bluuebunny/crossref_metadata_2025 huggingface dataset:
DYNAMICS AND STRUCTURE OF ABORTIONS IN THE RUSSIAN FEDERATION AND FAR EASTERN FEDERAL DISTRICT IN 2003-2022
Authors:   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Stupak Valerij , Banteva Marina ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia, Manoshkina Elena ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia
Published: June 2024

Significance. A high medical and social significance of abortions is due to high prevalence and substantial contribution to reproductive loss, maternal mortality and gynecological morbidity, including infertility. The purpose of the study was to analyze dynamics and structure of abortions in the Russian Federation and Far Eastern Federal District and its regions in 2003-2022. Material and methods. The study analyzed official statistics data (Federal statistical observation Form No. 13 “Information about pregnancy termination (up to 28 weeks of gestation),” and “Information about pregnancy termination (up to 22 weeks of gestation) - for the period from April 2012, in the Russian Federation, Far Eastern Federal District and its regions in 2003-2022. Dynamic series indicators (ratio indicators, growth rate, rate of increase/decrease) were calculated, the methods of direct ranking, descriptive statistics were used. Results. In 2003-2022, there was a decrease in the number of all types of abortions in the Far Eastern Federal District, as well as in the Russian Federation as a whole – by 71.32% and 76.4%, respectively. At the same time, the absolute number of medical (legal) abortions has significantly decreased: by 80.6% (from 89,564 in 2003 to 17,376 in 2022) in the Far Eastern Federal District and by 86.7% (from 1349,652 to 179,387) in the Russian Federation. However, in the Far Eastern Federal District, as in the Russian Federation as a whole, the share of medical abortions in the structure of medical (legal) abortions increased from 0.02% to 44.0%, and the share of spontaneous abortions of the total number of abortions increased from 9.4% to 20.0%. Conclusion. In 2003-2022, the number of all types of abortions decreased in both the Far Eastern Federal District and the Russian Federation as a whole, however, their level remains high. The decrease in the number of abortions is accompanied by an unfavorable change in their structure, with the increasing share of spontaneous abortions as the main sign of reproductive system disfunction. Keeping in mind that miscarriage is the main cause of reproductive loss, prevention and successful treatment of this pathology is an actual reserve for increasing fertility.
PREVENTIVE MEASURES BASED ON CARDIOVASCULAR RISK ASSESSMENT IN METALLURGICAL PRODUCTION WORKERS
Authors:   Ufa Research Institute of Occupational Medicine and Human Ecology, Ufa, Russia, Abdrakhmanova Elena ,   Bashkir State Medical University of the Ministry of Health of the Russian Federation, Ufa, Russia, Masyagutova Lyaylya ,   Ufa Research Institute of Occupational Medicine and Human Ecology, Ufa, Russia,   Bashkir State Medical University of the Ministry of Health of the Russian Federation, Ufa, Russia, Urazaeva Elvira ,   Ufa Research Institute of Occupational Medicine and Human Ecology, Ufa, Russia, Shaikhlislamova Elmira ,   Ufa Research Institute of Occupational Medicine and Human Ecology, Ufa, Russia,   Bashkir State Medical University of the Ministry of Health of the Russian Federation, Ufa, Russia, Vlasova Natal'ya ,   Ufa Research Institute of Occupational Medicine and Human Ecology, Ufa, Russia
Published: June 2024

Significance. The conducted studies are devoted to the analysis of the factors of disease development and prevention of major non-communicable diseases, the most common of which are cardiovascular diseases. The relevance of this work is determined by the possibility and need for timely identification of pre-pathological and pathological conditions, in order to develop optimal schemes of preventive measures to preserve professional longevity of workers. The purpose of the study was to develop a program of preventive measures based on the risk assessment of cardiovascular diseases in workers of metallurgical production, exposed to a complex of occupational risk factors. Material and methods. Results of periodic medical examination of workers of certain professional groups of a metallurgical enterprise have been analyzed. To determine the total fatal cardiovascular risk among workers, the SCORE (Systematic Coronary Risk Evaluation) was used. Results. A general sanitary audit of the working conditions of the metallurgical plant workers corresponds to hazardous class 3, degree 2-3 (3.2-3.3). According to the survey results, tobacco smoking is common among more than half of the surveyed workers - 56.8%. Among the professional group of temperers, tobacco smoking is more common (67.0%) compared to the professional group of wire-drawers (50.0%) and the control group (25.6%). The average body mass index among workers was 26.1±1.7 kg/m², and 27.8±1.5 kg/m² in the control group. Analysis of the average cholesterol group level was within the reference values of 4.8±0.1 mmol/l. 31.6% of the workers had high and very high levels of fatal cardiovascular risk, and 14.1% - a low one. Conclusion. Preventive measures to preserve professional longevity of metallurgical production workers should be carried out based on the cardiovascular risk assessment using the developed programs. Scope of application. The developed algorithm for selecting medical measures with due regard to cardiovascular risk assessment can be used as a corporate program for preserving health of the working population.
QUALITY ASSESSMENT OF CANCER CARE AS A TOOL FOR MANAGEMENT DECISION-MAKING
Authors:   Northern State Medical University of the Ministry of Health of the Russian Federation, Arkhangelsk, Russia, Tsyganova Olga , Yasko Natalja ,   Northern State Medical University of the Ministry of Health of the Russian Federation, Arkhangelsk, Russia,   Territorial Compulsory Health Insurance Fund of the Arkhangelsk Region, Arkhangelsk, Russia, Postoev Vitaly ,   Northern State Medical University of the Ministry of Health of the Russian Federation, Arkhangelsk, Russia
Published: June 2024

Significance. Objective data, including results of quality assessment and expertise carried out by health insurance organizations as part of monitoring over volumes, service periods, quality and conditions of medical care delivery within the compulsory health insurance system are needed to make management decisions on organizing appropriate quality care delivery at the regional and institutional levels. The subject of study: quality of medical care provided to patients with cancer. The purpose of the study: to evaluate results of medical and economic expertise and quality assessment of cancer care, carried out by health insurance organizations in the Arkhangelsk region in 2018 –first half of 2023 (25,012 expert opinions). Material and methods. The study used depersonalized results of medical-economic expertise and quality assessment of medical care (25,012 expert opinions). Methods: retrospective analysis, statistical (calculation of extensive and intensive coefficients and their comparison), analytical method. Results. In general, the frequency of cancer care defects during the period under study equaled to 29.1 per 100 assessed cases. The leading group of defects included a failure, untimely or improper implementation of diagnostic and (or) treatment activities necessary for the patient (49.3%). The study has identified significant differences in the frequency and structure of the identified defects of medical care under different conditions of its provision, in medical organizations of different levels and in different nosological groups. Conclusion. The study shows a decline in the total number of defects in cancer care delivery with the same frequency of medical-economic expertise and quality assessment in the Arkhangelsk region in 2018 - first half of 2023. To identify causes of the leading groups of defects in the provision of medical care according to code 3.2. (failure, untimely or improper implementation of diagnostic and (or) treatment activities necessary for the patient), it is necessary to conduct a sociological survey (questionnaire) of doctors involved in cancer care delivery. Scope of application: management decision-making aimed to improving access to and quality of cancer care at the regional and institutional levels.
THE EXPERIENCE OF USING SWOT - АNALYSIS AS A TOOL FOR INCREASING MANAGEMENT EFFICIENCY OF A MEDICAL ORGANIZATION DURING CONSTRUCTION, RECONSTRUCTION AND CAPITAL REPAIR
Authors:   Department of the Government of the Russian Federation, Moscow, Russia, Boenko Elena , Shikina Irina ,   Federal Research Institute for Health Organization and Informatics of the Ministry of Health of the Russian Federation, Moscow, Russia
Published: June 2024

Significance. The principal attention of the Government of the Russian Federation and the Russian Ministry of Health is focused on health preservation and health promotion, development of conditions for increasing access to and quality of medical care, including infrastructure development, renewal and upgrade of material and technical resources of medical organizations, and introduction of new modern medical technologies. Construction, reconstruction, and capital repair of health care facilities are implemented within the framework of state programs and projects through budgetary funding with direct participation of head physicians as customers of project and construction works and responsible for the upkeep of medical organizations. The purpose of the study was to conduct a SWOT analysis and substantiate its use as a tool for increasing management efficiency of a medical organization during construction, reconstruction and capital repair. Material and methods. Research methods: analytical, classical methodology of SWOT analysis, content analysis, statistical, expert assessments. The study used the 2021-2022 data of the federal statistical observation form No. 30 “Information about a medical organization”, audit materials of the Accounts Chamber of the Russian Federation, and reports of the pilot constituent entities of the Russian Federation. A SWOT analysis of 20 state medical organizations participating in healthcare modernization programs was carried out in the following constituent entities of the Russian Federation: the Republics of Tatarstan, Crimea, the cities of Moscow and Sevastopol. Results of the study identified groups of factors that influence the current state of meeting the need for construction, reconstruction, and capital repair of medical organizations: external influence (opportunities and threats) that are not directly controlled by the management of a medical organization, as well as strengths and weaknesses, manageable at the local level. Conclusion. The conducted SWOT analysis of the current state of medical organizations show that efficient management of infrastructure development at a modern level, ensuring safe provision of accessible and high-quality medical care, is possible by improving the quality of initial decisions for pre-project documentation and construction (reconstruction) assignments, capital repair of medical organizations with the participation of head physicians. We consider it important to increase the level of competency of head physicians and their teams for implementing the above processes.
Tibial Baseplate Migration Is Not Associated with Change in Patient-Reported Outcome Measures and Clinical Scores After TKA
Authors: van der Lelij Thies J.N. , Kaptein Bart L. , Tsonaka Roula , Nelissen Rob G.H.H. , Toksvig-Larsen Sören , Marang-van de Mheen Perla J.
Published: June 2024

Background:

Radiostereometric analysis (RSA) provides highly accurate data about the migration of a total knee arthroplasty (TKA) component. However, patient-reported outcome measures (PROMs) reflect the patients’ perspective of their functional status, pain, and overall health after TKA. The aim of this study was to evaluate the association between tibial implant migration and change in postoperative PROMs and clinical scores, using data pooled from long-term follow-up RSA studies.

Methods:

Individual implant migration data were collected from 5 randomized RSA studies, including a total of 300 patients with 6 distinct TKA implant designs (all Stryker). Tibial implant migration (maximum total point motion [MTPM]) was evaluated with RSA at 3 months, 1 year, and 2, 5, 7, and 10 years postoperatively. The Knee Society Score (KSS)-Knee and KSS-Function and Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales were collected in all studies at the same follow-up times. Linear mixed-effects models, with adjustment for TKA implant design and patient characteristics, were used to analyze the data. The 3-month follow-up visit was used as the baseline to assess the association between implant migration and PROMs across the 10-year follow-up.

Results:

No association between tibial implant migration and change in KSS-Knee (p = 0.384), KSS-Function (p = 0.737), KOOS-Symptoms (p = 0.398), KOOS-Pain (p = 0.699), KOOS-Activities of Daily Living (p = 0.205), KOOS-Sport and Recreation (p = 0.702), or KOOS-Quality of Life (p = 0.368) was found across the entire follow-up. Similar results were found when using the 2-year follow-up as the baseline, after which both cemented and uncemented implants are expected to have stabilized.

Conclusions:

Tibial baseplate migration was not associated with postoperative worsening in PROMs or clinical scores in patients who underwent TKA. These findings suggest that implant migration, as measured with RSA, measures a different parameter (i.e., implant-bone fixation) than PROMs (i.e., patient perception) and clinical scores. Therefore, to assess the performance and safety of TKA implant designs, RSA and PROMs cannot be used interchangeably during the postoperative follow-up of patients and evaluation of the fixation of knee implants.

Level of Evidence:

Prognostic Level III. See Instructions for Authors for a complete description of levels of evidence.
Education, Language, and Cultural Concordance Influence Patient-Physician Communication in Orthopaedics
Authors: Diaz Alondra , Castillo Tafur Julio C. , Lin Ye , Echenique Diego Barragan , Drake Brett , Choubey Apurva S. , Mejia Alfonso , Gonzalez Mark H.
Published: June 2024

Background:

Orthopaedic surgery has a diversity gap, as it is not representative of the racial or sex proportions of the U.S. population. This gap can lead to communication barriers stemming from health literacy, language proficiency, or cultural discordance that may contribute to current health inequities. This study assesses the influence of educational attainment, language, and cultural concordance on patient-physician communication.

Methods:

In this cross-sectional study, 394 patients from an urban orthopaedic clinic were administered a Likert-type survey regarding race or ethnicity, educational level, communication, patient satisfaction, language proficiency, and culture. One-way analysis of variance, chi-square tests, and Welch t tests were used to evaluate responses.

Results:

The majority of subjects identified as African-American/Black (50%) or Hispanic/Latino (30%). Completing high school was associated with a better ability of the subjects to communicate with their orthopaedic surgeon (p < 0.001). Hispanic subjects reported lower English proficiency (p < 0.001) and decreased ability to communicate with their physician (p < 0.001) compared with other subjects, with educational attainment influencing their ability to understand their orthopaedic surgeon in English (p < 0.001). African-American and Hispanic patients placed greater importance on orthopaedic surgeons understanding their culture than White patients (p < 0.001). Hispanic patients who saw a language and culture-concordant surgeon valued having a Spanish-speaking surgeon more than Hispanic patients who did not see a concordant surgeon (p = 0.04).

Conclusions:

These results suggest that patient-physician language concordance, particularly in patients with lower education, may be essential to delivering high-quality patient care. Hispanic and African-American patients placed significantly greater importance on their orthopaedic surgeons understanding their culture. Hispanic patients frequently sought care with language-concordant surgeons and placed higher value on physicians understanding their culture. To better serve minority communities, efforts should be made to increase orthopaedic surgeons’ cultural humility and to recruit a diverse multilingual surgeon workforce.

Clinical Relevance:

This research demonstrates that cultural and language concordance, specifically between Hispanic patients and Hispanic, Spanish-speaking surgeons, can significantly enhance patient preference and potentially improve patient satisfaction and outcomes in orthopaedic care. Additionally, it underscores the importance of understanding and addressing the diversity within the field and the patient population to better meet the needs of a multicultural society.
Origin of Au-Ag Mineralization in Sphalerite Ores from Data on Sphalerite Co-Crystallization with Ag and Au in Model Hydrothermal Systems
Authors: Tauson V.L. , Lipko S.V. , Babkin D.N. , Smagunov N.V. , Belozerova O.Yu. , Kaneva E.V.
Published: June 2024

––Au-Ag mineralization occurrences in sphalerite ores of hydrothermal genesis are paradoxical in view of the incompatibility of these elements in sphalerite. The formation of sphalerite with Au and Ag impurities under hydrothermal crystallization of ZnS at 450 °C and 1 kbar pressure was studied experimentally. Sn impurity was taken as a source of point defects in crystals modelling the interaction of Au and Ag with vacancies. The Ag solubility in low-Fe sphalerite is estimated as 3.8 ± 0.7 μg/g, Au ̶ ≤ 0.6 μg/g. The main forms of Ag and Au occurrence in sphalerite are the inclusions of (Ag, Au)xS phases with x varies mainly from 1.8 to 2.0, and Au varies from 0.01 to 0.75 a.p.f.u. The primary forms of the elements in ores might be microinclusions (Ag, Au) 1.8-2.1S or close to (Ag, Au)S at higher fS2. In presence of Sn, solubilities of Au and Ag become higher. The behavior of Au corresponds to the substitution reaction Sn4+ + Au+ + v‒ ↔ 2Zn2+ in the presence of two types of vacancy defects (v–) ‒ the “inherent” vacancies dependent on the crystallization conditions and the vacancies accompanying Sn4+ incorporation. Ag entrance is seemingly more dependent on fS2 conditions and does not correlate with Sn. The extra vacancies arise because of metastable crystallization under the conditions of oversaturation of growth medium. This is supported by the spherulite morphology of growth products and the admixture of wurtzite ZnS form. The distribution and cocrystallization coefficients show an increasing trend for both precious metals (PM), due to which Au changes from incompatible to the category of highly compatible elements in sphalerite. The geochemical environments favorable for the formation of imperfect mineral crystals are considered. Such crystals are capable to uptake PMs and other incompatible in “ideal” crystal elements because of their interaction with vacancies, both constitutional (inherent to the substance) and non-equilibrium defects, and surficial nano-sized formations (nonautonomous phases). The evolution of these initially “invisible” forms of PM under metamorphic processes and remobilization of ore substance may result in Au and Ag escape and aggregation into microparticles.
Simple fabrication of Nb2O5 /PANI nanocomposite for high performance lithium sulfur batteries
Authors: Qi Meili , Li Hui , Li Xinyi , Hu Ming
Published: June 2024

Lithium-sulfur batteries have attracted significant attention due to their high theoretical capacity density (1675 mA h g− 1) and low production cost. However, under practical conditions, the low conductivity of sulfur, volume expansion, and shuttle effect of lithium polysulfide (LiPSs) still hinder the broad application of lithium-sulfur batteries. A self-assembled flexible electrode material (Nb2O5/PANI-cc@S) is designed and fabricated here. The core of Nb2O5 nanowire arrays is coated with a shell of PANI and assembled with carbon cloth (cc) as a new sulfur fluid collector. The composite exposes more active sites between sulfur and the catalytic medium to capture LiPSs. In addition, the extra free space between Nb2O5 nanowire arrays is conducive to the penetration of liquid electrolytes. Moreover, the shell structure of PANI on the electrode surface enhances the structural stability of the composite electrode material. It effectively inhibits the outward diffusion of polysulfide and the volume expansion during the cycle. Thanks to these synergies, the self-supporting Nb2O5/PANI-cc@S has a high specific capacity of 1265.7 mA h g− 1 at 0.1 C and retains an impressive 1112.2 mA h g− 1 capacity even after 100 cycles at 0.1 C. It shows great potential to promote the practical application of flexible lithium-sulfur batteries.
Analysis of nutritional effects and other risk factors for the development of postoperative delirium in patients undergoing coronary arterial bypass grafting: A retrospective secondary analysis
Authors: Omran Ahmed
Published: June 2024

Background:
Delirium is an acute brain dysfunction associated with increased mortality, morbidity, and long-term cognitive dysfunction. Studies showed that the incidence of post-cardiac surgery delirium (PCSD) might reach up to 70% of patients.
This study aims to analyze risk factors contributing to the incidence of PCSD in patients undergoing elective cardiac surgeries.
Methods:
This study is a secondary retrospective cohort analysis that utilizes prospectively collected data from an 8-year follow-up period to investigate the nutritional status of patients undergoing cardiac surgery. Data from 1187 patients was analyzed for risk factors associated with PCSD. The statistical analysis was conducted using R version 4.2.0. A p-value less than 0.05 was considered statistically significant.
Results:
A total of 1,187 patients were included in our analysis based on the dataset. The prevalence of delirium in the sample set was 8% (96/1187). Each parameter underwent univariate analysis, and significant parameters were included in a multivariate logistic regression model. The analysis revealed that parameters like increasing age at p< 0.05, with an odds ratio (OR) of 1.05, CI (1.02 -1.07), the aortic cross-clamp time (p<0.05) with an OR=1.01 CI [1.01-1.02], longer ventilation hours (p<0.05) with an OR= 1.06 CI [1.02-1.10], hospital and intensive care length of stay with p<0.05 and, p<0.001, respectively to be associated with increased incidence of postoperative delirium.
Conclusion:
There is a significant association between PCSD and various factors such as advanced age, extended duration of aortic cross-clamp, prolonged mechanical ventilation, and increased length of hospitalization in patients undergoing cardiac surgeries.
Assessment of the phenotypic diversity and agronomic performance of a Mediterranean lentil collection under rainfed conditions: towards efficient use in breeding programs for adaptation to Mediterranean-type environment
Authors: Zeroual Abdelmonim , Mitache Mohammed , Baidani Aziz , Abderemane Bacar Abdallah , Benbrahim Nadia , Ouhemi Hanane , Çakır Esra , Hoyos-Villegas Valerio , Gadaleta Agata , Mazzucotelli Elisabetta , Özkan Hakan , Idrissi Omar
Published: June 2024

The improvement of lentil productivity and resilience to climate change requires the deployment of breeding approaches and sustainable agronomic practices. Germplasm from the Mediterranean region could be an important source of useful traits for lentil breeding programs. Additionally, no-tillage could also contribute to maintaining lentil productivity in drought-prone environments. However, there are few studies on breeding for adaptation to no-tillage in lentil, as this practice can create growing conditions that differ from those under conventional tillage. The main objectives of this study were to assess the phenotypic diversity of a lentil collection in different environments and to select promising accessions that can be used in lentil breeding programs. A Mediterranean lentil collection of 119 accessions was evaluated in Morocco (under no-till and conventional tillage) and in Turkey (during two growing seasons) under rainfed conditions. There was significant phenotypic variation among accessions for traits assessed. In addition, significant genotype-by-environment interaction effects were observed for grain yield and time to flowering. Moroccan landraces were the earliest to flower compared to landraces from Italy, Turkey, and Greece. Greek landraces displayed the highest mean values of hundred-seed weight. Landraces outperformed advanced lines in low-yielding environment (Turkey in 2022 season) in which higher yield was recorded in Turkish landraces, followed by Moroccan landraces. The high-yielding accessions identified in different environments could be used as donors in breeding programs.
The instrumental role of forgiving in the relationship between cognitive flexibility and decision-making and happiness in athletes
Authors: KARA Mehmet , KARA Nuriye Şeyma , DÖNMEZ Ahmet , ÇETİN Mehmet Çağrı , TOÇOĞLU Sinem , ÖNAL Ayşe , KARA Ahmet
Published: June 2024

This study intended to reveal the mediating relationship of forgiveness in the relationship between cognitive flexibility, decision-making, and happiness of athletes aged 18 and over through structural equation modeling. A total of 618 licensed athletes participated in the study, and the data were collected from volunteer participants using the "Forgiveness Decision Scale", "Cognitive Flexibility Scale", "Natural Decision-Making Scale" and "Happiness Scale". The results indicated that athletes’ forgiveness was the full mediator in the relationship between decision-making and happiness, and the partial mediator in the relationship between cognitive flexibility and happiness. The mediation study carried out offers clues to identify and eliminate the negativities on the way to the success of the athletes.
Sentiment Analysis of Operating Room Nurses in Acute Care Hospitals in Japan: Unveiling Passion for Perioperative Nursing Using ChatGPT
Authors: Hara Kentaro , Tachibana Reika , Kumashiro Ryosuke , Ichihara Kodai , Uemura Takahiro , Maeda Hiroshi , Yamaguchi Michiko , Inoue Takahiro
Published: June 2024

Aim This study aimed to elucidate the emotions of operating room nurses in Japan towards perioperative nursing using generative AI and identify factors contributing to burnout and turnover.Methods This single-center cross-sectional study, conducted from February 2023 to February 2024, employed semi-structured interviews with 10 operating room nurses from a national hospital in Japan. The interviews were designed to capture detailed qualitative data about the nurses' emotional experiences. These interviews were transcribed verbatim and analyzed using thematic, sentiment, and subjectivity analysis with ChatGPT (OpenAI, San Francisco, CA). Data visualization techniques, including keyword co-occurrence networks and cluster analyses, were also employed to uncover patterns and relationships in the data.Results Thematic analysis revealed key themes related to patient care, surgical safety, and nursing skills. The sentiment analysis showed a range of emotional tones, with high subjectivity scores indicating that the nurses' reflections were deeply personal and empathetic. Keyword co-occurrence networks highlighted the interconnectedness of various themes, such as the relationship between patient care and safety protocols. Cluster analysis identified distinct groups of emotional experiences, demonstrating the diverse emotional landscape of operating room nurses.Conclusions This study demonstrated the potential of generative AI to provide nuanced insights into the emotions of operating room nurses. The findings underscore the importance of emotional support, effective communication, and robust safety protocols in enhancing nurse well-being and job satisfaction. By leveraging AI technologies, healthcare institutions can better understand and address the emotional challenges faced by nurses, potentially reducing burnout and improving retention rates. Future research with larger and more diverse samples is needed to validate these findings and explore the broader applicability of AI in healthcare settings.
Effectiveness of Histogram Equalization and Ensemble Deep Learning Techniques for Detecting Autism Using Eye-Tracking
Authors: Ahmed Zeyad A.T. , Aldhyani Theyazn H.H , Alzahrani Eidah M , Albalawi Eid , Algarni Mohammad H , Jadhav Mukti E. , Ahmad Sultan , Al-Adhaileh Mosleh Hmoud , Alsubari Saleh Nagi , Mehdi Ali
Published: June 2024

Autism spectrum disorder (ASD) is a common neurological illness marked by difficulties in social communication and the presence of repetitive behaviors. Timely and precise identification is crucial but continues to be a substantial clinical obstacle in ASD. This study investigates an artificial intelligence approach using deep learning models trained on publicly available eye-tracking datasets to differentiate between autistic and typically developing children. The study focused on the prospective utilization of oculomotor biomarkers and artificial intelligence technology as a potential avenue in attaining a diagnosis of ASD. The study employed image preprocessing using histogram equalization to enhance visual feature representation, while data augmentation was used to address common dataset limitations in ASD research. Transfer learning and custom layers were further used to optimize model performance. Using DenseNet169, VGG16, VGG19, and MobileNet models, classification accuracies of 96%, 96%, 95%, and 96% were achieved, respectively. An ensemble model combining optimized VGG16, MobileNet, DenseNet169, and ViT architectures reached an impressive 98% binary classification accuracy, the highest reported for ASD screening using eye-tracking data.
Factors influencing treatment outcomes in a randomised clinical trial for gambling disorder
Authors: Mäkelä Niklas , Isotalo Jarkko , Alho Hannu , Castrén Sari
Published: June 2024

Background: Sociodemographic background factors, gambling game type, depressive symptoms and comorbid substance misuse have been associated with gambling disorder, but the effects of these factors on treatment outcomes remains unclear. The aim of this study was to examine the background factors associated with treatment outcomes in a clinical trial for gambling disorder.
Methods: This was a secondary analysis of a single-centre 12-week randomised placebo-controlled clinical trial investigating the effects of as-needed intranasal naloxone in the treatment of gambling disorder. Data was analysed with linear mixed models, with analyses both including and excluding treatment effect.
Results: Sociodemographic factors or game types were not associated with treatment outcomes. Adherence to the investigative medicinal product (IMP) dosing regimen was associated with greater reduction in gambling urge and severity, and greater increase in gambling self-efficacy. Higher readiness to change gambling behaviour was associated with greater gambling self-efficacy. Higher scores for depressive symptoms at baseline were associated with a greater increase in quality of life after the treatment. When treatment allocation was incorporated as a nuisance variable, most results that were previously identified as statistically significant were consequently nullified.
Conclusion: Authors hypothesize that recognizing gambling urges and acting in response to them is the underlying factor behind the positive effects of medication adherence in this trial. More rigorous monitoring of IMP use is recommended for future trials with as-needed formulations.
Trial registration: EudraCT number: 2017-001946-93 and ClinicalTriels.gov: NCT0343018).
Sleep and Daytime Function in People with Spinal Cord Injury
Authors: Kelly Monica , Badr Amira , Zeineddine Salam , Salloum Anan , Pandya Nishtha , Mitchell Michael , Sankari Abdulghani , Muñoz Isabel , Badr Safwan , Martin Jennifer
Published: June 2024

Study Design: Cross-sectional cohort study.
Objectives: To determine the role of sleep-disordered breathing (SDB), insomnia symptoms and sleep quality in the daytime function and quality of life of veterans with spinal cord injury (SCI).
Setting: A Veterans Administration (VA) medical center in the Midwestern US.
Methods: Thirty-eight male veterans with SCI (22 cervical, 16 thoracic; mean [SD] age = 62.9[9.5] years) completed baseline assessments within a larger clinical trial. Measures assessed sleep apnea severity (apnea-hypopnea index, AHI), insomnia symptoms (Insomnia Severity Index, ISI), self-reported sleep quality (Pittsburg Sleep Quality Index, PSQI), daytime sleepiness (Epworth Sleepiness Scale, ESS), fatigue (Flinders Fatigue Scale, FFS), depression (Patient Health Questionnaire-9 item, PHQ-9 excluding sleep item), functioning (Spinal Cord Independence Measure, SCIM), and quality of life (World Health Organization Quality of Life, WHOQOL-BREF). Bivariate correlations (alpha p<.05) were used to assess relationships between sleep (AHI, ISI, PSQI, ESS) and functon(FFS, PHQ-9, SCIM, WHOQOL-BREF).
Results: Mean AHI was 29.9(26.6), mean ISI was 9.38(6.2), mean PSQI was 9.0(4.6), and mean ESS was 7.0(5.2). There were no significant relationships between AHI and function measures. Significant relationships emerged between ISI and PHQ-9, some WHOQOL-BREF subscales, and SCIM as well as between PSQI and FFS, PHQ-9, and some WHOQOL-BREF subscales.
Conclusions: Among Veterans with SCI, insomnia symptom severity and poor sleep quality were associated with worse functioning, whereas SDB severity was not. Insomnia and poor sleep quality represent modifiable contributors to poor daytime function. Research evaluating the impact of evidence-based insomnia treatments among individuals living with SCI is warranted.
NAD+ modulates mitochondrial vulnerability and prevents retinitis pigmentosa
Authors: Zhang Shaochong , Feng Lujia , Wen Yuwen , Zhang Ting , Zhuo Xiaohua , Wei Yantao , Liu Lixian , Huang Zhaohao , Zhang Guoming , Chen Lu , Du Yong , Fang Dong , Li Wangting , Zhou Linbin , Zhao Ling , Zhu Yingting , Liang Jia , Li Zhiquan , Song Xiaojing , Deng Caibin , Mao Xingxing , Hou Xiaofeng , Su Wenru , Zhuo Yehong
Published: June 2024

Retinitis pigmentosa (RP) is the most common inherited blinding retinal degenerative disease characterized by the progressive loss of photoreceptors and retinal pigment epithelium (RPE) that eventually causes retinal degeneration. However, the mechanisms that initiate RP and drive retinal vulnerability remain incompletely understood, and new strategies for its prevention and therapy are urgently needed. Mitochondrial dysfunction is the initiator of a variety of neurodegeneration, whether mitochondrial dysfunction is an important pathogenic factor of RP is still unknown. Our single-cell RNA sequencing, transmission electron microscopy, and enzyme-linked immunosorbent assay revealed that both photoreceptor cells and RPE cells of RP rats have abnormal mitochondria, accompanied by decreased levels of nicotinamide adenine dinucleotide (NAD+) metabolism which rendered the lack of NAD+ vulnerable to disease-related insults. Moreover, similar experimental results were observed in an in vitro RP model established by human primary RPE cells. Furthermore, electroretinography combined with hematoxylin-eosin, immunofluorescence analysis, and fundus photograph investigations revealed that oral administration of the NAD+ precursor nicotinamide (NMN) protected RP rats against retinal degeneration. Mechanistically, single-cell RNA sequencing, siRNA targeting, and AAV virus applications demonstrated the therapeutic effect of NMN on RP through the glyceraldehyde-phosphate dehydrogenase-mitochondria pathway. Collectively, these findings indicate that mitochondrial abnormalities may be the drivers of RP and NMN has a therapeutic effect on RP.
The Efficiency of Clinical Laboratories: The case of Iran
Authors: Shaker Zohreh , Shaker Zainab , Barouni Mohsen , Sabermahany Asma
Published: June 2024

Background
Medical diagnostic laboratories are an essential work environment that plays an important role in diagnosing, treating, and being sensitive to diseases. One way to evaluate laboratories' performance is to calculate their efficiency. This study investigates the efficiency of laboratories that are related to health centers in the south of IRAN.
methods
This study was conducted in 2021. The input numbers include: the number of technical personnel and the number of cell counters, and the output data includes: the scores obtained from the level 2 health laboratory evaluation list. And efficiency was calculated with DEAP software.
Findings:
The efficiency of laboratories of Orzueeyeh and Ravar Cities had the highest efficiency with the assumption of variable returns to scale efficiency 1, and the model of all laboratories is the laboratory of Ravar City. The laboratories of Kuhbanan and Rabor cities had the lowest efficiency with the assumption of variable returns to scale efficiency of 0.859 and 0.899, respectively. The average scale efficiency, Variable returns to scale, and constant returns to scale for laboratories in the cities of Kerman province are 0.842, 0.943, and 0.895, respectively.
Conclusion
To increase the efficiency of laboratories, significant resources and funds should be used, as well as a few studies in this regard in the country, which require more attention.
A Miniaturized MEMS Accelerometer with Anti-Spring Mechanism for Enhancing Sensitivity
Authors: Wu Tao , Xiong Ruihong , Xu Xuankai , Liu Yushuai , Du Shihao , Jin Lihui , Chen Fang
Published: June 2024

Anti-spring mechanisms are widely used for improving the noise performance of MEMS accelerometers due to their stiffness softening effect. However, the existing mechanisms typically require large bias force and displacement for achiev¬ing stiffness softening, leading to large device dimensions. Here, we propose a novel anti-spring mechanism composed of two pre-shaped curved beams connected in a parallel configuration, which can achieve stiffness softening without requiring large bias force and displacement. The stiffness softening effect of the mechanism is verified through theoretical modeling and finite element method (FEM) simulation. After that, the mechanism is implemented in a 4.2 mm × 4.9 mm MEMS capacitive accelerometer prototype. The experimental results reveal that the sensitivity of the accelerometer increases by 10.4% compared to the initial sensitivity, at the same time, the noise floor and bias instability decrease by 10.5% and 4.2%. The sensitivity,nonlinearity, bias instability, and noise floor after biasing are 51.1 mV/g, 0.99%, 0.24 mg, and 21.3 μg/√Hz, respectively. Thus, the proposed mechanism can enhance the performance of the accelerometer. This work provides an innovative approach for improving the performance of MEMS accelerometers while enabling miniaturization.
Predicting, Protecting, and Minimizing: A Software Tool for Safe Interactions with Nuclear Medicine Patients
Authors: Sinnott Christine , RowshanFarzad Pejman , Chen Zhen , Tjia Elaine , Djukelic Mario
Published: June 2024

Nuclear medicine imaging patients are a source of radioactivity, and their bodily fluids pose a contamination risk. In the event of a medical emergency or an unplanned medical procedure, the radiation dose to individuals interacting with the patient must be considered. To address this, a patient-specific mathematical model was developed and this model was then translated into a user-friendly interface (GUI). This software provides personalized radiation safety precautions, based upon individuals interacting with the patient, aiming to minimize exposure to as low as reasonably achievable.
Willingness Factors in a Self-Quantification Program for Family Caregivers of Community-Dwelling Older Adults with Long-Term Care in Japan
Authors: Wakui Tomoko , Fujihara Satoko , Moriyama Yoko , Nakagawa Takeshi , Okubo Suguru , Obuchi Shuichi , Awata Shuichi , Kai Ichiro
Published: June 2024

Objective
This study aimed to examine the characteristics of willingness to participate in the self-quantification program for family CGs who provide long-term care to community-dwelling older adults. The family CGs, allocated based on the percentage of the nation’s older population who needed care and met the inclusion criteria, who provided caregiving at least once a week for those aged 65 + and who were certified as needing care under the Japanese long-term care insurance program, were collected through online monitors. We compared the characteristics of the program participants and nonparticipants using logistic regression.
Results
A total of 2653 family CGs whose data were available for all the variables of interest were analyzed. A total of 195 family CGs were willing to participate in the self-quantification program for 60 days. The survey included program participants who were predominantly male (55.9%), with an average age of 54.8 years (SD = 10.2). Participants tended to be fully employed (OR = 1.8; p < 0.01), but they were likely to experience greater burdens (OR = 1.8; p < 0.01) and daily caregiving demands (OR = 1.01; p < 0.01). This research highlights the potential efficacy of self-quantification programs for extensively burdened family CGs, illustrating that the requisites for support vary in accordance with the distinct characteristics of these CGs.
Long-Term outcomes of patients with a pre-existing neurological condition after SARS-CoV-2 infection
Authors: Hadidchi Roham , Al-Ani Yousef , Choi Solbie , Renteria Silhouette , Duong Katie S , Henry Sonya , Wang Stephen H , Duong Tim Q
Published: June 2024

Objectives.
This study investigated post COVID-19 outcomes of patients with pre-existing neurological conditions up to 3.5 years post-infection.
Methods.
This retrospective study consisted of 1,664 patients with COVID-19 (of which 1,320 had been hospitalized for acute COVID-19) and 8,985 non-COVID patients from the Montefiore Health System in the Bronx (Jan-2016 to Jul-2023). Primary outcomes were all-cause mortality and major adverse cardiovascular events (MACE) post-COVID-19. Secondary outcomes were depression, anxiety, fatigue, headache, sleep disturbances, altered mental status, and dyspnea post-COVID-19. Cox proportional hazards model was used to calculate adjusted hazard ratios for all-cause mortality and major adverse cardiovascular event (MACE). Cumulative incidence function and Fine-Gray sub-distribution hazards model analysis were performed for secondary outcomes.
Results.
Patients with a neurological disease hospitalized for COVID-19 were more likely to die (adjusted HR = 1.92 [CI:1.60, 2.30], P < 0.005), whereas patients non-hospitalized for COVID-19 had mortality rate (aHR = 1.08 [CI:0.65, 1.81], P = 0.76), compared to non-COVID patients. Patients with a neurological disease (hospitalized for COVID-19 aHR = 1.76 [CI:1.53, 2.03], P < 0.005; not hospitalized for COVID-19: aHR = 1.50 [CI:1.09, 2.05], P = 0.01) were more likely to experience a MACE compared to non-COVID patients. Notably Blacks (aHR = 1.49) and Hispanics (aHR = 1.35) had a higher risk of post COVID-19 MACE. Both hospitalized and non-hospitalized COVID-19 patients were more likely to develop higher cumulative incidence of altered mental status, fatigue, sleep disturbance, dyspnea compared to non-COVID patients (p < 0.05).
Conclusions.
Patients with pre-existing neurological conditions who contracted COVID-19 were more likely to have worse outcomes compared to controls. Identifying at-risk individuals could enable more diligent follow-up.
Chylothorax and Chylous Ascites in AIDS-Associated Kaposi's Sarcoma： A Case Report and Literature Review
Authors: Jiang Qunqun , Peng Kai , Zhang Zhongwei , Chen Xiaoping , Du Qian , Deng Liping , Xiong Yong , Ma Zhiyong , Zhang Yongxi
Published: June 2024

Background: Kaposi's sarcoma (KS) is one of the most common tumors in patients with AIDS, while the occurrence of chylous effusions in Kaposi's sarcoma patients is rare and often indicates a poor prognosis. This report presents a case of successful management of an AIDS patient with Kaposi's sarcoma who developed both chylothorax and chylous ascites, along with a review of the relevant literature.
Case presentation: A 31-year-old male patient, who was recently diagnosed with HIV infection and oral Kaposi's sarcoma at our clinic center, returned two weeks post-discharge. He reported significant enlargement of the oral tumor, increased abdominal girth with accompanying abdominal distension and pain, and a dry cough over the past week. Upon readmission, CT scans indicated the presence of extensive pleural and abdominal effusions. Aspirates from both the pleural and abdominal effusions exhibited a milky chylous appearance. After eliminating other potential etiologies for the chylous effusion, we associated it with the progression of Kaposi's sarcoma. The patient's condition was ultimately successfully managed through a combination of antiretroviral therapy, systemic chemotherapy, and intermittent thoracoabdominal paracentesis for drainage.
Conclusion: The emergence of chylothorax and chylous ascites should arouse suspicion of Kaposi's sarcoma, and the presence of chylous effusions in Kaposi's sarcoma patients is an indication of disease progression. Prompt diagnosis and systemic treatment are crucial for the prognosis.
Effect of 25- or 15-minute intermittent Pringle maneuver on early recurrence of hepatocellular carcinoma after hepatectomy: a protocol for a randomized controlled trial
Authors: Jia Xuehai , Liao Anque , Huang Yang , Du Xiangyu , Jiang Li
Published: June 2024

Background: Among various blood flow control techniques, the intermittent Pringle’s maneuver (IPM) remains the most convenient and widely used method to reduce bleeding during hepatic resection (HR). Now, the impact of IPM on human hepatocellular carcinoma (HCC) recurrence is still unclear. Currently, there has no randomized controlled trial (RCT) to directly confirm the impact of IPM on the tumor recurrence for HCC patients undergoing HR. Since 2019, our team has been investigating the effect of 25-min IPM on liver function and post-hepatectomy safety in HCC patients. To date, we have published two RCTs to directly confirm the safety and feasibility of 25-min IPM for those HCC patients with Child-Pugh grade A liver function. However, our previous RCTs only focused on the short-term outcomes of HCC patients after HR. They did not answer the hot topic of whether the 25-min IPM would increase postoperative HCC recurrence after HR. Therefore, we design this RCT to compare the effects of 25-min IPM and 15-min IPM on early tumor recurrence for HCC patients undergoing HR.
Methods: This will be a single-center, parallel, double-blinded, randomized controlled trial. A total of 334 consecutive patients who are eligible for the inclusion and exclusion criteria will be enrolled and randomized into either the 25-min IPM group or the 15-min IPM group in a ratio of 1:1 using a randomization protocol. After the completion of surgical intervention, patients will be included in a 2-year follow-up program.
Discussion: We design this protocol to compare the effects of the above two different IPM methods on tumor recurrence for HCC patients undergoing HR, which will have an important guiding significance for surgeons. Firstly, this RCT will be easy to implement and carry out. Secondly, this RCT will include various types of HR procedures (laparoscopic or open HR, minor or major hepatectomy, etc.), which will have well representativeness of clinical application. Thirdly, this RCT has well originality, which is the first RCT to compare the effects of 25-min and 15-min IPM on early tumor recurrence after HR.
Trial registration
This trial was registered on 29 April 2024, in the Chinese Clinical Trial Registry (http:// www.chictr.org.cn), ChiCTR2400083647. The protocol version is V1.0 (20240429).