bluuebunny/crossref_metadata_2025 huggingface dataset:
Post-NACA Aerodynamics: Optimizing H-Darrieus VAWT Design with CFD Simulations of J-Blades
Authors: Abdallah Ahmed , William Micheal A. , Zidane Iham F.
Published: October 2024

As the demand for sustainable energy sources continues to rise, improving the efficiency of existing renewable technologies is crucial. This study investigates the aerodynamic performance of a novel J-shaped blade design for H-Darrieus VAWT with the objective of enhancing starting torque and overall efficiency. A 2D URANS CFD model was employed to simulate the airflow around the J-shaped blades. The model underwent a comprehensive verification and validation process. This rigorous approach ensured the model's fidelity, enabling a systematic comparison of the J-shaped blade's aerodynamic performance with conventional NACA0015 airfoils. The numerical analysis reveals a significant enhancement in starting torque, with a 142% increase observed at low tip speed ratios (λ = 0.2). This finding positions the J-shaped blade as a promising solution to address the challenge of initiating rotation in low-wind environments, particularly relevant for urban applications. Furthermore, the simulations demonstrate comparable torque production between the J-shaped blade and the NACA0015 airfoil under typical operating conditions. The J-shaped blade exhibits improved torque uniformity and reduced wake turbulence intensity. This study highlights the potential of the J-shaped blade design to revolutionize VAWT technology by offering advancements in increased efficiency, reduced fatigue stresses on the turbine structure, and optimized energy generation.
Perspectives and experiences of parents of children with juvenile dermatomyositis: A semi-structured interview study.
Authors: Kelly Amy , Kelly Ayano , Grewal Davinder Singh , Chaitow Jeffrey , Jaure Allison
Published: October 2024

Background
Juvenile Dermatomyositis (JDM) is a rare, childhood inflammatory disease and its management can be challenging and confronting for both clinicians and caregivers. Little is known about the perspectives of parental caregivers of children with JDM. This study aimed to describe the experiences of parents of children with JDM to inform person-centred care.
Methods
Semi-structured interviews (face-to-face, telephone) were conducted with parents of children with JDM from three centres in Australia. Transcripts were analysed thematically.
Results
Nineteen parents (15 mothers) of 18 children aged 8 to 21 with JDM participated. Six themes were identified. Rapid crescendo of fear and desperation (alarming deterioration, sudden realisation of seriousness, desperate for a diagnosis ), lost and unsupported in the health system (at the mercy of the medical team, frustrated at the lack of services, neglected priorities, protracted and painful search for answers), disrupting family routines (sibling neglect and loss, overloaded with a medicalised schedule, always on standby, burdened by financial strains), grieving what has been lost (missing the sunlight, struggling with the loss of physical function, disrupted schooling, changes in their child from steroid side effects), managing an uncertain future (bound to chronicity, fearing relapse, insecurity with transition to adult care), gaining confidence and motivation (strengthening partnerships with clinicians, growing maturity and independence, gaining hope from shared experiences).
Conclusions
The diagnosis of JDM is often delayed and caregivers of children with JDM report distress, disruption and uncertainty throughout their treatment journey with their child. Addressing these fears and establishing support mechanisms that help parents navigate their way through the medical system and support changing family dynamics are vital to optimise health outcomes for children diagnosed with JDM.
Therapeutic effects and potential mechanisms of caffeine on obese polycystic ovary syndrome: bioinformatic analysis and experimental validation
Authors: Tonglin Bai , Yue Hu , Ling Luo , Yuhuan Liu , Chaoqin Yu
Published: October 2024

Background
The risk of PCOS is significantly increased in obese women, and studies have shown that weight loss can improve the symptoms of PCOS. Coffee has been shown to effectively reduce body weight. In this study, we focused on the SLC16A6 gene through bioinformatics and searched for coffee and its monomers through reverse network pharmacology.
Materials and Methods
The Gene Expression Omnibus (GEO) database was searched to screen differentially expressed genes (DEGs) with PCOS patients. Gene Ontology (GO) functional enrichment analysis and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were subsequently performed. The effects of caffeine on body weight, the estrous cycle, ovarian pathology, the serum insulin concentration and the insulin resistance index, and the expression of the SLC16A6 transporter gene in the ovarian tissues of obese PCOS rats were observed.
Results
The common differentially expressed gene SLC16A6 was identified in this study, and animal experiments confirmed the effectiveness of caffeine in the treatment of obese PCOS rats.
Conclusions
Caffeine can effectively improve the symptoms of obese PCOS rats. The mechanism by which caffeine can treat obese patients with PCOS is related to increasing the expression of the SLC16A6 gene.
Blood Pressure and Heart Rate Response to Orthostasis in Somali Americans
Authors: Greenlund Ian , Bock Joshua , Govindan Nivash , Kantas Dimitrios , Singh Prachi , Covassin Naima , Somers Virend
Published: October 2024

Purpose: Cardiovascular health disparities are present in African Americans, but it remains unknown whether this phenomenon affect Somali Americans. Study of Somali Americans is warranted due to distinct genetic and cultural differences from African Americans of western African ancestry. Orthostatic hemodynamic responses have implications for cardiovascular risk, especially among African American females. We sought to examine race and sex differences in systolic (SAP) and diastolic (DAP) arterial pressure and heart rate (HR) responsiveness to standing. We hypothesized that SAP, DAP, and HR change from supine to standing position would be higher in Somali Americans.
Methods: We studied blood pressure and HR responsiveness in 139 (70 Somali; age: 29±10 years, 69 White; age: 31±9 years) participants. Supine SAP, DAP, and HR were measured after at least five minutes of supine rest, and again after one minute of standing. SAP, DAP, and HR change was compared between groups.
Results: ΔSAP and ΔDAP were similar between groups (race × sex: p>0.05). However, HR responsiveness to orthostasis varied between race and sex comparisons (race×sex: p=0.011). Somali females exhibited an augmented HR response to orthostasis compared to White females (Δ19±13 vs. 11±9 beats/min, p=0.005) and Somali males (Δ19±13 vs. 12±9 beats/min, p=0.020).
Conclusion: ΔHR to standing is augmented in young female Somali Americans. These findings highlight an early potential impairment in hemodynamic regulation that may heighten future cardiovascular risk. Further work is warranted to identify the potential autonomic nervous system underpinnings that may contribute to potentiated orthostatic responses and cardiovascular risk in Somali American females.
Clinical Trial Registration: www.clinicaltrials.gov; unique identifier, NCT04124848; NCT05411029; NCT03308578.
Accelerated Accurate In-line Solder Joint Inspection Technique
Authors: Ong Teng Yeow , Tan Koon Tatt , Teoh Ping Chow , Haron Mohamad Hushnie
Published: October 2024

This paper reviews the entire vision inspection cycle, encompassing image acquisition, image enhancement, Region of Interest (ROI) localization and segmentation, features extraction followed by defect detection and classification. The aim of the study is to identify potential image processing time saving. The investigation innovatively suggests that optimizing image enhancement and ROI localization processing time could significantly accelerate the overall inspection cycle time without negatively impacting inspection accuracy. In Automated Optical Inspection (AOI) machine, camera sensor is mounted on precision X-Y gantries. To acquire images for inspection, the gantries will accurately move the camera to the predetermined coordinate position as stipulated in the inspection program. The vision camera will then capture the desired image using specified Field of View (FOV). Only ROI which is the solder joint position will be extracted out from the FOV image for processing. Meanwhile, the designated solder joint positions (i.e. solder pad coordinates) for all electronic components mounted on the PCB are priory known extracted from the PCB fabrication file. These coordinates can be used directly for ROI localization without employing any algorithm, and yet accuracy is not compromised. Meanwhile, through leveraging the state-of-art vision hardware, namely high-resolution camera and adaptive lighting system, quality images can be acquired and used directly without the need for any enhancement. Comparison analysis based on industrial PCB having 1000 electronics components (with 3000 solder joints of size 140x70 pixels per joint), the processing time utilizing NVIDIA GeForce RTX 2060 series Graphic Processing Unit (GPU) and Template Matching Algorithm for ROI localization needs 2 seconds. whereas when using Multiscale Morphology Algorithm for image enhancement, time required is approximately 3 seconds. Benchmarking of a typical production line with bottleneck cycle time of 25 seconds, indicating that the proposed methodology effectively addresses the challenges faced while implementing real-time machine vision inspection system in the industry, aligned with Industrial 4.0 Smart Manufacturing initiatives.
Prevalence and eradication rate of helicobacter pylori infection among the patient using the low dose of aspirin attending outpatient clinic at tertiary hospitals in Dodoma, Tanzania. A prospective longitudinal observational study
Authors: John Lawi , Sindato Emmanuel , Alphonce Baraka
Published: October 2024

Introduction:
Low-dose of aspirin has been widely used by health providers as primary prevention of major cardiovascular events, its benefit counterbalanced by side effects The synergistic interaction between H. pylori infection and LDA use has been identified as a significant risk factor for peptic ulcer disease, chronic gastritis, perforation, bleeding and gastric cancer with increase folds two to three times among H. pylori positive patient.
Methodology:
A prospective observational longitudinal study was carried out for patients using the low dose of aspirin attended outpatient clinic at Benjamin Mkapa Hospital and Dodoma Regional Referral Hospital in between September, 2023 to April, 2024.A sample size of 159 participants were recruited, aged 18 years or older met specified inclusion criteria. At baseline Demographic data, clinical characteristics were extracted from questionnaire form. Blood sample was collected for full blood picture and stool for H. pylori antigen test. Data analysis employing frequencies, chi-square test and binary logistic regression was done by using SPSS version 26. Statistical significance was ruled out for p < 0.05.
Results
Among 159 patients enrolled in this study, mean age was 57 (IQR 20–75), 57.7% were female. The prevalence was 74.8%. Variables which show significance in this study include use of alcohol [p value = 0.007, OR = 3.24, 95% CI (1.38–7.61)], non-adherence of medications [p value = 0.001, OR = 5.5, 95% CI (2.11–14.46)], smoking [p value < 0.001, OR = 13.61, 95% CI (2.30–56.30)].
Conclusion
H. pylori infection is frequently observed in patients using low dose of aspirin attending medical clinic to tertiary hospital in Dodoma. Factors which have significance with helicobacter pylori eradication failure were smoking, alcohol and non-adherence to medication during treatment period.
Examining the mediating role of college based capacities on the relationship between technology integration and teacher preparation program Implementation Quality in Southern Nation, Nationalities and People Region, Ethiopia
Authors: Legesse Befkadu , Legesse Dawit , Demissie Mesfin
Published: October 2024

The study investigated the mediating role of college-based capacities in the relationship between technology integration and implementation quality of teacher preparation programs in colleges within the South Nation, Nationalities, and Peoples region. A quantitative methods design employed, utilizing cross-sectional surveys with 294 participants from four teacher education colleges. In a study using structural equation modeling, it found that technological pedagogical content knowledge (TPACK) had a significant impact on the quality of implementation, the provision of materials, and outcomes such as instructor effectiveness. The study also revealed that college capacities, including leadership, resources, and the attitudes of diploma graduates, played a mediating role in the relationship between technology integration and implementation quality. Correlation analysis showed strong positive relationships between technology integration, and factors such as instructor efficacy, leadership support, resource availability, and attitudes toward technology integration. The findings highlight technology integration significance to the proposed model and its interconnectedness with organizational and human elements influencing effective technology use in teacher education. Theoretically, the results align with resource-based and transformational leadership theories, emphasizing strategic resource utilization and leadership practices enhancing teaching and learning through technology. Practically, a comprehensive approach investing in TPACK competencies, instructional leadership, and resource provision recommended for impactful educational reforms. The study contributes an original model clarifying the dynamics between technology integration, college capacities, and implementation quality in teacher preparation contexts.
Preoperatively Predicting Failure to Achieve the Minimum Clinically Important Difference and the Substantial Clinical Benefit in Patient-Reported Outcome Measures for Total Hip Arthroplasty Patients using Machine Learning
Authors: Park Jaeyoung , Zhong Xiang , Miley Emilie N. , Gray Chancellor F.
Published: October 2024

Background: Attention to the collection of patient-reported outcomes measures (PROMs) associated with total hip arthroplasty (THA) is growing. The aim of this study was to preoperatively predict failure to achieve the minimal clinically important difference (MCID) and substantial clinical benefit (SCB) between pre- and postoperative PROMs. In addition, we sought to identify factors predictive of failure to achieve MCID and SCB in patients undergoing a THA.
Methods: A retrospective query of the electronic health record data was performed at a single institution. Outcomes of interest were the anchor-based MCID, the distribution-based MCID, and the SCB for the Hip dysfunction and Osteoarthritis Outcome Score for Joint Replacement. Several machine learning models were built for each outcome, and areas under the receiver operating characteristic curve and the precision-recall curve were evaluated. Furthermore, logistic regression models were used to identify significant risk factors.
Results: Of the 857 patients who underwent THA, 350 patients completed both pre- and postoperative surveys. Of the final sample (i.e., 350 patients), 56 (16.0%), 29 (8.3%), and 71 (20.3%) failed to reach the anchor-based (i.e., 17.7 points) and distribution-based (10.6 points) MCIDs and the SCB (i.e., 22.0 points). The machine learning model performances were far beyond the baseline and comparable to the ones in existing studies, suggesting reliability in the prediction. Two shared factors associated with the failure in both MCIDs and the SCB were highlighted: a patient’s race and pre-existing mental illness.
Conclusion: Understanding the risk factors of failing to meet MCID and SCB may provide a more objective opportunity to quantify patient and surgeon expectations associated with THA. Our findings call stakeholders' particular attention to patients with preoperative mental disorders, and raise further questions regarding the impact of race, in the care of patients with degenerative hip disease.
The diagnostic value of NLR, PLR, SII and FAR in endometrioid carcinoma and their correlation analysis with clinicopathological characteristics of endometrioid carcinoma
Authors: zuo Hongling , Zong Yadi , Yao Zhi , Liu Yaxin , Du Juan , Liu Zhina , Liu Pan , Yang Yuxing , Guo Pengfei , Du Hui
Published: October 2024

Objective To investigate the potential utility of neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic inflammatory index (SII), and fibrinogen-to-albumin ratio (FAR) in the diagnosis of endometrioid carcinoma (EEC). Additionally, to explore the correlation between these ratios and the clinicopathological characteristics of EEC.
Methods 1.113 patients with EECdiagnosed in our hospital from November 2018 to November 2023 were selected as the study group, and 113 patients with endometrial polyps in our hospital during the same period were selected as the control group. Both groups were confirmed by pathology. The differences of NLR, PLR, SIIand FAR in the pre-operation peripheral blood of patients in the two groups were analyzed, and the value of individual indicators in diagnosis of EEC was evaluated using the Receiver Operating Characteristic (ROC) curve. 2. 147 patients of EEC with complete clinic-pathological data were divided into groups according to postoperative FIGO stage, histological grade, depth of muscle invasion, presence or absence of lymph-vascular space invasion (LVSI) and lymph node metastasis (LNM). The correlations between NLR, PLR, SII, FAR and different clinicopathological characteristics were analyzed.
Results 1. The levels of NLR, SII and FAR in patients of EEC were significantly higher than those in patients with endometrial polyps (P<0.05). While PLR showed no significant difference between the two groups (P>0.05). The optimal cut-off values of NLR, SII, FAR were 1.650, 361.260 and 0.071. The area under the curve (AUC) were 0.621, 0.622 and 0.590. The sensitivity and specificity were 66.4%, 72.6%, 48.7% and 54.9%, 47.8%,70.8%. 2. Among 147 EEC patients, there were 130 (88.43%) cases in FIGOI+II stage and 17 (11.56%) cases in III+IV stage, 5 (3.40%) cases with LNM and 142 (96.59%) cases without LNM. Significant differences of NLR, PLR, SII were observed between different clinical stages and LNM status, while FAR only showed an advantage in clinical stage (P<0.05). However, NLR, PLR, SII and FAR showed no significant differences in histological grade, depth of myographic infiltration, and LVSI (P>0.05).
Conclusion As a simple and non-invasive preoperative hematological index, NLR, PLR and SII have certain predictive value for EEC. NLR, PLR, SII and FAR are closely correlated with the clinicopathologic features of EEC, may serve as potential discriminative biomarkers for the diagnosis and prognosis of EEC.
Effects of feeding empty fruit bunch extract on milk production and milk fatty acid profiles in goats
Authors: Harun Nur Liyana Akmal , Samsudin Anjas Asmara , Sazili Awis Qurni , Goh Yong Meng
Published: October 2024

The effect of feeding empty fruit bunch extract on milk production and milk fatty acid profiles of lactating Saanen goats was evaluated. A total of four lactating Saanen goats (14 days in milk, 54.3 ± 9 kg of body weight) were subjected to a crossover design with a 17-d period (10-day adaptation period and 7-day for data and sampling period) with a 12-day washout period in between both periods. The treatment diets were; CON; (0% extract, basal diet of 60:40 of napier grass and concentrate) and EFB (5% OPEFB extract per DM basal diet). The 5% EFB extract in EFB diet did not affects milk yield, milk fat, milk total solid and milk solid non-fat compared to the CON diet. The milk protein content was significantly higher in EFB diet (P < 0.05) while milk lactose content was significantly higher in CON diet (P < 0.001) when compared to the others. Milk from EFB diet shows significantly higher (P < 0.05) in capric, lauric, myristic acid, and total SFA concentration as compared with milk from CON diet. Goat fed with EFB diet significantly reduced (P < 0.05) in stearic, oleic, total UFA, total MUFA concentration and UFA: SFA ratio in milk when compared with goat fed with CON diet. Meanwhile, the content of myristoleic acid, linoleic acid and PUFA: SFA ratio was similar between both treatment diets. Hence, the supplementation of 5% OPEFB extract in EFB diet did not alter milk production but the composition of the milk especially the profiles of milk fatty acid.
MAPKAPK2 (MK2) facilitates the epithelial-mesenchymal transition in lung adenocarcinoma through activation of the AKT/MYC signaling pathway
Authors: Qi Rong , Fang Chen , Liu Penghui , Gu Weiguo , Shi Chao , Zhang Guohua , Qiu Feng
Published: October 2024

Purpose
The protein kinase Mitogen-Activated Protein Kinase-Activated Protein Kinase 2 (MK2) is linked to higher risks of metastasis and mortality in some cancers. Nonetheless, its precise function in lung adenocarcinoma (LUAD) is still not well understood. Thus, our research focuses on examining MK2’s role within LUAD cells and identifying the underlying mechanisms involved.
Methods
Differences in MK2 expression among patients with LUAD were confirmed through Timer2.0 database and tissue microarrays. The activity of MK2 in LUAD cell lines A549 and H358 was inhibited using a specific MK2 inhibitor. Thereafter, the viability, migration and mobility were analyzed. Gene expression changes were confirmed through Western blotting. Additionally, an AKT activator was used to validate the role of the MK2-regulated AKT/MYC signaling pathway.
Results
MK2 shows higher expression in LUAD tissues than in surrounding normal tissues. Reducing MK2 activity not only curtails cell proliferation, migration, and EMT-related invasion in vitro but also disrupts the AKT/MYC signaling axis. Nevertheless, activating the AKT/MYC pathway can counteract the effects of MK2 inhibition.
Conclusions
Our research shows that MK2 promotes migration and invasion in LUAD through the AKT/MYC signaling pathways, highlighting MK2 as a potential therapeutic target for LUAD.
Bedside Tracheostomy for Pediatric Critically Ill patients in PICU: Clinical Experience in a Single center
Authors: Lim Young Tae , Kwon Jung Eun
Published: October 2024

Background
Children with neurological impairments, especially those who are bedridden, may require additional care services beyond what is available for the general pediatric population, and tracheostomy may be necessary for addressing respiratory problems, but no established consensus or clear guidelines have been established on the optimal timing of this procedure in the pediatric intensive care unit (PICU).
Methods
We conducted a study involving 39 bedridden patients with neurological impairments who underwent tracheostomy in the PICU from January 2017 to December 2022. We collected demographic, tracheostomy, and outcome data and compared the data between two groups based on the duration of mechanical ventilation before tracheostomy.
Results
The patients had heterogeneous neurological conditions, with refractory epilepsy being the most common. Almost all patients received tracheostomy for prolonged mechanical ventilation, with a median duration of 14.5 days of mechanical ventilation before the procedure. A majority of the patients (60.5%) experienced complications related to tracheostomy. The overall mortality rate was 36.8%, with 7.9% directly related to tracheostomy. When the patients were divided into two groups based on the median duration of mechanical ventilation before tracheostomy, the group that received tracheostomy earlier had significantly shorter total PICU stay and hospitalization stay compared to the group that received it later.
Conclusions
Tracheostomy is a procedure necessary for resolving respiratory difficulties in children with neurological impairments who are typically bedridden. As complications and mortality rates can be high in this population, careful and appropriate care is necessary.
Shape detection of cervical vertebrae growth stage using “No Coding” Deep Learning - Google’s Teachable Machine tool
Authors: Fattal Amine , Swinson Heather , Gudhimella Sudha , El-Baz Ayman , Deguchi Toru
Published: October 2024

Objective: Prediction of skeletal growth has always been an interest in the field of orthodontics. The shape of the cervical vertebrae was found to be correlated to different growth stages. Several studies have used machine learning to identify the cervical vertebrae maturation stage (CVMS), however, the accuracy was not as high as it was expected. Moreover, machine learning tool is complicated and is not familiar for most clinicians. Recently, user friendly and easily accessible website known as “Google’s Teachable Machine Tool” was introduced. If proved to be reliable, this kind of free and easy to use Ai tools can help expand and accelerate Ai applications in dentistry. The purpose of this study is to classify the CVMS using Google’s Teachable Machine tool and investigate the accuracy.
Materials and Method: Three hundred and sixty cephalograms (60 for each stage) were used in this study. Region of interests (ROIs) were cropped from each cephalogram to include the 2nd to 4th vertebrae. A different image type was made by using a digital edge detection tool to draw the shape of the vertebrae and construct a white mask of vertebrae with a black background. Both image types They were fed to Teachable Machine later to train the model. Furthermore, masks, which are often used for this task, were validated against human classifiers.
Results: F1 score was highest at 0.75 for post pubertal, 0.68 for Pre pubertal and 0.61 for pubertal. Accuracy was 0.81, 0.72, and 0.83 for pre pubertal, pubertal and post puberal. Mask were inferiorly classified by humans.
Conclusions: Google teachable can, with a reasonable accuracy, classify the CVMS in pre pubertal, pubertal and post pubertal classes and masks showed to be inferior image type to train the model and proved less valid in our study.
Association between advanced lung cancer inflammation index and all-cause and cardiovascular mortality among prediabetes patients: NHANES, 1999–2018
Authors: Yan Rui , Ma Xueping , Shi Bo , Ye Congyan , Fu Shizhe , Wang Kairu , Yan Ru , Jia Shaobin , Cong Guangzhi
Published: October 2024

Background
Prediabetes is a significant risk factor for type 2 diabetes and cardiovascular disease, yet effective prognostic tools are lacking. The Advanced Lung Cancer Inflammation Index (ALI), an emerging inflammatory marker, has shown prognostic value in various diseases. However, the role of ALI in prediabetic patients remains understudied. This study aims to evaluate the association between ALI and all-cause and cardiovascular disease (CVD) mortality in prediabetic patients, exploring its potential as a prognostic assessment tool.
Methods
This study utilized data from the National Health and Nutrition Examination Survey (NHANES) 1999–2018. Multivariate Cox regression models were used to analyze the relationship between ALI and mortality risk. Their non-linear relationship was analyzed by restricted cubic spline analysis. Sensitivity analysis was constructed through stratified analysis and interaction analysis.
Results
The study incorporated a total of 16,670 patients. An increase in ALI was associated with a reduced risk of all-cause and CVD mortality in prediabetes patients. Compared to the lowest ALI quartile, the highest quartile showed a 30% reduction in all-cause mortality risk (HR = 0.70, 95%CI: 0.62–0.79) and a 44% reduction in CVD mortality risk (HR = 0.56, 95%CI: 0.44–0.73). In addition, there were L-shaped non-linear relationships between ALI and all-cause, CVD mortality in prediabetes patients. The inflection points were 40.50 and 37.35, respectively. For values below the inflection point, for every 10U increase in ALI, all-cause mortality risk decreased by 26%, and CVD mortality risk decreased by 32%. Beyond the inflection point, the effect weakened both all-cause and CVD mortality.
Conclusion
ALI is significantly negatively associated with all-cause and CVD mortality in prediabetic patients. ALI may serve as an effective tool for assessing long-term prognosis in prediabetic individuals.
Central Retinal Artery Occlusion Following Delayed Acute Retinal Necrosis Post-SARS-CoV- 2 Recovery: Clinical Practice and Literature Review
Authors: Jiang RunDong , Lin Dan , Feng Han , Chen WenJuan , Pan AnNa , Wang YuQin
Published: October 2024

This study investigates acute retinal necrosis (ARN) complicated by central retinal artery occlusion (CRAO) post-SARS-CoV-2 infection, a rare clinical scenario. It highlights the clinical characteristics and potential pathogenesis of this condition based on a comprehensive literature review, emphasizing the role of SARS-CoV-2 in its development. The research demonstrates that cardiovascular or cerebrovascular diseases, herpes encephalitis, meningitis history, and immunocompromise are potential risk factors for CRAO in ARN patients. Misdiagnoses and delayed diagnoses are common in the initial stages of ARN complicated by CRAO, often leading to poor outcomes due to the lack of antiviral treatment or inappropriate use of corticosteroids. The study posits the synergistic role of SARS-COV-2 in activating herpes viruses and promoting thrombogenesis within the central retinal artery. Emphasizing the importance of dilated eye examinations in all new uveitis patients, particularly those with a history indicating a high risk for ARN, the study advocates for prophylactic antiviral therapy in such individuals following SARS-COV-2 infection. A multidisciplinary team (MDT) approach, combined with comprehensive antiviral treatment, is crucial for managing these cases, aiming to improve prognosis through urgent interventions for ARN-related CRAO.
The fire performance of GFRP-RC beams based on FE thermal analysis
Authors: Bolina Fabricio Longhi , Silva Débora Bretas , Pachla Eduardo Cesar
Published: October 2024

GFRP (glass fiber reinforced polymers) rebars can be used in RC (reinforced concrete) structures as an alternative to conventional steel rebars. Their application offers advantages, especially in chemically aggressive environments, as they can reduce the C (concrete cover) thickness required and also optimize the cross-sectional dimensions of these structures as well as their durability and service life. However, based on FE (finite element) numerical analysis solved by Abaqus software, this research has shown that the reduction in C-thickness promotes a notorious incongruity: an improvement in the fire sensitivity of these structures. The time in which GFRP-RC structures failed in fire can be around 400% lower in relation to identical conventional steel RC structures. In some cases, the fire resistance rate (FRR) of GFRP RC structures can be less than 10 min when the critical temperature of these rebars (around 100°C) is taken into account. The interest in structural durability criteria is not sufficient to justify the application of this new type of reinforcement in some concrete buildings.
The Prognostic Significance of Subcarinal Lymph Node Dissection in Esophagectomy for Middle and Lower Thoracic Squamous Cell Carcinoma
Authors: Xu Si Wei , Liu Jun Feng , Liu Xin-Bo , Shi Zhi Hua , Cao Bing Ji , Zhang Shao Wei
Published: October 2024

Background
This retrospective study assesses the prognostic value of subcarinal lymph node dissection (SCLND) in esophageal squamous cell carcinoma (SCC) of the middle and lower thoracic regions.
Methods
Conducted at the Fourth Hospital of Hebei Medical University, the study included 1588 patients with SCC who underwent radical resection from 2008 to 2014. After propensity score matching, 661 patients were analyzed, with 185 without and 476 with SCLND. Kaplan-Meier curves, Log-rank tests, and Cox regression were used for survival analysis, with SPSS 23.0.
Results
SCLN metastasis was found in 10.3% of patients. Factors influencing metastasis included tumor size, invasion depth, positive lymph node count, and smoking and alcohol history. SCLND significantly affected overall survival, with 5-year rates of 47.7% for non-metastatic versus 12.8% for metastatic patients. SCLND improved long-term survival for T3-T4a stage patients but not for T1-T2.
Conclusion
Despite a low SCLN metastasis rate, its presence significantly worsens prognosis. SCLND improves long-term survival, particularly for T3-T4a stage patients, guiding surgical decisions on lymph node dissection.
Correlation between circulating cell-free mitochondrial DNA content and severity of knee degeneration in patients with knee osteoarthritis
Authors: Wu Yan-lin , Wan Shao-gui , Long Yi , Ye Hua , Yang Jia-ming , Luo Yun , Zhong Yan-biao , Xiao Li , Chen Hai-yan , Wang Mao-yuan
Published: October 2024

Background
Mitochondrial damage and increased inflammation are hallmarks of knee osteoarthritis (KOA). Circulating cell-free mitochondrial DNA (ccf-mtDNA), which originates from damaged mitochondria, is an endogenous damage-associated molecular patterns (DAMPs) molecule that may trigger inflammation and has been recognized as a potential biomarker for various diseases. In this study, we aimed to investigate whether there is a potential association between plasma ccf-mtDNA levels and the severity of knee injury and whether it can be used as an early diagnostic biomarker in patients with KOA.
Methods
Plasma was collected from KOA patients and healthy controls (HC). Quantitative real-time polymerase chain reaction (qRT-PCR) was used to detect ccf-mtDNA content in plasma samples. X-ray Kellgren-Lawrence (K-L) classification criteria were used to classify KOA patients into four groups of grades I-IV. The severity of disease in KOA patients was assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and a Spearman analysis was performed to observe the correlation between ccf-mtDNA content and the K-L classification and WOMAC score. Logistic regression analysis was used to evaluate the relationship between ccf-mtDNA and the risk of KOA.
Results
60 patients with KOA and 60 HC matched for their age, sex, and body mass index (BMI) were enrolled. we found that plasma ccf-mtDNA contents were significantly higher in patients with KOA (median, 2.44; range, 1.10–3.79) than in HC (median, 1.08; range, 0.52–2.12) (P < 0.0001). Plasma ccf-mtDNA contents were sequentially higher in the KOA class I-IV group (P = 0.040), and positively correlated with K-L classification (r = 0.369, P = 0.004), and WOMAC scores (r = 0.343, P = 0.007). Subjects with high levels of ccf-mtDNA had a significantly increased risk of KOA compared with subjects with low levels of ccf-mtDNA [odds ratio (OR), 4.15, 95% confidence interval (CI), 1.71–10.07; P = 0.002]. Quartile analysis showed a significant dose-dependent effect for this association (P trend = 0.000).
Conclusion
Our study suggested that plasma ccf-mtDNA contents were significantly associated with the risk and severity of KOA. Plasma ccf-mtDNA may be a liquid biopsy biomarker for the early diagnosis of KOA and the assessment of its symptom severity and may shed light on the prevention and treatment of KOA.
Severe Perineal Tears during Childbirth: A Study of Ethnic Minority Women's lived Experiences and Healthcare Challenges
Authors: Olakotan Olufisayo Olusegun , Lim Jennifer , Bhavsar Mina , Siddiqui Farah , Ayaz Rabina , Henry Gillian O’Brady , Pillay Tilly
Published: October 2024

Background
The increasing incidence of Obstetric anal sphincter injury (OASI) has resulted in numerous reported cases of complications and risks among women, significantly impacting their quality of life. Qualitative studies focusing on lived experiences of women following OASI in the United Kingdom (UK) are scarce.
Aim
This study aims to explore the lived experiences of women with OASI from culturally diverse backgrounds in Leicester, UK.
Methodology:
A focus group discussions (FCDs) was held virtually with ten women from Leicester who had experienced third and fourth-degree tears in the last one to five years. Invitation to participate in the study were sent out by Leicester Mammas via email, attached with a flyer. The data was analysed using the five-step thematic analysis approach by Braun and Clarke.
Results
The study identified several key themes such as childbirth experiences, complications and reflection, societal influence and childbirth choices, cultural silence, stigmatization, and mental health issues. The women reported feeling uninformed and unprepared about possible complications and risks such as third and fourth-degree tears, resulting in traumatic birthing experiences, aggravated by inadequate healthcare communication and support from healthcare providers.
Conclusion
There is the need for future research to integrate physical, physiological and mental health support, as well as sustained follow-up into OASIS care bundle. This will essentially support women's health and well-being during the perinatal period.
Fractures and Geological Analysis of the Water Breakthrough Patterns for the Production in X Carbonate Reservoir: A Case Study from Southeast Iraq
Authors: Chafeet H. A. , Al-Abadi A. M. , Homod R. Z. , Handhal A. M.
Published: October 2024

This study examines fracture analysis and characterization of the X carbonate reservoir within the AG oilfield in southeast Iraq, near the Iraq-Iran border. The reservoir is categorized into zones A, B, and C, each presenting unique challenges due to its complex fractured-porous nature, limited conventional log responses, a lack of special logs, and the structural difficulties caused by the Zagros orogeny. To evaluate fracture geometry and distribution and water breakthrough patterns and their influence on reservoir quality and production efficiency, the core samples, well logs, and thin sections from 10 wells were studied. The X carbonate reservoir analysis indicated that fractures typically range from 1–25 cm in length and 0.02–0.08 mm in width, predominantly high-angle to near-vertical fractures enhancing the reservoir's permeability. The reservoir properties indicate that member B has better physical properties than member A, with higher porosity and permeability. Fracture density varies significantly across the reservoir zones, ranging between 0.7 and 9.6 fractures/meter, averaging 4.7 fractures/meter and decreasing from A to C. In zones A and B, especially in the dolomite and limestone lithologies, these fractures contribute to improved permeability and higher well productivity. For example, wells AG-7A and AG-16 maintain steady production rates of 5000 and 3000 barrels per day. However, these fractures also lead to water breakthroughs, with 57.9% of wells encountering increasing in water cuts above 10%, therefore highlighting the difficulty in managing water production. Additionally, the time for water breakthrough and the location and perforation of every well were also considered in the process of water breakthrough analysis. Furthermore, the study identified three primary mechanisms for water breakthrough: gradual edge water invasion in member B of the southern area, fractures causing water breakthrough from member B to A, and bottom water invasion in the northern area. These findings highlight fractures' essential role in encouraging oil extraction and fasting water breakthroughs, which requires effective reservoir management to maximize hydrocarbon recovery while limiting water production.
Association between CCND1 rs9344 polymorphism and clinical prognosis of gastric cancer
Authors: Liu Xiaofang , Chen Lin , Xiaobin Chen , Shaobin Qiu , Zhenwen Liu , Lie Wang , Yuan Dang , Xu Qianhui
Published: October 2024

To investigate the difference between CCND1 rs9344 polymorphism and the clinical prognosis of patients with gastric adenocarcinoma after operation. The clinical data of patients with gastric adenocarcinoma confirmed by postoperative histopathology who underwent total gastrectomy or subtotal gastrectomy from July 2017 to December 2020 in the 90th Hospital of the Joint Logistic Support Force of the Chinese People's Liberation Army were retrospectively analyzed. The polymorphism of CCND1 rs9344 in tissue samples was detected by PCR-RFLP. The relationship between the polymorphism of this locus and clinicopathological features and prognosis of gastric cancer was analyzed.A total of 529 patients with gastric cancer were enrolled. There were 88 (16.6%), 269 (50.9%) and 172 (32.5%) rs9344 polymorphisms detected in GG, GA and AA, respectively. The number of patients with each genome distribution was statistically significant in survival (P < 0.05). Cox multifactorial recurrence or metastasis, T4 stage, N3 stage, tumor diameter ≥5cm and AA genotype were independent risk factors for death. Female, tumor located in gastric antrum, low differentiation, lymph node metastasis stage N2-3, vascular nerve invasion, cancer nodule metastasis are independent risk factors for recurrence or metastasis. Homozygous mutation (AA) of CCND1 rs9344 polymorphism is an independent risk factor for postoperative death in gastric cancer patients.
Comparison of Diffusion-Weighted Magnetic Resonance Imaging and 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography for Detection of Peritoneal Carcinomatoses in Advanced Epithelial Ovarian Cancer
Authors: Cai Song-Qi , Huang Jian-Feng , Wu Min-Rong , Lu Jing-Jing , Ma Xiao-Liang , Ding Yu-Qin , Liu Guo-Bing , Qiang Jin-Wei , Liu Li-Heng , Zhou Jian-Jun , Zeng Meng-Su
Published: October 2024

Objectives: To compare the diagnostic accuracy of diffusion-weighted magnetic resonance imaging (DW-MRI) and 18F-fluorodeoxyglucose combined positron emission tomography combined with computed tomography(FDG-PET/CT) in detecting peritoneal carcinomatoses in advanced epithelial ovarian cancer (EOC).
Methods: This prospective study enrolled patients with stage III-IV EOC consecutively from October 2020 to February 2023. Participants underwent both DW-MRI and FDG-PET/CT. Three radiologists independently evaluated the radiological images using peritoneal cancer index (PCI) scoring systems. Clinical data, preoperative imaging assessments, and cytoreductive surgical outcomes were recorded. Univariate and multivariate analyses were performed to determine the critical regions for surgery associated with incomplete resection. The diagnostic performance of each imaging modality was calculated for each site. The interobserver agreement was assessed.
Results: Forty-eight patients were enrolled in this study. No statistically significant differences were found between the imaging modalities (p≥0.142) based on the PCI scoring evaluation system. Omental lesions extend to the hepatic flexure or splenic flexure (p=0.045, OR=20.891), and small bowel mesentery involvement (p=0.039, OR=21.814) were identified as surgically critical regions associated with incomplete resection. DW-MRI demonstrated significantly higher accuracy than FDG-PET/CT (p=0.049) in diagnosis at omental lesions extend to the hepatic flexure or splenic flexure and diaphragmatic peritoneum, with sensitivity and specificity of 0.773 and 0.792 for DW-MRI, and 0.619 and 0.696 for FDG-PET/CT, respectively. DW-MRI also showed higher interobservers agreement (k=0.654-0.782) compared to moderate agreement (k=0.515-0.745) in FDG-PET/CT.
Conclusion: DW-MRI and FDG-PET/CT were comparable in assessing the entire abdominopelvic tumor burden based on PCI scoring system. DW-MRI has an advantage in detecting omental lesions extending to the hepatic flexure or splenic flexure, which is predictive of incomplete resection.
Parental Bonding and Dyadic Adjustment. The Mediating Role of the Differentiation of Self
Authors: Lampis Jessica , Busonera Alessandra , Tommasi Marco
Published: October 2024

Emotional connections with significant caregivers greatly influence how individuals perceive themselves and others in intimate relationships. Grounded in adult attachment theory and the differentiation of self theory, this study examined factors that contribute to the quality of couple relationships. It investigated the association between parental attachment bonds and the quality of romantic attachments, as well as whether differentiation of self processes mediate these relationships. The study involved 480 participants in couple relationships, with an average age of 35.4 years, who completed assessments on parental attachment bonds (using the Parental Bonding Instrument), differentiation of self (using the Differentiation of Self Inventory Revised), and couple functioning (using the Dyadic Adjustment Scale). Structural Equation Modeling analyses revealed that the quality of parental attachment predicted distinct patterns of differentiation of self, which subsequently accounted for significant variability in dyadic adjustment levels. The implications of our findings are discussed.
Innovative Approach: MRI-Guided Fabrication of a Biomimetic Intervertebral Disc Scaffold
Authors: Ye Yuchen , Shao Chen , Wang Yi , Lin Fanguo , Su Peng , Niu Yanping , Yang Huiwen , Wang Zhicheng , Ma Tao , Ji Shuo , Chang Wenju , Wu Tao , Xi Jin , Wang Rui , Zhang Changchun , Sun Yongming
Published: October 2024

Study Design：A biomimetic intervertebral disc (IVD) scaffold was fabricated through the integration of magnetic resonance imaging (MRI) and 3D printing technology, and subsequently underwent in vitro experimentation.
Objective：This study aimed to create a new IVD scaffold using MRI grayscale image analysis and GE-DLP technology to mimic the natural structure of the IVD for improved biomechanical performance and cell compatibility, potentially providing a new treatment option for IVD regeneration.
Summary of Background Data: The IVD is a critical component of the spine, and its damage or degeneration can lead to severe back and neck pain. Current treatments provide symptomatic relief but do not address structural damage. Tissue engineering offers a promising alternative, with bio-scaffolds being a key element for IVD regeneration.
Methods: In this study, we constructed a 3D model of the IVD from MRI scans of a healthy volunteer and processed the grayscale images to distinguish between tissue types. Exposure times were adjusted based on grayscale values, and GE-DLP technology was applied to fabricate the biomimetic IVD scaffold in a single integrated process using a bicomponent polymer network (BCN) hydrogel laden with nucleus pulposus stem cells (NPMSCs). The microstructure and porosity of the scaffold were analyzed using scanning electron microscopy (SEM), and the elastic modulus across the radial distribution was tested via nanoindentation. The biomechanical performance was evaluated using finite element analysis (FEA). For biocompatibility assessment, cytoskeleton staining was utilized to observe cell morphology, and cell viability was evaluated using Calcein/PI staining.
Results: The biomimetic IVD scaffold exhibited gradient changes in elastic modulus and pore size, consistent with the ultrastructure and biomechanical characteristics of the natural IVD. FEA indicated that the scaffold's response in terms of displacement, strain, and stress closely resembled that of an actual IVD, particularly during simulations of left rotation and left lateral bending. SEM revealed a network structure of pores with varying sizes in different regions of the scaffold, which is crucial for cell adhesion and growth. The scaffold also demonstrated high biocompatibility, with cell survival rates maintained at a high level over a seven-day culture period.
Conclusion: In this research, we have successfully engineered a novel biomimetic IVD scaffold with excellent static structural integrity and biomechanical performance by integrating MRI image analysis with GE-DLP technology.
Level of Evidence: N/A