bluuebunny/crossref_metadata_2025_split huggingface dataset:
Saturation transfer (CEST and MT) MRI for characterization of U‐87 MG glioma in the rat
Authors: Lam Wilfred W. , Chudzik Agata , Lehman Natalia , Łazorczyk Artur , Kozioł Paulina , Niedziałek Anna , Gananathan Athavan , Orzyłowska Anna , Rola Radosław , Stanisz Greg J. 
Published: October 2024

AbstractThe focus of this work was to identify the optimal magnetic resonance imaging (MRI) contrast between orthotopic U‐87 MG tumours and normal appearing brain with the eventual goal of treatment response monitoring. U‐87 MG human glioblastoma cells were injected into the brain of RNU nude rats (n = 9). The rats were imaged at 7 T at three timepoints for all animals: 3–5, 7–9, and 11–13 days after implantation. Whole‐brain T1‐weighted (before and after gadolinium contrast agent injection), diffusion, and fluid‐attenuated inversion recovery scans were performed. In addition, single‐slice saturation‐transfer‐weighted chemical exchange saturation transfer (CEST), magnetization transfer (MT), and water saturation shift referencing (WASSR) contrast Z‐spectra and T1 and T2 maps were also acquired. The MT and WASSR Z‐spectra and T1 map were fitted to a two‐pool quantitative MT model to estimate the T2 of the free and macromolecular‐bound water molecules, the relative macromolecular pool size (M0, MT), and the magnetization exchange rate from the macromolecular pool to the free pool (RMT). The T1‐corrected apparent exchange‐dependent relaxation (AREX) metric to isolate the CEST contributions was also calculated. The lesion on M0, MT and AREX maps with a B1 of 2 μT best matched the hyperintensity on the post‐contrast T1‐weighted image. There was also good separation in Z‐spectra between the lesion and contralateral cortex in the 2‐μT CEST and 3‐ and 5‐μT MT Z‐spectra at all time points. A pairwise Wilcoxon signed‐rank tests with Holm–Bonferroni adjustment on MRI parameters was performed and the differences between enhancing lesion and contralateral cortex for the MT ratio with 2 μT saturation at 3.6 ppm frequency offset (corresponding to the amide chemical group) and M0, MT were both strongly significant (p < 0.001) at all time points. This work has identified that differences between enhancing lesion and contralateral cortex are strongest in MTR with B1 = 2 μT at 3.6 ppm and relative macromolecular pool size (M0, MT) images over entire period of 3–13 days after cancer cell implantation.
A Multi‐Trip Vehicle Routing Problem With Release Dates and Interrelated Periods
Authors: Bernardino Raquel , Janela João , Martins Carlos , Mourão Maria Cândida , Pinto Leonor Santiago , Rodrigues Filipe 
Published: October 2024

ABSTRACTThis article proposes a new multi‐trip vehicle routing problem variant, originally motivated by a practical application, namely a car components distribution to repair centers (warehouses). The problem is named the multi‐trip vehicle routing with release dates and interrelated periods (MTVRP‐RDIP). The routes may start at different pre‐defined periods, called departure periods, and may have different durations. Thus, two routes that start at different periods may be active at the same period, leading to the so‐called interrelated periods. Moreover, a route may only start at a period if a vehicle is available, and the availability of the vehicle depends not only on the existing vehicles but also on the active routes at that time period. The clients are classified according to their importance and represent warehouses that require car components that are made available throughout the time horizon, thus leading to the consideration of release dates. Delays in satisfying client orders and not serving orders in the time horizon result in penalty costs that must be minimized. The objective to minimize also includes routing costs and vehicle utilization costs. Two metrics are defined to compute an order's delay, each leading to a different mixed integer linear model. Computational results showed that one model clearly outperforms the other and even this one is only suited to address the smallest instances. A matheuristic based on a rolling‐horizon process that iteratively solves the better‐performing model with fewer periods was designed to tackle the largest instances. The matheuristic can provide feasible solutions for all test instances in an efficient manner that are, on average, better than the ones provided by the model in most of the compared key performance indicators.
The incidence and risk factors of gastrointestinal dysfunction during enteral nutrition in mechanically ventilated critically ill patients
Authors: Shi Ling , Shao Jianmei , Luo Yuxia , Liu Guiyan , OuYang Miao 
Published: October 2024

AbstractAimTo assess the occurrence and risk factors of gastrointestinal (GI) dysfunction during enteral nutrition (EN) in critically ill patients supported with mechanical ventilation.DesignProspective observational study.MethodsTotally 252 patients admitted at a mixed medical‐surgical ICU were enrolled. GI symptoms and the potential risk variables were recorded during the first 14 days of EN.ResultsThe incidence of GI dysfunction was 65.5%, and the incidence of diarrhoea, constipation, abdominal distension, and upper GI intolerance was 28.2%, 18.3%, 6.7% and 12.3%, respectively. The median onset days of constipation, diarrhoea, abdominal distension and UDI was 3, 5, 5 and 6 days, respectively. Multivariable Cox regression analysis showed a significant relationship between GI dysfunction and age (HR = 2.321, 95% CI: 1.024–5.264, p = 0.004), APACHE‐II score at ICU admission (HR = 7.523, 95% CI: 4.734–12.592, p = 0.018), serum albumin level (HR = 0.594, 95% CI: 0.218–0.889, p = 0.041), multidrug‐resistant bacteria‐positive culture (HR = 6.924, 95% CI: 4.612–10.276, p<0.001), negative fluid balance (HR = 0.725, 95% CI: 0.473–0.926, p = 0.037), use of vasopressor drugs (HR = 1.642, 95% CI: 1.297–3.178, p<0.001), EN way (HR = 6.312, 95% CI: 5.143–11.836, p<0.001), infusion rate (HR = 1.947, 95% CI: 1.135–3.339, p<0.001), and intra‐abdominal hypertension (HR = 3.864, 95% CI: 2.360–5.839, p<0.001).ConclusionCritically ill patients supported with mechanical ventilation are at a high risk of GI dysfunction. Interventions such as the use of laxatives or prokinetic agents, control of EN infusion rate, and maintaining a normal state of hydration, might be beneficial for the prevention of GI dysfunction in critically ill patients.Patient or Public ContributionNo.
Assessing the Nursing Workload in the Cardiothoracic Intensive Care Unit: Comparative Study
Authors: Stojakovic Natasa , Matic Aleksandra , Preveden Andrej , Rosic Milenko , Mikic Milena , Rosic Vesna , Mihajlovic Visnja 
Published: October 2024

ABSTRACTAimsThis study aimed to assess nursing workload in Cardiac Intensive Care Unit (CICU) after three cardiothoracic surgery procedures during first four postoperative days using Nursing Activities Score (NAS) and Nine Equivalents of Nursing Manpower Use Score (NEMS) systems, to compare their performance for that purpose and to investigate association between nursing workload and type of surgery.DesignA comparative study.MethodsThe research environment includes CICU of the University Hospital for Cardiovascular Diseases in Serbia. A total of 808 patients who underwent coronary, valvular, or combined surgery, resulting in 2282 filled NAS and NEMS pairs chart. Statistical analysis was performed using SPSS‐19. The correlation between NAS and NEMS was tested by Spearman's correlation coefficient. Differences were considered statistically significant at p < 0.05.ResultsThe lowest median of cumulative NAS 176 (175‐257) and NEMS 76 (64‐91) had coronary surgery patients, the highest NAS 224.5 (178‐334.5) and NEMS 83 (69‐121) had those with combined surgery; this difference was statistically significant (p < 0.001). The median of both scores decreased after surgery, with the following values from the first to the fourth postoperative day: NAS from 104 (102‐105) to 81 (74‐85) and NEMS from 46 (42–46) to 30 (30–37). The difference in mean values of both scores between the first and the fourth postoperative day was statistically significant (p < 0.001). NAS and NEMS were in a positive, strong correlation (r = 0.913; p < 0.005).ConclusionBoth scores can be used to measure nursing workload, identify the required number of nurses in CICU, and support task allocation. NAS may have an advantage because it better describes extensive postoperative monitoring and care needed for cardiac surgery patients. Nursing workload is associated with type of surgery, with the highest workload measured in patients who underwent combined surgery procedure and on the first postoperative day.
Minimal Clinically Important Difference of Vestibular Migraine Patient Assessment Tool and Handicap Inventory (VM‐PATHI)
Authors: Gardi Adam , Hum Maxwell , Wong Daniel , Allen Isabel , Sharon Jeffrey D. 
Published: October 2024

AbstractObjectiveTo calculate the minimal clinically important difference (MCID) for the Vestibular Migraine Patient Assessment Tool and Handicap Inventory (VM‐PATHI).Study DesignProspective cohort study.SettingA single tertiary care balance and falls center.MethodsFifty‐three subjects meeting Barany Society criteria for vestibular migraine (VM) or probable VM were included and divided into 3 treatment groups. Treatment was not standardized, instead, management was decided individually between each patient and their provider. All subjects completed VM‐PATHI before and after intervention. A Global Rating of Change (GRoC) questionnaire was also completed following intervention. Anchor‐based methods, using a GRoC questionnaire, were utilized to estimate the MCID that produced the highest sensitivity and specificity on a receiver operating characteristic (ROC) curve.ResultsForty‐three subjects were classified as responders and 10 were classified as nonresponders. The mean VM‐PATHI pretreatment score minus the posttreatment score between the responders (mean = 14, SD 13) and nonresponders (mean = 4 SD = 12) was statistically significant (mean difference = 10, 95% confidence interval, CI [1, 20], P = .03). The VM‐PATHI score change cutoff that best differentiated between responders and nonresponders was a VM‐PATHI change of 6. Thus, the MCID was defined as a change of 6 points (sensitivity = 72%, specificity = 70%). The area under the ROC curve was 0.89, 95% CI [0.80, 0.98], which demonstrates an excellent ability for the VM‐PATHI score change to discriminate between responders and nonresponders. The average change in VM‐PATHI scores was 9 points (SD 11) for those with “a little better” rating on the GRoC, 14 points (SD 14) for those with a “moderately better” rating, and 20 points (SD 13) for those with a “very much better” rating.ConclusionPatients with VM are likely to demonstrate clinical improvement if their VM‐PATHI score decreases by 6 or more.
Predictors of ongoing attendance at an Australian publicly funded specialist obesity service
Authors: Brightman Louise , Huang Hsin‐Chia Carol , Georgousopoulou Ekavi 
Published: October 2024

AbstractIntroductionThere is a demand for publicly funded specialist obesity services in Australia. A range of factors can impact on patient attendance which can result in poorer health outcomes.ObjectiveTo identify patient factors that predict ongoing in‐person attendance following initial medical assessment at the Canberra Obesity Management Service.MethodsData were collated from two retrospective reviews (July 2016–June 2017 and July 2018–June 2019). Predictive modeling was used to determine the likelihood of ongoing attendance.ResultsA total of 396 patients were identified. Mean age was 45.4 years (SD 13.1), mean weight was 139.5 kg (SD 27.8) and mean Body Mass Index was 49.87 kg/m2 (SD 8.7). Demographics and anthropometrics were not predictive of ongoing attendance. Patients with a higher comorbidity burden were more likely to continue attending (p < 0.001). Patients with obstructive sleep apnea (OSA) were 4.9 times more likely to continue attending (p < 0.001). Hypertension was more common among patients who continued attending (p = 0.005); however, this relationship was no longer significant when using a multi‐adjusted model. Comorbid depression and/or anxiety diagnoses were not predictive of ongoing attendance although the p‐value for anxiety severity classification approached significance.ConclusionsFindings are consistent with existing evidence linking OSA and attendance at specialist obesity services. Hypertension was predictive of ongoing attendance and warrants further research. Determining if anxiety is a true barrier to attendance at specialist obesity services may have implications in terms of optimizing diagnosis and treatment prior to referral or in the early stages of obesity management.
Device for Performing Spirometry in Total Laryngectomized Patients
Authors: Bianco Maria Rita , Pullano Salvatore Andrea , Occhiuzzi Federico , Latella Daniele , Di Mieri Marco , Pelaia Corrado , Allegra Eugenia 
Published: October 2024

AbstractPatients who have undergone total laryngectomy (TL) are, in most cases, affected by lung disease due to smoking habits. Therefore, as part of the follow‐up protocol for these patients, a spirometry test should be performed to adequately assess lung function. Current spirometers do not allow for spirometry tests in patients who breathe through a tracheostomy, as the patient cannot perform respiratory acts from the spirometer mouthpiece, which is designed to be used by mouth. We have, therefore, designed a device that allows the test to be performed through the tracheostoma. The device is made of biocompatible polymeric material, modeled using a 3‐dimensional printer, reusable, and hermetically connected to the spirometer distally and to the tracheostoma proximally. The device was used on 5 patients who underwent TL and was found to be comfortable, safe, and valid for diagnostic purposes.
The Nasopharyngo‐Septal Butterfly Flap: A Novel Adjunct for Reconstructing Large Skull Base Defects
Authors: Abouammo Moataz D. , Narayanan Maithrea S. , Alsavaf Mohammad B. , Alwabili Mohammed , Gosal Jaskaran S. , Bhuskute Govind S. , Callejas Claudio , VanKoevering Kyle K. , Wu Kyle C. , Prevedello Daniel M. , Carrau Ricardo L. 
Published: October 2024

AbstractObjectiveSkull base defects can be challenging to reconstruct. The nasoseptal flap (NSF) remains the first‐line option for reconstruction. However, it can be inadequate to cover wide defects or compromised by tumor invasion or prior surgery requiring additional reconstructive options. The goal of the study is to describe a novel flap for clival and craniovertebral junction (CVJ) reconstruction.Study DesignCadaveric study with an illustrative clinical case.SettingCadaver dissection laboratory and tertiary university hospital.MethodsEndoscopic endonasal dissection was performed in 15 cadavers. A modification of the inferior incision of the NSF was carried out. The inferior incision was performed at a more cranial location, sparing the mucosa of the posterior septum. Two lateral longitudinal incisions were carried out at the pterygo‐sphenoidal junction freeing the nasopharyngeal mucosa. A third incision was performed separating the rostral mucosa from the nasal floor. The resulting flap was rotated postero‐superiorly covering the clivus and CVJ.ResultsAn inferiorly based butterfly‐shaped nasopharyngo‐septal flap, consisting of nasopharyngeal and posterior septal mucosa and receiving blood supply from the bilateral ascending pharyngeal arteries, was formulated. The lower wings comprised nasopharyngeal mucosa while the upper wings comprised posterior septal mucosa. The mean surface area of the flap was 12.35 ± 0.21 cm2 covering the clivus and CVJ in all cadavers.ConclusionThe nasopharyngo‐septal flap is a novel vascularized flap that is well‐suited for reconstructing clival and CVJ defects where the NSF is insufficient and can also be used as a salvage flap in cases where the NSF is unobtainable.
Analysis of damage and failure behavior of additively manufactured stainless steel 316L by biaxial experiments
Authors: Gerke Steffen , Diller Johannes , Cruz Leonardo D. Pérez , Blankenhagen Jakob , Mensinger Martin , Brünig Michael 
Published: October 2024

AbstractThe austenitic stainless steel AISI 316L (1.4404) is frequently used in medical applications as well as in aerospace and automotive industries due to its corrosion resistance and high ductility. Individual parts or smaller series as well as complex geometries can be additively manufactured by laser powder bed fusion (PBF‐LB/M). The components produced in this process generally have different mechanical properties compared to components made from conventionally produced base material by cutting machining processes. Furthermore, the multiaxial stress state behavior of PBF‐LB/M/316L has not been investigated in detail and is the subject of current investigations. This paper deals with an initial experimental series with additively manufactured biaxial specimens made of AISI 316L stainless steel. The biaxial specimen geometry has been specially adapted for the requirements of PBF‐LB/M and the specimens are loaded under different biaxial proportional load paths up to failure. Accompanying numerical simulations are performed to determine the associated stress states and to analyze the experimentally obtained stress‐dependent damage and failure mechanisms. The formation of strain fields in critical parts of the modified H‐specimen is monitored by digital image correlation and the different failure modes are visualized by scanning electron microscopy of the fracture surfaces.
Comparative study of virgin and recycled polyethylene terephthalate and polypropylene intermingled thermoplastic composites
Authors: Karahan Mehmet , Özyurt İrem , Atalay Şakir Ömer , Turan Şeyma Yalçın , Haji Aminoddin , Karahan Nevin 
Published: October 2024

AbstractIn this study, a comparative analysis of the use of recycled PET (R‐PET) in synthetic and natural fiber blended composites was made. PET, R‐PET, and PP yarns were folded with reinforcing fibers by commingling technique and then fabrics were prepared using weaving technology. Hot compression molding technology was used for composite fabrication. Tensile and impact characterization revealed the significant influence of reinforcing and TP fibers on mechanical properties. R‐PET matrix glass fiber reinforced composites exhibited 41.77% higher tensile strength than virgin PET and 20.41% higher than PP. In terms of tensile strength for linen reinforced samples, R‐PET shows an impressive 181% improvement over virgin PET and 154% over PP. According to the drop weight test results, glass fiber reinforced R‐PET matrix sample exhibited a peak load value 53% higher than that of the virgin PET matrix, although it was 9.47% lower than the PP matrix. In linen fiber reinforced samples, R‐PET demonstrated a 57.73% improvement over virgin PET but lower by 9.47% compared to the PP matrix. During this time, DSC, TGA, FTIR, and flammability tests were also performed on the composite samples. The results showed that R‐PET has easy processability as a matrix material and provides better wetting of the reinforcing fibers. For this reason, it has been shown that R‐PET matrix samples provide better mechanical properties than both PET and PP matrix samples. It has also been determined that R‐PET is a more suitable matrix material compared with natural fiber reinforced composites.Highlights
Commingled yarns were used for preparing composites.
R‐PET yarns were used as matrix in preparing glass and linen reinforced composites.
R‐PET was compared with virgin PET and PP yarns.
R‐PET showed great potential in easy preparation of TP composites.
Composites made with R‐PET showed improved thermal and mechanical properties.
The relative contributions of genetic and non‐genetic factors to the risk of neuroblastoma
Authors: Jung Eun Mi , Heck Julia E. , Spector Logan G. 
Published: October 2024

ABSTRACTPrevious literature has well‐established genetic factors as being associated with neuroblastoma (NB). About 1%–2% of NB cases are familial, with 85% of these cases predisposed to mutations in the PHOX2B and ALK genes. The genetic basis of sporadic NB has been studied through genome‐wide association studies and next‐generation sequencing approaches. Particularly, germline variants, as well as copy number variations, confer increased risks of NB, often with effect estimates ≥1.5, underscoring the strong genetic contributions to NB. However, the strength of the association varied in non‐genetic factors. Some risk factors, such as birth defects, maternal illicit drug use, and early infections, had relatively stronger associations (effect estimates ≥1.5 or ≤0.67), while some other factors remain inconclusive. This suggests that certain non‐genetic factors may play a more prominent role in NB risk, while further research is needed to clarify the impact of others. We synthesized and critically evaluated existing literature on the risk factors of NB to provide an overview, analyze the current state of knowledge, and outline a research path to address the relative contributions of genetic and non‐genetic factors in NB. Future epidemiologic studies should incorporate novel methods for measuring genetic and non‐genetic factors to comprehensively assess the full extent of factors contributing to NB. Furthermore, the utilization of dried blood spots holds promise to overcome technical and recruitment challenges for future studies. These strategies will contribute to a more holistic understanding of NB etiology and potentially lead to improved prevention strategies.
Enhancing the high temperature resistance of nanocomposite materials through dimethyl methyl phosphate impregnation‐coating treatment
Authors: Wang Haochen , Chen Zhili , Zhao Jun 
Published: October 2024

AbstractIn order to enhance the thermal stability of polyvinyl alcohol (PVA), a modification scheme involving a dimethyl methyl phosphate (DMMP) impregnation‐coating treatment was adopted in this article. Initially, the interfacial compatibility of DMMP with PVA was characterized using scanning electron microscopy (SEM), inductively coupled plasma spectroscopy, elemental analysis and Fourier transform infrared spectroscopy (FTIR). Subsequently, the pyrolysis and combustion properties of DMMP‐coated PVA were evaluated via non‐isothermal thermogravimetric experiments and cone calorimeter tests. The pyrolysis products were then analyzed using a combination of thermogravimetric infrared chromatography and pyrolysis gas chromatography/mass spectrometry (Py‐GC/MS). Finally, a reaction model function closer to the actual co‐pyrolysis mechanism at high temperatures was established through thermal kinetics. The results indicated that the impregnation‐coating treatment could effectively distribute the DMMP molecules on the surfaces of PVA particles. Meanwhile, the DMMP coating could clearly slow the peak degradation rate of PVA grains and inhibit the combustion of PVA under fire conditions. Furthermore, the pyrolysis of DMMP‐coated PVA resulted in the formation of over 40 distinct compounds. The kinetic analysis revealed that the reaction model function established in this article could better characterize the actual reaction mechanism of the co‐pyrolysis of DMMP and PVA.