bluuebunny/crossref_metadata_2025 huggingface dataset:
Exosome miR-199a-5p modulated vascular remodeling and inflammatory infiltration of Takayasu's arteritis
Authors: Guo Shuning , Li Jiehan , Pang Shurui , Li Jing , Tian Xinping
Published: August 2024

Background
Advances in treatment that swiftly alleviate systemic inflammation of Takayasu’s arteritis (TAK), while subclinical vascular inflammation and the ensuing arterial remodeling continue to present unresolved challenges in TAK. The phenotypic switching of vascular smooth muscle cells (VSMC) is regarded as the first step in vascular pathology and contributed to arterial remodeling. Exosomes facilitate the transfer and exchange of proteins and specific nucleic acids, thereby playing a significant role in cell chat. Little is known about the modulation role of serum exosomes in phenotypic switching of VSMC and vascular remodeling in TAK.
Methods
Serum exosomes isolated from TAK patient were co-cultured with VSMC to identify the modulation role of exosomes. VSMC were transfected with miR-199a-5p mimic and inhibitor. The CCK8 assays and EdU assays were performed to measure proliferative ability. The migration of VSMC was evaluated by scratch assays and transwell migration assays. The flow cytometry was employed to identify apoptosis of VSMC. Dual-luciferase reporter assay, RNA immunoprecipitation assay and fluorescence in situ hybridization were utilized to validate the target gene of miR-199a-5p. The correlational analysis was conducted among exosome miRNA, serum MMP2, TIMP2 and clinical parameters in TAK patients.
Results
The coculture of VSMC with serum exosome mediated dedifferentiation of VSMC. Through gain- and loss-of-function approaches, miR-199a-5p over-expression significantly increased expression of VSMC marker genes and inhibited VSMC proliferation and migration, whilst the opposite effect was observed when endogenous miR-199a-5p was knocked down. The overexpression of miR-199a-5p suppressed VSMC apoptosis. Further, MMP2 serve as functional target gene of miR-199a-5p. The correlation analyses revealed an inverse correlation between Vasculitis Damage Index and exosome miR-199a-5p level or serum MMP2, which require validation in a larger cohort.
Conclusion
Our study indicated that the miR-199a-5p/MMP2 pathway played a role in inhibiting the migration, proliferation and apoptosis of VSMC. The decreased secretion of MMP2 may potentially prompt the intimal infiltration of inflammatory cells within the vascular wall, offering a novel therapeutic opportunity by tackling both inflammatory responses and the neointimal overgrowth associated with TAK arterial damage. Moreover, exosome miR-199a-5p and MMP2 derived from serum possessed potential as future biomarkers for vascular injury.
Modeling and analysis of tooth profile error in gear skiving
Authors: Wang Peng , Li Geng , Xing Kan
Published: August 2024

Gear skiving has obvious advantages of efficiency and precision in the pre-grinding process of cycloidal gear. The precision of skiving is mainly affected by the actual errors in processing system. In order to investigate the influence of error factors on skiving precision, the mathematical model of the sweeping trajectory of cutting edge was established based on the motion model of gear skiving. The shape of the edge-sweep surface was analyzed related to each error factor. The maximum deviation between the actual edge-sweep surface and the theoretical tooth surface was calculated by discrete comparison method, and the machining error could be predicted theoretically. Finally, the control variable method is used to set up the test cutting experiment. Measuring the actual workpiece size and analyzing the influence of each error on the tooth profile error. The results show that the center distance error, the coaxiality error of clamping and the cutter manufacturing error have specific influence on the tooth profile error of the workpiece. The center distance error is reflected in the tooth profile error by a proportion of 1:1 approximatively. The coaxiality error of cutter clamping is reflected in the tooth profile error by a proportion of 1:2 approximatively. The manufacturing error of cutting edge is reflected in the tooth profile error error by a proportion of 2:1 approximatively. The above research provides a theoretical basis for tolerance setting and adjustment of error factors.
Bridging the genetic and genotypic gain gap for Eucalyptus: the critical role of inbreeding and dominance effects in breeding strategies
Authors: Araujo Marcio , Bush David , Tambarussi Evandro
Published: August 2024

Understanding the mating system of Eucalyptus species is necessary to accurately estimate genetic parameters and improve breeding programs. Eucalyptus species often exhibit mixed mating systems, leading to complex relationships among progenies. Traditional tree breeding programs that assume a half-sibling relationship for open-pollinated (OP) trials may overestimate genetic gains by neglecting the effects of inbreeding and dominance. This study focuses on Eucalyptus pellita, a species with a mixed mating system, to quantify the impact of selfing and dominance on breeding strategies. We simulated OP trial growth data for 100 randomly selected families in a randomized complete block design, using published data for diameter at breast height (DBH). Our analysis indicated that marker-based models, particularly those incorporating dominance effects, provide more accurate genetic parameter estimates and higher predicted genetic gains than pedigree-based models. Furthermore, we identified significant genetic and genotypic gain gaps when traditional models were used, underscoring the need to consider non-additive genetic effects in breeding programs. These findings highlight the importance of using marker-based approaches to enhance genetic improvement and achieve sustainable forestry.
Blood Urea Nitrogen to Serum Albumin Ratio in critically ill patients with aspiration pneumonia : A retrospective cohort study
Authors: Xia Tingting , Lei Shu
Published: August 2024

Background: We aimed to investigate the relationship between the blood urea nitrogen (BUN) to serum albumin ratio (BAR) in critically ill patients with aspiration pneumonia (AP).
Methods: This is a retrospective cohort study from the Medical Information Mart for Intensive Care III (MIMIC-III) database, in which patients in ICU were diagnosed with aspiration pneumonia.The receiver operating characteristic (ROC) curve and survival curves were plotted to evaluate predictive performance of BAR.The multivariable Cox regression analysis were used to investigate the relationship between BAR and mortality. And subgroup analyses were stratified by relevant covariates.
Results: A total of 1121 critically ill patients with AP were enrolled in our study.
Patients in 28-day non-survivor group had significantly higher levels of BAR (P<0.001). The area under the curve (AUC) for predicting 28-day mortality, 90-day and 365-day mortality of BAR (0.693, P<0.001; 0.701, P<0.001; 0.703, P<0.001) was superior to that of SOFA scores or CURB-65 scores. Kaplan-Meier curves also showed similar results (P < 0.001). Multivariate cox regression analysis showed that BAR was a significant risk factor predicting 28-day (HR 1.89, 95%CI 1.37-2.60, P<0.001), 90-day (HR 1.76, 95%CI 1.34-2.31, P<0.001) and 365-day (HR 1.50, 95%CI 1.18-1.89, P=0.001) mortality even after adjusting for confounding variables such as age, gender, ethnicity, risk factors, comorbidities, interventions, score system, vital signs and laboratory results. This also showed intuitively in the restricted cubic spline curve. Moreover, subgroup analyses demonstrated a significant association between elevated BAR and 28-day mortality in mostly relevant subclasses.
Conclusions: Easily accessible BAR is a good prognostic predictor for critically ill patients with AP.
Clinical performance of deep learning enhanced ultra-fast whole-body scintigraphy in patients with suspected malignancy
Authors: Qi Na , Pan Boyang , Meng Qingyuan , Yang Yihong , Ding Jie , Yuan Zengbei , Gong Nan-Jie , Zhao Jun
Published: August 2024

Background
To evaluate the clinical performance of two deep learning methods, utilizing real clinical pairs and simulated datasets, for fast whole-body scintigraphy.
Methods
This prospective study enrolled 83 patients with suspected bone metastasis. All patients received SPECT whole-body scintigraphy (WBS) at the speed of 20cm/min (1x), 40cm/min (2x), 60cm/min (3x). Two deep learning models were introduced to generate high-quality images from fast scans, designated as 2x-real, 3x-real (from real model), and 2x-simu, 3x-simu (from simulated model). A 5-point Likert scale was utilized to evaluate the image quality of each acquisition. Accuracy, sensitivity, specificity, and ROC-AUC were used to evaluate the diagnostic efficacy. Learned perceptual image patch similarity (LPIPS) and fréchet inception distance (FID) were used to assess image quality. Additionally, count-level consistency of WBS was also compared.
Results
Subjective assessments indicated that 1x images exhibited the highest general image quality (Likert score: 4.40 ± 0.45). 2x-real, 2x-simu and 3x-real, 3x-simu images displayed significantly superior quality than those of 2x and 3x image respectively (Likert scores: 3.46 ± 0.47, 3.79 ± 0.55 vs. 2.92 ± 0.41, P < 0.0001;. 2.69 ± 0.40, 2.61 ± 0.41 vs. 1.36 ± 0.51, P < 0.0001). Notably, the quality of 2x-real images was inferior to those of 2x-simu (Likert scores: 3.46 ± 0.47 vs. 3.79 ± 0.55, P = 0.001). The diagnostic efficacy of 2x-real, 2x-simu was indistinguishable from 1x image (accuracy: 81.2%, 80.7% vs. 84.3%; sensitivity: 77.27%, 77.27% vs. 87.18%;specificity: 87.18%, 84.63% vs. 87.18%. all P > 0.05), while 3x-real, 3x-simu had better diagnostic efficacy than 3x (accuracy:65.1%, 66.35% vs. 84.3%; sensitivity: 63.64%, 63.64% vs. 87.18%; specificity: 66.67%, 69.23% vs. 87.18%, all P < 0.05).. Objectively, both real model and simulated model significantly enhanced image quality from the accelerated scans (FID: 0.15 ± 0.18, 0.18 ± 0.18 vs. 0.47 ± 0.34, P < 0.05༛LPIPS: 0.17 ± 0.05, 0.16 ± 0.04 vs. 0.19 ± 0.05, P < 0.05). The count-level consistency with the 1x images was excellent for 2x-real, 3x-real, 2x-simu, and 3x-simu (P < 0.0001).
Conclusions
The ultra-fast 2x speed (real and simulated) image could achieve comparable diagnostic value to those of standard acquisition, and the simulation algorithm could not necessarily reflect the real data.
Evaluation of Stabbing Assault Injuries in A Tertiary Emergency Department: A Retrospective Observational Study
Authors: Yeter Nil Deniz Kartal , Karaca Mehmet Ali , Yeter Ahmet Sefa , İnce Elif Öztürk , Erbil Bülent
Published: August 2024

Background
The study aims to evaluate injury patterns, trauma scores, radiological findings, types of treatment, and outcomes of stab assault patients admitted to a tertiary emergency department (ED).
Methods
This is a retrospective observational study of stabbing injury patients in the ED of Hacettepe University, Turkey. The sites and patterns of injury, radiological findings, treatment methods, consultations, and complications are acquired from the patients’ files. Trauma scores and frequency of outcomes, such as the need for surgery, hospitalization, or mortality, were calculated for all patients.
Results
Among the 648 patients, 564 (87%) were male. The median age was 28 (interquartile range [IQR]:13). The commonly injured body parts were the extremities (75%), thorax (21.9%), and abdomen (16.9%). The median RTS was 7,84 (IQR:0), and the median ISS was 2 (IQR:3). The fluid was detected in 13 of 88 patients by FAST, solid organ injuries in 21 patients, and gastric and intestinal injuries in 11 patients by abdominal CT. One hundred sixty-one patients underwent moderate and major surgery. Complications developed in 13 patients. 74,4% of the patients (n = 482) were treated in ED and 21.8% (n = 141) of patients were hospitalized in wards, 2.3%(n = 15) in intensive care unit and 1.5% (n = 10) patients died. GCS, RTS, and probability of survival (Ps) were significantly lower, and ISS was significantly higher in deceased patients and patients who needed erythrocyte replacement.
Conclusion
The majority of stab wounds were detected in extremities, but severe and lethal stabbing injuries were on the thorax and abdomen. In thoracoabdominal stabbing injuries, x-ray and FAST can be ineffective in detecting critical and fatal injuries. Therefore, thoracic and abdominal CT should be planned early to detect possible causes of death and make a timely and accurate diagnosis. Lower GCS, RTS, and Ps or higher ISS scores were related to need for erythrocyte replacement.
The effects of pregnancy on oral health, salivary ph and flow rate
Authors: Yilmaz Fatma , Dorterler Ozgul Carti , Halici Saniye Eren , Kasap Burcu , Demirbas Aysegul
Published: August 2024

Background:The frequent occurrence of dental caries and periodontal diseases in women during pregnancy may be due to many factors, such as salivary variables. The aim of this study was to evaluate the effects of pregnancy on salivary pH, flow rate, the DMFT index, and CPI sores.
Methods: A total of 198 volunteers (pregnant in different trimesters and non- pregnant) were included. Data about sociodemographic characteristics and dental and systemic health conditions were recorded. Unsitumulated saliva samples were collected for 5 minutes via the spitting method. The pH of the saliva was measured by a portable pH meter. The salivary flow rate was determined by the weight measurement method. The DMFT index and CPI were determined.
Results: There were significant differences between the pH values of the control and study groups (p < 0.05). There was no difference among the salivary flow rates of the study and control groups. The mean CPI of pregnant women was significantly greater than that of non-pregnant women (p < 0.05), while the DMFTs were similar among all groups.
Conclusion: Pregnancy causes a direct decrease in unsitumulated salivary pH and an increase in periodontal disease. It also negatively affects oral and dental health.
Trial registration: Clinical Trials-ID: NCT06343337; Registration Date: 04.01.2024.
Intraoperative Ultrasound and Magnetic Resonance comparative analyses in brain tumor surgery: a valuable tool to flatten ultrasound’s learning curve
Authors: Brugada-Bellsolà Ferran , Rodríguez Pilar Teixidor , González-Crespo Antonio , Menéndez-Girón Sebastián , Panisello Cristina Hostalot , Garcia-Armengol Roser , Alonso Carlos J. Domínguez
Published: August 2024

Background
Intraoperative ultrasound (IOUS) is a profitable tool for neurosurgical procedures’ assistance, especially in neuro-oncology. It is a rapid, ergonomic and reproducible technique. However, its known handicap is a steep learning curve for neurosurgeons. Here, we describe an interesting post-operative analysis that provides extra feedback after surgery, accelerating the learning process.
Method
We conducted a descriptive retrospective unicenter study including patients operated from intra-axial brain tumors using neuronavigation (Curve, Brainlab) and IOUS (BK-5000, BK medical) guidance. All patients had pre-operative Magnetic Resonance Imaging (MRI) prior to tumor resection. During surgery, 3D neuronavigated IOUS studies (n3DUS) were obtained through craniotomy N13C5 transducer’s integration to the neuronavigation system. At least two n3DUS studies were obtained: prior to tumor resection and at the resection conclusion. A post-operative MRI was performed within 48h. MRI and n3DUS studies were posteriorly fused and analyzed with Elements (Brainlab) planning software, permitting two comparative analyses: preoperative MRI compared to pre-resection n3DUS and postoperative MRI to post-resection n3DUS. Cases with incomplete MRI or n3DUS studies were withdrawn from the study.
Results
From April 2022 to March 2024, 73 patients were operated assisted by IOUS. From them, 39 were included in the study. Analyses comparing preoperative MRI and pre-resection n3DUS showed great concordance of tumor volume (p < 0,001) between both modalities. Analysis comparing postoperative MRI and post-resection n3DUS also showed good concordance in residual tumor volume (RTV) in cases where gross total resection (GTR) was not achieved (p < 0,001). In two cases, RTV detected on MRI that was not detected intra-operatively with IOUS could be reviewed in detail to recheck its appearance.
Conclusions
Post-operative comparative analyses between IOUS and MRI is a valuable tool for novel ultrasound users, as it enhances the amount of feedback provided by cases and could accelerate the learning process, flattening this technique’s learning curve.
Development of a Prognostic Model for Patients with Nodular Melanoma of the Lower Extremities: A Study Based on the SEER Database
Authors: Zhang Shun , Tian Si , Qin Xinrui , Mou Hao , He Bin , Wang Yi , Xue Bin , Lin Wentao
Published: August 2024

Background: Lower extremity nodular melanoma (NM) is a common malignant tumor with a poor prognosis. We aims to identify the prognostic factors and develop a nomogram model to predict overall survival (OS) in patients with lower extremity NM.
Method: A total of 746 patients with lower extremity NM were selected and randomly divided into a training set (522 cases) and a validation set (224 cases) from the Surveillance, Epidemiology, and End Results(SEER) database. The training set underwent univariate and multivariate Cox regression analyses to identify independent prognostic factors associated with patient outcomes, and to develop a nomogram model. The effectiveness of the nomogram was subsequently validated using the validation set.
Results: Multivariable Cox regression analysis of the training set indicated that age, ulceration, radiotherapy, chemotherapy, primary site of first malignant tumor, and Breslow thickness were independent variables associated with OS. In the training set, the area under the curve (AUC) of the nomogram for predicting 3-year and 5-year OS was 0.796 and 0.811, respectively. In the validation set, the AUC for predicting 3-year and 5-year OS was 0.694 and 0.702, respectively. The Harrell's C-index for the training set and validation set were 0.754 (95% CI: 0.721-0.787) and 0.670 (95% CI: 0.607-0.733), respectively. Calibration curves for both training and validation sets showed good agreement.
Conclusion: In this study, we develop and validate a nomogram to predict OS in patients with lower extremity NM. The nomogram demonstrated reasonable reliability and clinical applicability. Nomograms are important tools assessing prognosis and aiding clinical decision-making.
A comparative analysis of campus bullying between vocational schools and regular high schools
Authors: Haiyan Gao , Hong Lin , Guangming Shen
Published: August 2024

Introduction:
Campus bullying has attracted widespread attention in China. While previous research has focused extensively on the individual and familial factors of campus bullying, school environmental factors have been insufficiently explored. This study primarily examines the mechanisms by which the school environment influences campus bullying by contrasting vocational and regular high schools, two school ecosystems with distinct cultures. By investigating the frequency, characteristics, and significant influencing factors of campus bullying in both types of schools, this study aims to further explore how the school environment affects the occurrence of campus bullying.
Methods
Participants comprise 1348 students from 17 vocational high schools and 5341 students from 65 regular high schools in Taizhou City, Zhejiang Province, China. Moderation analysis is applied to examine the different effects of individual and family factors on school bullying in the two types of high schools. Mediation analysis is carried out to examine the mechanism of school bullying under the two types of school ecosystems.
Results and Conclusion:
Results show that the risk of explicit physical bullying in vocational and regular high schools is roughly equivalent. However, the risk of less noticeable forms of bullying, such as verbal bullying, relational bullying, and cyberbullying, is significantly higher in regular than vocational high schools. Further analysis reveals that the higher risk of campus bullying in regular high schools is attributed to significantly lower evaluations of teacher student relationships, poorer peer relationships, and heavier academic burden compared to vocational high schools.
Seasonal warming responses of the ecosystem CO2 sink of northern forests are sensitive to stand age
Authors: Zha Tianshan , Liu Peng , Black Thomas , Jassal Rachhpal , Jia Xin , Noormets Asko , Ouimette Andrew , Tian Yun , Li Xinhao
Published: August 2024

Northern forests (forests north of 30°N) are major terrestrial CO2 sinks, while rapid warming in these regions can disturb their CO2 sink function. The age-dependent nature of the CO2 sink in forests has been widely reported, but the impact of tree age on the response of forests to rapid climate change remains unclear. Here we use multi-year net CO2 exchange (NEE) observations from 65 northern forest sites to show that warmer springs are associated with increased net CO2 uptake (negative change in NEE (ΔNEE)), whereas warmer summers and autumns are associated with decreased net CO2 uptake. Annually, net CO2 uptake decreased by 5 g C m− 2 yr− 1 across all sites on average. When considering stand age differences, the increased net CO2 uptake during warmer springs was more pronounced in old forests (> 90 years old) compared to young (< 40 years old) and mid-aged (40–90 years old) forests. In addition, the decreased net CO2 uptake during warmer summers and autumns was more pronounced in young forests compared to mid- and old-aged forests. Annually, this resulted in an increase in net CO2 uptake due to seasonal warming for old forests (ΔNEE of -4.8 g C m− 2 yr− 1) and a decrease in young- and mid-aged forests (ΔNEE of 3.2 and 0.8 g C m− 2 yr− 1, respectively). The carbon sink of northern forests would be underestimated by approximately 8% if the impacts of stand age on the responses of NEE to seasonal warming are not taken into account, comparing scenarios of seasonal warming with and without accounting for stand age. In future projections, increasingly uneven seasonal warming may amplify the impacts of stand age on CO2 sinks of northern forests.
Adaptive Distributed Explicit Model Predictive Controller with Road Surface Identification for HM-AS
Authors: zhou Ying , Chen Xin , Li Zhongxing , Wang Xue , Yu Yi
Published: August 2024

The rapid advancement of hub-motor electric vehicle (HMEV) is propelled by its capacity to significantly improve energy efficiency, handling dynamics, and space utilization while minimizing mechanical losses and maintenance costs. A significant challenge in HMEV is mitigating the performance degradation caused by unbalanced electromagnetic force (UMEF), which result from the interaction between the hub motor and road-induced vibrations. This study introduces an Adaptive Distributed Explicit Model Predictive Control (ADEMPC) strategy for hub-motor electric vehicles equipped with air suspension (HM-AS), aiming to enhance ride comfort, handling stability, and reduce eccentricity between the stator and rotor. A full-vehicle dynamic model considering vertical-longitudinal coupling is established and validated. A road surface identification system based on a BP neural network is designed. The Whale Optimization Algorithm (WOA) is used to optimize weight coefficients on 16 conditions, which are then saved as tables for ADEMPC. An ADEMPC controller is designed based on distributed prediction model, which decompose the entire vehicle into four subsystems and consider the coupling of roll and pitch. Simulation results demonstrated that ADEMPC achieves improvements of 25% in body acceleration, 16% in eccentricity, 5% in tire dynamic load, 25% in roll, and 15% in pitch. It showcases its effectiveness in enhancing ride comfort and vehicle stability.
Parallel Visualization of Reservoir Models with ParaView
Authors: Kovalevskiy Oleg , Cancelliere Michel
Published: August 2024

Interactive visualization of subterranean formations models is essential for reservoir engineering. ParaView is a good option - it is feature rich, performance oriented, cross-platform, free and open-source. It can run in client-server mode, where heavy processing and rendering is executed on powerful servers in parallel with multiple processors. Custom format support can be implemented in ParaView as an extension in the form of a plug-in of a script for embedded Python-shell. Parallelization of the grid is defined explicitly in the logic of custom readers created as extensions for ParaView. It was identified that the way of splitting the grid between processes can significantly impact the efficiency of resources utilization. The main object of current study was a class of reservoir models that have resolution in vertical direction much smaller than that in horizontal direction. For such grids splitting by vertical blocks proved to be much more efficient than splitting by horizontal layers. In this case not only less memory is required - rendering is also faster. These important findings can help to get visualizations faster for more efficient design processes or even enable visualization of near-the-limits scales.
Evaluating Cognitive Function and Brain Activity Patterns via BolT in N-Back Working Memory Tasks
Authors: Zhang Zhenming , Jiang Zhuqing , Chen Yaojing , Men Aidong
Published: August 2024

Working memory, which involves temporary storage, information processing, and regulating attention resources, is a fundamental cognitive process and constitutes a significant component of neuroscience research. In this study, we aimed to evaluate brain activation patterns by analyzing functional magnetic resonance imaging (fMRI) time-series data collected during a designed N-back working memory task with varying cognitive demands. We utilize a novel transformer model, blood-oxygen-level-dependent transformer (BolT), to extract the activation level features of brain regions in the cognitive process, thereby obtaining the influence weights of regions of interest (ROIs) on the corresponding tasks. Compared with previous studies, our work reaches similar conclusions in major brain region performance and provides a more precise analysis for identifying brain activation patterns. For each task, we select the top 5 percent of the most influential ROIs and conduct a systematic analysis and discussion. Additionally, we examined the impact of prior knowledge conditions on task performance and explored task classification at different time stages. The comparison results reflect the brain's adaptive strategies and dependencies in coping with different levels of cognitive demands and the stability optimization of the brain's cognitive processing. This study introduces innovative methodologies for understanding brain function and cognitive processes, highlighting the potential of transformer in cognitive neuroscience. Its findings offer new insights into brain activity patterns associated with working memory, contributing to the broader landscape of neuroscience research.
Fire Safety Knowledge and Emergency Preparedness Assessment among Health Care Workers at Three Hospitals in Kunene Region, Namibia
Authors: Ndapewa Johannes Evelina , Koray Munawar Harun
Published: August 2024

Background
Hospital preparedness for accidents like fires is essential because fire outbreaks in healthcare settings can occur anytime and require quick responses. Therefore, this study assessed the knowledge of fire safety and emergency preparedness among healthcare workers, as well as the predictors of knowledge of fire safety and emergency preparedness among healthcare workers.
Methods
An institutional-based descriptive cross-sectional online survey was employed to assess knowledge of fire safety and emergency preparedness among 257 healthcare workers from three hospitals in the Kunene region. Both descriptive and inferential statistics were carried out using STATA version 18. Frequencies and percentages were used in the descriptive statistics and Pearson’s chi square test, correlation analysis and logistic regression were adapted for the inferential statistics. The statistical significance level was set at p-value ≤ 0.05 at 95% confidence interval.
Results
The study observed that (65.4%) of healthcare workers lack adequate level of knowledge concerning emergency preparedness while 6% of healthcare workers lack sufficient knowledge regarding fire safety. The findings indicated that there is a strong relationship (r = 0.992) between fire safety knowledge and emergency preparedness among healthcare workers. The study findings reported that gender (< 0.0001), and place of work (< 0.0001) were associated with knowledge of fire safety and emergency preparedness. Male participants were more likely to have adequate knowledge of fire safety ((aOR: 3.74; 95%CI: 2.016–6.950) and emergency preparedness (aOR: 3.64; 95%CI: 1.956–6.756) compared to females. Khorixas district hospital had lower odds (aOR: 0.354; 95%CI: 0.173–0.724) of having adequate knowledge of emergency preparedness compared to those working at the Opuwo hospital.
Conclusion
According to the study's findings, the vast majority of healthcare professionals do not know enough about fire safety and how to prepare for a fire. Ensuring a safe hospital workplace requires addressing the gaps in healthcare personnel' knowledge and awareness about fire safety.
An Approach to The Geometry of Persian Domes; The case study of Shah Nimatullah Vali shrine
Authors: Nezhad Akbar Dehghan , Daryani Nassim
Published: August 2024

Sometimes, history comes to us through historians and sometimes true artists. Creating masterpieces such as paintings, carpet weaving, sculpturing, and architecting eye-catching buildings, were among the ways artists of the past used to convey their beliefs and the history of their regions to the future generations. Therefore it is necessary to maintain the link between past and future generations by protecting and restoring these works. Mathematicians claim that one of the most efficient ways for this purpose is to know the geometric features of the relics. In this article, we will research a type of historical building i.e. domed roofs specially. The fundamental properties of these structures are based on the fact that they had been built by rotating a generating arc around the vertical axis called Shahang on a foundation called a drum. This concept is analogous to the definition of the surface of revolution in differential geometry. Modeling domes by using this concept and performing mathematical calculations on them, provides us with detailed information about the behavior of these structures.
As an example, we are going to investigate the cause of the collapse of a part of the dome of Shah Nimatullah Vali shrine, by using mathematical tools.
Methods for assessing exercise fidelity in unsupervised home-based cardiovascular rehabilitation: A scoping review
Authors: Jarallah Mohammad , Withers Thomas , Rosewilliam Sheeba , Stathi Afroditi , Greaves Colin
Published: August 2024

Background
Home-based cardiac rehabilitation is increasingly popular for patients with cardiovascular diseases. However, this mode of rehabilitation involves unsupervised exercise, making it challenging to assess, correct, and monitor exercise fidelity (the extent to which the patient performs the exercise intended by the intervention provider). This review aimed to identify the range, validity, and acceptability of measures for assessing exercise fidelity in unsupervised, home-based cardiovascular rehabilitation.
Methods
We searched PubMed, Embase, CINAHL, Medline, and PyschInfo for studies published between 2000 and 2021 to identify observational studies, trials, and protocols published in English with a home-based cardiovascular rehabilitation intervention and at least one measure of exercise fidelity (e.g., adherence to the intended frequency, intensity, time, type, safety, progression/regression). Two reviewers selected eligible studies and extracted data, including study characteristics, exercise components, adherence definition, adherence measures, and data on measurement validity or acceptability. We conducted a narrative synthesis using a comprehensive definition of exercise fidelity, which evolved as the analysis progressed.
Results
Forty-seven articles describing 41 studies were included. Exercise intensity was the most commonly measured fidelity component (34/41 studies), followed by exercise frequency (27/41 studies). Exercise intensity was mostly assessed by wearable devices (27/41 studies). Frequency of exercise was most commonly assessed subjectively using a self-reported exercise log or dairy, but also (objectively) using wearable devices. Exercise quantity was most commonly assessed (in terms of time or duration) by self-reported exercise logs, diaries and wearable devices, or (in terms of steps or distance) mostly by wearable devices (pedometers, other step activity monitors). Safety was only assessed in 8/41 studies. No studies monitor progression or regression of exercise. No studies assessed the quality of exercise (accuracy of movement) or the appropriateness of progression or regression.
Conclusions
Most studies to date have conceptualised exercise fidelity or adherence narrowly, ignoring important elements of the initial exercise prescription and many have relied on non-validated self-report measures. We present a comprehensive framework for assessing exercise fidelity, which may be useful for designing more robust assessments of exercise fidelity in home-based rehabilitation programmes.
Low BMI Is Not a Risk Factor for Scoliosis, but Female Sex Is: Insights from a Large-Scale Study in Wuxi, China
Authors: Yang Dong , Zhao Zhiyang , Wang Jun , Jiang Yingzi , Villa Juan J. , Yu Jun
Published: August 2024

Background
Scoliosis, characterized by lateral curvature of the spine, is a common concern in pediatric populations. While various risk factors have been proposed, the association between low body mass index (BMI) and scoliosis remains debated.
Methods
A large-scale screening study was conducted in Wuxi, China, in 2023, involving elementary school-aged children (10–17 years old). A total of 15,953 children were screened for scoliosis, and those with a Cobb angle of 10 degrees or more underwent further evaluation.
Results
Of the screened children, only 3.7% had a low BMI, and among those with a Cobb angle of 10 degrees or more, only 2.8% had a low BMI. These findings suggest that a low BMI is not a significant risk factor for the development of scoliosis in this population.
Conclusion
Contrary to previous assumptions, our study suggests that a low BMI does not appear to be a predisposing factor for scoliosis among elementary school-aged children in Wuxi, China. However, our findings indicate that female sex is a significant risk factor. These findings have implications for understanding the multifactorial nature of scoliosis etiology and may inform future screening and prevention efforts.
Research trends and Perspectives of Electric vehicle adoption in Climate change: Bibliometric Analysis
Authors: M NANTHAKUMAR , Raja S.
Published: August 2024

This paper aims to evaluate the impact of electric vehicles on climate change. In the 1990s, electric vehicle use and research increased worldwide. Yet, a bibliometric analysis was conducted to assess the relevance of adapting electric vehicles to climate change, filling this paper's research gap. The study used the Web of Science Database, we combine 39 search terms using advanced Boolean logic string. We obtained 866 records, of which only 797 were analyzed. Subject areas, relationships between keywords, international productivity and the development of most cited publications were used to analyze and understand the assumptions of the most cited literature on electric vehicles, a network of co-authors of scholarly journals. China, the UK, the US and Canada focus on climate issues and use maximum electric vehicles. Academic institutions such as the Helmholtz Association, the United States Department of Energy, and the University of California System focus on battery waste management. The fields of chemistry, energy fuels, business and engineering have initiated research on alternative sources. This study reveals that the number of articles published annually is low, which shows the lack of interest in this study's conclusion. We conclude our study with keyword analysis and literature based collaboration analysis. Further specializations can be used to carry out detailed research on flaws.
Evaluating the Effectiveness of Asthma Treatments Over Time: A Comparative Analysis Using Repeated Measure Models and Multilevel models of Longitudinal Data
Authors: Agbota Lawrence Mensah , Nsiah Abraham , Abubakari Sadick
Published: August 2024

Aim:
To asses the long-term effectiveness of asthma treatments by comparing the utility of repeated measure models (RMM) and multilevel models (MLM) in analyzing longitudinal data of pulmonary function measured by forced expiratory volume in one second (FEV1), over an extended periods.
Subject and Methods:
Seventy-two asthma patients were randomized into three groups: standard drug (a), test drug (c), and placebo (p), with 24 patients each. Forced expiratory volume (FEV1) was measured hourly for 8 hours post-treatment, plus a baseline measurement. Repeated measure models (RMM) and Multilevel models (MLM) were used to analyze forced expiratory volume (FEV1) changes over time.
Results:
The repeated measures model with an unstructured covariance matrix proved most effective, as indicated by Akaike Information Criterion (AIC) of 342.45, Bayesian Information Criterion (BIC) of 445, and corrected AIC (AICC) of 349.7. This model displayed a correlation decrease in forced expiratory volume (FEV1) from 0.7124 to 0.6429 over 8 hours, with a standard error of 0.1448.
Conclusion:
The study supports the use of repeated measures models with an unstructured covariance matrix for analyzing the efficacy of asthma treatments over time. This model effectively captured the dynamics of treatment effects on respiratory function, adhering to assumptions such as linearity, homoscedasticity, normality, and absence of significant outliers, thereby providing robust and reliable results.
Steatotic liver disease in metastatic breast cancer treated with endocrine therapy and CDK4/6 inhibitor
Authors: Malon Diego , Molto Consolacion , Prasla Shopnil , Cuthbert Danielle , Pathak Neha , Berner-Wygoda Yael , lorio Massimo Di , Li Meredith , Savill Jacqueline , Mittal Abhenil , Amir Eitan , Jhaveri Kartik , Nadler Michelle B.
Published: August 2024

Purpose
In early-stage breast cancer, steatotic liver disease (SLD) is associated with increased recurrence, cardiovascular events, and non-cancer death. Endocrine therapy (ET) increases the risk of SLD. The impact of cyclin-dependent kinases 4/6 inhibitors (CDK4/6i) on SLD and prognostic association in metastatic breast cancer is unknown. We characterized the incidence, prevalence, risk factors, and treatment outcomes of SLD in metastatic HR+/HER2- breast cancer receiving CDK4/6i.
Methods
This single institution, retrospective, cohort study included patients with metastatic HR+/HER2- breast cancer receiving first-line ET and CDK4/6i from January 2018 to June 2022. SLD was defined as a Liver Attenuation Index (LAI) > 25 HU on contrast-enhanced CT scans and/or > 10 HU on plain CT scans. Univariable binary-logistic regression was used to assess associations with SLD. Time to treatment failure (TTF) and overall survival (OS) were analyzed using Cox proportional hazards modeling.
Results
Among 87 patients with a median age of 58 years and 65.5% postmenopausal, 50 (57.5%) had SLD at anytime (24 at baseline, 26 acquired). SLD at baseline was quantitatively but not statistically associated with age > 65, post-menopausal status, diabetes, smoking, and HER2-low status. SLD at anytime was statistically significantly associated with longer TTF (median 470 vs 830.5 days, HR = 0.38, p < 0.001). No significant differences in OS or grade 3/4 adverse events were observed between groups.
Conclusion
This study demonstrated a high prevalence of SLD in this population, with SLD presence associated with longer TTF. SLD may be an indicator of better outcomes in metastatic HR+/HER2- breast cancer patients treated with CDK4/6i.
In-hospital trends of non-communicable disease mortality during the COVID-19 pandemic at a regional referral hospital in southwestern Uganda
Authors: Olds Peter K. , Nuwagira Edwin , Obwoya Paul S. , Kansiime Grace , Musinguzi Nicholas , Tumwekwatse Lenus , Ninsiima Racheal , Mwesigwa Shadia , Mujuni Daniel , Okii Ronald Awani , Atimango Lorna , Haberer Jessica E. , Okello Samson
Published: August 2024

Background
Non-communicable diseases (NCDs) represent a growing health burden in sub-Saharan Africa. In Uganda, 33% of deaths were attributed to NCDs in 2016 and to-date many health facilities are ill-equipped to properly manage NCDs. The COVID-19 pandemic presented significant challenges for the healthcare system in Uganda, though changes in hospital admissions and outcomes for adults with NCDs and without COVID-19 infection remain unknown.
Methods
Between March 1, 2019, and August 31, 2021, we conducted a chart review of Ugandan adults who carried a history of or were admitted for an NCD. Based on mortality trends, we broke admissions into three periods: Pre-Pandemic (March 1, 2019, to May 31, 2020), Early Pandemic (June 1, 2020, to March 31, 2021), and Late Pandemic (April 1, 2021, to August 31, 2021), and calculated admission and mortality rate for the most common NCD diagnoses during these periods. A multivariable logistic regression model was fitted for a primary outcome of in-hospital mortality.
Results
Of 3,777 total individuals, 1,655 were admitted Pre-Pandemic, 1,423 in the Early Pandemic, and 699 in the Late Pandemic. We found a five-fold increase in mortality in the Early Pandemic period compared to the Pre-Pandemic and Late Pandemic periods (15.4 vs 2.9 vs 2.4, p < 0.001). Factors associated with an increased odds for in-hospital mortality included admission with hypotension (OR 2.4; 95%CI 1.6, 3.6; p < 0.001) or hypertensive urgency (OR 1.6; 95%CI 1.1, 2.4; p = 0.03), each unit increase in Sequential Organ Failure Assessment score (OR 1.4; 95%CI 1.3, 1.5; p < 0.001), and each unit increase in Charlson Comorbidity Index (OR 1.2; 95%CI 1.0, 1.3; p = 0.045).
Conclusions
NCD-associated in-hospital mortality was high in the early COVID-19 pandemic period. Disruptions in longitudinal NCD care (e.g., due to strict movement restrictions) that occurred due to the pandemic may have been contributory. Future work should focus on understanding NCD morbidity and mortality for hospitalized individuals in resource limited settings, as well as working to develop more resilient systems for longitudinal NCD care to ensure adequate care even during disasters and pandemics.
The frequency effects of word and its constituent character in natural silent Chinese reading: Evidences from Electroencephalogram
Authors: Zeng Taishen , Lou Longxia , Liu Zhifang , Chen Chaoyang , Zhang Zhijun
Published: August 2024

We conducted two experiments to examine the lexical and sublexical processing of Chinese polysyllabic words in reading, by co-registration EEG to the first fixation on target word. The whole-word occurrence frequency and initial constituent character frequency were orthogonally manipulated in Experiment 1, and whole-word occurrence frequency and end constituent character frequency were orthogonally manipulated in Experiment 2. It demonstrated that word frequency facilitated eye-tracking measures, whereas its initial and end character frequency inhibited them. Classical word frequency effects on N170 and N400 in the posterior region, and reversed word frequency effects over the anterior region were consistently observed in both experiments. Experiment 1 revealed an inhibitory effect of initial character frequency on anterior N170, but a faciliatory effect on parietal-occipital N170, and non-reliable interactions. Experiment 2 demonstrated reliable inhibitory effects of end-character frequency on anterior N170 and N400, and that these effects were reduced by word frequency, with smaller inhibitory effects for high frequency words.
Correlation Analysis Between Changes in Root Canal Area and Intervertebral Foramen Cross-Sectional Area and Relevant Clinical Symptom Improvement Scores in Patients with Unilateral L4-L5 Spinal Stenosis after MIS-TLIF
Authors: Ban Wenrui , Wang Haifan , Bai Chuanyi , Zheng Shaozhi , He Chuanzheng , Wang Haoyu
Published: August 2024

Objective: This study aimed to investigate changes in the root canal area and the cross-sectional area of the intervertebral foramen in patients with unilateral L4-L5 spinal stenosis who underwent Minimally Invasive Surgery-Transforaminal Lumbar Interbody Fusion (MIS-TLIF) and their correlation with clinical symptom improvement.
Methods: We selected 35 patients diagnosed and treated for unilateral L4-L5 spinal stenosis at our hospital from June 2020 to February 2022. We recorded intraoperative blood loss, operation time, and postoperative complications. The study compared changes in nerve root canal area observed in CT scans before and after MIS-TLIF surgery in spinal stenosis patients. We also assessed the nerve root canal area at different heights and the L4-L5 intervertebral foramen area. Preoperative and postoperative scores were collected for ODI (Oswestry Disability Index), NRS (Numeric Rating Scale), EQ-5D (EuroQol-5D), and GPE (Global Perceived Effect) to evaluate clinical symptoms. Correlation analyses were conducted between changes in clinical scores and changes in the above-mentioned anatomical areas.
Results: All patients underwent successful surgeries with an average operation time of 122.2±20.33 minutes and an average intraoperative blood loss of 231.43±129.53 ml. Five cases required blood transfusions, and three cases experienced postoperative cerebrospinal fluid leakage, which resolved with bed rest and fluid infusion. There were no infections, but eight cases had postoperative anemia, and no other complications, such as pulmonary embolism, occurred. Postoperative ODI and EQ-5D scores at 3 months, 6 months, and 12 months showed significant improvement compared to preoperative scores. Linear correlation analysis revealed that the cross-sectional area of the lumbar root canal was negatively correlated with ODI scores (r=-0.45, P<0.01), positively correlated with EQ-5D scores (r=0.46, P<0.01), and negatively correlated with NRS-leg scores (r=-0.47, P<0.01). Moreover, the L4-L5 intervertebral foramen area was significantly negatively correlated with ODI scores (r=-0.80, P<0.01) and positively correlated with EQ-5D scores (r=0.517, P<0.01).
Conclusion: Identifying lumbar spinal stenosis preoperatively provides valuable guidance for effective decompression during minimally invasive surgery. However, this study has limitations, primarily due to the small sample size of patients with unilateral single-level L4-L5 symptoms. Further research with a larger sample size is warranted.