bluuebunny/crossref_metadata_2025_split huggingface dataset:
Material testing for injection molded and 3D printed pristine/glass reinforced nylon at various strain rates
Authors: Jain Mohit , Patil Santosh 
Published: April 2024

With the advent of new polymer material and non-conventional methods of manufacturing, the effect of loading conditions on mechanical properties has now been in huge demand to facilitate their industrial applications. Present paper has been focused on investigating the strain rate effects on mechanical properties of pristine nylon-6 and 20% glass reinforced nylon-6 material fabricated using injection molding and SLS (Selective Laser Sintering) printing manufacturing methods, respectively, at three strain rates of 0.0003, 0.003, and 0.01 per second. Tensile strength of injection molded nylon-6 has shown a positive relationship with strain rate whereas compressive strength has shown a reciprocal effect. At highest strain rate of 0.01 s−1, tensile strength exhibits 10.27% more as compared to lowest strain rate of 0.0003 s−1. Tensile strength at highest strain rate is found 60 MPa whereas at lowest strain rate it exhibits 54.41 MPa. At higher values of strain rate, rising of maximum strain is found very much sensitive than the rise in tensile strength. It also shows high percentage of deformation at higher value of strain rate. On the other hand, SLS printed 20% glass reinforced nylon-6 shows variable tensile strength with respect to strain rate due to uneven distribution of glass particles into nylon matrix created due to manufacturing process of SLS printing. FESEM images shows the cavity formation as observed before loading conditions whereas the glass fracturing phenomenon observed at the after loading conditions. However, compressive strength is found minimal with strain rate with an average value of 175.61 MPa. The findings of this study have contributed in avoiding the improper selection of material and its strain rate application during numerical modeling for industrial application purpose.
Transbronchial Lung Cryobiopsies, Transbronchial Forceps Lung Biopsies, and Surgical Lung Biopsies in Mechanically Ventilated Patients with Acute Hypoxemic Respiratory Failure: A Retrospective Cohort Study
Authors: Li Qi , Lafrance Dominique , Liberman Moishe , Leduc Charles , Charbonney Emmanuel , Titova Polina , Manganas Hélène , Chassé Michaël 
Published: April 2024

Importance Lung biopsies are sometimes performed in mechanically ventilated patients with acute hypoxemic respiratory failure (AHRF) of unknown etiology to guide patient management. While surgical lung biopsies (SLB) offer high diagnostic rates, they may also cause significant complications. Transbronchial forceps lung biopsies (TBLB) are less invasive but often produce non-contributive specimens. Transbronchial lung cryobiopsies (TBLC) yield specimens of potentially better quality than TBLB, but due to their novel implementation in the intensive care unit (ICU), their accuracy and safety are still unclear. Objectives Our main objective was to evaluate the risk of adverse events in patients with AHRF following the three biopsy techniques. Our secondary objectives were to assess the diagnostic yield and associated modifications of patient management of each technique. Design, Settings and Participants We conducted a retrospective cohort study comparing TBLC, TBLB, and SLB in mechanically ventilated patients with AHRF. Main Outcomes and Measures The primary outcome was the proportion of patients with at least one complication, and secondary outcomes included complication rates, diagnostic yields, treatment modifications, and mortality. Results Of the 26 patients who underwent lung biopsies from 2018 to 2022, all TBLC and SLB patients and 60% of TBLB patients had at least one complication. TBLC patients had higher unadjusted numbers of total and severe complications, but also worse Sequential Organ Failure Assessment scores and P/F ratios. A total of 25 biopsies (25/26, 96%) provided histopathological diagnoses, 88% (22/25) of which contributed to patient management. ICU mortality was high for all modalities (63% for TBLC, 60% for TBLB and 50% for SLB). Conclusions and Relevance All biopsy methods had high diagnostic yields and the great majority contributed to patient management; however, complication rates were elevated. Further research is needed to determine which patients may benefit from lung biopsies and to determine the best biopsy modality.
Racial and ethnic disparities in prostate cancer screening following the 2018 US Preventive Services Task Force recommendation statement
Authors: VanderVeer-Harris Nathan , Zippi Zachary D , Patel Dev P , Manoharan Murugesan , Caso Jorge R , Vaidean Georgeta D 
Published: April 2024

Objective In 2018, the United States Preventive Services Task Force promoted shared decision making between healthcare provider and patient for men aged 55 to 69. This study aimed to analyze rates of prostate-specific antigen (PSA) testing across racial and ethnic groups following this new recommendation. Methods A secondary analysis was conducted of the 2020–2021 Behavioral Risk Factor Surveillance System database to assess men aged 55 or older without a history of prostate cancer. We defined four race-ethnicity groups: non-Hispanic Whites (NHWs), non-Hispanic Blacks (NHBs), Hispanics, and Other. The primary outcome was the most recent PSA test (MRT), defined as the respondent's most recent PSA test occurring pre-2018 or post-2018 guidelines. Logistic regression adjusted for covariates including age, socioeconomic status factors, marital status, smoking history, and healthcare access factors. Results In the age 55 to 69 study sample, NHW men had the greatest proportion of MRT post-2018 guidelines (n = 15,864, 72.5%). NHB men had the lowest percentage of MRT post-2018 guidelines (n = 965, 66.6%). With NHW as referent, the crude odds of the MRT post-2018 guidelines was 0.68 (95% confidence interval (CI) = 0.53–0.90) for NHB. The maximally adjusted odds ratio was 0.78 (0.59–1.02). Conclusions We found that NHB aged 55 to 69 reported decreased rates of PSA testing after 2018 when compared to NHW. This was demonstrated on crude analysis but not after adjustment. Such findings suggest the influence of social determinants of health on preventative screening for at-risk populations.
Study on the Mechanism of Anti-atopic Dermatitis by Herba Siegesbeckiae Based on System Pharmacology
Authors: Chen Xiaowei , Wang YingYue , Zhang Xin , Liu Chang , You Chunxue , Xu Yubin 
Published: April 2024

Background Atopic dermatitis (AD) is a common but complex chronic inflammatory skin condition characterised by intense pruritus, severely impacting patients’ quality of life. At present, there is no specific drug for AD. Herba Siegesbeckiae (HS) had a therapeutic effect on AD, but its mechanism has not been completely elucidated. Purpose We aimed to understand the mechanism of HS in the treatment of AD in this study. Materials and Methods To investigate the mechanism of HS for AD, including active components, key targets and pathway analyses, systemic pharmacology was used. Molecular docking was conducted to validate the interactions between the key components and their targets. Afterwards, an AD-like animal model was established, skin pathology was observed and immunohistochemical staining was used to confirm the key targets. Results Six vital active components (daucosterol, d-mannitol, hythiemoside B, 15,16-di- O-acetyldarutoside, 19-acetoxy-15-hydroperoxy-12-oxo-13,14E-dehydro-10,11,14,15-tetrahydr-ogeranylnerol and 17- O-acetyldarutoside) highly correlated with potential targets and the key targets (TNF-α, VEGFA, TLR4, STAT3, TLR2, STAT1, MMP9, IL-6, TRPV1 and PPARG) highly correlated with disease processes were identified, pathway enrichment analysis revealed that the toll-like receptor, PI3K-Akt and HIF-1 signalling pathways were significantly enriched with key targets, suggesting their involvement in the anti-Alzheimer’s disease mechanism of HS. As a result of animal experiments, AD-like mice from the model group showed epidermal thickening and inflammatory cell infiltration; TNF-α, VEGFA, TLR4, STAT3, TLR2, STAT1, MMP9, IL-6, TRPV1 levels are significantly up-regulated and PPARG levels were significantly down-regulated; those of which could be reversed by 3.0 g/kg. Conclusion HS might exert its anti-AD effects by up-regulating PPARG and down-regulating TNF-α, VEGFA, TLR4, STAT3, TLR2, STAT1, MMP9, IL-6 and TRPV1. This study laid a foundation for understanding HS’s bioactive components and mechanism against AD.
Recommendation endpoints and safety of an online self-triage for depression symptoms
Authors: Miller Nathaniel E , North Frederick , Curry Elizabeth N , Thompson Matthew C , Pecina Jennifer L 
Published: April 2024

Introduction Online symptom checkers are a way to address patient concerns and potentially offload a burdened healthcare system. However, safety outcomes of self-triage are unknown, so we reviewed triage recommendations and outcomes of our institution's depression symptom checker. Methods We examined endpoint recommendations and follow-up encounters seven days afterward during 2 December 2021 to 13 December 2022. Patients with an emergency department visit or hospitalization within seven days of self-triaging had a manual review of the electronic health record to determine if the visit was related to depression, suicidal ideation, or suicide attempt. Charts were reviewed for deaths within seven days of self-triage. Results There were 287 unique encounters from 263 unique patients. In 86.1% (247/287), the endpoint was an instruction to call nurse triage; in 3.1% of encounters (9/287), instruction was to seek emergency care. Only 20.2% (58/287) followed the recommendations given. Of the 229 patients that did not follow the endpoint recommendations, 121 (52.8%) had some type of follow-up within seven days. Nearly 11% (31/287) were triaged to endpoints not requiring urgent contact and 9.1% (26/287) to an endpoint that would not need any healthcare team input. No patients died in the study period. Conclusions Most patients did not follow the recommendations for follow-up care although ultimately most patients did receive care within seven days. Self-triage appears to appropriately sort patients with depressed mood to emergency care. On-line self-triaging tools for depression have the potential to safely offload some work from clinic personnel.
The analysis of factors affecting medication adherence in patients with myasthenia gravis: a cross-sectional study
Authors: Su Yining , Wang Xinxian , Xing Yuemeng , Wang Zhenni , Bu Hailing , Cui Xiaoyan , Yang Yunying , Cai Bingxing 
Published: April 2024

Background: Clinically, patients with myasthenia gravis are generally treated with drugs to improve their physical condition, and poor medication adherence can hinder their recovery. Many studies have shown the importance of medication adherence for effective treatment. Various factors may affect a patient’s medication adherence; however, studies concerning medication adherence in patients with myasthenia gravis are rare. Objectives: This study aimed to identify the factors related to medication adherence in patients with myasthenia gravis, and determine the possibility of predicting medication adherence. Methods: This cross-sectional observational study was conducted among inpatients and outpatients with myasthenia gravis of the First Affiliated Hospital of Guangzhou University of Chinese Medicine in China. Data on patient demographics, disease-related characteristics, and medical treatment were collected. We evaluated medication adherence of the patients using the Morisky Medication Adherence Scale-8, Beliefs about Medicines Questionnaire, and the Self-efficacy for Appropriate Medication Use Scale. Results: We distributed 200 questionnaires and finally retrieved 198 valid questionnaires. A total of 139 (70.2%) women participated in this study, and 81 (40.9%) among the 198 participants were aged 40–59 years. In total, 103 (52.0%) participants exhibited bad adherence to pharmacological treatment, and factors such as taking medication irregularly [odds ratio (OR) = 0.242, 95% CI = 0.093–0.627], the necessity of taking medicine (OR = 1.286, 95% CI = 1.142–1.449), the concerns of taking medicine (OR = 0.890, 95% CI = 0.801–0.988), and the self-efficacy for taking medications under difficult circumstances (OR = 1.194, 95% CI = 1.026–1.389) had statistically significant impacts on medication adherence. Conclusion: Our study shows that taking medication irregularly and concerns of taking medicine are the risk factors for medication adherence. Meanwhile, the necessity of talking medicine and self-efficacy for taking medications under difficult circumstances are the protective factors for medication adherence. Our findings can help medical staff to enhance patients’ medication adherence by informing patients necessary medical knowledge, emphasizing the necessity for medication, relieving patients’ concerns regarding medication, and improving the self-efficacy for taking medications under difficult circumstances.
Smart Algorithms for Efficient Insulin Therapy Initiation in Individuals With Type 2 Diabetes: An in Silico Study
Authors: Bonet Jacopo , Visentin Roberto , Dalla Man Chiara 
Published: April 2024

Background: Insulin-naive subjects with type 2 diabetes (T2D) start basal insulin titration from a low initial insulin dose (IID), which is adjusted weekly or twice per week based on fasting plasma glucose (FPG) measurement as recommended by the American Diabetes Association (ADA). The procedure to reach the optimal insulin dose (OID) is time-consuming, especially in subjects with high insulin needs (HIN). The aim of this study is to provide a fast and effective, but still safe, insulin titration algorithm in insulin-naive T2D subjects with HIN. Method: To do that, we in silico cloned 300 subjects, matching a real population of insulin-naive T2D and used a logistic regression model to classify them as subjects with HIN or subjects with low insulin needs (LIN). Then, we applied to the subjects with HIN both a more aggressive insulin dose initiation (SMART-IID) and two newly developed titration algorithms (continuous glucose monitoring [CGM]-BASED and SMART-CGM-BASED) in which CGM was used to guide the decision-making process. Results: The new titration algorithm applied to HIN-classified individuals guaranteed a faster reaching of OID, with significant improvements in time in range (TIR) and reduction in time above range (TAR) in the first months of the trial, without any clinically significant increase in the risk of hypoglycemia. Conclusions: Smart basal insulin titration algorithms enable insulin-naive T2D individuals to achieve OID and improve their glycemic control faster than standard guidelines, without jeopardizing patient safety.
The Effectiveness of an Information-Motivation Behavioral Skill Health Promotion Video on Health Status Among Chiang Mai University Personnel During the COVID-19 Pandemic
Authors: Udomkhwamsuk Warawan , Chaisurin Patcharin , Pungchompoo Wanicha , Junsiri Tanutporn 
Published: April 2024

Purpose: The purpose of this research was to study the effectiveness of the IMB Educational Health Promotion (IMBEHP) video for improving quality of life, health risk awareness, and health promotion among Chiang Mai University (CMU) personnel. Methods: This research was a quasi-experimental study with a 1-group pre-posttest design. The sample group included 528 CMU personnel who worked at the university between June 2020 and December 2021. Data collection was conducted before and after participants watched the IMB health promotion video. Results: After watching the video, the participants’ quality of life scores were at a medium level. Moreover, physical health, mental health, social relations, and total quality of life score measures showed statistically significant differences between before and after viewing, at P < .05. The mean total for quality of life increased from the prior intervention implementation. Understanding of health risks also increased after watching the video, and the levels of health risk increased as follows: low level of health risk increased to 343 (64.96%), followed by medium and high health risk, at 21.78% (n = 115) and 10.04% (n = 53), respectively. Lastly, awareness about nutrition was statistically significant at .05. Conclusions: The results of this study demonstrate the efficacy of video in educating, motivating, and developing health-promoting skills among this population. After watching the video, CMU personnel increased their awareness of chronic disease risk factors, health promotion practice, illnesses prevention, healthy behaviors, and improvement of quality of life.
Nursing Students’ Learning Engagement Experiences During the COVID-19 Pandemic in Namibia: Implications for Nursing Education
Authors: Tomas Nestor , Munangatire Takaedza , Haita Sandrina Leila 
Published: April 2024

Introduction Ensuring strong student engagement in both traditional and virtual learning settings was essential for achieving positive educational results during the COVID-19 pandemic. However, fostering student engagement in both the traditional (face-to-face) and virtual learning environments has been accompanied by distinct challenges. There has been a lack of research specifically addressing the issue of nursing students’ engagement within a blended learning setting in Namibia. Aim To explore and describe nursing students’ learning engagement experiences at a university campus in Namibia during the COVID-19 pandemic. Methods A qualitative, descriptive, phenomenological study was employed to collect data from 10 purposively selected nursing students at a university campus in Namibia. Data from in-depth, face-to-face, individual interviews were collected using a semistructured interview guide. Data were analyzed using Colaizzi's seven-step method. Results The findings of the study describe students’ learning engagement experiences under four distinct themes: (a) conditions and contexts of engagement; (b) student acts of engagement: positionality of teacher- and student-facilitated engagement; (c) consequences of engagement in a blended learning environment; and (d) student engagement dispositions: students’ initiatives. Conclusion The research findings revealed that despite mental health challenges, both teacher-facilitated and student-facilitated engagement were necessary for positive learning engagement in the blended learning environment. Student-facilitated engagement was significantly responsible for enabling students to maintain focus, adhere to guidelines, and adapt to the blended learning environment. These findings are useful in understanding the challenges faced by students during the COVID-19 pandemic. The findings thus provide valuable data for future studies seeking to address challenges associated with the blended learning environment.
Tectonic architecture of the northern Dora-Maira Massif (Western Alps, Italy): field and geochronological data
Authors: Nosenzo Francesco , Manzotti Paola , Krona Mikaela , Ballèvre Michel , Poujol Marc 
Published: April 2024

AbstractHigh-pressure and ultra-high-pressure metamorphic terrains display an internal architecture consisting of a pile (or stack) of several coherent tectonic thrust sheets or units. Their identification is fundamental for understanding the scale and mechanisms active during subduction and exhumation of these crustal slices. This study investigates the geometry of the northern Dora-Maira Massif and the kinematics of the major tectonic boundaries, combining field and geochronological data. The tectonic stack of the northern Dora-Maira Massif comprises the following units. The lowermost unit (the Pinerolo Unit) is mainly characterized by Upper Carboniferous fluvio-lacustrine (meta-)sediments. The Pinerolo unit is overthrust by a pre-Carboniferous basement. The latter is subdivided in two tectonic units (the Chasteiran and Muret Units) with different Alpine metamorphism (ultra-high-pressure and high-pressure, respectively). The pre-Carboniferous basement of the Muret Unit is thicker than previously thought for two main reasons. Firstly, some paragneisses, traditionally assumed to be Carboniferous and/or Permian in age, display detrital zircon ages indicating a main source at about 600 Ma. Secondly, three samples of the Granero Orthogneiss, previously assumed to be a Permian intrusive body, have provided zircon U–Pb ages of 447 ± 1 Ma, 456 ± 2 Ma and 440 ± 2 Ma, indicating a late Ordovician or early Silurian age for the protoliths. The uppermost unit (the Serre Unit) comprises porphyritic (meta-) volcanic and volcaniclastic rocks dated to the Permian (271 ± 2 Ma), on top of which remnants of the Mesozoic cover is preserved. Detailed mapping of an area about 140 km2 shows that (i) the ultra-high pressure Chasteiran Unit is localized at the boundary between the Pinerolo and Muret Units, (ii) the Granero Orthogneiss may be considered as the mylonitic sole of the Muret Unit, characterized by a top-to-W sense of shear, and (iii) the contact between the Muret and Serre Units displays ductile-to brittle structures (La Fracho Shear Zone), indicating a top-to-the-NW displacement of the hangingwall with respect to the footwall. A final episode of brittle faulting, cutting across the nappe stack (the Trossieri Fault), indicates an extensional stage in the core of the Alpine belt, as previously documented in more external zones. This work provides a necessary and robust basis before an accurate discussion of processes acting during continental subduction of the Dora-Maira Massif may be understood.