bluuebunny/crossref_metadata_2025_split huggingface dataset:
Does laparoscopic sacrocolpopexy support the posterior compartment in women with multicompartment prolapse including rectocele?
Authors: Aichner Simone , Studer Andreas Martin , Frey Janine , Brambs Christine , Krebs Jörg , Christmann-Schmid Corina 
Published: May 2024

Abstract

Purpose
This study aimed to evaluate the effectiveness of nerve-sparing laparoscopic sacrocolpopexy in managing multicompartment prolapse with concurrent rectocele (≥ stage II). It sought to determine if additional posterior repair was necessary for successful support of the posterior compartment and to evaluate the impact on bowel function in women undergoing surgery.
Methods
Data from all women who underwent laparoscopic sacrocolpopexy with or without posterior repair between 01/2017 and 07/2022 for symptomatic multicompartment prolapse, including apical and posterior compartment descent ≥ stage II, were retrospectively evaluated. All women underwent a urogynecological examination, including assessment of genital prolapse using the POP-Q quantification system and completed the validated German Female Pelvic Floor questionnaire pre- and postoperatively (6-12 weeks). Preoperative anatomic support and bowel symptoms were compared to postoperative values.
Results
In total 112 women met the criteria for surgical correction. The majority (87%) had stage II posterior descent, with only 10% undergoing concurrent posterior repair during laparoscopic sacrocolpopexy. Significant (p<0.001) objective improvement was seen for all compartments post- compared to preoperatively (Ba: 0(-1/2) vs -3(-3/-2), C: -1(-2/0) vs -8(-12/-7), Bp:0(-1/0) vs -3(-2/-2); (Median 25%/75% quartiles)). Subsequent surgery for persistent rectocele and/or stool outlet symptoms was required in 4% of cases. Most bowel specific questions in the German Female Pelvic Floor Questionnaire showed significant improvement (p<0.001).
Conclusion
Nerve-sparing sacrocolopopexy alone seems to be a suitable surgical approach correcting multicompartment prolapse, including a rectocele ≥ stage II and results in a reduction of objective signs and symptoms of pelvic organ prolapse.
Hydrogen-rich syngas production from wood waste and wood waste pellet via gasification in updraft circulating fixed bed reactor
Authors: Parlak Kemal , Yilgor Nural , Öngen Atakan 
Published: May 2024

Abstract

This study aims to investigate the possibility of utilizing post-consumer wood waste by converting it into high value-added and environmentally friendly products via pyrolysis assisted gasification and direct gasification. Wood waste supplied from houses and garbage containers by Beşiktaş Municipality, Turkey, was used in the trials. After characterization of the wood waste was done, the experiments were carried out in an updraft fixed-bed reactor at temperatures of 700, 800, and 900°C with dry air (DA) and pure oxygen (PO) gasifying agents with varying flow rate parameters (0.05, 0.1, 0.2, and 0.4 L/min for DA, 0.01 L/min for PO). Wood waste was processed separately into chips and pellets, and appropriate experimental parameters were determined and compared. The maximum H2 yield of 57%, cold gas efficiency of 68%, and mean H2/CO ratio of 2.51 were experimentally obtained in pelletized wood waste. In addition, the maximum H2 production of 51%, cold gas efficiency of 52%, and mean H2/CO ratio of 1.97 were successfully achieved for chipped wood waste. The experimental results demonstrate that in terms of hydrogen-rich syngas, H2/CO ratio, cold gas efficiency, and material conversion, pelletized wood waste is superior to chipped wood waste.
Biogas production from anaerobic digestion of Phragmites australis: influence of mechanical pre-treatment, harvesting season and co-digestion with food waste.
Authors: Al-Iraqi Ahmed R. , Gandhi Bhushan P. , Folkard Andrew M. , Barker Philip A. , Semple Kirk T. 
Published: May 2024

Abstract

This study investigated the effect of harvesting time and using the co-digesting strategy on the digestibility of Phragmites australis biomass and methane production. The P. australis biomass harvested from summer, autumn, and winter was digested singly (mono-digestion) and combined with synthetic food waste (co-digestion) at an inoculum to substrate ratio 1:1 based on the volatile solid content of inoculum and substrate and under mesophilic conditions (37 ± 1°C). The results found that cumulative methane production was low during mono-digestion of summer, autumn, and winter P. australis (36.26 ± 4.48, 35.59 ± 3.08, and 34.90 ± 4.40 mL/g VS added, respectively) due to the effect of lignin on the biodigestibility of P. australis. This issue was addressed by co-digestion of P. australis biomass from these three seasons with synthetic food waste, which resulted in an increase of a cumulative methane production (135.66 ± 1.14, 137.33 ± 3.21, and 123.94 ± 1.01 mL/g VS added, respectively).
Evaluation of SVM and RF Machine Learning Algorithms in Land Use/Land Cover Change Assessment: Tessa Watershed Case Study (Northwest of Tunisia)
Authors: BACCARI Noamen , HAMZA Mohamed Hafedh , SLAMA Tarek , SEBEI Abdelaziz , REBAI Noamen 
Published: May 2024

Abstract

This study aims to highlight the changes in LULC (land use and Land cover) in the Tessa watershed (Northwest of Tunisia) between 1993 and 2023. Remote sensing coupled with geographic information systems (GIS) and statistical analysis, are used. Accuracy metrics make it possible to evaluate the performance of the image classification method, using the calculation of the producer’s accuracy, the user’s accuracy, overall accuracy, and the Kappa coefficient. Two Machine Learning (ML) algorithms related to the supervised classification are used for two Landsat images related to 1993 and 2023: the Support Vector Machine (SVM) and the Random Forest (RF). These algorithms are integrated into the SCP plugin of the QGIS software used in this study. The overall accuracy achieved by applying the SVM algorithm to the Landsat 5 TM image from 1993 is 88.24% with a Kappa value of 0.8, whereas the overall accuracy obtained for the Landsat 8 OLI image from 2023 is 99.4% with a Kappa value of 0.99. By applying the RF algorithm, the overall accuracy obtained for the 1993 Landsat 5 TM image is 86% with a Kappa value of 0.8, while for the 2023 Landsat 8 OLI image, the overall accuracy obtained is 81% with a Kappa value of 0.77. Using the transition matrix, it was possible to detect LULC changes spatiotemporally. A comparison of the classification results obtained from SVM and RF algorithms with ground truth showed that the SVM classifier was more accurate in the study area.
Implementation and Evaluation of a Communication Coaching Program: A CFIR-Informed Qualitative Analysis Mapped onto a Logic Model
Authors: Jensen Rachel M. , Sasnal Marzena , Mai Uyen T. , Korndorffer James R. , Miller-Kuhlmann Rebecca K. , Morris Arden M. , Nassar Aussama K. , Gold Carl A. 
Published: May 2024

Abstract

Background
Coaching programs in graduate medical education have the potential to impact trainee development across multiple core competencies but require rigorous program evaluation to ensure effectiveness. We sought to qualitatively evaluate the implementation of a multi-departmental, faculty-led communication coaching program using a logic model framework.
Methods
Study participants were selected from four key stakeholder groups: resident coachees, faculty coaches, medical education leaders, and programmatic sponsors. 30–45 minute semi-structured interviews were conducted via Zoom, transcribed, and de-identified for the analysis. Interviews captured stakeholders' perspectives on physicians' communication training needs, stakeholders perceived and actual roles, stakeholders’ involvement in the program, factors influencing the implementation process, and strategies for programmatic improvement, sustainment, and spread. The Consolidated Framework of Implementation Research (CFIR) guided the codebook development and data analysis. A combined inductive/deductive approach was used to develop a 20-item codebook, followed by a team-based thematic analysis. A strong intercoder agreement (Cohen’s kappa coefficient κ = 0.83) ensured coding consistency. The emerging themes were then mapped onto four domains of a logic model: Context, Inputs and Outputs, Outcomes, and Evaluation.
Results
35 interviews were conducted between November 2021 and April 2022 with representation from all stakeholder groups, including 10 resident coachees (who received coaching), 10 faculty coaches (who served as coaches and underwent coaching-specific faculty development), 9 medical education leaders (who designed and implemented program), and programmatic sponsors (who provided financial support). We mapped 8 emergent themes onto the critical domains of a logic model for program evaluation. For the domain of Context, themes included (1) gap in communication education and (2) patient-centeredness. For the domain of Inputs/Outputs, themes included (1) investment in the program and (2) perceived program value. For the domain of Outcomes, themes included (1) learning-focused outcomes and (2) patient-related outcomes. For the domain of Evaluation, themes included (1) defining success and (2) challenges with evaluation.
Conclusions
Mapping CFIR-informed themes onto a logic model for program evaluation presents a novel strategy for integrating program implementation and evaluation, both of which are essential to effective educational programming. These findings can be used to guide future programmatic modifications to better meet the needs of key stakeholders.
A novel laboratory-based strategy for single adipocyte and adipose-derived stem cells extraction for transplantation: an experimental research
Authors: Liu Yu , Yu Jiaying , Liao Dongsheng , Peng Jingming , Chen Changjin , Huang Yeqian , Chen Chiaoju , Li Zhengyong , Wijaya Wilson Adrian , Zhao Ziyi , Chen Zhixing 
Published: May 2024

Abstract

Background
Autologous fat grafting is widely used in plastic surgery. However, its main limitation is the low survival rate of fat grafts after transplantation. Transplantation of single adipocytes in combination with adipose-derived stem cells (ADSCs) could largely preserve the activity of the fat and improve graft survival.
Objective
To verify the long-term survival rate of a single adipocyte graft in vivo and its viable fat morphology for future fat transplantation.
Methods
Healthy adipose tissue was harvested and disassociated using fat dissociation solution, the Single-cell Suspension Preparation System (SSPS) was used to obtain a mixture of single adipocytes, ADSCs and stromal vascular fraction (SVF), and the structure of single adipocytes was verified by cell mask red and DAPI double staining. Nine male Balb/c nude mice were used and three different graft volumes were established (0.05, 0.1 and 0.2 ml). For each mouse, four sites were selected for transplantation, one for macrofat, the other three for single adipocytes. And different transplant volumes 30, 60 and 90 days after transplantation. In each period, 3 mice were selected to measure the volume of fat graft.
Results
Double staining with Cell Mask Red and DAPI confirmed that the nucleus was identified intracellularly, which also indicated that the adipocytes in the single cell suspension were structurally complete. When evaluating the transplantation, the groups with a volume of 0.05 ml and 0.2 ml performed better in the single-cell fat group in all transplantation periods, and the group with a volume of 0.1 ml performed better in the single-cell group in the 30- and 60-day transplantation, and the differences were significant (P < 0.05).
Conclusion
In this study, the SSPS was used to obtain a new transplant material containing single adipocytes and ADSCs by enzymatic hydrolysis of adipose tissue and converted into single cells. It effectively improved the survival rate of fat grafting and the long-term effect of transplantation.
Evaluation the neuroprotective effect of hyperbaric oxygen preconditioning in traumatic spinal cord injury rats using diffusion tensor imaging
Authors: Liu Fang , Wu Zhongyue , Yang Xinyi , Li Chenlu , Lai Huimin , Liu Ying , Zhang Chenhui , Cao Dairong 
Published: May 2024

Abstract

Study Design: Animal experimental study.
Objective: To investigate the potential value of diffusion tensor imaging (DTI) in spinal cord injury (SCI) rats undergoing hyperbaric oxygen preconditioning (HBO-PC) at different time points.
Setting: Hospital in Fuzhou, China.
Methods: Seventy-two rats were randomly allocated into three groups: sham-operated group (laminectomy only); SCI group (the spinal cord weight dropping model); HBO-PC group (HBO-PC for five consecutive days before SCI). Each group was further randomized into four time-point subgroups (6 hours, 24 hours, 3 days, 7 days). Basso, Beattie, Bresnahan (BBB) scores and DTI parameters including fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), and mean diffusivity (MD) were collected and analyzed. Spinal cord tissues were processed for hematoxylin and eosin staining, and Nissl staining.
Results: HBO-PC groups exhibited higher FA values than SCI groups at different time points (all P < 0.05). RD and MD values were higher in SCI groups than in HBO-PC groups from 24 hours to 7 days (all P < 0.05). Compared to HBO-PC group, SCI group showed more pronounced inflammatory cell infiltration and neuronal atrophy. The number of surviving neurons in injured spinal cord in HBO-PC group was higher than that in SCI group at each time point (all P < 0.05). FA values were negatively correlated with BBB scores, while RD and MD values were positively correlated with BBB scores.
Conclusions: HBO-PC can reduce neuronal cell death and promote nerve function recovery. DTI can quantitatively evaluate the protective effect of HBO-PC in rats with SCI.
Deep Learning Based Evaluation of Surgical Candidacy for Cervical Spinal Cord Decompression
Authors: Ratnaparkhi Anshul , Wilson Bayard , BSE David Zarrin , Suri Abhinav , Yoo Bryan , Salehi Banafsheh , Berin David , Cook Kirstin , Florence TJ , Laiwalla Azim , Gaonkar Bilwaj , Macyszyn Luke , Beckett Joel 
Published: May 2024

Abstract

Many patients who present to their primary care physician for neck pain undergo magnetic resonance imaging (MRI) as part of their diagnostic workup. The physician is then tasked with deciding if the findings of the MRI and workup warrant referral a spine surgery, an intricate task complicated by the high rates of background findings. This results in a high number of non-surgical patients being referred to surgery. Although there are a multitude of reasons for non-surgical patients to still see a subspecialist, deep learning has the potential to help inform physicians of their patients’ surgical candidacy. The preset work describes a proof-of-concept model for evaluating operative candidacy for cervical stenosis only using data from outpatient elective magnetic resonance imaging (MRI) scans. This deep-learning algorithm was trained to automatically segment the areas of both the spinal canal and spinal cord on 100 axial cervical spine MRIs. Once segmented, the model used these areas to generate a biomarker for cervical stenosis, calculated as the minimum difference in cross-sectional area between the spinal canal and the spinal cord within the cervical spine. Following training, the model and its biomarker were tested against a cohort of 147 consecutive patients evaluated in the outpatient setting by a group of board-certified neurosurgeons at our institution for complaints related to their cervical spines. Our automated model determined that the mean minimum difference in cross-sectional area between the spinal canal and spinal cord for our cohort was 35.90±25.00 mm2 for patients who ultimately underwent surgical decompression and 48.55±33.52 mm2 for patients who did not (P=0.005). Using this biomarker, the model distinguished between surgical and non-surgical patients with relatively high accuracy (AUC 0.79). When tested against a novel cohort of outpatient spine surgery clinic patients, the described algorithm determined whether the patient underwent decompression for cervical stenosis using data acquired solely from their cervical spine MRI scans. These findings support a proof-of-concept for our automated deep-learning model and biomarker, which could significantly improve the efficiency of the referral process for patients with neck complaints to a surgical subspecialist.
Influencing factors of Pediatric Intensive Care Unit Mortality at Bernard Mevs Hospital from January 2017 to December 2017
Authors: Brice Taïna , Chery Maurice J. , Miguel Anne-Rose , Désir Naïka Paulemie , Jean-Noël Maraïka , Laflèche Nelenda , Alexandre Richcard , Joseph Steeven , Jusca Kohlz Erley Saint , Pinchinat Raymonde , Julien Adonaï Aly Isaac 
Published: May 2024

Abstract

Introduction:
The morbi-mortality in a pediatric intensive care unit is an important determinant of child mortality worldwide. In Haiti, there are only two hospitals in the metropolitan area with a pediatric intensive care unit. The objective of this study is to identify the main factors influencing the mortality of patients aged 1 month to 16 years hospitalized in the pediatric intensive care unit at the Bernard Mevs Hospital (HBM).
Methodology:
We carried out a retrospecptive cross-sectional and analytical study over one year, within the Bernard Mevs Hospital Medishare Project (HBMPM). Our population consisted of all the patients aged 1 month to 16 years hospitalized in the pediatric intensive care unit of HBM from January 2017 to December 2017.
Results
From January 1, 2017, to December 31, 2017, 122 files of patients admitted to the pediatric intensive care units (PICU) at HBM were selected. Among those patients, a male predominance was demonstrated with 76 patients, or 63.30%, with a sex ratio of 1.65. The average age of the patients was 5.73 ± 4.73 years. In 43 patients (35.26%), trauma was the main cause of hospitalization, followed by respiratory illnesses, found in 22 patients, or 18.04% of admissions. The mortality rate was 33.60%, dominated by septic shock in 24% of cases. The average days of hospitalization in the deceased population was 12 days. This study demonstrated that the probability of dying in the PICU is higher in male patients (p-value of 0.0049) and in patients who have been intubated (p-value of 0.0021).
Conclusion
Our study has demonstrated a high mortality rate among male patients and those who have been intubated. Most of the causes of admission were preventable. Other studies should be carried out to generalize data and identify key measures to reduce the infant and child mortality in Haiti.
Pre and post diagnostic dementia care in four Scottish prisons
Authors: MacRae Rhoda , Chalmers Natalie , Tolson Debbie , Taylor James , Anderson Kirstin , Thompson Lindsay , Russ Tom 
Published: May 2024

Abstract

Background and purpose: The number of older people in prisons is increasing across the globe. Many have poor physical and mental health, higher prevalence of head injury, cognitive impairment and dementia than found in community populations. Meeting the complex needs of this vulnerable group has become an increasing concern for prison and prison healthcare services. This multi method qualitative study investigated how men with diagnosed or suspected dementia were identified, assessed, and cared for in Scottish prisons. The lived experience of individuals being assessed for or diagnosed with dementia within four prisons was also explored. This evidence was used to collaboratively propose principles for dementia care in prison and present the resultant co-designed care pathway.
Results: At the time of data collection almost all the men known to have a dementia diagnosis or suspected dementia had complex health and social care needs, and some were living with advanced dementia. Prison healthcare staff reported taking a ‘case by case’ approach to their pre- and post-diagnostic care. Meeting these prisoner’s needs was complicated by the absence of organisational leads for care of older adults or people with dementia and there was no pathway or model in place to guide staff. Prison healthcare teams often had difficulty accessing specialist community services to support diagnosis. There was a lack of dementia education and knowledge about how to provide pre and post diagnostic dementia care in this setting amongst staff. The findings arising from this research have informed the co-production of two important evidence informed innovations namely a Model of Care and a Care Pathway.
Conclusion: This research adds insights critical to understanding the adequacy of current approaches to meeting dementia related needs within the prison setting. To our knowledge this paper offers the first co-produced evidence informed pre- and post- diagnostic dementia care pathway and model of care for use in prisons. These could serve as tools for change that could enable prison healthcare staff to deliver the right care, at the right time, by the right people, and provide an opportunity to assess risk and plan care for the future.
Low Dose Rituximab and Calcineurin Inhibitor Combination as an Effective Treatment Strategy in Relapsed Primary Membranous Nephropathy
Authors: Yanık Ahmet Mert , Berke İlay , Aykent Mahmut Başar , Velioğlu Arzu , Aşıcıoğlu Ebru , Tuğcu Murat , Barutçu Dilek , Tuğlular Zübeyde Serhan , Koç Mehmet , Arıkan İzzet Hakkı 
Published: May 2024

Abstract

Purpose:In primary membranous nephropathy (PMN), treatment includes tailored immunosuppressive protocols to reduce renal progression risks, with relapse being a common challenge. Nevertheless, the existing body of literature on utilizing Rituximab (RTX) and calcineurin inhibitors (CNIs) in such cases is limited. We aimed to document the outcomes associated with the combined use of low-dose RTX and CNIs in the treatment of relapsed PMN patients with a moderate to high risk.
Methods: In this retrospective study, 22 relapsed PMN patients (22.7% female, average age 51.2 ± 12 years) were included. At the time of diagnosis, 27% (n=6) were identified as high-risk and 73% (n=16) as moderate-risk. The Patients were treated with two doses of 500 mg RTX administered 15 days apart. Low-dose CNI was started (n=2) or maintained (n=20) combined with RTX therapy.
Results: Mean post-treatment follow-up period was 46.9 ± 11.9 months. Initial mean proteinuria was 5.9 ± 3 g/day, decreasing to 2.1 ± 2.5 g/day by 12 months and to 2 ± 2.4 g/day by 24 months post-treatment. All achieved remission following treatment. Of these, 41% and 59% attained complete (CR) and partial remission (PR), respectively. The median time to remission was 6.68 months, with an average duration of sustained remission noted at 26.5 months. Sixteen patients (72.7%) experienced relapse, necessitating additional RTX doses after 20.1 (50±4) months. Serious adverse events were documented in 3 patients (13.6%).
Conclusion: Our results suggest that the combination of low-dose RTX and CNI could be a viable and safe treatment option for relapsed PMN patients with a moderate to high risk. The synergistic impact of CNI and RTX may augment treatment effectiveness, enabling the use of reduced RTX dosages. This approach might be a effective and safe treatment protocols.