bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Ficus pumila L. on Improving Insulin Secretory Capacity and Resistance in Patients Who Develop Diabetes After COVID-19 Infection
Authors: Gonda Kenji , Hai Takeshi , Suzuki Kouichi , Ozaki Akihiko , Thigusa Takashi , Takenoshita Seiichi , Maejima Yuko , Shimomura Kenjyu
Published: December 2024

(1) Background: It has been reported that people affected by COVID-19, an infectious disease caused by SARS-CoV-2, suffer from various diseases, after infection. One of the most serious problems is the increased risk of developing diabetes after COVID-19 infection. However, a treatment for post-COVID 19 infection diabetes has not yet been established. In this study, we investigated the effects of Ficus pumila L. extract, which has traditionally been used to reduce blood glucose level in Okinawa, on patients who developed diabetes after COVID-19 infection.; (2) Methods: Sixty-two rehabilitation patients who developed diabetes after COVID-19 infection were included. The HOMA-β (Homeostatic model assessment of β-cell function) and HOMA-IR (Homeostatic model assessment of insulin resistance) was assessed to evaluate the glucose tolerance.; (3) Results: The HOMA-β was decreased and also HOMA-IR was increased in patient who developed after diabetes after COVID-19 infection. Subsequently, 28 patients were given Ficus pumila L. extract and their HOMA-β and HOMA-IR improved after ingestion. On the other hand, the control group of patients who did not consume Ficus pumila L. showed no improvement in both HOMA-β and HOMA-IR. (4) Conclusions: Ficus pumila L. extract, ingested by patients who developed diabetes after COVID-19 infection, stimulated insulin secretion capacity and improved insulin resistance.
Comparative Self-Evaluation of Patient Education Practice: A Study of Novice and Experienced Physiotherapists
Authors: Grbavac Vedrana , Naletilić Mladenka , Šimić Josip , Forbes Roma
Published: December 2024

Background: Patient education is a key aspect of physical therapy practice, however, the differences in how experienced and novice physiotherapists perceive and apply patient education practice remain underexplored. Understanding these differences influences training approaches and improves physical therapy practice quality. The research aims to determine the difference in self-reported patient education practice between experienced and novice physiotherapists. Methods: A previously published online survey instrument was used to collect data from physiotherapists employed in public health institutions in Bosnia and Herzegovina. The survey questions included demographic characteristics and questions about approaches to patient education, perceived importance, and factors contributing to skills development. Participants were recruited in two groups: experienced physiotherapists with work experience ≥ 11 years (n = 139) and novice physiotherapists with work experience ≤ 5 years (n = 45). Descriptive statistics, such as numbers and percentages, were used to summarize participant responses. Results: Experienced physiotherapists more frequently provided advice on posture, movement correction, daily activity strategies, and pacing while addressing patient concerns and exploring perceptions (p < 0.05). In contrast, novice physiotherapists placed significantly greater value on continuing education courses, considering them an important factor in developing patient education skills (p < 0.05). Conclusion: Experienced physiotherapists prioritize patient education focusing on posture, movement, and self-care strategies compared to novice physiotherapists. However, novice physiotherapists place a higher importance role on continuous education. Identifying these differences may help tailor training and mentorship to improve physiotherapy practice, ensuring better patient outcomes.
Demographic Characteristics and Treatment Outcomes of Intracranial Atherosclerosis: A Single Institutional Analysis of 216 Patients
Authors: Sarshaev Marat , Turdaliyeva Botagoz , Tanbayeva Gulnur , Makhanbetkhan Shayakhmet , Musabekov Maxat , Davletov Dimash , Maidan Aiman , Berdikhojayev Mynzhylky
Published: December 2024

Background Intracranial atherosclerosis (ICAS) is a major cause of ischemic stroke, disproportionately affecting populations with significant vascular risk factors. Although ICAS imposes a considerable health burden, research on this condition in Central Asia remains scarce, especially among the Kazakh population. This study analyzes demographic characteristics, treatment outcomes, and procedural challenges associated with ICAS in 216 patients treated at a single institution. Methods: This retrospective study included patients with ≥70% intracranial artery stenosis confirmed by imaging and presenting with ischemic symptoms. All patients underwent angioplasty and stenting with dual antiplatelet therapy (DAPT). Data collected included demographics, comorbidities, stenosis characteristics, procedural details, and outcomes assessed by the modified Rankin Scale (mRS). Results The median age was 63.5 years (IQR: 57–68.6), and 73.7% were male. Hypertension was the most common comorbidity (98%), followed by ischemic heart disease (58%) and diabetes mellitus (40.9%). Multi-location ICAS was significantly associated with patients over 75 years of age (p=0.025). Additionally, obesity and stenosis severity greater than 70% showed trends toward significance, with p-values of 0.064 and 0.079, respectively. Stenosis predominantly affected the internal carotid artery (54.5%) and vertebrobasilar system (31.6%). The average hospital stay was longer for posterior circulation stenosis (7.1 days) compared to anterior circulation (4.7 days). The periprocedural complication rate was 0.7%, with two deaths attributed to ischemic complications. At follow-up, 4 patients experienced worsening mRS scores (>2), particularly those with severe stenosis in the basilar artery and M1 segment. Conclusion:  ICAS in the Kazakh population is strongly associated with hypertension and aging, with posterior circulation stenosis contributing disproportionately to worse outcomes. The low complication rates highlight the safety of modern endovascular techniques. However, further research is needed to optimize treatment strategies for severe and multi-location ICAS, particularly in Central Asian populations.
Control Error Convergence Using Lyapunov Direct Method Approach for Mixed Fractional Order Model Reference Adaptive Control
Authors: Ceballos Benavides Gustavo Eduardo , Duarte-Mermoud Manuel A. , Martell Lisbel Bárzaga
Published: December 2024

This paper extends Lyapunov stability theory to mixed fractional-order direct model reference adaptive control (FO-DMRAC), where the adaptive control parameter is of fractional order, and the control error model is of integer order. The proposed approach can also be applied to other types of model reference adaptive controllers (MRAC), provided the form of the control error dynamics and the fractional-order adaptive control law are similar. The paper demonstrates that the control error will converge to zero, even if the derivative of the classical Lyapunov function V is positive during a transient period, as long as V(e,ϕ) tends to zero as time approaches infinity. Finally, the paper provides application examples that illustrate both the convergence of the control error to zero and the behavior of V(e,ϕ).
International Perspectives on Skid Resistance Requirements for Pavement Markings: A Comprehensive Synthesis and Analysis
Authors: Bao Jieyi , Zhao Hua , Jiang Yi , Li Shuo
Published: December 2024

Pavement (or road) markings play an important role in road safety, influencing the dynamics of road users through their skid resistance properties. This study provides a comprehensive synthesis and analysis of international perspectives on skid resistance requirements for pavement markings. It examines marking skid test results across various regions, including North America, Europe, and other parts of the world, and emphasizes the impact of different materials and test environments on skid resistance. The study also reviews current skid resistance standards and guidelines, from North American state-level standards to European and global specifications. Furthermore, it discusses the safety implications of these standards for diverse road users, especially motorcyclists, cyclists, and pedestrians. In conclusion, this paper highlights the importance of further innovation and consistency in skid resistance testing and standards to improve road safety.
Pancreatic Neuroendocrine Tumors - Diagnostic Pitfalls of Non-Diabetic Severe Hypoglycemia: Literature Review and Case Report
Authors: Popa Simona Georgiana , Golli Andreea Loredana , Matei Cristina Florentina , Sonei Alexandra Nicoleta , Vere Cristin , Cimpeanu Radu , Munteanu Marian , Munteanu Alexandru
Published: December 2024

Background/Objectives: Hypoglycemia in the case of non-diabetic persons is a rare event, being usually, initially misinterpreted based on the symptoms that can mimic various diseases, especially of a neuro-psychiatric nature. In case of identification of insulin-mediated hypoglycemia, the evaluation of pancreatic neuroendocrine tumors, which represent the most common and worrisome causes of non-diabetic insulin-mediated hypoglycemia, must be considered. Methods/Results: We present the case of a 57-year-old patient, hospitalized for a history of approximately one month of recurrent episodes of symptoms suggestive for severe hypoglycemia. The biological evaluation performed during an episode of hypoglycemia showed a plasma glucose value of 44 mg/dl, insulinemia 16.3 µU/ml, C peptide 3.72 ng/ml, HbA1c 4.99%, absence of urinary ketone bodies and anti-insulin antibodies <0.03U/ml. The CT and MRI examination showed a 15.3/15 mm rounded tumor in the pancreatic corporeo-caudal region. The pancreatic tumor formation was enucleated and the histopathological and immunohistochemical analysis confirmed the diagnosis of pancreatic neuroendocrine tumor with a positive reaction for chromogranin A, synaptophysin and insulin, without malignancy features (Ki 67 positive in 1% of the tumor cells). The postoperative evolution was favorable, without episodes of hypoglycemia, the fasting insulinemia one day after surgery being 4.1 µU/ml and HbA1c at three weeks postoperatively being 5.51%. Conclusions: The management of patients with hyperinsulinemic hypoglycemia secondary to insulinoma involves multidisciplinary collaboration with an important role in recognizing symptoms suggestive of hypoglycemia in a person without diabetes, initiating biological and imaging evaluation, establishing the optimal therapeutic option and histopathological confirmation.
Comparing the Effects of Collagen Hydrolysate and Dairy Protein on Recovery from Eccentric Exercise: A Double Blind, Placebo-Controlled Study
Authors: Barclay Rachel , Coad Jane , Schraders Katie , Barnes Matthew J
Published: December 2024

Consuming collagen hydrolysate (CH) may improve symptoms of exercise-induced muscle damage (EIMD), however its acute effects have not been compared to dairy protein (DP), the most commonly consumed form of protein supplement. Therefore, this study compared the effects of CH and DP on recovery from EIMD. Thirty-three males consumed either CH (n=11) or DP (n=11), containing 25 g of protein, or an isoenergetic placebo (n=11) immediately post-exercise and once daily for three days. Indices of EIMD were measured before and 30 minutes, 24, 48, and 72 hours after 30 minutes of downhill running on a -15% slope at 80% of VO2max speed. Downhill running induced significant EIMD, with time effects (all P < 0.001) for delayed onset of muscle soreness (visual analogue scale), countermovement jump height, isometric midthigh pull force, maximal voluntary isometric contraction force, running economy, and biomarkers of muscle damage (creatine kinase) and inflammation (interleukin-6, high-sensitivity C-reactive protein). However, no group or interaction effects (all P > 0.05) were observed for any outcome measures. The findings suggest that post-exercise consumption of CH or DP does not improve indices of EIMD during the acute recovery period, in recreationally active males.
Economic Sustainability Assessment of Paulownia Farms in Dual Production System – Case Studies in Temperate Climates
Authors: Negrușier Cornel , Buzan Livia Ramona , Păcurar Ioan , Sîngeorzan Steluța Maria , Ceuca Vasile , Colișar Alexandru , Andreica Ileana , Rózsa Sándor , Borsai Orsolya
Published: December 2024

Paulownia trees represent a convergence of ecological innovation and economic opportunity. Beyond their extraordinary growth rates, adaptability to diverse climates, and capacity to produce high-value timber, Paulownia farms offer a unique solution to pressing environmental and economic challenges. However, economic sustainability is the crucial factor for any farmer to decide the introduction of this species. Therefore, the current study aimed to evaluate the profitability of seven existing paulownia farms from Romania. The economic analysis has been carried out by adopting the discounted cash flow method. The results showed that the cultivation of Paulownia for both timber and woodchip production as a dual production system with an annual gross margin between 27-55% can present a viable alternative as compared to other agricultural crops. However, the profitability highly depends on the selection of plant species according to certain environmental conditions, agricultural practices applied but also on demand and market price variations.
Explainable AI in Diagnostic Radiology for Neurological Disorders – a Review
Authors: Hafeez Yasir , Memon Khuhed , AL-Quraishi Maged S. , Yahya Norashikin , Elferik Sami , Ali Syed Saad Azhar
Published: December 2024

Artificial Intelligence (AI) has recently had unprecedented contributions in every walk of life, but it has not been able to work its way into diagnostic medicine and standard clinical practice yet. Although data scientists, researchers, and medical experts have been working in the direction of design and development of Computer Aided Diagnosis (CAD) tools to serve as assistants to doctors, their large-scale adaptation and integration in the healthcare system still seems far-fetched. Diagnostic Radiology is no exception. Imagining techniques like Magnetic Resonance Imaging (MRI), Computed Tomography (CT), and Positron Emission Tomography (PET) scans have been vastly and very effectively employed by radiologists and neurologists for the differential diagnoses of neurological disorders for decades, yet no AI powered systems, to analyze such scans, have been incorporated into the standard operating procedures in healthcare system. Why? It is absolutely understandable that in diagnostic medicine, precious human lives are on the line, and hence there is no room even for the tiniest of mistakes. Nevertheless, with the advent of Explainable Artificial Intelligence (XAI), the old school black boxes of Deep Learning (DL) systems have been unraveled. Would XAI be the turning point for medical experts to finally embrace AI in diagnostic radiology? This review is a humble endeavor to find the answers to these questions. In this review, we present the journey and contributions of AI in developing systems to recognize, preprocess, and analyze brain MRI scans for differential diagnoses of various neurological disorders, with special emphasis on CAD systems embedded with explainability. We also summarize the challenges up ahead that need to be addressed in order to fully exploit the tremendous potential of XAI in its application to medical diagnostics and serve humanity.
Population and Entropy Fluctuations in Ecology: A Thermodynamic Model of Biological Evolution
Authors: Deli Eva
Published: December 2024

Although Darwin's Theory of biological evolution is the cornerstone of modern biology, it lacks proper physical foundations. We applied the second law of thermodynamics to analyze biological evolution. Oscillating state variables such as entropy, energy, temperature, pressure, and volume can be conceptualized as an endothermic, reverse Carnot cycle. This endothermic process can accumulate genetic and morphological complexity through a multi-step, cyclic process. This cycle alternates between phases that favor order and maximum energy use (low entropy) or high entropy competition, where natural selection promotes minimal entropy production, favoring highly specialized species. Our argument reconciles the contradictions between the maximum power principle and Prigogine's minimum entropy production theory. Periodic mass extinctions act as pivotal reset points, removing highly specialized evolutionary dead ends while creating opportunities for surviving species to initiate new cycles of enhanced complexity. Notably, genetic material serves as an orthogonal, inert medium, carrying innovations forward and enabling the accumulation of biological complexity. Evolution's capacity to enhance complexity spontaneously through entropic effects suggests a conceptual extension: the "second law of intellect," a complementary
Heavy Metal Exposure and Its Health Implications: A Comprehensive Examination
Authors: Fatima Ghizal , Fedacko Jan , Dhole Priya , Mehdi Raza Ammar
Published: December 2024

Toxic metal exposure is a pervasive global health concern, with significant implications for human health. Toxic metals such as lead, mercury, arsenic, and cadmium are widely distributed in the environment due to natural processes and human activities. Industrial emissions, mining, smelting, and agricultural practices contribute to environmental contamination, while consumer products, food, water, and air serve as common exposure pathways for humans. Exposure to toxic metals can occur through inhalation, ingestion, and dermal contact. Inhalation is a significant route for metals like lead and cadmium, primarily through occupational settings and environmental pollution. Ingestion of contaminated food, water, and beverages is a primary route for mercury and arsenic exposure, while dermal contact with contaminated soil, water, or consumer products can also contribute to exposure. Toxic metals exert their adverse effects through various mechanisms, including oxidative stress, disruption of cellular function, and interference with enzymatic processes. These metals can enter cells and tissues, where they bind to biomolecules such as proteins and DNA, leading to cellular damage, inflammation, and apoptosis. The health effects of toxic metal exposure are diverse and can affect multiple organ systems. Neurological effects, including neurodevelopmental deficits in children and cognitive impairment in adults, are well-documented for metals such as lead and mercury. Cardiovascular effects, such as hypertension and increased risk of cardiovascular disease, are associated with cadmium exposure. Renal toxicity, manifested as kidney damage and renal dysfunction, is a common consequence of exposure to metals like cadmium and lead. Additionally, certain toxic metals, including arsenic and cadmium, are classified as carcinogens and have been linked to various cancers, including lung, bladder, and liver cancer. Prevention of toxic metal exposure requires a multi-faceted approach, including regulatory measures, environmental monitoring, and public education. Regulation of industrial emissions, implementation of pollution control measures, and promotion of safer alternatives are essential for reducing environmental contamination. Monitoring programs for environmental and human biomarkers of exposure are critical for assessing exposure levels and identifying at-risk populations. Efforts to mitigate these risks require collaborative action at the local, national, and global levels to implement effective preventive measures and safeguard public health. This comprehensive overview will provide valuable insights into the complex interplay between toxic metal exposure and human health, highlighting the importance of proactive measures to address this global health challenge.
Integrative Language Acquisition and Learning Model (ILALM): A Transformative Framework for Post-Pandemic Language Education
Authors: Eslit Edgar
Published: December 2024

The rapid shift to digital learning brought on by the COVID-19 pandemic has underscored the need for a more dynamic and integrated approach to language acquisition and learning. As education systems worldwide continue to adapt, the limitations of traditional language learning models, which often fail to incorporate technological advancements, have become evident. In response to this challenge, this paper introduces the Integrative Language Acquisition and Learning Model (ILALM), a novel framework that blends traditional theories of language acquisition with modern technologies such as artificial intelligence (AI), virtual reality (VR), and gamification. ILALM aims to address the evolving needs of language learners in the post-pandemic landscape by fostering personalized learning, real-time interaction, and cultural integration within a flexible, blended learning environment. Using a qualitative research methodology, including in-depth literature reviews, documents analyses, and published case studies, the study explores how ILALM can enhance engagement and language proficiency while promoting inclusivity and adaptability. The paper concludes by offering actionable recommendations for school administrators, educators, students, and researchers by proposing directions to examine the model’s long-term impact on language acquisition in diverse educational settings.
Public Health Inspectors Classification and Assessment of Environmental, Psychosocial, Organizational Risks and Workplace Hazards in the Context of the Global Climate Crisis
Authors: Adamopoulos Ioannis , Syrou Niki , Lamnisos Demetris , Dounias George
Published: December 2024

The global climate crisis impacts health in numerous ways, and Public Health Inspectors (PHIs) are also addressing these issues at work. Their responsibilities have evolved in response to this pressing crisis. This study examines the effects of PHIs in classifying and assessing environmental psychosocial, organizational risks and workplace hazards exacerbated by the global climate crisis at the workplace. It highlights PHIs' challenges in adapting to changing environmental conditions and the implications for Public Health. An α mixed-methods approach was utilized, combining Quantitative Reviews, and Secondary Data Analysis in the Development model of occupational risk, and environmental health incidents reported over the past decade, by public health inspectors. PHIs. The methodology is approached from a variety of sources, including PubMed, Medline, EMBASE, CINAHL, Web of Science, ScienceDirect, alongside databases and resources provided by WHO, OSHA. By categorizing environmental risks and workplace hazards PHIs identify and classify these risks, prioritize their efforts, and develop targeted strategies for prevention and mitigation. Findings underscore the necessity for enhanced education, training and resources to effectively address the evolving landscape of environmental health risks, to handle climate-related challenges and continuous education. Public Health services and organizations must enforce regulations for sustainable practices, leading to new workplace dynamics.
Terahertz CMOS High Sensitivity Sensor based on Hybridized Spoof Surface Plasmons Resonator
Authors: Wan Ming , Li Chenchen , Bao Di , Wang Jiangpeng , Lu Kai , Zhang Meng , Qu Zhenyu , Gao Hao
Published: December 2024

In recent years, spoof localized surface plasmons (SLSPs) have gained increasing attention due to their strong electromagnetic wave confinements. Based on the multipole resonance of the SLSPs, a high-Q-factor terahertz resonator based on CMOS technology is proposed. Specifically, a quad-rilateral hybridized SLSPs structure composed of a core and a cavity SLSPs resonator, is designed to reduce electric dimension and improve the Q-factor. The experimentally measured Q-factor reaches 56.7 at 194 GHz, which is a quite high value within the terahertz frequency band, partic-ularly given the compact electrical dimension of 0.081λ0.081λ. Moreover, the pharmaceutical testing in the terahertz frequency range have been successfully conducted, including glucose and two traditional Chinese medicine: Chuan bei and Sanqi. And three frequency shifts(4GHz, 3.2GHz, 1.4GHz) are observed. Thus, the SLSPs resonator holds great potential for high-performance te-rahertz applications.
PROGRESS AND CHALLENGES IN PLUNGE MILLING: A REVIEW OF CURRENT PRACTICES AND FUTURE DIRECTIONS
Authors: Khattab Afraa , Felhő Csaba
Published: December 2024

This review examines recent advancements and ongoing challenges in plunge milling. It is an increasingly utilised machining process renowned for its high material removal rates, particularly with hard-to-machine materials like hardened steels and titanium alloys. Plunge milling’s unique perpendicular tool path offers enhanced stability and reduced lateral cutting forces, making it valuable for applications that demand precision and efficiency, such as aerospace and automotive manufacturing. The paper systematically analyses and synthesises research on critical areas of plunge milling optimization, including tool geometry, material selection, coating technologies, and process parameters, highlighting strategies to mitigate common issues like rapid tool wear and chip evacuation difficulties. In this comprehensive overview, the review introduces theoretical and experimental findings on optimizing plunge milling tools and process parameters—such as cutting speed, feed rate, and coolant delivery—that are essential for improving performance and achieving desirable surface finishes. The paper also explores innovative trends, including AI-driven optimization algorithms and hybrid machining systems, which hold promise for addressing persistent limitations and enhancing plunge milling’s industrial applicability. By consolidating findings from recent studies, this review contributes to a deeper understanding of plunge milling’s role in high-precision manufacturing and identifies future research directions for advancing the process. The insights presented offer practical and strategic implications, aiming to guide ongoing developments in plunge milling technology and its adoption across various precision-oriented industries.
ASSESSMENT OF THE ROOT MEAN SQUARE DEVIATION ON SURFACES MACHINED BY HIGH-FEED TANGENTIAL TURNING
Authors: Sztankovics István , Pásztor István
Published: December 2024

Recent advancements in machining focus on precision, efficiency, and handling harder materials, driven by sectors like aerospace and automotive. Hard machining, or processing materials over 45 HRC, presents challenges such as rapid tool wear, intense heat, and maintaining dimensional accuracy. Innovations in cutting tool materials and CNC technology have improved these processes, but tool degradation and high forces still complicate machining hardened materials. Surface roughness is a key quality metric, impacting performance factors like wear resistance and fatigue life. By optimizing cutting parameters, manufacturers aim to achieve consistent surface finishes, essential for durability in demanding applications. In this paper, the effect of the input parameters (depth of cut, feed, and cutting speed) are analysed on selected surface roughness parameters. The setup parameters were selected according to the full factorial design of experiment method. The results showed that higher feed rates resulted in rougher finishes, leading to greater spacing between profile elements and steeper surface profiles in the studied range.
INFLUENCE OF HELICAL CUTTING-EDGE ANGLE ON END-MILLING STABILITY
Authors: Dyadya Sergei , Kozlova Olena , Tryshyn Pavlo , Yakhno Denys , Dziuba Denys
Published: December 2024

Increasing productivity, machining accuracy and efficient use of resources are important priorities for companies that manufacture competitive products. One of the main problems that hinders these processes is the vibration that occurs during cutting. Various methods are used to suppress vibration, one of which is the use of tools with a variable helical cutting-edge angle. However, when choosing the cutting-edge angle, it is important to consider the types of vibrations that occur during cutting, as they directly affect the efficiency of the milling process. In addition, the use of tools with different cutting-edge geometries, such as wavy, gives positive results in roughing, but becomes ineffective in finishing. The purpose of this paper is to study the effect of the helical cutting-edge angle on the stability of the end-milling at different cutting speeds. Both theoretical aspects and experimental data are considered, which make it possible to evaluate the effectiveness of using tools with different angles of inclination to ensure the stability of the machining process and increase productivity while minimizing vibrations in the most unfavorable third speed zone of oscillations for cutting. To conduct the experiments, a special stand was used to adjust the stiffness of the workpiece, record the vibrations that occur during cutting, and the time of contact between the workpiece and the tool. The milling was performed in the third high-speed oscillation zone using a tool whose design provides for the possibility of adjusting the angle of inclination of the helical cutting edge. Studies confirm that changing the angle of inclination can significantly affect the stability of the milling process, reducing the intensity of oscillations and improving machining accuracy. However, this effect depends on the initial cutting conditions, such as the cutting speed. With its increase, the amplitude of the accompanying free oscillations increases, regardless of the value of the angle of inclination. Ensuring the stability of the end-milling in the third speed zone by changing the angle of inclination is possible only at the speeds that determine the beginning of this zone. However, within the entire speed range covered by the third speed zone, it is impossible to ensure a stable milling process only due to the angle of inclination. The study emphasizes the importance of an integrated approach to selecting cutting parameters to achieve process stability.
Case Reports in Education: A Virtual Orthopaedic Surgery Summit Enhances Medical Student Confidence in Preparedness for Orthopaedic Surgery Subinternships
Authors: Schmerler Jessica , White Ryan C. , Agarwal Amil R. , Harris Andrew B. , Gu Alex , Tabaie Sean , LaPorte Dawn M. ,   on behalf of the Medical Student Orthopaedic Society
Published: December 2024

Introduction:

Medical school curricula offer limited exposure to orthopaedic surgery, and few national initiatives aim to prepare students for orthopaedic surgery subinternships, which are critical for success in matching into orthopaedic residency. In this study, we evaluated the effectiveness of a single-day virtual “Subinternship Summit” for medical students in 2 key areas: 1) enhancing participants' confidence in their preparedness for orthopaedic subinternship rotations and 2) mitigating any disparities based on student characteristics, such as race/ethnicity, gender, or whether or not the student's school is affiliated with a “home” orthopaedic program.

Methods:

In March 2024, a single-day national virtual summit was held, featuring panels on topics relevant to performance during orthopaedic subinternships. The panelists included senior medical students, orthopaedic residents, and attending orthopaedic surgeons from across the United States. Surveys were administered to participants through Qualtrics before and after the summit to collect demographic data and to assess confidence in 6 domains of subinternship performance using 5-point Likert-scale items: overall preparedness, on-call responsibilities, “soft skills,” role in the operating room, role in the outpatient clinic, and understanding of resources. Our analysis included descriptive statistics, paired t tests, and multivariable linear regression. Significance was set at p < 0.05.

Results:

Of 787 medical students who registered for summit, 426 attended, of whom 180 (42%) completed both the presummit and postsummit surveys. Before the summit, students reported low confidence in all domains, with 5 of 6 domains averaging less than moderate (3/5 points). Multivariable analysis revealed no differences in presummit confidence across various demographic characteristics. After the summit, all 6 domains showed significant increases in confidence, with the lowest average being 4/5 (all, p < 0.001).

Conclusions:

This virtual summit effectively increased medical students' confidence in their preparedness and knowledge about orthopaedic surgery subinternships. Given the weight of subinternship performance in the match process, such an initiative may have the potential to increase medical students' success in residency applications.

Level of Evidence:

Level V. See Instructions for Authors for a complete description of levels of evidence.
Your Other Job
Authors: Bell John S.
Published: December 2024

This message concerns an aspect of our jobs which most of us have ignored, principally because we have regarded it as someone else's area of specialization, not ours. Your other job is public relations, a fascinating and important activity in which every one of us has both a responsibility and an opportunity to help our industry win new friends and hold old ones. And if ever the oil and gas business needed friendly understanding it is now.

Such a situation is strange at a time which should be one of pride and honor for the petroleum industry. We have recently commemorated our 100th anniversary, but instead of receiving public commendation for a century of faithful service we find our industry plagued, put upon, and pot-shot by our critics who take every advantage of the woeful lack of public understanding of the simplest facts about oil and gas.

While we may rightfully question the motives of those who attack us, we must also manfully acknowledge our own acts of omission. What we haven't done has helped cause the vacuum which our accusers fill with fables, distorted facts, and misinformation. This they do with purpose and design-they are our enemies-they are out to get us. What we are faced with is no powder puff skirmish; it is a battle for survival.
Injectivity Profile Logging and Its Applications
Authors: Staples D. R. , Haines F. S.
Published: December 2024

The development and application of a technique that utilizes a radioactive solution to identify one of two streams being pumped into a water or gas injection well for establishing an injectivity profile is reported. One stream is fed into the tubing and the other fed into the annulus, with the latter stream containing a radioactive tracer. By controlling the injection rates of each stream, an interface at which the radioactive and non-radioactive streams meet in the annulus is established opposite the zone of interest. A conventional gamma ray sonde hanging in the tubing is used to determine the location of the interface. By a systematic adjustment of the relative stream rates and location of the interface, an injectivity profile is built up. Rates of injection of the two streams are always adjusted so that the sum of the two rates is a constant.

In application, the technique described herein has had primary use in determining the distribution of water and gas intake in input wells to verify their satisfactory operation. In other applications, this technique has been used to diagnose the effectiveness of selective plugging and selective remedial work, to determine whether or not the injection stream enters the zone of interest, to locate casing leaks and plugged wellbore conditions and to locate other anomalies in the wellbore itself.

Representative field data are included covering the use of this technique for injectivity profile surveys in secondary recovery projects.
Transport and Plugging Performance Evaluation of a Novel Recrosslinkable Microgel Used for Conformance Control in Mature Oil Fields with Superpermeable Channels
Authors: Alotibi Adel , Song Tao , Bai Baojun , Schuman Thomas
Published: December 2024

Although recrosslinkable preformed particle gel (RPPG) has been successfully evaluated in the literature for mitigating conformance problems in open-fracture applications, there are no studies that have examined the transportation and plugging performance of microsized RPPGs (micro-RPPG) in high-permeability channels. We systematically evaluated a novel micro-RPPG and its transportation mechanism in matrix-like media. The micro-RPPG can recrosslink to form a bulk gel after being placed in the reservoir, combining the advantages of both in situ and preformed particle gel (PPG) systems. This recrosslinking ability prevents the gel from being washed out easily, ensuring sustained performance under reservoir conditions. In this study, the micro-RPPG characterization, self-healing process, transportation behavior, and plugging performance were investigated. A sandpack model with multipressure taps was utilized to assess the micro-RPPG suspension’s transport behavior and plugging efficiency. In addition, micro-optical visualization of the gel particles was deployed to study the particle size changes before and after the swelling process. Bottle tests showed that micro-RPPG could be dispersed and remain as separate particles in water with a concentration below 8,000 ppm, which is a favorable concentration for particle gel pumping. However, during the flooding test, the amount of micro-RPPG can be entrapped in the sandpack, resulting in a higher microgel concentration (higher than 8,000 ppm), endowing the gel particles with recrosslinking ability even with excessive water. The micro-RPPG could propagate through the sandpack model, and the required pressure gradient mainly depends on the average particle/pore ratio and gel concentration. The gel suspension significantly reduced channel permeability, providing sufficient resistance to post-waterflooding (more than 99.97% permeability reduction). In addition, the evaluation of micro-RPPG retention revealed that it is primarily affected by both gel concentration particle/pore ratios. We have demonstrated that the novel recrosslinkable micro-RPPG can transport through large channels, and it can also provide effective plugging due to its unique recrosslinking property. However, by this property, the new microgel exhibits enhanced stability and demonstrates resistance to being flushed out in such high-permeability environments. Furthermore, with the help of novel technology, it is possible to overcome the inherited problems commonly associated with in-situ gel treatments, including chromatographic issues, low-quality control, and shearing degradation.
Heterogeneity Modeling and Heterogeneity-Based Upscaling for Reservoir Characterization and Simulation
Authors: Madalimov M. , Li D. , Haynes B. , Dair Y. , Ehighebolo I. T. , Ionescu C. L.
Published: December 2024

Reservoir heterogeneity is a key factor in modeling reservoir performance. Heterogeneity measures can be calculated for a given permeability field but are not sufficiently straightforward to reverse the process. Detailed heterogeneity can be built into a fine-scale model but can be lost during upscaling to a coarse scale, no matter which method is chosen from simple averaging to flow-based (FB). In this paper, we propose a method of heterogeneity modeling and heterogeneity-based upscaling with the aim of solving these problems.

Unlike the traditional geostatistical method used to generate a permeability field that is not directly linked to a desired heterogeneity coefficient, the proposed method creates a heterogeneous permeability field directly using a Lorenz coefficient. Using a given Lorenz coefficient as an input, the expected heterogeneous permeability field can be generated via the proposed steps and equations. Using the proposed heterogeneity-based upscaling method, the Lorenz coefficient and curve, defined from the fine-scale model, can be preserved with minimum heterogeneity loss after upscaling such that gas/oil ratio (GOR) can be matched between the fine- and coarse-scale models without using pseudofunctions.

The proposed method has been applied successfully in modeling a giant carbonate oil field in the Caspian Sea consisting of a matrix-dominated platform and a fracture/karst-dominated rim. Due to the field’s complex geology and high H2S content, a dual-porosity/dual-permeability compositional model has been created to model compositional flow within/between matrix and fracture/karst initialized with an abnormally high reservoir pressure. The field surveillance data show that reservoir heterogeneity is a key component for the field reservoir characterization and simulation. The Lorenz coefficient and curves can be estimated from the cores and logs, but the challenge is how to preserve the characteristics of the Lorenz coefficient and curves during modeling, upscaling, history matching, and uncertainty analysis (UA). Application of the new method has demonstrated its ability to overcome this challenge and has significantly improved the quality of the field’s reservoir modeling, upscaling, history matching, and UA. The fine-scale model Lorenz coefficient and curves were directly applied to calculate the coarse-scale permeability. The range of the Lorenz coefficient and curves estimated from cores and logs were used to generate a range of heterogeneous permeability fields for UA. Regional Lorenz coefficients were adjusted based on the mismatches of GOR, and new heterogeneous permeability fields were generated to improve the history-matching quality.
Real-Time Three-Dimensional Transesophageal Echocardiography vs. Three-Dimensional Printing: Detection of Multiple Perivalvular Leaks after Mitral Valve Replacement - A Case Report and Literature Review
Authors: Wang Zhirong , Wan Qiuxian , Fan Chengming , Ai Qi , You Hong , Zhao Tianli , Hu Shijun , Wu Qin
Published: December 2024

To report on a patient who developed multiple perivalvular leaks (PVLs) after a mechanical mitral valve replacement, and how clinicians successfully used real-time three-dimensional (RT-3D) transesophageal echocardiography (TEE) combined with three-dimensional (3D)printing to complete transapical perivalvular closure. Additionally, we reviewed the literature to explore the advantages and disadvantages of multimodal imaging for PVLs. The case is a 63-year-old female patient with a history of rheumatic heart disease underwent mitral mechanical valve replacement, tricuspid valvuloplasty, and left atrial reduction four years ago. She presented with shortness of breath and transthoracic echocardiography (TTE) revealed a PVL. RT-3D TEE combined with 3D printing technology was used to create a 3D model of the patient's heart, which allowed for precise identification of the PVLs. Ultimately, it was determined that the patient had two PVLs. The transapical occlusion was successfully performed with the guidance provided of 3D TEE. Postoperative follow-up indicated good recovery for the patient. The integration of 3D ultrasound with color Doppler mapping has demonstrated significant advantages in the identification and characterization of multiple PVLs. Furthermore, the synergistic application of RT-3D TEE and 3D printing technology facilitates superior precision and accuracy in PVLs closure, ensuring optimal positioning of occlusive devices. Utilizing multimodal imaging techniques is crucial for the effective management of PVLs, as it furnishes clinicians with vital data necessary to ensure the success of therapeutic interventions.
Experiences, perceptions and ethical considerations of the Malaria Infection Study in Thailand (MIST)
Authors: Naemiratch Bhensri , Kulpijit Natinee , Ruangkajorn Supanat , Day Nicholas P J , Prachumsri Jetsumon , Cheah Phaik Yeong
Published: December 2024

Background Thailand has made significant progress in malaria control efforts in the past decade, with a decline in the number of reported cases. However, due to cross-border movements over the past 5 years, reported malaria cases in Thailand have risen. The Malaria Infection Study in Thailand (MIST) involves deliberate infection of healthy volunteers with Plasmodium vivax malaria parasites, and the assessment of the efficacy of potential vaccine and drug candidates in order to understand acquired protection against malaria parasites.Methods This paper drew from ethics and social science qualitative study called MIST-ETHICS embedded within the MIST studies. MIST-ETHICS aimed to describe and understand the experiences, perceptions and ethical considerations of the MIST studies. Data were obtained from semi-structured interviews and focus group discussion. A total of 46 participants participated in the study.Results Three major themes emerged: experiences and perceptions of MIST, reasons for joining the study and ethical considerations. We found that though compensation was a motivation for participation, this was secondary to it being beneficial to self (health checks; link to health networks; building merit) and others (medical research contribution; altruism).Conclusions We conclude that the strict inclusion criteria, considered consent processes, and the reputation of the researchers and implementing institutes contributed to a largely positive perception of MIST. We also emphasize the need to continue the collection of ongoing perceptions for quality control such as improving information materials to clarify the purpose of initial phases as contributing to later phases, and the reasons for each selection criterion.Trial registration This manuscript is part of the clinical trials registered under ClinicalTrials.gov IDs NCT04083508 (MIST1) registered on 5 Sep 2019 and NCT05071079 (MIST2) registered on 28 July 2021. However, the manuscript pertains to a study involving human subject enrollment without specimen collection and does not require trial registration
High resolution chest computed tomography responses for a cohort of adult with pulmonary Langerhans cell histiocytosis
Authors: Chang Long , Wang Luo , Liu Zheng-zheng , Lang Min , Lin He , Liu Xiao-yan , Duan Minghui , Zhou Dao-Bin , Cao xinxin
Published: December 2024

Langerhans cell histiocytosis (LCH) is a heterogeneous histiocytosis with various pulmonary manifestations and imaging. We aim to evaluate the pulmonary response of LCH by high resolution chest computed tomography (HRCT) through continuous follow-up.We conducted a retrospective analysis of 73 adult LCH patients with pulmonary involvement. HRCT response was assessed by the change of HRCT global score (nodule score plus cyst score) between the baseline and after therapy. Among them, 69 patients (94.5%) had multi-system LCH with pulmonary involvement. 42 patients received methotrexate and cytarabine regimen, 15 received cytarabine monotherapy, 7 underwent target therapy. 14 (19.2%) achieved complete response (CR) and 45 (61.6%) achieved partial response (PR). The mean global lung-lesion score decreased from 12.2 to 10.6. The mean nodule score decreased from 4.7 to 4.1 and the mean cyst score decreased from 7.4 to 6.5. Overall, 25 (34.2%) exhibited an HRCT response and 3 (4.1%) had HRCT progression, while 45 (61.6%) maintained the same. Among patients with CR or PR, 57.1% and 40.5%, respectively, experienced an HRCT response, whereas no patient with SD or PD had an HRCT response. Multivariable analyses revealed that patients who received low dose cytarabine regimen and those with HRCT score ≥ 10 predicted a shorter PFS.