-quarter scale model of concrete hollow blocks masonry houses retrofitted with fiber-reinforced paint
Authors: Multazam Zamzam , Yamamoto Kenjiro , Timsina Kishor , Gadagamma Chaitanya Krishna , Meguro Kimiro
Published: June 2023

Concrete hollow block (CHB) is popular for masonry buildings in developing countries. However, CHB has a low compressive strength due to poor production methods. Most buildings are constructed without the involvement of engineers and are commonly called "nonengineered buildings." Unreinforced masonry (URM) buildings are highly vulnerable during an earthquake. Some strengthening methods have been proposed to increase the seismic capacity. However, some strengthening materials are beyond the economic capacity of the common people in developing countries, and there is a shortage of technical workforce in developing countries. In addition, other factors need to be considered when selecting the strengthening method; these include the failure mechanism of masonry walls, efficiency, complexity, and seismic safety of each technique. This paper introduces a new retrofitting method of fiber-reinforced paint using fiber as the primary reinforcing material. The proposed retrofitting method is easy to apply, and the paint is used to enhance the appearance of the house. Two 1:4 scale house models were constructed to observe the dynamic behavior of the masonry houses. The results show that the retrofitted house model can increase the deformation capacity and energy dissipation of the masonry structures. Fiber-reinforced paint has a robust performance even in high input motion at a seismic intensity JMA of 7 (Japan Meteorological Agency). This confirms that this retrofitting method has a high earthquake-resistant performance.
Pneumonia, diarrhoea, tuberculosis, malaria, and HIV among children and adolescents in Ecuador: A cross-sectional national study, 2015-2021
Authors: Acosta-España Jaime David , Altamirano-Jara Jenny Belén , Arnao-Noboa Adriana , Rodriguez-Morales Alfonso J.
Published: June 2023

Background
This study aimed to determine the distribution, burden, age groups, and differences in morbidity cumulative incidence of pneumonia, infectious diarrhoea, tuberculosis, malaria, and HIV infection among the 0–18-year-old population in Ecuador from 2015 to 2021.
Methods
Hospital morbidity data from patients aged 0–18 were analysed and filtered using the ICD-10 coding of the diseases studied. Data were processed using RStudio from the anonymised online database of the National Institute of Statistics and Census.
Results
Pneumonia was the most common infectious disease studied in Ecuador, with the highest burden in the provinces of Pichincha and Guayas. Most cases were reported in children aged 0–5 years, with the lowest cumulative incidence of 17 per 104 population (pop) in 2021. Diarrhoea had the highest incidence in the Guayas. Cases occurred mainly in children aged 0–5 years, with the lowest cumulative incidence of 8.58 per 104 pop in 2020. Tuberculosis mainly affected the province of Guayas. The 0–5 age group accounted for 41% of infections; the cumulative incidence decreased to 0.25 per 104 pop in 2021. Malaria mainly affected Esmeraldas province. Adolescents aged 13–18 were the most infected group, and the cumulative incidence increased to 0.07 per 104 pop in 2021. HIV mainly affects the Guayas Province. 50% of reported cases occurred in the 6–12 age group, and the lowest cumulative incidence was 0.18 per 104 pop in 2021.
Conclusions
Pneumonia and diarrhoeal were identified as the most common infectious diseases in the paediatric population of Ecuador. The provinces of Pichincha and Guayas had the highest burden of infectious diseases. The results of this study can help develop targeted public health interventions to reduce the morbidity cumulative incidence of these diseases in Ecuador.
HPTLC fingerprinting of Tinospora species: T. cardifolia, T. sinensis and T. crispa with microscopic imaging and physiochemical properties
Authors: Mokat Digambar Nabu , Yadav Santosh , BENKE ASHWINI PRASHANT
Published: June 2023

Wide geographic range, ethanol-botanical uses, ambiguity about species identification, and resemblance in physical appearance among various species are a few considerations that highlight the significance of qualitative analysis to safeguard the purity of botanicals and ensure quality control. The stem of T. cordifolia, T. sinensis, and T. crispa is described in the current work together with its physio-chemical characteristics, macroscopic observations, and anatomical details.These investigations uncovered crucial diagnostic traits that can be used to discriminate between different Tinosprora species and to identify raw materials that have been adulterated. T.crispa had the highest extractive value and drying percentage of any other species. T. crispa exhibits more pronounced warty protuberances on the stem than T. sinensis and T. cordifolia. By using biochemical markers to assess the product's quality, high-performance thin-layer chromatography (HPTLC) profiles of authorized materials also develop an effective way to identify products and species. Both T. crispa and T. cordifolia displayed dark bands of cordifolioside-A at RF values of 0.20 and 0.39, respectively, which can serve as reliable biochemical markers for species identification. All three species showed a berberine presence spot with varying amounts. Therefore, the current work can set up a low-cost technique for good quality control and species identification for these Tinospora species and aids in lowering botanical adulteration.
Precise thrombolytic drug treatments for stroke based on artificial intelligence：based on wide and deep model
Authors: Shen Huiwen , Lin Yongzhong , Chen Shuliang , Zhang Lihong , Ma Chunye , Ma Deyuan , Zheng Chunjun , Zhang Ce
Published: June 2023

This study aimed to establish an artificial intelligence algorithm model for patients with Ischemic stroke(IS) based on general patient characteristics, drug treatment methods, and recovery effects. We sought to achieve individualized precise thrombolytic therapy and provide data support for clinical drug decision-making. Data of 55621 patients diagnosed with IS were extracted from the big data server of Yidu Cloud. After screening using the inclusion and exclusion criteria, 1236 and 619 patients were included in the neurological improvement and control groups, respectively for a total of 1855. Single-factor screening was conducted for different influencing factors within the scope of the investigation. Principal component analysis was used to reduce the influencing factor dimensions. We built logistic, support vector machine, C5.0 decision tree arithmetic, deep neural network, and wide and deep models. We further evaluated these models to compare their prediction performance, determine the best model algorithm, and identify the best model parameters. Feature engineering was used to construct a simplified model and evaluate its accuracy. Patient data extracted from another hospital in Dalian were used for external model validation. We included 1855 patients and 26 patient characteristics were included in the model through single-factor screening. The dimensions were reduced to two principal components principal component analysis, and the cumulative variance contribution rate was 93.1%. The wide and deep models showed the best prediction performance with an accuracy and F-index of 81.5% and 87.1%, respectively. Furthermore, the area under the receiver operating characteristic curve values of the training and test set were 0.753 and 0.793, respectively. The number of hidden layers and neurons in each layer of the model was seven and 15, respectively. Using Sigmoid as the activation function showed that the model parameters were optimal. Feature-engineering treatment showed that the accuracy of the model was 81.9%, and that of the external verification model after model simplification was 80.1%. The external verification accuracy of the wide and deep models was 75%, indicating good prediction performance and generalizability. The evaluation indexes of the wide and deep models were excellent. The artificial intelligence algorithm enabled the timely and effective provision of support for drug thrombolytic treatment planning for clinicians and references for clinical decision-making. Furthermore, the algorithm could potentially improve patient treatment outcomes, achieve personalized and accurate treatment for IS patients, and positively contribute to significantly reducing the social burden of disease.
The diagnostic ability of NEWS2 in adult patients with positive blood cultures to detect sepsis according to SOFA-score
Authors: Prytz Karolina Liljedahl , Magnuson Anders , Sundqvist Martin , Kurland Lisa , Källman Jan
Published: June 2023

Background
Blood stream infection (BSI), and especially sepsis and septic shock, is associated with high mortality and significant morbidity. The visible, clinical signs can vary from patient to patient depending on several factors. NEWS2 is quick, easy and non-invasive and includes bedside measurable vital signs. Although NEWS2 is recommended as a risk-stratifying and identification tool in patients with suspected sepsis, it is not a sepsis-specific score. Correlations between vital signs and bacterial species found in blood cultures have not been sufficiently investigated. An early and clear signal through the NEWS2 score could be useful especially in those patients with infections caused by common bacteria rendering high mortality and morbidity. The primary aim was to evaluate the diagnostic accuracy of NEWS2 to detect sepsis in adult patients with positive blood cultures caused by community-acquired infections. A secondary aim was to study a possible association between NEWS2 score and different bacterial species.
Method
This is a retrospective observational study. All patients with positive blood cultures were evaluated for participation (n = 1318). After retrospective medical chart review, 555 patients were eligible for inclusion. Positive NEWS2-score indicating sepsis was defined as NEWS2 ≥ 5.
Results
The presence of sepsis according to SOFA-score was 425 of 555, 76.6% and 28 days mortality was 67 of 555, 12.1%. The sensitivity of NEWS2 to detect sepsis was 87% (95% CI 0.83–0.90). Most common pathogens were Escherichia coli 35.1%, followed by Staphylococcus aureus 15.7% and Streptococcus pneumoniae 13.0%. The ability of NEWS2 to predict sepsis was not statistically associated with the etiology of the infection. The specificity of NEWS2 detection of sepsis was low, 52% (95% CI 0.43–0.59) with no statistically significant differences observed between pathogens.
Conclusions
Patients attending the Emergency Department (ED) with positive blood cultures and NEWS2 score ≥ 5 presented an overall sensitivity of 87% and PPV of 85% to detect patients with sepsis defined by Sepsis-3 criteria. NEWS2 score ≥ 5 could be considered as a quick, first screening tool to highlight a high likelihood of sepsis in the ED. However, NEWS2 score could not discriminate different bacterial species causing the sepsis episode.
An all-ultrasound cranial imaging method to establish the relationship between cranial FUS incidence angle and transcranial attenuation in non-human primates in 3D
Authors: Singh Aparna , Jiménez-Gambín Sergio , Konofagou Elisa E
Published: June 2023

Focused ultrasound (FUS) is a non-invasive and non-ionizing technique which deploys ultrasound waves to induce bio-effects. When paired with acoustically active particles such as microbubbles (MBs), it can open the blood brain barrier (BBB) to facilitate drug delivery inhibited due to the presence of BBB. One of the parameters that affects the FUS beam propagation is the beam incidence angle on the skull. Prior work by our group has shown that, as incidence angles deviate from 900, FUS focal pressures attenuate and result to a smaller BBB opening volume. The incidence angles calculated in our prior studies were in 2D and used skull information from CT. The study presented herein develops methods to calculate incidence angle in 3D in non-human primate (NHP) skull fragments using harmonic ultrasound imaging without using ionizing radiation. Our results show that ultrasound harmonic imaging is capable of accurately depicting features such as sutures and eye-sockets of the skull. Furthermore, we were able to reproduce previously reported relationships between the incidence angle and FUS beam attenuation. We also show feasibility of performing ultrasound harmonic imaging in in-vivo non-human primates. The all-ultrasound method presented herein combined with our neuronavigation system stands to increase more widespread adoption of FUS and render it accessible by eliminating the need for CT cranial mapping.
Gut Microbial Community and Fecal Metabolomic Signatures in Different Types of Osteoporosis Animal Models
Authors: Qiao Xiaochen , Li Xiaoyan , Wang Zhichao , Feng Yi , Wei Xiaochun , Li Lu , Pan Yongchun , Zhang Kun , Zhou Ruhao , Yan Lei , Li Pengcui , Xu Chaojian , Lv Zhi , Tian Zhi
Published: June 2023

Background
The gut microbiota (GM) constitutes a critical factor in the maintenance of physiological homeostasis. Numerous studies have empirically demonstrated that the GM is closely associated with the onset and progression of osteoporosis (OP). Nevertheless, the characteristics of the GM and its metabolites related to different forms of OP are poorly understood. In the present study, we examined the changes in the GM and its metabolites associated with various types of OP as well as the correlations among them.
Methods
We simultaneously established rat postmenopausal, disuse-induced, and glucocorticoid-induced OP models. We used micro-CT and histological analyses to observe bone microstructure, three-point bending tests to measure bone strength, and enzyme-linked immunosorbent assay (ELISA) to evaluate the biochemical markers of bone turnover in the three rat OP models and the control. We applied 16s rDNA to analyze GM abundance and employed untargeted metabolomics to identify fecal metabolites in all four treatment groups. We implemented multi-omics methods to explore the relationships among OP, the GM, and its metabolites.
Results
The 16S rDNA sequencing revealed that both the abundance and alterations of the GM significantly differed among the OP groups. In the postmenopausal OP model, the bacterial genera g__Bacteroidetes_unclassified, g__Firmicutes_unclassified, and g__Eggerthella had changed. In the disuse-induced and glucocorticoid-induced OP models, g__Akkermansia and g__Rothia changed, respectively. Untargeted metabolomics disclosed that the GM-derived metabolites significantly differed among the OP types. However, a Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis showed that it was mainly metabolites implicated in lipid and amino acid metabolism that were altered in all cases. An association analysis indicated that the histidine metabolism intermediate 4-(β-acetylaminoethyl)imidazole was common to all OP forms and was strongly correlated with all bone metabolism-related bacterial genera. Hence, 4-(β-acetylaminoethyl)imidazole might play a vital role in OP onset and progression.
Conclusions
The present work revealed the alterations in the GM and its metabolites that are associated with OP. It also disclosed the changes in the GM that are characteristic of each type of OP. Future research should endeavor to determine the causal and regulatory effects of the GM and the metabolites typical of each form of OP.
Emotion Recognition in Arabic Speech From Saudi Dialect Corpus Using Machine Learning and Deep Learning Algorithms
Authors: Alamri Hanaa , alshanbari hanan
Published: June 2023

Speech can actively elicit feelings and attitudes by using words. It is important for researchers to identify the emotional content contained in speech signals as well as the sort of emotion that resulted from the speech that was made. In this study, we studied the emotion recognition system using a database in Arabic, especially in the Saudi dialect, the database is from a YouTube channel called Telfaz11, The four emotions that were examined were anger, happiness, sadness, and neutral. In our experiments, we extracted features from audio signals, such as Mel Frequency Cepstral Coefficient (MFCC) and Zero-Crossing Rate (ZCR), then we classified emotions using many classification algorithms such as machine learning algorithms (Support Vector Machine (SVM) and K-Nearest Neighbor (KNN)) and deep learning algorithms such as (Convolution Neural Network (CNN) and Long Short-Term Memory (LSTM)). Our Experiments showed that the MFCC feature extraction method and CNN model obtained the best accuracy result with 95 %, proving the effectiveness of this classification system in recognizing Arabic spoken emotions.
Investigation of Temperature Distribution, Microstructure Evolution, and Weld Performance in Stir Friction Welded Joints of 6061 Aluminum Alloys
Authors: zhaorui wang , Linchu Yang , Shujin Chen , Yuan Gao , jiacheng Yu
Published: June 2023

This paper investigates the relationship among welding process parameters, weld flow viscosity, welding heat generation, finite difference method (FDM) heat dissipation model, microstructural evolution, and mechanical properties during friction stir welding (FSW) of 6061-T6 aluminum alloy. Throughout the study, it was experimentally verified that the temperature inside the weld does not always increase on the AS side compared to the RS side under different welding process parameters, and the highest temperature did not always occur when the stirring pin passed through. As the flow viscosity is dependent on the weld temperature, and viscosity and temperature have corresponding inhibitory and promoting effects on the formation of intergranular structures in the weld, it is shown that the plastic flow of material differs at different positions in the weld nugget, subsequently affecting the macroscopic mechanical properties of the weld.
Successful Anesthesia Management of Massive Haemorrhage During C-Section Indicated of Placentapercreta Multidisciplinary Approach Based Team: A Case Report
Authors: Shantikaratri Emilia Tiara , Pankao Isngnadi , Hartono Ruddi
Published: June 2023

Background
Placenta perccreta accounts for 7–10% of maternal mortality. Immature preoperative management and planning could increase the risk of maternal mortality. Anesthetic management during the procedure are involved due to high risk of massive hemorrhage. A multidisciplinary team approach is important to reduce risk during the procedure. The author reports the multidisciplinary approach in a placenta perccreta patient.
Case Presentation
Gestating woman aged 33 years with a gestational age 30–32 weeks canceled going to RSUD dr. Saiful Anwar Malang with complaints of bleeding from the birth canal for the past 1 month. The patient had a history of caesarean section in the lower segment. In the last 1 month, the patient has received a total of 6 RRC bags with antibiotics. Caesarean section (SC) to be performed due to the abnormal estimation of placental implantation from ultrasonography and gross hematuria. The patient was consulted for anesthesia 7 days before the scheduled SC. Calculation of the Placenta Accreta Index (PAI) score obtained a total score of 5. The patient underwent a Magnetic Resonance Imaging examination and found placenta previa type III (partial placenta previa) accompanied by placenta percreta, the impression of infiltrating the superoposterior wall of the urinary bladder. Preoperative management is carried out by involving a multidisciplinary team.
Conclusion
Anesthetic management with a multidisciplinary team approach shows an effective and safe results in patients with placenta preccreta during a C-Section procedure. Hemodynamic monitoring is important during the procedure and need to be manage carefully.
Patterns of management of positive sentinel lymph nodes in breast cancer patients after the American College of Surgeons Oncology Group Z0011 trial: a retrospective cohort
Authors: Charif Mohamad Hadi El , Ghezzawi Malak , Kalot Nour , Alam Joelle , Kakati Rasha , Abbas Jaber , Assi Hazem , Sbaity Eman
Published: June 2023

Purpose
The ACOSOG-Z0011 clinical trial introduced drastic changes to the traditional surgical practice for early breast cancer with positive sentinel lymph nodes. This study evaluates how these changes have affected the surgical management of early breast cancer at our institution.
Methods
A retrospective chart review was conducted for Lebanese women with a diagnosis of invasive breast cancer and who were ≥18 years of age, had undergone upfront breast-conserving surgery, and SLNB without any prior chemotherapy had no distant metastasis and had one or more positive SLNs, between 2011 and 2016.
Results
Data from our cohort shows that 78% of patients out of the 233 with clinically negative nodes go on to have negative nodes on surgical sentinel pathology as well. However, the incidence of micromets is 5.5% amongst positive SLNs versus 94% of positive SLNs having macromets.
Survival data analysis showed a 5-year and 10-year locoregional recurrence rates of 1.72% and 2.15%, respectively. At 3-years follow-up, distant metastasis occurred in 3.4% of cases. Additionally, the 10-year overall survival is 98.7% and disease-free survival is 95.3%.
The rates of ALND decreased from 46.7% to 18.2% in patients with 2 or less positive sentinel nodes between the two time periods 2011-2013 and 2014-2016.
Conclusion
With a follow-up period extending more than five years, our study shows that ALND offers no superiority to SLNB alone in terms of overall survival and disease-free survival. This does not only conform with the findings of Z0011 but adds to its generalizability to populations of different ethnicities.
The effect of sex differences in percentage of body fat on speed and endurance running performance
Authors: Asma Kacem , Ghassen Ben Mansour , Laurent Grélot , Foued Ftaiti
Published: June 2023

Purpose – Technological developments over the past two decades induced lifestyle changes such as high TV-viewing and high computer/tablet/smartphone and increase population physical inactivity. This change in lifestyle can affect young people and adults of both sexes differently and modify or reverse the well-known male-female morphological and physical differences. The aim of this study is to compare the effect of sex differences in percentage of body fat on speed and endurance running performance. Methods − 72 male and 64 female students aged 20 to 23 years participated in this study. After assessing their morphological characteristics, running performances during 30 m and 400 m, and maximum aerobic velocity (MAV) and maximal oxygen consumption (VO2max) during a 20 m shuttle running test have been estimated for each subject. Male students were re-tested after being overweighed down with a weight equivalent to the mean differences in body fat recorded between the two sexes in the form of a loaded worn vest. Results – Male are 15,7% heavier and 7,4% taller (p < 0.001) and presented a percentage of fat mass (17.2 ± 2%) significantly (p < 0.001) lower than that of women subject (25.0 ± 2.5%) (difference male vs female for body fat mass: 45.34%). Running performances during 30 m and 400 m, MAV and VO2max were significantly (p < 0.001) better in males (4.81 ± 0.11 sec, 61.97 ± 2.63 sec, 12.53 ± 0.54 km/h and 49.67 ± 3.3 ml/min/kg, respectively) than in females (5.58 ± 0.31 sec, 87.95 ± 8.93 sec, 10.38 ± 0.57 km/h and 37.22 ± 3.31 ml/min/kg, respectively) In the weighted condition, male performances during 30 m and 400 m, MAV and VO2max were attenuated by 6.89%, 14.16%, 6.48% and 10.07%, respectively) but remain significantly better than those of female students. Conclusion - Excess body fat in female students has a detrimental effect (range ≈ -7 to -14%) on 30 m, 400 m, MAV and VO2max performances. The persistence of sex differences after overweighting male students indicates that body fat could be responsible for ≈ 50 to 70% of the observed differences between sexes performances during short and long sprints, and 20 m shuttle running test.
Limitation of Cerebral Blood Flow by Increased Venous Outflow Resistance in Elevated ICP
Authors: Zadka Yuliya , Rosenthal Guy , Doron Omer , Barnea Ofer
Published: June 2023

Background
Extensive investigation and modeling efforts have been dedicated to cerebral pressure autoregulation, which is primarily regulated by the cerebral arterioles ability to change their resistance and modulate cerebral blood flow (CBF). However, the mechanisms by which elevated intracranial pressure (ICP) leads to increased resistance to venous outflow have received less attention. We modified our previously described model of intracranial fluid interactions with a newly developed model of a partially collapsed blood vessel, which we termed the “Flow Control Zone” (FCZ). We sought to determine the degree to which ICP elevation causing venous compression at the FCZ becomes the main parameter limiting CBF.
Methods
The FCZ component was designed using non-linear functions representing resistance as a function of cross-sectional area and the pressure-volume relations of the vessel wall. We used our previously described swine model of cerebral edema with graduated elevation of ICP to calculate venous outflow resistance (VOR) and a newly defined parameter, the cerebral resistance index (CRI), which is the ratio between venous outflow resistance and cerebrovascular resistance.
Results
Model simulations of cerebral edema and increased ICP led to increased venous outflow resistance. There was a close similarity between model predictions of venous outflow resistance and experimental results in the swine model (cross correlation coefficient of 0.97). CRI was strongly correlated to ICP in the swine model (r2 = 0.77, p < 0.0001). A CRI value of 0.5 was associated with ICP values above clinically significant thresholds (23.7 mm Hg) in the swine model and a diminished the capacity of changes in arteriolar resistance to influence flow in the mathematical model.
Conclusions
Our results demonstrate the importance of venous compression at the FCZ in determining CBF when ICP is elevated. The cerebral resistance index may provide an indication of when compression of venous outflow becomes the dominant factor in limiting CBF following brain injury.
Chest computed tomography characteristics of critically ill COVID-19 patients with auto-antibodies against type I interferons
Authors: Rapnouil Baptiste Lafont , Zaarour Youssef , Arrestier Romain , Bastard Paul , Peiffer Bastien , Moncomble Elsa , Parfait Mélodie , Bellaïche Raphaël , Casanova Jean-Laurent , Mekontso-Dessap Armand , Mule Sébastien , de Prost Nicolas
Published: June 2023

Purpose: patients with auto-antibodies neutralizing type I interferons (anti-IFN auto-Abs) are at risk of severe forms of coronavirus disease 19 (COVID-19). The chest computed tomography (CT) scan characteristics of critically ill COVID-19 patients harboring these auto-Abs have never been reported.
Methods: Bicentric ancillary study of the ANTICOV study (observational prospective cohort of severe COVID-19 patients admitted to the intensive care unit (ICU) for hypoxemic acute respiratory failure) on chest CT scan characteristics (severity score, parenchymal, pleural, vascular patterns). Anti-IFN auto-Abs were detected using a luciferase neutralization reporting assay. Imaging data were collected through independent blinded reading of two thoracic radiologists of chest CT studies performed at ICU admission (±72h). The primary outcome measure was the evaluation of severity by the total severity score (TSS) and the CT severity score (CTSS) according to the presence or absence of anti-IFN auto-Abs.
Results: 231 critically ill COVID-19 patients were included in the study (mean age 59.5±12.7 years; males 74.6%). Day 90 mortality was 29.5% (n=72/244). There was a trend towards more severe radiological lesions in patients with auto-IFN anti-Abs than in others, not reaching statistical significance (median CTSS 27.5 (21.0-34.8] versus 24.0 (19.0-30.0), p=0.052; median TSS 14.5 (10.2-17.0) versus 12.0 (9.0-15.0), p=0.070). The extra-parenchymal evaluation found no difference in the proportion of patients with pleural effusion, mediastinal lymphadenopathy or thymal abnormalities in the two populations. The prevalence of pulmonary embolism was not significantly different between groups (8.7% versus 5.3%, p=0.623, n=175).
Conclusion: There was no significant difference in disease severity as evaluated by chest CT in severe COVID-19 patients admitted to the ICU for hypoxemic acute respiratory failure with or without anti-IFN auto-Abs.
Facilitators and barriers to implementing a specialized care unit for persons with cognitive impairment in an acute geriatric hospital: A process evaluation
Authors: Adlbrecht Laura , Karrer Melanie , Helfenberger Nicole , Ziegler Eva , Zeller Adelheid
Published: June 2023

Background: Implementing dementia care interventions in an acute hospital poses multiple challenges. To understand factors influencing the implementation, in-depth knowledge about specific facilitators and barriers is necessary. The aim of this study was to identify facilitators and barriers to implementing a multicomponent, interprofessional concept of a specialized unit for persons with cognitive impairment in an acute geriatric hospital.
Methods:We conducted a process evaluation as part of a participatory action research study. For data collection, semi-structured individual interviews with fifteen professionals involved in the implementation of the specialized unit. We further conducted two focus groups with twelve professionals working on other units of the geriatric hospital. We performed a qualitative content analysis following Kuckartz’s content-structuring analysis scheme.
Results: We identified the following barriers to implementing the concept: uncontrollable contextual changes (e.g., COVID-19 pandemic), staff turnover in key functions, high fluctuation in the nursing team, traditional work culture, entrenched structures, inflexible and efficiency-oriented processes, monoprofessional attitude, neglect of project-related communication, and fragmentation of interprofessional cooperation. An established culture of interprofessionalism, an interprofessionally composed project group, cooperation with a research partner, as well as the project groups’ motivation and competence of managing change facilitated the implementation.
Conclusions: The implementation faced numerous barriers that can be described using the key constructs of the i-PARIHS framework: context, recipients, innovation, and facilitation. Overcoming these barriers requires an organizational development approach, extended project duration and increased process orientation. Furthermore, strategically planned, precise and ongoing communication towards all persons involved seems crucial. Differences between the work cultures of the professions involved deserve particular attention with regard to project-related roles and processes.
Accuracy of robotic arm-assisted versus computed tomography-based navigation for cup orientation and positioning in total hip arthroplasty using the direct anterior approach in supine position
Authors: Okazaki Tomoya , Imagama Takashi , Matsuki Yuta , Tanaka Hiroshi , Shiigi Eiichi , Kaneoka Takehiro , Kawakami Takehiro , Yamazaki Kazuhiro , Sakai Takashi
Published: June 2023

Background
A robotic arm-assisted and a computed tomography (CT)-based navigation system have been reported to improve the accuracy of component positioning in total hip arthroplasty (THA). Although some previous studies have compared robotic arm-assisted THA (rTHA) with CT-based navigated THA (nTHA), most studies evaluated the outcomes in the lateral position. No study has compared rTHA to nTHA concerning accuracy of cup placement and acetabular fractures using the direct anterior approach (DAA) in supine position. This study aimed to compare the accuracy of cup placement and the presence of intraoperative acetabular fractures between rTHA and nTHA using DAA in supine position.
Methods
We retrospectively investigated 209 hips of 188 patients who underwent rTHA or nTHA using DAA in supine position (rTHA using the Mako system: 85 hips of 79 patients; nTHA: 124 hips of 109 patients). After propensity score matching for age and sex, each group consisted of 73 hips. Postoperative cup orientation and positions measured using a three-dimensional templating software were compared to preoperative planning with CT measurements. Additionally, we investigated the prevalence of occult acetabular fracture.
Results
The mean absolute error of cup orientation was significant smaller in the rTHA group than in nTHA (inclination: 1.4° ± 1.2° vs 2.7° ± 2.2°, respectively; p = 0.0001, anteversion: 1.5° ± 1.3° vs 2.2° ± 1.7°, respectively; p = 0.007). The cases within an absolute error of 5 degrees in both RI and RA were significantly higher in the rTHA (97.3%) than in nTHA group (82.2%) (p = 0.003). The absolute error of the cup position was not significantly different between the two groups. The prevalence of occult acetabular fracture did not differ significantly between the two groups (rTHA: n = 0 [0%] vs. nTHA: n = 1 [1.4%]).
Conclusion
Cup placement using DAA in the supine position in rTHA was more accurate with fewer outliers compared to nTHA. Therefore, rTHA performed via DAA in a supine position would be useful for accurate cup placement.
High burnout among maternity healthcare workers in Zomba and Lilongwe, Malawi
Authors: Singano Fikile Khangamwa , Mazengera Rose , Mbendela Ida , Singano Victor
Published: June 2023

Background Burnout is prevalent among healthcare workers due to chronic stress of patients suffering. In Malawi burnout has not been properly investigated in the maternity facilities, however it is believed that there are high burnout levels among maternal health care workers due to the high patient to provider ratio, poor remuneration and heavy work load. Therefore, the study aimed to assess the extent and factors associated with burnout among maternity health care workers at two hospitals (Zomba Central Hospital and Bwaila Hospital) in Malawi.Methods We conducted a cross-sectional study among maternity health care workers at Zomba Central Hospital and Bwaila Hospital in June 2018. Demographic data and constructs of burnouts (emotional exhaustion, depersonalization and reduced personal accomplishments) were collected using a validated adapted Maslach Burnout Inventory self-administered questionnaire.Results We enrolled 81 participants in the study, with a mean age 32 years (SD: 6.2); 68% were female; and 85% were nurse/midwives. 62% of the participants were from Bwaila Hospital and 38% from Zomba Central Hospital. The burnout rates on emotional exhaustion, depersonalization and reduced personal accomplishment on the Maslach Burnout Inventory Scale were 75%, 28% and 33%, respectively. In multivariate analysis, healthcare worker absenteeism (adjusted OR {P-value} 15.38(0.05) and low job satisfaction (adjusted OR {P-value} 17.72(0.02) were associated with emotional exhaustion. Working at Zomba Central Hospital (adjusted OR {P-value} 10.06(0.022), working in the labour and antenatal wards (adjusted OR {P-value} 0.166(0.047) low job satisfaction (adjusted OR {P-value} 0.056(0.023) and discussing work situation with colleagues (adjusted OR {P-value} 0.122(0.026) were associated with reduced personal accomplishment. healthcare worker absenteeism (adjusted OR {P-value} 9.91(0.05) was associated with depersonalisation.Conclusion There was a high burnout rate among maternity health care workers with high absenteeism rates.
Prognostic Factors of Classic Kaposi’s Sarcoma in the Hainan Area
Authors: Zhang Haihang , Xie Panpan , Han Fengxiang , Fu Yu , Wu Yi , Zeng Jiangzheng , Zheng Liping , Lu Yanda
Published: June 2023

Background: Hainan Province is situated at the southernmost tip of the People's Republic of China, within the northern tropical belt. However, the risk factors for classic Kaposi's sarcoma in this region remain unknown. To explore the prognostic factors for patients with classic Kaposi’s sarcoma (CKS) and develop a nomogram to quantitatively predict cancer-specific survival (CSS) probability.
Methods: This study retrospectively analyzed the clinical data of 42 CKS patients admitted between January 1999 and June 2022. Univariate analysis was performed to screen for significant variables, which were then included in a multivariate Cox regression analysis to futher investigate their impact. A nomogram was developed to predict patient CSS, and its performance was evaluated using an ROC curve.
Results: All patients were middle-aged and elderly, and there were significantly more males than females, with a male-to-female ratio of 4.2:1 Univariate analysis found several factors that might influence CKS prognosis, including sex, race, stage, lower limb lesions, concurrent upper and lower limb lesions, white blood cells(WBCs), hemoglobin(Hb), and human herpesvirus 8 (HHV-8) (P < 0.05). Multi-factor analysis showed that sex (hazard ratio [HR]: 0.146, confidence interval [CI]: 0.033–0.648, P = 0.011) and race (HR: 0.229, CI: 0.065–0.803, P < 0.021) were protective factors, while stage (HR: 3.728, CI: 1.015–13.695, P < 0.047) was an independent risk factor. The nomogram constructed from these factors had better predictive performance than sex, ethnicity, and stage.
Conclusions: Sex, nationality, and stage were independent factors influencing CKS prognosis, and the constructed nomogram could aid in survival estimation and individualized treatment decisions.
Pelvic Lipomatosis: Bladder Sparing Extirpation of Pelvic Mass with Ureteral Reimplantation
Authors: Albalawi Abdulaziz , Alhassan Abdullatif , Alanazi Abdullah , Alghamdi Abdullah
Published: June 2023

Background Pelvic lipomatosis is a proliferative disease characterised by excessive fat growth in retroperitoneal space leading to inadequate bladder drainage and ureteral compression. Cystitis glandularis, cystitis cystica, or cystitis follicularis can be found in majority of patients with the disease.Case Presentation We report a case of a 63-year-old man diagnosed outside our hospital with pelvic lipomatosis after finding of pelvic mass behind the bladder causing severe bilateral hydronephrosis. A bladder–sparing excision of the pelvic lipomatosis mass with bilateral ureteric reimplantation was performed, thereby avoiding the need for urinary diversion.Conclusion For patients suffering from pelvic lipomatosis and bilateral hydronephrosis, relief of obstructions to the urinary tract should be prioritized. This can be achieved through traditional surgery such as a ureteral stent insertion, or more radical surgical options such as a total cystectomy and urinary diversion. There have been recent reports of success found in bladder-sparing techniques using mass extirpation and ureteral reimplantation.
E-Peer Assisted Reflection (E-PAR) and Development in Discussion Board; An analysis of Medical Students’ Opinions
Authors: Mosalanejad Leili , Maghsodzadeh Sara , Karamzadeh Atefeh , Karimian Zahra
Published: June 2023

Introduction: Reflection is the process of critical reviewing what students have learned. The purpose of this study was to analyze medical students' opinions on e-peer-assisted reflection and development in a forum.
Methods: This study was conducted using a qualitative approach and content analysis methods. The study sample included all opinions experienced in 16 forums by 292 students of medicine, laboratory science, and public health at 0000 University of Medical Sciences (0000). The teacher presented the course concept to the class and asked questions based on the learning management system's (LMS) discussion forum. Students will then respond to it according to the requested time and time frame. After each course, we surveyed students' experiences of discussion and question-and-answer sessions in a forum environment. Data were analyzed by inductive content analysis, first open code was extracted and then classified based on semantic and thematic similarity. Three peers checked the categories and codings.
Results: The data were finally classified into two general categories: effectiveness and setting included Effectiveness [Peer Assisted Learning (11Items), Thinking (11Items), Active Learning(8Items), Self-critique(5Items)] and Setting [Environment(7Items), Teachers (7Items) and Students(2Items)] the repetition rate of each item was recorded.
Conclusion: It seems that is an appropriate method of enhancing student learning and appears to be effective in enhancing their reasoning, participation, and comprehension.
PTPN3 inhibition contributes to the activation of the dendritic cell function to augment the effect of cancer immunotherapy
Authors: Iwamoto Naoya , Onishi Hideya , Masuda Syogo , Imaizumi Akira , Sakanashi Keita , Morisaki Shinji , Nagao Shinjiro , Koga Satoko , Ozono Keigo , Umebayashi Masayo , Morisaki Takashi , Nakamura Masafumi
Published: June 2023

In a previous study, protein tyrosine phosphatase non-receptor type (PTPN) 3 was identified as an immune checkpoint molecule in lymphocytes, and its potential as a novel therapeutic target for cancer immunotherapy was anticipated. However, evaluation of dendritic cell (DC) function as antigen-presenting cells is critical for development of immunotherapy. This study aimed to analyze the biological effect of PTPN3 on DCs induced from human peripheral blood monocytes obtained from healthy individuals. PTPN3 knockdown by siRNA significantly increased the number of DCs, the expression of CD80 and CCR7, and the production of IL-12p40/p70 in mature DCs. Using an HLA-A24-restricted DC and human lung squamous cell carcinoma cell cytotoxic assay, PTPN3 inhibition in mature DCs induced cytotoxic T lymphocytes with increased production of INF-γ and granzyme B and enhanced cytotoxicity against cancer cells and migration to cancer. Furthermore, PTPN3 inhibition activated the MAPK pathway in DCs. These findings suggest that PTPN3 inhibition can contribute to the development of novel cancer immunotherapies that not only activate lymphocytes, as previously reported, but also activate DCs.
A note on area estimates for stable H-hypersurfaces and applications
Authors: Ranieri Marcos , Sampaio Elaine , Vitório Feliciano
Published: June 2023

We show some area estimates for stable CMC hypersurfaces which the ambient manifold haseither the scalar or sectional curvature bounded from below. In particular, we focus on immersions in three dimensional Riemannian manifolds. As application we derive upper estimates for the bottom spectrum of these hypersurfaces. The technique and most of our results are generalizations of the theorems obtained in [20] for stable minimal surfaces.
Journal Of Big Data: A Bibliometric Analysis
Authors: Mishra Puneet , Bhardwaj Manik
Published: June 2023

The Journal of Big Data has been a leading international journal in Decision Sciences and Computer Sciences. The goal of this research is to look into the Journal of Big Data's bibliometric attributes through scientific activity based on journal article citation links. Using a bibliometric approach, this study examines all of the journal's publications since its inception. The goal is to provide a comprehensive overview of the major factors influencing the journal. This analysis covers key issues such as the journal's publication and citation structure, the most cited articles, and the journal's leading authors, institutions, and countries. The network analysis was performed to look into author keywords through Journal of Big Data publications. The software that was utilized to create this analysis of present patterns and potential future developments was Scopus, Rstudio, and Vosviewer. A bibliometric study was utilized to examine articles and review papers, and only works published in the Scopus database between 2014 and 2021 were considered. The information on each manuscript's bibliometric was acquired after the findings were clearly explained. The initial findings included 632 articles.