bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluating the SarQoL® Questionnaire as a Screening Tool for Sarcopenia among Korean Older Adults
Authors: Lee Haneul , Kim Jiyoun
Published: September 2024

Sarcopenia, characterized by the progressive loss of muscle mass and strength, poses significant risks to physical health, leading to a reduced quality of life (QoL), increased disability, and higher mortality rates among older adults. Early detection and intervention are crucial to prevent the cascading effects of sarcopenia, including falls, fractures, and hospitalization. This study determined an optimal cut-off point of the SarQoL® score that can serve as an effective screening tool among community-dwelling Korean older adults. The study involved 451 South Korean older adults, assessing the correlation between SarQoL® scores and sarcopenia as defined by the Asian Working Group for Sarcopenia (AWGS) criteria. Participants completed the Korean version of the SarQoL questionnaire. Findings revealed that individuals diagnosed with sarcopenia had significantly lower SarQoL® scores compared to non-sarcopenic participants, with a cut-off score of ≤ 58.5 providing good diagnostic accuracy (AUC = 0.768, sensitivity = 69.3%, specificity = 75.2%). These results underscore the questionnaire’s reliability and validity in screening for sarcopenia-related QoL impairment and its potential utility as a clinical tool. Implementing the SarQoL® in routine assessments could improve clinical outcomes by enabling earlier and more precise identification of sarcopenia.
Artificial Intelligence and Innovative Surveillance Methods—An Additional Value in Livestock Farming?
Authors: Eddicks Matthias , Feicht Franziska , Beckjunker Jochen , Genzow Marika , Alonso Carmen , Reese Sven , Ritzmann Mathias , Stadler Julia
Published: September 2024

Artificial intelligence (A.I.) is the key to process big amounts of data to useful information for operators. In the present study the suitability of a 24/7 A.I. sound based coughing monitoring system for early detection of respiratory distress caused by porcine respiratory disease complex (PRDC) associated pathogens was assessed in the nursery of a conventional pig farm. Screening for PRDC associated pathogens was conducted by PCR examination of oral fluids (OFs) and bioaerosol samples (AS). A significant correlation between A.I. and human gained health data was observed in both batches. An increase in coughing episodes, either measured by A.I. or human, was significantly correlated with decreasing Ct-values of swIAV. The Odds to detect nucleic acids of PRRSV or Actinobacillus (A.) pleuropneumonia was significantly higher for OFs compared to AS. Moreover, PCR examinations of OFs revealed significantly lower Ct-values for swIAV and A. pleuropneumonia compared to AS. The quantity of swIAV RNA in OFs and AS was significantly associated with the A.I. calculated respiratory health score and thus, with clinical disease. Due to its reliable data A.I. based health monitoring is beneficial for early recognition of respiratory distress and thus can assist farmer’s daily work.
Lewis Acid-Base Site Assisted In-Situ Transesterification Catalysis to Produce Biodiesel
Authors: Zhang Zhuangzhuang , Meng Pan , Luo Hangyu , Pei Zhengfei , Liu Xiaofang
Published: September 2024

Biodiesel, a potent replacement for petroleum diesel, is derived from fatty acids in biomass through transesterification, which is renewable, non-toxic, and biodegradable and is a powerful replacement for petroleum diesel. Lewis acid has been proven effective for esterification and transesterification. The Lewis base enhances the electrophilic and nucleophilic properties of the molecules that bind to it, leading to the remarkable versatility in the Lewis base catalytic reaction. Many studies have shown that Lewis acid/base catalyzed in-situ transesterification is a fast and environmentally friendly method for producing biodiesel. The utilization of Lewis acid-base sites to catalyze transesterification has been shown to enhance their efficiency and utilization of ac-id-base active sites. This review explores biodiesel production by different catalysts using Lewis acid-base sites, the conditions for catalytic transesterification, the effects of different reaction parameters on biodiesel production, and biodiesel production process.
“Beyond the Knife” - Applying Theranostic Technologies to Enhance Outcomes in Neurosurgical Oncology
Authors: Guru Santosh , Lam Fred C , Hori Yusuke S , AbuReesh Deyaaldeen , Tayag Armine , Emrich Sara C , Ustrzynski Louisa , Park David J , Chang Steven D
Published: September 2024

Current standard of care for brain tumor management includes maximal safe surgical resection followed by concurrent chemotherapy and radiation therapy. Recent advances in image-guided surgical techniques have enhanced the precision of tumor resections, yet there remains a critical need for innovative technologies to further improve patient outcomes. The emerging use of theranostic technologies to improve surgical outcomes can further augment the efficacy of adjuvant radiosurgery/radiotherapy and systemic therapies. Stanford Neurosurgery is a leader in the field of translational neuro-oncology. In this review, we provide an expert view of how theranostics can be integrated into future therapeutic treatment algorithms to help improve survival for patients with brain tumors.
Trends in the Occurrence of Compound Extremes of Temperature and Precipitation in Côte d’Ivoire
Authors: AKOBE Elisée Yapo , DIAWARA Adama , YOROBA Fidèle , KOUASSI Benjamin K. , YAPO Assi Louis Martial , DIBA Ibrahima , KOUADIO Kouakou , TIÉMOKO Dro T. , KONÉ Dianikoura Ibrahim , Diedhiou Arona
Published: September 2024

The aim of this study is to characterize the compound extremes of rainfall and temperature in Côte d’Ivoire. For this purpose, we analyzed the outputs of fourteen (14) climate models from the CORDEX-Africa project. Results show an increase (approximately 4.3°C) of the surface temperature and a decrease (5,90 %) of the mean rainfall in the near (2036-2065) and far futures (2071-2100) over Côte d’Ivoire during January-February-March (JFM) period. The analysis of the compound extremes of wet/warm type highlights an increase in the frequency of this climatic hazard in the northern and central parts of the country during January-March (JFM) season in the near and far futures. The dry/warm mode will increase in the central and southern parts of the country during the near future and in the whole country during the far future. These increase in compound extremes could lead to an increase in droughts and natural disasters over the country and could have a negative impact on socio-economic activities, such as transportation and agricultural production. This work could provide decision support for political decision-makers in formulating future public policies for managing agricultural production, food security, and natural disasters.
Topological Delaunay Graph for Efficient 3D Binary Image Analysis
Authors: Yoshizawa Shin , Michikawa Takashi , Yokota Hideo
Published: September 2024

Topological data analysis (TDA) based on persistent homology (PH) has become increasingly popular in automation technology. Recent advances in imaging and simulation techniques demand TDA for 3D binary images, but it is not a trivial task in practice, especially in terms of the computational speed of PH. This paper proposes a simple and efficient computational framework to extract topological features of 3D binary images by estimating persistence diagrams (PDs) for 3D binary images. The proposed framework is based on representing a 3D binary image by constructing a topological Delaunay graph with distance edge weights as a Rips complex, and it utilizes PD computation libraries for the constructed graph. The vertices, edges, and edge weights of the proposed graph correspond to connected-components (CCs) in the 3D binary image, Delaunay edges of the generalized Voronoi diagram for the CC boundaries, and minimum distances between adjacent CCs, respectively. Thus, the number of elements required to compute PD is significantly reduced for large objects in 3D binary images compared with conventional representations such as cubical complexes, which results in efficient topological feature estimations.
Analysis of the Relationship Between Process Parameters and Microhardness for the Finishing Process by Wire Arc Additive Manufacturing Combined with the FSB Tool of Austenitic Stainless Steel 316L
Authors: Cordkaew Teerayut , Kaneko Jun’ichi , Abe Takeyuki
Published: September 2024

Wire arc additive manufacturing (WAAM), based on gas metal arc welding, is ideal for fabricating components with sizeable geometries and moderate structural intricacies. However, the electric arc introduces a heat source and directional heat dissipation during deposition, resulting in undesired microstructural characteristics, such as columnar dendritic structures, which lead to variations in hardness across the printed component. Our previous research introduced the friction stir burnishing (FSB) tool integrated with WAAM using a hybrid approach called simultaneous processing. This method suppressed dendrite formation and enhanced the microstructure within WAAM. This approach directly correlates process dynamics, force dynamics, and temperature control, facilitating efficient plastic deformation. This research investigates the relationship between process parameters and microhardness within the combined manufacturing systems of WAAM and FSB tools. The study primarily focuses on using SUS 316L austenitic stainless steel wire material for WAAM and examines how simultaneous operation with the FSB tool impacts microstructure and microhardness. The investigation emphasizes three key parameters: the distance between the welding torch and the FSB tool, tool rotational speed, and machine feed speed. Comprehensive experimentation, including Taguchi analysis, determines optimal values for these parameters. Results indicate that torch-to-tool distance and machine feed speed significantly influence microhardness, while tool rotational speed shows minimal impact. The most effective combination for enhancing microhardness was a torch-to-tool distance of 20 mm, a machine feed speed of 528 mm/min, and a tool rotational speed of 1900 rpm. This combination induced a plastic deformation transformation effect, contributing to the overall improvement in microhardness. Additionally, the optimal parameters for achieving a smaller grain size were a torch-to-tool distance of 17 mm, a machine feed speed of 356 mm/min, and a tool rotational speed of 1900 rpm, as indicated by the average grain size. Furthermore, this study shows significant improvements in microstructure and hardness within 50–200 µm depth from the surface. Comparative analysis between FSB tool-processed and non-processed samples indicates a 22.51% increase in microhardness, with the grain size of the simultaneous process being 7 µm compared to 11.55 µm. Optimizing the process parameters of simultaneous processing achieves superior microhardness and microstructural refinement. Additionally, it highlights the need for further material development to address challenges associated with tool durability, paving the way for advancements in simultaneous processes.
Development of a Compression Test Method for Badminton Shuttlecock Feathers
Authors: Woo To Ming Terence , Kootsookos Alex , Alam Firoz
Published: September 2024

The current badminton shuttlecock products are highly ineffective. The bird feather shuttlecocks used in official competitions have an unsustainably high change count due to rapid breakage from repeated racquet strikes. Meanwhile, the current synthetic shuttlecocks lack the structural properties of their feather counterparts to produce the desired aerodynamics as a projectile. This study discusses two material testing methods: the feather compression and hysteresis test, which can provide relevant mechanical data to be incorporated into the manufacturing process of future synthetic shuttlecocks. The compressive moduli from six feather shuttlecock products (four goose and two duck) were compared using the proposed methods at the strain rate of 1.15 mm/60 s. Subsequently, a three-cycle hysteresis test was conducted at an increasing strain rate of 1.15 mm/120 s, 1.15 mm/80 s, and 1.15 mm/60 s. The compression results were comparable to those from previous studies; however, there are currently no hysteresis data of shuttlecock feathers were available for comparison. The proposed methods have the potential to provide vital mechanical data that should be taken into account for future synthetic shuttlecock designs.
Dijital Finansın Bankacılık Sektörü İstikrarına Etkisi: Avrupa ve Orta Asya Ülkeleri (ECA) Örneği
Authors: Güneysu Yusuf , Ergün Tolga
Published: September 2024

Bu çalışmanın amacı, bankacılık sektörü istikrarı üzerinde dijital finansın etkisini incelemektir. Çalışmada ECA kapsamındaki 44 ülkeye ait 2006-2020 arasındaki yıllık veriler panel veri analizi yöntemi ile test edilmiştir. Araştırma modelindeki bağımlı değişken bankalara ilişkin Z skorudur. Dijital finans göstergesi olarak 100.000 kişi başına ATM sayısı, internet kullanan bireylerin toplam nüfusa oranı ve 100 kişi başına mobil telefon aboneliği kullanılmıştır. Analizin ilk aşamasında panel verilerin birim ve zaman etkisi incelenmiş ve ardından dirençli Hausman testi ile sabit etkiler ve tesadüfi etkiler modelleri arasından uygun model belirlenmiştir. İkinci aşamada tercih edilen modele ilişkin temel varsayımlar sınanmıştır. Son aşamada, varsayımlara ilişkin sapmalar nedeniyle dirençli tahminci yöntemi Driscoll-Kraay analizi yapılmıştır. Analiz sonuçlarına göre bankacılık sektörü istikrarı üzerinde ATM sayısı ile 100 kişi başına mobil telefon aboneliği değişkenlerinin negatif yönde etkisi tespit edilirken, internet kullanan bireylerin toplam nüfusa oranının pozitif yönde etkisi saptanmıştır. Sonuçlar, dijital finansın bankacılık riski ve finansal istikrar üzerinde etkili olduğunu göstermiştir.
Choice of Acromioclavicular Dislocation Treatment Should Not Be Influenced by Risk of Development of Acromioclavicular Osteoarthritis
Authors: Vossen Roderick J.M. , Verstift Daniel , Van Etten-Jamaludin Faridi S. , Hamans Bryan J. , van den Bekerom Michel P.J. , Verweij Lukas P.E.
Published: September 2024

Background:

It is currently unknown to what degree surgical or nonoperative treatment of acromioclavicular (AC) dislocation influences the development of osteoarthritis (OA). The aim of this study was to evaluate AC OA after surgical and nonoperative treatment for AC dislocations, compare OA prevalence between treatment options, and compare OA prevalence between the injured and contralateral shoulder.

Methods:

Articles reporting on the prevalence of OA after surgical or nonoperative treatment of an AC dislocation with a minimal 2-year follow-up were included. AC OA presence was extracted for the injured and contralateral shoulder. Treatment categories were defined based on anatomical variation in the reattachment of ligaments: AC fixation, coracoclavicular (CC) fixation, AC and CC fixation, Bosworth screw synthetic graft, tendon graft, and conservative. Study quality was assessed using the Methodological Index for Non-Randomized Studies (MINORS) criteria.

Results:

Ninety-four articles were included for qualitative analysis, and 7 articles were included for meta-analysis (n = 3,812; follow-up = 2.0-24.2 years; mean age 37.6 ± 10.4 years). A total of 3,483 patients underwent surgical treatment, and 329 patients underwent conservative treatment. OA prevalence ranged from 6.7%-29.3% between 7 pooled treatment categories. Most included studies had a follow-up <10 years (94%) and OA prevalence increased with time, regardless of treatment option. There was no difference in OA prevalence between the injured and contralateral shoulder (p = 0.120). MINORS scores were varied, ranging from poor to very good.

Conclusion:

The pooled AC OA prevalence of the 7 treatment categories ranged from 6.7% for the CC fixation surgical group to 29.3% for the conservative treatment group. However, the included studies were predominantly of low quality and had varying follow-up periods, with most having relatively short follow-up durations. No difference in AC OA prevalence was found between the injured and contralateral shoulder. Based on the available evidence, treatment choice for AC dislocation should not be influenced by the potential development of AC AO.

Level of Evidence:

Level IV. See Instructions for Authors for a complete description of levels of evidence.
Optical-electronic correlation-extreme navigation system of small unmanned aerial vehicle
Authors: Sheinikov A. A. , Malkin V. A. , Smolensky E. A. , Ivanitsky L. A.
Published: September 2024

An optical-electronic correlation-extreme navigation system for an unmanned aerial vehicle has been developed. The proposed navigation system is characterized by the use of a small-sized and affordable digital camera and computer, which is critical for small military unmanned aerial vehicles. The developed algorithmic support for the system is distinguished by the use of algorithms for reconstructing a three-dimensional digital terrain model using optical digital images from an on-board digital camera, as well as algorithms for correlation processing of current and reference models, which ensures the possibility of accurate autonomous air navigation using view information. The requirements for the flight parameters of a small unmanned aerial vehicle with an optical-electronic correlation-extreme navigation system are substantiated. The values of the true speed of an unmanned aerial vehicle and the correction period of the on-board strapdown inertial navigation system are substantiated according to the data of the proposed optical-electronic correlation-extreme navigation system. The results of the developed optical-electronic correlation-extremal navigation system accuracy studies depending on the shooting parameters and the quality of the reference models are presented.
Water-Alternating CO2 Injection in Carbonate Reservoirs: A Review of Fluid-Rock Interaction Studies
Authors: Marçon Diogo Reato , Iglesias Rodrigo Sebastian , Novaes Aline Machado de Azevedo , de Faria Rafaella Magliano Balbi
Published: September 2024

Water-alternating-CO2 (CO2-WAG) injection is a well-established method for enhanced oil recovery (EOR) and a promising option for geological carbon storage. The alternating injection of this gas with water also increases carbonate rock reactivity, which is higher than that in siliciclastic reservoirs, affecting the porosity and permeability near the well, thereby impacting the injectivity and well integrity. The composition of the produced water is also affected, increasing the potential for inorganic scaling. Moreover, reactivity also changes the pH of the produced water, thereby affecting material selection for producer wells. The characterization and modeling of such fluid-rock interaction effects are challenging but valuable for designing and optimizing the CO2-WAG process. To assess the current knowledge on this topic, we present a review encompassing laboratory- and field-scale studies of fluid-rock interactions resulting from CO2-WAG processes, particularly those pertaining to changes in the porosity, permeability, and produced water composition. Numerous studies within this scope have been published. This review summarizes the most pertinent findings and identifies opportunities for further research. In laboratory-scale studies, the main necessity is to expand the range of experimental conditions and parameters, either by conducting experiments with different mineralogies under representative reservoir conditions (e.g., pressure, temperature, and hydrodynamics) or by incorporating an oil phase, as such studies yield data essential for field-scale simulations, thereby enhancing their reliability. Addressing gaps in field-scale studies involves integrating the phenomenon of relative permeability hysteresis when assessing the impact of carbonate rock dissolution on the injectivity during CO2-WAG, as these phenomena are concurrent. Finally, we advocate for studies that establish an upscaling methodology for translating laboratory results into field-scale reactive transport simulations.
The diagnostic pathway of Parkinson’s disease: understanding patient perspectives in Australia
Authors: Dewson Grant , Lang Tali , McLean Iain , Shin Jenna , Jackson Victoria , Lawrenson Isobel , Zipper Belinda , Yeung Alex , Evans Andrew
Published: September 2024

Despite the increasing prevalence of Parkinson’s disease (PD) in Australia, there is limited data about experiences of people with Parkinson’s (PwP) during the diagnostic process and post-diagnosis. This study surveyed experiences of PwP from initial symptoms, throughout diagnostic consultation, and support provided following diagnosis through a national web-based survey. In total, 385 participants accessed the questionnaire, with 335 full completions. Responses from participants living in capital and regional city centers showed patient satisfaction with clinical care during diagnostic consultation at approximately 40%. Satisfaction in clinical care was less in rural areas (26%). Moreover, the majority of participants (68%), irrespective of geographical location, felt they were not adequately involved in discussions about treatment and care planning. Overall, 77% of participants reported dissatisfaction with the level of support of their clinical care teams. Furthermore, respondents reported that clinician referral to allied-health providers were low, with only 22% of participants accessing physiotherapy and 17% referred to mental health services. From respondents who provided additional feedback how PwP could be better supported following diagnosis, the top two responses were greater access and engagement with Parkinson’s disease Clinical Nurse Specialists, and the development of PD-specific apps to increase access to educational resources and support. Findings from this study highlight the necessity for the development of Australian guidelines for PD clinical management, greater resourcing for PD clinicians including development of educational programs, and creation of an Australian-centric educational resources. Addressing these gaps may improve perceived quality of care and overall patient satisfaction for PwP in Australia.
Application of multifunctional pulse wave sphygmomanometer combined with constant temperature ice in patients with forearm hematoma after coronary intervention
Authors: Qiao Jimin , Shi Yihang , Li Kai , Zhu Xiaomin , Wang Zhimei
Published: September 2024

Aim
This study aims to investigate the effects of combining a multifunctional pulse wave sphygmomanometer with constant temperature ice on patients with forearm hematoma following coronary intervention.
Methods
Patients who developed forearm hematoma after undergoing coronary intervention from March 2021 to March 2023 at our hospital were selected as the study cohort. Using a random number table, they were divided into two groups the control group and the research group. The control group received cuff compression treatment using a multifunctional pulse wave sphygmomanometer. The primary endpoint was the effective rate of one compression. Secondary endpoints included body surface temperature, pain, comfort, arm measurements, and swelling value.
Results
A total of 190 patients were included, with 95 in the control group and 95 in the research group. The research group showed a significantly higher effective rate of one compression compared to the control group (87.2% vs. 95.8%, p = 0.035). Additionally, the research group experienced significantly reduced pain (2.0 [2.0,3.0] vs. 1.0 [1.0,2.0], p < 0.001) and improved comfort levels. This approach also effectively reduced body surface temperature (32.91 ± 0.83℃ vs. 12.09 ± 1.09℃, p < 0.001), arm measurements (274.32 ± 9.56mm vs. 271.15 ± 8.82mm, p = 0.019), and swelling value (12.40 ± 1.95 vs. 11.07 ± 2.13, p < 0.001) after compression.
Conclusions
The combined use of a multifunctional pulse wave sphygmomanometer for cuff compression on forearm hematoma with simultaneous constant temperature ice application demonstrated more benefits. This approach effectively reduced pain, improved comfort levels, and enhanced compression-based hemostasis and reduction of swelling.
Chronic Recurrent Multifocal Osteomyelitis in Pediatric patients: A Case Series Study from China and Literature review
Authors: Hu Minhua , Zeng Wenxing , Zhang Jingtao , Yan Hongsong , Huang Feng , Xiong Hao , Fang Bin , Li Yue
Published: September 2024

Background
Chronic recurrent multifocal osteomyelitis (CRMO) is a rare auto-inflammatory disorder that often pose diagnostic challenges due to its atypical symptomatology. This retrospective study aimed to investigate the clinical features, laboratory tests, imaging features, and treatment strategies of CRMO in pediatric patients.
Methods
In the study, seven pediatric patients with CRMO treated at the Department of Pediatric Orthopedics, First Affiliated Hospital of Guangzhou University of Chinese Medicine, between January 2018 and February 2022, were retrospectively analyzed. The objective was to enhance understanding of CRMO by exploring clinical data in-depth.
Results
The study group comprised five males and two females, aged 3 to 13 years. They experienced symptoms for a median duration of 6 months before hospitalization, presenting with recurrent pain and various accompanying signs, including hypothermia (one case, 14.28%), swelling (three cases, 42.85%), localized skin warmth (three cases, 42.85%), and plantar pustules (one case, 14.28%). The femur (five cases,71.42%) and tibia (five cases, 71.42%) were frequently affected. Radiographic and CT scans showed osteosclerosis and osteolytic lesions, while MRI detected bone marrow edema. Histological examination of bone biopsies from four patients revealed fibrous tissue hyperplasia, lymphocytic, and neutrophilic infiltration, despite negative bacterial cultures. Laboratory tests generally showed normal or slightly elevated values. Symptomatic improvement was observed in six patients (85.72%) with nonsteroidal anti-inflammatory drugs (NSAIDs), while one patient (14.28%) resistant to NSAIDs responded well to tumor necrosis factor (TNF) inhibitors.
Conclusions
In summary, CRMO's clinical presentation lacks specificity, with unexplained bone pain being the most common symptom. Precise diagnosis and timely intervention depend on thorough MRI evaluation for lesion detection, enhancing CRMO diagnosis. This study offers valuable insights into CRMO's clinical manifestations, laboratory findings, imaging features, and treatment strategies in pediatric patients.
Applying microwave imaging in biomechanics: a feasibility study using tissue-mimicking phantoms
Authors: Radhakrishnan Vignesh , Serano Peter , Robinson Martin , Marchant Alex , Dale Taito J , Patil Samadhan , Pelah Adar
Published: September 2024

Incorporating actual bone movement in kinematic pipelines has shown to reduce the influence of soft tissue artefacts (STA), a critical source of error, in clinical biomechanical analysis. Ultrasound imaging, a non-ionising and cost-effective imaging modality, has been extensively integrated in biomechanics to locate the underlying bone. However, limitations of needing a probe to be held at the location to be imaged and the need for coupling liquid, impedes their widespread applicability. In this study we explore the feasibility of applying another non-ionising and cost-effective imaging modality, microwave imaging, in biomechanics. By collecting data, from both simulated and experimental tissue-mimicking phantoms, under conditions aimed to emulate a wearable system, our results indicate that the underlying bone can be detected from the skin surface using microwave imaging. We believe our findings support the fidelity of microwave imaging as an alternative imaging modality to ultrasound imaging and underscore the need for further research in integrating microwave imaging in biomechanics.
Enhancing Coagulation Management after Cardiac Valve Replacement and Valvuloplasty: The Benefits of Home Monitoring
Authors: Ying ChenXi , Fu YuFei , Dai BoHao , Liu LingShan , Chen Xin
Published: September 2024

Background
The research aims to analyze the impact of home monitoring on INR control and complications in patients undergoing valve replacement and valvuloplasty surgery. It is also the first to assess and predict associated risk factors by using a nomogram graph.
Methods
Conducted at the First Affiliated Hospital of Zhejiang University, the retrospective study involved 505 patients initially, with 406 completing the follow-up. Data collection included patient characteristic, medical history, valve replacement details, and INR values.
Results
The study found that self-management of INR testing significantly improved the time in therapeutic range (TTR), reduced INR variance, and decreased complications. Predictive factor for postoperative coagulation control included gender, history of atrial fibrillation, Preoperative medication history, valve replacement type, and education level.
Conclusion
With home monitoring of INR, patients can take more control of their coagulation management and decrease the frequency of hospital visits. Treatment compliance and outcomes are enhanced when this method is combined with patient education level. The useof a nomogram helps identify patients with stable coagulation function for clinical trials and allows for early intervention in high-risk patients.
Factors Influencing Breast Self-Exam Practice and Awareness among Females in Saudi Arabia
Authors: Alzakari Meshal , Alabdulkarim Alanoud , Alsuhaibani Renad , Alzkari Faisal , Alkanhal Abdulrahman , Alghanmi Amjad , Salahuddin Amra , Huda Arwa , Moiz Muhammad Umer Abdul , Khan Salahuddin
Published: September 2024

Background
Breast cancer is the most common global malignancy [1]. In 2022, about 2.3 million women were diagnosed with breast cancer globally highlighting the critical need for early detection strategies [2,3]. Breast self-exam is a simple and costless method of detection [4]. Despite its potential limitations in reducing mortality, women familiar with their breast tissue often find breast changes first [4]. This study is designed to investigate factors influencing the practice and awareness of breast self-exams among females in Saudi Arabia.
Methods
This prospective cross-sectional study is conducted in Saudi Arabia targeting females aged 18 to 65 in Saudi Arabia. Participants completed a structured questionnaire assessing their awareness and practices related to BSE and breast cancer. Statistical Package for the Social Sciences was used for analysis.
Results
The majority of participants were single (71.3%), held a Bachelor’s degree (59.4%), and currently students (65.5%). A personal history of breast cancer was reported by 1.3% of women, while 12.9% had a family history and 16.1% had friends diagnosed with the disease. Awareness of breast cancer risk factors and symptoms varied, with 13.5% recognizing that women in their fifties face the highest risk, and 38.1% knowing the common symptoms. Although 79% had heard of breast self-examination (BSE), only 42.6% knew how to perform it. Regular clinical breast examinations were deemed necessary by 69.1%. Only 32.6% knew that BSE was not a substitute for mammograms. Overall, 21.3% had good awareness of breast cancer and BSE, with social media being the primary source of information (49.1%).
Conclusion
Awareness and practice of breast cancer screening are suboptimal among Saudi women. Higher awareness was associated with older age, higher education, marriage, employment, and personal/familial history of breast cancer. Efforts to improve awareness and screening should target younger, less educated, single, and unemployed women, emphasizing regular screening and early detection.
Categories: Oncology
A rare phenomenon involving ventricular separation: a case report
Authors: Jin Huayong , Wen Yudan
Published: September 2024

Ventricular separation is a multipart, extensive disease of the heart that hinders the electrical conduction of the cardiac system ventricular muscle, causing a bidirectional conduction block therein. The occurrence of ventricular separation suggests that the myocardium is in a state of severe ischemia and prognosis is generally poor. Herein, we present one rescue case in which the extremely rare phenomenon of ventricular separation developed and was documented in real-time, the case ultimately resulted in patient death.
Prevalence and outcomes of Hartmann’s reversal following Hartmann’s procedure in a regional center, a retrospective cohort study.
Authors: Fleischl William , Clifford Kari , Wright Deborah
Published: September 2024

Background
Hartmann’s procedure (sigmoid resection with end colostomy) is a commonly performed emergency procedure for diseases of the sigmoid colon.
Aim
To determine the proportion of patients undergoing Hartmann’s reversal (restoration of GI continuity) following Hartmann’s procedure, the clinical and demographic factors associated with reversal, and the reasons for non-reversal.
Method
This is a single center, retrospective audit of patients undergoing Hartmann’s procedure between June 2011 and May 2020. Age, sex, American Society of Anesthesiologists classification (ASA), indication for Hartmann’s, surgical approach, specialty of responsible surgeon (General or Colorectal), 30-day reoperation, requirement for radiologically-guided drain, and reason for non-reversal were recorded. The association between these factors and reversal was determined with Fischer’s exact test and logistic regression. Cumulative reversal proportions were calculated with the Kaplan-Meier method.
Results
Data was obtained for 114/117 patients, of whom 31% (35/114) underwent Hartmann’s reversal. The median (IQR) time to reversal was 372 (188-500) days). Patients with restoration of GI continuity were younger (median 67 versus 73 years, P<0.001) with fewer co-morbidities, (ASA £2 34% versus 9% P=0.002). The estimated cumulative 24-month reversal incidence was 37%.
Patients who had a Hartmann’s procedure performed for diverticulitis had an increased odds of being reversed (OR 4.1 (95% CI 1.6, 10.5) P=0.001); Hartmann’s for malignancy was associated with decreased odds of reversal (OR 0.37 (95% CI 0.12, 1) P=0.035).
Conclusion
Of patients who underwent Hartmann’s procedure, the majority retained a permanent stoma. Older patients, those with high ASA, and those who underwent index procedures for malignancy had lower rates of reversal.
Extensive Q-Factor Tuning for Leaky Modes with Minimal Frequency Variation in Asymmetric Slab Grating Structures
Authors: Bark Hyeon Sang , Kim Seong-Han , Ji Young Bin , Kwon Jae Gwang , Kang Chul , Baek In Hyung , Lee Kitae , Oh Seung Jae , Jeon Tae-In , Kee Chul-Sik
Published: September 2024

We investigated an asymmetric slab grating structure to achieve significant tuning of the quality (Q) factor for a leaky mode while minimizing frequency variation. This structure comprises two identical gratings placed on the top and bottom of a slab waveguide, with one grating laterally shifted to introduce asymmetry. Simulations demonstrate that lateral shifting of one grating induces extensive changes in the Q-factor with minimal frequency variation, particularly near the band-flip filling fraction because the band-flip filling fraction remains unaffected by the shifting. The independence of the band-flip filling fraction from lateral shifting is attributed to the superposition property of Bragg scattering processes in the asymmetric grating structure. Experimental verification in the terahertz range confirms significant control over the Q-factor of the leaky mode of the structure. The proposed asymmetric slab grating structure offers possibilities for mechanically controllable optical devices, which are applicable to tunable filters and sensors. This study advances our understanding and application of leaky modes in asymmetric grating structures, revealing a previously unexplored aspect of asymmetric optical lattice.
An analysis of illegal trade of non-marine turtles in West Bengal, India: Study based on a seven-year confiscation scenario
Authors: Mandal Prasun , Mallick Priyanka Halder , Bhattacharya Tanmay
Published: September 2024

The global trade in non-marine turtles (NMTs) poses a serious threat to biodiversity. Its portrayal in the news media and other secondary sources provides a perspective on understanding what drives it, its effects and public involvement, helping in the identification of illegal trade lines. We used 133 confiscation reports from West Bengal, occurring between January 2017 and December 2023, as a case study on the confiscation scenario from various online news sources and from Forest Department reports. We identified seizure of 33,317 NMTs, belonging to nine species, six of which are threatened and one near-threatened. Lissemys punctata was the most commonly traded species accounting for 94% of the identified seized individuals and Geochelone elegans comprised 5% of the traded individuals. NMTs were seized from 15 districts of West Bengal, with North 24 Parganas found to be a hotspot accounting for 57% of confiscations. The supply chain of soft-shell turtles extended beyond West Bengal to Uttar Pradesh (50%) and Odisha (25%), whereas star tortoises were exclusively smuggled from Tamil Nadu. Additionally, we found 349 kg of body parts were seized. All confiscated materials were meant either for domestic consumption or for illegal international trade through Bangladesh. Significantly more confiscations were recorded during the winter (H = -11.429, p < 0.001) and throughout COVID-19 pandemics illegal trading remained high, with an increase in the involvement of women. West Bengal become a significant hub for the illegal trade of NMTs, with North 24 Parganas district as its epicentre which needs more conservation attention.
Combining same-target drugs exhibits additive efficacy with minimal toxicity
Authors: Cai Shao-Qing , Wang Yi , Xu Feng , Zhao Qian , Li Hong-Fu , Cai Weijing , Cui Jing-Rong , Liu Li-Jia , Zhang Yi-Fan , Wang Chao-Qun , Yang Xing-Xin , Yang Ping , Yang Zhi-Wei , Shang Ming-Ying , Liu Guang-Xue , Wang Xuan
Published: September 2024

Drug toxicity is a major concern in medicine, and toxicity is an unresolved obstacle to the efficacy of chemotherapy drugs for cancer. Based on our ‘additive effect’ and ‘toxicity scattering effect’ hypothesis, we propose a unique drug-combination strategy to overcome drug toxicities: combining 8–10 drugs that act on the same target at ineffective doses (much lower than their usual doses) to dramatically reduce the toxicity of each drug without weakening the efficacy of the combination. Using this strategy, we developed an anticancer combination of 8 drugs (topoisomerase II inhibitors); each drug was included at 7.7%–19.5% of its minimum effective dose. This combination prolonged life by 92.8% in ascites tumour-bearing mice and inhibited tumour growth by 54.3% in solid tumour-bearing mice, without causing mortality or detectable liver, cardiac, or renal toxicity. At an average of 1/3 of the combination dose, each drug alone resulted in ineffective tumour inhibition (only 24.6%–34.5% reduction) but caused a 10%–50% mortality. As number of drugs in the combination increased from 1 to 4 to 8, the dose of each drug and the overall toxicity progressively decreased. Combinations of four or six topoisomerase II inhibitors at low concentrations inhibited the proliferation of cancer cell lines and the activity of topoisomerase II, revealing an evident additive effect on the same target. These results demonstrate the significant advantage of this strategy in reducing toxicity. Although this strategy violates drug use principles, it may be a breakthrough in reducing toxicity and improving cancer treatment. This strategy can also be applied to other diseases with high drug toxicity.
Assessment of metallic trace element contents of soils and plants of urban and suburban areas of Safi City (Morocco)
Authors: MANDRI Btissam , KHALIL Hicham EL , BOULARBAH Ali
Published: September 2024

Our paper syntheses results obtained from studying the effect of typical contamination sources on soils and plants in selected urban and suburban areas in the Safi City. Using common methods, the physicochemical characterization and metallic trace elements (TEs) contents of plants and soils, collected from different urban areas, control area (CA), cement factory (SF), uncontrolled landfill (UL), treatment and transformation unit of phosphate (TP), were determined. Results show that the studied urban and suburban areas can be qualified as polluted by metallic trace elements and the most polluted one is TP area (CA < SF < UL < TP). Results underline the significant contribution of the atmospheric pollution on the contamination of soils and plants collected from TP, UL and surrounding areas with TEs. The most contaminated plants species by TEs are those sampled from TP area and they are Eucalyptus globulus, Nerium oleander, Ficus carica and Medicago sativa. Sinapis arvensis L. and Carpobrotus edulis plants come in the second level with remarkable contamination levels of TEs respectively. Industrial activities in urban areas constitute a potential source of contamination of soils and plants by metallic trace elements that may pose real health risk for human population in the city. We can considered this study as a primary work to develop a global process to assess the environmental contamination of plants and soils in the region of Safi city. It can help us to manage potential polluted sites in a sustainable development strategy.
Improving reproducibility of volumetric evaluation using computed tomography in pediatric patients with congenital heart disease
Authors: Cho Hyun-Hae , Lee So Mi , You Sun Kyoung
Published: September 2024

Background :The volumetric data obtained from the cardiac CT scan of congenital heart disease patients is important for defining patient’s status and making decision for proper management.
Objective :The objective of this study is to evaluate the intraobserver, interobserver, and interstudy reproducibility of left ventricular (LV) and right ventricular (RV) or functional single ventricle (FSV) volume. And compared those between manual and using semiautomated segmentation tool.
Method : Total of 127 patients (56 female, 71 male; mean age 82.1 months) underwent pediatric protocol cardiac CT from January 2020 to December 2022. The volumetric data including both end systolic, diastolic volume and calculated EF were derived from both conventional semiautomatic region growing algorithms (CM, TeraRecon, TeraRecon Inc., San Mateo, CA, USA) and deep learning-based annotation program (DLS, Medilabel, Ingradient Inc., Seoul, Republic of Korea) by three readers., who have different background knowledge or experience of radiology or image extraction before. The reproducibility was compared by using intra and interobserver agreements. And the usability was measured by using time for reconstruction and number of tests that were reconfigured before the reconfiguration time was reduced to less than 5 minutes.
Results :Inter and intraobserver agreements showed better agreements degrees in DLS than CM in all analyzers. The time used for reconstruction showed significantly shorter in DLS compared with CM. And significantly small numbers of tests before the reconfiguration is needed in DLS than CM.
Conclusion: Deep learning-based annotation program can be more accurate way for measurement of volumetric data for congenital heart disease patients with better reproducibility than conventional method.
Ductal Stenting in Duct-Dependent Pulmonary Circulation: Technical Challenges and Complications in a Resource-Limited Setting
Authors: Ara Andaleeb , Khan Tanzeela , Akhtar Khurram , Sadiq Nadeem , Haq Intisar Ul , Ahmad Kaleem , Rafique Saima
Published: September 2024

Objective
To examine the technical challenges and complications of palliative ductal stenting in patients with duct-dependent pulmonary circulation in a resource limited setting.
Methodology:
This retrospective study was conducted in Armed Forces Institute of Cardiology and National Institute of Heart Diseases, Rawalpindi, Pakistan covering a period from September 2020 to September 2023. The study was approved by the institutional ethical review board. Data of all patients who underwent ductal stenting for duct-dependent pulmonary circulation during the study period were explored. Demographic data of patients, details of the procedure, the immediate procedural outcome, occurrence of any immediate, and early onset complications, re-intervention procedures, and in-hospital mortality were noted. Statistical package for social sciences version 21 was used for data entry and analysis.
Results
A total of 52 patients underwent ductal stenting procedure during the study period. Males were 27 (51.9%) and females were 25 (48.1%). Age ranged from 1 day to 1460 days (Mean: 133.2 ± 257.47 days; Median: 60 days). The procedure was successful in 47 (90.4%) cases while it was unsuccessful in 5 (9.6%) cases. Seven (13.5%) patients had to undergo a re-intervention procedure raising the total number of ductal stenting procedures during the study period to 59. All of the re-intervention procedures were done successfully. Complications included stent dislodgement in 1 (1.7%) case, stent fracture in 1 (1.7%) case, stent migration in 2 (3.4%), branch pulmonary artery jailing in 5 (8.5%), and stenosis of the uncovered duct in 5 (8.5%) cases. Overall in-hospital mortality of ductal stenting was 5.1%.
Conclusion
Ductal stenting makes a reasonable palliative therapy in selected cases of duct-dependent pulmonary circulation.
Ectopic Thyroid Tissue in Adrenal Gland – A Case Report and Review of Literature
Authors: Vijayakumar Varadharajan , Mahender Banu , Bose Jagadesh Chandra , Kajamohideen SuhailDeen , Shanmugasundaram Gouthaman
Published: September 2024

Ectopic thyroid tissue along the line of descent of thyroid from foramen caecum along thyroglossal duct to the normal anatomic location in neck has been reported. Ectopic thyroid tissue in adrenal gland (ETTAG) is rarely encountered and very few cases have been reported in literature. The most common differential diagnosis to be considered when thyroid follicles are noted in adrenal gland are metastasis from a thyroid malignancy or a teratoma or an ectopic thyroid tissue in adrenal gland. We present a case of an adrenal incidentaloma in a young pregnant female which was diagnosed to be ectopic thyroid tissue in adrenal gland. The review of literature of similar cases of this rare embryological aberrance is discussed. To our knowledge, only 16 such cases have been documented in literature and our case is the first one from Indian subcontinent and the largest documented with respect to size.