bluuebunny/crossref_metadata_2025 huggingface dataset:
Impacto de la motivación laboral en la calidad de atención en una cadena peruana de restaurantes. Caso: Sede Ate (Lima-Perú), 2023
Authors:   , Alzamora Lazaro Clemencia Verenice , Ludeña Travi Jennifer Patricia
Published: October 2024

A lo largo del tiempo, las empresas han buscado mejorar los niveles de motivación de sus colaboradores debido a los efectos positivos que esto puede tener en la calidad de atención, lo que, a su vez, influye en la satisfacción del cliente. El objetivo principal de este estudio fue determinar cómo la motivación laboral afecta la calidad de atención en la sede Ate de una cadena peruana de restaurantes. Desde un punto de vista metodológico, el enfoque de investigación fue cuantitativo y se utilizó un diseño no experimental transeccional correlacional-causal; la muestra estuvo compuesta por 50 colaboradores de la sede Ate, a quienes se les administró un cuestionario tipo escala de Likert que constaba de 23 ítems. Debido a que los datos no siguieron una distribución normal, se empleó la regresión ordinal para verificar las hipótesis del estudio. Después de procesar y analizar la información, se pudo constatar que la motivación laboral tenía un impacto significativo en la calidad de atención (p <0.05), ya que el coeficiente de Nagelkerke obtenido fue de 0.774; del mismo modo, se evidenció la existencia de un impacto significativo de la motivación laboral en la eficiencia laboral, empatía con el cliente y capacidad de respuesta del colaborador.
Agentes químico-mecánicos versus sistema rotatorio para la remoción de caries: revisión sistemática de estudios in vitro
Authors:   , Quiroz Reynoso Josselyn Myriam
Published: October 2024

Esta revisión sistemática tuvo como propósito comparar la eficacia y la eficiencia de los agentes químico-mecánicos (CMA) frente al sistema rotatorio (RS) para la remoción de caries dental (DC) en molares permanentes. La búsqueda se realizó en cinco bases de datos electrónica (PubMed, Ebsco, Scopus, ScienceDirect, LILACS) y literatura gris, complementada con búsqueda manual en revistas de impacto, hasta julio de 2022 en idioma inglés, español y portugués. La eficacia del tratamiento de DC se analizó de forma histológica, microbiológica, radiográfica o fisicoquímico-mecánicas y la eficiencia según el menor tiempo para la remoción. El riesgo de sesgo se evaluó con la herramienta RoB. De 914 publicaciones, se incluyeron 9 estudios que evaluaron 337 molares con diseño partido tratados con RS de baja o alta velocidad y CMA como Carisolv, Papacarie, Carie Care y Brix 3000. Más estudios demostraron diferencias significativas (p<0,05) donde Carisolv tuvo mayor cantidad de: Caries residual, presencia de bacterias en dentina y menor extensión o volumen de caries extraída, Papacarie mostró ausencia de barrillo dentinario en túbulos dentinarios y RS obtuvo mayores valores de microdureza y requirieron menos tiempo para la remoción. No hubo diferencias entre ambos métodos respecto a valoración de calcio-fósforo o resistencia a la unión (p≥0,05). Los CMA fueron una buena opción para eliminar DC con una menor invasión a los tejidos de dentina sana que en comparación al RS, sin embargo, aminoraron la dureza de las superficies y requirieron un mayor tiempo para la remoción.
Nivel de conocimiento sobre cáncer oral que presentan los estudiantes del pregrado de Estomatología de una Universidad privada de Lima
Authors:   , Cordova Garcia Yaceny Magaly
Published: October 2024

Objetivo: Determinar el nivel de conocimiento sobre cáncer oral (CO) que presentaron los estudiantes de pregrado de estomatología. Materiales y Métodos: Estudio observacional transversal aplicado a una muestra poblacional de 184 estudiantes (24±3,09 años y 72,8% mujeres) de una universidad privada de Lima del sexto a décimo ciclo que estuvieron matriculados en un curso de clínica (14,1% de clínica V). Un cuestionario virtual y presencial con 24 preguntas sobre CO fue aplicado. El instrumento obtuvo validación por juicio de expertos (V de Aiken=0,96) y confiabilidad KR-20 (total=0,856; item≥0,837). Resultados: La frecuencia de respuestas correctas del total de preguntas fue de 56,6% siendo similar por sexo y curso de clínica, pero mayor en los >30 años (60%). Las preguntas mejor contestadas fueron el tipo más frecuente (epidemiología), el factor relacionado (diagnóstico) y factores pronósticos (prevención). Las dimensiones mejor contestadas fueron en tratamientos y complicaciones (72,2%) y diagnóstico (70,3%) sobre CO. El nivel de conocimiento sobre CO fue regular (78,8%). Ni las dimensiones, niveles o puntajes se asociaron a edad, sexo o clínica (P>0,05). Conclusiones: Los estudiantes presentaron un nivel de conocimiento regular sobre cáncer oral, indistintamente del sexo, edad o la clínica que cursan.
Eficiencia de dos tipos de estiércol para la producción de compost a partir de lodos residuales de una planta de tratamiento de aguas residuales
Authors:   , Sullca Curipaco Greysi
Published: October 2024

A raíz del tratamiento de aguas residuales domésticas se generan como subproductos los lodos, los cuales al no recibir un tratamiento adecuado se convierten en una fuente de contaminación ambiental. Los lodos residuales tienen potencial de ser reaprovechados por su contenido de nutrientes y materia orgánica, siempre y cuando pasen por un mecanismo de transformación como el compostaje, que permite la reducción de metales pesados y microorganismos patógenos. El objetivo del presente estudio es evaluar la eficiencia del estiércol de gallina y de caprino en la producción de compost a partir de lodos residuales de una PTAR. Ambos estiércoles se emplearon al cuarenta y cinco por ciento mezclados con lodos al veinte por ciento, y aserrín y tierra agrícola al quince por ciento cada uno, en un proceso de compostaje que se examinó durante 60 días. Al final del proceso, el lodo tratado con estiércol de gallina al cuarenta y cinco por ciento presentó una relación C/N de 17.52, además de una disminución en la concentración de metales pesados, siendo en conclusión el más eficiente en la producción de compost en comparación con el lodo tratado con estiércol caprino. Asimismo, ambos tratamientos con estiércol presentaron valores por debajo de los límites establecidos para la calidad del compost según el D.S N°015-2017-VIVIENDA, pudiendo ser aplicados en cultivos que no sean para productos de consumo crudo.
Asociación entre el miedo a contraer Covid-19 y la adherencia al tratamiento antirretroviral en los pacientes con VIH/SIDA de una ONG en Lima, Perú
Authors:   , Vargas Herrera Natalia Gladys
Published: October 2024

Antecedentes y objetivos: Una de las consecuencias psicológicas más frecuentes del COVID-19 es el miedo. Éste podría ocasionar una adherencia terapéutica no óptima y permitir la progresión de la enfermedad en personas con VIH. Evaluar la asociación entre el miedo a contraer COVID-19 y la adherencia al tratamiento antirretroviral en personas con VIH entre la tercera y cuarta ola epidémica de COVID-19 en el Perú. Métodos: Estudio transversal analítico en adultos con VIH del centro especializado Vía Libre enrolados por muestreo no probabilístico. Se empleó la escala “Fear of COVID-19 Scale” para medir el miedo a contraer COVID-19, y el cuestionario SMAQ para evaluar la adherencia terapéutica. Los resultados se presentaron de forma descriptiva, usando chi cuadrado para el análisis bivariado y modelos lineales generalizados familia Poisson para estimar razones de prevalencia crudas y ajustadas (RPa). Resultados: Entre febrero - julio del 2022, se enrolaron 149 personas con una mediana de edad de 35 años, el 91,3% fueron varones, y el 75,2% con carga viral indetectable. No se halló asociación entre el miedo a contraer COVID-19 y la adherencia terapéutica (RPa: 0,99; IC95%: 0,97 a 1,02). Adicionalmente, se encontró que las personas que presentaban alguna comorbilidad fueron 89% más adherentes que los que no las presentaban (RPa: 1,89; IC95%: 1,52 a 2,35). Conclusiones: El miedo a contraer COVID-19 no se asoció a la adherencia al TARGA durante la tercera ola de pandemia en el Perú. Sin embargo, el presentar alguna comorbilidad se asoció a una adherencia terapéutica óptima. Se debe poner énfasis en los posibles factores que afecten la adherencia en personas con VIH durante la pandemia por COVID-19.
Efecto in vitro de enjuagatorios bucales en la microdureza de tres diferentes resinas compuestas nanohibridas
Authors:   , Bernaldo Faustino Jhonn Luis
Published: October 2024

Introducción. El uso diario de diferentes enjuagues bucales en casa o en la consulta dental puede alterar las propiedades de dureza de la resina. El presente estudio tuvo como objetivo comparar la microdureza Vickers (VHN) in vitro de resinas compuestas nanohíbridas (NCR) sumergidas en enjuagues bucales. Materiales y métodos. En total, 120 discos (10 x 2 mm) fueron preparados a partir de tres tonos NCR A2 (n = 40/grupo) con FiltekTM Z350 XT (Z350XT), Tetric EvoCeram (TEC), y Polofil NHT (PNHT). Las muestras se incubaron en saliva artificial (37°C x 24 hr). Los especímenes se distribuyeron en cuatro enjuagues bucales (n = 10/grupo) de saliva artificial (control), clorhexidina (CHX 0,12%; pH 5,6), cloruro de cetilpiridina (CPC 0,075%; pH 5,84), y CHX 0,12% + CPC 0,05% (pH 6,2) (2 veces/día, 2' x 12 h). El VHN (300 gf/10'') se midió después de 24 h, 14 y 21 días. Los datos se analizaron mediante ANOVA de tres vías seguido de un análisis de Tukey post hoc con un nivel de significancia de 0,05. Resultados. Los resultados revelaron un efecto global de la interacción de los enjuagues bucales × tiempo entre los NRC evaluados (P = 0,001). El VHN inicial en PNHT y Z350XT fue mayor que en TEC. Dentro de cada grupo de NCR, VHN de CHX + CPC > otros enjuagues bucales (PNHT/14 días; Z350XT/21 días) y > CPC (Z350XT/14 días). En los enjuagues bucales intragrupos, el VHN de PNHT y Z350XT disminuyó a los 14 días (CHX, CPC) y se mantuvo en el tiempo en NCR (CHX + CPC). VHN-TEC fue similar entre los grupos. Conclusión. La microdureza mostró diferencias debido a la interacción del tipo de NCR, la composición de los enjuagues bucales y el tiempo. El VHN disminuyó después de 14 días y se vio más...
Pregnancy rates from ambient and frozen semen in Mpwapwa breed cattle after synchronisation
Authors: Kabuni Kabuni Thomas , Komba Erik , Laven Richard , Parkinson Tim , Peters Andrew
Published: October 2024

Artificial insemination (AI) services for the TALIRI breed of cattle in Tanzania have been in abeyance for many years, largely due to difficulties of supply of liquid nitrogen to remote and rural areas. Historically, AI using unfrozen ambient temperature or chilled semen have been effective alternatives to cryopreserved (frozen) semen, so, potentially, AI using ambient temperature semen could form the basis of an AI service for the TALIRI region (and other similar areas across East Africa). However more testing is needed. In this study 301 TALIRI cows were synchronised using a standard 14-day double prostaglandin (PG) programme and randomly assigned to insemination with either frozen semen (F) or ambent temperature semen (AT). Cows that showed oestrus after the first PG were inseminated to that oestrus; all other cows were inseminated after second PG. Bulls were then run with the cows for 60 days, after which conception rates to AI and overall pregnanvcy rates were determined by transrectal ultrasonography. Conception rates to AI for AT cows were 62% (94/151) and 38% (58/152) for F (RR for AT versus F: 1.63 (1.27–2.1)), while final pregnancy rates were 96% (145/151) for AT semen and 92% (140/152) for F semen. In this study, the conception rate to AI with ambient temperature semen was at least as good as that with frozen semen. It therefore demonstrates the feasibility of using PG synchronization and fixed time AI with AT to breed Mpwapwa cattle in rural Tanzania.
Wastewater as an Early Indicator for Short-Term Forecasting COVID-19 Hospitalization in Germany
Authors: Botz Jonas , Thiel Steffen , Abderrahmani Amal , Roehn Pauline , Kannt Aimo , Fröhlich Holger
Published: October 2024

Background
The COVID-19 pandemic has profoundly affected daily life and posed significant challenges for politics, the economy, and the education system. To better prepare for such situations and implement effective measures, it is crucial to accurately assess, monitor, and forecast the progression of a pandemic. This study examines the potential of integrating wastewater surveillance data to enhance an autoregressive COVID-19 forecasting model for Germany and its federal states.
Methods
We explore the correlations between viral load measured in wastewater and COVID-19 hospitalization. The study compares the performance of autoregressive models, including Random Forest regressors, XGBoost regressors, ARIMA models, linear regression, and ridge regression models, both with and without the use of wastewater data as predictors. For decision tree-based models, we also analyze the performance of fully cross-modal models that rely solely on viral load measurements to predict COVID-19 hospitalization rates.
Results
Our findings suggest that wastewater data can serve as an early warning indicator of impending trends in hospitalization at a national level, as it shows a strong correlation with hospitalization figures and tends to lead them by six to seven days. Despite this, including wastewater data in the prediction models did not significantly enhance the accuracy of COVID-19 hospitalization forecasts. The ARIMA model emerged as the best-performing model, achieving a Mean Absolute Percentage Error of 4.69%. However, wastewater viral load proved to be a valuable standalone predictor, offering a cost-effective and objective alternative to classical surveillance methods for monitoring pandemic trends.
Conclusion
This study reinforces the potential of wastewater surveillance as an early warning tool for COVID-19 hospitalizations in Germany. While strong correlations were observed, the integration of wastewater data into predictive models did not improve their performance. Nevertheless, wastewater viral load serves as a valuable indicator for monitoring pandemic trends, suggesting its utility in public health surveillance and resource allocation. Future research should explore broader applications of wastewater data for other pathogens and in conjunction with diverse data sources.
A rare case of autoimmune hemolytic anemia secondary to HCV/HIV coinfection complicated with chronic kidney disease
Authors: sabouri Reza
Published: October 2024

Background:
Autoimmune hemolytic anemia (AIHA) is an acquired disorder characterized by destruction of RBCs auto-antibodies, leading to varying degrees of anemia, from mild to life-threatening. Human immunodeficiency virus (HIV) can trigger autoimmunity complications including Autoimmune hemolytic anemia through various molecular mechanisms. Moreover AIHA is considered a rare extrahepatic manifestation of hepatitis-C virus. HCV/HIV coinfection increases the risk of AIHA incidence
Case report:
A 42-year-old male patient with a history of IV drug abuse and chronic HCV/HIV coinfection referred to the emergency center with complaints of lethargy, fatigue and shortness of breath. The patient’s past medical history revealed that he was nondiabetic and non-hypertensive and nonalcoholic. In the physical examination, icteric sclera and mild splenomegaly were evident. Considering the severe anemia (Hgb: 3.9 mg/dl), hyperbilirubinemia (Total/direct bilirubin: 2.5/0.6 mg/dl), elevated LDH, splenomegaly, positive HCV and HIV serological tests and positive coombs test, diagnosis of AIHA secondary to HIV/HCV was entertained.
Discussion:
We presented a rare case of AIHA secondary to HCV/HIV co-infection with concurrent acute severe hepatitis and ESRD. The exact cause of increased CKD risk in HCV-HIV co-infected individuals remains unclear. Chronic HCV infection is associated with increased deterioration of renal function and incidence of ESRD and CKD. A wide range of kidney diseases might occur in HIV positive Patients and HCV/HIV coinfection is associated with aggravation of renal failure. CKD risk is higher in HCV co-infected patients compared to those with HIV mono-infection.
Conclusion:
AIHA is rare cause of anemia and a potentially life-threatening phenomena in HCV/HIV infected individuals. A high degree of clinical suspicion for AIHA diagnosis in patients with HCV/HIV coinfected is crucial for proper management. Moreover HCV/HIV coinfection is associated with progression to CKD.
Weakening the CO2 Greenhouse Effect via Stratospheric Aerosol Injection
Authors: He Haozhe , Soden Brian , Vecchi Gabriel , Yang Wenchang
Published: October 2024

Stratospheric aerosol injection (SAI) represents one of the primary potential options for intentionally modifying the climate to offset the warming from increasing greenhouse gases. The hypothesized strategy typically involves the injection of scattering aerosols in the lower stratosphere to increase the amount of sunlight reflected to space, thereby reducing the amount of sunlight absorbed by Earth. We demonstrate a new and potentially more efficient approach to SAI, using it to induce a weakening of the Earth’s greenhouse effect. We show that the injection of absorptive aerosols in the upper stratosphere (~ 10 hPa) increases the emission of top-of-atmosphere infrared radiation. Warming the emission level of CO2 weakens the greenhouse effect by altering the thermal structure of the upper stratosphere rather than the concentration of greenhouse gases. Climate model simulations indicate that the reduction in global temperatures induced through this process is an order of magnitude larger (per unit aerosol mass) than the injection of more traditional reflective aerosols. These results argue for further research into the possible impacts, particularly unintended deleterious side effects, of injecting absorptive aerosols in the upper stratosphere as a potential alternative strategy for solar radiation management.
Formula - synchronized nutrient fertilizer designed based on crop nutrient absorption characteristics and fertilizer nutrient release characteristics and its fertilizer efficiency verification
Authors: Zhang Xiaolong , Zhao Li , Huang Qilong , Pang Bowen , Zhou Zhuoyi , Lu Ying
Published: October 2024

Rational fertilization has dual effects on maintaining high yield of banana and protecting the environment. To explore the effect of fertilization scheme based on banana nutrient absorption characteristics and fertilizer nutrient release characteristics on improving banana nutrient absorption efficiency and yield, in order to provide technical solutions for the green and sustainable development of banana industry. Zhongjiao No.9 was used as the tested banana variety. Firstly, the total nutrient accumulation of banana plants at mature stage was measured. Based on this, the formula fertilizer ( total nutrient amount and proportion ) of banana was calculated. Then, according to the nutrient release characteristics of fertilizer, the ratio of conventional fertilizer ( available nutrient ) and controlled release fertilizer ( controlled release nutrient ) was reasonably matched, and the fertilization scheme ( formula-synchronous nutrient fertilizer ) with nutrient release characteristics of fertilizer and nutrient absorption characteristics of banana in time dimension was further obtained. Finally, the field experiment was used to verify the application effect of the formula-synchronous nutrient fertilizer, and the differences in growth and development, nutrient accumulation and yield of banana plants were observed, and the reasons for the differences were analyzed. The results showed that compared with the conventional fertilizer treatment, the accumulation of nitrogen, phosphorus and potassium in the whole growth period of banana plants treated with formula-synchronous nutrient fertilizer was significantly increased by 8.66 %, 11.54 % and 19.55 %, respectively. The nutrient absorption efficiency was significantly increased by 35.72 %, 94.85 % and 29.41 %, respectively. The fresh weight and dry weight of banana plants were significantly increased by 20.93 % and 56.14 %, respectively, and the yield of banana was significantly increased by 7.03 %. Based on the nutrient absorption characteristics of banana and the nutrient release characteristics of fertilizer, the formula-synchronous nutrient fertilizer can effectively improve the absorption and utilization efficiency of banana nutrients, thereby improving the nutrient status of banana plants, and finally obtaining higher banana yield. Therefore, formula-synchronous nutrient fertilizer is an economical and environmentally friendly fertilization scheme, which can provide a choice for the green and sustainable development of banana industry.
Predicting RNA modifications by nanopore sequencing: The RMaP challenge
Authors: Alagna Nicolò , Spangenberg Jannes , Mündnich Stefan , Busch Anne , Pastore Stefan , Wierczeiko Anna , Goettsch Winfried , Dietrich Vincent , Pryszcz Leszek , Cruciani Sonia , Novoa Eva Maria , Joshi Kandarp , Perera Ranjan , Giorgio Salvatore Di , Arrubarrena Paola , Tellioglu Irem , Poon Chi-Lam , Wan Yuk , Göke Jonathan , Hildebrand Andreas , Dieterich Christoph , Helm Mark , Marz Manja , Gerber Susanne
Published: October 2024

The field of epitranscriptomics is undergoing a technology-driven revolution. During past decades, RNA modifications like N6-methyladenosine (m6A), pseudouridine (ψ), and 5-methylcytosine (m5C) became acknowledged for playing critical roles in gene expression regulation, RNA stability, and translation efficiency. Among modification-aware sequencing approaches, direct RNA sequencing by Oxford Nanopore Technologies (ONT) enabled the detection of modifications in native RNA, by capturing and storing properties of noncanonical RNA nucleosides in raw data. Consequently, the field's cutting edge has a heavy component in computer science, opening new avenues of cooperation across the community, as exchanging data is as impactful as exchanging samples. Therefore, we seize the occasion to bring scientists together within the RMaP challenge to advance solutions for RNA modification detection and discuss current ideas, problems and approaches. Here, we show several computational methods to detect the most researched mRNA modifications (m6A, ψ, and m5C). Results demonstrate that a low prediction error and a high prediction accuracy can be achieved on these modifications across different approaches and algorithms. The RMaP challenge marks a substantial step towards improving algorithms' comparability, reliability, and consistency in RNA modification prediction. It points out the deficits in this young field that need to be addressed in further challenges.
Environmental Impact Assessment Report (Eia) on Proposed Dualisation of Ijegun-ijegemo to Abule-ado Road Network, Lagos State, Nigeria
Authors: Babatunde Ameen , and Ajayi A. O , Akeem Akindele
Published: October 2024

The Lagos State Government plans to construct a 19 km road network connecting Abule Ado to Ijegun-Ijegemo Alape canoe side. This initiative aims to alleviate traffic congestion along LASU/Iba road and address growing access needs in the area. An Environmental Impact Assessment (EIA) has been completed to assess the project's potential environmental and social effects, including strategies to mitigate negative impacts and enhance positive ones. Field surveys identified and documented environmental impacts, while consultations involved various stakeholders such as local authorities and affected individuals. The EIA adheres to Nigerian Government regulations and guidelines from the Federal Ministry of Environment and NESREA. The proposed route will traverse Abule Ado (Latitude 06.45789, Longitude 03.25520), Alape/Arandun (Longitude 06.50612, Latitude 03.20202), and Befun (Longitude 06.50686, Latitude 03.22934), reaching Ijegun Ijeododo (Longitude 06.50695, Latitude 03.27605). The project, located in the Ojo Local Government Area of Lagos, Nigeria, is designed to significantly improve local infrastructure and traffic flow.
The investigation of relationship between allergic rhinitis with forward head posture and anxiety in children
Authors: Maddah Tahere , Daneshmandi Hasan , Alizade Mohammad Hossein , Rahmati Mohammad Bagher
Published: October 2024

Introduction: Forward head posture is a common postural issue across all age groups, often linked to the overuse of electronic devices such as computers, smartphones, and tablets, leading to poor posture in children. Allergic rhinitis is also prevalent in children, but its effects on musculoskeletal and psychological health are not well understood.
Objective: This study aimed to explore the relationship between allergic rhinitis, forward head posture, and anxiety levels in Iranian children aged 7-12 years.
Materials and Methods: Fifty children aged 7-12 were recruited from the Allergy-Infection Clinic at Bandar Abbas Children's Hospital. The participants were divided into two groups: 25 healthy children and 25 children diagnosed with allergic rhinitis. Anxiety levels were assessed using the Spence Anxiety Scale, while forward head posture was measured by analyzing photographs of the children’s body profiles using AutoCAD software.
Results: Of the total participants, 24 children (46%) exhibited a forward head posture, defined as a craniovertebral angle of less than 48 degrees. Among these, 14 (56%) were in the allergic rhinitis group and 10 (40%) were in the healthy group. However, there was no statistically significant association between allergic rhinitis, forward head posture, and anxiety based on age, gender, or duration of nasal allergy.
Conclusion: The study found no significant relationship between allergic rhinitis, forward head posture, and anxiety. The findings highlight the need for increased awareness of proper posture, particularly in relation to the use of electronic devices, and the importance of evaluating postural disorders in children.
WITHDRAWN: Optimal Distributed Tensor PCA with Statistical Guarantees for Heterogeneous and Decentralized Data
Authors: Li Chris Junchi
Published: October 2024

25 October, 2024. Research Square has withdrawn this preprint due to extensive overlap with the published work of another researcher (https://doi.org/10.48550/arXiv.2405.11681).
Alternative Paramedic Roles: An International Perspective
Authors: Feerick Fintan , Coughlan Eoin , Knox Shane , Murphy Adrian , Grady Ivan O , Deasy Conor
Published: October 2024

Background
While paramedicine is an evolving profession globally, there remain many disparities around titles and roles within the various jurisdictions that may not be fully captured in the literature. The aim of this study is to gain an international perspective on current and future roles within the field of paramedicine.
Methods
A mixed-methods approach was adopted for this survey, using both quantitative and qualitative data, and a link to the survey was distributed to international participants within the field of paramedicine through email, journals, and social media platforms.
Results
The study gathered responses from 158 participants representing 59 organisations across 16 countries. Ireland had the highest number of respondents (n = 56), followed by Australia (n = 41), and England (n = 21). Participants outlined (n = 54), current paramedic roles and (n = 39), future roles planned within their respective organizations. Participants described (n = 86), aspirational, non-traditional roles that they felt paramedics may adopt into the future. Respondents practitioner titles varied across a range of clinical, managerial, and academic specialties, with (n = 33) examples provided. Clinical level of practitioner available within the respondents organisations provided (n = 41), descriptions. Various ambulance care models were identified (n = 24), with various combinations. Paramedic medical oversight was predominantly provided by a physician, (n = 56), although (n = 22) other examples were described. Regulation of paramedic practice provided (n = 8), descriptions of regulatory bodies, and (n = 9) paramedic models of regulation described. Respondents described (n = 10), descriptions of patient safety framework models within the relevant organizations. Qualitative data did not require thematic analysis and respondents’ free text was recorded and transcribed verbatim.
Conclusion
Gaps in the healthcare provision are creating new innovative opportunities for a rapidly evolving paramedic profession. Paramedicine is evolving in response based often on local or sectoral need. Rather than trying to standardise practice perhaps an alternative approach might be to simply accept that paramedicine is a domain of practice and health profession that specialises across a range and variety of clinical settings and focus on creating and maintaining omnipotent healthcare practitioners adaptable to societal needs within a well governed health system.
MMX Rover MECSS - Separation from the Mothership: Multibody Simulation Analysis of the Ejection
Authors: Pignède Antoine , Buse Fabian , Grundmann Jan Thimo , Reershemius Siebo , Patscheider Hagen , Wippermann Torben , Lange Michael , Mierheim Olaf , Meyer Sebastian
Published: October 2024

This is a report about the simulation study of a lightweight rover being separated from a larger spacecraft in vicinity of a small Solar system body. Monte Carlo simulation and statistical analysis estimate the rate of requirement violation depending on uncertain rover and separation mechanism parameters. During the rover development phase, the full Monte Carlo analysis is only done with a simplified model. The first iterations show relatively high probability of non-compliance with requirements. Model refinement and more precise hardware values lead to the final assessment that separation meets the requirements within a ∼ 2 σ region. A more detailed model serves for analysis of selected samples during the development phase. For this model, a full Monte Carlo analysis is only done close to the end once the parameter ranges are fixed, mostly for time reasons. This more detailed analysis in general confirms the ∼ 2 σ requirement meeting. The main difference with the simplified model is the much larger number of outliers, a few of which also violate the allocated volume for the rover in proximity of the mothership.
Insight into the structure and chemical durability of Cr-bearing lead crystal glass
Authors: Brunswic Lea , Angeli Frederic , Charpentier Thibault , Gin Stephane , Gardie Lea , Tarrago Mariona , Cotte Marine , Losno Remi , Cormier Laurent , Hullebusch Eric van , Neuville Daniel
Published: October 2024

The scientific understanding and demonstration of the immobilization of heavy metals (notably lead and chromium) in food contact materials is crucial for the safety of environment and humans. To tackle this issue lead crystal glasses doped between 50 and 2000 ppm of chromium oxide were carried out under severe aqueous alteration conditions (acetic acid 4% (v/v), pH 2.4, 70°C, 330 days). The increase in Cr leads to a decrease in the Pb release into the solution. The leached Cr content was lower than Pb, itself much lower than alkali ones. Structural characterization before and after alteration points out the presence of Cr(III) exclusively, with no redox changes in the course of alteration. Cr and Pb are partially retained during alteration near cationic domains, less accessible to protonated species. Cr favors the Si recondensation in the rich non-bridging oxygen (NBO) mixing sites, leading in an increase of glass polymerization within the altered layer.
Exploring the Causal Relationships Between Brain Functional Networks and Psychiatric Disorders: A Mendelian Randomization Approach
Authors: Xi Qiufen , Sun Yu , Sun Jian , Wang Wanteng
Published: October 2024

Background:
Numerous studies have reported brain functional network impairments in individuals with psychiatric disorders; however, the causal relationships between the two remain unclear. We aimed to investigate the potential causal relationships between resting-state functional magnetic resonance imaging (rsfMRI) phenotypes and psychiatric disorders via Mendelian randomization (MR) analysis.
Method:
Employing a bidirectional two-sample MR analysis approach, this study assessed the associations between 191 rsfMRI phenotypes and 9 psychiatric disorders. Genetic variations were utilized as instrumental variables, ensuring the minimization of confounding factors in accordance with Mendel's laws of inheritance. Causal inferences were drawn by selecting genetic variants that were directly associated with the exposure variables and excluding those that might influence outcomes via alternative pathways. The study employed various statistical methods, including inverse variance weighting, the weighted median, and the MR Egger method, to evaluate causal relationships and adjusted for false discovery rates among outcomes.
Results:
The study identified significant causal associations between 21 rsfMRI phenotypes and five psychiatric disorders. For instance, in anxiety disorders, increased neural activity intensity in the parietal, frontal, and temporal lobes, along with enhanced functional connectivity between the attention, central executive, and default mode networks, are significantly associated with an increased risk of anxiety disorders. With respect to dementia, increased activity in the frontal lobe region was associated with a higher risk of dementia, and increased functional connectivity between the salience network and the central executive network was also linked to an increased risk of dementia.
Conclusion:
The findings of this study support the causal relationships between rsfMRI and psychiatric disorders, offering new insights for future prevention and treatment strategies.
Enhancing Hand Hygiene compliance in surgical wards: A Quality Improvement Initiative using two Plan- Do- Study- Act (PDSA) cycles
Authors: Rehman Ibad ur , Shafqat Muhammad Daniyal , Shafqat Muhammad Danish , Rehman Hammad ur , Rasool Talha , Amir Muhammad Ayhan , Satti Rida Altaf , Farooqui Fareeha , khan saad , Munir Aqsa , Iqbal Javed
Published: October 2024

Background:
Due to invasive procedures, healthcare-associated infections (HCAIs) present major risks, especially in surgical wards. Healthcare workers (HCWs) often show low adherence to hand hygiene (HH), with compliance close to 60%. Hand hygiene (HH) is a straightforward yet highly effective measure to prevent HCAIs. This study evaluated and enhanced HH adherence in the surgical wards of a tertiary hospital in Islamabad using the Plan-Do-Study-Act (PDSA) quality improvement (QI) method.
Methodology:
This prospective, quasi-experimental quality improvement study occurred in the surgical wards of a tertiary hospital in Islamabad from March to July 2024. With approval, all healthcare workers (HCWs), including doctors, nurses, and medical students, participated. Three monitoring phases were conducted on 750 hand hygiene (HH) opportunities: before the intervention, after the first PDSA cycle, and after the second PDSA cycle. The interventions included regular feedback, improved hand rub dispenser placement, and educational workshops. Statistical analysis used the chi-square test with a significance level of p < 0.05.
Results:
Pre-intervention HH compliance was 48%, with 114 out of 150 opportunities observed as compliant. After the first intervention, compliance improved to 67%, and following the second intervention, compliance increased further to 80.4% (281/350 opportunities). Significant improvements were noted in HH moments before patient contact, aseptic procedures, and after body fluid exposure (p < 0.001). However, compliance after patient contact remained more challenging. The main barriers identified were forgetfulness, inconvenient dispenser locations, and insufficient training, all addressed through targeted interventions.
Conclusions:
Implementing QI methodologies, specifically PDSA cycles, significantly improved HH compliance in the surgical wards, improving patient safety and reducing the risk of HCAIs. Continuous education, improved accessibility to hand hygiene supplies, and real-time feedback were vital in sustaining compliance improvements. This study demonstrates the value of structured, iterative interventions in fostering lasting behavioral change among HCWs.
Factors for Predicting Time to Acceptance in the Journal of the American Academy of Orthopaedic Surgeons
Authors: Crawford Ethan , Gergoudis Maria , Whitaker Sarah , Laubach Logan , Yeramosu Teja , Patel Nirav
Published: October 2024

Purpose
The Journal of the American Academy of Orthopaedic Surgeons (JAAOS) is a high-impact journal that publishes crucial research to inform surgeons’ clinical decision-making. The purpose of this study was to determine the median time from submission to acceptance for articles published by the JAAOS and to evaluate factors which may influence time to acceptance.
Methods
All studies published in JAAOS from 2020-2022 were obtained. Abstracts were screened for submission and acceptance dates, and time to acceptance was calculated. Studies were excluded if dates were unavailable. Data extracted included article type, main topic, and sex of the first author. Simple linear regression, analysis of variance (ANOVA), and independent samples t-test were utilized for univariate analysis. For multivariate analyses, a standard least squares regression was applied.
Results
We analyzed 754 articles. Over the past 3 years, time to acceptance has not significantly changed (p = 0.894). Regarding article type, letters had the shortest time to acceptance (median 5 days, IQR 2-10, p<0.0001), while interventional studies had the longest time to acceptance (median 171.5 days, IQR 106-309.5).. Articles pertaining to COVID-19 (median 62 days, IQR 2-121) and diversity (median 90 days, IQR 24-156) had the shortest times to acceptance. Articles pertaining to radiology (median 189.5 days, IQR 100-309.5) and trauma (median 183 days, IQR 126.5-269.5) had the longest times to acceptance (p<.0008). Time to acceptance was not significantly different between male and female first authors.
Conclusion
This study provides a tool for authors to estimate their mean time from submission to acceptance based on the characteristics of their study. With literature submissions constantly increasing each year with unknown times to acceptance, authors may make a more informed decision with journal selection based on the qualities of their study.
Preoperative Immunotherapy Combined with Chemotherapy: Evaluation of Nutritional and Immune-inflammatory Status in ESCC and Its Impact on Perioperative Period
Authors: Liu Qingwen , Hu Junxi , Chen Yong , He Wenbo , Hou Jiaqi , Shu Yusheng , Wang Xiaolin
Published: October 2024

Objectives
To investigate the effects of neoadjuvant therapy (NT) on the nutritional and immune-inflammatory status of patients with esophageal squamous cell carcinoma (ESCC), and to identify the relevant indicators that influence adverse perioperative outcomes.
Methods
From March 2021 to March 2024, a retrospective study was conducted on 78 patients clinically diagnosed ESCC who underwent surgery following immunotherapy and chemotherapy. The nutritional and immune-inflammatory status of pre-NT and pre-operation were compared, and logistic regression model and linear regression model were employed to investigate the indicators influencing postoperative complications and the duration of postoperative hospitalization.
Results
The malnutrition rates pre-NT and pre-operation were 37.2% and 44.9% respectively, p = 0.329. Preoperative indicators of nutritional status decreased compared with those pre-NT, but the differences were not statistically significant. The systemic immune-inflammation index (SII), white blood cell (WBC), neutrophil (NE) and platelet (PLT) counts showed significant decrease pre-operation compared to pre-NT (p < 0.05), while lymphocyte (LYC) and monocyte (MO) counts also decreased but not significantly (p > 0.05). Malnutrition under GLIM criteria was identified as an independent risk factor for postoperative complications (OR 11.366, 95% CI 1.079; 119.706, p = 0.043), and a reduction in intake by 50%-75% was an independent risk factor for prolonged postoperative hospital stay (OR 6.651, 95% CI 2.653; 10.648, p = 0.001).
Conclusion
The prevalence of malnutrition in patients with ESCC is high. Preoperative NT is not a primary factor exacerbating malnutrition but does suppress the body's immune-inflammatory status. In clinical practice, the predictive value of malnutrition under GLIM criteria and its indicators for adverse perioperative outcomes is significantly greater.
Mechanism of gas film formation and evolution on anode in microbubbles flow electrolytic plasma polishing
Authors: Wang Juan , Sun Huanwu , Fan Ruilong , Yang Dongliang , Xiang Yuxia , Duan Haidong
Published: October 2024

Microbubbles flow electrolytic plasma polishing (MF-EPP) facilitates controllable electrolytic plasma polishing (EPP) using a low-power supply. It is well established that a vapor gaseous envelope (VGE) around a workpiece is essential for EPP polishing. Nonetheless, the generation condition and its control parameter of a local gas film on the workpiece surface in MF-EPP is not fully understood. In this study, an analysis by the electrochemical and hydrothermal reactions revealed that the gas composition on the anode surface is mainly composed of water vapor, which is heated by Joule heat, and electrolysis gases such as oxygen, fluorine, hydrogen, and nitrogen. By analyzing formation conditions and calculating the volume flux of each gas, it was found that vapor is the main component of the gas film. For the vapor characteristics, the bubble nucleation and growth model has been established. On this basis, the main factors affecting the nucleation, growth, and coalescence of bubbles were then analyzed, indicating that superheating and heat flow density are the principal factors affecting the aggregation of bubbles and thus the formation of a gas film. It was determined that the presence of electrolytic gases exerts a beneficial influence on the nucleation of vapor bubbles. Additionally, a bubble dynamics model was constructed based on the conservation of energy, and the impact of processing parameters on the evolution of bubbles was analyzed. The threshold for the formation of a stable gas film under the conditions of this experiment was determined to be a voltage of 350 V and an initial electrolyte temperature of 80°C. The applicability of the model was validated through experimentation, and the establishment of the model provides theoretical and experimental references for the formulation and optimization of MF-EPP machining process parameters.
A Hybrid Process of Electrochemical Discharge Machining (ECDM) and High-Speed Milling (HSM) on Quartz Glass
Authors: Tong Hao , Luo Yuge , Liu Guodong , Li Yong , Nawaz Shan Ali
Published: October 2024

In traditional machining processes, surface microcracks are prone to generate due to the hardness and brittleness of quartz glass. A hybrid process of electrochemical discharge machining (ECDM) and high-speed milling (HSM) is proposed for efficiently machining quartz glass without surface microcracks. During ECDM-HSM process, a "mushroom cloud" gas film is found by a high-speed camera, which facilitates to constraint discharges to a tool-electrode end. Machining experiments of ECDM-HSM obtains the processing effect of key factors of tool rotation speed, applied voltage, and feed rate. The higher rotation speed requires higher critical voltage to start discharges. The high feed rate can improve machining efficiency and quality significantly owing to the combined action of plastic cutting, discharges, and chemical reaction. The homogenization mechanism of discharging energy and the transition mechanism of plastic cutting are proposed for illuminating the processing effect. The matching mapping of key parameters is established for optimizing the processing parameters. As an example, a regular groove without surface microcracks is machined with the processing efficiency improved up to 20 times as compared with that of HSM.
Title: 'Identification of potential growth centre in auto-transplanted costochondral graft in Temporomandibular joint- an experimental study on New Zealand white rabbit'.
Authors: Sultana Jachmen , Rahman Prof. Dr. Quazi  Billur , Chowdhury Prof. Dr. Emdadul Haque , Juyena Prof. Dr. Nasrin Sultana , B Prof. Dr. Md. Abul
Published: October 2024

Introduction
Relapse of Temporomandibular joint (TMJ) ankylosis and facial deformity are the common complications of reconstruction of TMJ by costochondral graft (CCG), especially in children. An unpredictable growth pattern in CCG is considered to be responsible for frequent relapse. However, CCG is regarded as a primary growth centre with inherent growth potential. Therefore, the lack of clear experimental evidence of predictability of growth patterns emphasizes further experiments.
Materials and Methods
To identify the potential growth centre of CCG in TMJ, an experimental study was done on 144 New Zealand white rabbits, 72 experimental and 72 control, which were divided into three batches. Each batch contains 48 (24 experimental and 24 control) male rabbits of known ages and species: growing (3–4) and adult (12–18) months old. After TMJ interpositional gap arthroplasty using a variable thickness of 1-mm and 4-mm cartilaginous cap with CCG follow-up was done clinically, radiologically and biochemically; sacrifices were done in batches after the 4th, 12th and 24th weeks and examined histologically.
Results
Clinically, facial changes were consistent with graft’s growth and a trend of regaining facial symmetry was observed from the 12th week to the 24th week. Radiologically, the graft’s growth was remarkable in terms of length and width. Biochemically, increased serum bone-specific alkaline phosphatase level was found in both age groups, but it was noticeably high among the growing rabbits at the 24th week of observation. Histologically, the costochondral junction (CCJ) zone of the CCG showed a distinctive histological arrangement and pattern of cell proliferation which embodied the normal endochondral bone formation. The features of growth plate cartilage with specific zonal distribution determined the intrinsic growth capacity of CCG.
Conclusion
It is well-established that the growth centre is present at the CCJ of the graft along with its actual pattern of growth, which is no to minimal growth at the 4th week, maximum growth at the 12th week and slightly increased to remain static at the 24th week.