bluuebunny/crossref_metadata_2025 huggingface dataset:
Investigation of Material Ejection in Laser Decal Transfer Based µ-3D Printing of ZnO ceramics with long Pulsed CO2 Laser
Authors: Sahu Anshu , Singh Arpit , Singh Ayush , Singh Vipul , Palani Iyamperumal Anand
Published: August 2023

In Laser decal transfer process, the materials are printed in micron-sized dots without changing its phase from thin film coated substrate (donor substrate). The pulsed laser irradiates the donor substrate opposite to the coated side and transfers the material in the same phase to another substrate kept very close to donor substrate. The process has shown its potential for printing micro sensors without any changes in physical and functional properties during the printing process for the electronics components. Generally, ZnO-based patterned structure is still challenging for the existing manufacturing techniques without hampering its functionality in the sensing application. In this work, an attempt has been made to print ZnO structure in solid phase using maskless based µ-3D printing using a long-pulsed CO2 laser. A two-dimensional numerical model in COMSOL Multiphysics is developed to estimate the temperature induced by the laser irradiation on the sacrificial layer, and energy conservation is applied to estimate the particle's velocity. A deformed mess geometry is used to predict the ablation depth of the sacrificial layer after the laser irradiation. The deformed geometry shows the ablated area in the sacrificial layer and the temperature induces different time frame. The ZnO ceramic film is coated on the sacrificial layer followed by the laser µ-3D printing of ZnO on silicon wafer using CO2 laser at three laser fluence i.e., 530 mJ/cm2, 1030 mJ/cm2, 1530 mJ/cm2 with 90% pulse overlap. The ejection of ZnO from substrate is visualized using the high-speed camera by shadowgraphy techniques. The ejection mode is defined based on the deviation of the particle from the laser beam direction.
The use of EQ-5D-5L as a patient-reported outcome measure in evaluating community rehabilitation services in Alberta, Canada
Authors: Short Hilary , Sayah Fatima Al , Churchill Katie , Keogh Eileen , Warner Lisa , Ohinmaa Arto , Johnson Jeffrey A.
Published: August 2023

Background: The purpose of this study was to evaluate the impact of community rehabilitation services on health-related quality of life (HRQL) in Alberta, Canada, using routinely collected EQ-5D-5L data, and explore factors associated with the impact of these services.
Methods: A retrospective, longitudinal, observational design was used. Patients completed the EQ-5D-5L and demographic questions at intake and end of rehabilitation care. Change in EQ-5D-5L dimensions from intake until end of rehabilitation was examined using the Pareto Classification of Health Change. Change scores were calculated for the EQ-5D-5L index, VAS, and total sum scores. Change groups in the EQ-5D-5L index and VAS scores, were defined by minimally important differences of 0.04 and 7.0, respectively. One level change was considered important for the total sum score. Effect size of the change in index, VAS, and total sum scores was also examined. Chi-squared tests were conducted to examine whether change in EQ-5D-5L varied by age, gender, region, and having anxiety/depression at intake.
Results: Three service programs were examined; pulmonary rehabilitation (n=542), group-based community exercise (n=463), and physiotherapy for bone and joint care (n=391). At intake, HRQL in all programs was lower than that of the general Alberta population norms and improved by end of rehabilitation. The mean (SD) change in index, VAS, and total sum scores were 0.02 (0.13), 6.0 (18.3), and -0.5 (2.4) in pulmonary rehabilitation, 0.06 (0.13), 6.6 (18.7), -1.2 (2.4) in community exercise, and 0.13 (0.16), 1.2 (0.9), and -2.8 (2.8) in physiotherapy, respectively. Based on change of the index score, 24% deteriorated, 38% improved, and 38% had no change in pulmonary rehabilitation; 17% deteriorated, 51% improved, and 32% had no change in community exercise; 5% deteriorated, 72% improved, and 23% had no change in physiotherapy. Similar trends were seen in the VAS and total sum scores. Age, region, and having anxiety/depression at intake were associated with change in EQ-5D-5L.
Conclusions: The results of this study are intended to inform program/service level decisions by describing the characteristics and HRQL of patients accessing community rehabilitation, as well as the predictors of change in health status, which will help direct future program growth and service changes.
Repeat Low-level Red-Light Therapy Using to Slow the Progression of Medium ~ High Myopia （≥4.00D） in Chinese Children
Authors: yu jun , li bin , zhang chi , Dong lingyan , cen jie , chen yiye , Zhao Peiquan , Zhu Huang
Published: August 2023

Purpose：RLRL (repeated low level red light) therapy has recently emerged as a new-type treatment to control myopia. In our study, we will focus on the effect of myopia control between RLRL and PDMSL in the children who had moderate to high Myopia. Its effectiveness have been reported in previous studies. In our study, we aim to compare the effects of RLRL and peripheral defocus modifying spectacle lenses (PDMSL) in Medium ~ High Myopia （≥4.00D）.
Methods: It is a Randomized, controlled , clinical trial. This trial is registered with ClinicalTrials.gov (identifier, NCT05184621) and Date 11/01/2022.The participants were 25 Chinese children who had aged 8 to 14 years old with ≥-4.00 diopters (D) of myopia ,and ≤-2.00 diopters (D) of astigmatism.
Groups of intervention (RLRL plus SVS) and control (PDMSL) were assigned 1:1. In RLRL group, the participant would use RLRL device. The usage method was: two sessions a day, five time a week, each session lasted three minutes, and there was at least a four-hour interval between sessions. The participant wore SVS daily. The participant wore PDMSL daily, in the control group. The axial length (AL), spherical equivalent refractions (SER) and other ophthalmic examinations were measured at baseline, one, three, six, nine and twelve months.
Result: Spherical equivalent refraction （SER ）change was 0.26±0.39D and 0.69±0.39D in 6 -month,0.34±0.51D and 0.93±0.44D in 9-month, 0.28±0.50D and 0.79±0.48D in 12-month, in the RLRL group and PDMSL group , respectively. There were all significant different between the two groups (P=0.000). Treatment-related adverse events were not reported. Axial length (AL) change was -0.13 ±0.11 mm and 0.09 ±0.01mm in 3 -month, -0.18 ±0.13 mm and 0.21 ±0.09mm in 6 -month, -0.21 ±0.16 mm and 0.27 ±0.14mm in 9 -month, and -0.18 ±0.17 mm and 0.34 ±0.13mm in 12 -month, in RLRL group and PDMSL control group , respectively. In the both groups, there were significant differences (P=0.000) . It was not reported that any adverse events were related to the treatment.
Conclusions: The RLRL therapy was more effective than PDMSL in Medium~ High Myopia（≥4.00D） control .The RLRL treatment cloud be well tolerated, with few adverse effects related to the treatment.
Echinacea purpurea extract intervention for counteracting neurochemical and behavioral changes induced by bifenthrin
Authors: Abdel-Wahhab Khaled , Sayed Rehab S. , Sahra Doaa G. EL , Hassan Laila K. , Elqattan Ghada M. , Mannaa Fathia A.
Published: August 2023

This study was conducted to elucidate the possible protective efficiency of Echinacea purpurea hydroethanolic extract (EchEE) against bifenthrin-induced neuro-chemical and behavioral changes in rats. Total phenolics content, reducing power and radical scavenging activity of EchEE were estimated. Four groups of adult male albino rats were used (10 rats each) as follows: 1) Control healthy rats ingested with placebo, 2) Healthy rats orally received EchEE (465 mg/kg/day), 3) Rats intoxicated with (7mg/kg/day) bifenthrin (BIF) dissolved in olive oil, and 4) Rats ingested with EchEE one-hour prior to intoxication with bifenthrin. After 30 days, some neuro-chemical and behavioral tests were assessed. The behavioral tests revealed that rats received bifenthrin exhibited exploratory behavior and spatial learning impairments, memory and locomotion dysfunction, and enhanced anxiety level. Biochemical findings revealed induced-oxidative stress in the cortex and hippocampus; this was achieved from the significant rise in malondialdehyde (MDA) and nitric oxide (NO) levels, coupled with decreased catalase (CAT), superoxide dismutase (SOD), paraoxonase-1 (PON-1) activities, and reduced glutathione (GSH) level in both brain areas. Also, BIF induced a significant increase caspas-3, tumor necrosis factor alpha (TNF), and interleukin-1beta (IL-1ß) in both areas; dopamine and serotonin levels and ACh-ase activity were markedly decreased in both areas. Interestingly, treatment of rats with EchEE one-hour prior to BIF resulted in a significant decrease in oxidative stress damage, and modulation of the apoptotic and pro-inflammatory markers. Also, EchEE markedly improved behavioral activities and neurotransmitters level that were impaired by BIF. In conclusion, the present study clearly indicated that EchEE can attenuate brain dysfunction induced by pesticides exposure through preventing the oxidative stress. This may be attributed to its high antioxidant component.
Development of organized manufacturing sector across Indian states -a spatial approach
Authors: Majumder Piyali
Published: August 2023

The paper examines the nature and pattern of development of the Indian organized manufacturing industries across Indian states using the Annual Survey of Industries (ASI) plant-level data. Four different indices of industrial concentration have been used to estimate the degree of agglomeration of industries. It has been observed that states with a large industrial base are also the hub of some of the highly polluting industries. The degree of industrial agglomeration has been observed to be higher in the case of polluting industries as opposed to non-polluting industries in the year 2013-14. The degree of agglomeration economies of the industry has been observed to be affected by the spillover effect from the adjacent regions. While examining the pattern of spatial concentration of industries over time, the paper concludes that during the period of the analysis 2000-01 to 2013-14, the polluting industries have shown some dispersion both across states (captured by the LQ index) as well as in terms of plant level concentration within-in the same industry.
JEL codes: L6, R12, R11
Melting Temperature Mapping Method Using Imperfect-match Linear Long Probes
Authors: Ootsuki Shinya , Niimi Hideki , Ueno Tomohiro , Mori Masashi , Minami Hiroshi , Kitajima Isao , Tabata Homare
Published: August 2023

Identifying pathogenic microorganisms as early as possible is critical for selecting the appropriate antimicrobial therapy in infected patients. We previously reported the development of the Tm mapping method for identifying a broad range of pathogenic bacteria within three hours of blood collection. However, the Tm mapping identification requires an analytical instrument with a tube-to-tube variation of no more than 0.1 °C, so we can only use a few instruments that have such high thermal accuracy. To address the problem, we developed the improved Tm mapping method using imperfect-match linear long quenching probes (IMLL Q-probes). Using IMLL Q-probes, almost all commercially available analytical instruments can be used for the Tm mapping method. Some bacterial species cannot be narrowed down to one species, but they can at least be narrowed down to the genus level. The Tm mapping method using IMLL Q-probes is useful for deciding on antimicrobial therapy in infected patients.
Dynamics of Land, Ocean, and Atmospheric Parameters Associated with Tauktae Cyclone
Authors: Kumar Rajesh , Pippal Prity S. , Chauhan Akshansha , Singh Ramesh P. , Kumar Ramesh , Singh Atar , Singh Jagvir
Published: August 2023

During the pre- and post-monsoon season, the eastern and western coasts are highly vulnerable to cyclones. The tropical cyclone "Tauktae" formed in the Arabian Sea on 14 May 2021 and moved along the western coast of India, and landfall occurred on 17 May 2021. During the cyclone, the maximum wind speed was 220 km/hr with a pressure of 935 millibars. This cyclone influenced the meteorological and atmospheric parameters and weather conditions of western, northern, and central India and caused devastating damage. A detailed satellite, Argo, and ground data analysis have been carried out to study the changes in the ocean, atmospheric and meteorological parameters during the cyclone formation until the landfall and beyond. During cyclone generation, the air temperature (AT) was maximum (30.51oC), and winds (220 km/h) was strong with negative omega values (0.3). RH and RF were higher near the origin and landfall location of the cyclone, with an average of 81.28% and 21.45 mm/day, respectively. The concentration of traces gases (NO2, SO2, CH4, TCO, COVMR, and H2OMMR) and aerosols (AOD, AE and PMs) loading were increased over land along the cyclone track that degraded the quality of air. The detailed analysis shows pronounced changes in the land, ocean, meteorological and atmospheric parameters. The strong wind associated with the cyclone amalgamated the surrounding airmass degraded the air quality, and severely threatened the people living in the landfall areas. The results discussed in the present study show a pronounced change in the ocean, land, meteorological and atmospheric parameters and a strong coupling between the land-ocean-atmosphere associated with the cyclone.
Clinical Outcomes of Inferior Oblique Myectomy in Patients with Unilateral Superior Oblique Palsy
Authors: Blau-Most Michal , Tremblay François , LaRoche G.
Published: August 2023

Background
– Unilateral superior oblique palsy (SOP) is the most common isolated cranial nerve palsy. This report looks at the results and safety of inferior oblique (IO) myectomy for SOP.
Methods
– A retrospective chart review of patients with fusional ability who underwent IO myectomy for unilateral SOP over a 15-year period, at one of our university-associated health care centers. Primary outcomes were distance hypertropia and excyclotropia in primary position, and inferior oblique overaction (IOOA). A secondary outcome was the correlation between the age at surgery and the residual distance hypertropia.
Results
– A total of 73 patients with unilateral SOP who underwent IO myectomy were included in the analysis. Mean pre-operative values were: distance hypertropia: 15.41 ± 6.8 Prism Diopters (range 4–30 PD), IOOA: +2.2 ± 0.7 (range 0-3.5) and excyclotropia:+5.34 ± 3.6° (range 0–12°). Mean post-operative values were: distance hypertropia: 3.7 ± 3.4PD [0-14PD], IOOA: -0.1 ± 0.8 [(-2)-2] and excyclotropia: +1.1 ± 2.3°[(-5)-10]. The younger age group (0–20 years old) had a trend toward smaller preoperative distance hypertropia (P = 0.051), and a significantly smaller distance hypertropia post-operatively (p = 0.007). There was no case of over-correction or ocular complication.
Conclusion
- On average, IO myectomy results in a 11.7PD reduction of the distance hypertropia, and 4° reduction of excyclotropia, with an effective reduction of IOOA. While these results are comparable to other surgical methods reported in the literature, they underline an efficacy without the risks of complications such as anti-elevation syndrome and possible scleral perforation. The younger age group had a trend toward smaller preoperative deviation, and better outcomes compared to the older age group.
Knowledge, Attitudes, and Practices Towards Infertility Among Women Living in Jordan: A Cross-sectional Study
Authors: Jaber Kamel , Albdour Karam , Ismail Omar , Jaber Yazan , Alsaras Amin , Younis Ahmad , Muhaidat Nadia
Published: August 2023

Background
Infertility is a common health issue worldwide. In Jordan, the burden of infertility is understudied, and the prevalence is likely underestimated. We aimed to assess the perceptions and level of awareness of Jordanian women concerning infertility and its health and social implications.
Study design:
429 women living in Jordan were invited to fill out an online questionnaire evaluating their knowledge of infertility, attitudes, and related perceptions. Linear regression was conducted to screen for variables affecting participants’ knowledge of infertility.
Results
The diagnosis of infertility was reported by 13% of participants. The majority of the participants reported that infertility adds strain to the marriage, and about 40% agreed that it is a valid reason for divorce. Almost half of the participants agreed that the community’s view of them would change had they learned of their infertility. Moreover, three-quarters of the participants (73%) believed that neither males nor females are to blame for infertility. Even though about ninety percent (88.1%) agreed that infertility should be treated, less than half of the participants (45.7%) considered it a disease. The majority preferred to discuss gynecologic and infertility-related issues and concerns with a female physician (57.8%, n = 248). Knowledge of infertility was found to be inadequate among the study population (average knowledge score of 51.8%). Furthermore, having a higher household income, carrying a healthcare-related degree and previously visiting an infertility clinic were significantly associated with a higher knowledge score.
Conclusion
In the setting of the lacking literature regarding infertility in Jordan, this study offers valuable insight into the knowledge, attitudes, and practices that are common among women residing in Jordan. Results from this study highlight negative trends in the help-seeking behavior of women, and gaps in infertility-related knowledge. This should prompt the adoption of educational programs as part of a nationwide approach addressing infertility and encouraging people to seek help when needed, emphasizing the role of primary healthcare in managing fertility issues. Official efforts are needed to collect data at a national level.
Post-Caesarean Wound Infections: Incidence, Bacterial Profiles, Antimicrobial Susceptibility Patterns and Associated Factors in Public Hospitals, Southern Ethiopia
Authors: Kebede Teshome , Manilal Aseer , Seid Mohammed , Tesfaye Mheret , Tolessa Dereje , Akiilu Addis , Zakir Abdurezak , Keyta Gebere , Kulyta Kebede , El-Sheikh Mohamed A. , Idhayadhulla Akbar
Published: August 2023

Post-caesarean wound infections are a maternal health concern associated with increased morbidity and extended hospital stays, mainly caused by drug-resistant pathogens. A prospective cross-sectional study was undertaken in the title public hospitals among pregnant women who had undergone Caesarean section (CS). All women were followed up for 30 days, and those who developed a clinically infected wound (i.e., 204) were included in the bacteriological analysis. A pre-tested questionnaire was used to collect the data. Wound samples were collected to identify bacteria as per the microbiological guidelines. Antimicrobial susceptibility profiles were determined by the Kirby–Bauer disk diffusion method. Of the 204 samples, 85.78% (175/204) were culture-positive, yielding 203 bacteria.Staphylococcus aureuspredominantly caused wound infections (n = 65, 32.01%), followed byKlebsiella pneumoniae(n = 54, 26.6%). Gram-negative bacilli were highly resistant to piperacillin, ceftriaxone, cefotaxime, and co-trimoxazole (> 85%), whereas Gram-positive cocci were highly resistant to penicillin and tetracycline (> 90%). Overall, 70.44% (n = 143) of isolates were multidrug-resistant. Parity [P = 0.01, AOR: 4.4, (CI: 1.40, 13.87)], previous CS [P = 0.0, AOR: 6.3, (CI: 3.10, 13.01)], diabetes mellitus [P = 0.05, AOR: 3.2, (CI: 2.1, 5.8)], and emergency CS [P = 0.05, AOR: 2.07, (CI: 1.06, 2.63)] were significantly associated with post-caesarean wound infections.
From One Size Fits All to a Tailored Approach: Integrating Precision Medicine into Medical Education.
Authors: Sbitan Lana , Alzraikat Noor , Tanous Haneen , Mohamed Abdelrahman , Odeh Mohanad
Published: August 2023

Introduction
As precision medicine gains momentum, the traditional - One Size Fits All - approach to disease prevention and treatment is becoming less reliable. Medical education must prioritize equipping physicians with the knowledge to apply precision medicine effectively. The present study aimed to investigate the knowledge, attitudes, and perceived barriers to precision medicine among medical students, interns, and physicians in Jordan.
Materials and Methods
An analytical cross-sectional study, using an online validated and reliable questionnaire to collect data, was conducted. The knowledge, attitudes, and perceptions related to precision medicine were assessed and explored for statistical associations. The strength of each association was further presented by calculating the Cramér's phi (φc).
Results
Participants in the present study were 607 individuals, 55.5% were males. 29.6% of participants had low knowledge scores (marks between -12 and 0). The strongest association was reported between knowledge score and primary care setting followed by age (φc= 0.27 and 0.29, respectively). Physicians at the Ministry of Health had the highest odds of a high knowledge score (OR=5.3, 95% CI 2.7 -10.2, P<0.001)
Most respondents (79.1%) would consider using genome-guided prescribing tools developed by researchers, with only (15.8%) deeming these tools clinically useless. Nevertheless, almost 78% of participants expressed concern regarding patient anxiety with test results. Students showed better perception than physicians (p=<0.001), but Physicians were more confident to implement precision medicine (P=<0.0001). Most participants (87.1%) considered expanding their knowledge in precision medicine. Physicians cited limited accessibility as the main barrier to adopt precision medicine (92.9%), while high cost was the primary obstacle reported by students (80.2%).
Conclusion
Medical students and Physicians share a positive attitude toward implementing Precision Medicine, but barriers must be overcome for successful implementation. Integrating precision medicine and genome-based technologies into medical education is necessary for its successful application in clinical practice.
Chaotic discrete map of pulse oscillator dynamics with threshold nonlinear rate coding
Authors: Boriskov Petr
Published: August 2023

The study presents 1D discrete map (DM) to describe the dynamics of the oscillator with chaotic pulse position modulation (PPM). The model circuit has pulse voltage-controlled oscillator (PVCO) and feedback (FB) loop with a threshold of pulse rate coding, which performs non-retriggerable monostable multivibrator (MMV). DM is based on the analysis of this circuit using a simple approximation of the frequency modulation, which includes a threshold condition on the pulse period and sigmoid function of rate coding. The model circuit and DM demonstrate dynamic chaos in a wide range of control parameters. The transition to the chaos occurs by a jump either from a fixed point (tangent bifurcation), or from a limit cycle. An experimental (digital-analog) circuit of the chaotic pulse oscillator, in which the FB unit is MMV with a microcontroller (MC), is implemented. The relationship between the presented DM and the well-known sawtooth (Bernoulli) map (STM), widely used in engineering, is discussed.
Pembrolizumab plus bevacizumab achieves long-term progression free survival in patients with lung adenocarcinoma with brain metastases: a case report and literature review
Authors: Wang Shizhuo , Wang Jinpeng , Zhang Duo , Chen Hong , Imam Murshid , Yan Shunchao , Ji Jiale
Published: August 2023

Background: Brain metastases (BMs) are an important cause of mortality in lung cancer. Tyrosine kinase inhibitor (TKI) based targeted therapy is recommended for driver gene mutation, non-squamous NSCLC with more than three BMs. For BMs without driver gene mutation, radiotherapy and systemic chemotherapy are standard treatments. However, radiotherapy results in neurocognitive impairment. Chemotherapeutic drugs have difficulty in crossing the blood-brain barrier.
Case presentation: This case was driver gene mutation negative, programmed-death-ligand-1 (PD-L1) positive lung adenocarcinoma with mildly symptomatic BMs, without a driver gene mutation. The patient benefited from treatment with a non-chemotherapy regimen of pembrolizumab plus bevacizumab. Intracranial edema and tumor enhancement were significantly reduced, and headache was alleviated after two cycles of treatment. Partial remission was achieved in BM after 10 cycles of treatment. As of May 2023, the patient had achieved >32 months of progression-free survival.
Conclusions: The combination of immune-checkpoint inhibitors and antiangiogenic agent might be a valuable therapeutic choice for patients with driver gene mutation negative, PD-L1 positive NSCLC with asymptomatic or mildly symptomatic BMs.
Novel batch polishing method of ceramic cutting inserts for reducing tool wear
Authors: Gao Rui , Wang Chunjin , Loh Yee Man , Liang Xiaoliang , Jiang Chen , Cheung Chi Fai
Published: August 2023

To reduce tool wear of inserts in cutting, this study presents an emerging magnetic field-assisted batch polishing (MABP) method for simultaneously polishing multiple ceramics cutting inserts. The wear characteristics are clarified by cutting S136H steel. The surface roughness in regard to mean height (\(Sa\)) at the flank face, edge, and nose has achieved below 2.5 nm, 6.25 nm, and 45.8 nm, respectively after 15 minutes of polishing, and the tool life was extended by 175%. The experimental results indicate that MABP is an effective method for mass polishing the cutting inserts, and the polished surfaces can notably reduce tool wear.
Implementing and Evaluating a Fully-Functional AI-Enabled Model for Chronic Eye Disease Screening in a Real Clinical Environment
Authors: Skevas Christos , de Olaguer Nicolás Pérez , Lleó Albert , Thiwa David , Schroeter Ulrike , Lopes Inês Valente , Mautone Luca , Linke Stephan , Spitzer Martin Stephan , Yap Daniel , Xiao Di
Published: August 2023

Background
Artificial intelligence (AI) has the potential to increase the affordability and accessibility of eye disease screening, especially with the recent approval of AI-based diabetic retinopathy (DR) screening programs in several countries.
Methods
This study investigated the performance, feasibility, and user experience of a seamless hardware and software solution for screening chronic eye diseases in a real-world clinical environment in Germany. The solution integrated AI grading for DR, age-related macular degeneration (AMD), and glaucoma, along with specialist auditing and patient referral decision. The study comprised several components: 1) evaluating the entire system solution from recruitment to eye image capture and AI grading for DR, AMD, and glaucoma; 2) comparing specialist’s grading results with AI grading results; 3) gathering user feedback on the solution.
Results
A total of 231 patients were recruited, and their consent forms were obtained. The sensitivity, specificity, and area under the curve for DR grading were 100.00%, 80.10%, and 90.00%, respectively. For AMD grading, the values were 90.91%, 78.79%, and 85.00%, and for glaucoma grading, the values were 93.26%, 76.76%, and 85.00%. The analysis of all false positive cases across the three diseases and their comparison with the final referral decisions revealed that only 17 patients were falsely referred among the 231 patients. The efficacy analysis of the system demonstrated the effectiveness of the AI grading process in the study's testing environment. Clinical staff involved in using the system provided positive feedback on the disease screening process, particularly praising the seamless workflow from patient registration to image transmission and obtaining the final result. Results from a questionnaire completed by 12 participants indicated that most found the system easy, quick, and highly satisfactory. The study also revealed room for improvement in the AMD model, suggesting the need to enhance its training data. Furthermore, the performance of the glaucoma model grading could be improved by incorporating additional measures such as intraocular pressure.
Conclusions
The implementation of the AI-based approach for screening three chronic eye diseases proved effective in real-world settings, earning positive feedback on the usability of the integrated platform from both the screening staff and auditors. The auditing function has proven valuable for obtaining efficient second opinions from experts, pointing to its potential for enhancing remote screening capabilities.
Trial registration
Institutional Review Board of the Hamburg Medical Chamber (Ethik-Kommission der Ärztekammer Hamburg): 2021-10574-BO-ff
Detecting thermal anomalies using thermochronometry around hydrothermal alteration zones in the Kii Peninsula, southwest Japan – An attempt
Authors: SUEOKA Shigeru , Iwano Hideki , Danhara Tohru , Niwa Masakazu , Kanno Mizuho , Kohn Barry , Kawamura Makoto , Yokoyama Tatsunori , Kagami Saya , Ogita Yasuhiro , Hirata Takafumi
Published: August 2023

Fluid-inclusion and thermochronometric analyses have been applied to hydrothermal alteration zones and their host rocks outcropping in the Hongu area of the Kii Peninsula, southwestern Japan in an attempt to detect thermal anomalies related to hydrothermal events and quantify the thermal effects on the host rocks. Hydrothermal events at ~150°C and ~200°C were identified by fluid-inclusion microthermometry of quartz veins in the alteration zones. For the host rocks and alteration zones, in the youngest population zircon yielded U–Pb dates ranging between ~74.7–59.2 Ma, fission-track dates of ~27.2–16.6 Ma, and (U–Th)/He single-grain dates of ~23.6–8.7 Ma. Apatite yielded pooled fission-track ages of ~14.9–9.0 Ma. The zircon U–Pb dates constrain the maximum depositional ages of the sedimentary samples. However, the fission-track and (U–Th)/He dates show no clear trend as a function of distance from the alteration zones. Hence, no thermal anomaly was detected in the surrounding host rocks based on the thermochronometric data patterns. The fission-track and (U–Th)/He dates are rather thought to record regional thermal and exhumation histories rather than a direct thermal imprint of fluid flow, probably because the duration of such activity was too short or because fluid flow occurred before regional cooling events and were later thermally overprinted. Apatite fission-track ages of ~10 Ma may reflect regional mountain uplift and exhumation related to the obduction of the SW Japan lithospheric sliver onto the Shikoku Basin, or the rapid subduction of the Philippine Sea slab associated with the clockwise rotation of the Southwest Japan Arc.
Her, His, and Their Journey with Endometriosis: A Qualitative Study
Authors: Shinan-Altman Shiri , Wertheimer Aya , Frankel Bat-El , Hamama-Raz Yaira
Published: August 2023

Background
Endometriosis, impacting roughly 10% of reproductive-age women and girls globally, presents diagnostic challenges that can cause significant delays between symptom onset and medical confirmation. The aim of the current study was to explore the experience of women with endometriosis as well as that of their partners, from pre-diagnosis to diagnosis to post-diagnosis.
Methods
In-depth semi-structured interviews were conducted with 10 couples coping with endometriosis. Each partner was interviewed separately, and each interview was analyzed both individually and as part of a dyad, using the dyadic interview analysis method.
Results
Three main themes emerged: (i) “Relationship in the shadow of uncertainty”: Coping with health symptoms prior to the formal endometriosis diagnosis; (ii) Coping together or alone when receiving the endometriosis diagnosis; and (iii) "The day after the diagnosis”: Moving between adversity and growth.
Conclusions
The study's findings emphasize the importance of viewing the diagnosis from a dyadic perspective and comprehensively – that is, from pre-diagnosis to accepting the formal diagnosis to post-diagnosis. This journey can have a profound impact on both couple members, affecting their day-to-day functioning, communication, emotional and physical intimacy, and fertility.
Ocular health and eye safety practices of the industrial welders in Nepal: A cross-sectional study
Authors: KHANAL SUDARSHAN , Chaudhary Meenu , Marasini Sanjay , Shrestha Gauri Shanker , Mishra Sanjeeb Kumar
Published: August 2023

Background
Occupational eye health access remains as a far-fetched dream in developing countries where, still, primary health care is inaccessible to general public. Illiteracy, ignorance, and casual attitude contribute to the majority of occupational morbidities, which are otherwise preventable. The aim of the researcher was to investigate the burden of preventable ocular hazards in Nepalese professional welders and elucidate their knowledge, attitude and practice (KAP) of the eye safety.
Methods
A comprehensive eye examination was conducted in 106 professional welders, which included assessment of several ocular and visual functions. The self-reported knowledge, attitude and practice (KAP) on potential health hazards and adherence to the safety measures were assessed in relation to the clinical observations.

Results

Possible radiation-induced DNA damages manifested in the form of corneal opacities (45%), and ambient light level effects in the form of several specific symptoms such as watery eyes (18%), sore eyes (20%), tired eyes (19%), and binocular double vision (4.7%) and after images (36.8%). Participants’ reported that their working site was fumy (60.4%) and dusty (59.4%) which presumably contributed to dry eyes (49%) and allergic conditions (2%).Other common ocular morbidities were lid disorders (57.5%), conjunctiva disorders (53%), cataract (16%) and posterior segment disorders (27%). Although, self-reported knowledge about the potential health hazards of welding was remarkable (84.6%), the safety practices were poor. With an increasing employment duration, however, welders became more careful with the safety practices(r=0.57).
Conclusion
A high prevalence of ocular and visual morbidity was observed along with a general tendency of avoiding the safety practices which are addressable by appropriate law enforcements, development of health insurance policies, and education.
Evaluation of students' online teaching satisfaction based on the concept of user experience ——A cross-sectional data study from medical schools in northern China
Authors: Xie Yuzhuo , Li Yuanheng , Wang Yazhou , Zhang Yuwei , Ma Mingxue , Wang Jingzhi , Guo Jiaqi , Shi Jiajun , Zhu Liling , Jiang Deyou , Jiao Mingli
Published: August 2023

Background
This study used the concept of user experience as the core, combined with the concepts of student evaluation and value-added evaluation, to design a course satisfaction questionnaire based on student experience regarding some entries of the Australian CEQ Course Experience Scale and conduct a questionnaire survey on students in two medical colleges in China, To explore the possible relationship between the relevant independent variables dominated by five-dimensional experience and students' overall course satisfaction.
Methods
A questionnaire survey was conducted on 2,504 students from two medical colleges in Heilongjiang, China. SPSS statistical software was used to conduct data difference test and regression analysis, etc., to explore the possible relationship between some basic conditions and subjective experience indicators and students' online education satisfaction.
Results
In a survey of 2,392 students who responded valiantly, it was found that the majority of students (72.62%) were very satisfied with their current teaching. Concrete results indicated that 1) the dimensions of user experience-based student interactive, behavioral, and speculative experiences positively affected overall satisfaction with classes; 2) students’ satisfaction with the drastic changes in education methods in the context of Chinese-style education was generally higher owing to objective factors such as the pandemic; and 3) a correlation existed between some personal factors, such as adaptation to campus life, grade level, relationship with parents, and student experience satisfaction. Other results indicated that students with poor grades may be more satisfied with online education, and online education positively affects promoting educational fairness.
Conclusion
At present, students generally have a high degree of satisfaction with online education. In the future, we will further refine the classification of experience dimensions on the basis of the conclusions of this study and pay attention to students' subjective experience feelings, so as to help steadily improve the effectiveness of education and teaching.
The impact of COVID-19 on management indicators of emergency department in Kowsar Hospital of Sanandaj City
Authors: rezaee Srva , Akhbari Kourosh , Hosseinzadeh Sajjad , Nezakati Aram , Mahmoodi Parvin , Pakniyat Abdolghader
Published: August 2023

Background
There is increasing evidence that patients avoid emergency departments due to fear of contracting COVID-19, which increases morbidity and mortality. To ensure the effectiveness of emergency services, department's performance must be measured. Today, various tools and methods are used to measure the performance indicators of the emergency department.
Methods
The current study is a descriptive-analytical cross-sectional study, which was conducted in the year 1400 in the emergency department of Kowsar hospital in Sanandaj. The research population included all patients admitted through triage from 1397 to 1400. Data were collected using SPSS statistical software version 23 and descriptive statistics (percentage, frequency, mean and standard deviation) and inferential (ANOVA, independent t-test, and post hoc test) were subjected to statistical analysis. A P value of 0.05 was considered.
Results
In the data related to emergency admissions after Corona during the outbreak of the disease, the first, second, third, fourth and fifth periods of the epidemic compared to the same period in the previous year were 48.7, 34.1, 31.7, 25.2, and 16.2, respectively. Percentage decreased. The average age of clients increased from 33.50 to 36.93 during the epidemic. In the study of the gender variable, before covid-19, 56.5% of clients were men, and 43.5% were women. After the pandemic, these percentages reached 62.5% and 37.5%, respectively. The index of assignment within 6 hours averaged 84.69% in 4 years, which has increased after the Covid-19 pandemic. The percentage of patients discharged under 12 hours was also calculated with an average of 94.54% in 4 years, which has decreased after the covid-19 pandemic. The percentage of self-responsible discharges in the emergency department was 40.8% before and 59.2% after the Covid-19 pandemic, which has been increasing. The index of unsuccessful cardiopulmonary resuscitation decreased from 112 cases before the pandemic to 64 cases after. The average duration of triage during four years was calculated as 8.11 minutes, which increased significantly compared to before.
Conclusion
The Covid-19 pandemic has had greatly impacted patient referrals to the emergency department. This research showed that the beginning of the covid-19 pandemic affected emergency management indicators and patients' visits to the emergency room.
Prediction of neurological disorders in HIV-infected persons in Taiwan: a nested case-control study
Authors: Weng Ya-Wei , Lee Susan Shin-Jung , Tsai Hung-Chin , Hsu Chih-Hui , Lin Sheng-Hsiang
Published: August 2023

Background
Neurological disorders are still prevalent in HIV-infected people. We aimed to determine the prevalence of neurological disorders and identify their risk factors in HIV-infected persons in Taiwan.
Methods
We identified 30,101 HIV-infected people between 2002 and 2016 from the National Health Insurance Research Database in Taiwan, and analyzed the incidence of neurological disorders. We applied a retrospective, nested case-control study design. The individuals with (case group) and without (control group) a neurological disorder were then matched by age, sex and time. Factors associated with neurological disorders were analyzed using a conditional logistic regression model, and a nomogram was generated to estimate the risk of developing a neurological disorder.
Results
The incidence of neurological disorders was 13.67 per 1000 person-years. The incidence remained stable during the observation period despite the use of early treatment and more tolerable modern anti-retroviral therapy. The conditional logistic regression model identified nine clinical factors and comorbidities that were associated with neurological disorders, namely age, substance use, traumatic brain injury, psychiatric illness, HIV-associated opportunistic infections, frequency of emergency department visits, cART adherence, urbanization, and monthly income. These factors were used to establish the nomogram.
Conclusion
Neurological disorders are still prevalent in HIV-infected people in Taiwan. To efficiently identify those at risk, we established a nomogram with nine risk factors. This nomogram could prompt clinicians to initiate further evaluations and management of neurological disorders in this population.
Three years of COVID-19-related school restrictions and children's mental health in Japan
Authors: Takaku Reo , Shobako Naohisa , Nakata Taisuke
Published: August 2023

During the three years of the COVID-19 pandemic, Japanese children had to continue compliance with restrictive mitigation measures at school, such as eating school lunches silently and wearing masks even during physical exercise classes, despite restrictions having been relaxed worldwide. Excursions and other school events were frequently cancelled, especially in 2020 and 2021. This study aimed to understand how the strict mitigation measures affected children's mental health and well-being, and hence, a retrospective survey on school experiences was conducted. Results revealed school excursion cancellation to be associated with higher risk of developing depressive symptoms (odds ratio [OR] 1.655 [95% confidence interval {CI} 1.194–2.293]), and high cancellation rate of other school events to be associated with dissatisfaction in school experience (OR 1.638 [95% CI 1.214–2.221]). Overall, the study demonstrated that persistent strict mitigation measures at schools could have a cumulative negative impact on children’s mental health and psychological well-being.
The Comparative Effects of Visible Light and UV-A Radiation on the Combined Toxicity of P25 TiO2 Nanoparticles and Polystyrene Microplastics on Chlorella sp
Authors: Rex Camil , Mukherjee Amitava
Published: August 2023

The ubiquitous presence of TiO2 nanoparticles (nTiO2) and microplastics (MPs) in marine ecosystems has raised serious concerns about their combined impact on marine biota. In the natural environment, marine microalgae can interact with mixtures of nTiO2 and MPs under both visible light and UV-A radiation conditions. However, most of the previous toxicity studies employed visible light conditions, so the influence of UV-A radiation on toxicity remains poorly understood. To address this gap, the current study aimed to compare the effects of visible light and UV-A radiation on the combined toxic effects of nTiO2 and polystyrene microplastics (PSMPs) in the marine microalga Chlorella sp using artificial seawater directly as the test medium. Our results demonstrated that under UV-A radiation the algal growth inhibition was significantly enhanced compared to that in visible light conditions. The mixtures of nTiO2 and PSMPs exhibited significant enhanced toxicity than their pristine forms. Specifically, the mixtures of nTiO2 and NH2-functionalized PSMPs (10mg/L) showed higher toxicity to algae than the mixtures with COOH-functionalized PSMPs (10mg/L). Furthermore, UV-A radiation exacerbated the hetero aggregation between algae and pollutants. The photoactive nTiO2, promoted increased production of reactive oxygen species under UV-A exposure resulting in cellular damage, lipid peroxidation, and impaired photosynthesis. The effects were more pronounced in case of the mixtures where PSMPs added to the oxidative stress. The toxic effects of the binary mixtures of nTiO2 and PSMPs were further confirmed through the Field Emission Electron Microscopy, revealing specific morphological abnormalities. This study provides valuable insights into the potential risks associated with the combination of nTiO2 and MPs in marine environments, considering the influence of environmentally relevant light conditions and the test medium.
A national survey on current state and development needs of clinical and academic emergency medicine in China
Authors: Du lanfang , Li Yan , wang Zhenjie , Zhang Guoqiang , Chen Xiaohui , Tian Yingping , Zhu Changju , Zhang Jinsong , Wu Lidong , Li Peiwu , Chen Yuguo , Ji Bing , Pan Shuming , Zeng Jun , Chai Yanfen , Mu Yesai , Zhang Mao , Ma Yu , Lv Chuanzhu , Ma Qingbian
Published: August 2023

Background
To characterize the current state of emergency medicine (EM) development and the needs for advancing EM practice, education and research in China.
Methods
An anonymous electronic survey was conducted by Chinese Society of Emergency Medicine during September to October 2021. The survey contained 30 questions divided into 2 sections: the current state of EM development and the needs for growth.
Results
Finally, 722 hospitals from 26 provinces were included, of 487 were Level III and 235 were Level II hospitals. We found that after 40 years of development, EM had established a mature disciplinary system and refined sub-specialties including cardiopulmonary resuscitation, toxicology, emergencies and disasters and critical care. The training system of emergency professionals had been initially established. 37.8% of emergency departments in Level III hospitals have master's degree program, 8.4% have doctor's degree program, only 2.9% have post-doctoral mobile research stations. Postgraduate curriculums of EM were available in 1/4 of EDs in Level III hospitals. Only 8% have national or provincial key laboratories. In addition to advance clinical practice, there was also a high demand to improve teaching and research capacities, mainly focusing on literature review, research design and delivery, paper writing, standardized training for residents.
Conclusions
EM has built a mature discipline system and refined sub-specialties in China. The training system of emergency professionals had been initially established. In addition to advance clinical specialty, we should also pay attention to the strong need for improving EM education and research capacities.