bluuebunny/crossref_metadata_2025_split huggingface dataset:
Off-pump Aortic Arch Interruption Surgery: Anesthetic Management and Outcomes
Authors: Wu Yingliang , Wu Duozhi 
Published: June 2024

Abstract

The present article provides an overview of the anesthetic pr ocedure employed during off-pump aortic arch interruption surger y, a cardiovascular operation. The case study involved a 54-year-o ld male patient who was diagnosed with aortic arch interruption and who underwent an off-pump surgical intervention. Anesthesia protocol: The patient fasted and abstained before surgery. In the operating room, anesthesia induction was achieve d using midazolam, esketamine, etomidate, sufentanil, and rocuro nium. Throughout the procedure, anesthesia was maintained using propofol, remifentanil, and sevoflurane, with dosage adjustments made in accordance with the progress of the surgical interventio n. Intraoperative monitoring: Conventional monitoring included E CG, blood pressure, pulse oxygen saturation, end-tidal CO2, bispec tral index, hemodynamic monitoring, and cerebral oxygen saturati on monitoring (rSO2). The patient's mean arterial pressure (MAP) was carefully regulated within the range of 60-80 mmHg, while t he heart rate was maintained between 50-90 beats per minute t o ensure a stable circulatory state. Anesthesia outcome: The patient's vital signs remained stable, with appropriate anesthesia depth. The surgery was successfully completed, and the patient was transferred to the critical care u nit for postoperative observation and treatment. In off-pump aortic arch interruption surgery, maintaining stabl e vital signs and ensuring stable circulation are crucial anesthetic management components. The reported case demonstrated a satis factory anesthesia effect with no significant complications. This ca se highlights the importance of employing reasonable anesthesia methods and monitoring measures for safe and effective patient care.
Can radiological response after downstaging of hepatocellular carcinoma serve as a basis for subsequent treatment selection?
Authors: Gao Chen-Hao , Yu Qi-Jian , Luo Xing-Yu , Chang Kai-Wun , Wang Shuo , Cao Lin-Ping , Wu Jian , Wang Lei , Yan Mao-Lin , Wang Ji-Zhou , Zheng Shu-Sen , Yang Zhe 
Published: June 2024

Abstract

Background and aims: Downstaging of hepatocellular carcinoma (HCC) has prevailed as a key method to curative therapy for patients who present with unresectable HCC. However, evidence to support how to choose the subsequent treatment strategies after downstaging therapy is limited. This study aim to explore the prognostic significance of radiological response after downstaging in patients with HCC. Further elucidate the impact of liver resection (LR), liver transplantation (LT) and maintenance therapy on the prognosis of patients with partial radiological response>90% (rPR>90%) and complete radiological response (rCR) following downstaging therapy.
Method: In this study, 354 consecutive patients diagnosed with HCC and treated with downstaging between January 2018 and December 2021 were included. Subsequently, they underwent LR, LT and maintenance therapy. Radiological response was assessed by determining the average percentage of tumor areas exhibiting inactivation. Specifically, radiological response was assessed as 100% minus the percentage of the longest surviving tumor diameter to the total tumor diameter. The endpoint of our study was to compare recurrence-free survival (RFS), and overall survival (OS) among patients who underwent LT, LR or maintenance therapy after downstaging therapy.
Results: Among all 354 patients included in the study, we found there were no significant differences between the rCR and rPR>90% groups in terms of three-year RFS (78.9% and 70.0% vs. 71.4% and 63.4% P=0.16) and three-year OS (97.8% and 93.3% vs. 96.9% and 93.8% P=0.90) after LR. For patients who undergo LT treatment after downstaging therapy, the one-year and three-year RFS (100.0% and 88.9% vs. 92.7% and 85.4% P=0.71) and OS (100.0% and 88.9% vs. 97.6% and 95.1% P=0.49) in pCR group and pPR>90% group are comparable. For patients with rPR>90% and rCR after downstaging, both the LT (96.2% and 92.5% vs. 88.0% and 80.0% P=0.03)and LR groups (98.4% and 93.6% vs. 88.0% and 80.0% P<0.01) exhibited better one-year and three-year OS compared with the maintenance treatment group. Additionally, LT patients demonstrated higher one-year and three-year RFS compared with LR patients(94.3% and 84.9% vs. 74.1% and 65.7% P<0.01), although there was no significant difference between the two groups in terms of one-year and three-year OS(96.2% and 92.5% vs. 98.4% and 93.6% P=0.72).
Conclusion: Surgical treatments following rPR>90% after downstaging is necessary.Besides, patients achieving rPR>90% or higher after downstaging followed by either LR or LT can both achieve satisfactory survival expectations.
Low albumin-to-creatinine ratios are associated with poor outcomes in cancer patients
Authors: Zhao Hong , Li Xiangrui , Liu Xiaoyue , Li Shuqun , Liu Chenan , Zheng Xin , Chen Yue , Shi Jinyu , Liu Qiteng , Bu Zhaoting , Shi Hanping 
Published: June 2024

Abstract

Background
Previous studies have shown that the albumin-to-creatinine ratio (ACR) is associated with the prognosis of patients with liposarcoma. However, the role of ACR in other tumors is unknown. Our aim was to evaluate the relationship between ACR and the prognosis of common tumors.
Methods
We used data from the Investigation on Nutrition Status and Clinical Outcome of Common Cancers (INSCOC) between 2013 and 2022 to identify Young and middle-aged patients (< 65). Spearman method was used to determine the correlation between albumin, creatinine, ACR and age. In a model adjusted for covariates, the prognostic relationship between ACR and common tumors was investigated. Subgroup analysis was performed in different tumors. Finally carried out C indices analysis to observe the value of ACR in cancer patient outcomes.
Results
In COX regression analysis of ACR and prognosis of tumor patients, whether ACR is used as a continuous variable (per 10 unit increase) or quartile, the greater the ACR value, the better the prognosis of the study population. The same results were found for different cancer species. In the C-index analysis, the prognosis of patients evaluated by ACR and tumor stage was significantly higher than that of patients evaluated by tumor stage alone.
Conclusion
A high ACR ratio is associated with a better prognosis in patients with common tumors, and is significantly better in evaluating cancer outcomes in combination with tumor stage than in evaluating tumor stage alone.
Ultra-Wideband PIN-PD THz Emitter with &gt;5.5 THz Bandwidth
Authors: Deumer Milan , Nellen Simon , Lauck Sebastian , Keyvaninia Shahram , Berrios Shaffi , Kieper Matti , Schell Martin , Kohlhaas Robert Bruno 
Published: June 2024

Abstract

We present novel PIN photodiode (PD) continuous wave (cw) terahertz (THz) emitters with an increased responsivity and reduced substrate thickness compared to the state-of-the-art. Our improved devices feature up to 4 dB higher output power below 500 GHz with maximum power of -0.53 dBm at 115 GHz and strongly reduced THz absorption of the substrate for frequencies above 3 THz. The latter enables us to measure coherent cw THz spectra with a record bandwidth of 5.5 THz, for the first time, which is 1 THz (22%) more than the state-of-the-art.
Exploring Barriers and Facilitators in Nurses' Reporting of Patient and Visitor Violence: A Cross-sectional Survey
Authors: Cai Jianzheng , Ying Yajie , Wang Haifang , Yu Weixia , Wu Sisi , Zhang Yingying , Wang Yalan 
Published: June 2024

Abstract

Background: Patient and visitor violence (PVV) among nurses has emerged as a critical issue, posing a significant threat to nurses’ occupational safety. The primary measures employed to understand and respond to PVV is nurses’ reporting. However, the current status of PVV reporting among nurses have proven inadequate. Therefore, it is essential to explore the barriers and facilitators in nurses' reporting of PVV.
Methods: A random sample of 3,363nurses in Jiangsu Province, China, was collected between January and July 2023. The binary logistic regression was utilized to ascertain the factors influencing the study parameters.
Results: Out of the 3,363 surveyed nurses, 1,813 (53.9%) reported experiencing PVV withinthe past year. Notably, only16.1% of these nurses proactively reported PVV incidents after encountering them. Factors that facilitatedreporting of PVV comprised being male, working in specialized hospitals, serving in departments with a high prevalence of PVV, possessing lively personalities, prior awareness of PVV, and having hospitals that actively encouraged reporting while safeguarding staff interests. Conversely, factors impeding nurses from reporting PVV included having night shifts 5-9 times per month and selectively reporting based on the severity of the violence.
Conclusion: The reporting rate of PVV among nurses was notably low. Nursing managers should consider implementingcomprehensive measures that address both the facilitating and blocking factors identified in the study. This strategic approach aims to enhance the reporting rate of PVV incidents among nurses, fostering a safer and more supportive environment within healthcare settings.
A Public Benchmark for Human Performance in FCD Detection
Authors: Walger Lennart , Schmitz Matthias H. , Bauer Tobias , Kügler David , Schuch Fabiane , Arendt Christophe , Baumgartner Tobias , Birkenheier Johannes , Borger Valeri , Endler Christoph , Grau Franziska , Immanuel Christian , Kölle Markus , Kupczyk Patrick , Lakghomi Asadeh , Mackert Sarah , Neuhaus Elisabeth , Nordsiek Julia , Odenthal Anna-Maria , Dague Karmele Olaciregui , Ostermann Laura , Pukropski Jan , Racz Attila , Ropp Klaus von der , Schmeel Frederic Carsten , Schrader Felix , Sitter Aileen , Unruh-Pinheiro Alexander , Voigt Marilia , Vychopen Martin , von Wedel Philip , von Wrede Randi , Attenberger Ulrike , Vatter Hartmut , Philipsen Alexandra , Becker Albert , Reuter Martin , Hattingen Elke , Specht-Riemenschneider Louisa , Radbruch Alexander , Surges Rainer , Rüber Theodor 
Published: June 2024

Abstract

This study aims to report human performance in the detection of Focal Cortical Dysplasias (FCDs), localized regions of malformed cerebral cortex, using a public dataset. Additionally, it defines a subset of this data as a representative testset to establish a baseline benchmark for the evaluation of automatic FCD detection approaches. The performance of 28 human readers was analyzed using 85 publicly available cases. Performance was measured based on the overlap between predicted regions of interest (ROIs) and ground truth lesion masks. The testset was chosen to consist of 15 subjects most predictive for human performance and 13 subjects identified by at most 3 readers. Expert readers achieved an average detection rate of 68%, compared to 45% for non-experts and 27% for laypersons. Neuroradiologists detected the highest percentage of lesions (64%), while psychiatrists detected the least (34%). Neurosurgeons had the highest ROI sensitivity (0.70), and psychiatrists had the highest ROI precision (0.78). In the testset, expert detection rate was 49%. Reporting human performance in FCD detection provides a baseline for assessing the effectiveness of automatic detection methods in a clinically relevant context. The representative testset will serve as an indicator for the clinical usefulness of computer-aided FCD detection approaches.
Perception of Exclusive Breastfeeding for Working Mothers at Royal Hospital: Qualitative Study
Authors: Al-Ajmi Najat , Al-Hadidi Aida , Al-Riyami Amina , Al-Adawi Mudhar , AlAnazy Wdad , Al-Salti Nusaiba 
Published: June 2024

Abstract

Background
In 2022, the rate of exclusive breastfeeding in Oman was reported at 23.2%, significantly below the WHO-recommended target of 50%. This low rate is concerning given the well-documented benefits of exclusive breastfeeding for both infants and mothers, including optimal nutrition, enhanced immune protection, and reduced risks of chronic diseases. Despite global health guidelines, many mothers in Oman face challenges in maintaining exclusive breastfeeding, particularly when returning to work, highlighting the need for focused research and intervention.
Method
This qualitative study employed face-to-face interviews with working mothers at the largest tertiary hospital in Muscat, Oman, to explore their experiences with exclusive breastfeeding practices upon returning to work.
Results
Content manifest analysis revealed seven key themes: the impact of rules and regulations on mothers' decisions, protected time for breastfeeding, shift patterns, mothers' knowledge about exclusive breastfeeding, workplace accessibility, individual characteristics of mothers, and available support.
Conclusion
The study highlights deficiencies in breastfeeding practices among working mothers and underscores the necessity for enhanced managerial support to increase exclusive breastfeeding rates among healthcare providers. Additionally, it emphasizes the need for workplace restructuring to provide private spaces for milk expression during working hours.
Parameter Study of a 5G Array Antenna at 28GHz
Authors: Lak Asma 
Published: June 2024

Abstract

In this paper a 5G compact antenna has been simulated, fabricated and measured which works at 28GHz. The antenna structure is according to quasi Yagi antenna. The SIW technology has been used to feed the antenna. The antenna array has been designed and simulated. The S11, E pattern, and H pattern have been simulated for single element and array antenna too. The E pattern, H pattern, and S11 have been measured for single antenna. Moreover the effects of some antenna parameters i.e. (the number of stubs, the length of director, the distance between director and driver, the length of driver, and the distance between driver and reflector) on S11 has been studied. The HFSS and CST software have been used to all simulation. Also for the array antenna the effect of changing the number of directors on S11 and antenna gain are considered.
Tyrp1 is the Mendelian Determinant of the Axolotl (Ambystoma mexicanum) Copper Mutant
Authors: Cecil Raissa F. , Strohl Lloyd , Thomas Maddie K. , Schwartz James L. , Timoshevskaya Nataliya , Smith Jeramiah J. , Voss S. Randal 
Published: June 2024

Abstract

Several dozen Mendelian mutants have been discovered in axolotl (Ambystoma mexicanum) populations, including several that affect pigmentation. For recessive mutants have been described in the scientific literature and genes for three of these have been identified. Here we describe and genetically dissect copper, a mutant with an albino-like phenotype known only from the pet trade. We performed a cross segregating copper and wildtype color phenotypes and used bulked segregant RNA-Seq to identify a region on chromosome 6 that was enriched for single-nucleotide polymorphisms (SNPs) between the color phenotypes. This region included Tyrosinase-like Protein 1 (Tyrp1), a melanin synthesis protein that when mutated, is associated with lighter than black melanin coloration in animal models and oculocutaneous albinism in humans. Inspection of RNA-Seq reads identified a single nucleotide deletion that is predicted to change the coding frame, introducing a premature stop codon in exon 6 and yield a truncated Tyrp1 protein in copper individuals. Using CRISPR-Cas9 editing, we show that wildtype Tyrp1 crispants exhibit copper pigmentation, thus confirming Tyrp1 as the copper locus. Our results suggest that commercial and hobbyist axolotl populations may harbor useful mutants for biological research.
Brown fat-specific mitoribosomal function is crucial for preventing cold exposure-induced bone loss
Authors: Tian Jingwen , Moon Ji Sun , Nga Ha Thi , Lee Ho Yeop , Nguyen Thi Linh , Jang Hyo Ju , Setoyama Daiki , Shong Minho , Lee Ju Hee , Yi Hyon-Seung 
Published: June 2024

Abstract

This study investigates the relationship between ambient temperature, brown adipose tissue (BAT) function, and bone metabolism, revealing how cold exposure and BAT mitochondrial activity influence bone health. Utilizing ovariectomized (OVX) mice to model primary osteoporosis and BAT-specific mitochondrial dysfunction (BKO) mice, we explored the effects of housing temperature on bone density, immune modulation in bone marrow, and the protective role of BAT against bone loss. The results showed that cold exposure universally decreases bone mass, increases osteoclastogenesis, and shifts bone marrow T-cell populations, suggesting a key role of the immune system in bone remodeling under cold stress. Crucially, the thermogenic function of BAT, underpinned by mitochondrial oxidative phosphorylation, protected against bone loss. Impairments in BAT function, either through surgical removal or mitochondrial dysfunction, exacerbated bone loss in cold environments, highlighting the importance of BAT metabolic activity for bone health. Additionally, we found that cold-induced alterations in BAT function led to systemic metabolic changes, including increased long-chain fatty acid levels, which directly and indirectly affected osteoclast differentiation and activity. These findings point to a systemic mechanism via which environmental temperature and BAT metabolism are interconnected with bone physiology, offering new insights into the metabolic and environmental determinants of bone health. In summary, our study underscores the complex interactions between ambient temperature, BAT function, and bone health, suggesting that novel bone disease therapies could be developed by targeting metabolic and environmental factors. Further research in these pathways may provide innovative approaches for managing bone health amid changing environmental conditions and metabolic dysfunctions.
Mental health issues in Adolescents Living with HIV/AIDS
Authors: Azeem Mohammed Abdul , BHAT Kamalakshi G , Gomes Rochelle Natasha , Dsa Smitha Sharlette 
Published: June 2024

Abstract

The Highly-Active Anti-Retroviral Therapy (HAART) has revolutionized the management of People Living With HIV/AIDS (PLWHA) in recent years, however with existing drawbacks with respect to drug resistance, adherence, complications, and importantly, mental health problems. Before the age of 14, half of all severe adult psychiatric issues occur, although therapy generally does not begin for another 6–23 years. We conducted a cross sectional study in adolescents in an ART centre affiliated to a tertiary care district level to assess the proportion of stigma, depression, the correlation between stigma and depression and between the CD4 count, duration/ stage of illness to stigma and depression. We administered the HIV Felt Stigma Scale (HFSS) to assess stigma and Centre for Epidemiological Studies-Depression Scale (CES-D) questionnaire to assess depression. 92.8% felt stigma and 66.3% of the study participants were moderately stigmatised. The proportion of depression was 20.5%, and a statistically significant correlation being observed in between stigma and depression (p value-0.020) and between depression and CD4 count (0.024). A statistically significant association was observed between the total Leukocyte Count and depression (0.01). Therefore, the assessment of youth for stigma leading onto depression allows early intervention in the treatment of depression before symptoms worsen, thereby overcoming a few important barriers to healthy behaviours like adherence to treatment and safer sexual behaviour and aid in reducing the harmful effects of stigma and depression among adolescents with HIV/AIDS. Trial registration number and date of application: not applicable
High risk factors for massive haemorrhage during medical abortion patients with missed miscarriage
Authors: Tan Yuru , Li Sen , Xu Hong , Wang Shuying 
Published: June 2024

Abstract

Background Recently, the incidence of missed miscarriage has gradually increased, and medical abortion is a common method to terminate a pregnancy. In the process of medical abortion, massive vaginal bleeding takes place, leading to emergency surgical haemostasis. Emergency surgery may produce infection and organ damage. Our study aimed to investigate the high-risk factors for massive haemorrhage during a medical abortion. Methods A total of 1062 missed miscarriage patients who underwent medical abortion participated in this retrospective study.According to the amounts of bleeding, the patients were divided into massive haemorrhage group and control group.By comparing the general conditions of the two groups, such as fertility history, uterine surgery history, uterine fibroids, etc, the high-risk factors for massive haemorrhage during medical abortion were identified. Results Relative to the control group, the massive haemorrhage group exhibited a higher proportion of patients with a previous artificial abortion (51.9% vs. 38.1%, P = 0.001). Additionally, the massive haemorrhage group had a lower percentage of first-time pregnant women (32.1% vs. 40.4%) and a higher proportion of women with shorter pregnancy intervals (44.9% vs. 33.1%, P = 0.03). Furthermore, there were notable differences between the two groups regarding maximum fibroid size, the duration of amenorrhea, and gestational week (P < 0.05). Conclusion In this study, we determined that a history of artificial abortion and an amenorrhea duration > 11 weeks represented high-risk factors for massive vaginal bleeding during medical abortion in missed miscarriage patients.
Protocol for the SELECT study: a sequential mixed methods study of the selection of UK medical students into clinical academic training
Authors: Byrne Matthew Henry Vincent , Chan Claudia , Karas Akamiya , Lynn Eabha , Dominic Catherine , Bain Robert , Wan Jonathan C M , Clelland Andrew , Hayes Siena , Asif Aqua , Bluemel Anna Harvey , Mogg Jasper , Lawrence Leigh , Church Helen , Finn Gabrielle , Brown Megan 
Published: June 2024

Abstract

Background
Internationally, there has been a move towards fostering diverse healthcare workforces that are representative of the patient populations they serve. Selection criteria for academic-clinicians often aim to capture skills and attributes that demonstrate both clinical and academic excellence. Currently, it is not known whether the selection criteria for early academic-clinical careers advantage or disadvantage certain ethnic or socioeconomic groups. The UK has a structured route of integrated clinical academic training with entry level training for newly qualified doctors administered through the ‘Specialised Foundation Programme’ which provides protected time for research within the first two years of postgraduate clinical training. In this study, we aim to identify what selection criteria are used within the UK Specialised Foundation Programme, and how these relate to demographic factors.
Methods
We will perform a mixed methods study consisting of a document analysis of person specifications and selection criteria used in the 2024 UK Specialised Foundation Programme, and a national cross-sectional survey of current medical students in the UK. We will obtain the person specifications, selection criteria, white space (open ended questions used during shortlisting) and interview questions and mark schemes from each Specialised Unit of Applications via information available on their websites or through Freedom of Information requests. Our survey will collect information relating to demographic data, selection criteria, and perceptions of specialised foundation programme selection.
Discussion
International literature has demonstrated inequity in academic markers used in selection of post-graduate clinicians and that disadvantages caused by selection can compound over time. As such it is important to understand what inequity exists within the selection of early academic-clinicians, as this can help inform more equitable selection practices and help nurture a more diverse academic-clinical workforce.
Trial Registration
Not applicable