bluuebunny/crossref_metadata_2025 huggingface dataset:
Efecto hipoglucemiante del extracto acuoso del stigma maydis de Zea mays L. (maíz morado) en Rattus rattus var. albinus
Authors:   , Maylle Mateo Ana Fiorella , Lazo Fallone Claudio Francesco
Published: November 2024

Introducción: Hasta la fecha existen fármacos que son usados en el tratamiento convencional de la Diabetes Mellitus tipo 2 (DM2); por otra parte, existe un gran desafío en el manejo de estos pacientes, como la baja adherencia al tratamiento, es por ello que es crucial buscar nuevas estrategias que puedan complementar el esquema de tratamiento. Objetivos: El objetivo principal es determinar, en el extracto acuoso, la existencia del efecto hipoglucemiante del stigma maydis del maíz morado (Zea mays L.) en Rattus rattus var. albinus. Materiales y métodos: La metodología usada fue experimental, la población fue conformada por 80 ratas de sexo macho Rattus rattus var. albinus, las cuales se distribuyeron en 9 grupos experimentales evaluando los siguientes parámetros: glucemia basal, proteinuria, glucosuria, ph en orina y cetonuria, a las 0, 1, 2, 6 y 24 horas después de la intervención. Resultados: En la presente investigación se demostró que el extracto acuoso del stigma maydis del Zea mays L. (maíz morado) con dosis de 200, 400 y 600 mg/kg (grupos VI, VII, VIII, respectivamente) siendo el grupo VII el que presentó mayor disminución de la glucosa. Los citados grupos iniciaron su actuación desde la 1ª hora, con un máximo de 6 horas, aumentando gradualmente hasta las 24 horas. Conclusión: Con el tiempo, la reducción de la glucosa en sangre fue mayor por la acción del extracto acuoso de stigma maydis del Zea mays L. (maíz morado) presentando un pico máximo con una dosis de 600 mg/kg a las 6 horas.
Relación entre el proceso asociativo y la capacidad exportadora de las cooperativas cacaoteras de Ucayali 2022
Authors:   , Camarena Alarco Soledad Norma Luz
Published: November 2024

Mediante el estudio titulado relación entre el proceso asociativo y la capacidad exportadora de las cooperativas cacaoteras de Ucayali 2022”, ha tenido como finalidad de relacionar el proceso asociativo y la capacidad exportadora, tomando como dimensiones de la variable “Proceso asociativo” al (i) Principios cooperativos (ii) Compromiso con la calidad y (iii) Capacidad de gestión y la segunda variable “Capacidad exportadora” a (i)Identificación de mercado (ii) Acceso a financiamiento y (iii) Herramientas de productividad, el estudio tiene enfoque cuantitativo de tipo aplicada con diseño no experimental y de nivel correlacional. La población objeto de estudio fueron 30 colaboradores que provienen de todas las cooperativas cacaoteras de la región Ucayali. Se concluye prueba positiva de Rho de Spearman (0.866), con una sig=0.000<0.01, demostrándose estadísticamente, que existe una fuerte asociación del proceso asociativo que tienen las cooperativas con la capacidad o desempeño exportadora. En la región es importante que se asocien para poder exportar de manera colectiva.
Análisis de la gestión de archivos en la productividad de una entidad pública del Perú 2023
Authors:   , Sanez Rodriguez Flor , Vasquez Del Solar Fernando Javier
Published: November 2024

En el actual mundo moderno, la información se ha convertido en el recurso más valioso tanto para las organizaciones públicas como privadas. Sin embargo, debido a la gran cantidad de información disponible, es crucial gestionarla de manera adecuada para obtener datos fiables y útiles que impulsen el desarrollo de las actividades. En este contexto, la gestión de archivos emerge como un elemento fundamental para lograr este objetivo. Enfocar la investigación en el sector público se justifica por el papel que juegan los documentos de archivo en la productividad de las entidades públicas, lo cual influye directamente en la satisfacción de las necesidades de la población a través de productos y servicios. Basándonos en la información proporcionada anteriormente, este artículo presenta los resultados derivados del análisis de la incidencia entre la gestión de archivos y la productividad en una entidad pública. Se utilizaron herramientas académicas como encuestas y técnicas estadísticas para evaluar su correlación y determinar su incidencia. La investigación fue de enfoque cuantitativo, con técnica de encuesta para la recogida de datos, se trabajó con una muestra de 80 empleados de la organización pública. Se analizaron los datos en base a la estadística descriptiva e inferencial aplicando la medida no paramétrica Rho de Spearman y las ecuaciones estructurales, concluyendo que existe relación positiva débil y una incidencia entre las variables (30.6%) que indican que aún no se hace uso de la información existente en los procesos archivísticos, además que para gestionar el área de archivo y aportar a la productividad de la entidad es necesario formar a los empleados del área archivística en temas de procesos técnicos normados en la directiva que establece el sistema institucional de archivos.
Clima organizacional y su impacto en la satisfacción laboral post pandemia en la empresa Cicsa Perú SAC, Lima 2022
Authors:   , Pantaleon Flores Sonia Lizet , Gutierrez Lizondro Rosa Maribel
Published: November 2024

Los escenarios laborales que se presentaron durante la pandemia dejaron estragos en diferentes empresas debido a la falta de un plan de contingencia que resuelva situaciones mediatas relacionadas directamente con el colaborador como; el trabajo, la comunicación, el liderazgo y como estos elementos repercutieron en su satisfacción para desarrollar su labor con mayor compromiso. En este estudio cuantitativo, se evaluó la incidencia entre el clima organizacional y la satisfacción laboral de 208 colaboradores. Mediante un modelo de regresión logística ordinal (Nagelkerke), se determinó que el clima organizacional explica aproximadamente el 37.6% de la variabilidad en la satisfacción laboral. Estos resultados sugieren una influencia moderada del clima organizacional en la percepción de satisfacción de los empleados.
Astenopia relacionada a distancia de visión e iluminancia de monitores de pantallas LCD en trabajadores administrativos de Mota Engil 2022
Authors:   , Noriega Herrera Katherine Giselle , Arnao Bedregal Aldo
Published: November 2024

Objetivo: determinar la relación entre la astenopia y la distancia de visión e iluminancia de monitores de pantalla LCD en trabajadores administrativos de una empresa constructora.Material y métodos: Realizamos un estudio de casos y controles con una muestra de 67 casos con astenopia y 67 controles. Utilizamos regresión logística multivariante para establecer las asociaciones entre distancia de visión e iluminancia con astenopia, reportando Odds Ratios con intervalos de confianza (IC) al 95 %.Resultados: La media de edad de la muestra fue 38.9±7.1 años, 67.2% presentaron distancia visual inadecuada y 89.6% presentaron iluminancia de pantalla LCD inadecuado. La regresión logística multivariante evidenció mayor posibilidad de astenopia cuando se tiene distancia visual inadecuada (OR=3,72; IC95%:1,51-9,15) y cuando la iluminancia de la pantalla es inadecuada (OR=3,16; IC95%:1,07-9,35). Conclusiones: la distancia visual y la iluminancia de pantalla LCD se relacionaron independientemente a la presencia de astenopia en trabajadores administrativos.
Book review of Guskaroska, A., Zawadzki, Z., Levis, J., Challis, K., Prikazchikov, M. (2024). Teaching pronunciation with confidence. Iowa State University.
Authors: Playsted Skye
Published: November 2024

Teaching Pronunciation with Confidence is a comprehensive, open educational resource (OER, 2024) aimed at ESL/EFL teachers and learners, with a focus on effective pronunciation teaching. The book was conceptualized by lead author, Guskaroska, who had worked on a course created by Levis with fellow PhD students at that time, Zawadski and Challis. The purpose of the book was to create an online resource for future students in Levis’ pronunciation teaching course that could transform the course’s paper-based activities into interactive online activities, providing immediate feedback for students completing the activities. At the same time, an OER publication offered teachers seeking to integrate pronunciation teaching into their classroom practice an accessible resource that drew on up-to-date technological resources and pedagogical approaches. ESL/EFL teachers and students will appreciate its clear, accessible format and descriptions of research-informed classroom activities that are appropriate for most levels of instruction. Teacher educators of TESOL trainees will find that the book (particularly in Chapters 1 and 2) provides succinct but thorough summaries of the theoretical background and research to ESL/EFL pronunciation teaching. Teacher trainers could find it a useful resource to draw on when preparing professional learning sessions. This review briefly outlines and evaluates each of the book’s sections, including the foundational aspects of pronunciation instruction, segmentals (vowels, consonants), suprasegmentals (stress, rhythm, intonation), and assessment strategies.
The Value of Alleviating Serious Health-Related Suffering and Palliative Care Based on Lived Experience: Development of the SAVE Study Protocol
Authors: Bhadelia Afsan , Greaves Natalie , Doubova Svetlana , Knaul Felicia
Published: November 2024

Health-related suffering generated by life-limiting or life-threatening conditions is a complex phenomenon inextricably linked with human experience. Most of this suffering can be ameliorated with access to quality palliative care that is not available in much of the world, especially low-resource settings. Some exploration of the definitional boundaries of and needs pertaining to health-related suffering suggests that patients and families assign specific importance to the compassionate and supportive aspects of palliative care. However, the intrinsic and personal value of alleviating health-related suffering to patients and caregivers has not been systematically studied to explicitly inform health systems priority-setting and practice. Exploration of health-related suffering based on personal experience is primarily focused on high-income contexts and/or clinical care management. Comprehensive evidence can support the overall investment case for expanding access to palliative care worldwide. The SAVE (Suffering Alleviation and the Value of Experiential knowledge) study protocol provides an instrument to examine the value assigned to suffering alleviation based on lived experience to guide health systems strengthening. Informed by literature reviews, deliberation of a global expert group on limitations of quantitative measurement of suffering, and piloting in two countries – Barbados and Mexico – the SAVE protocol can support evidence generation that is anchored by experiential knowledge of the illness trajectory to advance people-centered health policy and systems research. A part of broader work in follow-up to the Lancet Commission on Global Access to Palliative Care and Pain Relief, the protocol incorporates guidance on qualitative approaches and their importance to understanding lived experience, building on existing literature. Finally, implications for health systems responsiveness and high-value healthcare are discussed alongside opportunities for future research.
RETRACTED: Resource Allocation for Secure and Efficient Communication in 5G Networks using a Modified Crossover Genetic Algorithm
Authors: Khdhir Radhia , Othmen Salwa , Belghith Aymen
Published: November 2024

The authors have requested that this preprint be removed from Research Square.
RETRACTED: Determine Soil Loss Response to Agroforestry Land Use Change (ALUC) Using RUSLE Based GIS and RS in Gilgel Gibe I Catchment, Southwestern, Ethiopia
Authors: Jiru Endale , Abera Girma , Temesgen Habtamu
Published: November 2024

The authors have requested that this preprint be removed from Research Square.
An Interpretable Model for Health-care Insurance Fraud Detection
Authors: Wang Zeyu , Chen Xiaofang , Wu Yiwei , Lin Shiming , Jiang Linke , Qiu Gang
Published: November 2024

Healthcare insurance fraud imposes a significant financial burden on healthcare systems worldwide, with annual losses reaching billions of dollars. This study aims to improve fraud detection accuracy using machine learning techniques. Our approach consists of three key stages: data preprocessing, model training and integration, and result analysis with feature interpretation. Initially, we examined the dataset's characteristics and employed embedded and permutation methods to test the performance and runtime of single models under different feature sets, selecting the minimal number of features that could still achieve high performance. We then applied ensemble techniques, including Voting, Weighted, and Stacking methods, to combine different models and compare their performances. Feature interpretation was achieved through Partial Dependence Plots (PDP), SHAP, and LIME, allowing us to understand each feature’s impact on the predictions. Finally, we benchmarked our approach against existing studies to evaluate its advantages and limitations. The findings demonstrate improved fraud detection accuracy and offer insights into the interpretability of machine learning models in this context.
Solvent extraction of Ac-225 in nano-layer coated, solvent resistant PDMS microfluidic chips
Authors: Trapp Svenja , Santoso Albert , Hounat Yassine , Paulssen Elisabeth , Ommen J. Ruud van , Steijn Volkert van , de Kruijff Robin M.
Published: November 2024

Separating medical radionuclides from their targets is one of the most critical steps in radiopharmaceutical production. Among many separation methods, solvent extraction has a lot of potential due to its simplicity, high selectivity, and high efficiency. Especially with the rise of polydimethylsiloxane (PDMS) microfluidic chips, this extraction process can take place in a simple and reproducible chip platform continuously and automatically. Furthermore, the microfluidic chips can be coated with metal-oxide nano-layers, increasing their resistance against the employed organic solvents. We fabricated such chips and demonstrated a parallel flow at a considerably large range of flow rates using the aqueous and organic solutions commonly used in medical radionuclide extraction. In our following case study for the separation of Ac-225 from radium with the chelator di(2-ethylhexyl)phosphoric acid (D2EHPA), a remarkable extraction efficiency of 97.1% ± 1.5% was reached within 1.8 seconds of contact time, while maintaining a near perfect phase separation of the aqueous and organic solutions. This method will enable the automation of solvent extraction and faster target recycling, and serves, therefore, as a proof-of-concept for the applicability of microfluidic chip solvent extraction of (medical) radionuclides.
The effect of Emotional Freedom Techniques on anxiety depression and sleep in elderly AIDS patients: A Randomized Controlled Trial
Authors: 温 气 , 您 新义 , 吴 玉汉 , 杨 温温 , 歌曲 燕
Published: November 2024

Objective To investigate the effect of Emotional Freedom Techniques on anxiety, depression and sleep in older adults with AIDS.
Methods 70 cases of anxious and depressed older adults with AIDS with sleep disorders were randomly divided into control and experimental groups by random number table system (RNT), 35 cases in each group. The experimental group received Emotional Freedom Techniques once a day for 15-20 minutes as part of their routine care and health counselling, and the intervention continued for 2 weeks. The control group received routine nursing care and health guidance. The two groups were assessed using the Pittsburgh Sleep Quality Index (PSQI) and the Hospital Anxiety and Depression Scale (HADS) before and after the two weeks of intervention.
Results There are totally 67 participants in the trial. In the EFT group (n =33), PSQI scores decreased from 12.36±2.409 to 9.15±2.476(mean±SD P<0.001), HA scores decreased from 12.39±2.344 to 9.12±2.176(mean±SD P<0.001), HD scores decreased from 11.58±1.969 to 8.94±2.015 (mean±SD P<0.001), compared with no change in the usual care group (n=34). The EFT group showed significantly lower post-intervention scores than the control group on all scales (P < 0.001).
Conclusion Emotional Freedom Techniques can effectively alleviate anxiety and depression in older people with AIDS and improve their sleep quality.
Cerebellar transcranial AC stimulation produces a frequency-dependent bimodal cerebellar output pattern
Authors: Mourra Devry , Cavalieri Angela M. , Casey Madison M. , Sahin Mesut , Lang Eric J.
Published: November 2024

Transcranial alternating current stimulation (ctACS) has the potential to be an appealing, non-invasive treatment option for psychiatric and neurological disorders. However, its potential has been limited by significant knowledge gaps in the details and mechanisms of how ctACS affects cerebellar output on single cell and population levels. We investigated this issue by making single-unit recordings of Purkinje cells (PC) and lateral cerebellar nuclear (Lat CN) cells in response to ctACS in anesthetized adult female Sprague-Dawley rats. The ctACS electrode was positioned directly on the skull above crus 1, either ipsilaterally just medial to the recording site or contralaterally. The return electrode was placed under the skin of the shoulder ipsilateral to the recorded cell. In response to ctACS at frequencies ranging from 0.5 to 80 Hz, PC and CN activity was modulated in a frequency-dependent manner. PC and CN entrainment strength increased with stimulation frequency. Moreover, a unimodal response was seen for most PCs across all frequencies, whereas most CN cells transitioned to bimodal patterns as stimulus frequency increased. The phase of the local minima CN cells, and its change with frequency, was consistent with CN cells being driven synaptically by PC activity. Furthermore, the nearer ctACS location to the recording site, the stronger the entrainment, suggesting that ctACS electrode placement could be used to target specific cerebellar output channels. In sum, the results show that transcranial stimulation of the cerebellar cortex can modulate cerebellar output, which has potential implications for its use in treating neurological and psychiatric disorders.
Preparation of drug carrier material with targeted and sustained-release from modified lignin
Authors: Li Chenghan , Zhou Zijing , Li Yiping , Zhu Xudong , Yan Hong , Li Fen
Published: November 2024

In this paper, modified lignin drug carrier materials with targeted and sustained-release effect were studied and characterized by Fourier transform infrared spectroscopy (FIRS), hydrogen nuclear magnetic resonance (1HNMR), UV-Visible spectroscopy (UV), field emission scanning electron microscopy (SEM) and Zeta potential. In vitro drug release, toxicity, drug distribution and anticancer effect were tested. The results showed that the solubility of lacerated lignin in alcohol solution was 1.14 times than alkali lignin. The modified acetyl group replaced the free phenol hydroxide group in the benzene ring of lignin, and the structure of lignin itself did not change. The lignin-coated material was hollow small-hole ionospheres, and the drug loading rate and encapsulation rate of facilitate reached 17.8% and 71.23% respectively. Facilitate release rate was only 21.94% when pH value of human gastric juice was 1.2. The release rate of facilitate could reach 74.81% at pH 5.5 of simulated tumor cells. The drug release behavior was obvious within 10 h. When the concentration of lignin carrier material was 10–100 mg/ml, the survival rate of cells was greater than 95%, indicating that lignin coated material was non-toxic and had stable slow-release and targeting effect. In addition, the biological distribution of facilitate in mice showed that PTX was mainly concentrated in tumor sites of mice, but in liver, spleen, lung and kidney was low. In the anti-cancer effect test, the tumor cells were significantly reduced after 5 consecutive administration, which also proved that the lignin/PTX drug delivery system has high targeting and anti-cancer effect.
Machine Learning Approaches for Defect Detection in a Microwell-based Medical Device
Authors: Zhao Xueying , Chen Yan , Jiang Yuefu , Radenbaugh Amie , Moskwa Jamie , Jensen Devon
Published: November 2024

Microfluidic devices offer numerous advantages in medical applications, including the capture of single cells in microwell-based platforms for genomic analysis. As the cost of sequencing decreases, the demand for high-throughput single-cell analysis devices increases, leading to more microwells in a single device. However, their small size and large quantity increase the quality control (QC) effort. Currently, QC steps are still performed manually in some devices, requiring intensive training and time and causing inconsistency between different operators. A way to overcome this issue is to through automated defect detection. Computer vision can quickly analyze a large number of images in a short time and can be applied in defect detection. Automated defect detection can replace manual inspection, potentially decreasing variations in QC results. We report a machine learning (ML) algorithm that applies a convolution neural network (CNN) model with 9 layers and 64 units, incorporating dropouts and regularizations. This algorithm can analyze a large number of microwells produced by injection molding, significantly increasing the number of images analyzed compared to manual operator, improving QC, and ensuring the delivery of high-quality products to customers.
Electrospun fiber membranes of Fe2O3/ZnO with high photocatalytic activity for wastewater treatment application under visible light irradiation
Authors: Lin Qing , Zhang Rui , Zhang Xiujuan , Li Shuang , Dai Junhao , Li Shuiping , Wang Zhao , Liang Dong , Fu Hailuo , Zhang Xiaojuan
Published: November 2024

Fe2O3/ZnO fiber membranes with a high specific surface area and broadened UV-Vis absorption were successfully fabricated by electrospinning followed by calcination. The diameters of Fe2O3/ZnO fibers are approximately 150 nm, and the specific surface areas of Fe2O3/ZnO fiber membranes are around 29 m2/g. XRD, SEM, and XPS results confirm the formation of a heterojunction between hexagonal ZnO and hematite α-Fe2O3. Compared with pure ZnO fiber membranes, the UV-Vis absorptions of the Fe2O3/ZnO fiber membranes are extended, and transient photocurrent intensities are significantly increased from 0.65 mA/cm2 to 0.86 mA/cm2. The free radical capture experiments further reveal the generation of abundant •OH radicals, which play a crucial role in enhancing the photocatalytic performance of these Fe2O3/ZnO fiber membranes. Optimization studies have determined that the most effective molar ratio of Fe to Zn in the Fe2O3/ZnO heterojunction is 8 mol%, resulting in a 45% increase in photocatalytic degradation efficiency for MB. In addition to this enhanced photocatalytic efficacy, the Fe2O3/ZnO fiber membranes also demonstrate exceptional cycling stability, highlighting their significant potential for application in the photocatalytic treatment of dye wastewater.
Association of Child Opportunity Index with Outcomes in Pediatric Supraventricular Tachycardia
Authors: Karolcik Brock A. , Calcaterra Michael J. , Smith Kevin L. , Schiff Mary D. , Ragavan Maya I. , Alsaied Tarek , Follansbee Christopher W. , Beerman Lee B. , Arora Gaurav
Published: November 2024

Objectives: To assess the relationship between the Child Opportunity Index (COI), a validated measure that uses 29 indicators of social determinants of health linked to the US Census, and pediatric supraventricular tachycardia (SVT) management and outcomes, specifically looking at utilization of ablation.
Study Design: A retrospective, single-center study was performed evaluating pediatric SVT patients from January 2018-July 2023. Patients diagnosed at < 5 years old, with pre-excitation, and with hemodynamically significant congenital heart disease were excluded. Characteristics were compared among low, moderate, and high COI categories using Kruskal-Wallis tests for continuous variables, and chi-square or Fisher’s exact tests for categorical variables. Logistic regression and log-normal regression models were used to assess the relationship between COI category and primary outcomes of interest among SVT patients.
Results: A cohort of 306 patients met inclusion criteria. 45% had a high COI, 29% a moderate COI, and 26% a low COI. The odds of having one or more hospital admissions were 3.88 times greater for the low COI patients compared to high COI patients (95% CI: 1.39-10.8, p = 0.010). COI was not found to be associated with any other primary outcomes of interest, including utilization of ablation.
Conclusions: Lower COI was associated with greater odds of admission in SVT patients but did not differ in rates of ablation or outcomes. This suggests social factors may affect resource utilization while having limited impact on treatments like ablations.
Intranasal scope negotiation trajectories for flexible nasopharyngolaryngoscopy.
Authors: Bidkar Vijay , Selvaraj Kalaiselvi , Raipure Amrusha , Dabhekar Sandeep , Prathipati Kiran Kumar , Sarode Lisha
Published: November 2024

Background and Objectives The flexible nasopharyngolaryngoscopy (F-NPLS) is a routine office procedure. We compared two trajectories of intranasal scope negotiation used for F-NPLS and assessed patients comfort and performers satisfaction. Methods This is prospective, randomized, parallel group controlled study. Patients undergoing F-NPLS for evaluation of upper airway were enrolled and randomized into two study groups. Group A patients underwent intranasal scope negotiation trajectory “below middle turbinate”; for group B patients the trajectory of “along the inferior turbinate” was used. The primary outcome evaluated was successful unhindered scope negotiation in first attempt. Patient perceived pain, event of mucosal trauma and bleeding, episode and need of repetition of scopy were evaluated as secondary outcome. Results One hundred and eleven patients were randomized into group A (n = 53) and group B (n = 58). Baseline characteristics age, gender were similar in both the groups. Both groups did not show statistical difference with respect to primary outcome. (Group A: 52.8% Vs Group B: 55.2%, p = 0.8) The F-NPLS without episode of mucosal trauma was significantly higher in group B (Group A: 56.9% Vs Group B:35.9%, p = 0.004). The mucosal ecchymosis was commonly encountered finding in group A (Group A: 41.5% Vs Group B:13.8%, p = 0.03) whereas, nasal bleeding observed frequently in group B though statistically insignificant. (Group A: 29.3% Vs Group B:22.6% p = 0.42) Conclusion The present study showed that there is no difference in successful unhindered F-NPLS using either of the trajectory. However, patient experienced moderate to severe pain during repeat scopy as compared to the F-NPLS in first attempt itself.
The influence of vascular risk factors on cognition among patients over 65 years of age in rural area - preliminary report
Authors: Zachara Radoslaw , Wlaszczuk Adam , de Carrillo Daria Gendosz , Gorzkowska Agnieszka , Jedrzejowska–Szypulka Halina
Published: November 2024

Background: Hypertension (HTN) and diabetes mellitus (DM) are associated with cognitive impairment and dementia. Antihypertensive treatment may improve cognitive functioning. Elevated blood glucose levels can increase the risk of dementia even in non-DM. Both HTN and DM may contribute to the development of Alzheimer’s disease.
Aims: The aim of this study was to assess the influence of vascular risk factors on cognition.
Methods: The study was conducted in the south of Poland among rural population over 65 years of age. 85 patients qualified into the study were divided into groups according to the presence of HTN (n=18), DM (n=7), or both (n=40). Control group was also formed (n=20). Biochemical tests, neurological scales assessment and ultrasound examinations were conducted.
Results: The median score for the M-ACE scale was 3 points lower when HTN and DM coexisted, compared to the diagnosis of DM or HTN solely (25 points and 28 points respectively). Considering MMSE scale the results were comparable. The higher number of years of education correlated with better M-ACE result (median value of years of education 11 for the >25 points M-ACE results and 9 for patients with suspected dementia (<22 M-ACE points)
Conclusions: The coexistence of DM and HTN caused the most profound decline in cognitive functioning of patients. Moreover, the higher number of years of education was a protective factor against the development of dementia in old age. Cholesterol and uric acid roles in cognitive decline are still debatable.
Enhancing Patient Education With AI:A Readability Analysis of AI-Generated Versus American Academy of Ophthalmology Online Patient Education Materials
Authors: Kufta Allison , Djalilian Ali
Published: November 2024

Purpose: This study aims to compare the readability of patient education materials (PEMs) written by the American Academy of Ophthalmology (AAO) with those generated by large language models (LLMs), including ChatGPT-4o, Microsoft Copilot, and Meta-Llama-3.1-70B-Instruct.
Methods: LLMs were prompted to generate PEMs for 15 common diagnoses relating to cornea and anterior chamber, which was followed by a prompt to reword the content at a 6th-grade reading level. The readability of these materials was evaluated using nine different readability analysis python libraries and compared to existing PEMs found on the AAO website.
Results: For all 15 topics, ChatGPT, Copilot, and Llama successfully generated PEMs, though all exceeded the recommended 6th-grade reading level. While unprompted ChatGPT, Copilot, and Llama outputs were 10.8, 12.2, and 13.2, respectively, prompting significantly improving readability to 8.3 for ChatGPT, 11.2 for Copilot, and 9.3 for Llama (p < 0.001). While readability improved, AI-generated PEMs were on average, not statistically easier to read than AAO PEMs, which averaged an 8.0 Flesch-Kincaid grade level.
Conclusions: Prompted AI chatbots can generate PEMs with improved readability, nearing the level of AAO materials. However, most outputs remain above the recommended 6th-grade reading level, and the brevity of Copilot's responses raises concerns about content quality. By creating a blueprint, AI chatbots show promise as tools for ophthalmologists to increase the availability of accessible PEMs in ophthalmology.
Association of Preoperative Inflammatory Markers with Prognosis in Esophageal Squamous Cell Carcinoma: Development and Validation of a Survival Prognostic Model in a Two-Center Study
Authors: Chen ZhengWei , Wang Gaoxiang , Xia Tianyang , Shao Wei , Liu Changqing , Zhang Weiguo , Wang Fangqin , Xie Mingran
Published: November 2024

Objective
This study evaluates the prognostic value of preoperative inflammatory markers—Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), Systemic Immune-Inflammation Index (SII), and Fibrinogen-to-Prealbumin Ratio (FPR)—in patients with resectable esophageal squamous cell carcinoma (ESCC). A survival prognostic model integrating these markers with TNM staging was developed and validated.
Methods
Clinical data from 224 ESCC patients who underwent surgical resection between January 2017 and December 2017 at the First Affiliated Hospital of the University of Science and Technology of China were retrospectively analyzed as a training set, and data from 87 patients at Tongling People's Hospital (January 2018 to September 2019) served as the validation set. ROC analysis determined optimal cut-off values for NLR, PLR, SII, and FPR. Survival was analyzed using the Kaplan-Meier method, and prognostic factors were identified through Cox regression. A nomogram was constructed using R software to predict overall survival (OS) and disease-free survival (DFS). Model performance was assessed via ROC, calibration curves, and decision curve analysis (DCA).
Results
The optimal cut-off values for NLR, PLR, SII, and FPR were 2.70, 140.34, 360.73, and 0.015, respectively. Higher NLR, PLR, and FPR levels were associated with significantly poorer 5-year OS and DFS (all p < 0.01), while higher SII levels were associated with improved outcomes (p = 0.008 for OS, p = 0.013 for DFS). Multivariate Cox analysis identified age, T stage, N stage, differentiation, and NLR as independent prognostic factors. The nomogram demonstrated strong predictive accuracy, with ROC AUCs of 0.966 (3-year OS), 0.907 (5-year OS), 0.960 (3-year DFS), and 0.919 (5-year DFS). Calibration curves confirmed model reliability, and DCA indicated high clinical utility.
Conclusions
Preoperative NLR, PLR, SII, and FPR are significant predictors of ESCC prognosis, with NLR serving as an independent marker. The nomogram based on inflammatory markers and clinicopathological factors accurately predicts patient outcomes, aiding preoperative decision-making and postoperative management.
Effectiveness of Kinesio Taping in the Postoperative Period: a Study on Mandibular Third Molar Extraction
Authors: TEKE Mehmet Turhan , ÖZYURTSEVEN Betül TAŞ
Published: November 2024

Objectives: In our study, kinesio taping was used to reduce pain, edema and trismus more rapidly following extraction of impacted mandibular third molars. It was investigated whether kinesio taping affects the blood flow in the extraction site and the rate of edema drainage, and its potential to increase patient comfort in the postoperative period was evaluated.
Materials and Methods: 87 patients who underwent surgical extraction of impacted mandibular third molars were included in our parallel-arm randomized clinical study. While patients in the control group were only observed, a fan-shaped kinesio tape application was applied between the clavicle and tragus in the kinesio tape group to provide lymphatic drainage. Blood flow measurements were taken with a laser Doppler flowmeter device at four points identified in the head and neck region where lymphatic channels drain: preoperatively, immediately after the operation, and on the 2nd, 4th and 7th days post-operation. Additionally, pain symptoms, maximum mouth opening, and edema measurements were evaluated on the 2nd, 4th and 7th days of post-operation.
Results: The kinesio tape group consists of 22 females and 21 males, with a mean age of 23.5 ± 4.02 years, while the control group consists of 22 females and 22 males, with a mean age of 23.3 ± 3.19 years. In the kinesio tape group, higher blood flow was measured, with lower pain on the 2nd day and reduced edema on the 4th day compared to the control group. It was observed that mouth opening was regained more rapidly from the 2nd day onwards.
Conclusions: Our study shows that the application of kinesio tape reduces postoperative complications and improves quality of life. Kinesio tape application, which stands out with its atraumatic and ease of application, has been a supportive method which we believe to be useful in the management of morbidity following oral surgery applications.
ADSC-Exs Suppresses the Fibrosis Process of Derma in Secondary Lymphedema
Authors: Wang Xinxin , Li Yilan , Ye Jianping , Ma Xiwen , Wang Zhenyu , Guo Xiang , Xie Mengjia , Ma Jiahui , Wang Jingxin
Published: November 2024

Background
Mesenchymal stem cells (MSCs) and their exosomes, particularly adipose-derived stem cell exosomes (ADSC-Exs), have shown promise in treating secondary lymphedema (SLE), a condition characterized by fibrosis driven by the TGFβ-Smad signaling pathway. While ADSCs and ADSC-Exs have demonstrated antifibrotic effects, it is not yet clear whether these benefits stem from their ability to regulate this pathway. This study aimed to clarify the role of ADSCs and ADSC-Exs in reducing fibrosis in SLE by modulating the TGFβ-Smad pathway.
Methods
We established a secondary lymphedema model in C57BL/6 mice through surgical excision and localized radiation. Tissue staining was used to assess fibrosis progression at key time points, identifying the peak fibrosis stage. ADSCs and ADSC-Exs were injected into the affected areas to test their therapeutic effects, while TGFβ1 inhibitors were used as controls to block the TGFβ-Smad signaling pathway. This study compared the effects of ADSCs, ADSC-Exs, and the inhibitors on lymphedema and fibrosis markers, with a focus on their influence on the TGFβ-Smad pathway.
Results
Fibrosis in the SLE model peaked between the 4th and 5th weeks. Both ADSCs, ADSC-Exs, and the TGFβ inhibitor EW-7197 reduced edema and fibrosis, with ADSC-Exs having the most significant effect on skin fibrosis. This was evident by decreased levels of TGFβ1, Smad2/3, and phosphorylated Smad2/3, along with increased Smad7 levels, indicating that ADSC-Exs effectively regulate the TGFβ-Smad pathway to reduce fibrosis.
Conclusions
Our findings demonstrate that ADSCs and ADSC-Exs significantly alleviate edema and fibrosis in a secondary lymphedema mouse model. This therapeutic effect is largely mediated through the regulation of the TGFβ-Smad pathway, suggesting a promising approach for treating fibrosis in SLE.
Image Captioning Using Bidirectional LSTM Neural Network
Authors: Hoseini Farnaz , Notash Anaram Yaghoobi
Published: November 2024

Putting captions on images is an important phase in image processing and machine vision which divides an image into different regions. In the related captioning operation, similar attributes are extracted from each region and a single caption is opted for the title of the input for the relevant image. In the developed world, due to the considerable volume of images that are available on the Internet, it is complicated to choose a suitable method for captioning images automatically and determining concepts correctly. In this study, a method based on a Bidirectional LSTM neural network with 14 layers is used for automatic captioning. The dataset is trained on ImageNet by MobileNet architecture. Due to the high volume of the data set consequently with the huge calculations that are required for captioning, MobileNet architecture has been applied to decrease the computational load and to boost the performance of the proposed method. in this study, the data set is flickr8k with a volume of data of more than 1.04 GB which was selected as one of the challenging data sets for captioning images through the Kaggle site. The proposed method is implemented with Python language by artificial intelligence package TensorFlow and Cross on Google Colab. The proposed Bidirectional LSTM neural network has been compared with five other models based on the LSTM neural network. So, the results of these comparisons have been evaluated for Precision, Accuracy, Recall, F score, and Loss Function. According to the hardware's limitations and the huge volume of calculations, the proposed model was able to show convincing performance compared to other models. The obtained results with an accuracy of 75.90% indicate the improvement of the accuracy as well as the reduction of the cost in the captioning process for the proposed model.
How does just culture reduce negative work outcomes through support and distress in clinical nurses? A path analysis
Authors: Jeong Seohee , Kim Sunmi , Chang Hyoung Eun , Jeong Seok Hee
Published: November 2024

Background
Second victim experiences of nurses are a critical issue in healthcare. In addition to causing psychological and emotional distress to nurses, second-victim experiences adversely affect organizational performance and overall patient safety.
Purpose
This study aimed to identify the effects of the perceived just culture of medical institutions on the second victim experiences of nurses after patient safety incidents.
Methods
This was a cross-sectional correlational study. Data were collected from 183 clinical nurses in tertiary general hospitals between December 28, 2022 and January 14, 2023 using an online self-report questionnaire. Data were analyzed using SPSS WIN 23.0 and AMOS 23.0 programs.
Results
The hypothesized model was found to be statistically fit (normed χ2 /df = 2.53; root mean square error of approximation = .09; comparative fit index = .99; Tucker-Lewis index = .97; normed fit index = .99). Eight hypothesized pathways were tested, of which five direct effects and three indirect effect pathways were statistically significant. Just culture had a significant effect on second victim distress (β = -0.29, p = .001) and demand for support (β = -0.65, p = .001). Second victim distress had a significant effect on demand for support (β = 0.14, p = .025) and negative work-related outcomes (β = 0.66, p = .001). Demand for support had a significant effect on negative work-related outcomes (β = 0.18, p = .010).
Conclusions
This study demonstrates that a just culture in medical institutions can ameliorate second victim experiences of nurses involved in patient safety incidents. Implementing systemic interventions to establish a just culture in medical institutions is a key imperative to mitigate second victim experiences and improve organizational performance.
Comparation of non-intralesional or intralesional spondylectomy for chondrosarcoma in mobile spine: a retrospective study of surgery management, complications, and prognosis.
Authors: Liu Fangzhi , Wang Ben , Liu Xiaoguang , Wu Fengliang , Zhou Hua , Dang Lei , Li Yan , Tang Yanchao , Liu Xiao , Hu Panpan , Li Zihe , Wei Feng , Liu Zhongjun
Published: November 2024

Study Design: Retrospective Cohort Study
Objectives: Chondrosarcoma of mobile spine is a rare aggressive malignant tumor and postsurgical local recurrence rates remain high. En bloc resection is currently the preferred treatment. Resection that achieves non-intralesional removal of the tumor may enable more complete removal of tumor tissue but significantly increases the complexity and risk of surgery and results in more postoperative complications. We sought to compare surgical outcomes, complications, and prognoses between patients who underwent en bloc resection with and without intralesional removal of the tumor.
Methods: We reviewed 56 patients with spinal chondrosarcoma who underwent en bloc tumor resection and reconstructive surgery at our center between 2000 and 2024 with a minimum postoperative follow-up of 1 year. We collected and analyzed data regarding surgical procedures, complication characteristics, and local tumor control and recurrence.
Results: We included 56 patients. Of these, 36 patients underwent the first surgery, and 20 experienced recurrences. All patients underwent en bloc tumor resection; 36 and 20 underwent intralesional and non-intralesional resections, respectively. We recorded 83 complications; the incidence and the number of major complications were significantly higher in the non-intralesional surgery group. Thirty patients experienced tumor recurrence and 26 patients died. Non-intralesional en bloc resection and conventional-type chondrosarcoma were predictive factors for reduced long-term postoperative recurrence and mortality risk.
Conclusions: Non-intralesional resection carries higher risks and is associated with a greater number of perioperative complications, but reduces the risk of local tumor recurrence and prolongs recurrence-free survival and overall survival, providing patients with better prognoses.
Reference values of handgrip strength in children and adolescents living in a moderate altitude region of Peru.
Authors: Cossio-Bolaños Marco , Vidal-Fernandez Ruben , Sulla-Torres Jose , Viveros-Flores Antonio , Torres-Paz Luis , Granados-Barreto Juan , Gomez-Campos Rossana
Published: November 2024

Background
The evaluation of Hand Grip Strenght (HGS) is relevant for the early detection of muscle weakness. It may be an early indicator of juvenile sarcopenia and other alterations associated with neuromuscular disorders.
Objective
a) to compare hand grip strength (HGS) with other regional studies and b) to propose reference values of HGS by age, sex in children and adolescents living in a moderate altitude region of Peru.
Methodology:
A cross-sectional study was designed in school children and adolescents living in a moderate altitude region of Peru (2320 meters above sea level). The sample selection was non-probabilistic (accidental), considering 1058 schoolchildren (557 boys and 501 girls) with an age range of 6 to 17 years. These schoolchildren came from public schools. Weight, height and Body Mass Index (BMI) were assessed. HGS of both hands (right, left and both hands) was evaluated. The p50th percentile was used to compare discrepancies with studies from Chile, Colombia and Peru.
Results
The median values (p50) of both hands show a linear increase with advancing age. It is expected that HGS tends to increase as children get older. The maximum HGS of both hands occurred in males at 17 years of age (38.87kg/f). While in females it was at 15–16 years (23.56kg/f). Discrepancies in HGS were observed when comparing the 50th percentile (P50) of schoolchildren living at moderate altitude in Peru with regional studies carried out in Chile, Colombia and Peru. HGS percentiles by age and sex were developed for the left, right and both hands (P3, P5, P15, P25, P50, P75, P85, P90, P95 and P97).
Conclusion
The study demonstrated discrepancies in HGS between schoolchildren living in a moderate altitude region of Peru and neighboring regions. This allowed us to propose percentiles to evaluate HGS by age and sex. The results suggest its use in educational and clinical contexts.
Acute intercostal pulmonary hernia following uniportal video-assisted thoracoscopic surgery for pulmonary conditions
Authors: Huang Shaoqing , Song Xu , Shi Qiang , Li Jie
Published: November 2024

Intercostal pulmonary hernia is an uncommon condition characterized by the protrusion of lung parenchyma through a compromised or defective chest wall into the thoracic cavity. The etiologies of pulmonary hernia can be categorized as traumatic, post-thoracotomy, and spontaneous occurrences. Treatment modalities for pulmonary hernia are classified into conservative management and surgical intervention. We present a case of acute intercostal pulmonary hernia in a patient following wedge resection of the left upper lobe via uniportal video-assisted thoracoscopic surgery, which was successfully addressed through manual reinsertion.