bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of brain drain among physicians in Turkey: Findings from a national exploratory study
Authors: Bener Abdulbari , Ventriglio Antonio , Almas Furkan , Bhugra Dinesh 
Published: October 2024

Background: The shortage of physicians in Turkey is a highly critical emergency. In fact, physicians’ migration to developing or high-income countries, defined as brain drain, threatens the sustainability of the national healthcare system. Aims: This study explored the driving factors associated with Turkish Physicians’ brain drain, including high-economic inflation, social-politics, poor-living, equity, violence, and the desire to practice medical activity abroad. Methods: A cross-sectional survey of 1,861 Turkish physicians aged 25 to 65 years old was conducted employing the Brain Drain questionnaire, the Depression Anxiety Stress Scale (DASS-21), the Patient Health Questionnaire 9 (PHQ-9), and the Fatigue Assessment Scale (FAS). Results: Significant differences were observed among physicians staying in Turkey versus considering migration to Western countries, regarding their age, gender, marital status, educational level, occupational status, work years, hospital night shifts, income, and cigarette/nargileh smoking habits ( all p ⩽ .018). The main reasons for brain drain included transport problems, harassment, low salary, malpractice, bad environment, job insecurity, workload, burnout, treating difficult patients, inadequate postgraduate systems, peer-pressure, health safety concerns, and favoritism in the workplace, as well as stress and depression caused by work overload. In fact, depression, anxiety, stress, fatigue, and burnout varied significantly among the different groups of physicians (all p ⩽ .013). Additionally, key predictors of brain drain were better job opportunities, poor hospital management (in Turkey), job-related stress, dealing with difficult patients, research deficiencies, workload, burnout, transportation issues, short consultation time, low salary, and fatigue. Among the general factors contributing to the brain drain in the Turkish Health System, we identified significant issues related to research deficiencies, compulsory working duties, poor quality of postgraduate, inadequate medical-schools, poor hospital management, and shortage of consultants. Conclusion: Physicians’ migration is a major global public health concern, leading to substantial risks for healthcare services, especially in Turkey. Many physicians decide to migrate to work in Western countries.
Pre-disaster family visits and post-evacuation return to Fukushima among psychiatric inpatients evacuated to out-of-area hospitals after the nuclear accident
Authors: Suzuki Yuko , Terui Toshihiro , Kunii Yasuto , Kakamu Takeyasu , Hidaka Tomoo , Gotoh Daisuke , Anzai Nobuo , Niwa Shin-Ichi , Yabe Hirooki 
Published: October 2024

Objective: This study aimed to elucidate the effects of pre-evacuation family hospital visits on post-evacuation returns to Fukushima Prefecture (hometown) among psychiatric inpatients who mandatorily evacuated to hospitals outside the prefecture because of the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Method: Of the inpatients in Fukushima, 44 were admitted to a hospital in the nearby Soso district on March 11, 2011, and were therefore included in the current analysis. We collected information on their discharge after the evacuation and family visits before the evacuation by reviewing the medical records of both the evacuation destination and former hospitals. Results: The average durations from the accident to post-evacuation return among patients with and those without former family visits were 681.8 days (standard error [SE] = 163.3) and 1,027.8 days (SE = 152.0), respectively. The log-rank test showed a tendency of earlier return to Fukushima among inpatients who had received family visits to the hospital before evacuation ( p = .073). Conclusions: The results highlight the critical need for close collaboration between psychiatric medical practitioners and families, to not only support patients’ community reintegration into daily life but also facilitate a timely return to their hometowns following long-distance evacuation caused by an unforeseen large-scale disaster.
Correlation analysis of sacrococcygeal pressure and operation time in patients undergoing general anesthesia in the supine position
Authors: Lu Xiuying , Yang Qing , Zhu Lin , Liu Lu , Tang Honghua , Deng Jiaying , Lu Xiulan 
Published: October 2024

Objective This prospective study was performed to explore the change in sacrococcygeal pressure during an operation under general anesthesia in the supine position and identify the correlation between pressure injury and body mass index. Methods This study involved 99 patients who underwent general anesthesia. Sacrococcygeal pressure was measured and recorded at seven time points: before general anesthesia, 5 minutes after general anesthesia, and 1, 2, 3, 4, and 5 hours after the beginning of the operation. The pressure change at each time point was compared, and the factors affecting the pressure were analyzed. Results The correlation analysis showed that the operation time was significantly and positively associated with the occurrence of pressure injury. Conclusion Perioperative management should be strengthened to speed up the surgical process and shorten the operation time, which will help to reduce the occurrence of intraoperative pressure injury.
Bangalore International Airport Limited: A Hub for the Future
Authors: Mittal Ankur , Heggde Githa S. 
Published: October 2024

Bangalore International Airport Limited (BIAL) has been operating the Kempegowda International Airport near Bengaluru, India, since 2008. Bengaluru, the capital of Karnataka, is a major hub for startups and the IT industry. The COVID-19 pandemic significantly impacted the aviation industry, including BIAL, leading to a substantial decline in passenger traffic and cargo handling, weakening profitability. Mr Agarwal, the Corporate Strategist for BIAL, has been tasked with developing new strategies to address the various challenges the company faces. These challenges include the impending expiration of a concession agreement, decreasing non-aeronautical revenues and making critical strategic decisions related to infrastructure development. This case allows students to explore strategic decision-making using the Ansoff matrix. It encourages them to identify the key pillars of airport business growth that are internationally recognized, which can help BIAL expand its business portfolio, meet increasing demand, ensure infrastructure development in the right direction and achieve sustainability over the next 30 years.
Influence of Tibial Component Design Features and Interference Fit on Implant-Bone Micromotion in Total Ankle Replacement: A Finite Element Study
Authors: Clarke Gabriel , Johnson Joshua E. , de Cesar Netto Cesar , Anderson Donald D. 
Published: October 2024

Background: Implant survivorship in uncemented total ankle replacement (TAR) is dependent on achieving initial stability. This is because early micromotion between the implant and bone can disrupt the process of osseointegration, leading to poor long-term outcomes. Tibial implant fixation features are designed to resist micromotion, aided by bony sidewall retention and interference fit. The goal of this study was to investigate design-specific factors influencing implant-bone micromotion in TAR tibial components with interference fit. Methods: Three implant designs with fixation features representative of current TAR tibial components (ARC, SPIKES, KEEL) were virtually inserted into models of the distal tibias of 2 patients with end-stage ankle arthritis. Tibia models were generated from deidentified patient computed tomography scans, with material properties for modeling bone behavior and compaction during press-fit. Finite element analysis (FEA) was used to simulate 2 fixation configurations: (1) no sidewalls or interference fit, and (2) sidewalls with interference fit. Load profiles representing the stance phase of gait were applied to the models, and implant-bone micromotions were computed from FEA output. Results: Sidewalls and interference fit substantially influenced implant-bone micromotions across all designs studied. When sidewalls and interference fit were modeled, average micromotions were less than 11 µm, consistent across the stance phase of gait. Without sidewalls or interference fit, micromotions were largest near either heel strike or toe-off. In the absence of sidewalls and interference fit, the amount of micromotion generally aligned inversely with the size of implant fixation features; the ARC design had the largest micromotion (~540 µm average), whereas the KEEL design had the smallest micromotion (~15 µm). Conclusion: This study presents new insights into the effect of TAR fixation features on implant-bone micromotion. With sidewalls and interference fit, micromotion is predicted to be minimal for implants, whereas with no sidewalls and no interference fit, micromotion depended primarily on the implant design. Clinical Relevance: This study presents new insights into the effect of TAR primary fixation features on implant-bone micromotion. Although design features heavily influenced implant stability in the model, their influence was greatly diminished when interference fit was introduced. The results of this study show the relative importance of design features and interference fit in the predicted initial stability of uncemented TAR, potentially a key factor in implant survivorship.
Behaviors suggestive of pain: the perceptions and veterinary-related decisions of cat guardians in the USA
Authors: Kogan Lori R , Currin-McCulloch Jen , Hellyer Peter 
Published: October 2024

Objectives The aim of the study was to assess cat guardians’ concern levels and veterinary care decisions pertaining to behaviors that might signify pain before and after receiving brief pain-related educational information. The secondary aims were to evaluate cat guardians’ perceptions of the usefulness of a modified version of the Colorado State University Feline Acute Pain Scale (CSU-FAPS) in identifying their cat’s pain level, determining if they should take their cat to the veterinarian and describing their cat’s pain to their veterinarian. Methods Participants were recruited through Prolific. An electronic survey was created in Qualtrics and distributed via a link offered in Prolific. Results A total of 362 surveys were completed by participants who resided in the USA and were the primary caretaker of at least one cat. Significant differences between participants’ concern levels before and after pain-related educational information were found for two of the three scenarios. Significant differences were found between participants’ veterinary-related behavior choices before and after pain-related educational information for all three scenarios. The most common reasons for not seeking immediate veterinary care included elements related to cost and stress for guardian and cat during veterinary visits. The majority of participants reported finding the CSU-FAPS useful for identifying their cat’s pain level (90%), determining if they should take their cat to the veterinarian (86%) and describing their cat’s pain to their veterinarian (92%). Conclusions and relevance Guardians’ interpretations of and subsequent actions to behaviors that might suggest pain carry great implications for feline health and wellbeing. After exposure to brief pain-related educational material, guardians in our study reported significant increases in stated concern related to their cat’s change in behavior and intention to seek veterinary care. These findings suggest that even very brief pain-related educational material can have a positive impact on cat guardians’ perceptions of feline behavior changes and increase the possibility they obtain appropriate veterinary care.
Cost-effectiveness of follow-up algorithms for chronic thromboembolic pulmonary hypertension in pulmonary embolism survivors
Authors: Luijten Dieuwke , van den Hout Wilbert B. , Boon Gudula J.A.M. , Barco Stefano , Bogaard Harm Jan , Delcroix Marion , Kreitner Karl-Friedrich , Held Matthias , Huisman Menno V. , Jara-Palomares Luis , Konstantinides Stavros V. , Kroft Lucia J.M. , Mairuhu Albert T.A. , Meijboom Lilian J. , van Mens Thijs E. , Ninaber Maarten K. , Nossent Esther J. , Pruszczyk Piotr , Valerio Luca , Vonk Noordegraaf Anton , Klok Frederikus A. 
Published: October 2024

IntroductionAchieving an early diagnosis of chronic thromboembolic pulmonary hypertension (CTEPH) in pulmonary embolism (PE) survivors results in better quality of life and survival. Importantly, dedicated follow-up strategies to achieve an earlier CTEPH diagnosis involve costs that were not explicitly incorporated in the models assessing their cost-effectiveness. We performed an economic evaluation of 11 distinct PE follow-up algorithms to determine which should be preferred.Materials and methods11 different PE follow-up algorithms and one hypothetical scenario without a dedicated CTEPH follow-up algorithm were included in a Markov model. Diagnostic accuracy of consecutive tests was estimated from patient-level data of the InShape II study (n=424). The lifelong costs per CTEPH patient were compared and related to quality-adjusted life-years (QALYs) for each scenario.ResultsCompared to not performing dedicated follow-up, the integrated follow-up algorithms are associated with an estimated increase of 0.89–1.2 QALYs against an incremental cost-effectiveness ratio (ICER) of EUR 25 700–46 300 per QALY per CTEPH patient. When comparing different algorithms with each other, the maximum differences were 0.27 QALYs and EUR 27 600. The most cost-effective algorithm was the InShape IV algorithm, with an ICER of EUR 26 700 per QALY compared to the next best algorithm.ConclusionSubjecting all PE survivors to any of the currently established dedicated follow-up algorithms to detect CTEPH is cost-effective and preferred above not performing a dedicated follow-up, evaluated against the Dutch acceptability threshold of EUR 50 000 per QALY. The model can be used to identify the locally preferred algorithm from an economical point-of-view within local logistical possibilities.
Biological correlates of radiological features of systemic sclerosis interstitial lung disease
Authors: Volkmann Elizabeth R. , Tashkin Donald P. , Leng Mei , Kim Grace Hyun J. , Goldin Jonathan , Harui Airi , Roth Michael D. 
Published: October 2024

Background and objectivesThe extent and pattern of radiological features (e.g.fibrosis and ground glass) can influence treatment approaches for systemic sclerosis-related interstitial lung disease (SSc-ILD). However, the pathobiology underlying these radiological features is poorly understood and warrants further investigation.Methods68 proteins were measured in bronchoalveolar lavage (BAL) fluid from 103 SSc-ILD participants in Scleroderma Lung Study I. Quantitative image analysis calculated the extent of fibrosis (QLF) and ground-glass opacity (QGG) from concurrent high-resolution computed tomography (HRCT) scans. The relationship between BAL proteins and quantitative HRCT scores was assessed by univariate and multivariate analyses.ResultsQLF scores correlated weakly with the extent of QGG, suggesting two distinct processes. In a univariate analysis, 25 proteins from several biological pathways correlated with QLF scores, including profibrotic factors, tissue remodelling proteins, proteins involved in monocyte/macrophage migration and activation, and proteins linked to inflammation and immune regulation. In contrast, QGG scores correlated with only six proteins, of which four were unique and related to granulocyte activation, mobilisation of bone marrow mesenchymal stem cells and activation of T-cells, B-cells, macrophages and eosinophils. In the multivariate models, interleukin-4, CCL7, receptor activator of nuclear factor-κB and tumour necrosis factor-α were independently associated with QLF, whereas interferon-γ was independently associated with QGG.InterpretationQLF and QGG represent distinct radiological features of SSc-ILD, a conclusion reinforced by the presence of different biological pathways present within BAL fluid that associate with each. The identified proteins and related biological pathways may represent important therapeutic targets.
Pulmonary outcomes of incretin-based therapies in COPD patients receiving single-inhaler triple therapy
Authors: Ya See Xin , Xanthavanij Nutchapon , Lee Yu-Che , Ong Tze Ern , Wang Tsu Hsien , Ahmed Omer , Chang Yu-Cheng , Peng Chun-Yu , Chi Kuan-Yu , Chang Yu , Chang Ko-Yun , Chiang Cho-Han 
Published: October 2024

IntroductionPatients with chronic obstructive pulmonary disease (COPD) on triple therapy often face exacerbations and comorbidities. Emerging evidence suggests that glucagon-like peptide-1 (GLP-1) analogs may reduce the risk of exacerbation in patients with COPD and type 2 diabetes mellitus (T2DM). This study investigates the impact of GLP-1 analogs on pulmonary outcomes in patients with COPD on single-inhaler triple therapy (SITT) and T2DM.MethodsWe conducted a retrospective cohort study using the TriNetX database and analysed adult patients with COPD and T2DM who received SITT between April 2005 and July 2023. Patients were categorized into GLP-1 analog and dipeptidyl peptidase-4 inhibitors (DPP4i) cohorts. The primary efficacy outcome was COPD exacerbation and the secondary efficacy outcomes were pneumonia, acute respiratory distress syndrome, intubation, oxygen dependence, and all-cause mortality. The secondary outcomes were serious gastrointestinal adverse events.ResultsWe included 6898 patients, with 4184 receiving GLP-1 analogs and 2714 receiving DPP4i. After matching, 1751 GLP-1 analog users were matched with 1751 DPP4i users. GLP-1 analog users had an 18% lower risk of COPD exacerbation (hazard ratio [HR], 0.82 [95% CI: 0.71–0.94]), a 28% reduced risk of pneumonia (HR, 0.72 [95% CI: 0.61–0.85]), a 34% reduced risk of oxygen dependence (HR, 0.66 [95% CI: 0.47–0.91]), and a 40% decreased risk of all-cause mortality (HR, 0.60 [95% CI: 0.47–0.77]). No significant serious gastrointestinal adverse events were observed.ConclusionGLP-1 analogs may be associated with reduced COPD exacerbations, pulmonary comorbidities, and mortality in patients with COPD receiving SITT and T2DM, with no significant serious gastrointestinal safety concerns.
ELAVL1 regulates glycolysis in nasopharyngeal carcinoma cells through the HMGB3/β-catenin axis
Authors: Cui Yi , Wen Haojie , Tang Jinyong , Chen Jiawen , Zhou Juan , Hou Minghua , Rong Xiaohan , Lan Yuanzhao , Wu Qiong 
Published: October 2024

Abstract
Background
The role of ELAVL1 in the progression of various tumors has been demonstrated. Our research aims to investigate how ELAVL1 controls the glycolytic process in nasopharyngeal carcinoma cells through the HMGB3/β-catenin pathway.

Methods
The expression of ELAVL1 was detected in clinical tumor samples and nasopharyngeal carcinoma cell lines. A subcutaneous tumor model was established in nude mice to investigate the role of ELAVL1 in tumor progression. The relationship between HMGB3 and ELAVL1 was validated by RNA pull down and RIP assays. TOPFlash/FOPFlash reporter assay was used to detect β-catenin activity. Assay kits were utilized to measure glucose consumption, lactate production, and G6PD activity in nasopharyngeal carcinoma cells. Western blot was conducted to detect the expression of glycolysis-related proteins. The glycolytic capacity was analyzed through extracellular acidification rate (ECAR).

Results
In both clinical samples and nasopharyngeal carcinoma cell lines, the expression levels of ELAVL1 mRNA and protein were found to be upregulated. Knockdown of ELAVL1 significantly inhibited the in vivo proliferation of nasopharyngeal carcinoma and suppressed the glycolytic capacity of nasopharyngeal carcinoma cells. ELAVL1 interacts with HMGB3, leading to an increase in the stability of HMGB3 mRNA. Overexpression of HMGB3 elevated the reduced β-catenin activity caused by sh-ELAVL1 and reversed the inhibitory effect of sh-ELAVL1 on cellular glycolytic capacity. Treatment with β-catenin inhibitor (FH535) effectively suppressed the promotion of glycolytic capacity induced by HMGB3 overexpression.

Conclusions
ELAVL1 promotes glycolysis in nasopharyngeal carcinoma cells by interacting with HMGB3 to stabilize HMGB3 mRNA, thereby activating β-catenin pathway. Therefore, targeting the ELAVL1-HMGB3-β-catenin axis has the potential to be a novel approach for treating nasopharyngeal carcinoma.
Contour Detection Algorithm for α Phase Structure of TB6 Titanium Alloy fused with Multi-Scale Fretting Features
Authors: He Fei , Dou Yan , Zhang Xiaoying , Zhang Lele 
Published: October 2024

AbstractAiming at the problems of inaccuracy in detecting the α phase contour of TB6 titanium alloy. By combining computer vision technology with human vision mechanisms, the spatial characteristics of the α phase can be simulated to obtain the contour accurately. Therefore, an algorithm for α phase contour detection of TB6 titanium alloy fused with multi-scale fretting features is proposed. Firstly, through the response of the classical receptive field model based on fretting and the suppression of new non-classical receptive field model based on fretting, the information maps of the α phase contour of the TB6 titanium alloy at different scales are obtained; then the information map of the smallest scale contour is used as a benchmark, the neighborhood is constructed to judge the deviation of other scale contour information, and the corresponding weight value is calculated; finally, Gaussian function is used to weight and fuse the deviation information, and the contour detection result of TB6 titanium alloy α phase is obtained. In the Visual Studio 2013 environment, 484 metallographic images with different temperatures, strain rates, and magnifications were tested. The results show that the performance evaluation F value of the proposed algorithm is 0.915, which can effectively improve the accuracy of α phase contour detection of TB6 titanium alloy.
Cell death of long-lived ray parenchyma cells during heartwood formation in trees
Authors: Nakaba Satoshi , Funada Ryo 
Published: October 2024

AbstractCell death plays an important role in the determination of secondary xylem cell functions. Tracheary elements (TEs), such as vessel elements and tracheids, lose their organelles due to rapid autolysis after the completion of secondary wall thickening and lignification, and play an important role in water movement along the stem. In contrast, xylem axial and ray parenchyma cells (xylem parenchyma cells) remain alive for several years or longer and retain their organelles even after maturation. As a result, xylem parenchyma cells play important roles in nutrient storage, axial and radial transportation of materials, and defense responses in the stem. In addition, they are involved in the formation of heartwood, which contributes to increases in the resistance of the tree trunk to decay, as they synthesize heartwood components such as polyphenols prior to their death. The present review focuses on changes in long-lived ray parenchyma cells during heartwood formation, such as morphology and contents of organelles, gene expression, and survival rate in sapwood. This review also summarizes the differences in cell death characteristics between TEs and ray parenchyma cells. The elucidation of the cell death mechanism of ray parenchyma cells is expected to provide useful information for controlling the properties of heartwood.