bluuebunny/crossref_metadata_2025 huggingface dataset:
Long-term Outcomes of Birdshot Chorioretinopathy Treated With Corticosteroids: A Retrospective Cohort Study
Authors: Ferracci Dino , Mathis Thibaud , Gavoille Antoin , Gerfaud-Valentin Mathieu , Bert Arthur , Hafidi Meriem , Denis Philippe , Loria Olivier , Kodjikian Laurent , Sève Pascal
Published: June 2023

Purpose: To report the progression of patients diagnosed with birdshot chorioretinopathy (BSCR) initially treated with corticosteroids.

Methods: We included 39 BSCR patients followed for ≥1 year. Patients were classified into 2 groups according to their initial treatment: methylprednisolone followed by prednisone (n=28) and prednisone alone (n=11). We analyzed the progression under treatment after 1, 3, 6 months, 1 year, and at the end of follow-up.

Results: At the end of follow-up, 31/39 (79.5%) patients had reached inflammation control. Thirteen out of 28 (46.4%) and 6/11 (54.5%) patients were treated exclusively with corticosteroids, and 18/19 (94.7%) of them had reached inflammation control at the end of follow-up; their mean (range) corticosteroid dose was 3.5 (0-10) mg/day.

Conclusion: We found that the prolonged corticosteroid therapy treatment strategy resulted in inflammation control in half of BSCR patients. This control was maintained with low doses of cortisone, usually <5 mg/day.
Introducing a High Throughput Nanozymatic Method for Green Nanozyme-Mediated Degradation of Organic Dyes in Real Water Media
Authors: Hormozi Jangi Saeed Reza
Published: June 2023

In this work, a high throughput nanozymatic method was developed for green nanozyme-mediated biodegradation of organic dyes in real water media. The nanozymes were synthesized and characterized for their size and morphology by TEM and DLS analysis. The nanozymatic properties of the as-prepared nanomaterials were evaluated by standard enzyme activity assay, revealing high peroxidase-like performances for the as-prepared nanozymes. Therefore, for exploring more precise, the kinetics behavior of the as-prepared nanozymes was evaluated by the standard Lineweaver-Burk method, revealing a Vmax as high as 0.263 µM sec-1 and a Km as low as 0.03 mM, revealing high catalytic efficiency and affinity of the as-prepared nanozymes. Hence, the as-prepared nanozymes were utilized for organic dye degradation in real water media using methylene blue as a model organic dye. The effective factors on the dye degradation including pH, ionic strength, degradation time, nanozyme amount, etc. were optimized by the one-factor-at-a-time optimization method. At optimal experimental conditions, the as-prepared nanozymes can degrade about 99.0% of the organic dye within a degradation time as low as 7 min. The developed method was finally employed for the nanozyme-mediated degradation of methylene blue from real water media such as pool, mineral, river, and tap water samples. The results of this study revealed an excellent biodegradation yield of over 94.3%-99.0% for the different real samples, proving the suitability of the developed method for dye degradation in real water media.
Targeted microRNA Profiling Reveals That Exendin-4 Modulates the Expression of Several microRNAs To Reduce Steatosis in HepG2 Cells
Authors: Khalifa Olfa , Ouararhni Khalid , Errafii Khaoula , Alajez Nehad , Arredouani Abdelilah
Published: June 2023

Excess hepatic lipid accumulation is the hallmark of non-alcoholic fatty liver disease (NAFLD), for which no medication is currently approved. However, Glucagon-Like Peptide-1 Receptor Ag-onists (GLP-1RAs), already approved for treating type 2 diabetes, have lately emerged as possible treatments. Herein we aimed to investigate how the GLP-1RA Exendin-4 (Ex-4) affects the mi-croRNA (miRNAs) expression profile using an in vitro model of steatosis. Total RNA, including miRNAs, was isolated from untreated, steatotic, and Ex-4-treated steatotic cells and used for probing a panel of 799 highly curated miRNAs using NanoString technology. Enrichment path-way analysis was used to find the signaling pathways and cellular functions associated with the differentially expressed miRNAs. Our data shows that Ex-4 reversed the expression of a set of miRNAs. Functional enrichment analysis highlighted many relevant signaling pathways and cellular functions enriched in the differentially expressed miRNAs, including hepatic fibrosis, in-sulin receptor, PPAR, Wnt/β-Catenin, VEGF, and mTOR receptor signaling pathways, fibrosis of the liver, cirrhosis of the liver, proliferation of hepatic stellate cells, diabetes mellitus, glucose metabolism disorder and proliferation of liver cells. Our findings suggest that miRNAs may play essential roles in the processes driving steatosis reduction in response to GLP-1R agonists, which warrants further functional investigations.
Flexible and Stable N-Isopropylacrylamide/Sodium Alginate Gel Electrolytes for Aqueous Zn-MnO2 Batteries
Authors: Wang Kehuang , Shangguan Mingliang , Zhao Yibo , Tian Haoran , Wang Fu , Yuan Jinliang , Xia Lan
Published: June 2023

Rechargeable aqueous Zn-ion batteries (ZIBs) have attracted considerable attention owing to their high theoretical capacity of 820 mA h g‒1, low cost and intrinsic safety. However, the electrolyte leakage and the instability issues of Zn negative electrodes originating from side reactions between the aqueous electrolyte and Zn negative electrode, not only restricts the battery stability but also results in short-circuit of aqueous ZIBs. Herein we report a flexible and stable N-isopropylacrylamide/sodium alginate (N-SA) gel electrolyte, which possesses high mechanical strength and high ionic conductivity of 2.96×10‒2 S cm‒1, and enables the Zn metal negative electrode and MnO2 positive electrode to reversibly and stably cycle. Compared to the liquid electrolyte, the N-SA hydrogel electrolyte can effectively form a uniform Zn deposition and suppress the generation of irreversible by-products. The assemble symmetric Zn/Zn cells at a current density of 1 mA cm‒2 shows a stable voltage profile, which maintains a low level of about 100 mV over 2600 h without an obvious short circuit or any overpotential increasing. Specially, the assembled Zn/N-SA/MnO2 batteries can deliver a high specific capacity of 182 mAh g‒1 and maintain 98% capacity retention after 650 cycles at 0.5 A g‒1. This work provides a facile method to fabricate high-performance SA-based hydrogel electrolytes that illustrates their potential for flexible batteries for wearable electronics.
An Analytical Study of Unveiling Gender-Based Harassment in Cyberspace: An Exploration of Realities and Experiences
Authors: Khan Hajra , Basharat Dr Tahira , Hayat Dr Imran
Published: June 2023

This study critically analyses the realities and experiences of gender-based harassment in cyberspace, and aims to unveil the shadows that shroud this phenomenon. It discloses the online spaces that disseminate detrimental attitudes towards women, despite their physical absence. Cyber violence has become a global issue and it causes significant economic and societal consequences. Recognizing and dealing with the adverse effects caused by demeaning cyber gender harassment is essential. The study raises questions to explore the kind of cyberbullying offences that are brought on by misogynistic inclinations in online environments and the experiences of the women who have gone through cyberbullying. This study uses semi-structured interviews and the IPA technique of the analysis of data to thoroughly examine the unique experiences of cyber harassment victims by applying a qualitative research approach. The study looks into various misogynistic cyber harassment offences and analyses women's accounts. Due to obstacles to justice, cyber violence and harassment replicate physical problems like spousal abuse and sexual harassment. A constant assault of intimidation and harassment results from the traditionally male-dominated character of cyberspace, which affects women's social, economic, and psychological well-being. Participants related horrifying tales of families' indifference and law enforcement officials' trivialization. Mental health problems increase isolation and prevent involvement in academic and professional activities. Women's well-being is exacerbated by societal blaming and secondary victimization. This brief analysis clarifies the intricacies of gender-based harassment in cyberspace and emphasizes the urgent need for efficient solutions to address this widespread issue.
Analysis and Design of a Chopper Centrally-Mounted Channel for Sugarcane Harvester
Authors: Jiang Jiaoli , Liu Qingting , Xu Hai , Wu Tao , Feng Jiamu , Zou Xiaoping , Li Yuejin
Published: June 2023

After cut by basecutter, sugarcane stalks are carried to a chopper by the basecutter and the feeding/conveying rollers train of harvester. However, the conventional feeding/conveying channels of sugarcane chopper harvesters, when harvesting seriously lodged sugarcane, have numerous drawbacks, including easy clogging, and poor adaptability. In order to resolve these problems, a novel design and layout method of feeding/conveying and chopping channel are proposed in the paper. And a chopper centrally-mounted channel is designed for a sugarcane chopper harvester as well, which has been implemented in the HN4GDL-91 harvester. The proposed channel consists of a feeding/conveying rollers train, a chopper, and a billet conveying device. By mounting the chopper between the feeding/conveying rollers train and the billets conveying device, the harvester can avoid the chopper chopping back the billets, thus improving the harvest quality. The feeding/conveying rollers train is designed with only a pair of feeding rollers and a pair of conveying rollers, achieving a short channel path. Moreover, the structure of the basecutter and the mechanism carrying stalks to feeding rollers are studied via theoretical analysis and tests. The relationship between the basecutter and the chopper centrally-mounted channel is also conducted in systematic analysis. The results of the theoretical analysis show that the inclination angle of the disc of basecutter should be 2° greater than the angle of the feeding conveying channel (both angles are from the horizontal plane). The inclination angle of the disc of basecutter should go from 10° to 15°. A field experiment with four factors and three levels indicates that the field loss rate is 2.45%, the feed quantity is 16.66 kg/s, and the qualified rate of the billets is 98.02%, while the number of sugarcane stalks in a clump, the ground speed of harvester the rotational speed of the chopper, and the rotational speed of feeding/conveying roller are 10, 1.09 m/s, 390 r/min, and 230 r/min, respectively. It is concluded that the proposed chopper centrally-mounted channel could improve the conveying and harvesting performance significantly.
Fabrication and Characterization of Durable Superhydrophobic and Superoleophobic Surfaces on Stainless Steel Mesh Substrates
Authors: IQBAL SAIRA
Published: June 2023

Inspired by nature's examples such as lotus leaves and insect wings, superhydrophobic surfaces have been extensively studied and engineered. However, achieving superoleophobic surfaces, which repel oils, has proven to be more challenging due to the oils' lower surface tension than water. This article presents a novel, cost-effective technique for fabricating superoleophobic surfaces with enhanced durability. We demonstrate the effectiveness of this technique by using Perfluorooctyltriethoxysilane (PFOTES) and silicon dioxide nanoparticles on stainless steel mesh substrate. The resulting surfaces exhibit remarkable superoleophobic properties by incorporating re-entrant structures, low surface energy, and high surface roughness, making them ideal for oil-repellency applications.
Sex Differences in Frequencies of B and T Cell Subpopulations of Human Cord Blood
Authors: Bous Michelle , Schmitt Charline Sarah , Hans Muriel Charlotte , Weber Regine , Nourkami-Tutdibi Nasenien , Tenbruck Sebastian , Haj Hamoud Bashar , Wagenpfeil Gudrun , Kaiser Elisabeth , Solomayer Erich-Franz , Zemlin Michael , Goedicke-Fritz Sybelle
Published: June 2023

Background: Cord blood represents a link between intrauterine and early extrauterine development. Cord blood cells map an important time frame in human immune imprinting processes. It is unknown whether sex of the newborn affects the lymphocyte subpopulations in cord blood. Methods: 9 B and 21 T cell subpopulations were characterized by flow cytometry in human cord blood from 16 male and 21 female newborns, respectively. Results: Except for marginal zone B cells and transitional B cells, B cell count in all subsets was higher in cord blood of male newborns than in female newborns. Frequency of naive thymus negative Th cells was significantly higher in male cord blood whereas the remaining T cell subpopulations showed a higher count in cord blood of female newborns. Conclusion: Our study is the first revealing sex differences in B and T cell subpopulations of human cord blood. These results indicate that sex might have a higher impact for the developing immune system urging the need to expand research in this area.
Pectoralis Major in Salvage Total Laryngectomy After Irradiation. Morbidity, Mortality, Functional and Oncological Results in a Referral Center in Egypt
Authors: Abdelghany Mahmoud , Amin Ayman , Degni Emilia , Crescio Claudia , Hassan Asem Elsani M.A. , Ftohy Tarek , Bussu Francesco
Published: June 2023

Background: Non-surgical organ preservation protocols have known a large diffusion worldwide in the last decades. Their oncological and functional effectiveness in a real-world setting has been recently ques-tioned, also because of the high morbidity of salvage procedures. The aim of this study is to review the outcomes of post irradiation salvage total laryngectomy (STL) and reconstruction with pectoralis major flap. Methods: This retrospective observational study included 37 cases of STL in the period going from January 2015 to December 2021. Data for each patient were extracted from the hospital information system and reviewed. Results: The 3-year overall and disease specific survival are respectively 28% and 51%. All patients with recurrences died from the disease. Only 7 recurrences and 7 consequent deaths for cancer were rec-orded. The other 14 deaths derived from comorbidities, being diabetes the most significant predictive parameter for overall survival. Also low-er postoperative albumin levels were associated with a higher risk of death. Conclusions: Overall survival after STL and reconstruction with PMMF is low but most deaths are due to comorbidities and not to cancer progression or recurrence.
Living Wall Plants Are Affected by and Affect Temperature: How to (Not) Measure Plants’ Temperature in an Living Wall Experiment
Authors: Stollberg Maren , Von Birgelen Alexander
Published: June 2023

Living walls (LWs) are a climate change adaptation strategy for cities, as they have a cooling effect. Previous studies of the cooling effect of LWs were carried out in different climatic zones. These studies differed in their experimental design, or simulated data via models. Plants’ cooling capacity is explained by shading and transpiration, and depends on physical plant parameters, environmental factors, and system-related influences.
A three-year-long trial was carried out between 2017 and 2019 at an experimental garden in Geisenheim, Germany. We chose a textile-based LW system with high water demand and plants from a wet/fresh habitat. We assumed that this would achieve high evaporative cooling. The experimental setup included four experimental walls which were exposed to the north, south, east, and west, respectively. The plant choice was divided into three plant mix variants (Cascade, Ground cover, and Meadow) and a Control with no vegetation. We measured the temperature with sensors and a thermal imaging (IR) camera in different setups. The main results were that the measured vegetation temperature (TV) depends on air temperature (TA), measurement position, plant mix variant, and plant species. We could detect the cooling effect only at a small distance from the LW (microclimatic). Our methodological approaches should be continued in further studies.
Plant Composition and Species Use in Agroforestry Homegardens in the Eastern Amazon, Brazil
Authors: Pauletto Daniela , Guerreiro Martorano Lucieta , De Sousa Lopes Lucas Sérgio , Pinheiro de Matos Bentes Michelliny , Almeida Vieira Thiago , Gomes de Sousa Oliveira Thiago , Santos de Sousa Verena , Fernandes da Silva Ádria , Da Silva Ferreira de Lima Pricila , Santos Tribuzy Aldeize , Pinto Guimarães Iandra Victória
Published: June 2023

Agroforestry homegardens are integrated arrangements of common vegetable plants in areas close to residences, which follow a structure similar to that of tropical forests, with the cultivation of multiple species to meet the basic needs of families, such as the provision of food and medicine, as well as ensuring an environment for other family activities. Considering the importance of these environments, this work aimed to address the composition and use of plant species in agroforestry homegardens, in order to support society initiatives and government policies to strengthen the management of natural resources and individual and collective well-being in the region. For this, 119 homegardens were studied in the municipalities of Belterra, Mojuí dos Campos and Santarém, in the state of Pará, in the Brazilian Amazonia, comprising five different zones (peri-urban, urban, floodplain, indigenous land and tourist land), obtaining the data via questionnaires and guided visitation by the residents. A total of 5,323 vegetal individual plants were surveyed, distributed in 188 species and 62 botanical families. The data showed that 80.5% of the individual plants are concentrated in 18.6% of the species, with no significant difference in the average of species per homegarden in the five zones. The predominance of species for food use, primarily fruit-bearing, stands out, showing a possible direction for incentive actions and/or for the ordering of public policies and programs aimed at these spaces. Most homegardens have up to 17 plant species; less than half of homegardens have species intended for medicinal use; and there is percentage parity between native plant species and those of exotic origin, where native plants stand out for shading. Agroforestry homegardens play a crucial role in the conservation and cultivation of species for food purposes, with the cultivation or maintenance of plants based on their various purposes, showing distinct profiles of distribution and choice of species, evidencing their socioeconomic and environmental importance. Thus, it is important that these land use systems are valued, investing financial resources in actions and projects aimed at maintaining and enhancing their benefits for the region.
Deep Learning for Optical Sensor Applications: An Insight Review
Authors: Al-Ashwal Nagi H. , Al Soufy Khaled A. M. , Hamza Mohga E. , Swillam Mohamed A.
Published: June 2023

Over the past decade, Deep Learning (DL) had been applied in a large number of optical sensors’ applications. DL algorithms can improve the accuracy and reduce the noise level in optical sensors. Optical sensors are considered as promise technology for the modern intelligent sensing platforms. These sensors are widely used to process monitoring, quality prediction, pollution, defense, security and many other applications. However, they suffer major challenges such as the large generated data and low processing speed for that data and moreover the much cost of these sensor. These challenges can be mitigated by integrating deep learning system with the optical sensor technologies. This paper presents recent studies that integrate DL algorithms with optical sensors applications. This paper also highlights several of DL algorithms directions that promise a considerable impact on use for optical sensor applications. Moreover, this study provides new directions for the future related research development.
Lulusan Pendidikan Vokasi dan Probabilitas Bekerja di Sektor Intensitas Digital Tinggi
Authors:   Magister Perencanaan Ekonomi dan Kebijakan Pembangunan, Fakultas Ekonomi dan Bisnis, Universitas Indonesia, Amelia Dhea Rizky , Setyonaluri Diahhadi ,   Magister Perencanaan Ekonomi dan Kebijakan Pembangunan, Fakultas Ekonomi dan Bisnis, Universitas Indonesia
Published: June 2023

Sekolah Menengah Kejuruan berada pada posisi sulit akibat lambat merespon perubahan teknologi. Sementara itu, teknologi telah mengubah sifat pekerjaan dan mendorong peningkatan permintaan tenaga kerja yang adaptable terhadap perkembangan teknologi di sektor intensitas digital tinggi (SID Tinggi). Berdasarkan teori signaling dan investasi modal manusia, permasalahan tersebut dapat diselesaikan dengan meningkatkan pendidikan dan pelatihan. Menggunakan data Sakernas 2015 dan 2018, dan regresi logistik, hasil analisis menunjukkan bahwa lulusan SMK teknik dan teknologi memiliki kecenderungan tertinggi untuk bekerja di SID tinggi. Namun bekerja di sektor tersebut tidak dapat diasosiasikan dengan jenis pekerjaan dan kesejahteraan yang lebih baik (decent job) dibandingkan sektor lain. Hal ini mengacu pada temuan kedua yang menunjukkan lulusan SMK teknik dan Teknologi mempunyai probabilitas yang lebih rendah untuk bekerja sebagai kerah putih di SID tinggi. Maka dari itu, untuk meningkatkan upah dan posisi pekerjaan, dibutuhkan peningkatan pendidikan, karena dalam temuan terakhir pendidikan tinggi vokasi terbukti dapat meningkatkan probabilitas untuk bekerja sebagai kerah putih di SID tinggi.
Case Study of the Use of a Digital Twin for Leak Detection and Quantification in Underground Gas Storage Wells
Authors: Abdo Elia , Baronio Emanuele , Mauro Stefano , Troise Mario , Salamina Laura
Published: June 2023

Underground gas storage (UGS) wells are essential components in energy security. However, UGS wells present a complicated and delicate combination of elements where ensuring safe and secure functionality over long periods is paramount. This paper showcases how a digital twin is used to evaluate and forecast the link between leaks and temperature and pressure trends in a UGS well, allowing the identification and quantification of defects and, subsequently, well barrier integrity. The digital twin used for this application presents advantages compared with other solutions present on the market with regard to the simplified configuration; that is, with minimal input data, the system can produce an accurate and useful output, which is then used in the well integrity decision-making process.

UGS wells present additional criticalities with respect to normal production wells due to their longer life span and the repetitive production and injection cycles. This makes early and accurate leak detection essential for the safe management of the well barriers. The proposed digital twin simulates the trends of pressure and temperature within each annulus and compares results with data from the field, allowing the identification of the position and size of leaks. A genetic algorithm is applied to optimize the placement of leaks on their specific barriers. Once a leak is identified, a risk assessment is conducted to evaluate the overall integrity of the well. If the status of the well is found to be critical enough, an intervention may be planned.

The studies presented show how the digital twin has been used on two wells with similar problems. At first, it has confirmed the necessity to put the well out of service as opposed to planning maintenance, thereby saving both time and cost. In the second case, it allowed the validation of a solution that led to a 60% reduction in failure consequence, allowing the well to continue operating without major costs or risks. The errors of the resulting simulations were always confined within the 0.5 bar limit highlighting its accuracy.

The system has been in use for over a year and has shown great potential in accurate and efficient identification of leaks. This has accelerated the process of well integrity evaluation and allowed timely interventions on wells that required it. On the other hand, the process has highlighted cases where previous assumptions about leak location and size were corrected using the digital twin, therefore reducing the costs of interventions. Finally, the model showcases a clear readiness for predictive capabilities aimed to select, plan, and design fit for purpose mitigating actions.
Laparoscopic cholecystectomy for xanthogranulomatous cholecystitis: 18 years of experience.
Authors: Zubillaga-Mares Asya , Renteria-Palomo Enrique , Hall-Ramirez William Bryan , Lopez-Godinez Maria Fernanda , Nuñez-Venzor Alejandra , Cardenas-Lailson Eduardo
Published: June 2023

Background Xanthogranulomatous cholecystitis (XG) is a rare inflammatory disease of the gallbladder (GB), macroscopic appearance may be confused with gallbladder cancer (GC) making the diagnosis challenging. Laparoscopic cholecystectomy (LC) is considerate the gold standard for the management of benign gallbladder disease however LC in XGC is associated with a high conversion rate to open cholecystectomy with a rate of 10.6 to 80%. The aim of this study was to determinate the rate of laparoscopic cholecystectomy on patients with histopathological diagnosis of CXG and the associated morbidity to the procedure.
Material and methods This study is an observational, retrospective, and cross-sectional study carried out over a period of 18 years in a single institution. Patients underwent to laparoscopic cholecystectomy with histopathological diagnosis of xanthogranulomatous cholecystitis were included. The primary outcome was the rate of conversion to open surgery; secondary outcomes were the morbidity and mortality. The data were reported on percentages and averages. Statistical Package for the Social Sciences (SPSS, version 26) was used to analyze the data. The study was approved by the board of ethical committee in our institution in 2018.
Results We registered 142 patients operated from cholecystectomy with histopathologic results of XGC and 106 surgeries were performed laparoscopically (74.6%); 52 were emergency surgeries (49%) and 54 elective (51%). The conversion rate to open cholecystectomy was 3.7% (4 patients). There were 5 post-surgical complications (4.7%) two bilomas, one surgical site infection, and two biliary leak.
Conclusions XGX represents a surgical challenge from diagnosis to surgical management and is associated to a higher number of perioperative complications; nevertheless, a laparoscopic approach is safe in high volume centers with experience in laparoscopy.
Greedy Knot Selection Algorithm for Restricted Cubic Spline Regression
Authors: Arnes Jo Inge , Hapfelmeier Alexander , Horsch Alexander , Braaten Tonje
Published: June 2023

Non-linear regression modeling is common in many fields for prediction purposes or estimating relationships between predictor and response variables. For example, restricted cubic spline regression can model non-linear relationships as third-order polynomials joined at knot points. The standard approach is to place knots by a regular sequence of quantiles between the outer boundaries. A regression curve can easily be fitted to the sample using a relatively high number of knots. The problem is then overfitting, where a regression model has a good fit to the given sample but does not generalize well to other samples. A low knot count is therefore preferred. However, the standard knot selection process can lead to underperformance in the sparser regions of the predictor variable, especially when using a low number of knots. It can also lead to overfitting in the denser regions. We present a simple greedy search algorithm using a backward method for knot selection that shows reduced prediction error and Bayesian information criterion (BIC) scores compared to the standard knot selection process in simulation experiments. We have implemented the algorithm as part of an open-source R-package, knutar.
The effect of using desktop VR to practice preoperative handovers with the ISBAR approach: a randomized controlled trial
Authors: Andreasen Eva Mari , Berg Helen , Steinsbekk Aslak , Høigaard Rune , Haraldstad Kristin
Published: June 2023

Aim
The aim was to investigate whether second-year undergraduate nursing students practicing the Identification-Situation-Background-Assessment-Recommendation (ISBAR) communication approach in a desktop virtual reality (VR) application had a non-inferior learning outcome compared with the traditional paper-based method when sorting patient information correctly based on the ISBAR structure.
Methods
A non-inferior parallel group assessor blinded randomized controlled trial, conducted in simulation sessions as part of preparation for clinical placements in March and April 2022. After a 20-minute introductory session, the participants were randomized to self-practice the ISBAR approach for 45 minutes in groups of three in either an interactive desktop VR application (intervention) or traditional paper-based (TP) simulation. The primary outcome concerned the proportion of nursing students who sorted all 11 statements of patient information in the correct ISBAR order within a time limit of five minutes. The predefined, one-sided, non-inferiority limit was 13 percentage points in favor of traditional paper-based simulation.
Results
Of 210 eligible students, 175 (83%) participated and were allocated randomly to the VR (N = 87) or TP (N = 88) group. Practicing in the desktop VR application (36% of everything correct) was non-inferior to the traditional paper-based method (22% everything correct), with a difference of 14.2 percentage points (95% CI 0.7 to 27.1) in favor of VR. The VR group repeated the simulation 0.6 times more (95% CI 0.5 to 0.7). Twenty percent more (95% CI 6.9 to 31.6) of the students in the VR group reported liked how they practiced. All the other outcomes including the System Usability Scale indicated non-inferiority or were in favor of VR.
Conclusions
Self-practicing with the ISBAR approach in desktop VR was non-inferior to the traditional paper-based method and gave a superior learning outcome.
Trial registration number:
ISRCTN62680352 registered 30/05/2023.
Massage Manipulation and progression of osteosarcoma, Does It Really Correlate? : A Combination of Prospective and Retrospective Cohort Study
Authors: Karda I Wayan Arya Mahendra , Ismail Wan Faisham Wan , Kamal Achmad Fauzi
Published: June 2023

In Indonesia, the challenge of osteosarcoma progression is further worsened by patients' dependence on traditional massage therapy, low socio-economy, and educational status. This study aims to analyze the differences in the characteristics, laboratory findings, surgery techniques, degree of histopathological necrosis, and metastasis between osteosarcoma patients with and without prior massage manipulation therapy. This research is an analytical observational study with a prospective and retrospective cohort design. Patients were treated and followed for one year to evaluate the occurrence of metastasis. Prospective data was collected through interviews, and secondary data was collected from the patient's medical record. Of 84 subjects analyzed, 69% had a history of massage. There was an increase in LDH and ALP in patients with massage manipulation (p=0.026). The median time to metastasis from baseline in the massage group (4 months) was statistically significant compared to the non-manipulation group (12 months) (p<0.0001). This research found that massage therapy significantly increases LDH and ALP levels, making amputations more likely to be performed and a higher risk of metastasis that lowered the survival rate. The onset of metastasis was three times faster in patients with prior massage therapy. Therefore, we strongly recommend against massage manipulation therapy in osteosarcoma patients.
RETRACTED: Systems Dynamics Model: the Resilience of Mashhad Plain to the Reduction of Underground Water Resources
Authors: Liu Peide , Dogani Azadeh , Dogani Sara , KohnehkarLangroodi Fatemeh , Rouhi Ahmad
Published: June 2023

The authors have requested that this preprint be removed from Research Square.
Clinical and radiological outcomes of patients treated with the Orthofix Chimaera Long nailing system for proximal and diaphyseal femoral fracture
Authors: TRAVERSO Aurelien , STEINMETZ Sylvain , NGO Trieu-Hoai-Nam , BORENS Olivier , CHERIX Stephane , MOERENHOUT Kevin
Published: June 2023

Background Intramedullary long nailing is a popular method to treat femoral shaft or sub-trochanteric fractures. Various complications have been described such as intraoperative anterior cortical perforation of the distal femoral shaft or post-surgical lateral thigh pain. In order to prevent those possible complications, a new intramedullary nailing system (Chimaera, Orthofix®) was designed. This study aims to evaluate the clinical and radiological results after antegrade intramedullary nailing of traumatic femoral shaft and inter-/subtrochantreric fractures.Methods A prospective cohort study was conducted on 20 consecutive patients with AO/OTA type 31A2.3-A3.3 and type 32A-C fractures treated with the Chimaera long nailing system from December 2017 to January 2021 at our level 1 trauma center. Parker & Palmer and Jenson scores were assessed at 3 months and compared to before the surgery. Radiologic assessment consisted in checking the position of the cephalic screw, using the tip-apex distance (TAD) and Cleveland zone. The mean follow-up was 12.5 (1–33) months.Results Parker and Palmer scores were equivalent to before the fracture for 4 patients (31%); minor changes were seen in 6 patients (46%). Jensen score was equivalent or with maximum gain of 1 point for 11 patients (87%) at 3 months. No intra-operative major complication was recorded. The median TAD was 16.4 mm (IQR 14.0-20.2) and lag screw position was in 85% of patients in the Cleveland central zone. Two patients needed revision surgery. Fracture union occurred in all patient.Conclusion The long Chimaera nailing device showed good functional and radiological outcomes.
Phenotypic similarity-based approach for variant prioritization for unsolved rare disease: a preliminary methodological report
Authors: Lebreton Emeline , Matalonga Leslie , Hongnat Oscar , Chahdil Maroua , Piscia Davide , Paramonov Ida , Ellwanger Kornelia , Kohler Sebastian , Robinson Peter , Graessner Holm , Beltran Sergi , Lucano Caterina , Hanauer Marc , Rath Ana , Lagorce David
Published: June 2023

Rare diseases (RD) have a prevalence of not more than 1/2000 in the European population, and are characterised by the difficulty of obtaining a correct and timely diagnosis. According to Orphanet, 72,5% of RD have a genetic origin although 35% of them do not yet have an identified causative gene. A significant proportion of patients suspected to have a genetic RD receive an inconclusive exome/genome sequencing. Working towards the International Rare Diseases Research Consortium (IRDiRC)’s goal for 2027 to ensure that all people living with a RD receive a diagnosis within one year of coming to medical attention, the Solve-RD project aims to identify the molecular causes underlying undiagnosed RD. As part of this strategy, we developed a phenotypic similarity-based variant prioritization methodology comparing submitted cases amongst them and with known RD in Orphanet. A 3-step programmatic cascade of phenotypic similarity calculations using The Human Phenotype Ontology (HPO), the Orphanet Rare Diseases Ontology (ORDO) and the HPO-ORDO Ontological Module (HOOM) was developed; genomics data reanalysis was performed by the RD-Connect Genome-Phenome Analysis Platform (GPAP). The methodology was tested in 4 exemplar cases, discussed with experts from European Reference Networks. Variants of interest (pathogenic or likely pathogenic) were detected in 8.8% of the 725 cases clustered by similarity algorithms, formulating diagnostic hypotheses that were validated in 42.1% of them and need further explorations in another 10.9%. Based on the promising results, we are devising an automated standardized phenotypic-based re-analysis pipeline to be applied to the entire unsolved cases cohort in Solve-RD.
Design of a Novel α-shaped Flue Gas Route Flame Incinerator for the Treatment of Urban Waste Materials
Authors: Liu Xiaozhou , Zhu Guangyu , Asim Taimoor , Mishra Rakesh
Published: June 2023

Incineration is an effective method to treat urban waste materials like sewage sludge and solid waste. A conventional urban waste flame incinerator design is based on L-shaped flue gas route. A common issue with these incinerators is incomplete combustion of the waste material, leading to excessive air pollution. In the present study, a novel flame incinerator design has been developed, comprising of α-shaped flue gas route. Based on momentum flux method, and using momentum vector synthesis theory, theoretical design of the α-shaped flue gas route flame incinerator has been developed in this study. Design modifications have been carried out on a conventional flame incinerator, in-line with the theoretical design developed, to obtain α-shaped flue gas route for enhanced combustion of urban waste materials. The novel α-shaped flue gas route flame incinerator has been cold-tested using Computational Fluid Dynamics in order to ascertain that the flue gas is undergoing α-shaped route. Hot-tests on a full-scale 750 tonnes/day α-shaped flue gas route flame incinerator have been carried out to validate the cold-test results and record the thermal characteristics of the incinerator. The results obtained clearly show superior combustion performance of novel α-shaped flue gas route flame incinerator compared to conventional flame incinerators.
Clinical effects of uterine artery embolization combined with Mifepristone and Ethacridine Lactate in induction of labor for placenta previa
Authors: Pan Chun-hong , Cen Bing-kui , Wu Yu-hua , Wei Yu-lan , Wei Xiu-ling
Published: June 2023

Objective
To investigate the clinical efficacy of uterine artery embolization combined with mifepristone and levonorgestrel in the induction of labor for placenta previa.
Methods
A total of 108 high-risk pregnant women with placenta previa who underwent induction of labor were enrolled in this study from January 2018 to June 2022. They were randomly divided into two groups: the intervention group (n = 51) received uterine artery embolization combined with mifepristone and levonorgestrel amniocentesis injection for induction of labor, while the control group (n = 57) received oral mifepristone and levonorgestrel amniocentesis injection for induction of labor as a comparison. The induction time, blood loss during and after induction, and complications were compared between the two groups. Throughout the study, all procedures adhered strictly to the ethical principles outlined in the Helsinki Declaration. No intervention-related complications occurred during the follow-up period.
Results
Among the 57 cases in the control group, 55 cases (96.49%) delivered vaginally, 25 cases (43.85%) had postpartum hemorrhage, and 2 cases (3.50%) underwent emergency cesarean section due to bleeding volume reaching 1000 ml. All 51 cases (100%) in the intervention group delivered vaginally, and 6 cases had postpartum hemorrhage. The induction time in the control group was (25.296 ± 1.6303), while the induction time in the intervention group was (21.753 ± 0.5334), and the difference was statistically significant (P < 0.01). The total hospital stay after induction of labor in the control group was (5.767 ± 1.2977), while the total hospital stay after induction of labor in the intervention group was (4.169 ± 0.5771), and the difference was statistically significant (P < 0.01).
Conclusion
In placenta previa induction of labor, uterine artery embolization combined with mifepristone and levonorgestrel can effectively reduce blood loss during induction, shorten induction duration, improve induction success rate, and reduce the risk of cesarean section during induction. It can also protect the uterus and prevent placental adhesion, ensuring the safety of pregnant women. It is a safe, minimally invasive, and effective method that deserves clinical promotion.
A macro-modelling approach for the analysis of masonry-infilled RC frames with different opening dimensions and locations
Authors: Jia Mingming , Kong Jingchang , Wu Jinfeng
Published: June 2023

Based on structural experiments and a micro finite-element analysis in ABAQUS, the interaction between an infill wall and an RC frame under lateral loads was investigated. According to the load transmission mechanism and the stiffness and strength contribution of infill walls, a macro-model with multiple blocks around the opening (represented as double diagonal struts) was proposed. The macromodel was established in OpenSees to simulate the discontinuities in the force transmission paths and the stress states around the openings of the infill walls. In a comparison with the experimental data, the proposed macromodel was proven to adequately simulate the different failure modes and hysteretic behaviours of masonry infills with different opening modes and locations. By using the opening rate and opening position as variables, 52 macro-modelling analyses of masonry-infilled RC frames with different window and door openings were carried out. The results showed that the presence of masonry infill walls greatly increased the initial stiffness and ultimate load-bearing capacities of single-story, single-bay RC frame structures. A larger opening rate resulted in lower initial stiffness and ultimate load-carrying capacity values, which decreased more as the opening locations deviated further from the centre to the sides.
Quantitative Risk Factor Analysis of Prior Disease Condition and Socioeconomic Status with the Multiple Myeloma Development: Nationwide cohort study
Authors: Choi Suein , Kim Eunjin , Jung Jinhee , Park Sung-Soo , Min Chang-Ki , Han Seunghoon
Published: June 2023

Early diagnosis and following management are important determinants of the prognosis of multiple myeloma (MM). However, screening for MM is not routinely performed because it is a rare disease. In this study, we evaluated the association of prior disease condition and socioeconomic status (SES) with MM diagnosis and developed a simple predictive model that can identify patients at high risk of developing MM who may need screening using a nationwide database from South Korea. According to multivariate logistic regression analysis, seven prior disease conditions (congestive heart failure, autoimmune disease, chronic pulmonary disease, hepatic disease, renal disease, any malignancy, and metastatic solid tumor) and poor SES before diagnosis were shown as possible risk factors of MM development. Based on the result, the scoring model was developed to predict the risk of MM development, and total scores were categorized into four groups: no-risk (≤0) intermediate-1 (0.5−6), intermediate-2 (6.5−14), and high-risk (>14). The odds ratios for developing MM in the intermediate-1, intermediate-2, and high-risk groups were 1.31, 2.68, and 4.96 respectively when compared to the no-risk group. This scoring system is also provided by a web-based application and could be a useful tool to support clinicians in identifying potential candidates for MM screening.
The Factors Associated with Stillbirths among Sub-Saharan African Deliveries: A Systematic review and Meta-analysis
Authors: Kasa Getachew Adela , Alemu Bezatu , Woldemariam Abebech Yilma , Adella Alemayehu
Published: June 2023

Background
Globally, more than 2.6 million stillbirths occur each year. The vast majority (98%) of stillbirths occur in low- and middle-income countries, and over fifty percent (55%) of these happen in rural sub-Saharan Africa.
Methods
Pertinent articles conducted in sub-Saharan Africa were evaluated using a systemic review and meta-analysis approach to determine the factors associated with stillbirths. A literature search was performed using PubMed, the Cochran Library, Google Scholar, EMBASE, Scopus, the Web of Sciences, and gray literature. Rayyan`s software was used for literature screening. A random effects meta-analysis was conducted with STATA version 17. Heterogeneity was checked by using Cochran’s Q and I2 tests. The funnel plots and Egger’s test were used to examine the risk of publication bias. The protocol was sent for registration on January 31, 2023, and the PROSPERO registration number is CRD42023391874.
Results
Forty-one studies gathered from eight sub-Saharan countries with a total of 192,916 sample sizes were included. Nine variables were highly linked with stillbirth. These include advanced maternal age (AOR: 1.43, 95% CI: 1.16, 1.70), high educational attainment (AOR: 0.55, 95% CI: 0.47, 0.63), antenatal care (AOR: 0.45, 95% CI: 0.35, 0.55), antepartum hemorrhage (AOR: 2.70, 95% CI: 1.91, 3.50), low birth weight (AOR: 1.72, 95% CI: 1.56–1.87), admitted by referal (AOR: 1.55, 95% CI: 1.41, 1.68), history of stillbirth (AOR: 2.43, 95% CI: 1.84, 3.03), anemia (AOR: 2.62, 95% CI: 1.93, 3.31), and hypertension (AOR: 2.22, 95% CI: 1.70, 2.75).
Conclusion
A significant association was found between stillbirth and maternal age, educational status, antenatal care, antepartum hemorrhage, birth weight, mode of arrival, history of previous stillbirth, anemia, and hypertension. In order to fully screen women, cooperation between experts from many fields should be created beforehand and incorporated into the screening procedure. Keywords: Africa, fetal death, intrauterine fetal death, prenatal death
Discerning Rise Time Constants to Quantify Charge Carrier Extraction in Perovskite Solar Cells
Authors: Kruppa Lennard , Jenatsch Sandra , Wang Yueming , Ravishankar Sandheep
Published: June 2023

The small-perturbation analysis of perovskite solar cells (PSCs) highlights a fundamental conundrum - while time domain measurements yield two time constants corresponding to the rise and subsequent decay of the photovoltage or photocurrent, the corresponding frequency domain methods only yield one time constant from the analysis of the imaginary part of the transfer function. To solve this problem, we propose a modification of the frequency domain transfer function that focusses on the transition of its real part to negative values at high frequencies. After verification using drift-diffusion simulations and equivalent circuit analysis, the application of the method to experimental intensity-modulated photovoltage spectroscopy data of a PSC allows calculation of the hidden rise time constant, showing a good agreement with rise time constants obtained from transient photovoltage measurements. The calculated rise time constants are indicators of the charge extraction efficiency of the contacts, that determines short circuit and low-bias recombination losses.
Scene Context-aware Graph Convolutional Network for Skeleton-based Action Recognition
Authors: Zhang Wenxian
Published: June 2023

Skeleton-based action recognition methods commonly employ graph neural networks to learn different aspects of skeleton topology information However, these methods often struggle to capture contextual information beyond the skeleton topology. To address this issue, we propose a Scene Context-aware Graph Convolutional Network (SCA-GCN) that leverages potential contextual information in the scene. Specifically, SCA-GCN learns the co-occurrence probabilities of actions in specific scenarios from a common knowledge base and fuses these probabilities into the original skeleton topology decoder, producing more robust results. To demonstrate the effectiveness of SCA-GCN, we conducted extensive experiments on four widely used datasets, i.e.SBU, N-UCLA, NTU RGB+D and NTU RGB+D 120. The experimental results show that SCA-GCN supasses existing methods, and its core idea can be extended to other methods with only some concatenation operations that consume less computational complexity.