bluuebunny/crossref_metadata_2025 huggingface dataset:
Metanalysis of Controlled Studies Comparing Biologic and Synthetic Unabsorbable Mesh in Contaminated Fields
Authors: CARVALHO ALVARO COTA , GARCIA DIEGO PAIM DE CARVALHO
Published: January 2024

In 2019, approximately U$9.7 billion were invested in abdominal wall surgery in the United States. Additionally, opting for a biological mesh can increase the cost by more than $8,000 per surgery when compared to a polypropylene mesh. Knowing that, we conducted a meta-analysis evaluating controlled studies comparing biological and synthetic unabsorbable implanted on contaminated environments, with the primary outcome being Surgical Site Infection (SSI) and assessing other outcomes such as hernia recurrence, rehospitalization or reoperation, mesh removal, and hospitalization length of stay. Our systematic search was conducted on PubMed, EMBASE, and Cochrane in accordance with the PRSIMA guidelines, searching for controlled studies comparing the use of biologic mesh against synthetic polypropylene mesh in patients with Center of Disease Control infected site classification (CDC) class II or higher. We found 1036 studies, 20 were selected for full text review and 9 were included of comparative analysis of outcomes. Our analysis indicated a higher risk of SSI development in patients with biological mesh compared to synthetic mesh (P < 0.00001) and higher risk of hernia recurrence (P < 0.0001). Also, we did not observe apparently benefit for the biological mesh group in terms of reoperation (P = 0.54) or mesh removal (P = 0.92). Patients that were submitted to biological mesh implant had higher hospital length of stay (P = 0.004) and higher occurrence of intrabdominal infection (P = 0.05). Hence, we did not observe superiority in the use of biological mesh in contaminated environments concerning key post-operative complications. Moreover, the use of synthetic polypropylene mesh reduces the incidence of hernia recurrence with a lower risk SSI.
Assessing socio-cultural barriers related to induced abortion and reproductive health among married women in Rural Uttar Pradesh, India
Authors: Tomar Pratibha , Pathak Praveen Kumar , Bhakuni Kalpana
Published: January 2024

In the Global South, a disproportionate number of young married women who have unwanted and mistimed pregnancies, undergo unsafe abortion practices, leading to a heightened burden of maternal and infant deaths in developing countries. Unsafe abortion practices are frequently associated with limited contraceptive methods with a skewed focus on female sterilisation, a high unmet need for contraception, poor quality of sexual and reproductive health care services, low male involvement in reproductive health matters, and widespread gender discrimination against girls and women, which limit their access to quality health care services. The present qualitative study attempts to examine the practice of induce abortion at the village as well as assess the socio-structural barriers lead to the poor sexual and reproductive health in rural Uttar Pradesh, India. The study underlines the lived experience and process of decision-making related to induced abortion, and the intertwined family, social and healthcare-associated challenges faced by young married women in rural Uttar Pradesh, India. Evidence from the study suggests that inability to use safe contraception methods, unsupportive behaviour of the spouse towards childcare, financial hardship, lack of accessibility and affordability of contraception methods, lesser decision-making power, and social norms and customs appeared to pose critical barriers to safe abortion practices among young married women. Findings from the study also highlight an abysmal dearth of access to safe, affordable and quality abortion care services in rural Uttar Pradesh. The study emphasized individual and community-level perspectives on young married women’s or married couples’ decisions regarding induced abortion in rural Uttar Pradesh, besides highlighting various forms of social stigma, discrimination and health-related complications faced by them. This calls for program managers and policy makers to increase investments in high-quality comprehensive sexual and reproductive health services, and to revitalize efforts for greater male involvement in reproductive health matters, so as to ensure safe pregnancy and child health experiences in the Indian context.
Improved Differentiation of Cavernous Malformation and Acute Intraparenchymal Hemorrhage on CT Using an AI Algorithm
Authors: Kim Jung Youn , Choi Hye Jeong , Kim Sang Heum , Ju Hwangseon
Published: January 2024

This study aimed to evaluate the utility of an artificial intelligence (AI) algorithm in differentiating between cerebral cavernous malformation (CCM) and acute intraparenchymal hemorrhage (AIH) on brain computed tomography (CT).
A retrospective, multireader, randomized study was conducted to validate the performance of an AI algorithm (SK Inc. C&C Medical Insight+ Brain Hemorrhage) in differentiating AIH from CCM on brain CT. CT images of CM and AIH (< 3cm) were identified from the database. Six blinded reviewers, including two neuroradiologists, two radiology residents, and two emergency department physicians, evaluated CT images from 288 patients (CCM, n = 173; AIH, n = 115) with and without AI assistance, comparing diagnostic performance.
Brain CT interpretation with AI assistance resulted in significantly higher diagnostic accuracy than without (86.92% vs. 79.86%, p < 0.001). Radiology residents and emergency department physicians showed significantly improved accuracy of CT interpretation with AI assistance than without (84.21% vs 75.35%, 80.73% vs. 72.57%; respectively, p < 0.05). Neuroradiologists showed a trend of higher accuracy with AI assistance in the interpretation but lacked statistical significance (95.83% vs. 91.67%).
The use of an AI algorithm can enhance the differentiation of AIH from CCM in brain CT interpretation, particularly for nonexperts in neuroradiology.
The Effect of Sleep on the Association Between Built Environment and Good Health Status
Authors: Seo Bojung , Nan Hongmei , Monahan Patrick O , Duszynski Thomas J. , Thompson Walter R. , Zollinger Terrell W. , Han Jiali
Published: January 2024

Introduction:
Sleep quantity of city residents and environmental assets that support physical activity may jointly improve residents’ general health. Sufficient sleep also may mediate the effect of activity-related environmental factors on the general health. However, evidence regarding such associations is lacking. Thus, we aimed to investigate the moderating and mediating effects of sleep duration of residents on the association between environmental factors and general health status of city residents.
Methods
Our panel study used 2018/2019, 2021 to 2022 American Fitness Index® data for the 100 most populated US cities. Study outcome was good health status and exposures were environmental factors – percent of parks within a 10-minute walk, Walk Score®, Bike Score®, Complete Streets policy. Sleeping 7 + hours/day was used as a potential mediator or moderator. For analyses, we adopted crude and multivariable-adjusted linear mixed models.
Results
Our findings showed that most large cities whose residents slept longer had better baseline health and improvement in the general health status of their residents over time. Sufficient daily sleep showed a moderating effect on the association between environmental indicators and general health status. In the cities with higher percent of sufficient daily sleep, the magnitudes of the positive associations were increased, implying synergistic interactions between sufficient daily sleep and better environmental factors on good health status. However, no mediating effect of sufficient daily sleep was observed on the association between environmental indicators and good health status.
Conclusion
Our findings suggested a synergistic interaction effect between sufficient daily sleep and physical activity-related environmental factors on good health status. However, sleep duration was not found to be a mediator of the association between environmental indicators and good health status.
Do different vegetation types in green spaces affect human health? A comparison of summer and winter data
Authors: Duan Yifan , Bai Hua , yang Le , Li Shuhua
Published: January 2024

Based on the perceptions of participants in winter and summer, the effects of different vegetation structures within landscapes (single-layer woodland, tree-shrub-grass composite woodlands, tree-grass composite woodland, and single-layer grassland) and concrete squares without plants were investigated, and the skin conductivity level (SCL) and environmental perception recovery score (PRS) associated with landscape types were calculated. The results indicated that: (1) The seasonal differences in landscape perception significantly affected participants' PRS but had no effect on their SCL scores; (2) Viewing and experiencing single-layer and tree-shrub-grass composite woodlands in summer and single-layer woodland in winter improved participants' environmental perceptions; (3) The restorative effects of the four plant communities (and concrete squares without plants) were ranked in the following order: single-layer woodland > tree-shrub-grass composite woodlands > single-layer grassland > tree-grass composite woodland and concrete squares without plants. These results indicate that seasonal experiences in the natural environment cannot be substituted for each other. Therefore, it is recommended that specific plant species be chosen carefully for landscapes based on seasonal differences. Evergreen single-layer woodland vegetation types should be considered for use in winter urban landscapes. These results provide a scientific basis for future evaluations of landscape perception and preferences.
Geotechnical Behavior of Soil-electric Arc Furnace Slag Mixtures Under Carbonation
Authors: RODRIGUES KLAUS , Silva Taciano da , Pitanga Heraldo , Rodrigues Mateus , Pedroti Leonardo
Published: January 2024

Although the treatment of soils with lime-based materials is used in many earthworks projects, there are only a few studies that deal with the quantification of their carbonation.The objective of this work was to investigate the influence of carbonation in mixtures between two samples of tropical soils and Electric Arc Furnace Slag (EAFS) in terms of Unconfined Compressive Strength (UCS), mini-CBR index, mini-CBR expansion, and Resilient Modulus (RM) properties. Four types of curing were used: (1) conventional sealed curing in a humid chamber; (2) conventional sealed curing in a humid chamber followed by unsealed curing with exposure to air; (3) conventional sealed curing in a humid chamber followed by unsealed curing in an accelerated carbonation chamber. In addition, tests were performed to determine the carbonation depth by spraying phenolphthalein, pH, scanning electron microscopy (SEM), and X-ray diffraction (XRD). It was found that the results of the soil-EAFS were better than those of the soil samples not stabilized for all the curing processes analyzed. In the curing processes (1), the formation of calcium aluminum silicate hydrate structures (CASH) was found to improve the mechanical behavior of soil-EAFS mixtures. The formation of calcium carbonate (CaCO3) was observed in curing processes (2) and (3), which significantly improved the mechanical properties. Thus, the carbonation process increases the strength and stiffness of the soil-EAFS mixtures, which guarantees the durability of these mixtures over the years.
Enhancing Gain and Isolation of a Quad-Element MIMO Antenna Array Design for 5G Sub-6 GHz Applications Assisted with Characteristic Mode Analysis
Authors: Khan Rabia , Sethi Waleed Tariq , Malik Waqar Ahmad , Jan Latif , Tehseen M.Mustafa , Almuhlafi Ali , Himdi Mohamed
Published: January 2024

This paper presents a novel quad-element array with multiple inputs and multiple outputs (MIMO) designed for 5th generation sub-6 GHz applications. The MIMO system achieves a wide impedance bandwidth, high gain, and high isolation among its components, representing significant advancements in sub-6 GHz antenna applications. The radiating element, an elliptical resonator with a circular slot, is fed by a 50 Ω, achieves a broad characteristic bandwidth from 3.7 to 5.7 GHz with a gain of 1.81 dBi. Characteristic Mode Analysis (CMA) was employed to elucidate the evolution phases of this design. The quad-element MIMO antenna array maintains a compact size and broadband characteristics by arranging mirrored elements on the same ground plane. Implemented on a cost-effective FR-4 substrate measuring 44 × 44 x 1.6 mm3, the recommended MIMO antenna array, enhanced with a partial ground plane having a vertical strip, yields a realized gain of 3.01 dBi and a radiation efficiency of 71% in the 5G sub-6 GHz band. Noteworthy properties include high isolation, diversity gain (DG), and envelope correlation coefficient (ECC), verifying the appropriateness of the suggested MIMO scheme for 5G transmission and reception in sub-6 GHz applications.
Quantitative assessment of soil acidification in four Chinese forests affected by nitrogen deposition
Authors: Fujii Kazumichi , Zheng Jinsen , Zhou Zhang , Fang Yunting
Published: January 2024

Aims Nitrogen (N) deposition increases risks of accelerating soil acidification, but its impact could vary depending on acid-neutralizing capacity (ANC) and clay mineralogy. We analyzed effects of N deposition on acidification in four forest soils that differed in parent materials.
Methods We developed the method for assessing contribution of external proton input, N transformation, and plant uptake to soil acidification quantitatively in forest soils derived from loess (Qipanshan in Shenyang Liaoning), sandstone (Dinghushan in Zhaoqing Guangdong), granite, and basalt (Jianfengling in Hainan). We further estimated the acidity required for soil pH decreases using ANC (sum of cations) to predict soil pH change in forests affected by N deposition.
Results N deposition contributed 30%, 45%, and 4% of the total proton generation through nitrification in the Qipanshan, Dinghushan, and Jianfengling soils, respectively. Heavy N deposition (50 kg N ha-1 yr-1) also increased acidification through net cation accumulation in growing plant biomass (3.0 kmolc ha−1 yr−1) in Dinghushan, where soil pH decreased by 1 unit in 30 years. Acidity could account for 56% of exchangeable Al accumulation (268 kmolc ha−1), but not for depletion of ANC or total base reserves in the Dinghushan soil. Proton generation associated with N deposition was smaller for the depletion of ANC or total base reserves required for soil pH decrease in Qipanshan and Jianfengling.
Conclusion We found quantitatively that acidification progressed through increased nitrification and plant productivity in the forest soil due to chronic N deposition and low ANC and basic cation reserves derived from sandstone.
Cobalt-Catalyzed Cross-Electrophile Coupling of Alkynyl Sulfides with Unactivated Chlorosilanes
Authors: Huang Liangbin , Xing Donghui , Liu Jinlin , Cai Dingxin , Huang Bin , Jiang Huanfeng
Published: January 2024

Herein, we disclose a highly efficient cobalt-catalyzed cross-electrophile alkynylation of a broad range of unactivated chlorosilanes with alkynyl sulfides. Strategically, employing stable and easily synthesized alkynyl sulfides as alkynyl precursors allows access to various alkynylsilanes in good to excellent yields. Notably, this method avoids the utilization of strong bases, noble metal catalysts, high temperature and forcing reaction conditions, thus presents apparent advantages, such as broad substrate scope (72 examples, up to 97% yield), high Csp-S chemo-selectivity and excellent functional group compatibility (Ar-X, X = Cl, Br, I, OTf, OTs). Moreover, the utilities of this method are also illustrated by downstream transformations and late-stage modification of structurally complex natural products and pharmaceuticals. Mechanistic studies elucidated that the cobalt catalyst initially reacted with alkynyl sulfides, and the activation of chlorosilanes occurred via an SN2 process instead of a radical pathway.
Nursing Doctoral Students’ Experiences of the Courses and Comprehensive Examinations in China: A Mixed-Methods Study
Authors: Liu Kehan , Huang Chongmei , Wang Honghong , Tang Siyuan , Liu Minhui
Published: January 2024

Background
Understanding the experiences of doctoral students regarding courses and comprehensive examinations is crucial to enhance the quality of doctoral programs. Scarce information is available on the experiences of nursing doctoral students on the courses and comprehensive examinations in China. The purpose of this study was to understand the nursing doctoral students’ experiences on courses and comprehensive examinations of the doctoral program at Xiangya School of Nursing, Central South University, and propose improvements.
Design:
A convergent parallel mixed methods design adhering to EQUATOR guidelines for Good Reporting of a Mixed Methods Study.
Methods
A total of 20 doctoral students were recruited through purposive sampling in September 2022 from the Xiangya School of Nursing, Central South University. They completed the self-designed questionnaire on demographic data, course, and comprehensive examination evaluations and participated in focus groups. Quantitative data were analyzed using descriptive statistics. Qualitative data were recorded and transcribed for content analysis.
Results
Regarding course experience, doctoral students preferred in-person lectures (80%) and group discussions (60%) for specialized compulsory courses. They were satisfied with the course novelty (85%), difficulty (75%), and practicality (85%), and half of the students found the credit allocation reasonable. The qualitative findings revealed their preference for appropriate and mixed teaching methods, more interdisciplinary courses, statistics, and inter-school collaborative courses, accessible Nursing Philosophy and Theory courses, and higher proportion of compulsory course credits. Regarding comprehensive examination experience, only 20% considered it necessary, and qualitative data revealed that they prefer more distinctive and effective contents; moreover, students were confused about the purpose of comprehensive examinations. The triangulation of quantitative and qualitative data demonstrated relative convergence.
Conclusions
These findings illustrated nursing doctoral students' experiences on courses and comprehensive examinations and provide suggestions on improving the courses and comprehensive examinations in China and possibly in the world. This study contributes to improving the quality of nursing doctoral programs in China and can serve as valuable guidance for nursing doctoral programs with similar educational environment around the world that are undergoing course and comprehensive examination reform.
Law of overburden and surface deformation in roof cutting and backfilling mining under thin bedrock in shallow buried coal seam
Authors: Yang Weifeng , Huang Yousheng , Meng Henglei , Xia Xiaohong
Published: January 2024

Under the special geological conditions of shallow buried coal seams and thin bedrock, the caving method of coal mining can cause irreversible damage to the ecological environment such as the aquifer structure, surface subsidence, and ground fissures of the mine. However, the traditional backfill mining has problems such as insufficient material, low efficiency, and high cost. The paper focuses on the new ideas of roof cutting and backfilling mining treatment, taking Jinjie Mine as the research background, through theoretical analysis, similarity model experiments and numerical simulation, the laws of overburden failure and surface movement and deformation under shallow buried and thin bedrock geological conditions were studied when using roof cutting and backfilling mining method. The comparative study with the fully mechanized caving mining method shows that the use of roof cutting and backfilling method can suppress the development of fractures and achieve the effect of reducing subsidence. Before releasing the constraint of the filling gangue column, the maximum direct roof subsidence of the coal seam reached 375 mm, and the maximum surface subsidence value reached 263 mm. After releasing the constraint, the maximum direct roof subsidence of the coal seam reached 541 mm, and the maximum surface subsidence value reached 403 mm, which is much smaller than the subsidence value of 2804 mm in the caving mining method. A visual simulation study was conducted on the whole backfilling mining using numerical simulation software, which confirmed the conclusion of similar model experiments that the roof cutting and backfilling mining method can effectively control the overburden failure and surface subsidence.
Investigating executive function disparities in mice with PD utilizing the 5-CSRT paradigm
Authors: Gu Heng , Liao Zihan , Zhou Zihang , Liu Zhiyaun , Gu Mengying , Liang Xinyu , Pan Hong , Tang Chuanxi
Published: January 2024

This study is centered on the evaluation of executive functions (EFs) in a Parkinson's disease (PD) mouse model using the 5-Choice Serial Reaction Time Task (5-CSRT), with a specific focus on investigating the potential impact of lyso-phosphatidylcholine (LPC) on executive dysfunction in the pathogenesis of PD. The overarching goal is to establish a comprehensive framework and baseline for touch screen behavior analysis in PD model mice.The research encompassed the utilization of SNCA*A53T transgenic mice and C57BL/6J wild-type mice. A rigorous assessment of the motor ability and primary cognitive function of A53T mice was conducted to validate the qualification of the A53T-PD mouse model. Baseline performance metrics for touch screen behavioral experiments were meticulously explored through 5-CSRT for each cohort of mice. Furthermore, key indicators reflective of executive dysfunction in PD mice were meticulously evaluated using principal components analysis (PCA) and receiver operating characteristic (ROC) curve analysis.The findings of this study unveiled heightened α-syn expression and diminished tyrosine hydroxylase (TH) expression in the midbrain of A53T mice, signaling motor and primary cognitive dysfunction within the PD model. Notably, the 5-CSRT analysis divulged decreased accuracy and trace number, alongside an escalation in the number of punishments within the A53T group in comparison to the Control group. Moreover, the LPC group, MPTP group, and MPTP + LPC group all showcased impaired executive function, with the MPTP + LPC group demonstrating a more pronounced impairment relative to the Control group.In summation, this study established baseline accuracy levels for 5-CSRT in both wild-type and A53T mice, identified pivotal indicators of executive dysfunction, and underscored the potential of 5-CSRT in discerning drug-induced PD models. The implications of these findings suggest that intervention can be effectively administered once the baseline session accuracy reaches 80%. Ultimately, this study offers valuable insights into the evaluation of EFs in PD model mice and sheds light on the potential impact of LPC on executive dysfunction within the context of PD pathogenesis.
α-Fe 2 O 3 Tailored Bi 2 WO 6 Hierarchical Microspheres for the Effective Photocatalytic Degradation of Antibiotic Ciprofloxacin and Cationic Rhodamine B Aqueous Dye
Authors: P Rajkumar , S. Jayanthi T. , R. Suja , Reddy Vasudeva Reddy Minnam , Kim Woo Kyoung , Mohd Afzal
Published: January 2024

α-Fe2O3 tailored Bi2WO6 hierarchical microspheres have been effectively synthesized and well characterized. The photocatalytic efficacy was improved by the Fe-BW-3% heterojunction on the degradation of ciprofloxacin as a pharmaceutical and rhodamine B as a cationic dye pollutant. The increased photocatalytic activity was attributed to the increment of visible light absorbing ability and reduced rate of light-induced electron and hole recombination by moving electrons from one junction to another. The recycle investigations revealed that the catalysts are stable for CIP and RhB degradation after six cycles. Furthermore, scavenging experiments show that holes were the primary active species for the CIP and RhB degradation.
Translation, Cross-Cultural Adaptation and Validation of the Chinese version of Supportive and Palliative Care Indicators tool (SPICT-CH) to Identify Cancer Patients with Palliative Care Needs
Authors: Xie Zhishan , Tang Siyuan , Johnson Claire E , Xiao Lin , Huang Chongmei , Ding Jinfeng
Published: January 2024

Introduction People diagnosed with cancer are the most frequent users of palliative care. However, there are no specific standards for early identifying patients with palliative care needs in mainland China. The Supportive and Palliative Care Indicators tool (SPICT) can identify patients with cancer who are in need of palliative care across healthcare settings.Objective To translate, cross-cultural adapt and validate the SPICT in a Chinese healthcare context.Method We translated and culturally adapted the SPICT from English into Chinese, following both Beaton's and WHO's recommendations: 1) initial translation, 2) synthesis, 3) back translation, 4) expert committee review, and 5) pretest. The psychometric properties (e.g., content validity, internal consistency, and inter-rater reliability) were analyzed. Between January and August 2023, a convenience sample of 212 hospitalized cancer patients was assessed by two nurses within 24 hours to determine the inter-rater reliability and stability of the Chinese version of SPICT (SPICT-CH).Results All items were retained in response to expert review, resulting in a total of 36 items. The Scale-Content Validity Index/Ave (S-CVI/Ave) of the SPICT-CH was 0.98, demonstrating very strong content validity. The SPICT-CH exhibited good coherence (Cronbach’s alpha = 0.76) and reliability (Kappa = 0.71, 95% CI 0.71–0.72, p < 0.05).Conclusion The SPICT-CH has good content validity and acceptable reliability in assessing cancer patients within a Chinese hospital setting. This instrument can be effectively integrated into routine clinical practice to early identify patients who need palliative care in mainland China.
Evaluating Service Life of Metal Processing Machinery: An Intelligent Monitoring Perspective
Authors: Wang Hsiao-Yu , Hung Ching-Hua , Chen Cheng-Hui
Published: January 2024

This investigation addresses a range of critical challenges within the domain of mechanical engineering and anticipates their potential impacts. The study's goals include developing methods for detecting tool breakage in integrated milling-turning machines, evaluating the service life of punching machine components, and determining the durability of molds in forging equipment, alongside other complex issues. The primary aim is to devise a specialized equipment health diagnostic system, designed for complex industrial environments. Industry consultation has revealed that effective monitoring strategies and threshold values must be tailored to the specific characteristics of each piece of equipment and their respective sectors. Despite the metal processing industry lagging roughly a decade behind the semiconductor sector in adopting intelligent monitoring systems, it encounters similar hurdles. These include shrinking labor demographics necessitating increased reliance on shift-based external labor, higher turnover rates impacting the retention of skilled workers for essential tasks such as tool replacements and machinery maintenance. Furthermore, there is a pressing need to maintain traceability for the usage history of molds and punching heads, especially to meet aerospace industry regulations. In response, the sector aims to accomplish two primary goals for its critical production machinery: firstly, to implement diagnostic tools for evaluating the wear and overall quality of tools and molds; secondly, to shift from time-based to condition-based maintenance protocols, adaptable to the frequent mold changes required for varied product fabrication.
Gender-Based Disparities in Clostridium Difficile Infections in the United States: A Population-Based Study
Authors: Butt Muhammad Ali , Khan Tahir , Ali Hassam , Khan Zarak Hassan , Pamarthy Rahul , Shah Aun , Khalaf Mohamed
Published: January 2024

Introduction
Clostridium difficile infection (CDI) is a common hospital-acquired infection that affects older adults, leading to increased morbidity and mortality. While there is a significant body of literature examining socio-economic and ethnic disparities in the treatment of CDI, little is known about gender-based disparities. This study aims to investigate potential gender-based disparities in CDI readmissions.
Methods
The present study used the Nationwide Readmissions Database (2019) to identify principal hospitalizations of adult patients with CDI.
Results
The study included 64,710 index admissions, with 3,436 30-day readmissions (males = 35.2%, females = 65%). Recurrent colitis due to CDI was the most common cause of readmission for males and females (32.1% and 31.8%, respectively), followed by sepsis (20.8% and 21.2%, respectively). Males had higher rates of leaving against medical advice (AMA) (1.6% vs. 1%, P < 0.001) and inpatient mortality (1.3% vs. 1.2%, P < 0.001) for CDI readmissions compared to index admissions. However, there was no significant difference in median hospital stay and charges for both genders. There was a higher frequency of leaving AMA (1.6% vs. 1%, P < 0.001) and inpatient mortality (1.3% vs. 1.2%, P < 0.001) in 30-day readmissions compared to index admissions. In comparison, females only had a higher AMA rate (1.4% vs. 0.8%, P = 0.006) for 30-day readmissions compared to index admissions.
Conclusion
Both genders have a higher AMA rate, but only males have a higher inpatient mortality for CDI readmissions than index admissions. There is no gender-based disparity between stay and hospital charges for CDI readmissions. Our study contributes to understanding CDI's impact on patient outcomes. Healthcare providers should remain aware of these potential disparities to ensure appropriate care for all patients with CDI, regardless of gender.
A Comprehensive Study of Nonlinear Stretching Sheet in Stagnation Point Flow of Casson Fluid: Unveiling New Similarity Transformations
Authors: Sushma Sushma , Gireesha B. J.
Published: January 2024

This paper introduces novel similarity transformations to solve governing equations, addressing a common limitation in prior stretching sheet research. Past studies often employed similarity transformations with the variable η as a function of single independent variable, introducing errors due to overlooking two or more independent variables in the governing equations. Our newly derived transformations rectify this by incorporating all relevant independent variables, enhancing precision by converting differential equations that are partial into ordinary differential equations. This study explores the motion of a Casson fluid close to a point of stagnation along a nonlinearly stretched sheet, focusing on understanding the fluid's behavior in this specific configuration. To solve the modified equations resulting from the intricate interactions of the Casson fluid, a numerical method is developed utilizing shooting technique along with the 4-5th order Runge-Kutta Fehlberg scheme. The findings provide valuable perspectives on the behavior of Casson fluids in these circumstances, highlighting the thorough comprehension facilitated by the improved accuracy of the applied transformations.
Genetic Diversity Analysis and Fingerprinting Construction of the Vanda species (Orchidaceae) Germplasm Resources by inter-primer binding site (iPBS) Marker
Authors: Yin Wen-Yi , Cui Xue-Qiang , Zhao Qiu-Ju , Deng Jie-Ling , Huang Chang-Yan , Zhang Zi-Bin , Li Jia-Wei
Published: January 2024

Plants of the genus Vanda exhibit a diverse array of leaf shapes, with the number of flowers varying from few to many, and a rich palette of colors. These characteristics render them highly valuable for ornamental purposes as tropical orchids. This study employed iPBS molecular markers to analyze the genetic diversity and phylogenetic relationships of 36 species of Vanda and 2 species of Aerides. In addition, DNA fingerprint maps were constructed. All these works will provide a reference for the identification, variety conservation, and hybrid breeding of species in Vanda. Out of 83 iPBS primers, six were selected that produced distinct amplification bands, exhibited high polymorphism, and demonstrated good repeatability. These primers were used for PCR amplification of genomic DNA from 38 samples, resulting in a total of 210 bands. Among these, all 210 bands were polymorphic, achieving a polymorphism rate of 100%. Using the POPGENE 32 software, the mean observed number of alleles (Na) for 38 samples was calculated to be 1.9936, the mean effective number of alleles (Ne) was 1.4243, the mean Nei’s genetic diversity index (He) was 0.2778, and the mean Shannon’s information diversity index (I) was 0.4404. These results indicate a rich genetic diversity among the 38 samples. The genetic similarity coefficients among the samples, calculated using NTSYS-pc 2.1 software, ranged from 0.0345 to 0.6667. Based on these coefficients, UPGMA clustering was performed, and at a similarity coefficient of 0.31, the 38 samples were classified into 7 major groups.
Observation of the Clinical Efficacy and Safety of degludec/insulin aspart Combined with Metformin in Type 2 Diabetes Patients with Poor Blood Sugar Control.
Authors: wu di , wang fei , xiong xiaojing , sun wei
Published: January 2024

This study aimed to explore the application effect, and security of using degludec/insulin aspart combined with metformin treatment in type 2 diabetes patients with poor plasma glucose control despite the use of premixed insulin combined with metformin.
Methods: A total of 60 using Premixed insulincombined with metformin type 2 diabetes patients with uncontrolled plasma glucose ((HbA1c > 7%) admitted to the Endocrinology Department of Huai Bei People’s Hospital. They were randomly divided into two groups, with 30 patients in each group. The control group received insulin aspart 30 injection combined with metformin, while the observation group received insulin degludec/insulin aspart combined with metformin. The treatment duration for both groups was 3 months. The following indicators were compared: included fasting plasma glucose (FPG), postprandial 2-hour plasma glucose (2hPG), average daily insulin dose (U/Kg/d), and glycated haemoglobin (HbA1c) levels before and after 12 weeks of treatment, rate of glycated hemoglobin reaching the standard（HbA1c<7%）, and occurrence of hypoglycemia during treatment.
Results: In patients with type 2 diabetes who have poor glycemic control using premix insulin, IDegAsp combined with metformin and insulin aspartate 30 combined with metformin can effectively improve glycemic control. The former group showed advantages in fasting plasma glucose, average daily insulin dose after treatment, and rate of glycated hemoglobin reaching the standard（HbA1c<7%）, with statistically significant differences (P<0.05). There was no significant difference between the two groups in the risk of hypoglycemia, the change of glycated hemoglobin (ΔHbA1c) after 12 weeks of baseline treatment, and the change of blood glucose at 2 hours after meals (Δ2hPG) (P>0.05).
Parallel Processing of Real-time Tasks on Multi-core Systems
Authors: Alrashed Saleh , Allah Nasro
Published: January 2024

Real-time systems are becoming more and more compute-intensive establishing the need for novel techniques to distribute the workload on multi-core systems adequately. In this work, we divide directed acyclic graph (DAG) of a task into sub-tasks such that each sub-tasks is represented as a thread and hence becomes a candidate to run in parallel on multi-core systems. We begin by adjusting tasks deadlines based on fixed priority scheduling algorithm in such a way that required computation is done much faster on multi-core system by exploiting potential parallelism that exists in periodic tasks. We assign modified deadlines to tasks based on the concept of span and prove that such task sets remain schedulable with modified deadlines by utilizing adequate number of cores. This approach allows parallel processing of periodic tasks employing a minimum number of required cores. Our experimental results show that for embarrassingly parallel code, deadlines of unit lengths provide linear speedup while there is no improvement when a task can not be divided into sub-tasks and hence one processor suffice to deal with serial execution of the task. We run our experiments on synthetic task set of various system utilization. Our results show that significant speedup is achieved when the task system exhibits high degree of parallelism.
Fabrication of Multifunctional Nano Composite Fiber Extracted From Sambucus Nigra: Anti-Nociceptive, Anti-Inflammatory, Self-cleaning and UV-Blocking
Authors: Davodiroknabadi Abolfazl , Zohoori Salar , Talebikatieklahijany Reyhaneh , Mohammadisaghand Fariba , Shahsavari Sara , Mohammadisaghand Roya , Zangeneh Paresa
Published: January 2024

This paper introduces the extraction of Sambucus Nigra chemical compounds and fabrication of multifunctional nano fabric with/without nano zinc oxide particles made by electrospinning method. Field emission scanning electron microscope of the produced sample shows that the diameter of the produced fibers is about 35nm and elemental mapping analysis proved the excellent distribution of nano material on the surface of nano composite. Anti-nociceptive efficiency of samples were investigated and the results indicate that the existence methanol of Sambucus Nigra caused the prevention of pain and this effect illustrated anti-nociceptive consequence in specimens which were investigated through tail flick experiment. Moreover, anti-inflammatory property of samples was investigated which show good data results. On the other hand, self-cleaning of produced nano composite was studied. The results show that doping nano zinc oxide has direct effect on increasing the self-cleaning property. Also, ultraviolet transmission analysis of specimens indicates the produced nano composite has great UV blocking property.
Physician Engagement in Reproductive Health Advocacy: Findings from a Mixed Methods Evaluation of a Leadership and Advocacy Program
Authors: Jones Heidi E. , Manze Meredith , Brakman Anita , Kwan Amy , Davies MiQuel , Romero Diana
Published: January 2024

Background: Medical curricula include advocacy competencies, but how much physicians engage in advocacy and what enables this engagement is not well characterized. The authors assessed facilitators and barriers to advocacy identified by physician alumni of a reproductive health advocacy training program.
Methods: The authors present secondary results from a mixed methods program evaluation from 2018-2020, using alumni data from a cross-sectional survey (n=231) and in-depth interviews (IDIs, n=36). The survey measured engagement in policy, media, professional organization, and medical education advocacy and the value placed on the community fostered by the program (eight questions, Cronbach’s alpha=0.81). The authors estimated the association of community value score with advocacy engagement using multivariable Poisson regression and analyzed IDI data inductively.
Results: Over one third of alumni were highly engaged in legislative policy (n=90, 39%), professional organizations (n=98, 42%), or medical education (n=89, 39%), with fewer highly active in media-based advocacy (n=54, 23%) in the year prior to the survey. Survey and IDI data demonstrated that passion, sense of urgency, confidence in skills, and the program’s emphasis on different forms of advocacy facilitated engagement in advocacy, while insufficient time, safety concerns, and sense of effort redundancies were barriers. The program community was also an important facilitator, especially for “out loud” efforts and for those working in environments perceived as hostile to abortion care (e.g., alumni in hostile environments with high community value scores were 1.8 times [95% CI 1.3, 2.6] as likely to report medium/high levels of media advocacy compared to those with low scores after adjusting for age, gender, and clinical specialty).
Conclusion: Physician advocacy training curricula should include both skills- and community-building and identify a full range of forms of advocacy. Community-building is especially important for physician advocacy for reproductive health services such as abortion care.
Title：Percutaneous endoscopic interlaminar discectomy versus unilateral biportal endoscopy in the treatment of L5/S1 degeneration disease: a randomized controlled trial
Authors: Wu Junjie , Tao Bailong , Li Kai , Cheng Minghuang , Pan Xiaohan , Zhang Xiaojun , Jiang Wei , Hao Jie
Published: January 2024

Background: Lumbar degenerative disease(LDD)is a prevalent condition that significantly impairs individuals'quality of life due to the presence of lower back and leg pain symptoms. This retrospective study was designed to compare and analyze the clinical outcomes of percutaneous endoscopic interlaminar discectomy(PEID)and unilateral biportal endoscopy(UBE) in the treatment of LDD.
Methods: A total of 79 L5/S1 LDD patients admitted to the Spinal Surgery Department of the First Affiliated Hospital of Chongqing Medical University from September 2020 to May 2023 were selected and divided into Group A(PEID) and Group B(UBE) according to different surgical methods.Basic data, preoperative and postoperative lumbar and leg pain scores (as measured by the visual analogue Scale [VAS]), and functional recovery (as measured by the Dysfunction Index [ODI] score) were assessed for each group.The statistical analysis of the results from both groups was conducted using SPSS 25.0 software.
Results: There were significant differences in postoperative lumbar and leg pain scores and functional impairment indexes between the two groups. Lower back pain score 1 day and 1 month after surgery in PEID group was lower than that in UBE group, and leg pain score 1 day, 1 month and 3 months after surgery in PEID group was lower than that in UBE group. The functional impairment index at 1 day, 1 month, 3 months and 6 months after operation in UBE group was lower than that in PEID group, and the difference was statistically significant (P < 0.05).
Conclusion: This study suggests that although both approaches are effective in the treatment of L5/S1 degenerative diseases and can relieve back and leg pain and dysfunction, UBE is more advantageous in the treatment of central canal stenosis, and PEID is more effective in the short-term relief of back and leg pain caused by central protrusion. This may provide a basis for patients to make personalized surgical plans.
A Multi-tiered Solution for Personalized Baggage Item Recommendations using FastText and Association Rule Mining: A Novel Approach
Authors: Mudavath Ravi , Negi Atul
Published: January 2024

The use of automated systems is helpful for the social transformation to an advanced society. This research paper presents a baggage item recommendation system that leverages FastText word embeddings and Association Rule Mining (ARM) to deliver personalized suggestions to users. The methodology involves several key steps. First, the baggage data is collected and preprocessed, including loading pre-trained Fast-Text word embeddings for text representation. The Phase-I recommendation system is then developed, using FastText embeddings to calculate similarity scores between user input and existing items. Next, the Phase-II recommendation system is extended to incorporate user search history by recording searches and storing them in a data frame. In Phase-III, ARM is applied to the user search history, generating associationrules that enrich the recommendation process. The final stage, Phase-IV, combines FastText and ARM-based recommendations, providing users with more accurate and relevant suggestions. The research evaluates the recommendation model’s performance using metrics such as coverage, support, confidence, lift, leverage, and conviction. The proposed approach achieves enhanced item recommendations, offering insights intouser behavior and preferences, and opens opportunities for personalized recommendations, marketing strategies, and product optimization.
Frailty, adherence to healthy diet and risk of inflammatory bowel disease: a large-scale prospective cohort study
Authors: Jiang Ling-Qiong , Zhao Chan-Na , Zhao Yan , Zhao Yu-Qiang , Fang Xi , Zhang Ruo-Di , Chen Cong , Fang Yang , Wang Peng , NI Jing , Pan Hai-Feng
Published: January 2024

Background
Emerging research indicates a potential correlation between frailty, healthy diet and IBD because of overlapping mechanisms. To evaluate the individual and joint effects of frailty and healthy diet on the risk of IBD.
Methods
Data on frailty and diet were collected from a prospective cohort of 338,716 UK Biobank participants. Cox proportional-hazard regression was used to analyze the association of frailty status and dietary pattern with incident IBD. A joint effect analysis was conducted to demonstrate the potential modification effect of healthy diet on the relationship between frailty and IBD.
Results
During a median follow-up of 12.47 years, 2032 RA were identified. Compared with non-frail participants, those with pre-frailty and frailty showed a significantly increased risk of IBD, which was 13% higher in pre-frailty (95% CI: 1.03, 1.23) and 33% higher in frailty (95% CI: 1.08, 1.62), respectively. Participants with moderate and ideal dietary patterns had a significantly lower incidence of IBD compared with those with poor dietary patterns. The adjusted hazard ratios (HRs) were 0.84 (95% CI: 0.74, 0.96) and 0.76 (95% CI: 0.67, 0.88) for moderate dietary pattern and ideal dietary pattern, respectively. Moreover, individuals with non-frailty and ideal dietary pattern had a 43% (95% CI: 0.32, 0.89) reduced risk of IBD in contrast with those with frailty and poor dietary patterns.
Conclusion
The study provides evidence linking frailty and unhealthy diet to the risk of IBD. Our findings suggested that adherence to a healthy diet might attenuate the deleterious effect of frailty on IBD risk.
Achieving Treatment Goals in Elderly Breast Cancer Patients with Neoadjuvant Chemotherapy: A Remarkable Insight
Authors: Yildirim Eda Çaliskan , Atag Elif , Semiz Huseyin Salih , Unal Olcun Umit , Uzun Mehmet , Aksoy Suleyman Ozkan , Durak Merih Guray , Karaoglu Aziz
Published: January 2024

Background
Neoadjuvant chemotherapy (NAC) is established for locally advanced breast cancer, even in early stages, especially in HER2-positive and triple-negative cases. However, the role of age in NAC responses is debated. This study explores the efficacy and outcomes of NAC in elderly breast cancer patients, compared to a younger cohort, to address the current knowledge gap.
Methods
In this retrospective cohort study, 535 patients who underwent at least 80% of their NAC regimen followed by curative surgery from 2010 to 2021 were analyzed. We assessed breast and axillary downstaging, pathologic complete response (pCR), and post-treatment toxicities. Data were stratified by age, with patients aged 65 and older constituting the elderly group. Statistical significance was established at P < 0.05.
Results
Anthracycline-based chemotherapy was prevalent (97.6%), favoring younger patients who received a dose-dense anthracycline regimen (71.7% vs. 38.5%, p < 0.001). Surgical outcomes, breast and axillary downstaging, and the pathological complete response showed no age-related differences. Grade 3–4 toxicity was higher in elderly patients (71% vs. 46.4%, p < 0.01), but no treatment-related deaths occurred. With a median 50-month follow-up, recurrence rates were 10.4% for the elderly and 17% for the other group (p = 0.17).
Conclusion
Elderly patients under NAC achieve comparable outcomes to younger counterparts, supporting personalized treatment. Age alone shouldn't dictate treatment decisions, emphasizing the need for comprehensive investigations for optimal geriatric patient care.