bluuebunny/crossref_metadata_2025 huggingface dataset:
Teaching and Learning Clinical Reasoning in Nursing Education: A Student Training Course
Authors: Leal Paula , Poeira Ana , Mendes Diana Arvelos , Batalha Nara , Franco Hugo , Nunes Lucília , Marques Fernanda , Pađen Ljubiša , Stefaniak Małgorzata , Pérez-Perdomo Ana , Bangels Lore , Lemmens Kathleen , Amaral Guida
Published: June 2024

Clinical reasoning is an essential component of nursing. It has emerged as a concept that integrates the core competencies of quality and safety education for nurses. In cooperation with five European partners, Instituto Politécnico de Setúbal (IPS) realized the “Clinical Reasoning in Nursing and Midwifery Education and Practice” project as part of the Erasmus+ project. As a partner, our team designed a multiplier event—the student training course. The aim of this report is to describe the construction and development of this clinical reasoning training course for nursing students. We outline the pedagogical approach of an undergraduate training course on clinical reasoning in 2023, which we separated into four stages: (i) welcoming, (ii) knowledge exploration, (iii) pedagogical learning, and (iv) sharing experience. This paper presents the learning outcomes of the collaborative reflection on and integration of the clinical reasoning concept among nursing students. This educational experience fostered reflection and discussion within the teaching team of the nursing department regarding the concept, models, and teaching/learning methods for clinical reasoning, with the explicit inclusion of clinical reasoning content in the nursing curriculum. We highlight the importance of implementing long-term pedagogical strategies in nursing education.
Comparing Cancer Risks and Mortality between Phytopharmaceuticals and Estrogen-Progestogen Medications for Menopausal Women: A Population-Based Cohort Study
Authors: Lin Tsai-Bei , Hsieh Chia-Chi , Wang Chun-Hsiang , Chang Chiung-Hung , Hsueh Yu-Ling , Tseng Yuan-Tsung , Hsieh Men-Fong
Published: June 2024

We evaluated the long-term risks of overall cancer and all-cause mortality associated with five types of phytopharmaceuticals and the most commonly used estrogen-progestogen medications for the treatment of postmenopausal syndrome in women. Using data from Taiwan’s National Health Insurance Research Database (NHIRD) from 1 January 2000 to 31 December 2018, we conducted a 1:2 matched cohort study with 12,087 eligible patients. We compared phytopharmaceuticals -only users (n = 4029, phytopharmaceuticals group) with HRT-only users (n = 8058, HRT group) with a washout period of ≥6 months. The phytopharmaceuticals group had significantly lower risks of overall cancer and all-cause mortality than the HRT group (adjusted hazard ratio [95% confidence interval]: 0.60 [0.40–0.9] and 0.40 [0.16–0.99], respectively) after over 180 days of use. Bupleurum and Peony Formula were associated with lower risks of overall cancer and all-cause mortality (aHR: 0.57 [0.36–0.92] and 0.33 [0.11–1.05], respectively). In conclusion, phytopharmaceuticals may serve as an alternative therapy to HRT for alleviating menopausal symptoms and reducing health risks, leading to more favorable long-term health outcomes. Further randomized control trials are necessary to validate the findings of this study.
Share Repurchases and Corporate Sustainability: Evidence from South Africa
Authors: Mouton Frank , Londt Carly , Cloete Gerhard , Hattingh Wynand , Steenkamp Gretha
Published: June 2024

This study examined the relationship between share repurchases and corporate sustainability in South Africa during 2011–2019. According to stakeholder theory, companies may feel a sense of obligation to not only distribute returns to shareholders through share repurchases but also to other stakeholders by investing in environmental, social or governance (ESG)-related projects. Our study, the first of its kind in the context of an emerging economy, reported a positive relationship between share repurchases and corporate sustainability in South Africa (proxied using ESG scores)—specifically social scores. The emphasis on the social, rather than the environmental, dimensions of ESG might result from the emerging economy context, where several societal problems are experienced. The results support stakeholder theory, but increased disclosure pertaining to the social dimension of ESG in years when share repurchases are executed might also provide evidence of ‘social washing’ (when companies employ their integrated report disclosures to paint an overly positive picture of their social responsibility initiatives).
Fetoscopic Tracheal Occlusion for Isolated Severe Left Diaphragmatic Hernia: A Systematic Review and Meta-Analysis
Authors: Provinciatto Henrique , Barbalho Maria Esther , Araujo Júnior Edward , Cruz-Martínez Rogelio , Agrawal Pankaj , Tonni Gabriele , Ruano Rodrigo
Published: June 2024

Background: We aimed to conduct a systematic review and meta-analysis to evaluate the fetoscopic tracheal occlusion in patients with isolated severe and left-sided diaphragmatic hernia. Methods: Cochrane Library, Embase, and PubMed (Medline) databases were searched from inception to February 2024 with no filters or language restrictions. We included studies evaluating the outcomes of fetoscopic intervention compared to expectant management among patients with severe congenital diaphragmatic hernia exclusively on the left side. A random-effects pairwise meta-analysis was performed using RStudio version 4.3.1. Results: In this study, we included 540 patients from three randomized trials and five cohorts. We found an increased likelihood of neonatal survival associated with fetoscopic tracheal occlusion (Odds Ratio, 5.07; 95% Confidence Intervals, 1.91 to 13.44; p < 0.01) across general and subgroup analyses. Nevertheless, there were higher rates of preterm birth (OR, 5.62; 95% CI, 3.47–9.11; p < 0.01) and preterm premature rupture of membranes (OR, 7.13; 95% CI, 3.76–13.54; p < 0.01) in fetal endoscopic tracheal occlusion group compared to the expectant management. Conclusions: Our systematic review and meta-analysis demonstrated the benefit of fetoscopic tracheal occlusion in improving neonatal and six-month postnatal survival in fetuses with severe left-sided CDH. Further studies are still necessary to evaluate the efficacy of tracheal occlusion for isolated right-sided CDH, as well as the optimal timing to perform the intervention.
Long-Term Experience of Arterio-Venous Fistula Surgery in Children on Hemodialysis
Authors: Almási-Sperling Veronika , Gall Christine , Haney Briain , Latzel Nina , Knieling Ferdinand , Hilger Alina C. , Regensburger Adrian P. , Meyer Alexander , Lang Werner , Rother Ulrich
Published: June 2024

Background: Arterio-venous fistulas (AVF) are used as first-line access for hemodialysis (HD) in the pediatric population. The aim of this investigation was to describe a single-center experience in the creation of AVF, together with its patency in children. Methods: This single-center retrospective study included all patients aged ≤18 years with AVFs created between 1993 and 2023. The collected data included patients’ demographics, hemodialysis history, intraoperative data, and required reinterventions in order to determine the impact of these variables on primary, primary-assisted, and secondary patency. Results: Fifty-seven patients were analyzed with a median age of 15 years (range, 7–18 years). Fifty-four forearm and four upper arm fistulas were performed. The median follow-up was 6.9 years (range, 0–23 years). The primary failure rate was 10.5%. The primary patency rate was 67.6%, 53.6%, 51.4%, and 38.1% after 1, 3, 5, and 10 years; primary-assisted patency was 72.9%, 62.8%, 60.6%, and 41.5%; and secondary patency was 87.3%, 81.3%, 76.8%, and 66.6% after 1, 3, 5, and 10 years in the studied population. Conclusions: AVFs showed an acceptable rate of primary failure and excellent long-term patency. In this context, AVFs are an appropriate option for HD access, especially in pediatric patients.
Early and Mid-Term Outcomes of Transcaval Embolization for Type 2 Endoleak after Endovascular Aortic Repair
Authors: Nana Petroula , Panuccio Giuseppe , Rohlffs Fiona , Torrealba José I. , Spanos Konstantinos , Kölbel Tilo
Published: June 2024

Background: Among the endovascular approaches for the management of endoleak type 2 (EL 2), transcaval embolization (TCE) has shown encouraging outcomes. However, the literature is still limited. This study aimed to present the early and mid-term outcomes of TCE for EL 2 after endovascular aortic repair. Methods: A retrospective, single-center analysis of consecutive patients managed with TCE for EL 2 after standard or complex endovascular aortic repair, from August 2015 to March 2024, was conducted. The indication for TCE was the presence of an EL 2 related to ≥5 mm sac increase, compared to the first imaging after aneurysm exclusion or the smallest diameter during follow-up. Patients managed with TCE for other types of endoleaks were excluded. The primary outcomes were technical and clinical successes during follow-up. Results: Forty-three patients were included (mean age: 75.1 ± 6.0 years, 90.7% males). Technical success was 97.7%. Selective embolization was performed in 48.8% and non-selective in 51.2%. No death was recorded at 30 days. The estimated clinical success was 90.0% (standard error; SE: 6.7%) and the freedom from EL 2 was 89.0% (SE 6.4%) at 36 months. Cox regression analysis showed that the type of embolization (selective vs. non-selective), type of previous repair (f/bEVAR vs. EVAR), and use of anticoagulants did not affect follow-up outcomes. Reinterventions related to EL 2 were performed in 12.5%; three underwent an open conversion. Conclusions: TCE was related to high technical success and limited peri-operative morbidity, regardless of the type of initial endovascular aortic repair. Clinical success was encouraging with reinterventions for EL 2 affecting 12.5% of patients.
Gender-Affirming Surgery in Low- and Middle-Income Countries: A Systematic Review
Authors: Shah Viraj , Hassan Bashar , Hassan Rena , Alexis Malory , Bhoopalam Myan , Agandi Lorreen , Liang Fan
Published: June 2024

Objectives: Fewer than one-fifth of all studies on gender-affirming care originate from low- and middle-income countries (LMICs). This is the first systematic review to examine surgical demographics and outcomes following gender-affirming surgery (GAS) in LMICs. Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, five databases were systematically searched for original studies and case series on GAS within LMIC settings. Excluded reports included animal studies, non-English language studies, secondary studies including reviews, individual case reports and conference abstracts. Results: This review includes 34 studies involving n = 5064 TGNB individuals. Most studies (22, 64.7%) were from upper-middle-income countries, followed by lower-middle-income countries (12, 35.3%). A total of 31 studies (91.2%) reported on post-operative outcomes. Of n = 5013 patients who underwent GAS, 71.5% (n = 3584) underwent masculinizing and 29.5% (n = 1480) underwent feminizing procedures. The predominant procedures were metoidioplasty (n = 2270/3584, 63.3%) and vaginoplasty (n = 1103/1480, 74.5%). Mean follow-up was 47.7 months. In patients who underwent metoidioplasty, 6.8% (n = 155) of patients experienced a complication and 6.3% (n = 144) underwent revision surgery. In patients who underwent vaginoplasty, 11.5% (n = 127) of patients experienced a complication and 8.5% (n = 94) underwent revision surgery. Of the studies (25/34, 73.5%) that reported on quality of life and post-operative satisfaction, the majority showed marked improvements in psychosocial and functional outcomes. Notably, no post-surgical regret was reported among the surveyed patients. Conclusions: Existing literature on GAS in LMICs remains scarce and is concentrated in select institutions that drive specific procedures. Our review highlights the low reported volumes of GAS, variability in surgical outcomes and quality of life.
Pressure and Liquid Distribution under the Blade of a Basket Extruder of Continuous Wet Granulation of Model Material
Authors: Fekete Roman , Peciar Peter , Juriga Martin , Gužela Štefan , Peciarová Michaela , Horváth Dušan , Peciar Marian
Published: June 2024

This study explores the influence of blade design on the low-pressure extrusion process, which is relevant to techniques like spheronization. We investigate how blade geometry affects the extruded paste and final product properties. A model paste was extruded through a basket extruder with varying blade lengths to create distinct wedge gaps (20°, 26° and 32° contact angles). The theoretical analysis explored paste behavior within the gap and extrudate. A model material enabled objective comparison across blade shapes. Our findings reveal a significant impact of blade design on the pressure profile, directly influencing liquid distribution in the paste and extrudate. It also affects the required torque relative to extruder output. The findings of this study hold significant implications for continuous granulation, a technique employed in the pharmaceutical industry for producing granules with uniform size and properties. Understanding the influence of blade geometry on the extrusion process can lead to the development of optimized blade designs that enhance granulation efficiency, improve product quality, and reduce energy consumption. By tailoring blade geometry, manufacturers can achieve more consistent granule characteristics, minimize process variability, and ultimately produce pharmaceuticals with enhanced efficacy.
Fundamental Mechanisms Underlying the Effectiveness of Nanoparticle Additives to Lubricants: 25 Examples Linking Nano- to Macroscale Friction
Authors: Krim Jacqueline , Smirnov Alex I.
Published: June 2024

Studies of the fundamental origins of friction have undergone rapid acceleration in recent years by providing valuable information on the nanoscale mechanisms responsible for friction at the macroscopic level. Significant efforts have been directed at developing composite nanofluids and nanoparticle additives to unlock new tribological properties unattainable by traditional lubricants. The studies are now further evolving by developing methods to achieve active control over nano- and/or mesoscale friction through the application of magnetic and electric fields external to the contact. These methods constitute an area of rapidly growing interest, and they also illuminate how the performance of conventional lubricants could be enhanced through the synergistic addition of nanoparticles (NPs). This mini review highlights 25 publications that collectively reveal significant progress, as well as important outstanding challenges, to the fundamental understanding of how the addition of NPs impacts lubricant performance. The first two topics focus on how Quartz Crystal Microbalance (QCM) nanotribological response to solid contacts can be linked to macroscale friction coefficients in the boundary lubrication regime and how QCM response upon immersion into a liquid is linked to macroscale lubricity in the mixed and hydrodynamic regimes. The third and fourth topics highlight the pivotal role of nanoparticle charge and surface treatments, while also indicating that the rolling of nanoparticles is ineffective and/or detrimental. The fifth topic focuses on applications that demonstrate the tuning of friction by varying nanoparticle electric charge and/or an external electric potential. The highlighted literature was selected to demonstrate a range of experimental and theoretical research, to provide direct connections between the nanoscale and macroscale tribological attributes, and to emphasize environmentally friendly lubricating materials such as water-based nanofluids.
Investigation of Dynamic Viscoelastic Characteristics of Permeable Asphalt
Authors: Yan Xin , Zhou Zhigang , Liu Zhiren , Zhou Yang
Published: June 2024

In order to provide a basis for the structural analysis, design and maintenance of permeable asphalt pavements, and to promote their engineering promotion and application, this study investigated the dynamic viscoelastic properties of permeable asphalt mixtures (PAC-13) under complex stress states. A Simple Performance Tester (SPT) system was used to measure the dynamic modulus of the mix under complex stress states. The displacement factor and principal dynamic modulus curves were formed by fitting Sigmoidal functions and using 1stOpt (first optimization) software, the phase angle principal curves were further determined, and the dynamic modulus was predicted for the ambient phase (15–25 °C) using the Hirsch model. The results showed that the dynamic modulus of the mixtures decreases with an increasing temperature, and the maximum decrease in the dynamic modulus is 93% when the confining pressure is 100 kPa and the loading frequency is 10 Hz. The dynamic modulus increases with an increasing confining pressure and loading frequency, the maximum increase with an increasing confining pressure is 26.1% when the temperature is 25 °C and the loading frequency is 10 Hz, and the maximum increase with an increasing loading frequency is 411% when the temperature is 25 °C and the confining pressure is 100 Hz. The dynamic modulus has a strong frequency dependence at low temperatures, while it is stress-dependent at high temperatures. Meanwhile, based on the Hirsch model, a new modified prediction model was developed, which can well predict the dynamic modulus of permeable asphalt mixtures at room temperature.
Titanium Alloy Materials with Very High Cycle Fatigue: A Review
Authors: Wu Yuhang , He Weifeng , Ma Haitao , Nie Xiangfan , Liang Xiaoqing , Pan Jile , Wang Shiguang , Shang Min , Cheng Li
Published: June 2024

As the reliability and lifespan requirements of modern equipment continues to escalate, the problems with very high cycle fatigue (VHCF) has obtained increasingly widespread attention, becoming a hot topic in fatigue research. Titanium alloys, which are the most extensively used metal materials in the modern aerospace industry, are particularly prone to VHCF issues. The present study systematically reviewed and summarized the latest (since 2010) developments in VHCF research on titanium alloy, with special focus on the (i) experimental methods, (ii) macroscopic and microscopic characteristics of the fatigue fractures, and (iii) construction of fatigue fracture models. More specifically, the review addresses the technological approaches that were used, mechanisms of fatigue crack initiation, features of the S–N curves and Goodman diagrams, and impact of various factors (such as processing, temperature, and corrosion). In addition, it elucidates the damage mechanisms, evolution, and modeling of VHCF in titanium alloys, thereby improving the understanding of VHCF patterns in titanium alloys and highlighting the current challenges in VHCF research.
Study of Morphology Control of Electro-Deposited Silver on Electro-Chemically Exfoliated Graphene Electrode and Its Conductivity
Authors: Bak Siwon , Shim Jongwon
Published: June 2024

Solution-processed graphene is beneficial for large-scale, low-cost production. However, its small lateral size, variable layer thickness, and uncontrollable oxidation level still restrict its widespread electronic application. In this study, a newly developed electrochemical exfoliation process was introduced, and a graphene-patched film electrode was fabricated by interfacial self-assembly. We were able to minimize the deterioration of graphene colloids during exfoliation by voltage and electrolyte modulation, but the patched structure of the graphene electrode still showed low conductivity with numerous inter-sheet junctions. Therefore, we determined the optimal conditions for the growth of fully networked silver structures on the multi-stacked graphene film by direct current electro-deposition, and these silver–graphene composite films showed significantly lowered graphene-colloid-patched film surface resistance.
Study on the Friction and Wear Properties of Multiple Rare-Earth-Oxide-Reinforced Resin-Based Friction Materials
Authors: Huang Lirong , Huang Minjie , Du Junhua , Liu Zhigang , Li Wei , Zhu Jiangbo
Published: June 2024

Aiming to solve the problem of thermal decay of resin-based friction materials at high temperatures, rare-earth-lanthanum-oxide-/cerium-oxide-reinforced resin-based friction plates were prepared using a hot-pressing molding process. The effect of lanthanum/cerium oxide with different contents on the mechanical and tribological properties of the resin-based friction of materials was studied, and its mechanism was explored. The result shows that lanthanum/cerium oxide improves the mechanical and tribological properties of materials so that the coefficient of friction of the specimen is more stable on adding lanthanum/cerium oxide at 5% and 1%. Lanthanum/cerium oxide improves antidegradation properties of resin-based material and reduces the high-temperature wear rate by enhancing the interfacial effect so that the wear form of the specimen changes from predominantly adhesive wear to predominantly abrasive wear.
Enhancing Concrete Durability and Strength with Fly Ash, Steel Slag, and Rice Husk Ash for Marine Environments
Authors: Barragán-Ramírez Rodolfo , González-Hernández Andrés , Bautista-Ruiz Jorge , Ospina Michel , Aperador Chaparro Willian
Published: June 2024

The effect of an alternative source of silica, based on class F fly ash mixed with blast furnace slag and activated by rice husk ash (RHA), to produce concrete exposed to marine environments was evaluated. Four mixtures activated by the combination of 85% NaOH 14M + 15% RHA were manufactured to achieve a liquid/solid ratio of 0.20. Fly ash was incorporated into the steel slag mixture at addition percentages of 20, 40, 60, and 80%, and evaluated at 28, 900, and 1800 days for pore and chloride ion absorption. In general, including rice husk ash in the mixture of fly ash and steel slag significantly affected mechanical performance because it was possible to obtain concrete with high mechanical resistance. Concerning the durability evaluation, the effect of the activator generated by rice husk ash was observed, and the increase in steel slag added to the cementitious samples improved the capacity of the material to resist the penetration and diffusion of chloride ions.
Hyaluronic Acid/Chondroitin Sulfate-Based Dynamic Thiol–Aldehyde Addition Hydrogel: An Injectable, Self-Healing, On-Demand Dissolution Wound Dressing
Authors: Johnson Melissa , Song Rijian , Li Yinghao , Milne Cameron , Lyu Jing , Lara-Sáez Irene , A Sigen , Wang Wenxin
Published: June 2024

Frequent removal and reapplication of wound dressings can cause mechanical disruption to the healing process and significant physical discomfort for patients. In response to this challenge, a dynamic covalent hydrogel has been developed to advance wound care strategies. This system comprises aldehyde functionalized chondroitin sulfate (CS-CHO) and thiolated hyaluronic acid (HA-SH), with the distinct ability to form in situ via thiol–aldehyde addition and dissolve on-demand via the thiol–hemithioacetal exchange reaction. Although rarely reported, the dynamic covalent reaction of thiol–aldehyde addition holds great promise for the preparation of dynamic hydrogels due to its rapid reaction kinetics and easy reversible dissociation. The thiol–aldehyde addition chemistry provides the hydrogel system with highly desirable characteristics of rapid gelation (within seconds), self-healing, and on-demand dissolution (within 30 min). The mechanical and dissolution properties of the hydrogel can be easily tuned by utilizing CS-CHO materials of different aldehyde functional group contents. The chemical structure, rheology, self-healing, swelling profile, degradation rate, and cell biocompatibility of the hydrogels are characterized. The hydrogel possesses excellent biocompatibility and proves to be significant in promoting cell proliferation in vitro when compared to a commercial hydrogel (HyStem® Cell Culture Scaffold Kit). This study introduces the simple fabrication of a new dynamic hydrogel system that can serve as an ideal platform for biomedical applications, particularly in wound care treatments as an on-demand dissolvable wound dressing.
Effects of the Space Holder Shape on the Pore Structure and Mechanical Properties of Porous Cu with a Wide Porosity Range
Authors: Xiao Jian , He Yanping , Ma Wenjun , Yue Yiheng , Qiu Guibao
Published: June 2024

Porous copper (Cu), with varying porosities, has been made using carbamide as a space holder through the powder metallurgy route. Two shapes of carbamide particles were used, (i) needlelike and (ii) spherical, in order to investigate the effect of the space holder shape on the pore structure and mechanical properties of porous Cu. The compressive deformation behavior of porous Cu was studied under a compression test. The pores’ structural characteristics and mechanical properties of the porous Cu varied significantly with the shape of the space holder. Although the effect of the space holder shape on the porosity was not regular, the effect on the mechanical properties was regular. The stress increased monotonically with the increase in the strain, and strain hardening occurred at the plastic yield stage. The elastic modulus and yield strength followed the power law, with the relative density irrespective of the space holder shape. The empirical constants associated with different empirically developed power law relations were different, according to the shape of space holder. A quantitative relationship between the elastic modulus and yield strength and the spacer content was obtained to control the mechanical properties of the present porous Cu or other porous metals and metal foams using the well-known space holder method.
An Experimental Study on the Frictional Behavior of Ultrathin Metal Sheets at Elevated Temperatures
Authors: Xia Yuhang , Hou Zeran , Tan Jinjun , Wang Wenyao , Guo Nan , Min Junying
Published: June 2024

Hot forming is an effective approach for improving the formability of ultrathin metal sheets, such as those made of stainless steel and pure titanium. However, the increased friction coefficient between the tool and the high-temperature metal sheet negatively affects material flow during hot forming, potentially resulting in severe local thinning or even cracking. This study explores the frictional behavior of 0.1 mm thick ferritic stainless steel (FSS) and commercially pure titanium (CP-Ti) sheets at elevated temperatures. A friction testing apparatus was developed to measure the friction coefficients of these metal sheets from room temperature (25 °C) up to 600 °C. The friction coefficient of the FSS sheet increased monotonically with temperature, whereas that of the CP-Ti sheet first increased and then decreased. Post-friction testing microscopic examination demonstrated that built-up edges formed on the surfaces of the friction blocks when rubbed against the stainless steel, contributing to the higher friction coefficients. This study provides a foundation for understanding frictional behavior during the hot forming of ultrathin metal sheets.
Parametric Control via the Algebraic Expression of Lotus-Type Pore Shapes in Metals
Authors: Wang Liwei , Lee Bo-Yue , Wei Peng-Sheng , Quan Mingming
Published: June 2024

Lotus-type porous metals, characterized by low densities, large surface areas, and directional properties, are contemporarily utilized as lightweight, catalytic, and energy-damping materials; heat sinks; etc. In this study, the effects of dimensionless working parameters on the morphology of lotus-type pores in metals during unidirectional solidification were extensively investigated via general algebraic expressions. The independent dimensionless parameters include metallurgical, transport, and geometrical parameters such as Sieverts’ law constant, a partition coefficient, the solidification rate, a mass transfer coefficient, the imposed mole fraction of a solute gas, the total pressure at the top free surface, hydrostatic pressure, a solute transport parameter, inter-pore spacing, and initial contact angle. This model accounts for transient gas pressure in the pore, affected by the solute transfer, gas, capillary, and hydrostatic pressures, and Sieverts’ laws at the bubble cap and top free surface. Solute transport across the cap accounts for solute convection at the cap and the amount of solute rejected by the solidification front into the pore. The shape of lotus-type pores can be described using a proposed fifth-degree polynomial approximation, which captures the major portions between the initial contact angle and the maximum radius at a contact angle of 90 degrees, obtained by conserving the total solute content in the system. The proposed polynomial approximation, along with its working parameters, offers profound insights into the formation and shape of lotus-type pores in metals. It systematically provides deep insights into mechanisms that may not be easily revealed with experimental studies. The prediction of a lotus-type pore shape is thus algebraically achieved in good agreement with the available experimental data and previous analytical results.
Synthesis and Characterization of Sol–Gelled Barium Zirconate as Novel MTA Radiopacifiers
Authors: Lin Hsiu-Na , Chen May-Show , Chang Pei-Jung , Lee Yao-Chi , Chen Chin-Yi , Chiou Yuh-Jing , Lin Chung-Kwei
Published: June 2024

Barium zirconate (BaZrO3, BZO), which exhibits superior mechanical, thermal, and chemical stability, has been widely used in many applications. In dentistry, BZO is used as a radiopacifier in mineral trioxide aggregates (MTAs) for endodontic filling applications. In the present study, BZO was prepared using the sol–gel process, followed by calcination at 700–1000 °C. The calcined BZO powders were investigated using X-ray diffraction and scanning electron microscopy. Thereafter, MTA-like cements with the addition of calcined BZO powder were evaluated to determine the optimal composition based on radiopacity, diametral tensile strength (DTS), and setting times. The experimental results showed that calcined BZO exhibited a majority BZO phase with minor zirconia crystals. The crystallinity, the percentage, and the average crystalline size of BZO increased with the increasing calcination temperature. The optimal MTA-like cement was obtained by adding 20% of the 700 °C-calcined BZO powder. The initial and final setting times were 25 and 32 min, respectively. They were significantly shorter than those (70 and 56 min, respectively) prepared with commercial BZO powder. It exhibited a radiopacity of 3.60 ± 0.22 mmAl and a DTS of 3.02 ± 0.18 MPa. After 28 days of simulated oral environment storage, the radiopacity and DTS decreased to 3.36 ± 0.53 mmAl and 2.84 ± 0.27 MPa, respectively. This suggests that 700 °C-calcined BZO powder has potential as a novel radiopacifier for MTAs.
Investigation on Anti-Fuel Erosion Performance of Sasobit/SBS-Modified Asphalt and Its Mixtures
Authors: Wu Yongkang , Chen Meizhu , Jiang Qi , Zhang Jianwei , Fan Yansong , He Jun
Published: June 2024

The fuel leakage of fuel vehicles will exacerbate the occurrence of distresses on asphalt pavements, including peeling, chipping and potholes, especially under the synergistic effect of traffic load and environment. In this research, Sasobit, which is commonly used as a warm agent in asphalt, is selected as the anti-fuel erosion agent and incorporated into SBS-modified asphalt and its mixtures. Diesel and gasoline are selected as the fuel erosion media. Sasobit/SBS-modified asphalt binder and its mixtures are investigated for fuel erosion. The rheological properties of bitumen and the mechanical properties of asphalt mixtures are assessed. The experimental findings show that the dissolution velocity of SBS-modified asphalt with 3% Sasobit is 0.2%/min for diesel erosion, while it is 1.7%/min for gasoline erosion, lower than the control sample without Sasobit. Meanwhile, the rutting factor of Sasobit/SBS-modified asphalt decreases less than that of the control sample without Sasobit. Furthermore, the mass loss ratio after the Cantabro test of Sasobit/SBS-modified asphalt mixtures is 1.2% for diesel erosion, while it is 6.8% for gasoline erosion, lower than that of the control sample without Sasobit. The results of the mechanical properties for asphalt mixtures demonstrate that Sasobit can enhance the anti-fuel erosion performance. Moreover, the research results of the Sasobit modification mechanism show that Sasobit can form a microcrystalline structure in SBS-modified asphalt, which subsequently improves the anti-fuel of asphalt and its mixtures. This research provides a reference for anti-fuel erosion assessment methods and solutions to improve the anti-fuel erosion of asphalt pavement.
Reversed-Phase Medium-Pressure Liquid Chromatography Purification of Omega-3 Fatty Acid Ethyl Esters Using AQ-C18
Authors: Sang Mingxin , Pan Nan , Wu Jingna , Chen Xiaoting , Cai Shuilin , Fang Huan , Xiao Meitian , Jiang Xiaoming , Liu Zhiyu
Published: June 2024

Omega-3 fatty acids are in high demand due to their efficacy in treating hypertriglyceridemia and preventing cardiovascular diseases. However, the growth of the industry is hampered by low purity and insufficient productivity. This study aims to develop an efficient RP-MPLC purification method for omega-3 fatty acid ethyl esters with high purity and capacity. The results indicate that the AQ-C18 featuring polar end-capped silanol groups outperformed C18 and others in retention time and impurity separation. By injecting pure fish oil esters with a volume equivalent to a 1.25% bed volume on an AQ-C18 MPLC column using a binary isocratic methanol–water (90:10, v:v) mobile phase at 30 mL/min, optimal omega-3 fatty acid ethyl esters were obtained, with the notable purity of 90.34% and a recovery rate of 74.30%. The total content of EPA and DHA produced increased from 67.91% to 85.27%, meeting the acceptance criteria of no less than 84% set by the 2020 edition of the Pharmacopoeia of the People’s Republic of China. In contrast, RP-MPLC significantly enhanced the production efficiency per unit output compared to RP-HPLC. This study demonstrates a pioneering approach to producing omega-3 fatty acid ethyl esters with high purity and of greater quantity using AQ-C18 RP-MPLC, showing this method’s significant potential for use in industrial-scale manufacturing.
The Role of Virtual Reality in the Management of Football Injuries
Authors: Demeco Andrea , Salerno Antonello , Gusai Marco , Vignali Beatrice , Gramigna Vera , Palumbo Arrigo , Corradi Andrea , Mickeviciute Goda Camille , Costantino Cosimo
Published: June 2024

Injuries represent a serious concern for football players, with a significant loss in terms of sport participation and long periods of rehabilitation. According to the 2019/20 UEFA Élite Club Injury Report, the average incidence of injuries during training is 2.8 per 1000 h of training, with an average absence from training of 20 days. In addition, injured athletes are 4 to 7 times more likely to relapse than uninjured athletes. High workloads and reduced recovery periods represent two of the most important modifiable risk factors. In this context, prevention and an adequate rehabilitation protocol are vital in managing injuries, reducing their incidence, and improving the return to competition. In recent years, technological development has provided new tools in rehabilitation, and Virtual reality (VR) has shown interesting results in treating neurologic and orthopedic pathologies. Virtual Reality (VR) technology finds application in the sports industry as a tool to examine athletes’ technical movements. The primary objective is to detect the biomechanical risk factors associated with anterior cruciate ligament injury. Additionally, VR can be used to train athletes in field-specific techniques and create safe and controlled therapeutic environments for post-injury recovery. Moreover, VR offers a customizable approach to treatment based on individual player data. It can be employed for both prevention and rehabilitation, tailoring the rehabilitation and training protocols according to the athletes’ specific needs.
Advanced Interatrial Block across the Spectrum of Renal Function
Authors: Marano Marco , Senigalliesi Luigi , Cocola Rossella , Fontana Mariarosaria , Parente Erika , Russo Vincenzo
Published: June 2024

Background and Objective: Interatrial block (IAB) is defined as a conduction delay between the right and left atria. No data are available about the prevalence of both partial IAB and advanced IAB among the different stages of chronic kidney disease. The aim of this study was to describe the prevalence and type of advanced IAB across the spectrum of renal function, including patients on dialysis and the clinical characteristics associated with advanced IAB. Materials and Methods: Retrospective, single-center study of 151 patients consecutively admitted to the Nephrology and Ophthalmology Unit for 3 months. The study population was divided into three groups according to stages of chronic kidney disease. We evaluated the prevalence and pattern of IAB among the groups and the clinical characteristics associated with advanced IAB. Results: The prevalence of partial IAB was significantly lower in end-stage kidney disease (ESKD) group compared to control group (36.7% vs. 59.6%; p = 0.02); in contrast the prevalence of advanced IAB was significantly higher in both chronic kidney disease (CKD) (17.8% vs. 5.3%, p = 0.04) and ESKD group (24.5% vs. 5.3%, p = 0.005) compared to control group. The atypical pattern of advanced IAB was more frequent in both the ESKD and CKD group than in the control group (100% and 75% vs. 33.3%; p = 0.02). Overall, among patients that showed advanced IAB, 17 (73.9%) showed an atypical pattern by morphology and 2 (8.7%) showed an atypical pattern by duration of advanced IAB. The ESKD group was younger than the control group (65.7 ± 12.3 years vs. 71.3 ± 9.9 years; p = 0.01) and showed a higher prevalence of beta blockers (42.9% vs. 19.3%; p = 0.009), as in the CKD group (37.8% vs. 19.3%; p= 0.04). Conclusions: The progressive worsening of renal function was associated with an increasing prevalence of advanced IAB. Advanced IAB may be a sign of uremic cardiomyopathy and may suggest further evaluation with long-term follow-up to investigate its prognostic significance in chronic kidney disease.
Therapeutic Efficacy of Ultrasound-Guided Selective Nerve Block on Chronic Cervical Radiculopathy
Authors: Joo Hyo Jin , Choi Seongmin , Kim Byoung Hoon , Kim Min-Su , Shim Ga Yang , Chung Sung Joon , Chon Jinmann , Yoo Myung Chul , Soh Yunsoo
Published: June 2024

Background and Objectives: Cervical radiculopathy (CR) manifests as pain and sensorimotor disturbances in the upper extremities, often resulting from nerve root compression due to intervertebral disc herniation, degenerative changes, or trauma. While conservative treatments are initially preferred, persistent or severe cases may require surgical intervention. Ultrasound-guided selective nerve root block (SNRB) has emerged as a promising intervention for alleviating symptoms and potentially obviating the need for surgery. This study evaluates the therapeutic efficacy of ultrasound-guided SNRB in managing chronic CR, aiming to determine its potential in symptom relief and delaying or avoiding surgical procedures. Materials and Methods: A retrospective analysis was conducted on 720 outpatients treated for CR between October 2019 and March 2022. After excluding patients with traumatic CR, previous surgeries, malignancies, progressive neurological symptoms requiring immediate surgery, or inadequate conservative treatment, 92 patients who had experienced cervical radicular pain for more than three months and had failed to improve after more than six weeks of conservative treatment with VAS scores ≥ 5 were included. The patients underwent single or multiple ultrasound-guided SNRB procedures, involving the injection of dexamethasone and lidocaine under real-time ultrasound guidance. Symptom severity was assessed at the baseline, and at 4, 8, and 12 weeks post-procedure using the Visual Analog Scale (VAS). The data collected included age, sex, presence of neck and/or radicular pain, physical examination findings, recurrence of symptoms, improvement in symptoms, and whether surgical intervention was ultimately required. Statistical analyses were performed to identify the factors associated with symptom improvement or recurrence. Results: Significant symptom improvement was observed in 69 (75.0%) participants post-SNRB, with 55 (79.7%) showing improvement at 4 weeks, 11 (15.9%) at 8 weeks, and 3 (4.4%) at 12 weeks. Symptom recurrence, defined by an increase in VAS score accompanied by a pain flare lasting at least 24 h after a pain-free interval of at least one month, was noted in 48 (52.2%) patients. The presence of combined neck and radicular pain was a significant predictor of recurrence (p = 0.008). No significant associations were found between symptom relief and factors such as age, gender, initial pain severity, or MRI findings. Conclusions: Ultrasound-guided SNRB effectively manages chronic CR, providing substantial symptom relief and potentially reducing the need for surgical intervention. This technique offers a promising conservative treatment option, especially given its real-time visualization advantages and minimal radiation exposure.
Influence of Biomarkers on Mortality among Patients with Hepatic Metastasis of Colorectal Cancer Treated with FOLFOX/CAPOX and FOLFIRI/CAPIRI, Including Anti-EGFR and Anti-VEGF Therapies
Authors: Popovici Dorel , Stanisav Cristian , Sima Laurentiu V. , Negru Alina , Murg Sergiu Ioan , Carabineanu Adrian
Published: June 2024

Background and objectives: Colorectal cancer is a major global health concern, with a significant increase in morbidity and mortality rates associated with metastatic stages. This study investigates the prognostic significance of various clinical and laboratory parameters in patients with metastatic CRC. Materials and Methods: A retrospective cohort of 188 CRC patients with hepatic metastasis from the OncoHelp Association in Timisoara was analyzed from January 2016 to March 2023. Data on demographics, clinical characteristics, and biomarkers, such as lymphocyte counts, as well as various inflammation indices, were examined. Statistical analyses included univariate and multivariate logistic regression, Kaplan-Meier survival analysis, and ROC curve assessments. Results: Our findings indicate significant associations between survival outcomes and several biomarkers. Higher BMI and lymphocyte counts were linked with better survival rates, while higher values of Neutrophil-Hemoglobin-Lymphocyte (NHL) score, Neutrophil-Lymphocyte Ratio (NLR), Platelet-Lymphocyte Ratio (PLR), and Systemic Immune-Inflammation Index (SII) were predictors of poorer outcomes. Notably, the presence of hepatic metastasis at diagnosis was a critical factor, significantly reducing overall survival. Conclusions: The study has expanded the current understanding of prognostic factors in CRC, advocating for a multi-dimensional approach to prognostic evaluations. This approach should consider not only the traditional metrics such as tumor stage and histological grading but also incorporate a broader spectrum of biomarkers. Future studies should aim to validate these findings and explore the integration of these biomarkers into routine clinical practice, enhancing the precision of prognostic assessments and ultimately guiding more personalized treatment strategies for CRC patients.
Effectiveness of Gabapentin as a Benzodiazepine-Sparing Agent in Alcohol Withdrawal Syndrome
Authors: Alzghoul Hamza , Al-Said Mohammed I. , Obeidat Omar , Al-Ani Hashim , Tarawneh Mohammad , Meadows Robyn , Youness Houssein , Reddy Raju , Al-Jafari Mohammad , Alzghoul Bashar N. , Khan Akram
Published: June 2024

Background and Objectives: Gabapentin has shown promise as a potential agent for the treatment of alcohol withdrawal syndrome. We aimed to evaluate the effectiveness of gabapentin as a benzodiazepine-sparing agent in patients undergoing alcohol withdrawal treatment in all the hospitals of a large tertiary healthcare system. Materials and Methods: Medical records of patients admitted to the hospital for alcohol withdrawal management between 1 January 2020 and 31 August 2022 were reviewed. Patients were divided into two cohorts: benzodiazepine-only treatment who received benzodiazepines as the primary pharmacotherapy and gabapentin adjunctive treatment who received gabapentin in addition to benzodiazepines. The outcomes assessed included the total benzodiazepine dosage administered during the treatment and the length of hospital stay. The statistical models were calibrated to account for various factors. Results: A total of 4364 patients were included in the final analysis. Among these, 79 patients (1.8%) received gabapentin in addition to benzodiazepines, and 4285 patients (98.2%) received benzodiazepines only. Patients administered gabapentin required significantly lower average cumulative benzodiazepine dosages, approximately 17.9% less, compared to those not receiving gabapentin (median 2 mg vs. 4 mg of lorazepam equivalent dose (p < 0.01)). However, there were no significant differences in outcomes between the two groups. Conclusions: Our findings demonstrate that using gabapentin with benzodiazepine was associated with a reduction in the cumulative benzodiazepine dosage for alcohol withdrawal. Considering gabapentin as an adjunctive therapy holds promise for patients with comorbidities who could benefit from reducing benzodiazepine dose. This strategy warrants further investigation.
A 2-Year Randomized Clinical Trial of Three Bonding Techniques in Non-Carious Cervical Lesions
Authors: Pappa Eftychia , Gkavela Grigoria , Sampri Ioanna , Masouras Konstantinos , Rahiotis Christos , Kakaboura Afrodite
Published: June 2024

Background and objective: The aim of this randomized split-mouth study-controlled clinical trial was to compare the 2-year clinical performance of resin composite restorations placed at non-caries cervical lesions (NCCL) with one-step self-etch, total-etch, and selective enamel etch and self-etch adhesive techniques. Materials and methods: Thirty-two patients received three resin composite restorations each at NCCLs (Tetric EvoCeram/Ivoclar/Vivadent), bonded with a total-etch adhesive agent (ExciTE F/Ivoclar/Vivadent) and a self-etch (AdheSE One F/Ivoclar/Vivadent) without and with selective enamel etching. All restorations were evaluated by two examiners at baseline, 6-, 12-, 18-, and 24-months with FDI clinical criteria (post-operation regarding retention, caries occurrence, marginal adaptation, and marginal staining). A logistic regression analysis, a Cohen’s kappa statistic, a multifactorial analysis, and X2 were performed with generalized estimating equations. Results: After 2 years, the retention rate was 86.8% for total etch, 92.26% for self-etch, and 93.63% for selective enamel etching and self-etch. No caries was detected on the restorations. Concerning marginal adaptation, the clinically perfect restorations were 26.9% for the total-etch technique, 16% for self-etch, and 25.9% for selective enamel etch and self-etch. The logistic regression model revealed that only time reduced the probability of perfect marginal adaptation. Conclusions: All three adhesive strategies provided restorations with no significant differences in the retention rate or marginal adaptation, whereas the total etch yielded better performance for marginal staining. All restorations were assessed as clinically acceptable after 2 years.