bluuebunny/crossref_metadata_2025_split huggingface dataset:
Prevalence and antimicrobial susceptibility patterns of bacteria colonizing the external ocular surfaces of patients undergoing ocular surgeries at Bugando Medical Center in Mwanza, Tanzania
Authors: Rukyaa Johannes , Temba Lillian , Kachira Princekened , Mwanansao Christopher , Seni Jeremiah 
Published: April 2024

Abstract

Objective Understanding microbiota colonizing ocular surfaces is key to expedite antibiotic prophylactic options for ocular surgeries, and therefore, prevent subsequent surgical site infections (SSIs). To fill this critical gap, we aimed at determining the prevalence and antibiotic susceptibility patterns of bacteria colonizing the external ocular surfaces of 224 patients undergoing ocular surgeries at Bugando Medical Centre (BMC) in Mwanza, Tanzania between May and August 2023.
Results The study participants had a median age of 62.5 (interquartile range: 39.5-75.0) years. A total of 78.1% (175/224) ocular swabs were culture positive yielding 196 bacterial isolates. S. epidermidis [43.4% (n=85)] followed by S. aureus [21.9% (n=43)] and Pseudomonas aeruginosa [14.3% (n=28)] were the most common bacteria. There was low proportions of resistance among predominant Gram positive and Gram-negative bacteria to gentamicin (≤25.0%), and similarly, low resistance among Gram negative bacteria was observed against 3rd generation cephalosporins (≤25.0%) and piperacillin-tazobactam (0.0%). Variable resistance profiles were notable to the most commonly used antibiotics (ciprofloxacin and tetracycline: 0.0% to 66.7%). Our findings underscore an urgent need to revisit antibiotic prophylactic guidelines for ocular surgeries in this tertiary hospital, and calls for prospective evaluation of incident SSIs post-ocular surgeries to guide specific management.
Oxygen Vacancy-engineered CeO 2 Mediated by Cu-Pt Exhibit Enhanced SOD/CAT-mimicking Activities to Regulate the Microenvironment for Osteoarthritis Therapy
Authors: Yang Junxu , Xiao Shihui , Deng Jiejia , Li Yuquan , Hu Hao , Wang Jiawei , Lu Chun , Li Guanhua , Zheng Li , Wei Qinjun , Zhong Jingping 
Published: April 2024

Abstract

Cerium oxide (CeO2) nanospheres have limited enzymatic activity that hinders further application in catalytic therapy, but they have an "oxidation switch" to enhance their catalytic activity by increasing oxygen vacancies. In this study, according to the defect-engineering strategy, we developed PtCuOX/CeO2 − X nanozymes as highly efficient SOD/CAT mimics by introducing bimetallic Cu and Pt into CeO2 nanospheres to enhance the oxygen vacancies, in an attempt to combine near-infrared (NIR) irradiation to regulate microenvironment for osteoarthritis (OA) therapy. As expected, the Cu and Pt increased the Ce3+/Ce4+ ratio of CeO2 to significantly enhance the oxygen vacancies, and simultaneously CeO2 (111) facilitated the uniform dispersion of Cu and Pt. The strong metal-carrier interaction synergy endowed the PtCuOX/CeO2 − X nanozymes with highly efficient SOD/CAT-like activity by the decreased formation energy of oxygen vacancy, promoted electron transfer, the increased adsorption energy of intermediates, and the decreased reaction activation energy. Besides, the nanozymes have excellent photothermal conversion efficiency (55.41%). Further, the PtCuOX/CeO2 − X antioxidant system effectively scavenged intracellular ROS and RNS, protected mitochondrial function, and inhibited the inflammatory factors, thus reducing chondrocyte apoptosis. In vivo, experiments demonstrated the biosafety of PtCuOX/CeO2 − X and its potent effect on OA suppression. In particular, NIR radiation further enhanced the effects. Mechanistically, PtCuOX/CeO2 − X nanozymes reduced ras-related C3 botulinum toxin substrate 1 (Rac-1) and p-p65 protein expression, as well as ROS levels to remodel the inflammatory microenvironment by inhibiting the ROS/Rac1/nuclear factor kappa-B (NF-κB) signaling pathway. This study introduces new clinical concepts and perspectives that can be applied to inflammatory diseases.
Improved Quantum-inspired Hybrid Particle Swarm Optimization Based Resource Allocation for Quantum- Enabled IoT Devices in Ad Hoc Networks
Authors: K Sudharson , R Santhiya 
Published: April 2024

Abstract
Ad hoc networks of quantum-enabled IoT devices require efficient resource allocation techniques to optimize energy consumption and data transmission rates. This paper proposes an enhanced version of quantum-inspired hybrid particle swarm optimization called the Improved quantum-inspired hybrid particle swarm optimization (IQHPSO) algorithm for resource allocation in ad hoc networks of quantum-enabled IoT devices. The enhanced QHPSO algorithm incorporates a novel innovation technique based on adaptive parameter tuning and a global best selection strategy that further improves the optimization performance of the QHPSO approach. We evaluate the proposed approach through simulations and compare its performance with the original QHPSO algorithm and other state-of-the-art optimization techniques regarding objective functions such as energy consumption, data transmission rate, and network lifetime. Our results show that the IQHPSO algorithm outperforms the original QHPSO algorithm by 10-15% in energy consumption, 5-10% in data transmission rate, and 3-7% in network lifetime. Furthermore, our results demonstrate that the IQHPSO algorithm outperforms other state-of-the-art optimization techniques regarding these objective functions. We also discuss the practical implementation of the IQHPSO algorithm in a real-world ad hoc network of quantum-enabled IoT devices. This research contributes to the ongoing development of quantum-inspired optimization techniques for wireless networking applications. Furthermore, it demonstrates the benefits of incorporating innovative approaches, such as adaptive parameter tuning and global best selection strategy, to improve the performance of existing optimization algorithms.
Multi-depot vehicle routing problem with drones in emergency logistics
Authors: Weng Xun , She Wenke , Fan Hongqiang , Zhang Jingtian , Yun Lifen 
Published: April 2024

Abstract
In order to expand the application of truck-drone cooperative delivery in emergency logistics, this paper investigates the multi-depot vehicle routing problem with drones for emergency logistics scheduling. A mixed-integer programming model with the objective of minimizing the maximum expected rescue time from urban distribution centres to temporary distribution stations is proposed. To address this problem, a new two-stage hybrid heuristic algorithm is proposed. In the first stage, we employ an improved K-means clustering to cluster the temporary distribution stations. In the second stage, a combination of Tabu search (TS), enhanced genetic algorithm (GA), and simulated annealing (SA) is applied to optimize the routes of both trucks and drones. The numerical study involves the validation of the model using real-world cases. Through comparison experiments with the Gurobi solver, we demonstrate the significant advantages of the proposed heuristic algorithm in terms of solution quality and efficiency.
TLR7 regulates tumor microenvironment to influence prognosis of Asian gastric cancer patients
Authors: Wang Yanjie , Dai Liya , Huang Sijia , Tao Jialong , Wang Hui , Feng Zhengyang , jiao Chenchen , Liang Yong , Zhang Yusong 
Published: April 2024

Abstract
Background and Objective Gastric cancer (GC) is the fifth most common malignant tumor in the world, and Asia has the highest incidence of GC. The tumor microenvironment (TME) and immunogenic cell death (ICD) mechanisms play important roles in the prognosis of patients with GC. In this study, we investigated the relationship between the TME and the prognosis of Asian patients with GC by analyzing data from Asian patients with GC obtained from The Cancer Genome Atlas (TCGA) database and further explored by which mechanism TME affects prognosis.
Methods We downloaded the data of Asian GC patients from the TCGA database, scored the TME of each sample, explored the relationship between the score and survival as well as clinical stage, performed differential analysis on stromal cells and immune cells, screened out differential genes (DEGs) and identified the intersections, and performed Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analyses on the DEGs that intersected and constructed the protein interaction network. Then, we screened ICD-related genes (IRGs) from the intersecting stromal cell- and immune cell-related DEGs, extracted the expression of IRGs, performed differential expression analysis to screen out the differential IRGs, constructed a prognostic model by regression analysis, and verified the accuracy of the model with Kaplan–Meier (K–M) survival curves and receiver operating characteristic (ROC) curves.
Results Population survival was lower in the group with high stromal and immune cell content. The higher the clinical stage is, the greater the stromal and immune cell content. There were a total of 1367 upregulated DEGs and 157 downregulated DEGs in the stromal and immune cell high content group, which were highly enriched in some GO and KEGG pathways. There were 29 IRGs in the intersecting stromal cell- and immune cell-related DEGs. There were 19 IRGs that differed between tumor samples and normal samples. Through multifactorial regression analysis, it was found that TLR7 was closely related to patient prognosis, and a new risk score prognostic model was constructed for Asian GC patients based on TLR7. Validation of the model through K‒M survival curves and receiver operating characteristic (ROC) curves proved that the model had certain predictive value.
Conclusion TLR7 may regulate the number of stromal and immune cells in the TME of Asian GC patients through ICD-associated mechanisms, thereby affecting patient prognosis.
Inflammation from Eutectic Mixture of Local Anesthetics during Neonatal Male Circumcision: A Case Report
Authors: SanamVenkata Sachindra , Nthiga Lynda , Ogunbiyi Abiola , Hills Edward 
Published: April 2024

Abstract
Background
We report an unusual case of inflammation following the application of eutectic mixture of local anesthetic (EMLA) cream, a topical lidocaine-prilocaine anesthetic, resulting in an aborted neonatal male circumcision (NMC). Inflammation from EMLA cream are rare adverse events; the only pictured instance of this reaction occurred in two neonates from Botswana dating back to 2013. However, we observed inflammation in a neonate of Haitian descent. This report is important for two primary reasons: firstly, to inform clinicians about the appearance and duration of inflammation to help manage similar neonates; and secondly, to discuss the etiology and incidence of this reaction, particularly if the reaction occurs in diverse neonates.
Case presentation
The neonate displayed normal male genitalia on examination prior to planned circumcision using a Gomco clamp on day two of life. We applied EMLA cream on the prepuce and placed an occlusive dressing. After one hour, we examined the penis and then aborted the procedure due to edema and erythema of the prepuce resulting in difficulty visualizing the glans. We did not observe any distress in the neonate nor any systemic sequelae from this reaction. Although the neonate voided successfully in the interim, inflammation had not fully decreased by day three of life. We discharged the neonate on day three of life without incident and counseled the mother on expectations for reduction in swelling. During the neonate’s well-baby visit five days later, the pediatrician did not note any irregularities during the physical exam.
Conclusions
Inflammation may be a result of vasodilation induced by lidocaine-prilocaine blockage of sympathetic nerves of vasoconstriction. Management of this reaction is supportive, and if the parent still desires circumcision, evidence-based alternatives for neonatal anesthesia or analgesia exist. As this reaction to EMLA cream is harmless, many cases of inflammation during NMC may go unreported. Furthermore, adverse reactions in diverse patients have historically been underexplored. With this report, three neonates of sub-Saharan African ancestry have experienced this reaction. Increased reporting and further research are needed to understand which neonates are most susceptible to EMLA-induced inflammation.
The return of investing healthcare resources in rehabilitation: should governments push the pedal or slowdown?
Authors: Ramos Quelly Mae Rivadillo , Neill Rachel , Bachani Abdulgafoor M. , Trujillo Antonio J. 
Published: April 2024

Abstract
Understanding rehabilitation’s return on investment (ROI) is important to improve budgetary prioritization for rehabilitative care. This study estimates the relationship between rehabilitation expenditure and years lived with disability and analyzes expected savings from increased rehabilitation investments. The Institute for Health Metrics and Evaluation Global Burden of Disease Study provided data on years lived with disability and the WHO Global Health Expenditure database was used to identify total rehabilitation expenditure from 2016 to 2018 for 88 countries. Sequential regression models were performed to estimate the effect of rehabilitation expenditure on years lived with disability and savings estimated with varying value of a statistical life years. We identify that increasing rehabilitation expenditure by 10% decreases the average amount of years lived with disability up to 6%. Our findings suggest that increasing available public resources to expand access to rehabilitative care is warranted.
Assessing left ventricular pathology in patients with Ebstein anomaly using Cardiovascular magnetic resonance: Looking past the right heart
Authors: Gupta Aditi , Silva Luciana Da , Castrillon Carlos Diaz , Wang Li , Dobson Craig , Silva Jose Da , Olivieri Laura , Alsaied Tarek , Christopher Adam 
Published: April 2024

Abstract

Background: Ebstein Anomaly (EA) is a malformation of the right heart, but there is data to suggest that the left ventricle (LV) can suffer from intrinsic structural and functional abnormalities which affect surgical outcomes. Hypothesis: The LV in patients with EA is hypertrabeculated with abnormalities in LV function and strain. Methods: In this retrospective single-center study, patients with EA who underwent pre-operative cardiac MRI (CMR) between the period of 2014-2023 were included along with a group of healthy-age-matched controls. Left ventricular and right ventricular volume, function and strain analyses were performed on standard SSFP imaging. LV noncompacted:compacted (NC/C) ratio and the displacement index of the tricuspid valve were measured. Results: Thirty-five EA patients were included with mean age of 21.0 +/- 16.4 years. Thirteen EA patients (37%) had mild pre-operative LV dysfunction on CMR and 1 (3%) had moderate LV dysfunction. The global circumferential and longitudinal strain were significantly lower in the reduced LVEF group compared to those with preserved LVEF (-15% vs. -16.8%, p =0.01 and −11.8% vs. −16.1%; p =0.04; respectively). A single EA patient (3%) met criteria for LVNC with a maximal NC/C ratio > 2.3. There was no statistically significant difference in NC/C ratio in the EA population (1.33 +/- 0.5) vs. controls (1.11 +/- 0.2), p = 0.16. There was an inverse correlation of LV ejection fraction (EF) with right ventricular end-diastolic volume and displacement index (DI). All patients underwent the Da Silva Cone procedure at our center. Patients with preoperative LV dysfunction had longer bypass time (163 +/- 42 vs 142 +/-38 min, p=0.17) and duration of postoperative epinephrine support (23.5 +/- 22 vs 11.2 +/- 22.3 hours, p=0.20). Conclusions: This is the largest study to date to evaluate preoperative LV structure and function in EA patients by CMR. In this cohort of 35 patients, LV non-compaction was rare, though there was a trend toward increased trabeculation. Pre-operative LV dysfunction is common and associated with more severe EA with larger RV size. The presence of LV dysfunction is relevant to perioperative management and further study with larger cohorts and longer follow up are necessary.
Triplicated middle cerebral arteries (duplicated and ipsilateral accessory) associated with triplicated anterior cerebral arteries (accessory) diagnosed by magnetic resonance angiography
Authors: Uchino Akira , Tokushige Kazuo 
Published: April 2024

Abstract

Purpose
To describe a case of duplicated middle cerebral artery (MCA) combined with ipsilateral accessory MCA, forming a triplicated MCA, associated with the accessory anterior cerebral artery (ACA), forming a triplicated A2 segment of the ACA detected incidentally on magnetic resonance (MR) angiography.
Methods
A 70-year-old woman with internal carotid artery (ICA) stenosis at the origin, which was detected by ultrasound, underwent cranial MR imaging and MR angiography of the intracranial region for an evaluation of brain and cerebral arterial lesions. The MR machine was a 3-Tesla scanner. MR angiography was performed using a standard 3-dimensional time-of-flight technique.
Results
Multiple ischemic white matter lesions are observed. No significant stenotic lesions were observed in intracranial arteries. The right duplicated MCA, main MCA, and right accessory MCA arose from the A2 segment of the right ACA. Thus, the right MCA was triplicated. There was also an accessory ACA forming a triplicated ACA at its A2 segment. These findings were clearly identified on partial volume-rendering (VR) images.
Conclusion
We herein report a case of triplicated MCA associated with triplicated ACA. MCA variations are relatively rare, and this is the third case of triplicated MCA reported in relevant English-language literature. To identify multiple cerebral arterial variations, creating partial VR images using MR angiographic source images is useful.
Preliminary Study on the Use of Perfluoropropane Contrast Agent in Monitoring Drug Diffusion during Fascial Plane Blocks
Authors: Zhang Zhicheng , Zhang Yue , Ni Yong , Wang Lina , Nie Lixiang , Zhao Xianda 
Published: April 2024

Abstract
Objectives：This reserach aims to preliminarily verify the feasibility of utilizing a novel perfluoropropane ultrasound contrast agent (UCA) for observing the spread of drugs within the fascial plane.We demonstrated the feasibility of this method by conducting transverse abdominis plane block(TAPB) using two-dimensional (2D) ultrasound.
Methods：Firstly, to explore the optimal dilution ratio of UCA mixed with local anesthetics (LA), this study conducted in vitro simulation experiments by diluting the UCA with 0.375% ropivacaine at various ratios (0, 10x, 30x, 100x, 300x, 1000x).The contrast of images under 2D ultrasound was observed and measured in a six-well plate. After selecting two relatively suitable doses, TAPB was performed using rabbits to determine the best dilution ratio. Next, 0.375% ropivacaine was mixed with UCA at the selected optimal dilution ratio (with the addition of methylene blue). TAPB was performed, and the diffusion area of the contrast agent was recorded in real-time under 2D ultrasound. After dissection, photographs were taken to record the spread range of methylene blue, and the correlation and consistency between the two methods of observing drug diffusion were compared. Finally, we conducted in vitro and in vivo experiments to evaluate the muscular and neural toxicity of the novel UCA when combined with 0.375% ropivacaine.
Results:Using 2 ml of 0.375% ROP in combination with perfluoropropane UCA, without further dilution, produced stable and high-contrast 2D ultrasound images in an in vitro simulation experiment and TAPB in rabbits.This mixture ratio was subsequently used to observe drug diffusion and toxicity in further studies. A paired t-test analysis showed no statistically significant difference in the measured area between the spread of 0.375% ROP + perfluoropropane UCA in 2D ultrasound imaging and the spread of MB after dissection.The area recorded by ultrasound images exhibited a strong correlation with the distribution range of LA as reflected by MB after dissection (R = 0.70, P = 0.02).Bland-Altman analysis showed that the mean difference in the measured area between the two methods was 0.65 cm2, and the 95% confidence interval (CI) of the difference was [-1.38 cm2, 1.16 cm2]. Only one data point was outside the 95% CI.Neither in vivo nor in vitro studies have found that perfluoropropane UCA increases the known muscular and neural toxicity of 0.375%ROP.
Conclusions:Our study demonstrates the feasibility and safety of real-time monitoring of LA diffusion by the novel perfluoropropane UCA under 2D ultrasound.
Using ChatGPT as a Lesson Planning Assistant with Preservice Secondary Mathematics Teachers
Authors: Gurl Theresa J. , Markinson Mara P. , Artzt Alice F. 
Published: April 2024

Abstract

The purpose of this qualitative study was to examine the use of ChatGPT as a lesson planning assistant with preservice teachers (PSTs) of secondary mathematics. PSTs asked ChatGPT to solve a mathematics problem and to assist with lesson planning in a microteaching context in a methods course. The PSTs first completed parts of the lesson plan individually, then asked ChatGPT to do the same thing, reflecting on the output. They then used ChatGPT any way they saw fit throughout the planning process. An analysis of the PSTs’ reflective statements about ChatGPT’s output revealed the importance of critical and evaluative reflection. Although PSTs were generally accurate in their assessment of pedagogical output, noting that ChatGPT’s suggested lessons were teacher-centered and repetitive, indicating little knowledge of students’ needs, they were less accurate about their assessment of mathematical output, often attributing incorrect solutions as a “different approach'' to the problem. The findings of this study have implications for the value of a reflective process for PSTs when using ChatGPT and other chatbots for lesson planning and solving mathematics problems.