bluuebunny/crossref_metadata_2025 huggingface dataset:
A novel nature-inspired nutcracker optimizer algorithm for congestion control in power system transmission lines
Authors: Kumar Vivek , Rao R Narendra , Singh Ajendra , Shekher Vineet , Paul Kaushik , Sinha Pampa , Alghamdi Thamer AH , Abdelaziz Almoataz Y
Published: June 2024

In the restructured power system, where uncertainties are common, managing congestion becomes a crucial aspect of power system operation and control. Congestion management aims to alleviate the power system transmission line congestion while meeting the system constraints at minimal cost. This research introduces a generation rescheduling method for congestion management in the electricity market, leveraging an innovative nutcracker optimizer algorithm. The nutcracker optimizer algorithm, inspired by nutcrackers’ food accumulation mechanisms, is a recently developed nature-inspired algorithm. The efficacy of this proposed approach is assessed across modified IEEE 30-bus, and IEEE 118-bus test systems, considering the system parameters. The effectiveness of the proposed congestion management with the nutcracker optimizer algorithm is analyzed by comparing its results with those generated by other recent optimization techniques. Results demonstrated that the nutcracker optimizer algorithm surpasses other comparative methods, requiring fewer fitness function evaluations, avoiding local optima, and displaying encouraging convergence traits. Implementing this approach can assist the system operators in swiftly addressing contingencies, ensuring secure and reliable power system operation within a deregulated environment.
Sedimentary evolution and sequence stratigraphic model of Neogene–Quaternary terrestrial foreland basin in Southwest Tarim
Authors: Ma Tao , Tan Xiucheng , Yang Haijun , Xu Qiang , Tang Hao , Ma Qing
Published: June 2024

Based on the research results of stratigraphic sedimentary facies, plane maps of sedimentary facies for four periods of the Neogene terrestrial foreland basin in Southwest Tarim were compiled. Research results conclude that the Neogene Miocene developed alluvial fan facies, fan delta facies, and lacustrine facies successively from the piedmont belt to the Maigaiti Slope. During the sedimentation of the Miocene Anju’an Formation, the lake range expanded to its maximum. According to the new division scheme for five-order sequences in prototype sedimentary basin, the stratigraphic sequence of a terrestrial foreland basin was divided and compared, and a sequence development and evolution model was established. Research results show that: (1) the Neogene–Quaternary is a typical type I sedimentary sequence with huge thickness; (2) the Neogene is a period of tectonic compression and flexural subsidence sedimentation in the foreland basin; with the maximum lake flooding surface at the top of the Miocene Anju’an Formation as the boundary, the lower part is a second-order super-sequence of the lacustrine transgression system tracts (TST), the upper part is a second-order super-sequence of the highstand system tracts (HST), and the Quaternary is a second-order super-sequence of the lowstand system tracts (LST) in forced lacustrine regression caused by the Late Himalayan tectonic movement; (3) the classic sequence stratigraphy made an error in establishing the theoretical model of marine type I sequences, as it placed the LST in the wrong position. The corrected type I sequences are in the order of TST, HST, and LST. (4) Finally, two examples were applied to demonstrate the development position of the LST, indicating that whether it is a marine or terrestrial prototype sedimentary basin, the LST was developed during the late stage of tectonic compression and uplift in a basin, and is the sedimentary sequence at the top of the prototype sedimentary basin.
Understanding patients’ doctor choice behavior: Elaboration likelihood perspective
Authors: Yan Junhui , Liang Changyong , Gu Dongxiao , Zhu Keyu , Zhou Peiyu
Published: June 2024

The rise of health 2.0 technologies has led to an increasing number of patients seeking medical advice in online health communities. This has ignited scholarly interest in exploring patients’ online doctor choice behaviors. While many researchers have examined the various determinants that impact this decision-making process, relatively few have delved into doctors’ functional quality embedded in doctor-patient interactions, and fewer have considered the role of patient health literacy. Thus, this study focuses on doctors’ functional quality, online reputation, and patient health literacy. Grounded in the Elaboration Likelihood Model and service quality theory, this study analyzes 143,895 doctor-patient text interactions involving 764 doctors. Results indicate that both functional quality and online reputation significantly influence patients’ choices of doctors. Additionally, patient health literacy moderates the impact of doctors’ online reputation on patient decisions. The findings contribute theoretical insights for researchers and practical implications for doctors and platform administrators.
Research trends in library and information science research in Tanzania, 1990–2023
Authors: Kassim Mohamed
Published: June 2024

This study aimed to analyze the trends in library and information science (LIS) research in Tanzania from 1990 to 2023. A descriptive research design utilizing a content analysis approach was employed to analyze data sourced from Google Scholar during the specified period. The study identified an overall fluctuating trend in LIS research, with a shift in research focus from information-seeking to other areas within the LIS domain. The predominant methodologies observed in most LIS studies were descriptive research design and a mixed methods approach. The study further highlighted a dynamic pattern in research collaboration, albeit with limited international collaboration. Additionally, there was a noticeable underrepresentation of female researchers in the LIS field, as evidenced by the scarcity of publications authored solely by women. The University of Dar es Salaam, Sokoine University of Agriculture, and Mzumbe University emerged as the top three institutions contributing to LIS research. While most LIS researchers published their work in the University of Dar es Salaam Library journal, there was a growing tendency to also publish in other similar international journals. Overall, this study contributes to the existing literature on LIS research trends, emphasizing the evolving nature of LIS research in Tanzania. It also underscores the importance of Tanzanian LIS researchers to actively seek international collaborations to enhance the impact of their research and further advance the field on a global scale.
Novel intravital approaches to quantify deep vascular structure and perfusion in the aging mouse brain using ultrasound localization microscopy (ULM)
Authors: Nyúl-Tóth Ádám , Negri Sharon , Sanford Madison , Jiang Raymond , Patai Roland , Budda Madeline , Petersen Benjamin , Pinckard Jessica , Chandragiri Siva Sai , Shi Helen , Reyff Zeke , Ballard Cade , Gulej Rafal , Csik Boglarka , Ferrier Jeremy , Balasubramanian Priya , Yabluchanskiy Andriy , Cleuren Audrey , Conley Shannon , Ungvari Zoltan , Csiszar Anna , Tarantini Stefano
Published: June 2024

Intra-vital visualization of deep cerebrovascular structures and blood flow in the aging brain has been a difficult challenge in the field of neurovascular research, especially when considering the key role played by the cerebrovasculature in the pathogenesis of both vascular cognitive impairment and dementia (VCID) and Alzheimer’s disease (AD). Traditional imaging methods face difficulties with the thicker skull of older brains, making high-resolution imaging and cerebral blood flow (CBF) assessment challenging. However, functional ultrasound (fUS) imaging, an emerging non-invasive technique, provides real-time CBF insights with notable spatial-temporal resolution. This study introduces an enhanced longitudinal fUS method for aging brains. Using elderly (24-month C57BL/6) mice, we detail replacing the skull with a polymethylpentene window for consistent fUS imaging over extended periods. Ultrasound localization mapping (ULM), involving the injection of a microbubble (<<10 μm) suspension allows for recording of high-resolution microvascular vessels and flows. ULM relies on the localization and tracking of single circulating microbubbles in the blood flow. A FIJI-based analysis interprets these high-quality ULM visuals. Testing on older mouse brains, our method successfully unveils intricate vascular specifics even in-depth, showcasing its utility for longitudinal studies that require ongoing evaluations of CBF and vascular aspects in aging-focused research.
Exploring the Influencing Mechanisms of Neighborhood Environment on the Physical and Mental Health of Chinese Migrant Children
Authors: Hu Wenyan , Tan Shilin
Published: June 2024

Based on a sample of migrant children in Kunming City, Yunnan Province, this study investigated the effects and mechanisms of the neighborhood environment on the physical and mental health of migrant children. This study found that the effects of community landscape and neighborhood cohesion on the physical and mental health of migrant children are significant. In contrast, the impact of the built environment such as community roads and traffic safety was not significant. Path analysis showed that the sense of inclusion and exclusion had a mediating effect on the association between the neighborhood environment and children’s health. A high-quality neighborhood environment could enhance the sense of inclusion and reduce the sense of exclusion, thereby promoting the physical and mental health of migrant children. This study revealed the underlying mechanisms in the environment-health link, and provided practical implications for relevant policymakers and practitioners.
Comparing the accuracy of four machine learning models in predicting type 2 diabetes onset within the Chinese population: a retrospective study
Authors: Liu Hongzhou , Dong Song , Yang Hua , Wang Linlin , Liu Jia , Du Yangfan , Liu Jing , Lyu Zhaohui , Wang Yuhan , Jiang Li , Yu Shasha , Fu Xiaomin
Published: June 2024

Objective

To evaluate the effectiveness of machine learning (ML) models in predicting 5-year type 2 diabetes mellitus (T2DM) risk within the Chinese population by retrospectively analyzing annual health checkup records.

Methods

We included 46,247 patients (32,372 and 13,875 in training and validation sets, respectively) from a national health checkup center database. Univariate and multivariate Cox analyses were performed to identify factors influencing T2DM risk. Extreme Gradient Boosting (XGBoost), support vector machine (SVM), logistic regression (LR), and random forest (RF) models were trained to predict 5-year T2DM risk. Model performances were analyzed using receiver operating characteristic (ROC) curves for discrimination and calibration plots for prediction accuracy.

Results

Key variables included fasting plasma glucose, age, and sedentary time. The LR model showed good accuracy with respective areas under the ROC (AUCs) of 0.914 and 0.913 in training and validation sets; the RF model exhibited favorable AUCs of 0.998 and 0.838. In calibration analysis, the LR model displayed good fit for low-risk patients; the RF model exhibited satisfactory fit for low- and high-risk patients.

Conclusions

LR and RF models can effectively predict T2DM risk in the Chinese population. These models may help identify high-risk patients and guide interventions to prevent complications and disabilities.
Procalcitonin and C-reactive protein as early predictors in patients at high risk of colorectal anastomotic leakage
Authors: Hu Yilong , Ren Junjie , Lv Zhixin , Liu He , Qiu Xiewu
Published: June 2024

Objective

To assess the diagnostic value of C-reactive protein (CRP) and procalcitonin (PCT) for anastomotic leakage (AL) following colorectal surgery.

Methods

We retrospectively analyzed data for patients who underwent colorectal surgery at our hospital between November 2019 and December 2023. CRP and PCT were measured postoperatively to compare patients with/without AL, and changes were compared between low- and high-risk groups. Receiver operating characteristic (ROC) curve analysis was used to assess the diagnostic accuracy of CRP and PCT to identify AL in high-risk patients.

Results

Mean CRP was 142.53 mg/L and 189.57 mg/L in the low- and high-risk groups, respectively, on postoperative day (POD)3. On POD2, mean PCT was 2.75 ng/mL and 8.16 ng/mL in low- and high-risk patients, respectively; values on POD3 were 3.53 ng/mL and 14.86 ng/mL, respectively. The areas under the curve (AUC) for CRP and PCT on POD3 were 0.71 and 0.78, respectively (CRP cut-off: 235.64 mg/L; sensitivity: 96%; specificity: 89.42% vs PCT cut-off: 3.94 ng/mL; sensitivity: 86%; specificity: 93.56%; AUC: 0.78). The AUC, sensitivity, and specificity for the combined diagnostic ability of CRP and PCT on POD3 were 0.92, 90%, and 100%, respectively (cut-off: 0.44).

Conclusions

Combining PCT and CRP on POD3 enhances the diagnostic accuracy for AL.
Association of physical performance with cognitive impairment in middle-aged to older haemodialysis patients: a multicentre cross-sectional observational study
Authors: Xu Jia , Zhao Xinhui , Guo Qi , Yu Cheng , Ding Wei , Niu Jianying , Zhao Junli , Zhang Liming , Zhang Suhua , Qi Hualin , Xi Minhui
Published: June 2024

Objective

To determine the prevalence of cognitive impairment (CI) among middle-aged to older patients receiving maintenance haemodialysis (MHD) and to investigate the potential association between CI and physical performance.

Methods

This cross-sectional observational study enrolled participants aged 55–85 years who received MHD. Cognitive status was assessed using the Mini Mental State Examination (MMSE). Physical performance was measured by hand grip strength, the Timed Up and Go Test (TUGT) and the 4-m walking speed. Sociodemographic, clinical and laboratory parameters were recorded for each patient.

Results

The study included 592 patients (363 males); and of these, 126 (21.3%) were diagnosed with CI. Compared with patients with normal cognitive function, those with CI were significantly older and had significantly longer dialysis duration, lower educational level, higher Malnutrition Inflammation Score, higher depression and higher Charlson Comorbidity Index score. After adjustment for covariates, multiple regression analysis suggested that grip strength (odds ratio [OR] = 0.959, 95% confidence interval [CI] = 0.924, 0.996) and 4-m walking speed (OR = 0.161, 95% CI = 0.070, 0.368) were protective factors. TUGT (OR = 1.037, 95%CI = 1.003, 1.071) was a risk factor.

Conclusion

Physical performance was correlated with CI and might be a significant indicator for the early identification of CI in middle-aged to older MHD patients.
Undergraduate Economics Program Enhancements to Increase Doctoral Program Participation by Under-Represented Students
Authors: Mitch David
Published: June 2024

The economics profession as with STEM (Science, Technology, Engineering, and Mathematics) disciplines has recognized that it faces a “pipeline” problem of low numbers of under-represented minorities (URM) completing PhDs. The ancillary described in this article addresses the economics pipeline problem by using strategies modeled after University of Maryland Baltimore County’s (UMBC’s) STEM focused Meyerhoff Scholars program. These strategies include identifying URM students in early stages of their undergraduate careers with the ability and motivation to pursue graduate work, providing information about career opportunities for those completing PhDs, guidance on course selection and on undergraduate research opportunities. UMBC’s Predoctoral Fellows in Economics Program prepares students for successful admission into well-regarded PhD programs by enhancing their likelihood of successful applications to predoctoral programs in economics. URM undergraduates who maintain strong grades in mathematics, statistics, and economics and who engage in productive undergraduate research experiences and produce high-quality research output should find exciting predoctoral, doctoral and career opportunities.
Recommendations to Improve Management of Incidental Pulmonary Nodules in Canada: Expert Panel Consensus
Authors: Digby Geneviève C. , Lam Stephen , Tammemägi Martin C. , Finley Christian , Dennie Carole , Snow Stephanie , Habert Jeffrey , Taylor Jana , Gonzalez Anne V. , Spicer Jonathan , Sahota Jyoti , Guy Danielle , Marino Paola , Manos Daria
Published: June 2024

Introduction: Incidental pulmonary nodules (IPN) are common radiologic findings, yet management of IPNs is inconsistent across Canada. This study aims to improve IPN management based on multidisciplinary expert consensus and provides recommendations to overcome patient and system-level barriers. Methods: A modified Delphi consensus technique was conducted. Multidisciplinary experts with extensive experience in lung nodule management in Canada were recruited to participate in the panel. A survey was administered in 3 rounds, using a 5-point Likert scale to determine the level of agreement (1 = extremely agree, 5 = extremely disagree). Results: Eleven experts agreed to participate in the panel; 10 completed all 3 rounds. Consensus was achieved for 183/217 (84.3%) statements. Panellists agreed that radiology reports should include a standardized summary of findings and follow-up recommendations for all nodule sizes (ie, <6, 6-8, and >8 mm). There was strong consensus regarding the importance of an automated system for patient follow-up and that leadership support for organizational change at the administrative level is of utmost importance in improving IPN management. There was no consensus on the need for standardized national referral pathways, development of new guidelines, or establishing a uniform picture archiving and communication system. Conclusion: Canadian IPN experts agree that improved IPN management should include standardized radiology reporting of IPNs, standardized and automated follow-up of patients with IPNs, guideline adherence and implementation, and leadership support for organizational change. Future research should focus on the implementation and long-term effectiveness of these recommendations in clinical practice.
Implementation of a Pharmacist-Driven Contraception Service at a Safety-Net Health-System
Authors: Sanders Kala L. , Walroth Todd A. , Pence Lauren M. , Brown Michelle E. , Boyd Allison N. , Meredith Ashley H.
Published: June 2024

Background: Access to safe, effective, and appropriate contraception significantly reduces the rates of unintended pregnancies; however, this preventative care is not always easily accessible. There is a high patient demand for contraception visits that is often delayed or unmet due to lack of access to traditional providers. Pharmacists are highly accessible and can help manage this high demand, yet clinical pharmacists as providers of contraception services remains a gap in published literature. Objective: Develop and implement a pharmacist-led contraception service at a safety-net health-system. Methods: A comprehensive pharmacist-led clinical contraception service was created to improve patient access. To support this project, a collaborative practice agreement (CPA) was developed and enhancements were built into an electronic medical record. The CPA allowed the pharmacist to complete contraception-related interventions such as ordering urine pregnancy tests, prescribing hormonal and emergency contraceptives, and manage adverse effects. The piloting pharmacist was available at the Narcotics Treatment Program (NTP) clinic one half-day each week for scheduled and same-day visits. Results: Within the initial five half-day clinic sessions at NTP, the pharmacist had written seven prescriptions, including three for emergency contraceptives. Of all patients seen for this service at NTP, only one had been using a method of contraception consistently prior to their visit. Conclusion: The interventions that were able to be made by the pharmacist highlighted the need for improved access to contraceptives. Pharmacist-managed services in sexual and reproductive health can help fill this gap. Patients also self-reported ease of access as a benefit to this service.
The Phenytoin Ataxia Enigma Unveiled “A Case Report’’
Authors: Khadela Avinash , Dave Bhavarth , Premal Yatvi , Patel Nishi , Sadhwani Devang
Published: June 2024

Background: Phenytoin (PHT) has been approved for the treatment of epilepsy. It belongs to the category of medications with a limited therapeutic window and requires therapeutic drug monitoring (TDM). PTH has been observed to induce a variety of Adverse drug reactions (ADRs) including ataxia, dystonia, nystagmus, dyskinesia, etc. Phenytoin-induced ataxia is an uncommonly observed ADR of Phenytoin whose reports are extremely limited. Case: Herein, we present a case report of a 16-year-old Asian patient with a past history of epilepsy that was admitted to a tertiary care hospital due to the development of ataxia, giddiness, and vomiting when taking Phenytoin in addition to Oxcarbazepine, Clobazam, and Levetiracetam to treat seizures. On admission, Magnetic resonance imaging (MRI) findings revealed bilateral variable cerebrospinal fluid (CSF) lesions in the parieto-occipital region of the periventricular area (periventricular leukomalacia). Additionally, serum Phenytoin levels were observed to be in the toxic range (40 μg/mL) due to which physicians confirmed the ADR to be due to Phenytoin toxicity. Thus, the Phenytoin drug was discontinued in the patient gradually and he was continued on clobazam, oxcarbazepine, and brivaracetam which led to reversal of the ADR in the patient. Conclusion: In this case, ataxia resulted from Phenytoin overdose, as confirmed by MRI and serum tests suggesting that TDM of Phenytoin is essential to prevent ADRs. Given the scarcity of ataxia cases caused by Phenytoin, awareness is lacking within the scientific community. Our aim is to provide insights to promote better monitoring and patient-centered treatment outcomes for epileptic patients.
Effect of Oxy hydrogen (HHO) gas on energy, exergy, and sustainability analysis of a diesel engine fueled with palm oil biodiesel
Authors: Rajpoot Aman Singh , Choudhary Tushar , Chelladurai Hussain Mohamed , Rajak Upendra , Sinha Abhinav Anand
Published: June 2024

Various types of alternative fuels and their additives have undergone extensive investigation to analyze their effects on diesel engine performance. The aim of this study is to comprehensively evaluate the effects on performance and sustainability while employing blends of palm oil biodiesel and diesel, together with the introduction of oxyhydrogen (HHO) gas, in a diesel engine. The objectives include evaluating energy, exergy and sustainability parameters in order to ascertain the effectiveness of certain fuel mixtures. The study examined five different fuel mixtures: PB0, PB10, PB20, PB10HHO and PB20HHO. The HHO gas was injected into the cylinder alongside the air at a flow rate of 0.3 LPM. The primary results indicate significant enhancements in energy and exergy efficiency when HHO gas is used in conjunction with palm oil biodiesel, resulting in gains of up to 1.52% and 1.43%, respectively, compared to using biodiesel blends alone. In addition, the introduction of HHO gas resulted in a drop of up to 4.58% in brake-specific fuel consumption (BSFC). The use of biodiesel blends in conjunction with HHO gas led to a noteworthy decrease of up to 11.4% in carbon dioxide (CO2) and 5.7% in hydrocarbon (HC) emissions. Nevertheless, there was a notable rise of up to 9.56% in nitric oxide (NO) emissions. With the HHO-supplied condition, the combination was shown to have up to a 2.05% better sustainability index. The PB10HHO and PB20HHO blends provide improved performance when compared to pure biodiesel blends and conventional diesel. This study offers a unique approach to increasing diesel engine performance through the synergistic usage of biodiesel blends and HHO gas.
Exploring the effect of bio-silica on the mechanical, microstructural, and corrosion properties of aluminium metal matrix composites
Authors: Periasamy K. , Prathap P. , Arunnath A. , Madhu S.
Published: June 2024

The role of silica in the aluminium alloy is to enhance its mechanical properties. Silica is an eco-friendly material that lowers the melting temperature which in turn enhances the fluidity of alloys. Low-cost synthesis, abundant natural resources, and mass production are other merits of silicon. In this investigation, plant-based bio-silica particles were incorporated in aluminium 7075 hybrid composites. The rice husk is rich in silica, and when it is burned or processed, it turns into ash, known as rice husk ash (RHA). After purification, the silica in RHA can be extracted using alkali fusion. Stir casting processes were used to fabricate hybrid composite material. Aluminium 7075 hybrid composites reinforced with different wt.% (0, 3, 6, and 9) of bio-silica extracted from rice husk were fabricated. Mechanical properties such as tensile, hardness, and impact were evaluated. Also, corrosion resistance was studied for the fabricated composites. The samples with different proportional values such as AlB (Al7075), AlBS1 (97 wt. % Al7075 + 3 wt. % bio-silica), AlBS2 (94% Al7075 + 6 wt. % bio-silica), and AlBS3 (91 wt. % Al7075 + 9 wt. % bio-silica) were fabricated by the stir casting process. Detailed microstructure characterization has been investigated using scanning electron microscopy (SEM). AlBS3 hybrid composites demonstrate a notable enhancement of 303.66 Mpa tensile strength and we observed a remarkable 10% increase in ductility compared to other composites. It was noticed that the sample AlBS3 shows an increased hardness of 162.4 HV and an impact energy of 26.67 kJ/mm2 due to the increased number of bio-silica particles. SEM-based fractography analysis of tensile and impact test specimens revealed the presence of dimples, cleavage facets, and intergranular cracks offering valuable insights into the failure mode.
Utilization and challenges of artificial intelligence in the energy sector
Authors: Park Chankook , Kim Minkyu
Published: June 2024

This study harnesses structural topic modeling and expert surveys to delve into the expanding influence of artificial intelligence (AI) within the energy sector, analyzing around 6000 academic paper abstracts from 2011 to 2020. Our detailed examination identified 100 distinct topics, of which 15, accounting for a combined proportion of 16.4% of the total, were directly related to energy, highlighting key areas such as power consumption, thermal energy management, wind energy evaluation, and building energy management. Furthermore, an expert survey offered deep insights into future changes, spotlighting AI's role in enhancing safety, stability, efficiency, and environmental sustainability of energy systems. It also pinpointed challenges in AI adoption within the sector, proposing pathways to bolster AI reliability, improve data quality, and enhance human–AI collaboration. This comprehensive analysis not only highlights the dynamic role of AI in transforming the energy sector but also sets a foundational framework for future interdisciplinary research, aiming to integrate quantitative and qualitative insights for a holistic understanding of AI's potential in sustainable energy development.
Efficacy of Neonatal Porcine Bone Marrow–Derived Mesenchymal Stem Cell Xenotransplantation for the Therapy of Hind Limb Lymphedema in Mice
Authors: Morita Yuichi , Sakata Naoaki , Nishimura Masuhiro , Kawakami Ryo , Shimizu Masayuki , Yoshimatsu Gumpei , Sawamoto Osamu , Matsumoto Shinichi , Wada Hideichi , Kodama Shohta
Published: June 2024

Lymphedema is an intractable disease with few effective therapeutic options. Autologous mesenchymal stem cell (MSC) transplantation is a promising therapy for this disease. However, its use is limited by the cost and time for preparation. Recently, xenotransplantation of porcine MSCs has emerged as an alternative to autologous MSC transplantation. In this study, we aimed to clarify the usefulness of neonatal porcine bone marrow–derived MSC (NpBM-MSC) xenotransplantation for the treatment of lymphedema. One million NpBM-MSCs were xenotransplanted into the hind limbs of mice with severe lymphedema (MSC transplantation group). The therapeutic effects were assessed by measuring the femoral circumference, the volume of the hind limb, the number and diameter of lymphatic vessels in the hind limb, and lymphatic flow using a near-infrared fluorescence (NIRF) imaging system. We compared the effects using mice with lymphedema that did not undergo NpBM-MSC transplantation (negative control group). The condition of the transplanted NpBM-MSCs was also evaluated histologically. The femoral circumference and volume of the hind limb had been normalized by postoperative day (POD) 14 in the MSC transplantation group, but not in the negative control group ( P = 0.041). NIRF imaging revealed that lymphatic flow had recovered in the MSC transplantation group by POD 14, as shown by an increase in luminance in the hind limb. Histological assessment also showed that the xenotransplantation of NpBM-MSC increased the proliferation of lymphatic vessels, but they had been rejected by POD 14. The xenotransplantation of NpBM-MSCs is an effective treatment for lymphedema, and this is mediated through the promotion of lymphangiogenesis.
Dear England: A critical discourse analysis of how sports stars and politicians battle for legitimacy in debates around athlete activism
Authors: McGlynn Kathryn , Tacon Richard
Published: June 2024

This article looks at how high-profile individual and collective actors within the worlds of sport and politics seek to advance their views on significant social issues. It focuses on the public debate around the anti-racist actions taken by the England men's football team at Euro 2020 and uses a form of critical discourse analysis to look at how the England manager and players, on one side, and members of the UK Government, on the other, sought to gain and maintain legitimacy for their opposing positions. It also seeks to understand legitimacy as a relational process, by looking at how members of the public and national newspapers responded. Drawing on Strittmatter et al.'s framework of legitimacy, the article examines the subjects, sources, strategies, bases and scenarios of each side's efforts. The article seeks to contribute to a more detailed understanding of political discourse and legitimacy in the context of sport, as well as offering some critical reflections on the nexus of sport and politics.
Implementing Practices Within an Integrated Multi-Tiered System of Support: Introduction to the Special Series
Authors: Simonsen Brandi , Coyne Mike , Goodman Steve
Published: June 2024

This overview article introduces the special series focused on implementing practices within an integrated multi-tiered system of support (I-MTSS) framework. The I-MTSS Research Network defines I-MTSS as “a comprehensive and equitable prevention framework for improving the outcomes of all students, including students with or at-risk for disabilities, through integrated academic and behavioral support.” In this special series, members of the I-MTSS Research Network Each descirbe a different component of I-MTSS: (a) integrating evidence-based practices in Tier 1, (b) integrating evidence-based practices in Tier 2, (c) integrating evidence-based practices in Tier 3, (d) providing professional development to support effective implementation, and (e) practical applications of I-MTSS in elementary settings. Across articles, demonstrate that integrating academic and behavior support within an I-MTSS framework can be feasible and effective with the right supports in place.
Cleft lip Sidedness and the Association with Additional Congenital Malformations
Authors: Fell Matthew , Fitzsimons Kate J. , Hamilton Mark J. , Medina Jibby , Butterworth Sophie , Park Min Hae , Van der Meulen Jan , Lewis Sarah , Chong David , Russell Craig JH
Published: June 2024

Objective

To investigate the association between the sidedness of orofacial clefts and additional congenital malformations.

Design

Linkage of a national registry of cleft births to national administrative data of hospital admissions

Setting

National Health Service, England

Participants

2007 children born with cleft lip ± alveolus (CL ± A) and 2724 with cleft lip and palate (CLP) born between 2000 and 2012.

Main outcome measure

The proportion of children with ICD-10 codes for additional congenital malformations by the sidedness (left, right or bilateral) of orofacial clefts.

Results

For CL ± A phenotypes, there was no evidence for a difference in the prevalence of additional anomalies between left (22%, reference), right (22%, aOR 1.02, 95% CI 0.80 to 1.28; P = .90) and bilateral clefts (23%, aOR 1.09, 95% CI 0.75 to 1.57; P = .66). For CLP phenotypes, there was evidence of a lower prevalence of additional malformations in left (23%, reference) compared to right (32%, aOR 1.54, 95% CI 1.25 to 1.91; P < .001) and bilateral clefts (33%, aOR 1.64, 95% CI 1.35 to 1.99; P < .001).

Conclusions

The prevalence of additional congenital malformations was similar across sidedness subtypes with CL ± A phenotypes but was different for sidedness subtypes within CLP cases. These data support the hypothesis that CL ± A has a different underlying aetiology from CLP and that within the CLP phenotype, right sided CLP may lie closer in aetiology to bilateral CLP than it does to left sided CLP.
Understanding the Quality of Life Among Patients With Cancer in Saudi Arabia: Insights From a Cross-Sectional Study
Authors: Aljawadi Mohammad H. , Alkhudair Nora , Alrasheed Marwan , Alsuhaibani Abdulaziz S. , Alotaibi Basil J. , Almuqbil Mansour , Alhammad Abdullah M. , Arafah Azhar , AlGahtani Farjah H. , Rehman Muneeb U.
Published: June 2024

Introduction

Cancer patients’ quality of life (QoL) significantly influences treatment response and mortality rates. Understanding QoL domains among patients with cancer and what affects it can help create interventions that improve QoL and ease patients’ experience. This study measures the OoL among patients with cancer and influencing factors.

Methods

A prospective cross-sectional questionnaire-based study included cancer patients aged >18 currently receiving treatment. The questionnaire collected social and economic data, followed by the validated Arabic version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ-C30). Means and standard deviations for described numeric variables and frequencies and percentages described categorical variables. Analysis of variance, F-tests, and P-values were reported.

Results

Among 182 cancer patients, 60% were female. Younger patients exhibited higher QoL in physical and role functioning ( P = .016 and .03) and experienced more significant financial impact ( P = .0144). Females reported more adverse effects from cancer symptoms, including fatigue, nausea, vomiting, and pain (36.7% vs 25.5%, P = .005; 20.6% vs 11.5%, P = .0186; 34.7% vs 25.1%, P = .0281). Single patients had superior QoL in physical functioning compared to others ( P = .0127). Patients traveling long distances were more likely to face adverse financial consequences ( P = .007). Asthmatic patients exhibited lower QoL in physical, role, and cognitive functioning (72.3 vs 37.8, P = .0147; 76.4 vs 22.2, P = .0024; 84.7 vs 44.4, P = .0038) and reported increased dyspnea and appetite loss (16 vs 55.6 and 26.1 vs 66.7, both P < .05).

Conclusion

Factors influencing QoL in Saudi cancer patients include age, marital status, gender, hospital distance, and chronic conditions. Thus emphasizing the necessity for personalized care strategies to enhance outcomes and alleviate the overall burden of cancer care.
Efficacy and Safety of Rivaroxaban Versus Enoxaparin in Prevention of Recurrence of Venous Thrombo-Embolism Events in Cancer Patients: A Meta-Analysis
Authors: Awan Abdul Rafeh , Ahmad Abdullah , Daniyal Muhammad , Khan Malik Muhammad Hamza , Saeed Shaikh Jehanzaib , Siddiqui Muhammad Bilal , Hakeem Sheraz , Shahab Azka , Ali Syed Hasham , Siddiqi Ahmed Kamal
Published: June 2024

Objective

To examine the effectiveness of rivaroxaban compared to enoxaparin in patients diagnosed with cancer and venous thromboembolism.

Methods

A search of Pub Med, Scopus, and Google Scholar, from inception through April 2023 was conducted. Articles comparing rivaroxaban with enoxaparin in patients with cancer and VTE/PE/DVT were included. Review Manager Version 5.2 was utilised for the analysis of the following outcomes; VTE, PE, DVT, major bleeding, and mortality.

Results

A total of 8 articles and 2276 patients were included in the final analysis. Pooled analysis showed that rivaroxaban had a statistically insignificant reduced association with VTE occurrence (RR:0.83, 95% CI:0.58–1.18, P:0.3) as well as a statically insignificant reduction in major bleeding (RR:0.79, 95% CI:0.53–1.18, P:0.25). Analysis showcased that there was an insignificant reduction of mortality rivaroxaban as compared to enoxaparin (RR:0.74, 95% CI: 0.46–1.20, P:0.23).

Conclusion

Rivaroxaban can serve as a viable alternative to enoxaparin, with no appreciable drawbacks, for preventing and managing VTE in patients with malignancy.
A Practical Nomogram for Predicting the Bleeding Risk in Patients with a History of Myocardial Infarction Treating with Aspirin
Authors: Jing Jin , Wanling Lei , Maofeng Wang
Published: June 2024

Background

Aspirin is a widely used antiplatelet medication to prevent blood clots, reducing the risk of cardiovascular event. Healthcare providers need to be mindful of the risk of aspirin-induced bleeding and carefully balancing its benefits against potential risks. The objective of this study was to create a practical nomogram for predicting bleeding risk in patients with a history of myocardial infarction treating with aspirin.

Methods

A total of 2099 myocardial infarction patients with aspirin were enrolled. The patients were randomly divided into two groups, with a 7:3 ratio, for model development and internal validation. Boruta analysis was utilized to identify clinically significant features associated with bleeding. Logistic regression model based on independent bleeding risk factors was constructed and presented as a nomogram. Model performance was assessed from three aspects: identiﬁcation, calibration, and clinical utility.

Results

Boruta analysis identified eight clinical features from 25, and further multivariate logistic regression analysis selected four independent risk factors: hemoglobin, platelet count, previous bleeding, and sex. A visual nomogram was created based on these variables. The model achieved an area under the curve of 0.888 (95% CI: 0.845-0.931) in the training dataset and 0.888 (95% CI: 0.808-0.968) in the test dataset. Calibration curve analysis showed close approximation to the ideal curve. Decision curve analysis demonstrated favorable clinical net benefit for the model.

Conclusions

Our study focused on creating and validating a model to evaluate bleeding risk in patients with a history of myocardial infarction treated with aspirin, which demonstrated outstanding performance in discrimination, calibration, and net clinical benefit.
Semi-active yaw dampers in locomotive running gear: New control algorithms and verification of their stabilising effect
Authors: Jeniš Filip , Michálek Tomáš , Kubík Michal , Hába Aleš , Strecker Zbyněk , Žáček Jiří , Mazůrek Ivan
Published: June 2024

It is generally accepted that semi-actively (S/A) controlled dampers can significantly improve the behaviour of a road or rail vehicle. In the case of a railway vehicle, it is possible to increase comfort using S/A control of vertical or lateral secondary dampers. On another way, S/A control offers the possibility of solving a contradiction in the damping requirements for different driving modes, in the case of control of bogie yaw dampers. However, this case has not yet been sufficiently investigated. This paper deals with applying magnetorheological dampers with semi-active control in the locomotive bogie to reduce hunting oscillation. The magnetorheological bogie yaw damper design, new algorithms for its control and application on a complex multi-body locomotive model that simulates fast running on a real straight track are shown. An essential part of the paper focuses on the effect of the damping force level and damper force transient response time. The results have shown that using the semi-active control of the yaw dampers makes it possible to reduce vehicle body lateral oscillation by 60% and improve running stability for higher equivalent conicity and subcritical speed. The critical speed can be increased by more than 250 km/h. The efficiency of the proposed semi-active control increases with increasing damping force level and decreasing transient response time. The control is most effective under conditions of low equivalent conicity.
Direct solutions for robust vibration suppression through motion design
Authors: Boscariol Paolo , Richiedei Dario , Trevisani Alberto
Published: June 2024

Motion planning is an effective tool for the suppression of residual oscillation in underactuated mechanical systems, and in particular, model-based method can be used to virtually eliminate any unwanted oscillation after the completion of a motion task. Here, a novel motion planning method, aimed at maximizing robustness to model uncertainties and based on a direct formulation, is proposed and tested. The choice of a direct formulation is aimed at overcoming the numerical problems often encountered when dealing with indirect trajectory planning methods, including the limited robustness to any model-plant mismatch. The proposed direct method is based on three different motion profiles, and is tested for the rest-to-rest motion of a slender beam, with and without parametric robustness constraints, but the same framework can be adapted to countless other situations and formulations. The experimental results showcase good accuracy and a sensible improvement in mitigating the effects of unmodeled perturbations on the system sported by the proposed robustified method over its non-robust counterpart. Experimental results show also the outcome is very similar to the one resulting from a more numerically challenging solution formulated as an indirect problem by means of a two-point boundary value problem.
Predictive modeling of mortality in carbapenem-resistant Acinetobacter baumannii bloodstream infections using machine learning
Authors: Özdede Murat , Zarakolu Pınar , Metan Gökhan , Köseoğlu Eser Özgen , Selimova Cemile , Kızılkaya Canan , Elmalı Ferhan , Akova Murat
Published: June 2024

Acinetobacter baumannii, a notable drug-resistant bacterium, often induces severe infections in healthcare settings, prompting a deeper exploration of treatment alternatives due to escalating carbapenem resistance. This study meticulously examined clinical, microbiological, and molecular aspects related to in-hospital mortality in patients with carbapenem-resistant A. baumannii (CRAB) bloodstream infections (BSIs). From 292 isolates, 153 cases were scrutinized, reidentified through matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF-MS), and evaluated for antimicrobial susceptibility and carbapenemase genes via multiplex polymerase chain reaction (PCR). Utilizing supervised machine learning, the study constructed models to predict 14- and 30-day mortality rates, revealing the Naïve Bayes model’s superior specificity (0.75) and area under the curve (0.822) for 14-day mortality, and the Random Forest model’s impressive recall (0.85) for 30-day mortality. These models delineated eight and nine significant features for 14- and 30-day mortality predictions, respectively, with “septic shock” as a pivotal variable. Additional variables such as neutropenia with neutropenic days prior to sepsis, mechanical ventilator support, chronic kidney disease, and heart failure were also identified as ranking features. However, empirical antibiotic therapy appropriateness and specific microbiological data had minimal predictive efficacy. This research offers foundational data for assessing mortality risks associated with CRAB BSI and underscores the importance of stringent infection control practices in the wake of the scarcity of new effective antibiotics against resistant strains. The advanced models and insights generated in this study serve as significant resources for managing the repercussions of A. baumannii infections, contributing substantially to the clinical understanding and management of such infections in healthcare environments.
Epidemiology, diagnosis, and management of cardiac amyloidosis
Authors: Bashir Zubair , Younus Adnan , Dhillon Saud , Kasi Amail , Bukhari Syed
Published: June 2024

Cardiac amyloidosis (CA) is an infiltrative restrictive cardiomyopathy caused by the deposition of amyloid fibrils in the myocardium. It manifests in two primary subtypes: transthyretin cardiac amyloidosis (ATTR) and immunoglobulin light chain cardiac amyloidosis (AL). ATTR is further classified into wild-type and hereditary based on transthyretin gene mutation. Advances in diagnostics and therapeutics have transformed CA from a rare and untreatable condition to a more prevalent and manageable disease. Noninvasive diagnostic tools such as electrocardiography, echocardiography, and cardiac magnetic resonance can raise suspicion for CA; bone scintigraphy can non-invasively confirm ATTR, while AL necessitates histological confirmation. The severity of ATTR and AL can be assessed through serum biomarker-based staging. Treatment approaches differ, ranging from silencing or stabilizing transthyretin and degrading amyloid fibrils in ATTR to employing anti-plasma cell therapies and autologous stem cell transplantation in AL.
Safety and effectivity of endoscopic ultrasound with bronchoscope-guided fine-needle aspiration in elderly patients
Authors: Doğan Deniz , Doğan Derya , Taşçı Cantürk
Published: June 2024

Endobronchial ultrasound (EBUS)-guided transbronchial needle aspiration (TBNA) is a well-established technique for assessing lesions near the central airway. While EBUS is typically used via the airway, the esophageal approach known as endoscopic ultrasound with bronchoscope-guided fine needle aspiration (EUS-B-FNA) has gained popularity for evaluating previously inaccessible lesions. This study aimed to assess the safety and diagnostic contribution of EUS-B-FNA in elderly patients. This retrospective study included elderly patients (≥65 years) who underwent EUS-B-FNA with concurrent convex probe-EBUS (C-EBUS) between June 2019 and December 2022. Inclusion criteria were age >64, having chest computed tomography (CT) or FDG-PET/CT, and undergoing C-EBUS, with the exclusion of patients with prior malignancy diagnoses and undergoing EBUS-TBNA. Among 68 patients who underwent combined EBUS and EUS-B-FNA, 31 met the inclusion criteria. The mean age was 71.7 years and 74.2% were male. All EUS-B-FNA material provided adequate material for histopathological analysis. Among patients, 67.7% received a malignancy diagnosis. Samples were obtained from mass lesions (58.1%) and lymph nodes (41.9%), primarily from the subcarinal (station 7) and left paratracheal (station 4L) regions. The mean number of needle passes was 2.83, with an average procedure duration of 9.4 min. No significant complications occurred. EUS-B-FNA is a safe and effective diagnostic method in elderly patients, offering an alternative when the transbronchial approach is not feasible. This underscores the importance of bronchoscopists’ training in the transesophageal approach via EBUS scope.