bluuebunny/crossref_metadata_2025 huggingface dataset:
The Effects of Expansions in Hospitals on the Applicability ofPerformance Certificate Programme
Authors: Kaymakamzade Bilgen , Savaşan Ahmet , Kara Beyhan , Tulbentci Tugsad , Amilo David
Published: August 2023

This study examines how the implementation of the Leadership in Energy and Environmental Design (LEED)certification system has affected healthcare services in private hospitals in North Cyprus. The Near EastUniversity (NEU) hospital achieved Gold-level recognition with a minimum score of 79 points, while Dr.Burhan Nalbanto ̆glu Hospital (BNH) received 31 points. Through sensitivity analysis of indoor air qualityand sustainable land criteria, it becomes evident that hospitals adopting LEED certification systems offerhigher-quality services and present distinct advantages. The findings suggest that aligning government hos-pitals with green certification criteria may contribute to improved patient outcomes. Furthermore, datacollected from government hospitals and the Near East Hospital support a positive relationship betweengreen hospital criteria and enhanced patient and employee satisfaction. Statistical analysis reveals signifi-cant evidence (p < 0.05) that distinguishes hospitals meeting the green hospital certification criteria fromthose that do not. The study also examined the effects of hospital expansions on the applicability of per-formance certificate programs and the management of COVID-19. Various criteria, including LEED points,sustainable sites, regional priorities, water efficiency, design innovation, materials and resources, and indoorenvironmental quality, are analyzed using data from two hospitals, YD ̈U and BNH, to assess changes inthese criteria before and after the expansions. The results provide valuable insights for decision-makers andhealthcare administrators seeking to enhance hospital infrastructure and operations to meet certificationstandards and ensure effective pandemic management. This study highlights the importance of adoptinggreen certification criteria in hospital infrastructure and management to enhance patient outcomes, employeesatisfaction, and overall service quality.
Rhinocerebral Mucormycosis and Trichosporon asahii Fungemia in a patient with acute lymphoblastic leukemia: A rare co-infection and literature review
Authors: Hu Liuyang , Liu Guiliang , Wang Xiuri , Chen Xingchun
Published: August 2023

Background
We report one rare case of concomitant rhinocerebral mucormycosis and Trichosporon asahii (T. asahi) Fungemia secondary to Pseudomonas aeruginosa bloodstream infection(BSI) in a neutropenic patient with acute lymphoblastic leukemia. A review of the literature is included.
Case presentation:
A 1-year-old baby was diagnosed with B-line acute lymphoblastic leukemia and received regular chemotherapy which was admitted to hospital for vomiting, diarrhea, low fever and poor mental reaction. Carbapenem resistant- Pseudomonas aeruginosa was isolated via blood culture, and ceftazidime/ averbactam was administrated. The patient presented with necrotizing lesion on the right side of the nasal alar and the right corner of the eye. Later, necrosis rapidly expanded to almost his entire face on the 8th day, Rhizopus delemar and T. asahi was isolated from necrotic tissue. T. asahi was further recovered via blood culture. The anti-infection protocol was changed to treatment of Pseudomonas aeruginosa BSI with ceftazidime/ averbactam, amphotericin B cholesterol sulfate and voriconazole was administrated for Rhizopus delemar and T. asahi. Unfortunately, He deteriorated and died for multiple organ failure and rapid progress of infection.
Conclusions
For acute lymphoblastic leukemia patients, by maintaining a high level of clinical suspicion, promptly starting antifungal treatment, aggressively removing necrotic tissue through surgery, and addressing the underlying immunosuppression, it may be possible to decrease mortality rates.
Suppurative thyroiditis: Coinfection by Nocardia spp. and Mycobacterium Tuberculosis in an immunocompromised patient
Authors: Rueda Jhon Edwar Garcia , Naranjo Andrés David Monsalve , Benítez Carolina Giraldo , Quintero Juan David Ramírez
Published: August 2023

Suppurative thyroiditis (ST) is a rare entity with an incidence of 0.1–0.7% of thyroid diseases. The resistance to infection of the thyroid gland is explained by its encapsulated position, high blood flow, bactericidal action of iodine and extensive lymphatic network. Clinically, ST manifests with pain, fever, erythema, and dysphonia, usually with preserved thyroid function. Fine-needle aspiration is preferred for diagnosis because it not only allows microbiological sampling, but also therapeutic drainage and differentiation with subacute thyroiditis in cases of thyrotoxic. Regarding its etiology, it is most caused by Gram-positive bacteria, mainly Streptococcus and Staphylococcus. Among the Gram-negative, Salmonella is the most isolated. Regarding opportunistic microorganisms, Mycobacterium tuberculosis has a prevalence between 9.3–16%, while Nocardia represents 4%. Nocardia can spread hematogenously to any organ with tropism to the central nervous system and infrequently to the thyroid. It is characterized by abscess formation and chronic progression with relapses despite adequate treatment. Diagnosis requires clinical suspicion and microbiological isolation with an incubation time of up to 14 days, imaging studies are nonspecific and may show abscesses, thyroid scintigraphy is usually abnormal, with evidence of cold nodules. Infections in the thyroid gland are infrequent due to Mycobacterium tuberculosis even in areas where it is endemic; it presents a frequency of 0.1–0.4% of all cases of tuberculosis with a varied range of presentation as solitary nodule, diffuse or multinodular goiter. We present the first report in the literature of an immunocompromised patient with suppurative thyroiditis in coinfection by Nocardia and Mycobacterium tuberculosis.
Validation of key Arctic energy and water budget components in CMIP6
Authors: Winkelbauer Susanna , Mayer Michael , Haimberger Leopold
Published: August 2023

We investigate historical simulations of relevant components of the Arctic energy and water budgets for 39 Coupled Model Intercomparison Project Phase 6 (CMIP6) models and validate them against observation-based estimates. We look at simulated seasonal cycles, long-term averages and trends of lateral transports and storage rates in atmosphere and ocean as well as vertical fluxes attop-of-atmosphere and the surface. We find large inter-model spreads and systematic biases in the representation of annual cycles andlong-term averages. Surface freshwater fluxes associated with precipitation and evaporation as well as runoff from Arctic lands tend to be overestimated by most CMIP6 models and about two thirds of the analysed models feature an early timing bias of one month in the runoff cycle phase, related to an early snow melt bias and the lack of realistic river routing schemes. Further, large biases are found for oceanic volume transports, partly because data required for accurate oceanic transport computations has not been archived. Biases are also present in the simulated energy budget components. The net vertical energy flux at the Arctic surface as well as poleward oceanic heat transports are systematically underestimated by all models. We find strong anti-correlation between average oceanic heat transports and mean sea ice cover, atmospheric heat transports, and also the long-term ocean warming rate. The latter strongly suggests that accurate depiction of the mean state is a prerequisite for realistic projections of future warming of the Arctic. Our diagnostics also provide useful process-based metrics for model selection to constrain projections.
Impact resistance of Macro and Micro steel fibre reinforced Self- Compacted Concrete (SFRSCC) with modelling and reliability analysis
Authors: R Kesavamoorthi , G Mohan Ganesh
Published: August 2023

Adding steel fibres can transform the brittle characteristic of concrete into a ductile state. The objective of the current study is to test the impact resistance of macro and micro steel fibre-reinforced self-compacting concrete (SFRSCC) experimentally by applying a simulated drop-weight impact, as well as statistically and through reliability studies. Cube specimens were used for the experiment. The inclusion of macro and micro steel fibre (SF) greatly increased the concrete mixture’s impact resistance. All the concrete samples exhibited the same failure pattern. Using Response Surface Methodology (RSM), the impact resistance of SFRSCC mixtures can be accurately predicted. The first and failure cracks (N1 and N2) follow a two-parameter Weibull distribution (WD) function of drop-weight impact test.
Numerical conformal mapping for underground tunnels with arbitrary shapes based on Symm’s method
Authors: Chengzhang Jianing , Cheng Jun , Jiang Quan
Published: August 2023

Conformal mapping technique is important in theoretical analysis and numerical computation for the fields of stress and displacement, since that these computations for tunnels with arbitrary shapes are always based on it. In general, a tunnel with arbitrary shape has no analytical solution for conformal mapping. Therefore, the study of numerical method for the conformal mapping has great significance. The basic functions of numerical conformal mapping are given based on Symm’s method. Furthermore, the inverse mapping functions were deduced firstly according to the relationships between the boundary nodes in physical and mapped plane. Compared to the other numerical methods, the presented method has some advantages such that, it is simple in concept to be understood, and can give the mapping function without iteration process. The method can be used to the numerical forward and inverse conformal mappings for multiple underground tunnels with arbitrary shapes in finite and infinite domains. With the help of method of fundamental solutions, the interpolation equations were proposed for multiple underground tunnels with arbitrary shapes. Finally, several numerical examples for the groups of U-shaped and rectangle tunnels have been given to verify the effectiveness of this method. The numerical results can convergent to real cases, which show that the proposed method has the properties of high accuracy and strong adaptability.
Admissibility and event-triggered dissipative observer-based stabilization of discrete-time T-S fuzzy singular systems via fuzzy Lyapunov functions
Authors: Nguyen Ngoc Hoai An , Kim Sung Hyun
Published: August 2023

This paper presents a new method to design an event-triggered dissipative observer-based control for discrete-time Takagi-Sugeno fuzzy singular systems by handling admissibility, dissipativity, observer-based control, and event-triggered data problems all in one. In particular, the proposed method has the advantage of being able to realize a one-step design framework that simultaneously designs both fuzzy observer and controller gains without using any iterative search algorithms. Furthermore, the proposed method provides the flexibility to set the fuzzy event weighting matrix in conjunction with other variables and supports the performance improvement of control systems by using a fuzzy Lyapunov function. Not only that, different from other eventtriggered output-feedback control techniques, the event generation function of this paper is constructed based on actual system outputs rather than estimated states so that estimation errors are not reflected in the event-triggered mechanism. Finally, two illustrative examples are given to verify the effectiveness of the proposed method.
Numerical simulation of a coupled GMAW process model
Authors: Weigelt Felix , Trautmann Marcus , Ungethüm Tim , Manzke Sebastian , Schmale Hans Christian , Füssel Uwe
Published: August 2023

With the help of numerical simulations of welding processes, precise predictions can be made and, if necessary, elaborate test series for the production of complex components can be reduced. Since the interactions between the arc and the workpiece surface play a central role, a coupled consideration of these sub-areas leads to a reduction of the assumptions on the model side. Therefore, a coupled GMAW process model has been developed, which consists of the partial models of the arc (finite volume method) and the weld pool (smoothed particle hydrodynamics method), and by combining them with a suitable coupling algorithm, the mutual dependence is taken into account. In this paper, the development of the coupled model will be presented. This contribution is funded within the DFG project FU 307/18-1. First, welding tests were carried out to determine boundary conditions and validation parameters. With the help of these values, a further developed, three-dimensional GMAW arc model could be validated. Furthermore, a particle-based weld pool model was developed taking the material transition into account. These partial models were coupled on the side of the arc by varying the distribution of the heat flux density, the arc pressure and the shear stress, and on the side of the weld pool by changing the surface topology of the workpiece. By comparing the dimensions of the melt zones, it was finally possible to verify the overall model and  determine its high validity.
Characterization of a novel endornavirus isolated from the phytopathogenic fungus Rhizoctonia solani
Authors: Li Yangyi , Huang Xingxue , Zhou Guolin , Ye Anhua , Deng Yaohua , Shi Lingfang , Zhang Runhua
Published: August 2023

Rhizoctonia solani endornavirus 8 (RsEV8) was isolated from strain XY175 of Rhizoctonia solani. The full-length genome of RsEV8 is 16147 nucleotides (nt) in length and contains a single open reading frame that encodes a large polyprotein of 5227 amino acid. The polyprotein contains four conserved daomains including viral methyltransferase, putative DEAH box helicase, Viral helicase and RNA-dependent RNA polymerase (RdRp). RsEV8 has a shorter 3' leader (58 nt) and a longer 5' trailer (404 nt) sequences. A multiple sequence alignment indicated that the RdRp of RsEV8 has eight typical RdRp motifs. According to the BLASTp result of the nucleotide sequence, RsEV8 shares 39.31% identity to Rhizoctonia cerealis endornavirus-1084-7. Phylogenetic analysis demonstrated that RsEV8 clustered with members of the genus Betaendornavirus.
Establishment and evaluation of a nomogram prediction model for the risk of vascular calcification in stage 5 chronic kidney disease patients
Authors: Yang Yan , Gong Wenyu , Li Shishi , Chen Sining , Yang Zhiqian , Kuang Chaoying , Zhong Yuzhen , Liu Fanna
Published: August 2023

Vascular calcification (VC) is a common complication of chronic kidney disease (CKD) that has a detrimental effect on patients' survival and prognosis. The aim of this study was to develop and validate a practical and reliable prediction model for VC in CKD5 patients. The medical records of 544 CKD5 patients were reviewed retrospectively. Multivariate logistic regression analysis was used to identify the independent risk factors for vascular calcification in patients with CKD5 and then created a nomogram prediction model. The area under the receiver operating characteristic curve (AUC), Hosmer-Lemeshow test, and decision curve analysis (DCA) were used to assess model performance. The patients were split into groups with normal and high serum uric acid levels, and the factors influencing these levels were investigated.Age, BUN, SUA, P and TG were independent risk factors for vascular calcification in CKD5 patients in the modeling group (P< 0.05). In the internal validation, the results of model showed that the AUC was 0.917. No significant divergence between the predicted probability of the nomogram and the actual incidence rate (x2=5.406,P=0.753) was revealed by the calibration plot and HL test, thus confirming that the calibration was satisfactory. The external validation also showed good discrimination (AUC=0.973). The calibration chart and HL test also demonstrated good consistency. Besides, the correlation analysis of serum uric acid levels in all CKD5 patients revealed that elevated uric acid levels may be related to gender, BUN, P, and TG.
Virome analysis of Desmodus rotundus tissue samples from the Amazon region
Authors: Albuquerque Nádia K. , Silva Sandro P. , Aragão Carine F. , Cunha Tânia Cristina A. S. , Paiva Francisco A. S. , Coelho Taciana F. S. B. , Cruz Ana Cecília R.
Published: August 2023

Background: Bats are renowned for harboring a high viral diversity, their characteristics contribute to emerging infectious diseases. However, environmental and anthropic factors also play a significant role in the emergence of zoonotic viruses. Metagenomic is an important tool for investigating the virome of bats and discovering new viruses. Results: 24 families of virus were detected in lung samples by sequencing and bioinfomatic analysis, the largest amount of reads was focused on the Retroviridae and contigs assembled to Desmodus rotundus endogenous retrovirus, which was feasible to acquire complete sequences. The reads were also abundant for phages. Conclusion: Tissue samples provided a large amount of data and could serve as a basis for comparison for other studies that exclusively obtain results through blood or excreta. The identification and taxonomic categorization of viruses hosted by bats carry epidemiological significance due to the potential for viral adaptation to other animals and humans, which can have severe repercussions for public health. Furthermore, the characterization of endogenized viruses helps to understanding the host genome and the evolution of the species.
Synthetic return of the Meldrum’s acid. 2,2-dimethyl-1,3-dioxane- 4,6-dione assisted formation of tetrahydroquinolin-2-one derivatives. Short synthetic pathway to the biologically useful scaffold
Authors: Ryczkowska Małgorzata , Trocka Alicja , Hromova Anna , Makowiec Sławomir
Published: August 2023

A new method for the preparation of tetrahydroquinolin-2-one derivatives has been described. The two-step reaction between enaminone and acylating agent followed by electrophilic cyclization can be performed in a single synthesis procedure, without isolation of intermediates. The whole process is facilitated by the use of acyl Meldrum’s acids which not only shortens the preparation time of the substrates but also easily extends the range of substituents used. Method scope and limitation were verified on various combinations of reagents and revealed general applicability of the method to the synthesis of tetrahydroquinolin-2-one core. Some exceptions to the regular course of the reaction were observed when a strongly EDG was introduced via acyl Meldrum’s acids, and the mechanism of this process was elucidated during the investigation.
Lipopolysaccharide pretreatment increases the sensitivity of the TRPV1 channel and promotes an anti-inflammatory phenotype of capsaicin-activated macrophages
Authors: Vašek Daniel , Fikarová Natálie , Marková Vendula Nagy , Honc Ondřej , Pacáková Lenka , Porubská Bianka , Somova Veronika , Novotný Jiří , Melkes Barbora , Krulova Magdalena
Published: August 2023

Background: The transient receptor potential vanilloid 1 (TRPV1) is well-established in neuronal function, yet its role in immune reactions remains enigmatic. The conflicting data on its inflammatory role, suggesting both pro-inflammatory and anti-inflammatory effects upon TRPV1 stimulation in immune cells, adds complexity. To unravel TRPV1 immunomodulatory mechanisms, we investigated how the TRPV1 agonist capsaicin influences lipopolysaccharide (LPS)-induced pro-inflammatory macrophage phenotypes. Results: Changes in the surface molecules, cytokine production, and signaling cascades linked to the phenotype of M1 or M2 macrophages of the J774 macrophage cell line and bone marrow-derived macrophages, treated with capsaicin before or after the LPS-induced inflammatory reaction were determined. The functional capacity of macrophages was also assessed by infecting the stimulated macrophages with the intracellular parasiteLeishmania mexicana. Conclusion: Our findings reveal that TRPV1 activation yields distinct macrophage responses influenced by the inflammatory context. LPS pre-treatment followed by capsaicin activation prompted increased calcium influx, accompanied by a shift toward an anti-inflammatory M2b-like polarization state.
Design on Modified Glass Fiber Separator by Ball-milled Tin Fluoride particles for Zn Metal Anodes with High Reversibility
Authors: Zhang Huaijun , Yang Hengyu , Wu Banghui , Liang Yongle , Ni Wentao , Xu Guobao , Yang Liwen
Published: August 2023

Aqueous zinc ion batteries (AZIBs) are considered as a promising alternative to lithium-ion batteries for grid-scale energy storage due to superior energy density, high safety, eco-friendliness and low cost. However, uncontrollable zinc dendrite growth and parasitic side reactions seriously compromise the performance of zinc metal anodes, thereby hindering practical development of AZIBs. In this work, zinc metal anodes are reinforced via a SnF2-modified glass fiber separator (denoted as SnF2@GF). Due to excellent ionic conductivity and zincophilicity of SnF2, the SnF2@GF separator can effectively homogenize Zn2+ flux to inhibit the growth of zinc dendrite and the formation of Zn4SO4(OH)6·5H2O byproducts. As a result, the Zn||Zn symmetric cell exhibits highly reversible plating/stripping behaviors for 1400 h at 1 mA cm− 2, and even at 5 mA cm− 2, it can operate stably for more than 1000 h. In addition, the assembled Zn||MnO2 full cells demonstrate a high capacity retention of 80% after 200 cycles at 1 A g− 1. Our results provide a facile and low-cost method of enhancing reversibility of zinc metal anodes for high-performance AZIBs.
Agriculture-derived Cellulose Nanocrystal Hybrid Composite of Chitosan and Polyethylene Glycol for Enhanced Antimicrobial Properties
Authors: Chaudhary Shivani , Jaiswar Gautam
Published: August 2023

The biocompatible nanocomposite of cellulose nanocrystals / Chitosan / Polyethylene glycol was successfully prepared by the solution casting method. The prepared nanocomposite was characterized by UV-visible, Scanning Electron Microscopy (SEM), Fourier transform infrared spectroscopy (FT-IR), and X-Ray diffraction (XRD). UV -visible revealed the composite peaks formed by the absorbing wavelength. SEM images showed the uniformity of the composite formed. In XRD peaks obtained helps in comparative study of the pristine and composite of the material. The nanocomposite obtained had enhanced biocompatibility and antimicrobial activity. The variation study was also done with the help of various percentage composite prepared. The Cellulose nanocrystals/ Polyethylene glycol/chitosan (CPC1%) have different antimicrobial properties in comparison to CPC3% and CPC5% these composites have enhanced antimicrobial properties in comparison to CPC1%. These studies were done against gram-negative bacteria. Various percentages and different bacteria had different properties.
Prognostic significance of right ventricular free wall longitudinal strain in patients undergoing percutaneous edge-to-edge mitral valve repair for functional mitral regurgitation
Authors: Iuliano Giuseppe , Silverio Angelo , Maio Marco Di , Bellino Michele , Esposito Luca , Cristiano Mario , Migliarino Serena , Baldi Cesare , Galasso Gennaro , Vecchione Carmine , Citro Rodolfo
Published: August 2023

Purpose
To evaluate if right ventricular (RV) dysfunction assessed by RV free wall longitudinal strain (RVFWLS) is associated with poor clinical outcome of patients with functional mitral regurgitation (FMR) undergoing transcatheter edge-to-edge repair (TEER), and to investigate the potential incremental value of RVFWLS for prognostic stratification over tricuspid annular plane systolic excursion (TAPSE).
Methods
This study included consecutive FMR patients undergoing successful TEER at our Institution. All patients underwent systematic echocardiographic assessment of RV function with both RVFWLS and TAPSE. Values of TAPSE < 17 mm and of RVFWLS >-20% were considered abnormal. The primary outcome was the composite of hospitalization for worsening heart failure and all-cause mortality.
Results
The study included 102 patients. At long-term follow-up (median 22 months), the primary outcome was reported in 60 (58.8%) patients. Patients with RV dysfunction according to both TAPSE and RVFWLS cut-off values showed a lower survival free from the primary outcome compared to patients with preserved RV function. After weighting for clinical confounders and multivariable adjustment for the main echocardiographic parameters, RVFWLS resulted independently associated with the primary outcome; conversely, TAPSE was not significantly associated with the primary outcome. Among patients with preserved RV function according to TAPSE, impaired RVFWLS identified patients with the lower survival free from the primary outcome compared to those with preserved RVFWLS (Log-Rank = 0.008).
Conclusions
In patient with FMR undergoing TEER, RV dysfunction assessed by RVFWLS was independently associated with long-term outcome and showed incremental value for prognostic stratification of patients with normal TAPSE.
Magnet-guided temozolomide and superparamagnetic iron oxide-loaded nanoparticles to enhance therapeutic efficacy in a glioma model
Authors: Thomas Reju George , Kim Subin , Tran Thi-Anh-Thuy , Kim Yeong Hee , Nagareddy Raveena , Jung Tae-Young , Kim Seul Kee , Jeong Youg Yeon
Published: August 2023

Background
This study aimed to synthesize liposomal nanoparticles loaded with temozolomide and ferucarbotran (LTF) and evaluate their theranostic effects in a glioma model.
Results
The particle size and surface charge of LTF were measured to be 80 nm and − 38 mV, respectively. Additionally, the presence of ferucarbotran significantly increased the contrast agent effect in glioma in MR imaging, compared to the control group. The application of magnet-guided LTF significantly reduced tumor size compared to the control and other comparison groups. Furthermore, our results demonstrated significant inhibition of brain tumor growth and an associated increase in lifespan compared to the control group.
Conclusions
These findings suggest that LTF with magnetic guidance represents a novel approach to address current obstacles, such as blood-brain barrier (BBB) penetration by nanoparticles and drug resistance. Magnet-guided LTF is able to enhance therapeutic efficacy in mouse brain glioma.
Distal tibiofibular syndesmosis injury: How to determine the optimal position using CT scan during reconstruction？
Authors: Yu You , Gan Yiwen , Li Junjie , Xiong Jixiang , Qing Jiwen , Wang Nan , Jiang Caiyi , Zeng Yuzhou , Zhang Yufan
Published: August 2023

Distal tibiofibular syndesmosis (DTS) injuries account for 1–11% of all ankle injuries. The establishment of minimally invasive and precise treatment mode to repair the bone structure and soft tissue has been discussed in literature, but the optimal reconstruction for this unique clinical problem has not been determined. We retrospectively collected 517 CT images of tibia and fibula (289 males, 228 females, 270 right feet and 249 left feet). To set the ideal implant point cp through CT images first, and then measuring a series of parameters through point cp, including the maximum front and rear radial distance between the point cp, the distance between the axis, the distance from the medial and external ankle, and the distance from the tibia joint surface to the axis. Then we figure out the optimal implantation point through these parameters. On the cross section, the values of a. b. c. and β were 1.84 ± 1.24mm, 3.58 ± 1.62mm, 4.74 ± 1.93mm, 25.30 ± 14.70 °, respectively. On the coronal section, the values of d. e. f. g. h. were 2.94 ± 2.24mm, 1.35 ± 0.75mm, 3.18 ± 1.48mm, 1.93 ± 0.71mm, 2.93 ± 1.31mm, respectively. There are significant differences between gender (P < 0.05) and no significant difference in the left and right foot parameters (P > 0.05). The CT scan provided a feasible option of surgical bone tunnel reconstruction of combined DTS, where the surgeons could drill a tunnel with the angle of 20–25° from the Coronal and horizontal planes, with the distance of 1.84 ± 1.24mm (male) and 1.74 ± 1.00mm (female) from the ankle tip, with the diameter of 2.50mm (male) and 2.00mm (female). Because the parameters of female patients are lower than male patients, surgeons should be more cautious in surgery. Level of evidence Level IV, retrospective case series.
Effect of corrosion media on biofilm detachment and the corrosion mechanism of Serratia marcescens on carbon steel in river water
Authors: AN Lakshmi , Bhuyan Angira Devi , Pasupulety Lata
Published: August 2023

The bacterial biofilms formed on metal surfaces play an important role in the corrosion of the metal. Biofilm detachment can greatly influence the corrosion rate. Since the biofilms formed by certain strains of \textit{Serratia marcescens} are known to get sloughed after prolonged surface exposure, studying the effect of corrosion media on this phenomenon and the corrosion rate will help in understanding the corrosion mechanism of \textit{S.marcescens}. In this work, carbon steel was exposed to multiple systems containing \textit{S.marcescens} isolated from treated river water used as a coolant in an oil refinery, referred to as industrial water (IW). The bacterial cultures were anaerobically cultivated in the American Petroleum Institute (API) growth medium and identified using 16S rRNA gene sequencing. Electrochemical impedance spectroscopy (EIS), potentiodynamic polarization, weight loss and surface morphological studies were performed on four different media. While sterilized IW served as a control, biofilm detachment occurred during polarization studies only in the system where the metal sample was exposed to IW containing \textit{S. marcescens} and the API medium. However, detachment did not occur during other analyses and in similar systems without the API medium or when nitrate ions were added to the API medium. Based on these observations, the mechanism adopted by \textit{S.marcescens} for its growth and the corrosion of carbon steel under various conditions could be elucidated.
PERAN KETERLIBATAN ORGANISASI DALAM MEMEDIASI HUBUNGAN ANTARA LINGKUNGAN KERJA DAN RETENSI KARYAWAN
Authors: Pabisa Yuyun Alvionita , Sisnuhadi Sisnuhadi
Published: August 2023

ABSTRAKPenelitian ini dilakukan untuk mengeksplorasi pengaruh lingkungan kerja terhadap retensi karyawan yang dimediasi oleh keterlibatan organisasi di Bank Tabungan Pensiunan Nasional (Bank BTPN) Yogyakarta.  Sampel yang dipergunakan dalam penelitian ini sebanyak 67 responden yang merupakan karyawan dari Bank BTPN Yogyakarta. Software SEM PLS dipergunakan untuk menganalisis data dan diperoleh hasil penelitian bahwa lingkungan kerja yang semakin baik akan memperkuat retensi karyawan, lingkungan kerja yang semakin bagus akan meningkatkan keterlibatan organisasi, dan variabel  keterlibatan organisasi meningkatkan pengaruh lingkungan kerja terhadap    retensi karyawan. Temuan penelitian ini diharapkan bisa memberikan panduan bagi para manajer Sumbr Daya Manusia akan pentingnya memelihara lingkungan kerja yang baik dan nyaman untuk meningkatkan retensi karyawan.Kata kunci: Lingkungan kerja, retensi karyawan, keterlibatan organisasi  ABSTRACTThis research was conducted to explore the influence of the work environment on employee retention mediated by organizational involvement at Bank BTPN Yogyakarta branch. The samples used in this study were 67 respondents who were employees of Bank BTPN Yogyakarta. PLS SEM software was used to analyze the data and the research results  show that a better work environment will strengthen employee retention, a better work environment will strengthen employee retention, a better work environment will increase organizational involvement, and organizational  involvement variables will increase the effect of the work environment on employee retention. The findings of this research are expected to provide guidance for Human Resources managers on the importance of protecting the environment.Keywords: Work environment, employee retention, organizational engagement
De Facto or De Iure? Ukrainian Autocephaly as a Contentious Issue in Orthodoxy
Authors: Kałużny Tadeusz
Published: August 2023

The purpose of this article is to present the contentious issue of Ukrainian autocephaly in today’s Orthodox Church. The topic is developed in four sections. Firstly, the method of proclaiming autocephaly in the Orthodox Church is presented. Then the history of establishing Ukrainian autocephaly is shown. The third section presents the problems related to the recognition of Ukrainian autocephaly in the Orthodox world. The final section sums up the results of the reflection and draws conclusions. They demonstrate that the Orthodox Church does not have unambiguous canonical regulations on the establishment of autocephaly, resulting in controversies surrounding Ukrainian autocephaly. The controversies consist especially of three theological-canonical issues: (1) the jurisdictional affiliation of the Kyiv Metropolitan See; (2) the manner of establishing Ukrainian autocephaly; and (3) the validity of the ordination of certain clergy of the new Ukrainian Orthodox Church. Finally, it is concluded that a definitive solution to the contentious issue of Ukrainian autocephaly requires agreement at the level of the whole Orthodox Church.
WITHDRAWN: Antibacterial Activity of Ag-graphene Nanocomposites Against Gram-Positive and Gram-negative Bacteria
Authors: Kala Anuskha , Verma Rashmi , Meenu Maninder , Gambhir Lokesh , Kar Kamal K. , Chamoli Pankaj
Published: August 2023

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Investigating the Potential of a Conversational Agent (Phyllis) to Support Adolescent Health and Overcome Barriers to Physical Activity: Co-Design Study (Preprint)
Authors: Moore Richard , Al-Tamimi Abdel-Karim , Freeman Elizabeth
Published: August 2023

BACKGROUND

Conversational agents (CAs) are a promising solution to support people in improving physical activity (PA) behaviors. However, there is a lack of CAs targeted at adolescents that aim to provide support to overcome barriers to PA. This study reports the results of the co-design, development, and evaluation of a prototype CA called “Phyllis” to support adolescents in overcoming barriers to PA with the aim of improving PA behaviors. The study presents one of the first theory-driven CAs that use existing research, a theoretical framework, and a behavior change model.

OBJECTIVE

The aim of the study is to use a mixed methods approach to investigate the potential of a CA to support adolescents in overcoming barriers to PA and enhance their confidence and motivation to engage in PA.

METHODS

The methodology involved co-designing with 8 adolescents to create a relational and persuasive CA with a suitable persona and dialogue. The CA was evaluated to determine its acceptability, usability, and effectiveness, with 46 adolescents participating in the study via a web-based survey.

RESULTS

The co-design participants were students aged 11 to 13 years, with a sex distribution of 56% (5/9) female and 44% (4/9) male, representing diverse ethnic backgrounds. Participants reported 37 specific barriers to PA, and the most common barriers included a “lack of confidence,” “fear of failure,” and a “lack of motivation.” The CA’s persona, named “Phyllis,” was co-designed with input from the students, reflecting their preferences for a friendly, understanding, and intelligent personality. Users engaged in 61 conversations with Phyllis and reported a positive user experience, and 73% of them expressed a definite intention to use the fully functional CA in the future, with a net promoter score indicating a high likelihood of recommendation. Phyllis also performed well, being able to recognize a range of different barriers to PA. The CA’s persuasive capacity was evaluated in modules focusing on confidence and motivation, with a significant increase in students’ agreement in feeling confident and motivated to engage in PA after interacting with Phyllis. Adolescents also expect to have a personalized experience and be able to personalize all aspects of the CA.

CONCLUSIONS

The results showed high acceptability and a positive user experience, indicating the CA’s potential. Promising outcomes were observed, with increasing confidence and motivation for PA. Further research and development are needed to create further interventions to address other barriers to PA and assess long-term behavior change. Addressing concerns regarding bias and privacy is crucial for achieving acceptability in the future. The CA’s potential extends to health care systems and multimodal support, providing valuable insights for designing digital health interventions including tackling global inactivity issues among adolescents.
Joint modeling of social determinants and clinical factors defines subphenotypes in out-of-hospital cardiac arrest survival (Preprint)
Authors: Abbott Ethan , Oh Wonsuk , Dai Yang , Feuer Cole , Chan Lili , Carr Brendan G , Nadkarni Girish N.
Published: August 2023

UNSTRUCTURED

Machine learning clustering offers an unbiased approach to better understand the interactions of complex social and clinical variables via integrative subphenotypes, an approach not studied in out-of-hospital cardiac arrest (OHCA). We conducted a cluster analysis for a cohort of OHCA survivors to examine the association of clinical and social factors for mortality at one year.We utilized a retrospective observational OHCA cohort identified from Medicare claims data, including area level SDOH features and hospital level datasets. We applied k-means clustering algorithms to identify subphenotypes of beneficiaries who had survived an OHCA and examined associations of outcomes by subphenotype.27,028 unique beneficiaries survived to discharge after OHCA. We derived 4 distinct subphenotypes, finding subphenotype 1 with the highest unadjusted mortality (53.8%) and subphenotype 4 with low mortality (31.7%). Jointly modeling of these features demonstrated an increased hazard of death for subphenotypes 1-3 but not for subphenotype 4 when compared to reference.We identified four distinct subphenotypes with differences in outcomes by clinical and area level SDOH features for OHCA. Further work is needed to determine if individual or other SDOH domains are specifically tied to long-term survival after OHCA.
The efficacy and safety of Tuina for painful diabetic peripheral neuropathy: A protocol for systematic review and meta-analysis (Preprint)
Authors: Yan Huixin , Guan Hongyi , Zhu Haiyu , Zhang Shaobo , Guo Haoze , Bi Yunpeng , Wu Xingquan , Song Bailin
Published: August 2023

BACKGROUND

Due to changes in lifestyle and eating habits, diabetes and its related syndrome are increasingly occurring around the world. Painful diabetic peripheral neuropathy (PDPN) is one of the most common syndromes of diabetes, and it is also one of the common pain symptoms of the human body. At present, many studies have shown that Tuina therapy can improve the clinical symptoms and functional status of painful diabetes peripheral neuropathy. However, there is currently no systematic review found to evaluate and report on this clinical scientific issue.

OBJECTIVE

This study aims to develop a protocol for a systematic review and meta-analysis that will assess the efficacy and safety of Tuina therapy for patients with PDPN.

METHODS

Randomized controlled trials (RCTs) related to Tuina treatment of painful diabetic peripheral neuropathy will be retrieved from the Chinese or English databases or Clinical Trial Register. These databases include CNKI, Wan Fang, CBM, VIP, PubMed, Embase, Web of Science, Cochrane Library and Medline, etc. We will consider articles published in English or Chinese. If the inclusion criteria are met, our team will use Revman 5.3 software provided by the Cochrane Collaborative Network to conduct this systematic review and meta-analysis.

RESULTS

This study will provide a comprehensive scientific evaluation of the efficacy and safety of Tuina therapy for PDPN.

CONCLUSIONS

The results of this systematic review and meta-analysis will be published in a peer-reviewed journal, which will provide evidence and reference for clinicians to use Tuina therapy to treat PDPN.

CLINICALTRIAL

PROSPERO CRD42023424749; https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=424749
An mHealth App to Support Caregivers in the Medical Management of Their Child With Cancer: Beta Stage Usability Study (Preprint)
Authors: Mueller Emily L , Cochrane Anneli R , Campbell Madison E , Nikkhah Sarah , Holden Richard J , Miller Andrew D
Published: August 2023

BACKGROUND

Previous research demonstrated that caregivers of children with cancer desired a mobile health (mHealth) tool to aid them in the medical management of their child. Prototyping and alpha testing of the Cope 360 app (Commissioning Agents, Inc) resulted in improvements in the ability to track symptoms, manage medications, and prepare for urgent medical needs.

OBJECTIVE

This study aims to engage caregivers of children with cancer in beta testing of a smartphone app for the medical management of children with cancer, assess acceptance, identify caregivers’ perceptions and areas for improvement, and validate the app’s design concepts and use cases.

METHODS

In this pilot, study caregivers of children with cancer used the Cope 360 mHealth app for 1 week, with the goal of daily logging. Demographics and a technology acceptance survey were obtained from each participant. Recorded semistructured interviews were transcribed and analyzed iteratively using NVivo (version 12, QSR International) and analyzed for information on usage, perceptions, and suggestions for improvement.

RESULTS

A total of 10 caregivers participated in beta testing, primarily women (n=8, 80%), married, with some college education, and non-Hispanic White (n=10, 100%). The majority of participants (n=7, 70%) had children with acute lymphocytic leukemia who were being treated with chemotherapy only (n=8, 80%). Overall, participants had a favorable opinion of Cope 360. Almost all participants (n=9, 90%) believed that using the app would improve their ability to manage their child’s medical needs at home. All participants reported that Cope 360 was easy to use, and most would use the app if given the opportunity (n=8, 80%). These values indicate that the app had a high perceived ease of use with well-perceived usefulness and behavioral intention to use. Key topics for improvement were identified including items that were within the scope of change and others that were added to a future wish list. Changes that were made based on caregiver feedback included tracking or editing all oral and subcutaneous medications and the ability to change the time of a symptom tracked or medication administered if unable to do so immediately. Wish list items included adding a notes section, monitoring skin changes, weight and nutrition tracking, and mental health tracking.

CONCLUSIONS

The Cope 360 app was well received by caregivers of children with cancer. Our validation testing suggests that the Cope 360 app is ready for testing in a randomized controlled trial to assess outcome improvements.
Remote Patient Monitoring and Machine Learning in Acute Exacerbations of Chronic Obstructive Pulmonary Disease: Dual Systematic Literature Review and Narrative Synthesis (Preprint)
Authors: Glyde Henry Mark Granger , Morgan Caitlin , Wilkinson Tom M A , Nabney Ian T , Dodd James W
Published: August 2023

BACKGROUND

Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are associated with high mortality, morbidity, and poor quality of life and constitute a substantial burden to patients and health care systems. New approaches to prevent or reduce the severity of AECOPD are urgently needed. Internationally, this has prompted increased interest in the potential of remote patient monitoring (RPM) and digital medicine. RPM refers to the direct transmission of patient-reported outcomes, physiological, and functional data, including heart rate, weight, blood pressure, oxygen saturation, physical activity, and lung function (spirometry), directly to health care professionals through automation, web-based data entry, or phone-based data entry. Machine learning has the potential to enhance RPM in chronic obstructive pulmonary disease by increasing the accuracy and precision of AECOPD prediction systems.

OBJECTIVE

This study aimed to conduct a dual systematic review. The first review focuses on randomized controlled trials where RPM was used as an intervention to treat or improve AECOPD. The second review examines studies that combined machine learning with RPM to predict AECOPD. We review the evidence and concepts behind RPM and machine learning and discuss the strengths, limitations, and clinical use of available systems. We have generated a list of recommendations needed to deliver patient and health care system benefits.

METHODS

A comprehensive search strategy, encompassing the Scopus and Web of Science databases, was used to identify relevant studies. A total of 2 independent reviewers (HMGG and CM) conducted study selection, data extraction, and quality assessment, with discrepancies resolved through consensus. Data synthesis involved evidence assessment using a Critical Appraisal Skills Programme checklist and a narrative synthesis. Reporting followed PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines.

RESULTS

These narrative syntheses suggest that 57% (16/28) of the randomized controlled trials for RPM interventions fail to achieve the required level of evidence for better outcomes in AECOPD. However, the integration of machine learning into RPM demonstrates promise for increasing the predictive accuracy of AECOPD and, therefore, early intervention.

CONCLUSIONS

This review suggests a transition toward the integration of machine learning into RPM for predicting AECOPD. We discuss particular RPM indices that have the potential to improve AECOPD prediction and highlight research gaps concerning patient factors and the maintained adoption of RPM. Furthermore, we emphasize the importance of a more comprehensive examination of patient and health care burdens associated with RPM, along with the development of practical solutions.