bluuebunny/crossref_metadata_2025 huggingface dataset:
Learning from patient safety: A 5-year retrospective analysis (2017-2022) of incidents from a primary care-based education provider
Authors: Musa Afsha , Musa Afsha , Witton Robert , Witton Robert , Ali Kamran , Ali Kamran , McColl Ewen , McColl Ewen
Published: May 2024

Background. Patient safety incident reporting and analysis are often confined to secondary care, despite 95% of dentistry occurring in primary care. Peninsula Dental Social Enterprise (PDSE) delivers primary care dentistry in education-based settings, using a report-review-action process to underpin its patient safety framework.
Aim. This article analyses trends in clinical incident data, reflecting on learning to improve overall patient safety.
Methods. A retrospective observational study was employed to analyse incidents over a five-year period (2017-2022) using anonymised data from the PDSE reporting system.
Results. Over the 5-year reporting period, there were an average of 13.1 total incidents per 1,000 appointments. Sub-analysis of reported incidents revealed 1.5 clinical incidents, and 0.9 ‘near miss’ incidents. A soft-tissue injury rate of 0.6, a contamination injury rate of 0.9 and 0.3 written complaints were reported per 1,000 appointments.
Conclusion. Patient safety is a key component of quality dental care, especially when delivering clinical dental education. PDSE fosters an environment of transparency, enabling the provider to monitor incident rates. This results in quality improvement systems which sit at the heart of clinical delivery. With a lack of data published from similar settings, comparison to the sector is limited. Further sharing of data is encouraged to enable standardisation and quality benchmarking.
A moderated mediation analysis of the quality of life, gambling craving, escape expectancies and gambling disorder relationships.
Authors: Awo Larry O. , Nwonyi Sampson K. , Igwe Ernest A. , Orakwe Daniella C. , Agbo Aaron A.
Published: May 2024

We test a moderated mediation model in which the effect of quality of life on gambling disorder was mediated by escape, and this mediation effect was further moderated by gambling craving. Participants (N = 197: 83% male, M age = 24.05 years, SD age = 7.23 years) online gamblers took part in the survey and responded to the Problem Gambling Severity Index, Gambling Quality of Life Scale, Gambling Outcome Expectancies Scale – Escape, and the Gambling Craving Scale. PROCESS macro analysis result reveals a significant moderated mediation effect of the QoL-escape path by GAC. The findings provide support for escape outcome expectancies as a potential pathway through which the QoL-GD association may thrive specifically, influenced by how disordered gamblers crave for gambling generally. We contribute to growing QoL-GD literature. However, further investigations are needed to reach a consensus on craving as a criterion for GD.
Shotgun metagenomics reveals environmental instability reduces resistance to shocks by enriching specialist taxa with distinct two component regulatory systems
Authors: Mills Simon , Ijaz Umer , Lens Piet
Published: May 2024

Different microbial communities are impacted disproportionately by environmental disturbances. The degree to which a community can remain stable when faced with a disturbance is referred to as resistance. However, the contributing ecological factors, which infer a community’s resistance are unknown. In this study, we investigate the impact of historical environmental stability on ecological phenomena and in turn, microbial community resistance to shocks. Three separate methanogenic consortia, which were subjected to varying degrees of historical environmental stability, and displayed different levels of resistance to an organic overload were sampled. Their community composition was assessed using high throughput sequencing of 16S rRNA genes and assembly based metagenomics. A suite of ecological analysis were applied to determine the effect of environmental stability on ecological phenomena such as microbial community assembly, microbial niche breadth and the rare biosphere and in turn, the effect of these phenomena on community resistance. Additionally, metagenome assembled genomes were analysed for functional effects of prolonged stability/instability. The system which was subjected to more environmental instability experienced more temporal variation in community beta diversity and a proliferation of specialists, with more abundant two component regulatory systems. This community was more susceptible to deterministic community assembly processes caused by a large environmental disturbance. These results imply that microbial communities experiencing longer term environmental instability (e.g. variations in pH or temperature) are less able to resist a large disturbances.
Introducing the antibacterial and photocatalytic degradation potentials of biosynthesized chitosan, chitosan-ZnO, and chitosan-ZnO/PVP nanoparticles
Authors: Aouadi Abdelatif , Saoud Djamila Hamada , Rebiai Abdelkrim , Achouri Abdelhak , Benabdesselam Soulef , El-Mordy Fatma Mohamed Abd , Pohl Pawel , Ahmad Sheikh F. , Attia Sabry M. , Abulkhair Hamada S. , Ararem Abderrahmane , Messaoudi Mohammed
Published: May 2024

The development of nanomaterials has been speedily established in recent years, yet nanoparticles synthesized by traditional methods suffer unacceptable toxicity and the sustainability of the procedure for synthesizing such nanoparticles is inadequate. Consequently, green biosynthesis, which employs biopolymers, is gaining attraction as an environmentally sound alternative to less sustainable approaches. Chitosan-encapsulated nanoparticles exhibit exceptional antibacterial properties, offering a wide range of uses. Chitosan, obtained from shrimp shells, aided in the environmentally friendly synthesis of high-purity zinc oxide nanoparticles (ZnO NPs) with desirable features such as the extraction yield (41%), the deacetylation (88%), and the crystallinity index (74.54%). The particle size of ZnO NPs was 12 nm, while that of chitosan-ZnO NPs was 21 nm, and the bandgap energies of these nanomaterials were 2.5 and 2.3, respectively. The strong antibacterial action was demonstrated by ZnO NPs, chitosan-ZnO NPs, and chitosan-ZnO/PVP, particularly against Gram-positive bacteria, making them appropriate for therapeutic use. The photocatalytic degradation abilities were also assessed for all nanoparticles. At a concentration of 6×10− 5 M, chitosan removed 90.5% of the methylene blue (MB) dye, ZnO NPs removed 97.4%, chitosan-coated ZnO NPs removed 99.6%, while chitosan-ZnO/PVP removed 100%. In the case of toluidine blue (TB), at a concentration of 4×10− 3 M, the respective efficiencies were 96.8%, 96.8%, 99.5%, and 100%, respectively. Moreover, in sillico toxicity studies were conducted to predict the organ-specific toxicity through ProTox II software. The results from the three tested samples were completely safe and showed no organ-specific toxicity.
Application of precision whole-process nursing care to patients undergoing radiotherapy for head and neck tumors based on a Patient- Hospital-Share model
Authors: Dan Wang , Li Xie , Jiantao Wang , Hanni Zhang , Li Junying , Zhiping Li , Qing You , Yanchu Li
Published: May 2024

Background: Radiotherapy patients need real-time nursing management due to their high daily mobility to improve the therapeutic effect of radiotherapy and reduce the risk of related adverse reactions and recurrence. In clinical practice, classical nursing methods can only collect part of patients’ follow-up treatment and examination information, and data quality is uneven. Therefore, conducting accurate nursing throughout the entire process is impossible. Hence, construction of a nursing follow-up system based on the patient radiotherapy management database can provide an important basis for whole-process management of cancer patients.
Methods: Based on the ‘Wikipedia data donation’ model and the patient-led medical data sharing mechanism, our team constructed a database of radiotherapy patient information sharing and big data system under the Patient-Hospital-Share architecture, and included head and neck cancer patients who received radiotherapy from January 2022 to January 2023 for precision care. Precision care includes the whole process management platform and follow-up management system, based on the patient’s overall situation, to provide patients with maximum support and personalized care throughout radiotherapy.
Result: Through precision whole-process nursing care, the decline of physical, role, and cognitive function was alleviated, worsening of fatigue symptoms was improved, and pain and gastrointestinal reactions were reduced. Simultaneously, the patient radiotherapy management database contains an online collection of patients' medical data inside and outside the hospital, thus initially opening up a complete medical data chain and transforming the hospital-centered data distribution/collection model into a patient-led medical data sharing model.
Conclusion: Precision nursing can significantly improve quality of life in patients undergoing radiotherapy for head and neck tumors. Furthermore, in this mode, patients can infinitely supplement medical data and realize cross-regional and cross-time data updates to practice a new and standardized whole-process management radiotherapy process and build a new and efficient medical treatment and nursing follow-up system.
In vivo kinematic study of lumbar center of rotation under different loads
Authors: li zhenyu , Liu Ziwen , Yang Yuming , Zhang Zepei , Meng Lin , Miao Jun
Published: May 2024

Background：Dual fluoroscopic imaging system (DFIS) was employed to identify the Center of Rotation(COR) in the lower lumbar spine and determine its relationship with weight bearing.
Methods：Nine participants were recruited in this study. The lumbar spine of each participant was 3D modeled based on CT images, and their relative positions were obtained using DFIS. By combining CT and DFIS, the kinematic data of the participants' spines during motion were acquired. The lower lumbar spine's Center of Rotation (COR) was calculated using the method of perpendicular bisectors.
Results：While flexing and extending, the Center of Rotation (COR) initially moved downward with increasing load, followed by upward movement as the load further increased.
The anterior-posterior position of the COR shifted posteriorly with increasing weight-bearing. Throughout the lateral bending exercises, the upper and lower COR positions increased as the load increased, while the left and right COR positions remained unaffected by the load increment. The COR height differed between flexion and lateral bending. We observed variations in the COR position of the lumbar spine during lateral bending and flexion-extension movements. This enhanced our comprehension of coupled motion patterns within the lumbar spine.
Conclusions：Position of the lumbar spine COR changes with variations in the load. During different movements, the COR location of the lower lumbar spine varied. Furthermore, the manner in which the COR position changes with load differs during different motions. This finding suggests the presence of distinct motion patterns in the lower lumbar spine. It helps enhance our understanding of the kinematic traits of the lumbar spine and clarifies the mechanisms that contribute to different diseases.
Evaluation of Efficacy and Safety of Different Treatment Regimens in Treatment-Naïve High Viral Load Chronic Hepatitis B Patients: A Real-World Study
Authors: Wu Xue , Yan Qin , Jiang Chunmei , Fan Rongshan , Li Sheling
Published: May 2024

Background: Evaluate the real-world effectiveness and safety of different treatment regimens for treatment-naïve high viral load chronic hepatitis B (CHB) patients.
Methods: Prospective cohort study. Between January 2021 and August 2022, CHB patients with HBV DNA ≥107 IU/mL were collected from four medical centers in Shenzhen. Patients treated with mono or combine antiviral therapy. The primary endpoint was the cumulative incidence of virological response at 48 weeks, and other endpoints included changes in HBsAg, HBeAg, ALT, and eGFR at 48 weeks. We used propensity score-based inverse probability of treatment weighting (IPTW) to balance the bias. Weighted logistics regression was used to estimate the factors affecting virological response.
Results: A total of 391 patients were included in the study, with 296 patients undergoing statistical analysis using IPTW. The patients were distributed into four groups: ETV (n=62), TDF (n=89), TAF (n=36), TDF+LdT/ETV (n=109). The 48-week cumulative incidence of virological response was significantly lower in ETV group (52.3%) compared to TDF (71.7%), TAF (74.2%), and TDF+LdT/ETV groups (77.9%) (P<0.05). There were no significant differences in HBsAg loss among the four groups, but the HBeAg seroconversion rate was significantly higher in the TAF group. The ALT normalization rate was significantly higher in the TAF group (72.2%) compared to the others at 48 weeks (P<0.05).
Conclusions: In treatment-naïve CHB patients with high viral load, combination therapy did not show superiority over monotherapy in term of antiviral efficacy at 48 weeks. TAF group exhibited superiority in HBeAg seroconversion and ALT normalization.
Distinct Gut Microbiota Signatures in Order People with Sarcopenia without Obesity and Sarcopenic Obesity
Authors: Wang Ling , He Xiangfeng , Zhang Zhen , Chen Nan
Published: May 2024

Background
Previous evidence suggests that gut dysbiosis plays an important role in the development and progression of sarcopenia and sarcopenic obesity, but evidence supporting this association is lacking. Thus, this study aimed to investigate the characteristics of gut microbiota in older people with sarcopenia and sarcopenic obesity.
Methods
The study involved 60 elderly individuals aged 65 years or older, recruited from Chongming, Shanghai, China. Participants were categorized into three groups based on the Asian Working Group for Sarcopenia 2019 (AWGS 2019) and World Health Organization obesity guidelines: sarcopenic obesity (SO, n = 20), sarcopenic without obesity (Sar, n = 18), and control (Con, n = 22). The gut microbiota was analyzed by sequencing the V3-V4 regions of the 16S rRNA gene.
Results
Significant differences in the diversity and composition of the gut microbiota were observed in Sar and SO groups. A reduction in alpha diversity, as measured by Chao1 and ACE index, was found in the SO group. Beta diversity based on unweighted Unifrac was significantly different between SO, Sar, and Con groups. Bacterial community composition analysis showed that at the family and genus level, the relative abundance of Rikenellaceae, Christensenellacea, Alistipes, Christensenellaceae R-7 group, Ruminococcus, and Odoribacter were significantly abundant in Sar group, whereas Enterobacteriaceae was more enriched in the SO group. Furthermore, as revealed by linear discriminant analysis effect size (LEfSe) and receiver operating curve (ROC) analysis, Alistipes and Christensenellaceae R-7 group was identified as biomarker for the diagnosis of sarcopenia without obesity, and Enterobacteriaceae was identified as a biomarker for the diagnosis of sarcopenic obesity.
Conclusion
This study demonstrated that the gut microbiota of sarcopenic obesity and sarcopenia without obesity have distinct diversity and composition profiles. The results provide new insights into the role of the gut microbiota in sarcopenic obesity, highlighting the potential of gut microbiota as a therapeutic target in this condition.
Investigating distinct clinical features and constructing a nomogram model for survival probability in adults with cerebellar high-grade gliomas
Authors: Chang Tao , Zhang Rui , Gan Jiahao , Yang Yuan , Liu Yanhui , Ju Yan , Niu Xiaodong , Mao Qing
Published: May 2024

Background The clinical features of cerebellar high-grade gliomas (cHGGs) in adults have not been well explored. This large-scale population-based study aimed to comprehensively outline these traits and construct a predictive model.
Methods Patient records diagnosed with gliomas were collected from various cohorts and analyzed to compare the features of cHGGs and supratentorial HGGs (sHGGs). Cox regression analyses were employed to identify prognostic factors for overall survival and to develop a nomogram for predicting survival probabilities in patients with cHGGs. Multiple machine learning methods were applied to evaluate the efficacy of the predictive model.
Results There were significant differences in prognosis, with SEER-cHGGs showing a median survival of 7.5 months and sHGGs 14.9 months (p < 0.001). Multivariate Cox regression analyses revealed that race, WHO grade, surgical procedures, radiotherapy, and chemotherapy were independent prognostic factors for cHGGs. Based on these factors, a nomogram was developed to predict 1-, 3-, and 5-year survival probabilities, with AUC of 0.860, 0.837, and 0.810, respectively. The accuracy of this model was validated by machine learning approaches, and it exhibited good consistency in predicting effectiveness.
Conclusions Adult cHGGs are characterized by distinctive clinical features different from those of sHGGs and have an inferior prognosis. The nomogram prediction model, which is based on the risk factors affecting cHGGs prognosis, serves as a crucial tool for clinical decision-making in patient care.
Building Footprint Segmentation Using the Modified YOLOv8 Model
Authors: Falahatnejad Shahrzad , Karami Azam , Sharifirad Rabe’e , Shirani Mojdeh , Mehrabinejad Mohsen , Khrasanimotlagh Mohammadhossein , Soleymani Mohammadreza
Published: May 2024

This paper proposes an enhanced YOLOv8 model specifically designed for precise building footprint segmentation. The model incorporates several key modifica- tions to achieve superior performance and efficiency. Firstly, a novel fusion layer integrates RGB image information with a Digital Elevation Model (DEM), enrich- ing feature representation and facilitating the distinction of building structures. Secondly, Depthwise Separable Convolution (DSConv) replaces standard convo- lutions throughout the backbone and head, leading to a more compact model with faster inference speed. Thirdly, Varifocal Loss (VFL) is employed as the clas- sification loss function, effectively addressing class imbalance issues prevalent in segmentation tasks. Our proposed model demonstrates significant improvements over three DeepLabv3+, SAM, and the original YOLOv8 state-of-the-art models. We achieve a precision of 91.11%, a recall rate of 89.71%, and a mAP (mean Average Precision) of 87.42%, surpassing all compared models in accuracy. Fur- thermore, the proposed model boasts a remarkably fast inference time of only 45.1 milliseconds per image, making it suitable for real-time applications.
Clinical significance of sarcopenia in elderly patients undergoing endoscopic submucosal dissection - A systematic review and meta-analysis
Authors: Su Yuanhao , Wu Yongke , Li Cheng , Zhao Yiyuan , Li Yunhao , Jin Xing , Wang Zhidong
Published: May 2024

Background and Aims:
As global life expectancy rises and gastrointestinal tumor incidence increases, more elderly patients are undergoing endoscopic submucosal dissection (ESD) for tumor treatment. This highlights the importance of sarcopenia assessment before ESD. This systematic review and meta-analysis aims to assess sarcopenia's role in predicting post-ESD adverse outcomes in the elderly.
Methods:
We conducted a systematic review and meta-analysis to investigate the impact of sarcopenia on the prognosis of elderly patients undergoing ESD treatment. A comprehensive search was conducted across three databases (PubMed, Embase, Web of Science). Using NEWCASTLE - OTTAWA ASSESSMENT SCALE for risk of bias assessment. The data were synthesized using Review Manager 5.3.
Results:
A total of 9 reports were identified, analyzing 7 indicators, with a combined sample size of 6044. Through a series of analyses, we have derived several highly credible research findings: the overall OR and 95% CI for gastric and colorectal post-ESD perforation between sarcopenia and nonsarcopenia groups were 1.34 [0.92, 1.97], for CTCAE grade > 2 were 2.65 [1.45, 4.82], for gastric post-ESD pneumonia were 1.90 [1.24, 2.90], and for gastric post-ESD mortality within 5 years were 2.96 [1.33, 6.58].
Conclusions:
Sarcopenia is a risk factor for increased incidence of complications (CTCAE > 2) after undergoing gastric and colorectal ESD, increased pneumonia rates and higher mortality rates within five years following gastric ESD treatment in elderly patients. However, sarcopenia does not lead to an increased perforation rate in elderly patients undergoing gastric and colorectal ESD treatments.
Exploring the Rehabilitation Needs of Patients with Coronary Artery Diseases: An Effort to Design A Contextual Home-based Cardiac Rehabilitation through A Qualitative Enquiry
Authors: Yaqoob Adnan , Barolia Rubina , Ladak Laila , Khan Aamir Hameed , Pannu Furqan Yaqub , Hanif Asif , Sahar Wajeeha
Published: May 2024

Background
Cardiovascular diseases (CVDs) continue to be a major global public health concern, accounting for a considerable portion of the burden of morbidity and mortality. The CAD in Pakistan imposes a substantial economic and social burden on individuals, families, and the healthcare system. Despite advances in medical interventions and therapies, comprehensive cardiac rehabilitation programs in Pakistan remain underdeveloped and inaccessible to many patients, particularly those residing in rural or underserved areas.
Aim
This study aims to explore the needs of Pakistani patients with heart disease in helping to design contextual home-based cardiac rehabilitation.
Methods
Based on the data saturation, 20 individuals were interviewed using a qualitative descriptive exploratory approach. Semi-structured, in-depth interviews that lasted 40 to 50 minutes were used to gather the data. NVIVO software was used to conduct a thematic analysis of qualitative data.
Results
The qualitative data obtained from participants revealed five themes: Understanding heart disease, Cardiac anxiety, Challenges faced by patients, Difficulties in behavior change, and Patient readiness for home-based cardiac rehabilitation.
Conclusion
The findings uncover the importance of tailored interventions that address patients' preferences for guidance, support, and lifestyle modification.
Cerebral venous thrombosis with myelodysplastic syndrome: a rare case report
Authors: Zhang Jia , Jiang Tianfang , Chen Xu
Published: May 2024

Background: Cerebral venous thrombosis (CVT) is an important cause of stroke in young adults caused by complete or partial occlusion of the cerebral major venous sinuses or smaller feeding cortical veins. Myelodysplastic syndrome (MDS) represents a heterogeneous group of myeloid neoplasms that are characterized by ineffective hematopoiesis, variable cytopenias, and a risk of progression to acute myeloid leukemia. However, CVT is rarely reported in patients with MDS.
Case presentation: A 45-year-old woman with recurrent chronic headache for three months. Later, the headache symptoms gradually worsened, accompanied by disturbance of consciousness and cerebral hemorrhage. Multiple thromboses of the intracranial venous sinus were confirmed by cranial magnetic resonance venography (MRV). After treatment with heparin anticoagulation and mannitol dehydration, the symptoms gradually improved, and the hematoma was absorbed before discharge. Bone marrow biopsy revealed morbid hematopoiesis in the erythroid system and 10% of the circular iron granulocyte erythrocytes. Whole-exon detection revealed U2AF1 c.101C>T, CEBPA c.283G>A, and KMT2D c.468T>G gene mutations, which confirmed the diagnosis of MDS.
Conclusions: MDS complicated with venous sinus thrombosis is rare. A highindex of suspicion is needed for a correct diagnosis of CVT presenting with ICH or chronic headache in female patients.
TFAM downregulation contributes to cognitive dysfunction after anesthesia and surgery by activating STING-dependent endoplasmic reticulum stress and neuroinflammation
Authors: Zhu Yongliang , Fu Youli , Lian Jiahe , Liu Yinglong , Liu Yongxin , Huang Jingyao , Liu Jie , Zhang Zhihao , Zhang Zhenjiang , Zhang Rui
Published: May 2024

Background
Perioperative neurocognitive disorder (PND) is a common neurological complication during the perioperative period in the elderly, but no ideal prevention and treatment strategy has been found yet. cGAS-STING pathway has confirmed to play vital roles in to neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease and Huntington's disease. However, whether the cGAS–STING pathway participates in the regulatory process of neuroinflammation and apoptosis in the development of PND and the underlying mechanisms involved remain unclear.
Methods
In this study, 18-month-old C57BL/6 male mice were subjected to tibial fracture surgery with sevoflurane anesthesia to establish the PND animal model. In the interventional study, mice were treated with the cGAS inhibitor RU.521 or the combination of RU.521 and the STING agonist 2′3′-cGAMP. On the third and fourth postoperative days, novel object recognition(NOR)test and Y maze test were performed to assess the cognitive function in each group of mice. Thereafter, we determined the protein levels of TFAM, cGAS, STING, and GRP78, as well as the mRNA levels of the typical inflammatory factors IL-6, IL-1β and TNF-α in the hippocampus. In addition, we investigated the apoptosis in the hippocampus after the surgery by detecting Bax, Bcl2 apoptotic proteins, and the terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) staining assay.
Results
After anesthesia and surgery, the expression of TFAM in the hippocampus were down-regulation, leading to mitochondrial dysfunction, which further induced mitochondrial DNA (mtDNA) leakage into the cytoplasm. As the important source of damage-associated molecular patterns (DMAPs), the leaked mtDNA was recognized by the cytoplasmic DNA receptor cGAS, which activated the expression of downstream STING genes, causing endoplasmic reticulum stress (ERS), neuroinflammation and neuronal apoptosis in the hippocampus, and ultimately led to cognitive dysfunction in aged mice.
Conclusions
Collectively, our results revealed that TFAM downregulation contributes to cognitive dysfunction after anesthesia and surgery by activating STING-dependent ERS, neuroinflammation, and neuronal apoptosis in the hippocampus, which might serve as a promising therapeutic target for cognitive dysfunction after anesthesia and surgery.
"Pure" robot simple hysterectomy with four arms and no uterine manipulator: a retrospective, non-blind, and non-randomized, comparative study
Authors: Kawamura Shogo , Ota Kuniaki , Fujiwara Hitomi , Tasaka Keiichiro , Okamoto Hana , Morimoto Yumiko , Saito Wataru , Sugihara Sayaka , Koike Eiji , Takahashi Toshifumi , Shiota Mitsuru , Shimoya Koichiro , Ota Yoshiaki
Published: May 2024

Nearly 20 years have passed since the introduction of robotic surgery for total hysterectomy, and its development has accelerated. However, its advantages over laparoscopic and open surgeries remain unclear, especially since some its drawbacks include the requirement of skilled assistants and the effective use of the robotic arms. We developed a robotic hysterectomy technique (pure robotic simple hysterectomy [PRSH]). PRSH uses four robotic arms without interference and does not require a uterine manipulator, thereby minimizing the number of assistants. However, intraoperative use of a uterine manipulator may be necessary in some cases. We retrospectively compared the characteristics and surgical outcome of patients who underwent PRSH (113 patients) or PRSH with a uterine manipulator (58 patients). Patients in the PRSH group were significantly older and had significantly higher BMI than those in the PRSH with a uterine manipulator group (48.4 ± 6.3 versus 46.0 ± 5.5, P = 0.02 and 24.4 ± 4.3 versus 26.0 ± 4.6, P = 0.03, respectively). There were no statistically significant differences between the two subgroups in terms of type of benign disease. We additionally investigated the factors that necessitated the intraoperative use of a uterine manipulator using multivariate logistic analysis. We found that in complex cases, such as endometriosis with suspected Pouch of Douglas obliteration (PRSH versus PRSH with a uterine manipulator: 1.8% versus 25.9%, P < 0.0001) and cervical and broad ligament fibroids, it was difficult to continue with the uterine manipulator-free technique, requiring the intraoperative addition of a uterine manipulator. We suggest that in such cases, assistants should be prepared preoperatively to regulate uterine manipulation.
Efficacy and Safety of Immune Checkpoint Inhibitors Combined with Iodine-125 Seed Implantation in Driver-Gene-NSCLC: A Retrospective Study
Authors: Tao Xipeng , Liang Lan , Xu Junjie , Xie Lici , Wen Qing , Zhou Xiangdong , Luo Hu
Published: May 2024

Retrospective analysis of 95 patients with driver gene-negative NSCLC who visited First Affiliated Hospital of Army Medical University between December 2018 and December 2023. Among them, 33 cases in the observation group were treated with I125 seed implantation combined with chemotherapy and ICIs(ICIs + CT + I125), and 62 cases in the control group were treated with extracorporeal radiotherapy combined with chemotherapy and ICIs(ICIs + CT + RT). The primary observational endpoint was median progression-free survival(mPFS), while the secondary observational endpoints included the 1 and 2-year PFS rate and the incidence of adverse events. mPFS was not reached in the observation group and 11.8 months(95%CI 9.743–13.857) in the control group, a statistically significant difference(P<0.001). The restricted mean survival time (RMST) was 22.2(95% CI 18.257–26.101) and 13.8 months (95% CI 11.912–15.718) in both groups at 31.7 months, PFS was better in the observation group than in the control group. In the observation group, 2 cases(6.1%) developed grade 3 pneumothorax or hemorrhage, and in the control group, 16 cases(25.8%) developed grade 3 radiation pneumonitis, which was higher in the control group than in the observation group (P = 0.019). Compared to radiotherapy in combination with chemotherapy and immunotherapy, patients with driver gene-negative NSCLC who received I125 seed implantation had greater advantages about their longer survival and fewer adverse effects.
Length of hospital stay for liver cancer patients: risk factors and predictive model construction
Authors: Sun Bin , He Xiuying , Zhang Na
Published: May 2024

Purpose:
In the context of rapid rehabilitation, the length of hospital stay can serve as a reflection of the overall diagnosis and quality of nursing care provided. However, the factors influencing the duration of hospitalization in patients with primary liver cancer are currently not well understood. This research aimed to develop a predictive model for evaluating the length of hospital stay of patients.
Methods:
Admitting information of patients with liver cancer and undergoing surgical treatment were included in this study. This research analyzed 31 indicators. A binary logistic regression model was constructed with the length of hospital stay greater than the median as the dependent variable and presented in a line chart format. The performance of the line chart was tested through ROC curve, calibration plot, and decision curve analysis. Furthermore, the model underwent internal validation by utilizing the validation dataset.
Results:
This study included a total of 966 patient data. The research cohort was randomly divided into a training set and a validation set in a 7:3 ratio. Multifactor logistic regression analysis showed that factors such as Cholinesterase are predictive factors for prolonged hospital stay in patients with primary liver cancer. The nomogram model constructed using these factors demonstrated good consistency and accuracy. The AUC of the prediction model and internal validation set were .66 (95% CI .61-.70) and .56 (95% CI .49-.63) respectively. Hosmer-Lemeshow test values were p = .857 and p = .590. The calibration curve showed significant consistency between the nomogram model and actual observations. ROC and DCA indicated that the nomogram has good predictive performance.
Conclusion:
The model serves as a valuable tool for healthcare professionals to anticipate the risk factors associated with extended hospital stays in patients diagnosed with primary liver cancer.
Data-driven Design of Electrolyte Additives for High-Performance 5 V LiNi0.5Mn1.5O4 Cathodes
Authors: Liao Chen , Wang Bingning , Doan Hieu , Son Seoung-Bum , Abraham Daniel , Trask Stephen , Jansen Andrew , Xu Kang
Published: May 2024

LiNi0.5Mn1.5O4 (LNMO) is a high-capacity spinel-structured material with an average lithiation/de-lithiation potential at ca. 4.6–4.7 V, far exceeding the stability limits of electrolytes. An efficient way to enable LNMO in lithium-ion batteries is to reformulate an electrolyte composition that stabilizes both graphitic (Gr) anode with solid-electrolyte-interphase (SEI) and LNMO with cathode-electrolyte-interphase (CEI). In this study, we selected and tested a diverse collection of 28 single and dual additives for the LNMO||Gr system. Subsequently, we trained machine learning (ML) models using this dataset and employed these models to identify 6 optimal binary compositions out of 125, based on their predicted final area-specific-impedance, impedance-rise, and final specific-capacity. The additives generated through this ML approach demonstrated superior performance compared to those in the in the initial dataset. This finding not only underscores the efficacy of ML in identifying new materials in a highly complicated application space, but also showcases an accelerated material discovery workflow that directly integrates data-driven methods with battery testing experiments.
A Naturalistic Follow-up Study Focusing on Potential Sex Differences in Children and Adolescents with ADHD and Co-occurring Psychiatric Disorders
Authors: Uygun Sabide Duygu , Kosku Zeynep Toprak , Temeltürk Rahime Duygu , Uytun Merve Çıkılı , Yürümez Esra , Öztop Didem Behice , Babayiğit Tuğba Menteşe , Efendi Gökçe Yağmur , Kılıç Birim Günay
Published: May 2024

A retrospective study assessed the prevalence, timing, and distribution of psychiatric comorbidities in 322 Turkish children with ADHD (aged 6–18 years), focusing on potential sex differences. Data were collected from university-based clinical records. Assessments included periodic psychiatric examination, Wechsler Intelligence Scale for Children-Revised (WISC-R) and Conners’ Parent/Teacher Rating Scales (CP/TRS). Females with ADHD had higher psychiatric comorbidity rates compared to males (83.5% vs. 62.7%, p < .001). Intellectual disabilities and speech disorders were more prevalent in females (p < .001 and p = .028, respectively). Anxiety disorders were prevalent in both sexes. Higher rates of internalizing and externalizing disorders were observed in females. CTRS scores and indexes showed mild negative correlations with the timing of the first comorbidity other than neurodevelopmental disorders. Age and specific learning disorders (SLD) were predictors of comorbidity onset (p = .004 and p = .001, respectively). Females with ADHD need more clinical attention. ADHD severity, age, and SLD are important for the onset of comorbidities.
Application of chitosan-citric acid variant resins in the cyclic sorption-desorption of toxic ions from Zn dominant Adsorbate system
Authors: Patel Prabhat Kumar , Pandey Lalit Mohan , Uppaluri Ramagopal V.S
Published: May 2024

Targeted sorbents for the real-world adsorptive separation of heavy metals shall exhibit high sorption capacity, reusability, and cost-effectiveness. In this study, a novel composite sorbent has been synthesized for the concurrent mitigation of iron, lead, and zinc metal ions from synthetic wastewater systems. For this purpose, chitosan with alternate molecular weight (low, medium, and high) and with hydroxyl and amine functional groups was employed as a substrate. The successful anchoring of the organic compound citric acid was achieved with the glutaraldehyde crosslinker. The work focused on the concurrent elimination of iron, lead, and zinc ions under diverse conditions of sorbent dose (0.2 to 2 g L− 1), initial concentration (194.9-584.7 mg L− 1, 2.65–7.95 mg L− 1, and 104.8-314.4 mg L− 1 respectively for zinc, lead, and iron), and adsorbent contact duration (5 to 720 min). Accordingly, it was ascertained that other alternative ions in the adsorbate system significantly alter the sorption patterns. Following this, the desorption of metal ions was effective with simple basic and acidic eluents and for a three-cycle-based simultaneous regeneration. In summary, the findings demonstrate the promising performance of the sorbent for metal ions eradication from intricate solutions.
Exercise protects against AMLN diet-induced lipid deposition in hepatocytes during MAFLD progression by regulating the UPRmt and FGF21 secretion
Authors: Yuan Xinmeng , Xiang Mengqi , Gao Yaran , Feng Wanyu , Sun Wen , Xu Ye , Zhang Liumei , Wu Jingyi , Tang Qiang , Lu Jiao , Zhang Yuan
Published: May 2024

Background
A high-calorie diet and lack of exercise are the primary risk factors contributing to metabolic associated fatty liver disease (MAFLD) initiation and progression. Although mitochondrial dysfunction in MAFLD has been widely recognized, the precise molecular mechanisms of mitochondrial function alteration during MAFLD development remain to be fully elucidated.
Methods
A total of sixty male C57/black mice were maintained on a normal or amylin liver NASH (AMLN) diet for 6 and 10 weeks. Half of the AMLN diet mice were then subjected to 8 weeks of voluntary wheel running with an AMLN diet persistently, while the other AMLN diet mice were sedentary until 14 and 18 weeks. After the experimental intervention, the mice were sacrificed under anesthesia, blood and liver tissue were collected for further analysis. Changes in biochemical parameters, histopathology, lipid accumulation, endoplasmic reticulum stress, mitochondrial function and mitochondrial unfolded protein response-related proteins were assessed and correlation analysis of serum FGF21 and mitochondrial unfolded genes expression was also performed.
Results
The results showed that the hepatic lipid deposition and PERK-eIF2α-ATF4 pathway activation were significant increased with prolonged duration of AMLN diet. However, expression of mitochondrial unfolded protein response (UPRmt) genes, such as LONP1, HSP60, and HSP70, as well as mitokine FGF21 secretion were significantly enhanced in the 14-week AMLN diet mice, but were markedly reduced with the excessive lipid deposition induced by the 18-week AMLN diet. In addition, there is a significant positive correlation between circulating FGF21 and the amount of mitochondrial unfolded genes expression during MAFLD progression. Moreover, exercise intervention significantly rescued the hepatic phenotype through improving mitochondrial function, regulating UPRmt activation pattern and increasing FGF21 secretion.
Conclusions
During the development of AMLN diet-induced MAFLD, the relationship between the degree of lipid deposition and mitochondrial function is not a linear model of negatively correlation. Instead, mitochondria could experience self-remodeling at the earlier stage of lipid accumulation, then lose their self-repair ability due to lipid overload. Exercise effectively prevents excessive lipid deposition, through regulating UPRmt, remodeling mitochondrial protein homeostasis and promoting the secretion of mitokine FGF21, which plays an essential role in delaying the MAFLD occurrence and progression.
Laterite used as pigment source- Analysis of Geological cum Anthropogenic specimen found in the Kaimur range, India through SEM-EDX and WD-XRF
Authors: Kumar Dharini , Sanyal Anindya , Rao Prof N.V Chalpathi , Prakash Rajiv , Tiwary Sachin Kumar
Published: May 2024

This study investigates the possible ancient colour extraction methods by analysing a sample from the Adhaura block rock shelters in Bihar's Kaimur Range. The sample was collected based on the assumption of being Haematite. To state factual evidence, it was then analysed using scanning electron microscopy (SEM) and energy dispersive X-rays (EDX) for a detailed study of its morphology and composition and wavelength dispersive X-ray fluorescence (WDXRF) to determine the elemental composition and presence of trace elements in the bulk rock. The results provide a new perspective on rock art colour schemes and enable a basic understanding of the geological nature of the landform. The sample analysis indicates that locally sourced materials, including a geological lateritic formation containing Haematite and Goethite in distinct phases, were used instead of the commonly used Haematite. This study bridges the need for scientific analysis in understanding the material and techniques in archaeology and anthropology. The results of these analyses provided a novel geological perspective for understanding rock art colour schemes and enabled a basic theoretical understanding of the rock art site and the geochemical nature of the landform. It also is an ensemble of technological investigations and natural science that helped achieve the results.
Determination of Optimal Concentration of the Plastifier (DIDP) for a PVC/ DIDP Industrial Formulation
Authors: bendjaouahdou Chaouki
Published: May 2024

The objectif of this work is to investigate the effects of the concentation of a plastifier, i.e, Di-Iso-Decyl-Phtalate (DIDP) on the properties of p ol yvi nyl chlor ide ( P V C) po l yme r u s ed i n t he fab r i ca tio n o f el ec tr i ca l cab l e s he at h. T he r e s u l t e d bl e nd ba s e d o n DIDP and P V C resin is prepared by dry blending followed by melt extrusion. The obtained results showed a decrease the tensile strength and shore A hardness when the amount of the used plastifier (DIDP) increases before and after thermal ageing. Furthermore, the strain at the break increases when the amount of the plastifier (DIDP) increases before and after thermal ageing. The thermal stability (deshydrochloration or Beilstein test) is maximal when the c o n cen t r at i o n of t he DIDP plastifier was equal to 45 wt. %.
Growth of the WTE industry in China and environmental performance
Authors: Ma Wenchao , Boré Abdoulaye , Cui Jicui , Huang Zhuoshi , Chen Guanyi , Themelis Nickolas J.
Published: May 2024

In the last twenty years, the waste-to-energy (WTE) capacity of China has become greater than any other nation. This study examines the environmental performance of the Chinese WTE power plants, including greenhouse gas (GHG), SO2, NOx, HCl, dioxins, particulate matter (PM), and heavy metal (HMs, 11 types) emissions, from 2005 to 2020. The results showed that GHG, NOx, and HCl national emissions increased with increasing WTE capacity. In contrast, PM, CO, SO2, and dioxins peaked in 2015 and gradually declined by 26%, 33%, 28%, and 82%, respectively, in 2020. MSW generation intensity, GDP per capita, and population were factors driving up pollutant emissions, whereas enhancing emission control and MSW treatment structure were key to lower emissions. Between 2005 and 2020, emission factors decreased by 22%-96%. Replacing landfilling by combustion with energy recovery (WTE) reduced the carbon footprint by 137 million tons of CO2-eq in 2020. Limiting emissions of PM, SO2, and NOx in line with the ultra-low emission (ULE) requirements can result in a yearly health benefit of US$18.4 million.
An Innovative Teaching & Learning Paradigm to Enhance College Students’ Long-Term Memory & Learning Gains
Authors: Warley Raquel
Published: May 2024

This article elaborates on the active ingredients and theory of change used to explain an innovative model of teaching and learning called MISSAL. MISSAL is an abbreviation for Meaningful Instruction, Social, Self-Regulated, and Active Learning. This learning intervention is in the third year of research and development. Drawing upon prior scholarly investigations on brain-based learning and various instructional strategies, the active ingredients of this framework are summarized. Using a sample of 12 undergraduate social work students, I examined to what extent the MISSAL approach facilitates short- and long-term knowledge retention and recall of acquired learning, successful exam performance, and learning gains among students enrolled in a content-intensive course. Findings of this preliminary investigation are hopeful. Implications for the higher education sector and future research are discussed.
A non-canonical Arp2/3 complex is essential for Plasmodium DNA segregation and transmission of malaria.
Authors: Hentzschel Franziska , Jewanski David , Sokolowski Yvonne , Agarwal Pratika , Kraeft Anna , Hildenbrand Kolja , Dorner Lilian , Singer Mirko , Marti Matthias , Frischknecht Friedrich
Published: May 2024

Plasmodium parasites, the causative agents of malaria, undergo a crucial development within the mosquito vector, initiated by the formation of male and female gametes from gametocytes. Male gametogenesis involves three rapid rounds of endomitosis followed by a single round of DNA segregation and nuclear division during gamete budding. How the cell organises the segregation of eight genomes from a single octoploid nucleus is currently unknown. Here, we discovered an atypical five-subunit Arp2/3 complex in Plasmodium essential for DNA segregation during male gametogenesis. Unlike the canonical seven-subunit Arp2/3 complex found in other eukaryotes, Plasmodium Arp2/3 localizes to endomitotic spindles and interacts with the kinetochores. Disruption of key Arp2/3 subunits or actin polymerization impedes proper DNA segregation, resulting in the formation of sub-haploid gametes and halting transmission. Our work identified an evolutionary divergent Arp2/3 protein complex in malaria parasites that offers novel insights into its function and potential targets for transmission-blocking interventions.
Load transfer mechanism and design strength of hybrid bolted joint with friction- and bearing-type connections
Authors: Chen Yu , Yamaguchi Takashi , Hayashi Gen , Yamauchi Motoshi , Ueno Keita
Published: May 2024

Long slip-critical bolted joints are extensively used in steel- bridge construction to accommodate increasing traffic loads and optimise steel components. However, as the joint length increases, challenges arise owing to interference with secondary members, uneven bolt force distribution leading to premature failure, and reduced serviceability limit strength. Existing design codes incorporate reduction factors based on joint length to address these issues. This study proposes a hybrid bolt joint that combines friction and bearing-type bolted connections to reduce the joint length while maintaining or improving strength . Finite element analysis was used to investigate the interactive effects of bearing and friction connections, load sharing of hybrid connections, component deformation, and reductions in friction and bearing forces. The results show that the hybrid joint exhibits a uniform load distribution among the friction bolts but an uneven bearing force distribution among the bearing bolts, with the foremost bolt experiencing severe friction force loss. An effective correction factor was proposed to account for the reduction in friction and bearing forces. This study defines the serviceability limit state based on bolt shank shear yielding and provides recommendations for the strength assessment and design of hybrid bolted joints (αs Fs + αb Fb). The results contribute to the development of rational compact joints for steel-bridge construction and address the challenges associated with long multi-row bolted joints.