bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical outcomes of conservative surgery for diffuse uterine leiomyomatosis: Experience of 17 cases in a single center
Authors: Kweon Sojung , Kim Sujin , Lee Jeong Soo , Kwack Jae Young , Kwon Yong-Soon
Published: March 2023

Background:
This study aimed to introduce the clinical outcomes of conservative surgery for uterine leiomyomatosis, which also included the specific gross findings of the disease and the specialized surgical technique.
Methods:
All patients with uterine leiomyomatosis underwent conservative surgery with fertility preservation, such as transient occlusion of the uterine arteries(TOUA) adenomyomectomy. All 17 surgeries were performed by a single surgeon (Y. S. Kwon), at Eulji University Hospital between 2018 and 2021. The clinical outcomes included surgical and follow-up outcomes after conservative surgery.
Results:
The mean age of the 17 patients was 36.12 years old (range29-48, SD = 5.4). Fourteen of the 17 patients received a previous myomectomy via a laparotomic (6, 35.3%), laparoscopic (6, 35.3%), or hysteroscopic (2, 11.8%) approach for symptom-relief. The major symptom was menorrhagia (94.1%); the mean operation time was 97.06 minutes (70–160, SD = 22.71), and the mean estimated blood loss was 283.53mL (20-1000, SD = 273.72). One patient required an intraoperative transfusion due to heavy bleeding. The mean hemoglobin level one day after the operation was 9.64g/dL (7.2–13.1, SD = 1.85). The mean hospital stay was 6.47 days (6–8, SD = 0.62). The mean follow-up duration was 116.41 weeks (32–216, SD = 50.88). The recurrence rate was 5/17 (29.4%), and the recurrence-free interval was 50.6 weeks (27–87, SD = 23.71).
Conclusions:
In patients with uterine leiomyomatosis, who want fertility preservation and relief of disease-related symptoms, conservative surgery, such as TOUA adenomyomectomy, could be a good option to preserve the uterus. However, further studies are required to assess fertility outcomes with a long-term follow-up.
Post-graduation intervals related to nonstandard preoperative antibiotic prophylaxis in gynecological procedures and surgical site infection
Authors: Tanvisut Rajavadi , Thongaram Man , Kantathavorn Nuttavut , Krisorakun Wasanai , Saeloo Siriporn
Published: March 2023

Objective
Pre-operative antibiotic prophylaxis guideline has been endorse in many institute aims to reduce surgical site infection. Our study conducted to identify the rate of appropriate antibiotic prophylaxis in gynecological procedures based on American College of Obstetrics and Gynecology’s recommendations. And to determine the relevant factors for surgical site infection (SSI).
Study design
A retrospective case-control study.
Results
Total 112 procedures were studied and found 5.3% rate of SSI. The risk factors for SSI were inappropriate antibiotic use (12% vs 0%, P=0.01), higher age (45 vs 56.5 years, P=0.01), higher body mass index (30.32 vs 24.35 kg/m2, P=0.02), higher fasting blood sugar (129 vs 96 mg/dL, P=0.01), having medical comorbidities with diabetes and/or hypertension (P=0.01), and post-menopausal status (16.7% vs 1.2%, P=0.01). The procedural factors significantly related to SSI were performing procedures in nonoffice hours (13.8% vs 2.4%, P=0.04), surgery for cancer conditions (20% vs 1.1%, P<0.01). The rate of inappropriate antibiotic prophylaxis was 43.8%. The postgraduation interval of more than 3 years was significantly associated with inappropriate antibiotic prophylaxis (55.8% vs 36.2%, P=0.04).
Conclusion
The overall rate of SSI was 5.3% following gynecological procedures. Risk factors for infection were being elderly, higher BMI, higher fasting blood sugar, having medical comorbidities (diabetes and/or hypertension), post-menopausal status, non-office hour procedures, and cancer surgery. Rate of nonstandard preoperative antibiotic prophylaxis was 43.8% and significantly related to SSI. Endorsing standard recommendations on antibiotic prophylaxis is one of the modifiable factors for SSI prevention. A postgraduation interval longer than 3 years was significantly related to nonstandard antibiotic usage.
Study on the influencing factors of bone mass abnormalities in postmenopausal Tibetan women in Tibet
Authors: Zhong Huaichang , Zhou Yaxi , Wang Peng , Jia Qundi , Wan Yang , Xiong Hai
Published: March 2023

Background: To analyze the current situation and influencing factors of bone mass abnormalities in postmenopausal women in Tibet, in order to provide reference for the prevention and treatment of abnormal bone mass in local postmenopausal women.
Methods: A total of 229 Tibetan postmenopausal women were randomly selected from six counties by multi-stage stratified random sampling method. Multiple Logistic regression were used to analyze the status and influencing factors of bone mass abnormalities in Tibetan postmenopausal women.
Results: Among 229 postmenopausal Tibetan women, 81(35.4%) had normal bone mineral density, 126 (55.0%) had osteopenia, and 22(9.6%) had osteoporosis. Altitude is the influencing factor for osteopenia and osteoporosis, creatinine and hypertensive heart disease are the influencing factors for osteoporosis.
Conclusion: Tibetan postmenopausal women have higher rates of bone mass abnormalities in Tibet, but lower prevalence of osteoporosis. High altitude is a protective factor for osteopenia and osteoporosis, while low creatinine and hypertensive heart disease are risk factors for osteoporosis. We suggest that relevant departments should take targeted measures to reduce the prevalence of bone mass abnormalities in Tibetan postmenopausal women and improve their quality of life.
Predicting multiple linear stapler firings in double stapling technique with an MRI-based deep-learning model
Authors: Fu Zhanwei , Li Shuchun , Zang Lu , Dong Feng , Cai Zhenghao , Ma Junjun
Published: March 2023

Background
Multiple linear stapler firings is a risk factor for anastomotic leakage (AL) in laparoscopic low anterior resection (LAR) using double stapling technique (DST) anastomosis. In this study, our objective was to establish the risk factors for ≥3 linear stapler firings, and to create and validate a predictive model for ≥3 linear stapler firings in laparoscopic LAR using DST anastomosis.
Methods
We retrospectively enrolled 328 mid–low rectal cancer patients undergoing laparoscopic LAR using DST anastomosis. With a split ratio of 4:1, patients were randomly divided into 2 sets: the training set (n = 260) and the testing set (n = 68). A clinical predictive model of ≥3 linear stapler firings was constructed by binary logistic regression. Based on three-dimensional convolutional networks, we built an image model using only magnetic resonance (MR) images segmented by Mask region-based convolutional neural network, and an integrated model based on both MR images and clinical variables. Area under the curve (AUC), sensitivity, specificity, accuracy, positive predictive value (PPV), and Youden index were calculated for each model. And the three models were externally validated by an independent cohort of 128 patients.
Results
There were 17.7% (58/328) patients received ≥3 linear stapler firings. Tumor size ≥5 cm (odds ratio (OR)=2.54, 95% confidence interval (CI)=1.15–5.60, p=0.021) and preoperative carcinoma embryonic antigen (CEA) level >5 ng/mL [OR=2.20, 95% CI=1.20–4.04, p=0.011] were independent risk factors associated with ≥3 linear stapler firings. The integrated model (AUC=0.88, accuracy=94.1%) performed better on predicting ≥3 linear stapler firings than the clinical model (AUC =0.72, accuracy=86.7%) and the image model (AUC=0.81, accuracy=91.2%). Similarly, in the validation set, the integrated model (AUC=0.84, accuracy=93.8%) performed better than the clinical model (AUC =0.65, accuracy=65.6%) and the image model (AUC=0.75, accuracy=92.1%).
Conclusion
Our deep-learning model based on pelvic MR can help predict the high-risk population with ≥3 linear stapler firings in laparoscopic LAR using DST anastomosis. This model might assist in determining preoperatively the anastomotic technique for mid–low rectal cancer patients.
Evidence of Zelkova carpinifolia as a potential host of Tuber uncinatum in Hyrcanian temperate forests
Authors: Azar Saeed Mirzavash , Riahi Hossein
Published: March 2023

Tuber uncinatum (Tuberaceae, Pezizales) is a commercially important ectomycorrhizal (EcM) fungal species that associate with many deciduous EcM host species belonging to the Fagales lineage. Because of its host multiplicity among deciduous species, we hypothesized that it may associate with other plant lineages including Rosids which is the most recent common ancestral of the ectomycorrhizae (MRCA-EcM) of Ulmaceae radiated preceding to Fagaceae. The host plant specimens, ascomata, and soil were collected from homogeneous Caucasian elm populationsof the Hyrcanian temperate forests of Iran. Caucasian elm species diagnosis was performed using available botanical sources. The EcM symbiosis evidence and EcMF identity were illustrated by surveying gleba, spore shape, and EcM root anatomy using SEM, light, and stereo-microscopy, followed by molecular analysis. The micrographs obtained from root examination demonstrated the Hartig net penetration among cortical and epidermal cells and the presence of mantle as the EcM sheath. This study supports the EcM symbiosis of T. uncinatum with Zelkova carpinifolia.
The Effect of Mandatory Post-call Relief on Sleep and Wellness in Ophthalmology Residents
Authors: Feng Shu , Davis John A. , Chowdhary Apoorva , Lomazow Whitney , Yi Jonathan S. , Huang Johnson , Ding Leona , Taravati Parisa
Published: March 2023

Background
Multiple duty hour reforms have been implemented to optimize resident wellness through increasing opportunities for sleep recovery, but few studies have recorded objectively measured sleep or shown direct sleep and wellness benefits from such interventions. This study seeks to determine whether mandatory post-call relief policies with a partial night float system improved resident sleep, activity, and burnout among ophthalmology residents taking home call.
Methods
We conducted a two-group cohort study of ophthalmology residents at the University Washington comparing post graduate year-2 (PGY-2) resident sleep, activity, and burnout between the optional post-call relief group from July 1, 2017 to June 30, 2019 to the mandatory post-call relief group from July 1, 2019 to June 30, 2021.
Results
The mandatory post-call relief group recorded longer total sleep on call than the optional post-call relief group (p < 0.001). There was no difference in overnight sleep recorded on call (median 3.4 hours), but residents recorded more time napping in the mandatory post-call relief cohort (p < 0.001). There was no significant difference between cohorts in amount of sleep while not on call. Residents in the mandatory post-call relief cohort recorded higher average daily steps, higher exercise time, and lower sedentary time than residents in the optional post-call relief cohort (p < 0.001). They also recorded lower median emotional exhaustion on the Maslach Burnout Inventory and lower stress in the Depression and Anxiety Stress Scale in the mandatory post-call relief cohort (p = 0.008).
Conclusions
Implementation of mandatory post-call relief policies with a partial night-float system among PGY-2 residents resulted in more post-call naps with more overall physical activity, lower emotional exhaustion scores, and lower stress scores, despite no changes to overnight sleep on call or total sleep.
Traffic light optimization using Non-Dominated Sorting Genetic Algorithm (NSGA2)
Authors: Leal Samara Soares , Almeida Paulo Eduardo M.
Published: March 2023

The number of vehicles in the world has increased significantly. The optimization of traffic light control plans in large cities is an extremely important area of research in traffic engineering, as poorly coordinated traffic lights can lead to increased waiting times for vehicles at traffic lights and thus to long delays at intersections. In addition, suboptimal control plans could contribute to traffic congestion, which has become a major concern for public administrations, as it is one of the factors that reduce productivity and the quality of life of people. In this context, this paper presents a method for Active Control of Traffic Signals (ACTS) associated with the use of NSGA2 multi-objective algorithm, aimed at optimizing the traffic signal control plan in response to the traffic demand of a region of the city of Belo Horizonte (Brazil), at each cycle time interval. The objectives are to minimize the average delay time and the number of vehicles stops per cycle. Actual data collected by the Company of Transport and Traffic of Belo Horizonte (BHTrans) were used with the AIMSUN simulator and the experiments were compared with the current signal control plan used by BHTrans to determine if NSGA2 is efficient in optimizing the traffic control plan of the region under study.
Crop succession and nitrogen splitting fertilization in common bean in newly implemented no-tillage system
Authors: Jardim Celso Antônio , Mingotte Fábio Luiz Checchio , Coelho Anderson Prates , Lemos Leandro Borges
Published: March 2023

The management practices impacts on a crop succession system in newly implemented no-tillage area should be investigated to provide more accurate recommendations. A two-year experiment was conducted in Southeastern Brazil to evaluate the interactions between crop succession (grasses/legume) and nitrogen splitting fertilization in common bean in a production system with newly implemented no-tillage. The plots were formed by three crop succession schemes, with grasses cultivated in spring/summer and the legume crop (common bean) in winter. The cropping systems in spring/summer were: sole maize, maize intercropped with U. ruziziensis and sole U. ruziziensis. The subplots consisted of ten splitting schemes of side-dressing nitrogen fertilization in common bean, with applications in the phenological stages V3, V4 and R5. The common bean grain yield (GY) was 5 to 12% lower when it was cultivated after sole U. ruziziensis compared to other successions. However, when U. ruziziensis was intercropped with maize, the GY of common bean was similar to that obtained in the succession with sole maize. In addition, the intercropping had little effect on the maize agronomic performance. Compared to the application in a single rate, the GY of common bean was on average 12% higher when nitrogen fertilization was split, and the best schemes were 45-00-45 and 45-45-00. Nitrogen fertilization in common bean did not affect the GY of maize in succession. Intercropping of maize with U. ruziziensis and nitrogen splitting fertilization in common bean in succession allows obtaining the ecosystem benefits promoted by the forage without affecting the cash crops yield.
Implementation of interactive control of a crane ship model in MATLAB/Simulink environment
Authors: Makarov Oleg , Yase Hayato , Harada Takashi
Published: March 2023

The increased demand for performing crane ship modeling has led to the necessity for fast and accurate numerical experiments. This paper presents an approach for creating a numerical model of a crane vessel with a suspended load that allows for real-time control of crane parts. The model is developed in the MATLAB/Simulink environment, which makes it possible to extend it further to the user's needs. The authors describe the approach to the calculation of wave-induced ship motions, presents the Simulink block model and describes the features encountered during the simulation process. The possibility of real-time control of the position of crane parts is also shown, keeping the calculation speed of the ship hydrodynamics.
Lean Indian patients with non-alcoholic fatty liver disease (NAFLD) have less metabolic risk factors but similar liver disease severity as non-lean patients with NAFLD
Authors: De Arka , Mehta Manu , Singh Priya , Bhagat Naveen , Mitra Suvradeep , Das Ashim , Duseja Ajay
Published: March 2023

Introduction
Although most patients with NAFLD are obese or overweight, some are lean with normal BMI. Our aim was to assess differences in clinicopathological profile and liver disease severity among lean and non-lean NAFLD.
Methods
Data of 1040 NAFLD patients over last 10 years was analysed. BMI <23kg/m2 categorised lean patients. Non-invasive assessment of steatosis was done by ultrasound and controlled attenuation parameter (CAP) while fibrosis was assessed with FIB-4 and liver stiffness measurement (LSM). FibroScan-AST (FAST) score was used for non-invasive prediction of NASH with significant fibrosis. Histology was reported using NASH-CRN system.
Results
149 (14.3%) patients were lean while 891 (85.7%) patients were non-lean. Diabetes mellitus [25 (16.7%) vs 152 (17.05%), p>0.99], elevated triglycerides [81 (54.3%) vs 525 (58.9%), p=0.33] and low HDL [71(47.6%) vs 479(53.7%),p=0.18] were observed in a similar proportion. Lean patients were less likely to have central obesity [72 (48.3%) vs 788 (88.4%),p<0.001], hypertension [16 (10.7%) vs 239(26.8%),p<0.001] and metabolic syndrome [21 (14.09%) vs 290 (32.5%),p<0.001]. No difference in steatosis assessment was noted using ultrasound (p=0.55) or CAP (0.11). FAST [0.38 (0.18-0.66) vs 0.39 (0.27-0.73),p=0.53],FIB-4 [1.08 (0.65-1.91) vs 1.09 (0.66-1.94),p=0.94] and LSM [6.1 (4.8-7.9) vs 6.2 (4.7-8.6),p=0.19) were similar.
Liver biopsy was available in 149 patients [lean: 19 (12.7%), non-lean: 130 (87.3%)]. There was no difference in the number of patients with NASH [4 (21.05%) vs 20 (15.3%),p=0.51], significant fibrosis [2 (10.5%) vs 32 (24.6%),p=0.25] or advanced fibrosis [1 (5.26%) vs 18 (13.84%),p=0.47].
Conclusion
Although metabolic co-morbidities are less common, there is no difference in liver disease severity among both groups.
A Psychometric Evaluation of the Swedish Translation of the Perceived Stress Scale: A Rasch Analysis
Authors: Rozental Alexander , Forsström David , Johansson Magnus
Published: March 2023

Background: Stress reflects physical and psychological reactions to imposing demands and is often measured using self-reports. A widely-used instrument is the Perceived Stress Scale (PSS), intended to capture more general aspects of stress. A Swedish translation of the PSS is available but has not previously been examined using modern test theory approaches, such as Rasch analysis.
Methods: The current study used data from 793 university students to investigate the dimensionality of different version of the PSS (14, 10, and 4 items) as well as potential response patterns among the participants.
Results: The current study demonstrates that the PSS-14 has two separate factors, divided between negatively worded items (stress) and positively worded items (self-efficacy), although with only the negative subscale exhibiting good reliability. Response patterns were analyzed using Differential Item Functioning analysis, which did not find an influence of gender on the perceived difficulty of the items, but for age regarding the positive subscale (items 6 and 9). The PSS-10 also demonstrated adequate reliability for the negative subscale, but the PSS-4 was not deemed suitable as a unidimensional scale.
Conclusions: Based on the results, none of the versions of the PSS should be used by sum-scoring all of the items. Only the negative items from the PSS-14 or PSS-10 can be used as unidimensional scales to measure general aspects of stress. Content validity is discussed, questioning the relevance of anger and being upset when measuring more general aspects of stress. Finally, a table to convert the PSS-7 ordinal sum scores to interval level scores is provided.
Big data simulation of science and technology finance supporting Shaanxi urban-rural integration development based on BP neural network algorithm
Authors: Yuling Shi
Published: March 2023

In the context of the current era, if China wants to implement the strategic goal of rural revitalization, it must promote the integrated development of urban and rural areas. This paper takes Shaanxi Province as the main research goal, which is at the strategic intersection of the "the Belt and Road", has an important position, can affect the process of regional coordination and urban and rural integration throughout the country, and is a major province of characteristic agriculture and a national transportation hub. In this context, this paper uses BP neural network algorithm to simulate and analyze the coordinated development of urban and rural areas based on the actual development of science and technology finance in Shaanxi Province. After obtaining the economic status data of the province, this paper builds a regional characteristic platform that can provide targeted science and technology finance services, which can achieve diversified processing, complete multi entity fund supply and maintain the transparency of information between the supply and demand sides. Based on the field survey and literature review and analysis, it can be seen that the ten prefecture level cities included in the study area and province have different levels of coordinated development of urban and rural economy, and there is a Matthew effect characteristic of uneven strength, so the regional differences show a weakening feature, and they need to be adjusted gradually to make them develop in an orderly manner. Based on the research conclusion, this paper carries out the construction of urban-rural economic coordinated development and scientific and technological financial model support, and analyzes the financial support function and actual effect of the province in detail. In this paper, the BP neural network algorithm is applied to the integration of urban and rural development in Shaanxi Province to conduct big data simulation for science and technology finance.
A high fidelity approach to assembling the complex Borrelia genome
Authors: Hepner Sabrina , Kuleshov Konstantin , Tooming-Kunderud Ave , Alig Nikolas , Gofton Alexander , Casjens Sherwood , Rollins Robert E. , Dangel Alexandra , Mourkas Evangelos , Sheppard Samuel K. , Wieser Andreas , Hübner Johannes , Sing Andreas , Fingerle Volker , Margos Gabriele
Published: March 2023

Background: Bacteria of the Borrelia burgdorferi sensu lato (s.l.) complex are the causative agents of Lyme borreliosis. These pathogens are maintained in transmission cycles between tick vectors of the Ixodes ricinus–persulcatus species complex and vertebrate reservoir hosts. Different B. burgdorferi s.l. genospecies vary in their host and vector associations and human pathogenicity but the genetic basis for these adaptations is unresolved and requires completed and reliable genomes for comparative analyses. Linear and circular plasmid genes are associated with host/vector interactions but assembling complete plasmids is challenging due to the high levels of complexity and sequence homology.
Here, using recently developed high-fidelity (HiFi) PacBio sequencing, we explored strategies to obtain gap-free, complete and high quality Borrelia genomes. For this, we sequenced and assembled three isolates belonging to three species within the B. burgdorferi s.l. complex (B. bavariensis, B. garinii and B. valaisiana). We investigated if use of HiFi reads will lead to substantial improvement of genome assemblies.
Results: Stand-alone sequencing and assembly methods are insufficient for the generation of complete and high quality Borrelia genomes. Optimizing genome assembly, quality control and refinement steps, we critically appraised existing techniques to create and ensemble an improved genome reconstruction pipeline.
Conclusion: Our study demonstrates that, with HiFi sequencing and an ensemble reconstruction pipeline with refinement steps, chromosomal and plasmid sequences can be fully resolved, even for complex genomes such as Borrelia. The presented pipeline may be of interest for the assembly of further complex microbial genomes.
Socioeconomic status and depressive symptoms among older adults in China: the mediating role of cognitive function, lifestyle and social participation
Authors: Liu Xiyu , Liu Huimin , Liu Dandan , Zhou Qianyu , Chen Jiajun , Liu Mengting , Sun Changqing
Published: March 2023

Introduction:Socioeconomic status (SES) is an important risk factor for depression in older adults, while cognitive function, lifestyle and social participation also have an impact on depression. The purpose of this study was to explore the mediating role of cognitive function, lifestyle and social participation in the association between SES and depressive symptoms.
Methods: This Data was obtained from the Chinese Longitudinal Healthy Longevity Survey (CLHLS) (2017-2018). A total of 7595 participants at age 65 or older were included in this study. The 10-item of the Center for Epidemiologic Studies Depression Scale (CES-D-10) was used to measure depressive symptoms in older adults. SES was assessed using a composite index by considering the participant's education level, occupation, and economic status. Cognitive function was assessed by the Mini Mental State Examination (MMSE). The lifestyle and social participation scores were constructed by collecting information on relevant items in the questionnaire. Mediating effect analysis was used to explore the mediating effect of cognitive function, lifestyle and social participation in the association between SES and depression in older adults.
Results: The incidence of depressive symptoms was 41.1% among 7595 participants. SES negatively predicted depression in older adults (b = -0.887, P< 0.001) after controlling for sociodemographic variables and health status variables. In addition, SES had a significant mediating effect on depression in older adults through “cognitive function” (b = -0.071, 95%CI: -0.095~-0.048), “lifestyle” (b = -0.177, 95%CI: -0.213~-0.140) and “social participation” (b = -0.068, 95%CI: -0.095~-0.042), respectively.
Conclusion: It is necessary not only to change the disadvantaged status of SES of some elderly groups, but also to improve their cognitive level, advocate a healthy lifestyle and promote their active social participation.
Screening for Generalized Anxiety Disorder in Older Adults who visited an Outpatient Clinic in a Low-Resource Setting
Authors: Segura-Chorres Luis Angel , Tello-Rodriguez Tania , Galvez-Cano Miguel , Casas-Vasquez Paola Marcelina , Aliaga-Diaz Elizabeth Garby , Orrego-Ferreyros Luis Alexander , More-Bustos Hodaya Ana Carolina
Published: March 2023

PURPOSE:This study aimed to screen for Generalized Anxiety Disorder (GAD) in older adults who visited the outpatient clinic of a general hospital in Lima, Peru.
METHODS:We conducted a cross-sectional study between January and March 2014 in the outpatient services of the Cayetano Heredia Hospital (HCH). Adults aged ³60 years and who provided written informed consent were included. Patients with communication difficulties and cognitive impairment were excluded. We screened for GAD with a Spanish version of the Penn State Worry Questionnaire (PSWQ). In addition, other variables such as depressive symptoms, independence in performing daily activities and social support were explored.
RESULTS:Five hundred twenty-six older adults participated, 84.6% were between 60-79 years and 15.4% were ≥80 years. A positive screening for GAD was present in 23.2%, moderate-severe depressive symptoms in 11.7% and mild depressive symptoms in 33.8%. Older adults with moderate-severe depressive symptoms had 31.42 times the prevalence of a positive screen for GAD compared to those without depressive symptoms. In addition, older adults with social problem had 3.77 times the prevalence of a positive screen for GAD compared to those with adequate social support.
CONCLUSION: The screening for GAD was positive in almost one-quarter of older adults who visited the outpatient clinic of a general hospital. Depressive symptoms were present in approximately half of the study population.
Asynchronous Dichoptic Visual Perceptual Training for Patients with Primary Open-Angle Glaucoma: A Pilot Study
Authors: Li Jiameng , Huang Xin , Zhang Chun , Pu Mingliang , Xu Ke
Published: March 2023

Purpose
We aimed to observe changes in the visual function of patients with primary open-angle glaucoma (POAG) after undergoing binocular asynchronous visual training.
Methods
Seven patients with POAG with binocular visual field defects underwent binocular asynchronous dichoptic virtual reality (VR)-based visual perceptual training for 20 days (45 min/session/day, 5 sessions/week, for 4 weeks). Perimetry, contrast sensitivity (CS), and vision-related quality of life assessments were performed for all patients.
Results
Six months after completing training, nine of 14 eyes showed better performance in the perimetry (the mean deviation [MD] of perimetry was improved as compared to baseline), including six severe eyes and three mild POAG eyes. Moreover, the MD values of four of the nine eyes showed significant improvement (more than 1-dB increase as compared to baseline), including three severe eyes and one mild POAG eye. However, the MD values did not differ significantly between baseline and post-training. Contrast sensitivity tests, performed at three spatial frequencies (3, 6, and 18 cycles/degree) were significantly enhanced after asynchronous dichoptic training (p = 0.021, 0.026, and 0.020, respectively).
Conclusion
Patients with POAG, particularly those with severe POAG, performed significantly better in perimetry after training. All patients showed significantly improved performance on the CS tests. Improvements in visual function were sustained for at least 6 months. These results suggest that visual rehabilitation in patients with POAG can be achieved through asynchronous VR-based dichoptic visual perceptual training. A larger randomized clinical trial is required to confirm these effects.
Trial registration:
The trial registration number is #ChiCTR2100054625.
Early diagnostic value of serum IGF-1, FGF23 and Klotho in girls with rapidly progressive central precocious puberty
Authors: Liu Yuping , Cheng Yaying , Sun Meng , Hao Xiaojing , Li Mengmeng
Published: March 2023

Purpose: This study explored the early warning value of serum insulin-like growth factor-1(IGF-1), fibroblast growth factor 23(FGF23), and Klotho levels in girls with rapidly progressive central precocious puberty (RP-CPP).
Method: This is a prospective cohort study on the progression rate of central precocious puberty in girls, who complained of breast development before the age of 8 years and were followed between June 2021and June 2022. At the same time, 28 healthy girls less than 8 years old who had not started puberty were recruited as the control group. The physical examination and laboratory evaluation of each group was completed. Only patients with CPP received pelvic ultrasound examination and bone age test. The ROC curve was used to judge the warning value.
Results: Bone age index (BAI), basal LH levels (BLH), basal LH levels / basal FSH levels (BFSH), peak LH (PLH) / peak FSH (PFSH), IGF-1, Klotho, FGF23 and ovarian volume in RP-CPP group were higher than those in slowly progressive CPP (SP-CPP) group. In the RP-CPP group, IGF-1 was correlated with Klotho, FGF23, and BLH; Klotho was correlated with FGF23 and BLH; FGF23 was correlated with BLH. The AUC of BLH, Klotho, and IGF-1 were 0.931,0.829 and 0.809, respectively. The AUC was the largest when BLH and Klotho were combined.
Conclusions: The BLH, Klotho, and IGF-1 have early warning effects on RP-CPP. The binding analysis improves the effectiveness of diagnosis.
Stress-strain Monitoring Technology for Bolted Fasteners Based on 3D- Digital Image Correlation Method
Authors: Xu Xiaoming , Wang Ziping , Ni Yang , Zhang Yang
Published: March 2023

The monitoring of stress and strain of bolt fasteners is crucial for stress testing threaded holes and bolt ends. To accomplish this, Three-Dimensional Digital Image Correlation (3D-DIC) technology is employed to capture surface morphological feature images before and after deformation through a digital lens. Using 3D reconstruction and DIC operations, the corresponding coordinates of each pixel of the image are obtained, enabling analysis of the strain and displacement fields. The consistency of the experimental results demonstrates that the DIC method is a suitable approach for monitoring stress on bolt and hole edges.
Experimental comparison of non-contact and tactile R-test instruments in dynamic measurement
Authors: Ibaraki Soichi , Onodera Koki , Jywe Wen-Yuh , Hsu Chia-Ming , Chang Yu-Wei
Published: March 2023

The R-Test measures the three-dimensional displacement of a tool center point with respect to a work table in five-axis machine tool, as linear axes are driven synchronously with a rotary axis. This paper experimentally compares the measuring performance of the R-Test instruments with 1) tactile linear displacement sensors, 2) laser displacement sensors based on the refraction in a glass ball lens (Laser R-Test), and 3) laser interferometers, in dynamic tests described in ISO 10791-6:2014. A tactile displacement sensor pushes its measuring contact to the target surface by a spring, and its stiffness can limit the measurement bandwidth. This paper experimentally investigates this influence in the measurement of dynamic synchronization error of rotary and linear axes particularly near the reversal point in the present tests. This paper also presents a test to measure the bandwidth of a tactile displacement sensor.
Deep learning-based ultrasound transducer induced CT metal artifact reduction using generative adversarial networks for ultrasound-guided cardiac radioablation
Authors: Puvanasunthararajah Sathyathas , Camps Saskia , Wille Marie-Luise , Fontanarosa Davide
Published: March 2023

In US-guided cardiac radioablation, a possible workflow includes simultaneous US and planning CT acquisitions, which can result in US transducer-induced metal artifacts on the planning CT scans. To reduce the impact of these artifacts, a metal artifact reduction (MAR) algorithm has been developed based on a deep learning Generative Adversarial Network (CycleGAN) called Cycle-MAR, and compared with iMAR (Siemens), O-MAR (Philips) and MDT (ReVision Radiology), and CCS-MAR (Combined Clustered Scan-based MAR). Cycle-MAR was trained with a supervised learning scheme using sets of paired clinical CT scans with and without simulated artifacts. It was then evaluated on CT scans with real artifacts of an anthropomorphic phantom, and on sets of clinical CT scans with simulated artifacts which were not used for Cycle-MAR training. Image quality metrics and HU value-based analysis were used to evaluate the performance of Cycle-MAR compared to the other algorithms. The proposed Cycle-MAR network effectively reduces the negative impact of the metal artifacts. For example, the calculated HU value improvement percentage for the cardiac structures in the clinical CT scans was 59.58%, 62.22%, and 72.84% after MDT, CCS-MAR, and Cycle-MAR application, respectively. The application of MAR algorithms reduces the impact of US transducer-induced metal artifacts on CT scans. In comparison to iMAR, O-MAR, MDT, and CCS-MAR, the application of developed Cycle-MAR network on CT scans performs better in reducing these metal artifacts.
Thermal management of Induction Motor through the combination of air-cooling and an integrated water-cooling system
Authors: Madhavan Sameer , B Raunak Devdatta P , Konda Yashwanth Reddy , Gundabattini Edison , Mystkowski Arkadiusz , Palka Ryszad , Wardach Marcin , Prajzendanc Pawel
Published: March 2023

In this paper, the thermal management element strategies of the induction motor are developed to assure better endurance and boost efficiency. As the main result, the thermal analysis of an air-cooled and large-capacity induction motor is given considering well-known heat distribution problems. Moreover, this study also presents an integrated approach with two or more cooling strategies to be the need of the hour. The integrated system comprising air- and water-cooled systems are investigated using SolidWorks 2017 and ANSYS Fluent version 2021. Three different flow rates of water 5 LPM, 10 LPM and 15 LPM are analyzed and compared with a conventional air-cooled induction motor, which was validated with the available published resources. Performed analyses indicate that for different flow rates of 5 LPM, 10 LPM and 15 LPM respectively, we have obtained a reduction of temperature accordingly of 2.94%, 4.79% and 7.69%. Hence, the results indicated that an integrated induction motor is efficient in bringing down the temperature compared to air cooled induction motor.
Identifying characteristics of vocational rehabilitation journeys for patients who retain their success.
Authors: Brynjolfsdottir Ragnheidur D. , Haraldsson Saemundur O. , Adair Jason , Bergstrom Mattias , Brynjolfsson Jon H. , Gudnason Vilmundur , Hjaltason Omar , Lund Ruth , McClenaghan Ashley , Siggeirsdottir Kristin , Thomson Sarah L.
Published: March 2023

Vocational Rehabilitation (VR) is a multidisciplinary health and social services process where patients are supported to permanently enter or re-enter the workforce. The aim of this retrospective cohort study spanning the last two decades was to investigate prolonged success after personalised VR and to identify aspects of VR that could be influenced to improve prolonged success. Former patients of an interdisciplinary VR centre in Iceland were surveyed and, using logistic regression, their responses were modelled with respect to socioeconomic information and descriptions of their progression and experience during the VR obtained by rigorous scientific methodology.
Several aspects were found that could be influenced to increase the probability of prolonged success. These relate to three main areas; financial security, social skills and mental status as well as the importance of time and support during the transition from VR to work or education. This was independent of age and gender. Personalised VR is a cornerstone of successful VR.
Factors Affecting the Use of Electronic Logistics Management Information System (eLMIS) Data in Bottom-up Quantification of Health Commodities in Public Health Facilities in Coast Region, Tanzania: A mixed-methods study
Authors: Mkumbwa Nambua M. , Kagashe Godeliver A.B. , Mlugu Eulambius M. , Mwakalukwa Rogers
Published: March 2023

Background: Effective supply chain management is an essential component of effective/affordable healthcare services. It ensures accurate quantification and availability of health commodities. Bottom-up quantification has proved the most effective in Tanzania, it relies mostly on electronic logistic management information system (eLMIS). This study aims to explore factors influencing the use of eLMIS data in bottom-up quantification of health commodities in Coast region, Tanzania.
Methods: An explorative cross-sectional study design employing mixed-method approach (qualitative and quantitative for data collectiona and analysis) was conducted. We focused on healthcare workers whose role is to create health commodities report by eLMIS and finally aggregate in bottom-up quantification tools (N=30). Structured interviews and checklist were adopted for qualitative and quantitative data collection, respectively. Data analyses were achieved with help of NVivo 12 and SPSS version 23.
Results: We found that lack of training to healthcare workers on bottom-up quantification was one of the key factors affecting them to use eLMIS data. Furthermore, insufficient infrastructure such as computers, poor ICT skills to using computers and eLMIS software, lack of regular supportive supervision on the use of eLMIS data, and inadequate fund and qualified staff emerged as other major factors that affect the use of eLMIS data in bottom-up quantification of health commodities in public health facilities. Training was shown to be a significant source of knowledge to improve eLMIS system use, and to enhance positive attitude toward the use of eLMIS data (p=0.003).
Conclusion: In summary, the factors unveiled in the present study may affect forecasting which relies on data that comes from eLMIS which tracks the demand for use of commodities over time. This is of particular concern for consistent availability and affordability of health commodities in public health facilities, as inaccurate forecasting may lead to inaccurate quantification of the commodities.
The shark and ray teeth of the Lower Miocene (Upper Marine Molasse) from Ballendorf, Baden-Württemberg, Southern Germany.
Authors: Höltke Olaf , Maxwell Erin , Bracher Helmut , Rasser Michael W.
Published: March 2023

In an abandoned sand pit near Ballendorf (Alb-Donau District, Baden-Württemberg, sediments of the Upper Marine Molasse (Lower Miocene) are present. In these sediments, 30 shark and ray genera were identified (Aetobatus, Alopias, Araloselachus, Carcharhinus, Carcharias, Centrophorus, Chaenogaleus, Dasyatis, Galeocerdo, Hemipristis, Iago, Isistius, Isogomphodon, Keasius, Notorynchus, Pachyscyllium, Paragaleus, Physogaleus, Pristiophorus, Raja, Rhinobatos, Rhinoptera, Rhizoprionodon, Rhynchobatus, Scyliorhinus, Sphyrna, Squalus, Squatina, Taeniurops, Triakis). However, in this paper we only illustrate and describe the 23 taxa not already discussed in previous publications on the Upper Marine Molasse deposits of Äpfingen, Rengetsweiler and Ursendorf, apart from two exceptions: teeth from jaw positions not previously illustrated, and specimens that are better preserved than those in the previous publications. Specimens only determined as “sp.” were illustrated because it cannot be ruled out that they represent different species to the ones published earlier. Nearly all of the taxa found have recent relatives, only Araloselachus, Keasius and Physogaleusare extinct. Most of the recovered taxa lived on or near the bottom in the shelf region. Alopias and possibly also Keasius lived higher in the water column. With Isistius, a taxon living in the oceanic realm was present, and the Recent representatives of Centrophorus live in deeper waters. Nearly all taxa fed on invertebrates and/or fishes; Isistius also fed as an ectoparasite. Additionally, two generalist feeders (Galeocerdo, Notorynchus) and one filter feeder (Keasius) were identified. The species Carcharias crassidens, which is not common in the Upper Marine Molasse, was also verified. Other fossils which were found in this deposit are remnants of odontocete cetaceans, molluscs, balanid barnacles, algae, and teeth of terrestrial mammals. The palaeoenvironment was a warm, shallow water habitat. Based on greater proximity to the palaeo-coastline, the water depth was probably less than in other Upper Marine Molasse deposits.
The Increase in Diaphragm Thickness in Preterm Infants is Related to Birth Weight: A Pilot Study
Authors: Alonso-Ojembarrena Almudena , Morales-Navarro Alicia , Rodriguez-Medina Julia , Correro-Almagro Antonio , Martínez-García Rosario , Francisco Rosa Lopez-de , González-Haba-Martinez Blanca
Published: March 2023

Purpose
Diaphragm ultrasound (DU) has been used in adult and pediatric critical patients in relation to prediction of extubation success or to detect diaphragm dysfunction, but there is a lack of evidence in neonates. Our aim is to study the evolution of diaphragm thickness in preterm infants, as well as related variables.
Methods
Prospective monocentric observational study that included preterm infants born before 32 weeks (PT32). We performed DU to measure right and left inspiratory and expiratory thickness (RIT, LIT, RET and LET) and calculated the diaphragm-thickening fraction (DTF) in the first 24 hours of life and then weekly until 36 weeks postmenstrual age, death, or discharge. Using multilevel mixed-effect regression, we evaluated the influence of time since birth on diaphragm measurements, as well as bronchopulmonary dysplasia (BPD), birth weight (BW) and days of invasive mechanical ventilation (IMV).
Results
We included 107 infants, and we performed 519 DUs. All diaphragm thickness increased with time since birth, but the only additional variable that influenced this growth was BW: beta coefficients RIT=0.00006; RET=0.00005; LIT=0.00005; LET=0.00004, p<0.001. Right DTF values remained stable since birth.
Conclusions
In our population we found that the higher the BW, the higher diaphragm thicknesses at birth and follow-up. Contrary to the previously published findings in adult and pediatric settings, we were unable to describe a relationship between days of IMV and diaphragm thickness in PT32. The final diagnosis of BPD does not influence this increase either.
In-situ Hearing Threshold Estimation using Gaussian Process Classification
Authors: Boven Christopher , Roberts Reagan , Biggus Jeff , Patel Malini , Matsuoka Akihiro J. , Richter Claus-Peter
Published: March 2023

One in six Americans suffers from hearing loss. While treatment with amplification is possible for many, the acceptance rate of hearing aids is low. Poor device fitting is one of the reasons. The hearing aid fitting starts with a detailed hearing assessment by a trained audiologist in a sound-controlled environment, using standard equipment. The hearing aid is adjusted step-by-step, following well-described procedures based on the audiogram. However, for many patients in rural settings, considerable travel time to a hearing center discourages them from receiving a hearing test and treatment. We hypothesize that hearing assessment with the patient’s hearing aid can reliably substitute the hearing test in the clinic. Over-the-counter hearing aids could be programmed from a distance and can be fine-tuned by the hearing aid wearer. This study shows that a patient-controlled hearing assessment via a hearing aid in a non-clinical setting is not statistically different from an audiologist-controlled hearing assessment in a clinical setting. The differences in hearing obtained with our device and the Gaussian Process are within 3 dB of the standard audiogram. At 250 Hz, the sound delivery with the hearing aid used in this study added an additional reduction of sound level, which was not compensated.
Trends and Variability of Total Column Ozone and its Relationship with Meteorological Parameters during different Seasons
Authors: Reshma T , Varghese Binsy , Varikoden Hamza
Published: March 2023

In this study we investigated the trends and variability in total column ozone, and we attempted to discover the relationship between atmospheric parameters and Total Column Ozone (TCO). It is found that in extratropical locations, January climatology TCO has a higher concentration compared to July, however in the tropics, the opposite is true. It was also shown that places with a greater concentration had a decreasing TCO trend and vice versa. Based on the composite analysis of TCO surplus and deficit years with meteorological parameters, the OLR pattern demonstrates asymmetry in respect to ozone levels between January and July. During January, specific humidity was high in most of the investigated regions, including the Pacific and Indian Ocean, while it got high during surplus years over the equatorial and south-west Pacific. TCO concentration and specific humidity have a dipole-like connection in the equatorial Indian Ocean throughout July. During deficit years in the tropics, the stability value is high in January, while there is a TCO surplus in July when the atmosphere is stable throughout the region. During excess TCO in January, there is downdraft (updraft) in the equatorial Pacific (Equatorial Indian) Ocean, and vice versa in July. During July, there is a dipole-like interaction in the equatorial Indian Ocean. High wind shear is related with excess TCO over the tropical Pacific. TCO have varying relationships during the summer and winter months. Moreover, annual analysis does not completely capture the link between TCO and meteorological conditions.