bluuebunny/crossref_metadata_2025 huggingface dataset:
Craniocaudal cyclic load improve risk assessment of lumbar pedicle screw loosening：finite element analysis based on computer tomography
Authors: Jiang Chenyu , ouyang Hanqiang , Li Yali , Ni Ming , Jin Dan , Zhang Yan , Jiang liang , Yuan Huishu
Published: May 2024

Background:
Screw loosening remains a prominent complication for osteoporotic patients with pedicle screw fixation surgeries, yet with limited risk assessment approach. The aim of this study was to investigate influence of craniocaudal cyclic load on pedicle screw fixation strength by computed tomography (CT) based finite element analysis (FEA) and we examined predict ability in pedicle screw loosening (PSL).
Methods:
12 clinical PSL cases (7 men, 5 women) and 12 age- and sex-matched controls were enrolled for CT based FEA. Simple axial pullout load and axial pullout load with preset craniocaudal cyclic load were applied to each model respectively, and the ultimate pullout force under both conditions is calculated as the fixed strength and compared. Besides, HU values of the vertebral body trabeculae and screw trajectory were measured as an assessment of osteoporosis. The ultimate pullout force and HU value were compared between PSL and controls cases.
Results
The cyclic load remarkably reduce the pullout force of pedicle screws (906.2 ± 180.2 N vs. 729.3 ± 172.3 N, p<0.0001) by CT based FEA. No significant difference between the PSL and the control group in the simple axial pull-out force and HU values of the vertebral body. But the pullout force with preset cyclic load (639.2 ± 169.4 N vs. 819.4 ± 125.1 N, p = 0.072) and the HU value of the screw trajectory (177.5 ± 43.8 vs. 217.2 ± 29.6, p = 0.016) in the PSL group is significantly lower than that in the control group. Area under receiver operating characteristic curve (ROC) revealed pullout force with preset cyclic load slightly better predicted PSL than HU value of the screw trajectory (AUC = 0.798 vs. 0.750).
Conclusions
The craniocaudal cyclic load significantly reduces the screw fixation strength. HU value of screw trajectory and pullout force with preset cyclic load by CT based FEA are helpful for the clinical prediction of PSL.
Plasma free hemoglobin is associated with LDH, AST, total bilirubin, reticulocyte count, and the hemolysis score in patients with sickle cell anemia
Authors: Liu Angela , Jacobs-McFarlane Charleen , Sebastiani Paola , Glassberg Jeffrey , McCuskee Sarah , Curtis Susanna
Published: May 2024

Plasma free hemoglobin (PFH) is a direct biomarker for hemolysis that has been associated with clinical complications such as pulmonary hypertension and death in patients with sickle cell disease (SCD). We sought to characterize the relationship between PFH and more clinically available hemolytic markers including lactate dehydrogenase (LDH), aspartate aminotransferase (AST), bilirubin, reticulocyte percentage and to derive a composite hemolysis score derived from principal component analysis (PCA) of these biomarkers. In 68 adult patients (median age 31 years old, IQR 25-39) with HbSS or HbSβ0-thalassemia enrolled in the IMPROVE II study, median PFH was elevated at 21.9 mg/dL (IQR 9.9-44.9 mg/dL). Using Pearson correlation analysis, PFH had a stronger relationship to LDH (R=0.699), AST (R=0.587), and total bilirubin (R=0.475), compared to reticulocyte count (R=0.316). The hemolysis score was significantly associated with PFH (R=0.677). When compared with other laboratory measures, PFH correlated with hemoglobin (R= -0.275) and HbS (R=0.277),but did not correlate with white blood cell count (WBC) or HbF. The hemolysis score was significantly associated with WBC (R=0.307), hemoglobin (R = -0.393), HbF (R=- 0.424), and HbS (R=0.423). This study confirms that the conventional hemolytic biomarkers LDH, AST, bilirubin, and reticulocyte percentage correlate with PFH. Additionally, the hemolysis score is a valid tool to measure hemolysis and that it may be a marker of global hemolysis as opposed to PFH, which quantifies intravascular hemolysis. Further studies will be needed to elucidate the role of PFH and intravascular hemolysis in the development of clinical complications of sickle cell disease.
Effects of high-intensity interval training on physical morphology, cardiopulmonary function, and metabolic indicators in older adults: A PRISMA-based systematic review and meta-analysis
Authors: #Men Jie , Zhao Chengrui , Xiang Chenmin , Zhu Guoyu , Yu Zhengyang , Wang Pengbo , Wu Simin , Zhang Yuxi , Li Yishan , Wang Liuliu , Gong Xueyan , Yang Xiang , Zou Shuangling , Ma Jia , Cui Chenglong , Li Hao , Ma Xuedi , Wu Wenjie , Wang Yaoming
Published: May 2024

Background
Despite the growing attention towards the efficacy of high-intensity interval training (HIIT) on elderly health, a consensus regarding the pleiotropic effects of HIIT in this population is yet to be reached. Previous studies have predominantly focused on specific outcomes or particular groups, lacking comprehensive analysis.
Objective
We aimed to conduct a systematic evaluation of the impact of HIIT on body composition, cardiopulmonary function, and metabolic parameters in older adults.
Methods
The databases searched included PubMed, Web of Science, Cochrane Library, Scopus, WanFang, and other relevant sources from the inception of the database until July 2023. We supplemented the randomized controlled trials (RCTs) and retrieved relevant meta-analyses, and found that 5 highly relevant non-RCTs were also included in the supplement to study the effects of high-intensity interval training (HIIT) on body composition, cardiopulmonary function and metabolic parameters in the elderly.
Result
A total of 92 studies, including 87 RCTs and 5 non-RCTs, involving a sample size of 4355 elderly individuals were included in the analysis. The meta-analysis results demonstrated that HIIT significantly improved body mass index (BMI) [MD: -0.38kg m-2,P = 0.01], body fat percentage (BF%) [MD༚-1.38%, P<0.00001], maximal oxygen uptake (VO2max) [MD:2.23ml min− 1kg− 1, P<0.00001], maximal heart rate (HRmax) [MD:2.84 beats min− 1, P = 0.02], and high-density lipoprotein levels (HDL) [MD:0.04mmol L− 1, P = 0.0007] among the elderly population. However, no significant improvements were observed for systolic blood pressure (SBP) [MD: -0.28mmHg, P = 0.75], resting heart rate (HRrest) [MD: -0.95time min− 1, P = 0.24], triglycerides (TG) [MD: -0.04mmol L− 1, P = 0.27], low-density lipoprotein (LDL) [MD: -0.05mmol L− 1, P = 0.23]. Sensitivity analysis found that HIIT significantly improved waist circumference (WC) [MD: -2.13cm, P = 0.04], diastolic blood pressure (DBO) [MD: -0.96 mmHg, P = 0.03], respiratory exchange rate (RER) [MD: 0.01, P = 0.04], total cholesterol (TC) [MD: 0.15 mmol L− 1, P = 0.009], fasting plasma glucose (FPG) [MD: -0.23 mmol L− 1, P = 0.04]in the elderly, but the results lacked robustness.
Conclusions
The results of this study provide further support for HIIT to improve the physical health of the elderly, especially in terms of body shape and cardiopulmonary function, more importantly, provide a reference for HIIT in clinical practice and family health management of the elderly and the development of HIIT guidelines.
Clinical evolution of patients with Intracerebral hemorrhage in relation to the achievement of intensive blood pressure lowering target
Authors: Vázquez-Justes Daniel , Paul-Arias Miriam
Published: May 2024

Introduction: Spontaneous intracerebral hemorrhage (ICH) is one of the most disabling forms of stroke. Intensive lowering of blood pressure (BP) has been postulated as one of the therapies that can improve functional outcomes. However, this intensive reduction is not always achieved.
We aimed to study the differences between patients in whom intensive BP lowering was achieved during the first 24 h after admission and those in whom this BP lowering was not possible.
Methods: We retrospectively reviewed medical charts to obtain information on BP management during the first 24 hours. Our protocol establishes that intensive BP lowering below 140 mmHg of SBP should be pursued.
Results: A total of 210 patients were included. In 103, an intensive target BP was achieved. This group of patients had a lower initial NIHSS score and better clinical evolution, with less early neurological deterioration, fewer requirements of antihypertensive treatment, less necessity for surgical evacuation, less withdrawal of life-sustaining therapies (WLST), and lower mortality at three months (all p < 0,05). However, in the multivariable analysis, BP target achievement was not related to mortality, and only NIHSS score (OR 1,010 [CI 95% 1,007 − 1,203], p = 0,034) and WLST (OR 10,816 [CI 95%: 2,768 − 42,270], p < 0,001) remained related.
Conclusions: In our study, patients with intensive BP lowering had better clinical outcomes and lower mortality at 3 months. However, this observation could be related to a better clinical situation at the onset of stroke and fewer requirements for antihypertensive treatment. The initial NIHSS score and adoption of WLST were independently associated with mortality at 3 months.
A randomized controlled trial exploring the effect of placement versus nonplacement of a drainage tube around the cervical anastomosis in McKeown esophagectomy
Authors: Oshikiri Taro , Goto Hironobu , Kato Takashi , Takiguchi Gosuke , Koterazawa Yasufumi , Kanaji Shingo , Yamashita Kimihiro , Matsuda Takeru , Nakamura Tetsu , Murakami Sae , Kakeji Yoshihiro , Hasegawa Hiroshi
Published: May 2024

Purpose
Esophageal cancer has an overall five-year survival rate of < 20%. The McKeown esophagectomy is invasive and carries a high risk of anastomotic leakage. Robust prospective outcome data comparing non-placement versus placement of a cervical drainage tube during McKeown esophagectomy are lacking. This study aimed to evaluate whether the placement of a cervical drainage tube is useful.
Methods
In this randomized controlled, noninferiority trial, 106 patients with histologically proven, surgically resectable esophageal carcinoma were randomized to either placement or non-placement of a cervical drainage tube. The primary outcome was the percentage of Clavien–Dindo grade 2 or higher anastomotic leakage. Secondary outcomes included the duration from surgery to oral intake, hospital stay, and type and dose of analgesics used during hospitalization.
Results
Fifty-two and 54 patients were randomized to McKeown esophagectomy with non-placement and placement of a cervical drainage tube, respectively. There was no significant difference in anastomotic leakage rates between the drain placement. However, non-inferiority was not demonstrated (13/54 [24%]) and non-placement groups (12/52 [23%]; risk difference, -0.100 [-0.17, 0.15]; p = 0.0591). There were no significant differences in the secondary outcome measures.
Conclusion
Non-inferiority of nonplacement of a drainage tube around the cervical anastomosis after McKeown esophagectomy to placement of that was not demonstrated. Further large multicenter studies are needed.
Trial registration
: Japan Registry of Clinical Trials (identification number: jRCT1052180016).
Analysis of abrasive impact wear of a bimetal composite using a newly designed wear testing rig
Authors: Yuan Shengnan , Wu Hui , Xie Haibo , Jia Fanghui , Liang Xiaojun , Zhao Xing , Jiao Sihai , Jiang Zhengyi
Published: May 2024

In this study, the abrasive impact wear behaviour of a bimetal composite made of MMSs and LCSs (Mn8/SS400) were investigated by comparison with the existing wear resistant steels (benchmark steels) using a newly designed wear testing rig. The parameters including wear loss, wear rate, and hardness were evaluated. Scanning electron microscopy (SEM), X-ray diffractometer (XRD), and electron backscatter diffraction (EBSD) were used to analyse the wear mechanisms. The wear resistance of Mn8/SS400 bimetal composite is up to 2.8 times higher than that of benchmark steels due to better work hardening sensitivity of the bimetal composite. After 300 h abrasive impact wear, the highest microhardness of the subsurface layer for Mn8 reaches 601.31 HV, which is much greater than that of matrix (292.24 HV), showing a remarkable work hardening effect. The wear mechanism of Mn8/SS400 bimetal composite is ascribed to synergistic effect of grain refinement strengthening, dislocation strengthening, and twin strengthening. Prior to the 200-h abrasive impact wear test, the dominant wear mechanism in the Mn8/SS400 bimetal composite is primarily attributed to twin strengthening. However, following the 300-h impact wear test, the contribution to wear resistance becomes increasingly significant from all three strengthening mechanisms (dislocation, grain refinement, and twin strengthening).
Proteomic profiling identifies muscle-invasive bladder cancers with distinct biology and responses to platinum-based chemotherapy
Authors: Contreras-Sanz Alberto , Negri Gian Luca , Reike Moritz , Oo Htoo Zarni , Scurll Joshua , Miko Sandra Spencer , Nielsen Karina , Ikeda Kenichiro , Wang Gang , Jackson Chelsea , Gupta Shilpa , Roberts Morgan , Berman David , Seiler Roland , Morin Gregg , Black Peter
Published: May 2024

Platinum-based neoadjuvant chemotherapy (NAC) prior to radical cystectomy is the preferred treatment for muscle-invasive bladder cancer (MIBC) despite modest survival benefit and significant associated toxicities. Here, we profiled the global proteome of MIBC tumours pre- and post-NAC treatment using archival formalin-fixed paraffin-embedded tissue. We identified four pre-NAC proteomic clusters with distinct biology and response to therapy and integrated these with transcriptomic subtypes and immunohistochemistry. We observed proteomic plasticity post-NAC that was associated with increased extracellular matrix and reduced keratinization compared to pre-NAC. Post-NAC clusters appeared to be differentially enriched for druggable proteins. For example, MTOR and PARP were over-expressed at the protein level in tumours identified as neuronal-like. In addition, we determined that high intratumoural proteome heterogeneity in pre-NAC tissue was associated with worse prognosis. Our work highlights new aspects of MIBC tumour biology associated with clinical outcomes, and suggests new biomarkers and therapeutic targets based on proteomic clusters.
A retrospective cohort study of coagulation function in patients with liver cirrhosis receiving cefoperazone/sulbactam with and without vitamin K1 supplementation
Authors: Liu Jianmo , Xiao Jingyang , Wu Hongfei , Ye Jinhua , Li Yun , Zou Bin , Li Yixiu
Published: May 2024

Background Cefoperazone/sulbactam is commonly prescribed for the treatment of infected patients with cirrhosis.Aim To investigate the effect of cefoperazone/sulbactam on coagulation in cirrhotic patients and assess the efficacy of vitamin K1 supplementation in preventing cefoperazone/sulbactam-induced coagulation disorders.Method This retrospective cohort study compared coagulation function in 217 cirrhotic patients who received Cefoperazone/sulbactam with and without vitamin K1 supplementation (vitamin K1 group, n = 108; non-vitamin K1 group, n = 109).Results In the non-vitamin K1 group, the post-treatment prothrombin time (PT) was 16.5 ± 6.5s and the activated partial thromboplastin time (aPTT) was 34.8 ± 9.4s. These were significantly higher than pre-treatment values (PT: 14.6 ± 2.4s, p = 0.005; aPTT: 30.4 ± 5.9s, p < 0.001). In the vitamin K1 group, no differences were observed in PT, thrombin time, or platelet count, except for a slightly elevated post-treatment aPTT (37.0 ± 10.4s) compared to that of pre-treatment (34.4 ± 7.2s, p = 0.033). The vitamin K1 group exhibited a lower risk of PT prolongation (OR: 0.211, 95% CI: 0.047–0.678) and coagulation disorders (OR: 0.257, 95% CI: 0.126–0.499) compared to that of the non-vitamin K1 group. Propensity score matching analysis confirmed a reduced risk in the vitamin K1 group for prolonged PT (OR: 0.128, 95% CI: 0.007–0.754) and coagulation disorders (OR: 0.222, 95% CI: 0.076–0.575). Additionally, the vitamin K1 group exhibited lower incidences of PT prolongation, aPTT prolongation, bleeding, and coagulation dysfunction compared to the non-vitamin K1 group.Conclusion Cefoperazone/sulbactam use may be linked to a higher risk of PT prolongation and coagulation disorders in cirrhotic patients. Prophylactic use of vitamin K1 can effectively reduce the risk.
Gender-Related Measurement Invariance on the Self-Reporting Questionnaire (SRQ-20) With Older Adults in Puerto Rico
Authors: Burnette Denise , Kim Kyeongmo , Kim Seon
Published: May 2024

Purpose
Using an intersectional approach to the detection of common mental disorders based on age, gender, and culture, this study: 1) examined the factor structure of the 20-item version of the SRQ (SRQ-20) and 2) explored gender-related measurement invariance in the instrument’s performance with older adults in Puerto Rico.
Methods
We merged data from two cross-sectional studies on mental health status and needs of older adults in Puerto Rico (N = 367). The first study was in 2019, two years after Hurricane María devastated the island (N = 154); the second study, in 2021, assessed knowledge, attitudes and practices (KAP) concerning COVID-19 (N = 213). We used chi-square and t-tests to examine gender differences in each SRQ item and assessed internal consistency reliability with Cronbach’s alpha and McDonald’s omega (values > .70). We ran two CFA models, then multigroup CFA to test for gender-related measurement invariance. We used weighted least square mean and variance adjusted (WLSMV) estimation to account for the binary response options in the SRQ-20 and Mplus version 8.4 for analyses. We interpreted standardized factor loadings. There were no missing data for any SRQ-20 items.
Results
The SRQ-20 had strong internal consistency reliability (α = .89; omega = .89). Female scores were higher than males (t = -2.159, p = .031). Both unidimensional and two-factor models fit the data well. We selected the unidimensional model, which is most widely used in practice. Standardized factor loadings were 0.548 to 0.823 and all were statistically significant (p < .001). We tested gender invariance with the one-factor model. Our findings did not support invariance.
Conclusion
We favored the unidimensional model for several reasons. First, the SRQ-20 was designed to assess global distress. Also, physical symptoms have both somatic and psychological components, so their co-occurrence makes a single-factor model more meaningful. Finally, since older adults experience more physical health problems, instruments that emphasize both types of distress may provide a more accurate measure than those that exclude somatic symptoms. Using the unidimensional model, the SRQ-20 was not invariant, meaning that it performed differently for male and female participants. Future studies of common mental disorders with older adults in Puerto Rico should consider using the SRQ-20 for research and practice and should determine appropriate threshold scores for men and women.
Prognostic Role of Unusual Clinical Presentation in Acute Mastoiditis
Authors: Huélamo María Suárez-Bustamante , Alonso-Cadenas Jose Antonio , Moreno María Pérez , Sánchez Sonia Clavero , González Daniel Sánchez , Espí Mercedes de la Torre
Published: May 2024

Purpose
To determine if unusual manifestations of acute mastoiditis (AM) have a worse outcome than when the disease presents characteristically. As a secondary objective, we describe the patients with an atypical clinical presentation of AM included in the series.
Methods
Retrospective single-center observational study of patients younger than 18 years diagnosed with AM from June 1, 2018 to May 31, 2023.
Unusual or atypical presentation is defined as any clinical manifestation in the absence of retroauricular erythema and/or ear protrusion observed on physical examination.
Results
A total of 110 children with AM were included in the registry. The clinical presentation was usual in 104 patients (94.5%) and unusual in 6 (5.5%). The signs and symptoms on physical examination of children with an unusual presentation were as follows: fever, otalgia, and altered level of consciousness (Patients 1 and 2), ataxia (Patients 3 and 4), fever, ataxia, and vomiting (Patient 5), and headache and vomiting (Patient 6).
Poor outcomes were more frequent in children with an unusual presentation (P < 0.001), mainly due to intracranial complications. In this series, only one patient with a usual clinical presentation developed sequelae (P > 0.05).
Conclusions
While AM with an unusual presentation is an uncommon finding, it should be considered in the differential diagnosis of young children with neurologic symptoms. Our results do not suggest a delay in diagnosis, but do show a greater risk of poor outcome.
Sero and Salivary Toxoplasma Immunoglobulins: In Silico Study on Anti-genicity-Based Therapies Docked TgERP and its Dysregulatory Action on Immunoglobulins Running title: Sero and salivary toxoplasmosis and drug docking
Authors: Hassanein Faika , Fadel Hewida H. , Shehata Amany I. , Hamdy Noha Alaa , Masoud Inas M.
Published: May 2024

We aimed to assess salivary and seroprevalence of toxoplasma immunoglobulins in risky populations and evaluate drug docking targeting TgERP. A Cross-sectional study was conducted in Alexandria University hospitals' outpatient clinics. 192 participants were enrolled from September 2022 to November 2023. Anti-Toxoplasma IgG and IgM were determined in serum and salivary by ELISA. An in-Silico study examined TgERP's protein-protein interactions with pro-inflammatory cytokine receptors, anti-inflammatory cytokine, cell cycle progression regulatory proteins, a proliferation marker, and nuclear envelope integrity-related protein Lamin B1. Our findings revealed that anti-T. gondii IgG were detected in serum (66.1%) and saliva (54.7%), with 2.1% of both samples were positive for IgM. Salivary IgG had 75.59% sensitivity, 86.15% specificity, 91.40% PPV, 64.40% NPP, 79.17% accuracy and fair agreement with serum IgG. On the other hand, the sensitivity, specificity, PPV, NPV, and accuracy in detecting salivary IgM were 75.0%, 99.47%, 75.0%, 99.47%, and 98.96%. AUC 0.859 indicates good discriminatory power. Examined synthetic drugs and natural products can target specific amino acids residues of TgERP that lie at the same binding interface with Lamin B1 and Ki67, subsequently, hindering their interaction. Hence, salivary samples can be a promising diagnostic approach. In addition, this study may help alleviate toxoplasmosis' inflammatory effects.
Vanadium Dissolution Eliminate the Lattice Distortion of Co-O Octahedron during Oxygen Evolution for Water Splitting
Authors: Fu Honggang , Liang Zhijian , Shen Di , Wei Yao , Sun Fanfei , Xie Ying , Wang Lei
Published: May 2024

The electrocatalysts for high-energy consumed anodic oxygen evolution reaction (OER) especially in water splitting are generally prone to reconfiguration, so the dynamic structural evolution mechanisms should be deeply investigated. Herein, coral-like nanoarray assembled by nanosheets were synthesized via the layered effect of cobalt (Co) and the one-dimensional guiding effect of vanadium (V). The unique structure facilitates the full contact between active sites and electrolyte to enhance the electrocatalytic activity. The hydrogen evolution reaction (HER) and OER activity can be respectively promoted through modulating the electronic structure with nitrogen and phosphate anions. Thus, the assembled anion exchange membrane electrolyzer exhibits a direct current energy consumption of 4.31 kWh Nm–3@250 mA cm–2 at 70°C. It only required 1.88 V voltage to achieve a current density of 500 mA cm–2 with excellent stability over 200 h. Operando synchrotron radiation and Bode phase angle analyses reveal that the dissolution of vanadium species makes the distorted Co-O octahedral to regular octahedral structure during OER, accompanying by a decrease of band gap and a shortening of the Co-Co bond length. Such a structural evolution plays as the key active site for the formation of oxygen-containing intermediates, thereby accelerating the reaction kinetics.
Feline Respiratory Disease Complex: Insights into the Role of Viral and Bacterial Co- infections
Authors: Maboni Grazieli , Che Sunoh , Tallmadge Rebecca , Luca Eliana , Goodman Laura B. , Weese J Scott , Sanchez Susan
Published: May 2024

Feline respiratory disease complex (FRDC) is caused by multiple viral and bacterial pathogens. There is limited information about the role of co-infections in pathogenesis and the current prevalence of pathogens in North America. We aimed to conduct a study using technical advances in molecular diagnosis and statistical modeling analysis to elucidate the occurrence of pathogens and how co-infections affect disease severity. We attained information from three diagnostic laboratories in North America regarding the occurrence of Bordetella bronchiseptica, Chlamydia felis, Mycoplasma, Felid alphaherpesvirus 1 (FeHV-1), feline calicivirus (FCV), and influenza A, along with age, seasonality, sex, and clinical signs. We also evaluated the role of co-infections in disease severity. These pathogens were also investigated in clinically normal cats (control). The most detected pathogens were Mycoplasma, FCV, and FeHV-1. Most pathogens were detected in the control group, highlighting the challenge of interpreting positive testing results. Co-infections of Mycoplasma and FCV, as well as Mycoplasma and FeHV-1, were important predictors of disease severity. Age, sex, and season had a minor impact on pathogen occurrence. This study provides new insights into FRDC and underlines the relevance of diagnostic panels to screen for a range of pathogens, providing knowledge for timely diagnosis and therapeutic interventions.
Prevalence and risk factors of gunshot wound infection in the Eastern Democratic Republic of the Congo: a hospital-based cross-sectional study
Authors: Budema Paul Munguakonkwa , Manegabe Jean de Dieu Tumusifu , Hatu'm Victoire Urbain , Gulimwentuga Fabrice Cikomola , Toha Georges Kuyigwa , Mukuku Olivier , Tsongo Zacharie Kibendelwa , Kabesha Theophile Barhwamire , Wembonyama Stanislas Okitosho
Published: May 2024

Background
Survivors of gunshot injury have a major risk of wound infection. The prevalence of gunshot wound infection rates in low-income countries various to a country from another. Overall, there are limited data on civilian gunshot wound infection and its predisposing factors. The aim of this study is to determine the prevalence of gunshot wound infection and associated risk factors in a tertiary hospital of eastern part of the Democratic Republic of the Congo (DRC).
Materials and methods
This was a retrospective analysis of data on the entire patients who presented in Provincial General Reference Hospital of Bukavu in the DRC with gunshot injury from January 1st 2019 to December 31, 2020.
Results
There were 549 patients, and wound infection was a complication in 26.6% of them. Multivariate logistic regression analysis identified fractures (adjusted odds ratio [aOR] = 1.81; 95% CI: 1.12–2.92; p = 0.0146), nerve damage (aOR = 2.65; 95% CI: 1.70–4.14; p < 0.0001), trunk (aOR = 5.64; 95% CI: 2.61–12.16; p < 0.0001), lower extremity (aOR = 2.71; 95% CI: 1.39–5.28; p = 0.0034), and multiple > 2 (aOR = 2.35; 95% CI: 1.05–5.25; p = 0.0378) as independent predictors of gunshot wound infection.
Conclusion
The independent predictors of gunshot wound infection identified in this study implied ajudicious assessment and a high priority accorded to trunk perforating wounds, fractures and vasculo-nervous damage in interventions aimed at reducing gunshot wound infection rate.
The Correlation between Caries and Vitamin: A Retrospective Investigation
Authors: Li Chuang , Chen Kexiao , Xin Weini
Published: May 2024

Objectives
Vitamin consumption and caries are related, although not much research has looked at the two together. This study examined the connection between the total number of decayed teeth (Decay, D) and vitamin intake using data from the National Health and Nutrition Examination Survey (NHANES) database.
Methods
NHANES (2011–2018) provided the data for this retrospective analysis. Dental examiners, who were licensed dentists in at least one U.S. state, defined the number of caries-ridden teeth using the Radike AW Criteria for Diagnosis of Caries (1968), whereas the vitamin consumption data came from in-person interviews. To investigate the link between the total number of decayed teeth (D) and vitamin, multiple linear regression analysis was done. The quantitative data was described by mean ± standard deviation, whereas the categorical data was described by number of instances and proportion [n (%)].
Results
Results: This retrospective study comprised 3226 people in total. Approximately 579955.26 mg (579955.26/3226/30 = 5.99 mg/day/person) of vitamin C was the most consumed throughout the course of 30 days, making up 88.72% of the total amount of vitamin nutrients consumed. The total number of decayed teeth (D) was influenced by age (years) (β = 0.0125, P = 0.0281), PIR (β = 0.3348, P < 0.0001), BMI (β = -0.0299, P < 0.0391), gender (β = 0.5127, P = 0.0063), race (β = -0. 8265, P < 0.0001), education (β = 0.9201, P = 0.0013), vitamin B6 (β = 0.0112, P = 0.0076), vitamin C (β = 0.0005, P = 0.0370), and vitamin D (β = -0.0080, P = 0.0001), with BMI, race, and vitamin D exhibiting a negative correlation.
Conclusions
There is a correlation between vitamin intake and carie. Caries is more common when there is an excess of vitamin C, insufficient vitamin D, and excessive vitamin B6. Naturally, additional prospective clinical trials are required to confirm our findings and investigate potential causes.
Atypical Scurvy Presentation with Profound Bony Abnormality Detected via Magnetic Resonance Imaging- A Case Report
Authors: Qiyu Melvin Lee , Dawson Tom , Ahmed Amna
Published: May 2024

Background
Scurvy, arising from vitamin C deficiency, remains relevant despite historical declines. The U.S. study found a 7.1% vitamin C deficiency rate in people aged 6 and older, and 1.6% among those aged 6 to 11 years old. Scurvy commonly presents with severe leg pain, reluctance to walk, and limping. Other symptoms include gingival bleeding, hypertrophy, and ecchymoses. Due to its rarity in the pediatric population, vitamin C deficiency poses a diagnostic challenge for those with atypical symptoms.
Case presentation
This case report details a 3-year-old boy presenting with musculoskeletal issues, initially evaluated for an injury. With no apparent fractures, X-rays led to further investigations, including Magnetic Resonance Imaging Short Tau Inversion Recovery (MRI STIR). The MRI STIR results revealed bone and soft tissue oedema, prompting concerns about systemic disorders. Abnormal blood results, coupled with comorbidities such as suspected autistic spectrum disorder, triggered collaboration among paediatric, orthopaedic, and haematology/oncology specialists. Extensive imaging and consultations unveiled a diagnosis of scurvy, illustrating the challenges in recognizing this vitamin deficiency amid overlapping symptoms with serious conditions.
The interdisciplinary team-initiated treatment with oral ascorbic acid and analgesia, addressing the patient's reluctance to consume a varied diet. Parental decline for measuring ascorbic acid levels added complexity. Following a multi-disciplinary approach involving paediatric dietitians and physiotherapists, the patient exhibited positive progress, emphasizing the importance of tailored interventions.
Conclusion
This case highlights the diagnostic challenges posed by scurvy's diverse clinical presentations and the imperative for healthcare providers to recognize its potential, especially in cases involving musculoskeletal symptoms. The enduring relevance of scurvy in contemporary healthcare underscores the need for heightened awareness, interdisciplinary collaboration, and ongoing monitoring, emphasizing both short-term treatment and long-term preventive measures through dietary habits.
Spectral Characteristics of Water-Soluble Rhodamine Derivatives for Laser- Induced Fluorescence
Authors: Ratanpara Abhishek , Kim Myeongsub , Kim Yeo Jun , Hidrovo Carlos H.
Published: May 2024

We present a comprehensive fluorescence characterization of seven water-soluble rhodamine derivatives for applications in laser-induced fluorescence techniques (LIF). Absorption and emission spectra for these dyes are presented over the visible spectrum of wavelengths (400 to 700 nm). Their fluorescence properties were also investigated as a function of temperature for LIF thermometry applications. Rhodamine 110 depicted the least fluorescence emission sensitivity to temperature at -0.11%/°C, while rhodamine B depicted the most with a -1.55%/°C. We found that the absorption spectra of these molecules are independent of temperature, supporting the notion that the temperature sensitivity of their emission only comes from changes in quantum yield with temperature. Conversely, these rhodamine fluorophores showed no change in emission intensities with pH variations and are, therefore, not suitable tracers for pH measurements. Similarly, fluorescent lifetime, which is also a property sensitive to local environmental changes in temperature, pH, and ion concentration, measurements were conducted for these fluorophores. It was found that Rhodamine B and Kiton Red 620 have shorter fluorescence timescales compared to those of the other five rhodamine dyes, making them least suitable for applications where temporal changes in emission are monitored. Lastly, we conducted experiments to assess the physicochemical absorption characteristics of these dyes’ molecules into PDMS, the most common material for microfluidic devices. Rhodamine B showed the highest diffusion into PDMS substrates as compared to the other derivative dyes.
Efficient Virtual Machine Allocation using Human Based Optimizer (TLBO) with Artificial Neural Network Model
Authors: Sharma Sanjeev , Rawat Pradeep Singh
Published: May 2024

Cloud computing has revolutionized how resources are provisioned and utilized, offering scalability and flexibility to meet varying computational demands. Virtual Machine (VM) allocation, a critical aspect of cloud resource management, aims to optimize resource utilization while minimizing operational costs. In this paper, we propose a novel approach for VM allocation using a combination of Teaching Learning Optimization (TLO) and Artificial Neural Networks (ANN). The TLO-ANN model is designed to enhance the accuracy and efficiency of VM allocation decisions by leveraging knowledge transfer from pre-existing cloud environments. The proposed approach integrates historical allocation patterns and resource usage characteristics from multiple source clouds, allowing the model to learn from diverse scenarios. The TLO mechanism adapts the knowledge acquired from the source clouds to the target cloud's specific conditions, enabling effective allocation even in cases with limited target domain data. Furthermore, the ANN component of our approach provides a dynamic decision-making framework by continuously learning and adapting to changing workload patterns. The model considers multiple parameters to predict optimal VM allocation strategies, including CPU utilization, memory usage, and network traffic. The results demonstrate that our TLO-ANN approach outperforms traditional allocation methods regarding resource utilization, cost efficiency, and scalability. Through extensive experimentation and comparative analysis, we validate the effectiveness of the proposed TLO-ANN approach across various workload scenarios. The results showcase its ability to adapt to cloud environments, improving allocation accuracy and response times. Overall, this research contributes to advancing intelligent VM allocation techniques in the cloud computing Environment.
Post-secondary and post-baccalaureate medical school admission models: Perspectives from matriculating medical students in China and the United States
Authors: Deng Xiaomeng , Hou Jianlin , Luo Youhui , Zhang Huailin , Wells Traci
Published: May 2024

Background
Medical school admission practices vary globally, with China and the US representing two mainstream models: post-secondary and post-baccalaureate. The former relies on a single standardized test score, while the latter evaluates candidates holistically. In this study, we aim to delineate the distinct advantages of each model by examining the experiences of matriculating medical students from both countries and analyzing their perspectives on these divergent admission models.
Methods
The authors conducted individual semi-structured interviews with first-year medical students from two highly ranked higher-education institutions in China and the US: Peking University Health Sciences Center (PKUHSC), Beijing, and David Geffen School of Medicine (DGSOM) at UCLA, Los Angeles, California. The authors interviewed twenty students from each institution, performed inductive thematic analysis on interview transcripts, and conducted descriptive quantitative analyses of medical student survey data.
Results
PKUHSC participants were younger and less exposed to clinical medicine before application; many cited external factors that influenced their decision to pursue medicine, and some stated that medicine was not their top choice field of interest. DGSOM participants had more clinical experiences; many took gap years before committing to medical school. Altogether, participants desired medical school admission practices that allow for 1) adequate opportunity for career exploration, 2) consideration of non-cognitive skills and non-academic achievements, and 3) flexibility in the journey before medical school and diversity in the student body. Participants also cautioned about the impact on finances and personal lives, bias in standardized test scores, and limitations to a holistic evaluation in medical school admission.
Discussion
Striking a balance between selectivity and equity in medical school admission is challenging. The post-baccalaureate model excels in identifying candidates demonstrating preparedness for career in medicine, while the post-secondary model offers accessibility to applicants from disadvantaged backgrounds. Further research is essential to inform best practices in medical school admission.
Transformation behavior of hazardous jarosite into recyclable hematite in a solution with high concentrations of K + and Na +
Authors: Xing Yubo , Deng Zhigan , Wei Chang , Li Xingbin , Li Minting
Published: May 2024

Iron in the leaching solution with high K+ and Na+ concentrations was usually precipitated as the typical hazardous and toxic jarosite residues. However, this method of treatment has been greatly restricted by increasingly strict environmental regulations. Here we propose that iron can be precipitated from the solution with high K+ and Na+ concentrations as recyclable hematite products by adjusting the concentration ratio of sodium and potassium ions in the solution. The transformation behavior of jarosite into hematite in high concentration potassium ion and sodium ion solution was explained based on collision theory. The results indicated that in instances where the concentration ratio of Na+/K+ is ≥ 4:1, the iron present in the solution can be effectively precipitated as a recyclable hematite product, as opposed to forming the conventional hazardous jarosite residue, even under conditions where the potassium ion concentration reaches levels as high as 4g/L. On the other hand, thermodynamic and molecular dynamics simulations indicate that at a temperature of 185°C, the decomposition transformation of Na-jarosite (32.64 kJ and 7.25 eV) is more energetically advantageous compared to that of K-jarosite (61.07 kJ and 15.31 eV). The results were verified by the leaching solution from smelting industry. The iron content in the residues is above 58%, the sulfur content is below 4%, the zinc content is below 1%, and the total iron concentration in the supernatant is about 4g/L, reaching the production index of the smelting industry. The green, environmentally friendly, and recyclable separation of iron in a solution with high concentrations of potassium and sodium ions is achieved, which is of great significance for the treatment of iron-containing solution and wastewater in the chemical industry and metallurgy fields.
Left–right differences in oral function and QOL of patients who underwent tongue resection
Authors: Harada Yuka , Ihara Yoshiaki , Tamai Tomoki , Tashimo Yuichi , Nozue Shinji , Shimane Toshikazu
Published: May 2024

In this study, we investigated the effect of left–right differences on oral function and QOL in patients with TC underwent tongue resection. Forty patients with TC underwent resection smaller than hemiglossectomy were divided into left (LG) and right (RG) tongue groups. The evaluation items were evaluated at baseline and 1, 3, and 6 months posttreatment. Maximum tongue pressure and lip-closure force were measured for oral function evaluation. Peak expiratory flow was used to evaluate the respiratory function. The Functional Oral Intake Scale was used to evaluate the feeding functions. The QOL was assessed using the European Organization for Research and Treatment of Cancer QOL Questionnaires: QLQ-C30, QLQ-H&N35. No significant differences in oral, respiratory, or feeding function between LG and RG were observed at all evaluation periods. However at 3 months, LG had a significantly higher QOL score than RG for swallowing and trouble with social eating. At 6 months, the LG had a significantly higher QOL than RG for global health status and physical function. The left–right differences in tongue function did not lead to functional impairment but significantly affected the QOL. This indicates the importance of considering these differences in postoperative care to address QOL concerns effectively.
Analysis of Risk Factors for Persistent PSA After Radical Prostatectomy: Results from a High- Volume Center in Southeast China
Authors: Wang Hao , Hao Sida , Lin Shen , Chen Hong , Xie Liping , Zheng Xiangyi
Published: May 2024

Background: For localized prostate cancer, a comprehensive treatment approach centered around radical prostatectomy (RP) is often their optimal choice. Successful RP can typically reduce prostate-specific antigen (PSA) levels to below 0.1 ng/mL within 6 to 8 weeks postoperatively. However, in clinical practice, 5 to 24% of patients may have a PSA ≥ 0.1 ng/mL at 6 to 8 weeks after surgery, a phenomenon known as PSA persistence. Many studies based on data from Europe and United States have shown an association between PSA persistence and poor postoperative outcomes, further analyzing the risk factors for PSA persistence. However, relevant research based on data from China remains scarce.
Methods: Retrospective study of 1,347 prostate cancer patients who underwent RP at the First Affiliated Hospital of Zhejiang University School of Medicine from July 15, 2016, to August 31, 2022. After excluding 521 patients based on exclusion criteria, univariate and multivariate logistic regression analyses were conducted to explore the independent risk factors for persistent PSA.
Results: Among the 826 prostate cancer patients after RP, 124 patients experienced persistent PSA. In univariate logistic regression analysis, robot-assisted laparoscopic radical prostatectomy (RARP), preoperative PSA, high-risk group, preoperative International Society of Urological Pathology (ISUP) grades 2-5, postoperative ISUP grades 3-5, percentage of positive cores, cT3, ≥pT3b, extracapsular extension (EPE), seminal vesicle invasion (SVI), positive surgical margins (PSM) and Prostate Specific Antigen Density (PSAD) were all significantly associated with PSA persistence after RP (P < 0.05). In terms of surgical approach, RARP was considered a protective factor against postoperative PSA persistence (OR:0.53, p<0.05). In multivariate logistic regression analysis, preoperative ISUP grade 4, percentage of positive cores and PSM were independent risk factors of PSA persistence after RP (P < 0.05).
Conclusion: Preoperative PSA, high-risk group, preoperative ISUP grades 2-5, postoperative ISUP grades 3-5, percentage of positive cores, cT3, ≥pT3b, EPE, SVI, PSM and PSAD were independent risk factors for PSA persistence in prostate cancer patients after RP. This provides assistance for early monitoring and treatment of patients at high risk of persistent PSA in clinical practice.
Design of the efficient, tunable T-shaped Metal-Free Organic Dyes for TiO 2 Dye-Sensitized Solar Cells—A TD-DFT study analysis
Authors: Tanoli Sheraz A. K. , Urooj Nazish
Published: May 2024

Dye sensitized-solar cells (DSSCs) have drawn much attention as being a low cost, in simple fabrication and as a high power conversion alternative to photovoltaic cells. In this study, small meta-free sensitizers comprising of Triphenylamine (TPA) as a donor moiety, double bond as a л-linker and cyanoacrylic acid as an acceptor (anchoring group) having different substitutions at donner sides were designed and analysis by Time-dependent Density Functional theory (TD-DFT). The substitution effects at different positions (R1, R2, R3 and R4) with different a variety of electron-withdrawing and electron-donating groups at donor moiety has been demonstrated to investigate the optoelectronic properties, absorption energy. For the proposed structures, molecular orbitals, HOMO, LUMO energy levels, and absorption spectra were calculated on DFT and TD-DFT level of theory by employing CAM-B3LYP methods and LANL2DZ /6-31G basis set using Gaussian 9.0 software. Eight dye-sensitizers (D1-D8) posing different substitutions (-CH3, -F, -NH2, -C (CH3)3, -NO2, -C6H5) on donor sides are capable of lowering the Egap (HOMO-LUMO), however, a few sensitizers show much lower Egap than to the conduction band edge value (4.0 eV). Nevertheless, the calculated properties inferred that three (D1, D4, and D6) studied sensitizers are supposed to be the good candidates for use and observe experimentally and eventually provide a guideline to design new sensitizers for dye-sensitized solar cells.
Numerical simulation of the formation of the Zaozigou gold deposit i n the West Qinling Mountains: distribution of hidden mineralization and its controlling factors
Authors: Wang Yuang , Li Baozhu
Published: May 2024

The Zaozigou gold deposit, situated in Gansu Province within the West Qinling orogenic belt, is classified as a super-large gold deposit. In the exploration of mineralization processes, numerous factors pose challenges for traditional identification methods. This study employs numerical simulation techniques to investigate factors that are challenging to discern through conventional methodologies in the formation of the Zaozigou gold deposit mineralization system. We aim to utilize multi-field coupling, integrating thermodynamics and fluid mechanics, to replicate the intricate movement of ore-bearing fluids. The research uncovers the mineralization patterns of the Zaozigou gold deposit. By constructing a two-dimensional model and examining the interplay of time, space, materials, and evolution, we pinpoint areas of abnormal temperature and normal pressure within the fluid, where the spatial distribution of S2− correlates with known mineralization patterns. Numerical simulations demonstrate that the migration of ore-bearing fluids, influenced by thermal flow fields and pressure dynamics, can lead to mineral concentration in regions exhibiting pronounced barotropic stress anomalies. These zones boast favorable mineralization conditions, elucidating disparities in mineralization between the northeastern and southwestern flanks of the fault-fold structure within the mining field. The outcomes of this investigation introduce a novel approach for advancing hidden ore prospecting efforts in the Zaozigou region.