bluuebunny/crossref_metadata_2025 huggingface dataset:
Relationship between dietary carotenoid intake and sleep duration in American adults: A population-based study
Authors: Deng Ming-Gang , Liu Fang , Wang Kai , Liang Yuehui , Nie Jia-Qi , Liu Jiewei
Published: October 2023

Objective: To investigate the relationship between dietary carotenoid intake and sleep duration.
Methods: Adults enrolled in the National Health and Nutrition Examination Survey (NHANES) 2007-2018 without missing information on dietary carotenoid intake (α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein + zeaxanthin), sleep duration, and covariates were included. Participants’ carotenoid consumption was divided into three groups by quartiles and sleep duration was grouped as short (<7 h/night), optimal (7-8 h/night), and long (>8 h/night). Multinominal logistic regression was constructed to examine the association between dietary carotenoid intake and sleep duration. Restricted cubic spline (RCS) regression was further utilized to explore their dose-response relationship. The weighted quantile sum (WQS) model was adopted to calculate the mixed and individual effect of 5 carotenoid sub-types on sleep duration.
Results: Multinominal logistic regression presented that people with higher intakes of α-carotene, β-carotene, β-cryptoxanthin, lycopene, and lutein + zeaxanthin were less likely to sleep too short or too long. Consistent with the findings from multinominal logistic regression, the RCS models suggested a reverse U-shaped relationship between sleep duration and carotenoid intakes. The mixed effects were also significant, where β-cryptoxanthin and lutein + zeaxanthin were the top 2 contributors associated with the decreased risks of short sleep duration, while β-carotene, α-carotene, and β-cryptoxanthin were the main factors related to the lower risk of long sleep duration.
Conclusion: Our study revealed that the American adults with optimal sleep duration were associated with more dietary carotenoid intake, in comparison to short or long sleepers.
Treatment of mine wastewater using a coal fly ash-based coagulant: Coagulation adsorption isotherm study
Authors: Apua Momboyo Clotilde
Published: October 2023

The authors have requested that this preprint be removed from Research Square.
Vitamin B12 as an epidrug for regulating peripheral blood biomarkers in long COVID-associated visuoconstructive deficit
Authors: Cassiano Larissa , Paula Jonas , Rosa Daniela , Miranda Debora , Romano-Silva Marco , Coimbra Roney
Published: October 2023

Approximately four months after recovering from a mild COVID-19 infection, around 25% of individuals developed visuoconstructive deficit (VCD), which was found to be correlated with an increase in peripheral immune markers and alterations in structural and metabolic brain imaging. Recently, it has been demonstrated that supplemental vitamin B12 regulates hyperinflammation during moderate and severe COVID-19 through methyl-dependent epigenetic mechanisms. Herein, whole peripheral blood cultures were produced using samples obtained from patients with confirmed persistent VCD, and controls without impairment, between 10 and 16 months after mild COVID-19. This experimental model was used to assess the leukocyte expression patterns of 11 biomarkers previously associated with VCD in long COVID and explore the potential of pharmacological B12 in regulating these genes. The results showed that patients with persistent VCD displayed continued upregulation of CCL11 and LIF compared to controls. It is worth noting that elevated serum levels of CCL11 have been previously linked to age-related neurodegenerative diseases. Notably, the addition of 1 nM of vitamin B12 to blood cultures from individuals with VCD normalized the mRNA levels of CCL11, upregulated the neuroprotective HGF, and, to a lesser extent, downregulated CSF2 and CXCL10. There was an inverse correlation observed between CCL11 mRNA levels and methylation levels of specific cytosines in its promoter region. These findings underscore the significance of systemic inflammation in persistent VCD associated with long COVID. Moreover, the study provides evidence suggesting that B12, acting as an epidrug, shows promise as a therapeutic approach for addressing this cognitive impairment.
Application of antibiotic bone cement combined with d-LCFA lobulated perforator flap in treatment of infected tissue defects of foot under the guidance of ERAS concept
Authors: Xu Zhong-Bao , Dai Guo-Guang , Sun Zhong-Ye , Li Hao , Yan Jun , Li Hai-Qing , Guo Zhao-Qi
Published: October 2023

Objective
To evaluate the clinical efficacy of antibiotic bone cement combined with lobulated perforator flap based on the descending branch of lateral circumflex femoral artery (d-LCFA) in treating infected tissue defects of the foot under the guidance of ERAS concept.
Methods
From December 2019 to November 2022, 10 patients with infected tissue defects of the foot were treated with antibiotic bone cement combined with d-LCFA lobulated perforator flap. This cohort comprised 6 males and 4 females, aged 21 to 67 years. All 10 cases underwent debridement and antibiotic bone cement coverage to control infection, with 9 cases undergoing debridement once and one case undergoing debridement twice. After infection control, the d-LCFA lobulated perforator flap was used to repair the tissue defects of the foot, and the donor site was sutured primarily. The flap area ranged from 12 cm×6 cm to 31 cm×7 cm. The follow-up included an evaluation of flap survival, donor site healing, and ambulatory function of the foot.
Results
The follow-up period ranged from 7 to 24 months, averaging 14 months. Infection control was successful in all cases. The flaps had excellent survival rates, and the donor site healed by first intention. Based on the American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot scale, pain and function were evaluated as excellent in 3 cases, good in 5 cases, and moderate in 2 cases.
Conclusion
The application of antibiotic bone cement combined with d-LCFA lobulated perforator flap is an effective method for infected tissue defects of the foot with the advantages of simplicity, high repeatability, and exact curative effects. The application of d-LCFA lobulated perforator flap in wound repair reduces iatrogenic injury, shortens hospital stays, lowers medical expenses, and accelerates patient rehabilitation, aligning with the ERAS concept. Therefore, it is a practice worth promoting in clinical use.
The efficacy of virtual reality technology on postoperative rehabilitation of patients with cervical spondylotic myelopathy(CSM): study protocol for a randomized controlled trial
Authors: Wu Jiajun , Sun Zhongchuan , Ge Zhichao , Zhang Dong , Xu Jianghan , Zhang Rilin , Liu Xuecheng , Zhao Qing , Sun Hao
Published: October 2023

Background
Patients with cervical spondylosis myelopathic (CSM) may experience severe neurological dysfunction due to untimely intervention of the spinal cord compression after surgery. These disorders may lead to sensory and motion disorders, causing considerable psychological distress. Recent studies have demonstrated virtual reality (VR) technology can be an effective tool in treating spinal cord injuries.On this basis, we have developed an exploratory research project to investigate the impact of this intervention on postoperative patients with CSM.
Methods
The purpose of this randomized controlled trial was to evaluate the efficacy of combining VR training with conventional rehabilitation for postoperative patients with CSM. A total of 78 patients will be recruited, randomized to either the conventional rehabilitation group or the group receiving VR training and conventional rehabilitation.The Japanese Orthopaedic Association (JOA) will be the main measurement, also with secondary outcomes will be measured by the Visual Analog Scale (VAS), Neck Disability Index (NDI), and functional MRI (fMRI).The data analysis will identify differences between the intervention and control groups, as well as any relationship between intra-group brain functional area changes and subjective scales after the intervention.
Discussion
This trial aims to investigate the effect of VR training on postoperative rehabilitation for patients with CSM after 12 intervention treatments. Positive and negative measurement results would further our understanding of the effectiveness of the intervention and its neural impact. If effective, it would provide new evidence for treatment option of postoperative rehabilitation of CSM.
Trial registration
Chinese Clinical Trial Registry (ChiCTR2300071544).Registered 17 May 2023, https://www.chictr.org.cn/
Building a communication and support network among Quality Improvement teams in Nursing Homes: a longitudinal study of the SCOPE trial
Authors: Nooraie Reza Yousefi , Qin Qiuyuan , Wagg Adrian , Berta Whitney , Estabrooks Carole
Published: October 2023

Background:
We applied a longitudinal network analysis approach to assess the formation of knowledge sharing and collaboration networks among care aide-led quality improvement (QI) teams in Canadian nursing homes participating in the Safer Care for Older Persons (in residential) Environments (SCOPE) trial which aimed to support unregulated front-line staff to lead unit-based quality improvement (QI) teams in nursing homes. We hypothesized that, its communicative and participatory nature would provide opportunities for peer-support, knowledge-sharing, and collaboration-building among teams.
Methods:
Fourteen QI teams in Alberta (AB) and seventeen QI teams in British Columbia (BC) participated in the study. Communications across nursing homes occurred through a series of 4 collaborative Learning Congresses (training sessions) over a one-year period. The senior leaders of QI teams participated in two online network surveys about the communication/collaboration between teams in their province, one month after the first and six months later, after the fourth Learning Congress. We developed communication and collaboration network maps pertaining to three time points: before SCOPE, at two-months, and at 9 months.
Results:
Over time, teams made significantly more new connections and strengthened existing ones, within and across regions. Geographic proximity and co-membership in organizational chains were important predictors of connectivity before, and during SCOPE. Teams whose members were well connected at baseline disproportionately improved connectivity over time. On the other hand, teams that did not have prior opportunities to connect appeared to use SCOPE to build new ties.
Conclusions:
Our findings suggest the importance of network-building activities to the formation of collaboration networks, amongst QI teams across nursing homes. Active strategies could be used to better connect less connected teams and facilitate collaboration among geographically proximate teams. These findings may inform the development of interventions to leverage existing networks and provide new networking opportunities to develop and sustain organizational improvements.
Nonlinear numerical analysis of corroded reinforced concrete structures using laminated frame elements
Authors: Teodoro Chiara , Carrazedo Rogério
Published: October 2023

This study presents an innovative numerical model built on the position-based finite element method, using laminated frame elements to predict the displacement of beams under corrosion—a common type of damage in reinforced concrete structures resulting from the penetration of chlorides and carbon dioxide. Over time, these reactions lead to detrimental effects such as cracks, reduction of rebars’ area and consequently stiffness reduction. The expected increase of corrosion impact due to climate change-induced rising temperatures and heightened carbon dioxide levels highlights the crucial need to comprehend the structural behavior under corrosive conditions for precise displacement prediction and determination of maintenance intervals. The proposed model incorporates the geometric and physical non-linearity along with the uniform reduction in rebar area that subsequentially affects the elements’ inertia and, therefore, the stiffness of the structure. Notably, the obtained results for beam displacements under carbonation-induced corrosion exhibit promising agreement with existing literature, validating the effectiveness of the proposed approach.
COVID-19 Vaccine Confidence in Zimbabwe and Sierra Leone: An Application of Health Behavior Change Constructs
Authors: West Joshua , Ssentongo Simon , Muhereza Alex , Mustapha Morie , Gemi Ruth , Cherian Dennis , Waugh Rebecca , Crookston Benjamin , Hall Cougar , Linehan Mary
Published: October 2023

Introduction
Over the past three years, the global health community has been primarily focused on matters related to COVID-19, such as infection rates, mortality figures, and vaccination campaigns. While African countries, in general, experienced a milder COVID-19 impact compared to Western nations, they faced challenges in vaccine uptake. Specifically, Zimbabwe and Sierra Leone saw vaccine acceptance rates below global averages. This research delves into the underlying factors that influenced these disparities in vaccine acceptance in these two countries, using the Health Belief Model (HBM) and the Theory of Planned Behavior (TPB) as guiding frameworks.
Methods
This study utilized data from a cross-sectional survey encompassing 2,312 participants from areas where the Africa Christian Health Associations Platform (ACHAP) operates in Zimbabwe and Sierra Leone. The survey assessed respondents' views in line with core HBM and TPB constructs, in addition to their levels of vaccine acceptance. We then employed adjusted regression models to investigate the correlation between health behavior change theory constructs and vaccine confidence, taking into account variables like gender, age, education, and country of residence.
Results
Several associations were identified, including high vaccine confidence correlated with a heightened perceived threat of COVID-19, recognized benefits of vaccination, stronger perceived behavior control, and fewer perceived barriers to vaccination. Conversely, low vaccine confidence was linked to diminished perceived threats, an abundance of perceived barriers, weaker perceived behavior control, and heightened perceptions of barriers.
Discussion
Results underscore the significance and utility of theoretical constructs in understanding variations in vaccine confidence levels. They highlight the importance of relying on well-established theories to grasp decision-making mechanisms and to shape suggestions for behavior modification. Consequently, to boost vaccine acceptance, public health campaigns should focus on reshaping risk perceptions, addressing obstacles, emphasizing the advantages of getting vaccinated, and fostering a sense of self-efficacy within target communities.
Triple-drug combination therapy versus six-month proton pump inhibitor monotherapy in non-Helicobacter pylori Helicobacter eradication: a clinical study.
Authors: TSUKADAIRA Toshihisa , HAYASHI Seiichi , OTA Hiroyoshi , KOBAYASHI Natsuko , AGAWA Hiroyuki , KODAIRA Himiko , SEKIGUCHI Yasuhiro , MATSUMOTO Takehisa , HORIUCHI Kazuki , NEGISHI Tatsuya , TADA Toshifumi
Published: October 2023

Background Reports on eradication of non-Helicobacter pylori Helicobacter (NHPH) gastritis in Japanese patients are rare. We investigated effectiveness of the standard triple-drug combination therapy for Helicobacter pylori eradication and of proton pump inhibitor (PPI) monotherapy in eradication of non-Helicobacter pylori Helicobacter.Methods Subjects were the patients who were diagnosed as NHPH-infected gastritis at Kenwakai Hospital between November 2010 and September 2021, whose NHPH species were identified by polymerase chain reaction (PCR) analysis of urease genes in endoscopically-biopsied samples, and who consented to eradication therapy of NHPH with either the triple-drug combination therapy for one week or PPI monotherapy for six months. Six months after the completion of the first-round eradication, its result was determined with esophagogastroduodenoscopy, microscopic examination, and urease gene analysis. In cases in which the first-round eradication therapy was unsuccessful, the second-round eradication with the other therapy than the first-round was suggested to the patient.Results PCR analysis detected NHPH in 38 patients: 36 as Helicobacter suis and two as Helicobacter heilmannii/Helicobacter ailurogastricus. Fourteen Helicobacter suis-infected and one Helicobacter heilmannii/Helicobacter ailurogastricus-infected patients requested eradication therapy. In the first-round eradication, the triple-drug combination therapy succeeded in four of five patients, while PPI monotherapy succeeded in five of 10 patients. Three of five patients who had been unsuccessful with the latter therapy requested the triple-drug combination therapy as the second-round eradication and all three were successful. In total, the triple-drug combination therapy succeeded in seven out of eight (87.5%) attempted cases, while PPI monotherapy in five out of 10 (50%) attempted cases.Conclusions Triple-drug combination therapy was also effective in NHPH eradication. PPI monotherapy for six months also appeared to be a promising option for eradicating NHPH. The effectiveness of the latter therapy may be attributed to NHPH’s preference for over-acidic environments and PPI’s antacid effects.Study registration: This study was approved by the Research Ethics Committee of Kenwakai Hospital (No. 2017024).
Effects of continuous grafting on the growth and selenium accumulation characteristics in the post-generations of tomato
Authors: Huang Zhi , Song Xiaoli , Meng Shiling , Zhou Wende , Huang Juan , Zhao Yatian , Tang Yi , Sun Bo , Li Huanxiu
Published: October 2023

To clarify the effect of continuous grafting on selenium (Se) uptake using tamarillo as rootstocks and tomato seedlings as scions, a pot experiment was used to study the physiological and selenium accumulation characteristics of progeny seedlings produced by continuous grafting in 10 mg kg− 1 soil. The results indicated that multiple grafting improved the biomass and soluble protein content of post-grafting generation. Chlorophyll a, b, and carotenoids were significantly increased by different numbers of grafting. In addition, POD and CAT activities increased with the number of grafting, but SOD activity decreased. Furthermore, the selenium content in the root significantly increased with the grafting treatments, with increases of 66.43% in the triple grafting, compared to the control. Moreover, the triple grafting treatment resulted in relatively high selenium accumulation in the root and aboveground parts, with increases of 74.48% and 14.29% compared to the control, respectively, which was beneficial for selenium accumulation in the progeny of grafted plants. However, the translocation coefficient decreased, inhibiting the transfer of selenium to the aboveground parts to some extent.
Inherently integrated microfiber-based flexible proprioceptive sensor for feedback-controlled soft actuators
Authors: Lee Jaehong , Kim Hwajoong , Na Hyunbin , Noh Seungbeom , Chang Shinwon , Kim Jinho , Gong Taejune , Shin Gyowook , Lee Chankyu , Lee Seonggyu , Park Yong-Lae , Oh Sehoon
Published: October 2023

For the accurate and continuous control of soft actuators in dynamic environments, the movements of the soft actuators must be monitored in real-time. To this end, various soft actuators capable of self-monitoring have been developed by separately integrating sensing devices into actuators. However, integrating such heterogeneous sensing components into soft actuators results in structural complexity, high manufacturing costs, and poor interfacial stability. Here, we report on intelligent pneumatic fiber-reinforced soft actuators with an inherent flexible proprioceptive sensor that uses only the essential components of typical fiber-reinforced soft actuators. The inherent flexible proprioceptive sensor is achieved by leveraging two parallel conductive microfibers around an elastomeric chamber of the soft actuator, which simultaneously acts as both a capacitive bending sensor and radial expansion limiting fibers of typical fiber-reinforced soft actuators. The proprioceptive soft actuator exhibits excellent mechanical actuation up to 240° bending motion and proprioceptive sensing performance with high sensitivity of 1.2 pF/rad. Mathematical analysis and simulations of the soft actuator can effectively predict the bending actuation and capacitive responses against input pressures. We demonstrate that proprioceptive soft actuators can be used to construct a soft gripping system and prosthetic hand which express various hand gestures and perform dexterous manipulation with real-time proprioceptive sensing capability.
Role of PGPB in phytoremediation of heavy metal contaminated soils and the biochemical responses of Vicia faba-soil system
Authors: Saadani Omar , Abdelkrim Souhir , Taamali Wael , Challougui Imen Fatnassia , Mannai Khedhiri , Jebara Moez , Jebara Salwa Harzalli
Published: October 2023

Phytoremediation is an eco-friendly and promising strategy for heavy metal (HM) removal from polluted soils. The present study focuses on assessing the potential of faba bean - plant growth promoting bacteria (PGPB) symbiosis in phytoremediation and soil fertility restoration. Vicia faba L. var. minor was inoculated with efficient and HMs resistant PGPB, and was cultivated in three soil samples differently contaminated by HMs; through the addition of different concentrations of copper (Cu), zinc (Zn), lead (Pb) and cadmium (Cd).An increase in shoot dry weight (SDW) and nodule dry weight (NDW) was observed after bacterial inoculation mostly in C1 soil. Furthermore, the inoculation effect was marked in the moderately contaminated soil, where a significant increase in shoots Zn, Pb and Cd accumulation (by 56%, 66% and 441, respectively). Likewise, in C1, Cu, Zn, Pb and Cd content in plants was more pronounced in inoculated V. faba by 54%, 217%, 179% and 319%, respectively, compared to the non-inoculated. Nevertheless, HMs induced a significant increase in roots antioxidant enzyme such as superoxide dismutase (SOD), catalase (CAT) and glutathione reductase (GR) and inoculation further enhancing their activities essentially in C1. Moreover, PGPB considerably reduced Cu and Cd available fractions by 31% and 53%, in C1 and C2, respectively, and increased soil nitrogen (N) and phosphorus (P) content, urease and β-glucosidase activities. The obtained results highlight the effectiveness of V. faba- PGPB symbiosis in the reclamation of low and moderately Cu, Cd and Zn contaminated soils. The consortium could be used as biofertilizer to improve soil quality and fertility.
Comparative analysis of ultrastructural and metabolic changes in the transmitting tissue of Ananas comosus (L.) Merr. after various pollinations.
Authors: VIJAYAN VRINDHA , Radhamany P M
Published: October 2023

The study of enzyme activity during pollen development can provide an idea of the role of different enzymes in pollen tube growth and elucidate certain basic patterns and mechanisms of plant growth.The tissue-specific peroxidases in the style transmitting tissue may play a direct role in regulating pollen tube growth. Coordination between pollen and pistil is essential for successful pollination in flowering plants. A.comosus (pineapple) in Bromeliaceae prevents self-fertilization rates due to gametophytic self-incompatibility. The stigma of two commercial cultivars of Ananas was pollinated with its pollen and also pollen from other cultivar. Cross-pollinated stigma showed higher peroxidase activity compared to self-pollinated and open pollinated pistil of the flower. In peroxidase localization reddish color appeared on the stigma of cross-pollinated pistil.TEM analysis showed ultrastructural and metabolic changes in the transmitting cells of styles in Ananas after various pollinations. The cells in the transmitting tissue of Ananas is rich in cytoplasm and numerous large rough endoplasmic reticulum, large vacuole, golgi vesicles and prominent nucleus in cross-pollinated pistil.
Minimally Invasive Tibial Osteotomy and Telescopic Rod Osteosynthesis in Anterior Bowing of Osteofibrous Dysplasia of the Tibia: A Preliminary Study with a Four-Case Report, Avoiding Lesion Resection
Authors: Jing Yanhui , Zhang Zhiqiang , Mo Yueqiang , Wang Dahui , Wu Chunxing , Ning Bo
Published: October 2023

Background: Osteofibrous dysplasia (OFD) occurs most frequently in the tibia and may result in deformity and pathological fracture. Surgical treatment such as curettage or segment excision has been performed but remains controversial due to high complication rates and surgical burden. This study introduces a new method to manage OFD with anterior bowing of the tibia using minimally invasive tibial osteotomy and telescopic rod (TR) osteosynthesis without extensive lesion resection.
Methods: A retrospective study of 4 children with OFD and tibia bowing deformity treated with minimally invasive tibial wedge osteotomy and TR fixation between January 2015 and November 2020 was performed. Results including bone healing, complications, function based on MSTS score, and recurrance of deformity were assessed.
Results: The median follow-up was 29 months. Radiographs showed the median time for union was 3 months. There were no instances of refracture or recurrence of deformity. The mean post-operative MSTS score was significantly higher than preoperative score.
Conclusions: This method avoids large bone defects and reconstructive procedures. It is an effective and minimally invasive approach for managing anterior bowing deformity secondary to OFD while improving function and quality of life.
Level of evidence: Level IV; Case Series; Treatment Study.
Chemotherapy versus personalized therapy for EGFR mutant lung adenocarcinoma resistance to EGFR-Tyrosine Kinase Inhibitors: A Retrospective Dual-Center Study
Authors: Jiang Kan , Wu Lin , Zheng Xinlong , Xu Yiquan , Miao Qian , Zhen Xiaobing , Zhang Longfeng , Huang Cheng , Lin Gen
Published: October 2023

Background
Advanced lung adenocarcinoma patients often develop resistance to EGFR tyrosine kinase inhibitors (EGFR-TKIs), leaving uncertainties regarding subsequent treatment strategies. Although personalized therapy targeting individual acquired resistances (ARs) shows promise, its efficacy has not been systematically compared with platinum-containing doublet chemotherapy, a widely accepted treatment after EGFR-TKIs failure.
Methods
A retrospective dual-center study was conducted involving patients with advanced lung adenocarcinoma and EGFR mutations who developed resistance to EGFR-TKIs between January 2017 and December 2022. Eligible patients were adults aged 18 years or older with an Eastern Cooperative Oncology Group score of 0–1, normal organ function, and no prior chemotherapy. Patients were divided into the chemotherapy group (CG) or personalized therapy group (PG) based on the treatment received after disease progression. The primary endpoints were progression-free survival (PFS) and objective response rate (ORR).
Results
Of the 144 patients enrolled, there were 53 patients in the PG and 91 patients in the CG. The PG acquired resistance to EGFR-TKIs through the MET amplification and small cell lung cancer transformation and 18% of them reported multiple resistance mechanisms. The ORR of the PG was similar to that of the CG (34% vs. 33%, P = 1.0) and the PFS of the PG patients was not statistically different from that of their CG counterparts [4.2 months (95% CI: 3.6–4.8 months) vs. 5.3 months (95% CI: 4.6-6.0 months), P = 0.77].
Conclusions
These findings suggest that the therapeutic efficacy of chemotherapy approximates to that of personalized therapy, which signifies that chemotherapy is still a reliable choice for patients who develop resistance to EGFR-TKIs and that further research is awaited to explore the benefit of personalized treatment.
Financial burden of the surgical treatment for retroperitoneal sarcoma
Authors: Yokoyama Yukihiro , Sunagawa Masaki , Kurimoto Keisuke , Sakai Tomohisa , Nishida Yoshihiro , Ebata Tomoki , Kodera Yasuhiro
Published: October 2023

Background
The surgical treatment for retroperitoneal sarcoma (RPS) is challenging because of its complex clinical features. According to the Japanese National Health-Care Insurance System, the fee for the surgical treatment of RPS is nearly equal to that of open distal gastrectomy for gastric cancer (GC). The purpose of the present study is to compare the financial burdens of surgery for RPS and GC.
Methods
All patients who underwent surgery for GC or RPS between 2020 and 2021 at Nagoya University Hospital were included. The clinical characteristics, surgical fee per surgeon and surgical fee per hour were compared between the two groups.
Results
There were 35 patients in the GC group and 63 patients in the RPS group. In the latter, 37 patients (59%) underwent tumor resection combined with organ resection; the most common organ was the intestine (n = 23, 37%), followed by the kidney (n = 16, 25%). The mean operation time (248 vs. 417 min, p < 0.001) and intraoperative blood loss (423 vs. 1123 ml, p < 0.001) were significantly greater in the RPS group than in the GC group. The mean surgical fee per surgeon was 1,667 dollars in the GC group and 1,022 dollars in the RPS group (p < 0.001); that per hour was 1,388 dollars and 777 dollars, respectively (p < 0.001).
Conclusions
The financial burden of surgical treatment for RPS was unexpectedly higher than that for GC. Additional data are needed to determine the actual costs of RPS treatment and to justify the fee for the surgical treatment of RPS.
Time-Cost and Safety Trade-off in Project Scheduling under Uncertainty
Authors: Nasrolahi Fatemeh , Shahsavari-Pour Nasser
Published: October 2023

The aim of this study is to find a balance between cost, time, and fuzzy safety constraints in project scheduling. The objective is to minimize both the duration and the cost of the project while maintaining the safety standards within acceptable limits. Appropriate attention to safety can lead to increased customer satisfaction. By optimizing significant objectives such as cost and time, along with other project objectives like safety, project managers can deliver superior-quality projects. The existence of multiple factors that could potentially jeopardize project safety significantly impacts initial managerial estimates, and unforeseen changes may arise. Thus, it is crucial to consider the impact of safety on project scheduling, particularly when juggling multiple project objectives. Most real-world optimization problems are more complex and challenging to solve than those solvable through exact methods. Metaheuristic algorithms are typically employed to address NP-hard problems. In this study, we utilize the NHGA metaheuristic algorithm, proving to be more efficient than the classic genetic algorithm. As safety factors in project realms are often uncertain, we employ fuzzy number theory and linguistic variables to measure safety and account for the project manager's risk tolerance.
Symptom Clusters and Influencing Factors in Elderly Patients on Maintenance Hemodialysis
Authors: Weng JiaMin , Lu ChuHan , Huang BiHong , Chen Jing , Yang XiaoLi , Wang MengJing
Published: October 2023

Background
Symptom clusters can provide empirical evidence for the development of personalized and accurate symptom management strategies. This study aimed to investigate symptom clusters in elderly patients on maintenance hemodialysis, and to explore factors influencing symptom clusters.
Methods
We conducted a cross-sectional study at the Huashan Hospital Hemodialysis Center. A total of 171 maintenance hemodialysis patients were enrolled. We noted demographic characteristics and collected biochemical indicators. Symptom presence and distress ratings were assessed using the Dialysis Symptom Index (DSI). Factor analyses and latent profile analyses were used, respectively, to explore symptom clusters and differing levels of distress. Binary logistic regression was used to explore risk factors associated with differing levels of distress in symptom clusters.
Results
The mean (± SD) age of participants in our cohort was 69.10±8.06 years, and 57.9% of patients were male. Six symptom clusters were obtained from our exploratory factor analysis, including a “mental emotional symptom cluster”, a “dialysis insufficiency symptom cluster”, a “neuromuscular symptom cluster”, a “pulmonary-intestinal symptom cluster”, a “vegetative nerve dysfunction symptom cluster”, and a “sexual function symptom cluster”. A three-class solution demonstrated the best fit [low distress class (71.9%), moderate distress class (20.5%), and high-distress class (7.6%)]. Female sex (OR: 3.503; 95%CI:1.424, 8.617), cardiovascular disease history (OR: 3.566; 95%CI:1.470, 8.651), low BMI (OR: 2.965; 95%CI: 1.239, 7.093), high iPTH (OR: 5.559; 95%CI: 1.096, 28.207), and high β2 microglobulin (OR: 2.485; 95%CI: 1.034, 5.974) significantly predicted moderate & high-distress profiles of symptom clusters compared to the low distress profile.
Conclusion
We identified six symptom clusters, and three different levels of distress amongst those clusters, in elderly patients receiving maintenance hemodialysis. Identifying risk factors for higher symptom cluster distress profiles could help formulate accurate and effective symptom management strategies.
Knowledge, Attitudes, and Practices Regarding Monkeypox Surveillance – A Systematic Review and Meta-Analysis
Authors: Shaik Riyaz Ahamed , Ahmed Mohammed Shakil , Miraj Mohammed , Mehta Vini , Mathur Ankita , Obulareddy Vishnu Teja , Barboza Joshuan J. , Sah Sanjit , Rustagi Sarvesh , Sheran Hashem Abu , Kishore Surekha , Mohanty Aroop , Sah Ranjit
Published: October 2023

Background
Core elements such as emergency coordination, cooperative surveillance, community protection, safe and scalable care, countermeasures, and research have been used to direct preparedness and response operations. Among these, healthcare workers (HCWs) attitudes and knowledge regarding monkeypox (Mpox) play a crucial part in epidemic response, prevention, and readiness. We carried out a systematic review and meta-analysis to look into the knowledge, attitudes, and practices (KAP) of HCWs about Mpox surveillance and reporting.
Methods
Using Boolean operators and MeSH keywords, a thorough search was carried out across numerous databases, including PubMed, Scopus, Embase, Web of Science, CINAHL, PsycINFO, Cochrane Library, and Google Scholar. Papers reporting on KAP assessments among HCWs were included according to inclusion criteria. To ensure uniformity in data extraction, a standardized technique was used, and interrater reliability was verified. Quality assessment and meta-analysis were carried out.
Results
There was no statistically significant difference between the average mean KAP groups, according to the pooled odds ratio (ORs) for high knowledge (0.97), high altitude (1.00), and high practice (1.00) scores. High knowledge, attitude, and practice scores made up 35.6%, 32.9%, and 31.5% of the total scores, respectively. The pooled risk ratios (RRs) for high knowledge (0.98), high altitude (1.00), and high practice (1.01) scores were not significant, indicating that there was no discernible difference in KAP scores between the two groups, in line with the results of the OR analysis. Low heterogeneity was found in the examined studies overall and for each KAP category.
Conclusion
This study emphasizes the importance of addressing knowledge gaps and differences in attitudes and practices among HCWs regarding Mpox. Some HCWs showed excellent awareness and positive attitudes, whereas others lacked fundamental skills and preventative measures. The management of prospective Mpox outbreaks should be improved through the implementation of targeted educational interventions.
Analysis of Formation Mechanism of Crystal Form I in Isotactic Polybutene-1 Based on a Melting Memory Method
Authors: Zhang Ziqi , Zhang Weijia , Li Hongshu , Wen Huiying
Published: October 2023

In this paper, the melting memory effect generated by a new protocol of cyclic thermal treatment with form II as “seeds” on the polymorphic transformation in isotactic polybutylene-1(iPB-1) was investigated. Polar Optical Microscope (POM), wide angle X-ray diffraction (WAXD) and Fourier transform infrared spectroscopy (FTIR) were used to study the change of morphology and crystal form II→I transition during aging. Selected crystallization temperature (Tsc) and melting temperature (Tsm) were applied to generate residual nuclei of form II. The cycled and uncycled samples were analyzed to demonstrate the formation of crystal I and polymorphic transformation. The results indicate that the melting memory has a significant effect on tetragonal modification, with an increased nucleation density and an accelerated nucleation speed. The ordered chain sequences in crystal II initiated the formation of crystal nucleus of form I, which subsequently induce fast conversion and increased transition degree in the hexagonal crystal growth. Form I was found to have two formation pathways, including the transformation of the unstable crystal form II and the direct formation from residual crystal and melt, which have been rarely discussed before and may shed light on understanding of crystal formation mechanism in polymorphism polybutene-1.
Fully tunable Fabry-Pérot cavity based on MEMS Sagnac loop reflector with ultra-low static power consumption
Authors: Park Young Jae , Her Man Jae , Jeong Youngjae , Choi Dong Ju , Kim Dong Uk , Lim Min Gi , Hong Myung Seok , Gwon Hyug Su , Han Sangyoon , Yu Kyoungsik
Published: October 2023

The Fabry-Pérot interferometer, a fundamental component in optoelectronic systems, offers interesting applications such as sensors, lasers, and filters. In this work, we show a tunable Fabry-Pérot cCavity consisting of tunable Sagnac loop reflectors (SLR) and a phase shifter based on electrostatic microelectromechanical actuators. The fabrication process of the device is compatible with the standard wafer-level passive silicon photonics platform. The electrical power and energy consumption of the device are extremely low, measuring less than 675nW of static power, and the energy needed for tuning is below 20 pJ. This electrostatic actuation mechanism provides well-balanced, scalable pathways for efficient tuning methodologies. The extinction ratio of the continuously tunable SLR's reflectivity is larger than 20 dB. Full 2π phase shifting is achieved, and all component's actuation times are less than 25 μs.
A Systematic review and Network Meta-analysis of pharmaceutical interventions used to manage chronic pain
Authors: Shetty Ash , Delanerolle Gayathri , Cavalini Heitor , Deng Chunli , Yang Xiaojie , Boyd Amy , Fernandez Tacson , Phiri Peter , Bhaskar Arun , Shi Jian Qing
Published: October 2023

Background: It is estimated 1·5 billion of the global population suffer from chronic pain with prevalence increasing with demographics including age. It is suggested long-term exposure to chronic could cause further health challenges reducing people’s quality of life. Therefore, it is imperative to use effective treatment options. We explored the current pharmaceutical treatments available for chronic pain management to better understand drug efficacy and pain reduction.
Methods: A systematic methodology was developed and published in PROSPERO (CRD42021235384). Keywords of opioids, acute pain, pain management, chronic pain, opiods, NSAIDs, and analgesics were used across PubMed, Science direct, ProQuest, Web of science, Ovid Psych INFO, PROSPERO, EBSCOhost, MEDLINE, ClinicalTrials.gov and EMBASE. All randomised controlled clinical trials (RCTs), epidemiology and mixed-methods studies published in English between the 1st of January 1990 and 30th of April 2022 were included. A total of 119 studies were included. The data was synthesised using a tri-partied statistical methodology of a meta-analysis (24), pairwise meta-analysis (24) and network meta-analysis (34). Mean, median, standard deviation and confidence intervals for various pain assessments were used as the main outcomes for pre-treatment pain scores at baseline, post-treatment pain scores and pain score changes of each group.
Findings: Our meta-analysis revealed the significant reduction in chronic pain scores of patients taking NSAID versus non-steroidal opioid drugs was comparative to patients given placebo under a random effects model. Pooled evidence also indicated significant drug efficiency with Botulinum Toxin Type-A (BTX-A) and Ketamine.
Conclusion: Chronic pain is a public health problem that requires far more effective pharmaceutical interventions with minimal better side-effect profiles which will aid to develop better clinical guidelines. The importance of understanding ubiquity of pain by clinicians, policy makers, researchers and academic scholars is vital to prevent social determinant which aggravates issue.
Occurrence, source apportionment, and ecological risk assessment of organophosphate esters in surface sediment from the Ogun and Osun Rivers, Southwest Nigeria
Authors: Gbadamosi Muideen Remilekun , Ogunneye Adeyemi Lawrence , Jegede David Olaoluwa , Abdallah Mohamed Abou-Elwafa , Harrad Stuart
Published: October 2023

Organophosphate esters (OPEs) are synthetic chemicals widely used as e.g., flame retardants and plasticisers in various consumer products. Due to the toxicity of OPEs in aquatic ecosystems, exposure of fauna and flora to these compounds is of potential concern. In this study, the concentrations, profiles, sources, and ecological risk of eight OPEs were investigated in two major rivers in southwest Nigeria. Concentrations of SOPEs in surface sediments were in the range 13.1 – 2110 ng/g dry weight (dw) (median: 378 ng/g dw) in the Ogun River and 24.7 - 589 ng/g dw (median: 174 ng/g dw) in the Osun River. These concentrations are broadly within the range of those reported in surface sediment in previous studies conducted in other locations around the world. Tris (butoxyethyl) phosphate (TBOEP) was the dominant OPE in the sediment samples with a median concentration of 337 and 126 ng/g dw for the Ogun and Osun Rivers respectively, while tri-n-butyl phosphate (TnBP) was not detected in any sample. Excluding TBOEP, the chlorinated organophosphate esters: tris(2-chloroethyl) phosphate (TCEP), tris(2-chloro-propyl) phosphate (TCIPP), and tris(1,3-dichloro-2-propyl) phosphate (TDCIPP) were the dominant OPEs in the Osun River, while the aryl-OPEs: triphenyl phosphate (TPHP), 2-ethylhexyl diphenyl phosphate (EHDPP), and tri-m-tolyl phosphate(TMTP) were dominant in the Ogun River. Under a median exposure scenario, moderate ecological risk was predicted from exposure to TCIPP in the Osun River. In contrast, under a high exposure scenario, concentrations of TDCIPP (risk quotient, RQ = 5.33 - 5.37) constituted a high ecological risk in both rivers, with moderate risks observed for tris(2-butoxyethyl) phosphate TBOEP (RQ = 0.022 - 0.18) and TCIPP (RQ = 0.097 – 0.16). Therefore, the risk to aquatic organisms from concomitant exposure to mixtures of OPEs and their metabolites in freshwater ecosystems requires further investigation.
Autism Spectrum Disorder Classification Using Enhanced Whale Optimization and Improved Convolutional Neural Network Algorithm
Authors: R.P Meenaakshisundhari , L Murali , R Rajesh Sharma , A Nivethitha , Abebe Mesfin
Published: October 2023

The phrase "autism spectra disorder" (ASD) signifies a collection of neurodevelopmental diseases that are distinguished by difficulties in interacting with others and communicating, in addition to limited interests and behaviours that are performed in a repetitive manner. The frequency of ASD has grown in recent years, although the disorder's fundamental symptom remains unclear. Even though there is no real cure for ASD, early diagnosis is still preferable since it enables more effective treatment to mitigate symptoms. Usually, ASD is diagnosed by the age of two; however, if the symptoms are minimal, the diagnosis may be made later. In the existing system, classification accuracy and feature selection is not ensured significantly. To solve these issues, the Enhanced Whale Optimization (EWO) algorithm and Improved Convolutional Neural Network (ICNN) algorithm are proposed for ASD prediction effectively. The proposed work consists of preprocessing, feature selection, and classification. The research's three primary components are pre-processing, classification, and feature selection. A procedure known as data pre-processing is used to make meaning of enormous quantities of raw data. EWO is used to identify the most relevant autistic dataset characteristics for the feature selection technique. Using the objective function of the EWO algorithm, selecting optimum fitness characteristics is one way to increase classification precision. The more precise ASD findings are then classified using the ICNN classification algorithm. The experimental outcomes demonstrate that the proposed EWO - ICNN algorithm provides superior sensitivity, accuracy, precision, and False Positive Rate (FPR) compared to existing methods.
Patient characteristics and predictors of mortality among children hospitalised with tuberculosis: A six-year case series study in Uganda
Authors: Amuge Pauline , Becker Greta L , Ssebunya Rogers N. , Nalumansi Esther , Adaku Alex , Juma Michael , Jackson J Brooks , Kekitiinwa Adeodata R. , Elyanu Peter , Wobudeya Eric , Blount Robert J
Published: October 2023

Background: The high case-fatality rates among children with tuberculosis (TB) are reportedly driven by in-hospital mortality and severe forms of TB. Therefore, there is need to better understand the predictors of mortality among children hospitalised with TB. We examined the patient clinical profiles, length of hospital stay, and predictors of mortality among children hospitalised with TB at two tertiary hospitals in Uganda.
Methods: We conducted a case-series study of children below 15 years of age hospitalised with TB, from January 1st, 2016, to December 31st, 2021. Convenience sampling was done to select TB cases from paper-based medical records at Mulago National Referral Hospital (MNRH) in urban Kampala, and Fort Portal Regional Referral Hospital (FRRH) in rural Fort Portal. We fit linear and logistic regression models with length of stay and in-hospital mortality as outcomes.
Results: Out of the 201 children hospitalised with TB, 50 were at FRRH, and 151 at MNRH. The male to female ratio was 1.5 with median age of 2.6 years (Interquartile range-IQR 1-6). There was a high prevalence of HIV (67/171, 39%), severe malnutrition reported as weight-for-age Z-score <-3SD (51/168, 30%). Among children with pulmonary TB who initiated anti-tuberculosis therapy (ATT) either during hospitalisation or within seven days prior to hospitalisation; cough (134/143, 94%), fever (111/143, 78%), and dyspnoea (78/143, 55%) were common symptoms. Children with TB meningitis commonly presented with fever (17/24, 71%), convulsions (14/24 58%), and cough (13/24, 54%). The median length of hospital stay was 8 days (IQR 5-15). Of the 199 children with known in-hospital outcomes, 34 (17.1%) died during hospitalisation. TB meningitis was associated with in-hospital mortality (aOR=3.50, 95% CI=1.10-11.17, p=0.035), while male sex was associated with reduced mortality (aOR=0.33, 95% CI=0.12-0.95, p=0.035). Hospitalisation in the urban hospital predicted a 0.48-day increase in natural log-transformed length of hospital stay (ln-length of stay) (95% CI 0.15- 0.82, p = 0.005), but not age, sex, HIV, malnutrition, or TB meningitis.
Conclusions: In-hospital mortality was high, driven by TB meningitis, with longer hospital stay among children in urban hospitals. The high in-hospital mortality and long hospital stay may be reduced by timely TB diagnosis and treatment initiation among children.