bluuebunny/crossref_metadata_2025_split huggingface dataset:
High Q-factor multi-Fano resonances in all-dielectric metasurface for high-performance optical switching and sensors
Authors: Zhang Tao , Huo Yiping , Xu Congmu , Li Jiamin , Zhang Zilong 
Published: November 2024

The bound state in the continuum (BIC) in photonics has received widespread attention owing to its ultra-high Q-factors and promise in realizing field enhancement and sensing. In our study, we proposed and studied an all-dielectric metasurface composed of two silicon nano-quadriprisms. By introducing broken symmetry in the nano-structure, the BIC modes were transformed into quasi-BIC modes, resulting in four Fano resonances with limited but extremely high Q-values. Through multipole decompositions and electromagnetic field analysis, we revealed that these resonances were dominated by magnetic dipoles and magnetic quadrupoles responses. The sensing characteristics of the structure were examined, revealing a maximum sensitivity and figure of merit of 383.3 nm/RIU and 958.3RIU−1, respectively. The structure we proposed achieved dynamic adjustability by changing the polarization angle of incident light, and thus implemented the function of an optical switch. The ON and OFF states of the structure are obtained at y polarization and x polarization, respectively, and the ON/OFF ratio was 29.75 dB. In addition, the phase variations and group indices at the four Fano resonances were analyzed, with the maximum group index reaching 3000. These characteristics make the metasurface suitable for applications in high-performance biosensors, optical switches, and slow-light effects.
Heterogeneously integrated silicon-conductive oxide MOSCAP microring modulator array
Authors: Hsu Wei-Che , Abdolhosseini Saeed , Rong Haisheng , Kumar Ranjeet , Zechmann Bernd , Wang Alan X. 
Published: November 2024

In pursuit of energy-efficient optical interconnect, the silicon
microring modulator (Si-MRM) has emerged as a pivotal device offering
an ultra-compact footprint and capability of on-chip wavelength
division multiplexing (WDM). This paper presents a
1×4 metal-oxide-semiconductor capacitor
(MOSCAP) Si-MRM array gated by high-mobility titanium-doped indium
oxide (ITiO), which was fabricated by combining Intel’s
high-volume manufacturing process and the transparent conductive oxide
(TCO) patterning with the university facility. The
1×4 Si-MRM array exhibits a high
electro-optic (E-O) efficiency with V
π
·L of 0.12  V·cm and achieves a modulation rate of
(3×25+1×15)  Gb/s with a measured bandwidth of
14 GHz. Additionally, it can perform on-chip WDM modulation at
four equally spaced wavelengths without using thermal heaters. The
process compatibility between silicon photonics and TCO materials is
verified by such an industry-university co-fabrication approach for
the MOSCAP Si-MRM array and demonstrated enhanced performance from
heterogeneous integration.
Polarization-insensitive silicon intensity modulator with a maximum speed of 224  Gb/s
Authors: Zhang Zanyun , Huang Beiju , Wang Qixin , Chen Zilong , Li Ke , Zhang Kaixin , Li Meixin , Jiang Hao , Xing Jiaming , Liu Tianjun , Lv Xiaoqing , Reed Graham T. 
Published: November 2024

Polarization-insensitive optical modulators allow an external laser to be remotely interconnected by single-mode optical fibers while avoiding polarization controllers, which would be convenient and cost-effective for co-packaged optics, 5G, and future 6G applications. In this article, a polarization-insensitive silicon intensity modulator is proposed and experimentally demonstrated based on two-dimensional centrally symmetric gratings, featuring a low polarization-dependent loss of 0.15 dB in minimum and polarization insensitivity of eye diagrams. The device exhibits a low fiber-to-fiber insertion loss of 9 dB and an electro-optic (EO) bandwidth of 49.8 GHz. A modulation speed of up to 224 Gb/s is also demonstrated.
Postoperative Karnofsky performance status prediction in patients with IDH wild-type glioblastoma: A multimodal approach integrating clinical and deep imaging features
Authors: Sasagasako Tomoki , Ueda Akihiko , Mineharu Yohei , Mochizuki Yusuke , Doi Souichiro , Park Silsu , Terada Yukinori , Sano Noritaka , Tanji Masahiro , Arakawa Yoshiki , Okuno Yasushi 
Published: November 2024

Background and purpose
Glioblastoma is a highly aggressive brain tumor with limited survival that poses challenges in predicting patient outcomes. The Karnofsky Performance Status (KPS) score is a valuable tool for assessing patient functionality and contributes to the stratification of patients with poor prognoses. This study aimed to develop a 6-month postoperative KPS prediction model by combining clinical data with deep learning-based image features from pre- and postoperative MRI scans, offering enhanced personalized care for glioblastoma patients.

Materials and methods
Using 1,476 MRI datasets from the Brain Tumor Segmentation Challenge 2020 public database, we pretrained two variational autoencoders (VAEs). Imaging features from the latent spaces of the VAEs were used for KPS prediction. Neural network-based KPS prediction models were developed to predict scores below 70 at 6 months postoperatively. In this retrospective single-center analysis, we incorporated clinical parameters and pre- and postoperative MRI images from 150 newly diagnosed IDH wild-type glioblastoma, divided into training (100 patients) and test (50 patients) sets. In training set, the performance of these models was evaluated using the area under the curve (AUC), calculated through fivefold cross-validation repeated 10 times. The final evaluation of the developed models assessed in the test set.

Results
Among the 150 patients, 61 had 6-month postoperative KPS scores below 70 and 89 scored 70 or higher. We developed three models: a clinical-based model, an MRI-based model, and a multimodal model that incorporated both clinical parameters and MRI features. In the training set, the mean AUC was 0.785±0.051 for the multimodal model, which was significantly higher than the AUCs of the clinical-based model (0.716±0.059, P = 0.038) using only clinical parameters and the MRI-based model (0.651±0.028, P<0.001) using only MRI features. In the test set, the multimodal model achieved an AUC of 0.810, outperforming the clinical-based (0.670) and MRI-based (0.650) models.

Conclusion
The integration of MRI features extracted from VAEs with clinical parameters in the multimodal model substantially enhanced KPS prediction performance. This approach has the potential to improve prognostic prediction, paving the way for more personalized and effective treatments for patients with glioblastoma.
The influence of horizontal violence on intention to leave among Jordanian nurses: A cross-sectional study
Authors: Al-Nawafleh Ahmad H. , Al-Hamdan Zaid M. , Bawayzah Hamzah , Bawadi Hala 
Published: November 2024

Aim
To determine nurses’ perception of horizontal violence and its relationship with intention to leave among Jordanian nurses.

Background
Horizontal violence is detrimental to healthcare organizations. Healthcare employees who are victims of horizontal violence may become unable to perform well, living with severe stress. Few studies in the world and no study in Jordan has examined the influence of horizontal violence on intent to stay among nurses.

Method
A descriptive, cross-sectional, correlational study design was used in this study.

Result
520 registered nurses were recruited, and 436 surveys were returned, resulting in an 83% response rate. The findings showed that, horizontal violence is moderate among nurses in Jordan. The mean score for nurse’s intent to leave work indicated a solid willingness to leave the job. The correlation analysis revealed that there was a significant relationship between horizontal violence and intent to leave. Female nurses reported significantly higher scores than males; also, there is a significant difference in responses in horizontal violence based on educational level.

Conclusion
In this study, it was found that horizontal violence in Jordanian organizations is moderate, and it has a significant relationship with nurses’ intention to leave.

Implication for nursing management
Nursing managers have a vital role in ensuring and enforcing the ‘zero violence’ policy in their department, which means that no reported incident of horizontal violence will be ignored. Each identified case of horizontal violence will be investigated and addressed appropriately.
Delayed presentation of breast cancer patients and contributing factors in East Africa: Systematic review and meta-analysis
Authors: Mulugeta Chalie , Emagneneh Tadele , Kumie Getinet , Ejigu Betelhem , Alamrew Abebaw 
Published: November 2024

Introduction
Breast cancer remains a significant public health issue, with delayed medical attention often leading to advanced stages and poorer survival rates. In East Africa, evidence on the prevalence and factors contributing to the delayed presentation of breast cancer is limited. As a result, this study aims to assess the pooled prevalence of delayed breast cancer presentation and identify contributing factors in East Africa.

Methods
We conducted a systematic review of observational studies from East Africa using PubMed, Google Scholar, Embase, Cochrane Library, Hinari, and Mednar databases. The Newcastle Ottawa 2016 Critical Appraisal Checklist assessed methodological quality. Publication bias was evaluated using a funnel plot and Egger’s test, and heterogeneity was examined with the I-squared test. Data were extracted with Microsoft Excel and analyzed using Stata 11.

Results
The pooled prevalence of delayed presentation among breast cancer patients in East Africa was 61.85% (95% Confidence Interval: 48.83%–74.88%). Significant factors contributing to delayed presentation included visiting traditional healers (Adjusted Odds Ratio: 3.52; 95% CI: 1.43–5.59), low educational levels (Adjusted Odds Ratio: 3.61; 95% CI: 2.39–4.82), age>40 years (Adjusted Odds Ratio 1.87; 1.03, 2.71), absence of breast pain (Adjusted Odds Ratio 2.42; 1.09, 3.74), distance >5km away from home to health institution (Adjusted Odds Ratio 2.89; 1.54, 4.24), and rural residence (Adjusted Odds Ratio: 3.33; 95% CI: 2.16–4.49).

Conclusion
This meta-analysis’s findings demonstrated that over half of breast cancer patients in East Africa delayed detection. Significant factors associated with delayed presentation include age over 40 years, illiteracy, rural residence, use of traditional healers, distance greater than 5 km from a health facility, and absence of breast pain. Healthcare stakeholders and policymakers must be focused on raising awareness and educating people to encourage early detection and prompt therapy.
Extended-spectrum beta-lactamase-producing Enterobacterales in human health: Experience from the tricycle project, Ghana
Authors: Obeng-Nkrumah Noah , Korang-Labi Appiah , Kwao Paul , Egyir Beverly , Nuertey Benjamin D. , Hedidor George , Boateng Gifty , Asah-Opoku Kwaku , Dankwah Thomas , Okine Esther , Opintan Japheth A. 
Published: November 2024

Background
Vulnerable groups, such as pregnant women, are at increased risk of potentially life-threatening infections with extended-spectrum beta-lactamase-producing Enterobacterales (ESBL-E) for both mother and newborn. However, data regarding ESBL-E carriage and associated risk factors in Ghanaian pregnant women remain scarce.

Objective
This study aimed to determine the prevalence of ESBL-E carriage and its associated risk factors among pregnant women attending the antenatal clinic at the Korle Bu Teaching Hospital.

Methods
A systematic sample of 700 pregnant women with gestational age ≥ 34 weeks attending the antenatal clinic at Korle Bu Teaching Hospital was included in the study. After administering a structured questionnaire to assess potential risk factors associated with ESBL-E carriage, patients were given a sterile stool container to submit at least 1 g of stool specimen. Recovered isolates from faecal specimens were identified using MALDI-TOF-MS technology. These isolates were then subjected to susceptibility testing and ESBL identification. A random subset of 24 ESBL-producing Escherichia coli isolates was whole-genome sequenced on the MiSeq Illumina platform. Risk factors associated with ESBL-E carriage were determined using multivariable logistic regression analysis.

Results
Among the 700 pregnant women, 42% (294) carried ESBL-E. The predominant ESBL-producing Enterobacterales were Escherichia coli (95%). Fifty percent (50%) of ESBL-E were multidrug resistant isolates (MDRs). Whole-genome sequencing of 24 ESBL-producing E. coli isolates revealed that blaCTX-M-15 (96%) was the most prevalent ESBL gene type. Notably, most isolates belonged to commensal phylogenetic groups (A, B1, and C; 88%). Having a primary level of education (aOR 1.45, 95% CI 1.05–1.96) and consuming legumes as the main source of protein (aOR 0.17, 0.40–0.83) were significantly associated with intestinal carriage of ESBL-E.

Conclusion
This study identified a high prevalence of ESBL-E and MDR-ESBL-E carriage among pregnant women. Our findings underscore the urgent need for public health interventions to control the spread of AMR.
Incidence and factors associated with prolonged use of mechanical ventilation in pediatric intensive care unit in a single tertiary care hospital
Authors: Pisitcholakarn Varisa , Sunkonkit Kanokkarn , Reungrongrat Sanit 
Published: November 2024

Introduction
Invasive mechanical ventilation (IMV) is frequently used as a life-supporting device in Pediatric Intensive Care Units (PICU). To date, there are few studies evaluating the impact of prolonged mechanical ventilation (PMV) in children which is associated with high morbidity and mortality. We aimed to determine the incidence and factors associated with PMV in PICU at our institution.

Methods
A retrospective review was performed of children aged 1 month to 18 years who were admitted to the PICU at Chiang Mai University Hospital, Thailand between January and December 2020. PMV was defined if the duration of IMV was ≥ 96 hours. Baseline characteristics and factors associated with PMV were analyzed by descriptive statistics, and univariable and multivariable logistic regression analysis, respectively. A p-value of < 0.05 was considered significant.

Results
Ninety-two episodes of IMV were performed in 90 children. The median (IQR) age of the children was 22.8 (7.2–111.9) months (male 64.1%). Forty-six of 92 (50%) children received PMV and 32.6% of children with PMV required a tracheostomy. Following multivariable analysis, factors associated with PMV were age <2 years old (OR 2.86, 95% CI 1.04–7.84, p = 0.041), male gender (OR 3.21, 95% CI 1.15–8.94, p = 0.026), and multiple antibiotics administration during PICU admission (OR 7.83, 95% CI 1.87–32.78, p = 0.005), respectively.

Conclusions
Pediatric PMV was notably common, with younger age, male gender, and multiple antibiotic use contributing to higher risk. Developing weaning protocols and strategies to reduce PMV duration is crucial.
Better accuracy of robotic-assisted total knee arthroplasty compared to conventional technique in patients with failed high tibial osteotomy
Authors: Baek Ji-Hoon , Lee Su Chan , Lee Dong Nyoung , Heo Juneyoung , Kim Taehyeon , Ahn Hye Sun , Nam Chang Hyun 
Published: November 2024

Purpose
This study aimed to compare the clinical outcomes, mechanical axis, component positioning, leg length discrepancy (LLD), and polyethylene liner thickness between robotic-assisted total knee arthroplasty (TKA) and conventional TKA in patients with failed high tibial osteotomy (HTO).

Methods
A total of 30 patients (30 knees) with failed HTO who underwent TKA using a robot-assisted system between June 2020 and December 2023 were included in this study (robotic group). Additionally, 60 patients (60 knees) with failed HTO who underwent conventional TKA were included as controls (conventional group). Propensity score matching was performed using a 2:1 ratio between the matched participants. The mean follow-up period was 2.1 years in the robotic group and 2.2 years in the conventional group. Clinical evaluations were performed using the Knee Society Score (KSS) rating system. Mechanical axis, component coronal and sagittal positioning, and LLD were evaluated using postoperative radiographs. The thickness of the polyethylene liner was also determined. The mean error values and outliers were calculated and compared between the two groups to determine the accuracy of the mechanical axis, postoperative component positioning, and LLD.

Results
The postoperative KSSs in the robotic and conventional groups were not statistically different. The robotic group achieved better accuracy than the conventional group in terms of postoperative mean mechanical axis (1.7° vs. 2.4°, p < 0.05), femur coronal inclination (90.0° vs. 91.6°, p < 0.05), tibial coronal inclination (90.3° vs. 91.3°, p < 0.05), tibial sagittal inclination (90.5° vs. 91.4°, p < 0.05), and LLD (2.2 vs. 7.0 mm, p < 0.05). A significant difference in polyethylene liner thickness was observed between the two groups (p < 0.05).

Conclusions
Robotic-assisted TKA showed improved mechanical axis, higher accuracy of component positioning and polyethylene liner thickness, and reduced LLD compared with those of conventional TKA in patients with failed HTO. Further studies with a larger sample size and long-term follow-up are warranted to ascertain whether the accuracy of robotic-assisted TKA can translate into better clinical outcomes and patient satisfaction.
Patient Satisfaction with a Women’s Health Hub 4 months in
Authors: Wang Emily , Slade Guy , Graham Anna 
Published: November 2024

Introduction

Women’s health hubs (WHHs) are aimed at improving access to women’s health services and reducing health inequalities. This report collates patient feedback on a new WHH located in Tower Hamlets, a borough of high deprivation and multi-ethnicity. It aims to evaluate patient experience, waiting times, satisfaction, and to identify areas for improvement.

Methodology

1. Friends and family questionnaire (FFQ): Patients completed a questionnaire via a QR code following their WHH appointment.
2. Over 5 weeks all patients who attended 1

st WHH appointments were called and surveyed using a questionnaire developed from validated NHS surveys.

Results

Of 88 telephoned, 45 completed the questionnaire. 78% answered ‘excellent’ for quality, 71% ‘very good’ for overall experience, 96% found staff welcoming and respectful. 71% were seen on time. More patients saw a specialty consultant (57%) compared to a GP (17%), or physio (26%) but were satisfied by who they saw (96%, 87% and 100% respectively). 57.8% were offered a choice of dates, however 17% were not given options. Of 22.2% needing a translator only 50% reported being offered one. 84% were not offered a choice in gender preference of clinician. The FFQ was equally positive with 100% of 60 patients reporting that WHH was good/very good.

Conclusions

Patients reported high levels of satisfaction across all areas and short wait times, supporting the call for more WHHs. Areas for improvement include: offering translators to all, gender preference of clinicians and a wider choice of appointment dates.
Obesity in a patient with acromegaly: a case report
Authors: Gabaidze G. D. , Perepelova M. A. , Przhiyalkovskaya E. G. , Pigarova E. A. , Kuzmin A. G. , Vengrzhinovskaya O. I. , Lapshina A. M. , Dzeranova L. K. 
Published: November 2024

Acromegaly is a severe neuroendocrine disease characterized by excessive production of the growth hormone (GH). The slow development of symptoms increases the diagnostic search up to 15 years. Permanent effect of the growth hormone on the human body can cause structural and functional disorders of organs. The main complications of acromegaly include cardiovascular, respiratory, and musculoskeletal system dysfunction, as well as impaired carbohydrate metabolism and an increased risk of developing neoplasms.Often, nonspecific symptoms of acromegaly can be masked by other pathologies or their complications, such as obesity. An increase in subcutaneous fat, increased blood pressure, joint pain, edema, and impaired carbohydrate and lipid metabolism are observed both in acromegaly and in obesity. An additional factor in the development of obesity as a complication of acromegaly is the development of sleep apnea, which triggers a series of pathological processes that ultimately lead to Pickwickian syndrome.We present a clinical case of a patient with acromegaly and obesity, discussing the effects of excess body weight on the course of the underlying disease, the presence of complications, and an individual approach to treatment.
Pengaruh Pergerakan Pasang Surut terhadap Perubahan Kualitas Air Sumur Gali Masyarakat di Pesisir Kelurahan Fitu – Kota Ternate Selatan
Authors: Salnuddin Salnuddin , Bemba Jefry , Harahap Zulhan Arifin , Kader Muhammad Faisal , Wahidin Nurhalis , Ichsan Kusdi Hi , Taeran Imran 
Published: November 2024

Air merupakan salah satu elemen penting yang menyokong keberlangsungan hidup manusia tak terkecuali masyarakat pesisir Kelurahan Fitu- Kota Ternate Selatan yang berada di wilayah pulau kecil dan gunung api. Sumber air bersih masyarakat pesisir umumnya bersumber dari sumur gali dan memiliki potensi dicemarkan oleh berbagai macam faktor terutama intrusi air laut. Penelitian bertujuan untuk mendeterminasi pengaruh pergerakan pasang surut terhadap perubahan kualitas sumur gali dalam upaya determinasi karakteristik dan parameter penciri instrusi air tanah di pulau kecil gunung api. Pengumpulan data dilakukan melalui pengukuran dan observasi dengan bantuan instrument survei sedangakan analisis data menggunakan persamaan umum matematik serta analisis statistik regresi linear sederhana dengan 3 pendekatan analisis berdasarkan input data yang diberikan. Hasil analisis Berdasarkan hasil analisis menunjukkan bahwa pendekatan analisis III lebih informatif dalam mendeterminasi pola hubungan pergerakan pasang surut dan perubahan kualitas air tanah di sumur gali masyarakat. Kecenderungan hubungan tersebut lebih konsisiten berdasarkan nilai “b” (koefisien korelasi) yang mengkuti pergerakan pasang surut terhadap masing-masing parameter kualitas air. Pergerakan pasang surut berpotensi mempengaruhi kualitas air tanah pada sumur gali masyarakat terutama untuk parameter DHL dan salinitas pada sumur sampel 1 (R2 > 50%) dan juga pada sumur sampel 2 (R2 = 14 % dan 62 %) saat ABP Nilai koefisien determinasi (R2) menunjukkan bahwa masih banyak faktor lain yang mempengaruhi perubahan kualitas air pada sumur sampel selain oleh pergerakan pasang surut.