bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of three different postoperative treatment options after interposition arthroplasty of the thumb. An observational study
Authors: Krasny Christian , Auerbach Melanie , Radda Christian , Schallmayer Daniel , Borchert Gudrun H. , Frauscher Barbara , Rampesreiter Manuela , Albrecht Christian , Wurnig Christian
Published: September 2024

Background:
In rhizarthrosis the saddle joint of the thumb is affected. Occupational therapy after interposition arthroplasty is of particular importance and a key factor for a successful outcome. Orthosis use and/or the timeline of using the orthosis is still under debate.
Research questions:
- In patients with rhizarthrosis after interposition arthroplasty, what is the effect of an orthotic thumb device compared with no orthotic thumb device during accompanying occupational therapy?
- In patients with rhizarthrosis after interposition arthroplasty, what is the effect of a long orthotic thumb device compared with a short orthotic thumb device during accompanying occupational therapy?
Methods:
42 patients with confirmed symptomatic rhizarthrosis after interposition arthroplasty by Weilby and 2 weeks cast fixation were randomly assigned to one of the following study arms: Group I: long orthotic thumb device, Group II: short orthotic thumb device, Group III without orthotic thumb device for 4 weeks, accompanied by 12 weeks postoperative occupational therapy. After 6 and 12 weeks, VAS-Pain-Score, Quick-DASH, pinch-grip-strength, and ROM were evaluated.
Results:
All groups improved in their hand functions 12 weeks after surgery. The VAS pain score improved by 5 points. The Quick-DASH score halved for patients with short or no orthotic thumb device. Patients with the short orthotic thumb device showed the highest rate of improvement (pain, QuickDASH, mobility of the carpometacarpal joint in abduction, interphalangeal joint mobility and thumb function) 12 weeks after surgery, followed by the non-orthotic thumb device-group. Non-orthotic thumb device patients did not show higher pain levels. Patients of the long orthotic thumb device-group showed more impairment of their function, especially for pain and grip- and pinch strength compared to the other groups, 12 weeks after surgery.
Conclusion:
After interposition arthroplasty of the thumb followed by two weeks cast fixation, a thermoplastic short orthotic thumb device should be used, which only restricts motion of the operated first carpometacarpal joint, leaving all other joints of the thumb moveable for 4 weeks, due to the best results obtained 12 weeks after surgery.
Trial registration:
not applicable because this is the publication following a thesis in Austria. At the time of the start of the study there was no need for registration for such studies in Austria.
Clinical characteristics and management of adipsic diabetes insipidus in children and adolescents with sellar germ cell tumors
Authors: Tong Tao , Xu Jian , Chen Han , Guo Ying , Mo Caiyan , Wang Yao , Zhong Liyong
Published: September 2024

Purpose
Adipsic diabetes insipidus (ADI) is a rare, high-risk syndrome, particularly difficult to recognize and manage in children and adolescents. This investigation examined the clinical features and management of ADI in children and adolescents with sellar germ cell tumors (GCTs).
Methods
A retrospective survey was performed on 260 patients with sellar GCTs, categorized into ADI and non-ADI groups based on thirst presence. General characteristics, hypothalamic syndrome, pituitary function, metabolic indicators, and complications were compared. Biochemical indicator changes in the ADI group were analyzed after systematic management, and receiver operating characteristic (ROC) curve analysis established the optimum serum sodium cut-off for predicting the ADI.
Results
25 patients (9.6%) developed ADI. The ADI group had larger tumors with hypothalamic involvement and more surgical resections. They also demonstrated more hypothalamic syndrome, central adrenal insufficiency, central hypogonadism, and insulin-like growth factor-1 levels below norms. Furthermore, ADI patients exhibited significantly higher rates of hypernatremia (100% vs 20.9%, p < 0.001), hyperuricemia (60.0% vs 23.4%, p < 0.001), renal impairment (32.0% vs 1.7%, p < 0.001), and venous thrombosis (4.0% vs 0%, p = 0.002). Following systematic management, ADI patients experienced significant reductions in serum sodium, uric acid, and creatinine levels, although these remained higher than in the non-ADI group. ROC analysis indicated that a serum sodium level above 149.5 mmol/L predicted ADI.
Conclusion
Patients with ADI had more tumor involvement in the hypothalamic region, surgical resections, hypothalamic syndrome, hypopituitarism, and complications. Serum sodium levels above 149.5 mmol/L necessitated heightened vigilance for ADI. Early identification and systematic management reduced complications, though clinical management remained challenging.
Analysis of influencing factors of falls among rural elderly in China and construction of nomogram model
Authors: Zhao Yaodong , Wang Chi , Chen Yujie , Wan Pengcheng , Wang Haibo , Li Yi , Wang Hui , Ding Hong
Published: September 2024

Objective
To explore the factors influencing falls among elderly individuals in rural China and to construct a nomogram model. This study aims to provide a scientific basis for identifying high-risk populations and implementing fall prevention interventions.
Methods
A multi-stage random sampling method was employed, selecting one city each from the northern, central, and southern regions of Anhui Province—Suzhou, Hefei, and Anqing, respectively. From each city, one county was randomly selected, and within these counties, a total of 18 villages were randomly chosen as survey sites. Elderly individuals from these villages constituted the study population, with a total of 1546 participants. These participants were randomly divided into a training set (1208 individuals) and a validation set (338 individuals) in an 8:2 ratio. Univariate analysis was conducted using the Mann-Whitney U test and Kruskal-Wallis H test, while multivariate analysis employed binary logistic regression to identify influencing factors of falls in the training set of rural elderly. A nomogram model was subsequently developed based on these factors.
Results
From the univariate and multivariate analyses of the training set, five variables were identified: age, anxiety, frailty, living style, and frequency of coarse grain consumption. These variables were incorporated into the nomogram model, which exhibited an area under the ROC curve (AUC) of 0.722, indicating good discriminative ability. The calibration curve demonstrated high calibration accuracy. Internal validation of the nomogram model using the validation set yielded an AUC of 0.703, reflecting high discriminative ability, and the Hosmer-Lemeshow test result of P = 0.08 indicated high calibration accuracy.
Conclusion
Falls among the elderly in rural China are influenced by age, anxiety, frailty, living style, and coarse grain consumption frequency. The nomogram model can predict the probability of falls among rural elderly individuals based on these factors, providing significant value for identifying high-risk populations and offering targeted interventions to reduce the occurrence of falls among older adults, which can ultimately enhance the quality of life and well-being of elderly individuals in their later years.
Quantifying the technical-tactical diversity of elite tennis players during match-play
Authors: Zhao Zichen , Cui Yixong , Gomez Miguel-Angel , Zong Shouxin , Qi Bing
Published: September 2024

The study aimed to model the diversity in technical-tactical performance among elite tennis players during matches in relation to match outcome and gender. Match performance data of 236 singles matches (136 for male and 130 for female) from the 2023 Australian Open and US Open were collected. Standard entropies were calculated for five technical-tactical performance indicators (shot type, forehand/backhand groundstroke direction, first/second serve distribution) to reflect each player’s technical-tactical diversity. The linear mixed model was used to examine the effects of match outcome and gender on each performance category. The results showed that there was no statistically significant interaction effect between match outcome and gender on the diversity of five performance indicators (p > 0.05). However, both match outcome and gender independently had significant main effects on shot type, forehand/backhand groundstroke direction, and first-serve distribution (p < 0.05, conditional R-squared = 0.17–0.70). Losing players showed higher diversity in shot type (ES = 0.33, small) compared to winning players. Male players generally showed greater diversity in shot type, and forehand groundstroke direction (ES = 0.63–0.97, moderate) than female players, but less diversity in backhand groundstroke direction and first-serve distribution (ES = 0.62–0.70, moderate). These findings suggest that (i) the technical-tactical diversity may help describe match styles of tennis players, instead of serving as a reliable indicator for assessing match outcome; (ii) the stability of technique usage is more crucial than the diversity of techniques used for elite players; and (iii) male players should focus on improving the attacking ability of their backhand to achieve higher rankings, while female players with exceptional serving abilities should prioritize the stability of their first serve.
Evaluation of Vertigo-Related Information from Artificial Intelligence Chatbot
Authors: Liu Xu , Shi Suming , Zhang Xin , Gao Qianwen , Wang Wuqing
Published: September 2024

Objective: To compare the diagnostic accuracy of an artificial intelligence chatbot and clinical experts in managing vertigo-related diseases and evaluate the ability of the AI chatbot to address vertigo-related issues.
Methods: 20 clinical questions about vertigo were input into ChatGPT-4o, and three otologists evaluated the responses using a 5-point Likert scale for accuracy, comprehensiveness, clarity, practicality, and credibility. Readability was assessed using Flesch Reading Ease and Flesch-Kincaid Grade Level formulas. The model and two otologists diagnosed 15 outpatient vertigo cases, and their diagnostic accuracy was calculated. Statistical analysis used ANOVA and paired t-tests.
Results: ChatGPT-4o scored highest in credibility (4.78). Repeated Measures ANOVA showed significant differences across dimensions (F=2.682, p=0.038). Readability analysis revealed higher difficulty in diagnostic texts. The model's diagnostic accuracy was comparable to a clinician with one year of experience but inferior to a clinician with five years of experience (p=0.04).
Conclusion: ChatGPT-4o shows promise as a supplementary tool for managing vertigo but requires improvements in readability and diagnostic capabilities.
Association between cardiovascular disease and chronic kidney disease and influencing factors of their comorbidity: Evidence from the China Health and Retirement Longitudinal Study (CHARLS)
Authors: Fu Zhike , Gui Chuying , Deng Weitian , Zhou Xiaoshan , Li Huijie , Zhang Di , Wang Zan , Deng Yueyi
Published: September 2024

Background and Hypothesis:
Chronic Kidney Disease (CKD) and Cardiovascular Disease (CVD) are significant public health concerns with high morbidity and mortality rates. the relationship between CKD and CVD comorbidities and their influencing factors in Chinese middle-aged and elderly people remains underexplored. We hypothesize that some socio-demographic factors, lifestyle factors, and physical condition factors significantly influence the prevalence and comorbidity of CKD and CVD.
Methods
Data from the China Health and Retirement Longitudinal Study (CHARLS) were used to perform logistic regression analyses on adults aged 45 and above. CKD stages were defined based on estimated glomerular filtration rate (eGFR), while CVD status was determined through self-reported diagnosis. Factors considered in the analysis included socio-demographic variables (age, gender, household registration, education, marital status), lifestyle behaviors (smoking, drinking), and physical conditions (body mass index (BMI), blood pressure, blood sugar, blood lipids, serum uric acid).
Results
CVD risk begins in early stages of CKD. Factors such as hypertension, diabetes, non-rural household registration, abnormal BMI, and lower education levels were significantly associated with CKD prevalence and its comorbidity with CVD. Low BMI increased CKD progression, while high BMI elevated the risk of CKD and CVD comorbidities. Specifically, in CKD patients, lower BMI was linked to reduced CVD risk, suggesting a complex interplay between physical health metrics, such as BMI, in influencing health outcomes..
Conclusion
Socio-demographic factors and physical conditions are crucial in managing and preventing CKD and its comorbidity with CVD. Targeted public health strategies are needed for non-rural and lower-educated populations. Further research should explore underlying mechanisms and develop effective interventions.
A Unified Contraction Characterization for the Identification of Spontaneous Onset of Labor in Term Nulliparous Women via Multi-Channel Electrohysterography and Tocodynamometer
Authors: XU Jinshan , Shen Junhua , Lin Yiwei , Bai Xiaoxia , Pumir Alain , Li Baohua
Published: September 2024

Background
Strong and synchronized contractions that occur in the last stage of pregnancy are essential for onset of labor. In clinics, the lack of effective description of these characteristics results in inaccurate prediction of the onset of labor. The commonly used contraction monitoring device tocodynamometer (TOCO) detects contractions with relatively high specificity but is unable to quantify the strength and synchrony. The electrohysterography (EHG) quantifies the myoelectric activities that trigger contractions of muscle cells under the electrodes. Therefore, multiple channel EHG signals are well suited for characterizing the strength and synchrony of uterine contractions via their spatiotemporal pattern.
Object:
The purpose of this study was to provide quantitative descriptions of the contraction characteristics and to investigate their significance for predicting the spontaneous onset of labor in nulliparous women.
Study Design:
100 pregnant women with a gestational age of more than 37 weeks were recruited for the study. Multichannel EHG and tocodynamometer recordings were performed simultaneously for 46 of them, both during pregnancy and during labor (defined a time to onset of labor (TTL) less than 24 h). Contractions were identified from the TOCO recordings, and then the frequency and duration of contractions were determined. The multichannel EHG segments under the identified contractile time windows were used to calculate the strength and level of synchrony. Statistical analyses were carried to demonstrate the difference of these variables between the pregnant and labor groups. Multivariate logistic regression was created to provide obstetricians with an assessment tool in predicting spontaneous onset of term labor.
Results
The frequency, duration, strength, and level of synchrony of uterine contractions for 46 pregnant women during their 37 weeks of gestation to the onset of labor were quantified. All constructed features in labor, with the exception of concordance correlation-based synchrony \(\:\psi\:\), showed statistically significant differences from those in pregnant phase, with degree of synchrony described by the sample entropy SamEn being the strongest feature for distinguishing pregnant and labor (0.5154 ± 0.1720 vs. 0.3555 ± 0.1422, \(\:p=0.00001\)). The multivariate logistic regression model constructed from these features showed high significance in identifying the onset of spontaneous labor in nulliparous women, with an AUC value of 0.80.
Conclusion
The contraction properties in terms of frequency, duration, strength, and level of synchrony have been quantitated. Continuous observations on 46 pregnant women throughout their pregnancy demonstrated statistically significant difference between contractions in pregnant and labor phase, which enabled a prediction model on spontaneous onset of labor in term nulliparous women.
Impact of Cr Doping on the Optical, and Photocatalytic Performances of TiO2 for Solar Drivin Wastewater Treatments
Authors: Irfan Muhammad , Arif Umaima , Rehman Mubashra , Khursheed Nimra
Published: September 2024

Commercially used chemical pollutants, such as methylene blue (MB) dye, are dumped into water reservoirs and can potentially harm both humans and aquatic life. To investigate the effect of Cr doping on the morphological, structural, optical, and photocatalytic properties of TiO2, Cr-doped TiO2 nano photocatalysts were synthesized using a simple and cost-effective single-step sol-gel technique. XRD investigations revealed that all of the samples contain only the anatase phase, and the absence of any extra Cr peaks indicates successful Cr doping. Furthermore, Cr doping causes a considerable increase in the average crystallite size of TiO2 nanocrystal from 71.42 to 86.16 nm. The Fourier Transform Infrared (FTIR) spectra revealed the presence of functional groups (Ti-O and H-O) in all of the samples. UV absorbance spectra tauc plots showed that Cr doping caused the TiO2 band gap to shrink from 3.21 eV to 2.90 eV. In addition, the generated Cr-doped TiO2 nano photocatalysts were used to degrade MB dye under direct sunlight irradiation photocatalytically. At optimal conditions, the photo-degradation efficiency of MB dye achieved 21.24%, 31.18%, and 35.76%, for pure, 0.3%, and 0.5% Cr-doped TiO2 respectively. A high rate constant of 2.24 x 10− 3 min− 1 was observed for 0.5% Cr-doped TiO2 nano photocatalyst. An increased photocatalytic activity of Cr-doped TiO2 in visible light makes them ideal candidates for solar-powered water filtration systems.
Regular versus As-needed Treatments for Mild Asthma in Children, Adolescents, and Adults: A Systematic Review and Network Meta-analysis
Authors: Pornsuriyasak Prapaporn , Thadanipon Kunlawat , Sa-nguansai Sunatee , Numthavej Pawin , McKay Gareth J , Attia John , Thakkinstain Ammarin
Published: September 2024

Background
Inhaled corticosteroids (ICS) are recommended treatment for mild asthma. We aimed to update the evidence on the efficacy and safety of ICS-containing regimens, leukotriene receptor antagonists (LTRA), and tiotropium relative to as-needed (AN) short-acting β2-agonists (SABA) in children (aged 6 − 11 years) and adolescents/adults.
Methods
A systematic review of randomized controlled trials (RCTs) of regular and AN treatment for mild asthma was conducted. PubMed, Scopus, and ClinicalTrials.gov were searched up to 31st March 2024. RCTs in children or adolescents/adults with mild asthma were eligible if they compared any of the following treatments: ICS alone or in combination with fast-acting bronchodilators (FABA, i.e., formoterol or SABA) or long-acting β2-agonists (LABA), LTRA, tiotropium, and SABA alone, for the following outcomes: exacerbations, asthma symptoms, forced expiratory volume in 1 s (FEV1), asthma-specific quality-of-life (QoL), or severe adverse events (SAEs). Network meta-analysis (NMA) was used to pool risk ratios (RR) or mean differences for treatment outcomes.
Results
Thirteen RCTs in children, and 29 in adolescents/adults were included. Regular ICS ranked best for preventing exacerbations and improving FEV1 in children. NMA of RCTs suggested regular ICS were better in preventing exacerbations than LTRA (RR [95% confidence intervals], (0.81[0.69,0.96]) and AN-SABA (0.61[0.48,0.78]), similar to AN-ICS (0.83[0.62,1.12]). In adolescents/adults, for preventing severe exacerbations, regular ICS outperformed AN-SABA (0.58[0.46,0.73]), but AN-ICS/FABA (0.73[0.54,0.97]), and regular ICS/LABA (0.68[0.48,0.97]) surpassed regular ICS. Symptom relief and improved FEV1 were similar among the ICS-containing regimens. Regular ICS ranked best for improved QoL and least likely for SAEs.
Conclusions
Regular ICS use ranked best for exacerbation prevention and increasing FEV1 in children with mild asthma. In adolescents/adults, ICS-containing regimens outperformed AN-SABA for exacerbation prevention. Severe exacerbation risk was lowered in regular ICS use than AN use in patients with low FEV1. Furthermore, regular ICS use enhances FEV1 and QoL more than AN-SABA and LTRA.
Histogram analysis of whole placental T2-weighted magnetic resonance image-derived in patients with Pre-eclampsia
Authors: Chen Yonglu , Deng Yamei , Tang Wenyan , LIU Yi , Liu Zhaoran , Huang Jianwei , Su Qun , Song Ting
Published: September 2024

Background
The placenta plays a pivotal role in the development of pre-eclampsia (PE). The purpose of this retrospective study was to distinguish the patients with PE from normal pregnant women using the whole placental T2-weighted image(T2W) histograms.
Methods
The clinical and prenatal pelvic MRI data of 22 patients with PE and 22 normal pregnant women were retrospectively analyzed. Histogram parameters including mean, variances, skewness, kurtosis, entropy, 10th percentile, 50th percentile, 90th percentile and 99th percentile were calculated from the whole-volume placental of T2W. The volume and thickness were recorded as the morphological parameters. Histological examinations of placenta were conducted following delivery. Student-t test or Mann-Whitney U test was used to compare the continuous data between the two groups. Chi-square test was used to compare the categorical data. The diagnostic efficacy for PE with parameters was analyzed by receiver operating characteristic (ROC).
Results
The difference between the two groups in two histogram parameters (variance and 99th percentile) and one morphological parameter (volume) were statistically significant (P < 0.05). The distinguishing ability of variances, 99th percentile and volume for PE was good, with area under the ROC (AUC) were 0.713, 0.693 and 0.709 respectively.The combined AUC value of the three parameters was higher than that of a single parameter (AUC = 0.899, P = 0.000), with sensitivity of 86.36% and specificity of 77.27%.
Conclusions
The histogram parameters of the whole placenta T2W have good diagnostic efficacy, which provides a novel method for distinguishing the patients with PE from the normal pregnant women.
Local halide heterogeneity drives surface wrinkling in mixed-halide wide-bandgap perovskites
Authors: Datta Kunal , Laar Simone van , Taddei Margherita , Hidalgo Juanita , Kodalle Tim , Aalbers Guus , Lai Barry , Li Ruipeng , Tamura Nobumichi , Frencken Jordi , Westbrook Robert , Graham Daniel , Sutter-Fella Carolin , Correa-Baena Juan-Pablo , Ginger David , Wienk Martijn , Janssen René
Published: September 2024

Compositional heterogeneity in wide-bandgap (1.8 − 2.1 eV) mixed-halide perovskites is a key bottleneck in the processing of high-quality solution-processed thin films, and prevents their application in efficient multijunction solar cells. Notably, mixed-cation (formamidinium-methylammonium) wide-bandgap perovskite films are prone to form micrometer-scale wrinkles which can interfere with the smooth surfaces ideal for multijunction devices. Here, we study the formation dynamics of wrinkled mixed-halide perovskite films and its impact on the local composition and optoelectronic properties. We use in situ X-ray scattering during perovskite film formation to show that crystallization of bromide-rich perovskites precedes that of mixed-halide phases in wrinkled films cast using an antisolvent-based process. Using nanoscopic X­ray fluorescence and hyperspectral photoluminescence imaging, we also demonstrate the formation of iodide- and bromide-rich phases in the wrinkled domains. This intrinsic spatial halide segregation results in an increased local bandgap disorder and Urbach energy. Morphological and compositional heterogeneity also aggravate the formation of sub-bandgap electronic defects reducing photostability and accelerating light-induced segregation of iodide and bromide ions in thin films and solar cells.
Challenges in Diagnosing and Managing Disseminated Mycobacterium avium and Talaromyces marneffei Co-infection: A Case Report
Authors: Wu Hui-Hui , Zhao Yu-Kun , Lai Yun , Wan Chun-Lei , Liao Qiang , Zheng Yi-Hong , Lu Sha , Lu Jing-Fa
Published: September 2024

Background
Mycobacterium avium (M. avium) is emerging as an opportunistic pathogen and has been grouped with the nontuberculosis mycobacteria (NTM). Tuberculosis (TB), caused by Mycobacterium tuberculosis (Mtb), primarily affects elderly individuals with chronic lung disease and remains one of the leading causes of death in many regions worldwide. Distinguishing between NTM infection and drug-resistant TB is challenging due to similar manifestations and resistance to conventional anti-tuberculosis therapies (ATT). Talaromyces marneffei (T. marneffei) is a pathogenic fungus causing devastating infection, primarily in immunocompromised individuals. Few reports describe disseminated co-infection of M. avium and T. marneffei in HIV-uninfected persons.
Case presentation:
Herein, we present a case study of an HIV-negative Chinese woman who initially presented with chronic cough, sputum production, and recurrent low-grade fever, which was initially diagnosed as TB. After three years of anti-TB treatment, her situation progressed, and she developed multiple subcutaneous abscesses throughout the body, including the brain. Subsequent bacterial culture and genetic analysis confirmed the presence of NTM specifically identified as M. avium. However, despite receiving anti-NTM treatment, it remained ineffective until co-infection with T. marneffei was eventually diagnosed.
Conclusions
Early utilization of genetic diagnostic methods is necessary to detect the possibility of NTM infections, especially when patients do not respond adequately to ATT. It is also crucial to remain vigilant for co-infections when the disease progresses despite ongoing anti-NTM treatment.
Study Protocol Transvaginal Natural Orifice Transluminal Endoscopic Surgery for Tubal Ectopic Pregnancy(vNOTESTEP): a Protocol for a Randomized Controlled Trial
Authors: Xiao Xinyu , Liu Tianjiao , Li Xin , He Li , Lin Yonghong , Feng Dan
Published: September 2024

Background
Tubal ectopic pregnancy poses a severe threat to the life of women in early pregnancy. There is an increasing tendency to use minimally invasive laparoscopic surgery to treat tubal ectopic pregnancies. Many retrospective studies have shown that Transvaginal Natural Orifice Transluminal Endoscopic Surgery (vNOTES) has a lower rate of perioperative complications, faster postoperative recovery, and better cosmetic outcomes when treating tubal ectopic pregnancy. However, the lack of unbiased, detailed perioperative and long-term postoperative data to support the feasibility and safety of vNOTES remains contentious and may impede its acceptance in gynecology.
Methods
The vNOTESTEP study is a randomized controlled trial (RCT) that will recruit about 72 gynecologic patients with indications of laparoendoscopy for treating tubal ectopic pregnancy. Patients will be randomly divided into the vNOTES or transumbilical laparoendoscopic single-site (TU-LESS) group and undergo corresponding approach. After obtaining the participants’ consent, a perioperative assessment and a 5-year postoperative follow-up with eight visits will be conducted. Data collection will be performed perioperatively and postoperatively at designated time points, e.g., 1st, 2nd, and 3rd postoperative day; 1st, 3rd, and 6th month; and 1st, 2nd, 3rd, 4th, and 5th year after the surgery. The baseline information collection will include subjects’ sociodemographics and their health- and gestation-related history obtained from the Hospital Information System and face-to-face interviews. As planned, perioperative and postoperative outcomes will be examined based on intraoperative assessment, in-patient clinical observation, and follow-up WeChat questionnaires or clinic services. Among these outcomes, long-term postoperative results, such as sexual function, pregnancy, vaginal delivery, and incisional hernia, will be the focus.
Discussion
The vNOTESTEP study aims to assess the perioperative and long-term postoperative outcomes of vNOTES in the treatment of tubal ectopic pregnancy compared to TU-LESS, using a RCT design and focusing on patients’ sexual function, pregnancy, vaginal delivery, and incisional hernia. This two-arm, prospective vNOTESTEP study, incorporating a comprehensive long-term follow-up items, has the potential to furnish substantial and robust clinical evidence for refining and establishing guidelines for gynecologic vNOTES procedures. This initiative is also expected to enhance patients' perceptions and acceptance of this innovative minimally invasive surgical approach.
Trial registration number:
ChiCTR2400082909(registered on April 10th, 2024)
Mobile phone applications for midwives with focus on antenatal care: A mapping and assessment of quality and suitability for low-resource settings.
Authors: Panman Amalie , Sakalidis Vanessa S. , Bohle Leah F.
Published: September 2024

Background
Reducing maternal mortality in low-resource settings remains a priority in achieving the Sustainable Development Goal 3. The provision of antenatal care is an essential pillar in maternal health care. Digital health applications, which target midwives providing antenatal care, can assist workers in low-resource settings by providing access to quality tools and education for evidence-based care. This study aimed to identify mobile apps for midwives focusing on antenatal care and assessed their quality and suitability for use in low-resource settings.
Methods
A systematic mapping of mobile apps accessible on Google Play Store was performed using pre-defined search terms related to midwifery and antenatal care. Inclusion criteria based on numbers of downloads, English language, free of cost, and thematic focus, resulted in 15 apps for evaluation. The quality of apps and suitability for use in low-resource settings was assessed using two frameworks. An individual score was calculated for each app and a ranking was performed.
Results
Of the 15 apps identified, the focus was on educational content (n = 10), antenatal care measurement tools (n = 4), and patient documentation (n = 1). The quality of apps overall ranged between 1.77–4.80 points, with a maximum of 5 points. Suitability for low-resource settings was favourable in that the majority of the apps were available offline (n = 11), however, only some offered additional languages (n = 5), and few integrated cultural diversity and sensitivity (n = 2). All apps integrated at least one of WHO’s recommendations for a positive pregnancy, suggesting the apps were somewhat suitable for midwives delivering antenatal care; although no apps referenced WHO or referred to national clinical guidelines.
Conclusions
Significant gaps in the availability of apps targeting midwives represented a missed opportunity in the digital health landscape. Only two apps holistically implemented WHO antenatal care recommendations, and were rated high quality. No apps combined educational content and tools; or connected the midwife and pregnant woman. This review demonstrated that while there are several comprehensive apps targeting midwives, the minority of these are focusing on antennal care in low-resource settings and would benefit from further resources, development and regulation.
Correlation of Angle Kappa and Angle Alpha on Visual Outcomes in Eyes Implanted with Three Types of Diffractive Trifocal Intraocular Lenses
Authors: Ang Robert Edward T. , Doroy Zoe Alethinos M. , Yao Justin Alan A. , Cruz Emerson M.
Published: September 2024

Purpose: To evaluate the correlation between preoperative, postoperative, and change in angle kappa and alpha to visual outcomes following implantation of three diffractive trifocal intraocular lenses.
Methods: This is a retrospective study which included 122 eyes of 61 patients. There were 38 eyes in the Synergy (Johnson & Johnson, USA) group and 42 eyes each from both the Panoptix (Alcon Laboratories, USA) and FineVision (Physiol BVI, Belgium) groups. Visual outcome parameters (uncorrected distance, intermediate, near vision, halo and starburst) and angle kappa and alpha were recorded preoperatively and at three months postoperatively. The preoperative, postoperative and the amount of change in angle kappa and alpha were correlated to visual outcomes and photic phenomena among the three different diffractive trifocal IOLs.
Results: There were no significant differences in the preoperative and postoperative magnitude of angle kappa and alpha among the Synergy, Panoptix, and FineVision groups. There was no significant correlation between the preoperative and postoperative magnitude, and change in angle kappa and alpha with the postoperative uncorrected distance, intermediate and near visual acuity, and halo and starburst scores of the three different diffractive IOLs.
Conclusion: The frequency of eyes with greater than 0.5 mm angle kappa and alpha values were low. Visual outcomes can be good even in eyes in which the angle kappa and alpha were greater than 0.5 mm. The newer diffractive trifocal IOLs were observed to be more tolerant to low and intermediate levels of angle kappa and alpha.
Effects of different anesthesia methods on post-stroke dysphagia in a mouse model
Authors: Rao Tong , Rao Zhehua , Tian Cong , Lu Meng , Liu Xin , Cheng Ankun , Murong Zhimiao , Zhang You , Liu Qiuyao , Yue Zenghui
Published: September 2024

Photochemical embolization is an emerging method for establishing post-stroke dysphagia models. The use of different anesthetics is a key factor affecting the outcome of ischemic stroke modeling. This study compared the effects of three different anesthetics on the outcomes of mice with dysphagia modeled by photochemical embolization. Sixty-six male C57BL/6J mice were divided into four groups consisting of tribromoethanol, isoflurane, pentobarbital sodium and control. The cerebral blood flow and wake-up time were recorded before and after modeling. Mortality, cerebral blood flow, neurological deficit score, infarct volume, water intake, swallowing counts, and swallowing EMG area were assessed 48 hours later. The results of the study showed that 48 hours after modeling, mice in the three groups all developed localized cerebral infarction and dysphagia. The mice in the isoflurane group had a different decreasing trend in cerebral blood flow within 48 hours after modeling. These mice needed less time to wake up and had lower mortality compared with those in the other model groups. These findings provided suggestions and evidence for the future selection of anesthesia for PSD model preparation using the PT method.
Sedimentary Petrology and Basin Analysis of the Mamu Formation: Insights into Provenance, Depositional Environments, and Paleohydrodynamic Conditions
Authors: Agbo Christian , Onyekuru Samuel , Ikoro Diugo
Published: September 2024

The Mamu Formation, a sedimentary unit of significant geological and economic interest, remains incompletely understood. This study employed sedimentary petrology and basin analysis techniques to investigate the provenance, depositional environments, and paleohydrodynamic conditions associated with the formation. Sediment samples (MA.1 through MA.8) were collected from various stratigraphic levels to capture the lithological variations within the Mamu Formation. A three-step methodology was implemented. First, samples underwent standard preparation techniques (washing, sieving, drying, crushing, homogenization). Second, petrographic analysis involved creating thin sections from each sample for examination under a polarizing microscope. Modal composition (quartz, feldspar, rock fragments) was quantified using the point-counting method. Finally, a ternary diagram was utilized to visualize the compositional data and classify the sandstones based on their detrital grain composition (quartz, feldspar, rock fragments). The dominance of quartz suggests a likely igneous or metamorphic source area, while the presence of feldspar and rock fragments indicates a potentially mixed source and relatively short transport distances. Grain size distribution points towards a high-energy environment like a fluvial or beach setting. Poor sorting and variable skewness values suggest fluctuations in flow strength during deposition. This analysis provides valuable insights into the origin, transport, and depositional history of the Mamu Formation sediments.
Developing a Cognitive Profile for Early Detection of Cognitive Decline: Identifying Key Risk Factors and Target Populations
Authors: Gil-Peinado María , Muñoz-Almaraz Francisco Javier , Ramos Hernán , Sendra-Lillo José , Moreno Lucrecia
Published: September 2024

Purpose: Early screening for cognitive decline (CD) is crucial for managing dementia risk factors and preventing disease progression. This study seeks to create a detailed cognitive profile for patients who are candidates for CD screening, with a focus on identifying emerging cognitive deficits and their underlying causes.
Methods: We first performed a systematic review of CD screening practices within community pharmacies. Following this, we analyzed data from 286 individuals who were screened after the introduction of these practices across 18 community pharmacies. This analysis aimed to pinpoint factors influencing patients who report subjective memory complaints (SMC).
Results: Our findings reveal that CD screening is not widely promoted globally, and participation among pharmacies remains limited. We identified specific characteristics associated with a higher risk of subjective cognitive decline (SCD), including age, usage of internet and social media, sleep patterns, and educational attainment. These factors are essential for defining the profile of individuals who would benefit most from CD screening services.
Conclusion: Enhancing early dementia detection in primary care settings may be achieved by focusing on individuals with limited engagement with internet and social media, irregular sleep patterns, and lower levels of education. Targeting these groups could significantly improve the effectiveness of CD screening programs.
Computational task transfer scheme based on multi-agent generative adversarial imitation learning
Authors: Huang Haojing , Li Jiajun , Lu Fei , Li Jianxin
Published: September 2024

The multi-agent computing task scheduling problem can be transformed into a task assignment optimization problem under the premise of minimum system cost and maximum sample utilization. For this problem, this paper proposes a computational task migration scheme based on multi-agent body generation adversarial imitation learning. In the battlefield, this scheme uses the idle computing power of tanks, fighting vehicles, drones or infantry equipment to form a Ad Hoc cloud. Based on the characteristics of distributed training of reinforcement learning algorithm, it makes full use of equipment resources to solve the transfer scheme of computing tasks. By using behavioral cloning to construct the data set and build the initial strategy model, the reward function is simplified, and the network structure, parameters and training hyperparameters are set. Driven by the training set, the generative adversarial inverse reinforcement learning method is used for network training. The simulation results show that the MAGAIL-MCT algorithm can mimic the expert trajectory behavior and successfully train the neural network. The experimental results prove that the scheme is improved in reducing system overhead, improving sample utilization, reducing migration delay, migration energy consumption and reducing the impact of mobility.
Long-term complications of Shiga toxin-producing Escherichia coli O157 (STEC O157) infection and STEC-associated haemolytic uraemic syndrome (STEC-HUS), Wales, 1990-2020
Authors: Merrick Rachel , Song Jiao , Fina Laia , Sawyer Clare , Jenkins Claire , King Grace , Turner Drew , Thomas Daniel , Williams Christopher
Published: September 2024

Background Information on sequelae of Shiga toxin-producing Escherichia coli (STEC) O157 infection is limited to short-term follow-up of paediatric haemolytic uraemic syndrome (HUS) cases. We investigate recorded long-term health outcomes experienced by individuals exposed to STEC O157 and STEC-HUS up to three decades on.Methods We compared acute or new onset of chronic outcomes in individuals ≥ 1 year after STEC O157 or STEC-HUS to unexposed general population comparators between 01/01/1990-01/01/2019. The unexposed were their age- and sex-equivalents (4:1 matching ratio) and assigned the same study entry date. Outcomes were identified in primary and secondary care and categorised as renal, neurological, cardiac, gastrointestinal, respiratory, or endocrine. Hazard ratios (HRs) and 95% confidence intervals (95%CI) were calculated using Cox regression.Results Of 1,245 individuals with STEC O157, 65 developed HUS (5.2%). Individuals with STEC O157 were more likely to experience renal (adjusted (a)HR: 1.9, 95%CI: 1.1–3.3), gastrointestinal (aHR: 1.7, 95%CI: 1.2–2.6) and respiratory (aHR: 1.3, 95%CI: 1.2–1.5) outcomes compared to the unexposed, on average between 3.4–11 years after exposure. Gastrointestinal (HR: 7.7, 95%CI: 2.6–23), renal (HR: 5.5, 95%CI: 1.6–19), cardiac (HR: 5.1, 95%CI: 1.1–23) and respiratory (HR: 1.9, 95%CI: 1.1–3.1) outcomes were more common in the STEC-HUS cohort and occurred sooner, on average after 2.7–4.8 years.Conclusions Long-term complications were nearly twice as likely in the STEC O157 cohort, and as many as eight times more likely following STEC-HUS. We recommend that those exposed to STEC be monitored for at least five years for late-emerging renal and extrarenal complications.
Prevalence of acute jaundice syndrome (AJS) in Rajshahi, Bangladesh: A sociodemographic and clinical manifestation
Authors: Mubassira Mahi , Muhib Md. Muntasir Alam , Abeed-Ul-Haque Syed , Khanam Sanzida , Hasan Md. Faruk
Published: September 2024

Background
The present study was designed to determine the outbreak pattern, diagnosis and treatment of jaundice patients at Rajshahi, Bangladesh.
Methods
A total of 1151 students living near the University of Rajshahi were included in the sample. Jaundice syndromes were determined by physiological and laboratory tests. Blood and urine were tested to confirm the pathophysiology by an automated clinical chemistry analyzer.
Results
Among the total number of tested patients, 27.28% and 72.72% had jaundice-positivity and negativity, respectively. Jaundice-positive patients had the highest average alanine transaminase (ALT) level (1312.67 ± 1.32 U/L), and the total bilirubin level was 2.08 ± 0.70 mg/dL for adults.
Conclusion
The present study provides vital information about the patterns of jaundice outbreaks, prompt diagnosis and effective control measures to protect students' health and the whole community.
Functional Insights into Novel Extremophilic Bacteria Isolated from the NASA Phoenix Mission Spacecraft Assembly Cleanrooms
Authors: Schultz Júnia , Jamil Tahira , Sengupta Pratyay , Sivabalan Shobhan Karthick Muthamilselvi , Rawat Anamika , Patel Niketan , Krishnamurthy Srinivasan , Alam Intikhab , Singh Nitin Kumar , Raman Karthik , Rosado Alexandre Soares , Venkateswaran Kasthuri
Published: September 2024

Human-designed oligotrophic environments, such as cleanrooms, harbor unique microbial communities shaped by selective pressures like temperature, humidity, nutrient availability, cleaning reagents, and radiation. During the Phoenix spacecraft mission, genomes of 215 bacterial isolates were sequenced and based on overall genome related indices, 53 strains belong to 26 novel species were recognized. Metagenome mapping indicated less than 0.1% of the reads associated with novel species, suggesting their rarity. Genes responsible for biofilm formation, such as BolA (COG0271) and CvpA (COG1286), were predominantly found in proteobacterial members but were absent in other non-spore-forming and spore-forming species. YqgA (COG1811) was detected in most spore-forming members but was absent in Paenibacillus and non-spore-forming species. Cell fate regulators, COG1774 (YaaT), COG3679 (YlbF, YheA/YmcA), and COG4550 (YmcA, YheA/YmcA), controlling sporulation, competence, and biofilm development processes, were observed in all spore-formers but were missing in non-spore-forming species. COG analyses further revealed resistance-conferring proteins in all spore-forming novel species (n=13) and eight actinobacteria, responsible for enhanced membrane transport and signaling under radiation (COG3253), transcription regulation under radiation stress (COG1108), and DNA repair and stress responses (COG2318). Additional functional analysis revealed that Agrococcus phoenicis, Microbacterium canaveralium, and Microbacterium jpeli contained biosynthetic gene clusters (BGCs) for ε-Poly-L-lysine, beneficial in food preservation and biomedical applications. Two novel Sphingomonas species exhibited zeaxanthin, an antioxidant beneficial for eye health. Paenibacillus canaveralius harbored genes for bacillibactin, crucial for iron acquisition. Georgenia phoenicis had BGCs for alkylresorcinols, compounds with antimicrobial and anticancer properties used in food preservation and pharmaceuticals. Despite strict decontamination and controlled environmental conditions, cleanrooms foster novel bacterial species which can form biofilms, resist various stressors, and produce biotechnologically valuable compounds.
Covid-19 Vaccine Acceptance, Hesitancy and Refusal Among Workers in a Paris Hospital Group
Authors: SAVIN Priscilla , CLIN Bénédicte
Published: September 2024

Background
The aim of this study was to analyse the determinants of COVID-19 vaccination and booster dose acceptance and underlying reasons for hesitancy or refusal, among workers of a Paris hospital group.
Methods
This prospective questionnaire study included 845 hospital workers who completed a questionnaire between 16 November 2021 and 10 January 2022.
Results
The main reasons for vaccine hesitancy were insufficient hindsight on the vaccine, lack of information, and fear of side effects. 48.8% of respondents did not feel vaccine hesitant, whereas 34.8% felt little hesitancy, and 16.4% felt significant hesitancy. 35.9% of auxiliary nurses felt strong vaccine hesitancy compared to 3.8% of medical practitioners (p < 0.001). Acceptance of the vaccine booster dose was 78.0%. The main reasons for vaccination were personal conviction (61.7%), mandatory vaccination (38.6%) and sanitary pass implementation (23.8%). The main reasons for hesitancy were lack of data (40.1%) followed by fear of side effects (29.3%). In 78 of the 105 employees who refused the vaccine booster dose, the reasons were the same as those for initial vaccination.
Conclusion
The employees expressing the highest COVID-19 vaccine hesitancy were women, hospital housekeepers, nurses and the 20–29 year age group. We must therefore focus our reinsurance and information efforts on these populations with greater vaccine hesitancy.