bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating Undergraduate Learning in Ophthalmology Rotation: A Cross-Sectional Study Using Virtual Questionnaires
Authors: Faneli Adriano Cypriano , Amaral Dillan Cunha , Gonzalez Luanna Guimarães de Almeida , Chagas Julia Motta , Torres Rodrigo Amaral , Oliveira Ricardo Danilo Chagas , Guedes Jaime , Souza Murilo Barreto , Paez Denisse 
Published: December 2023

Abstract
Background
Traditional ophthalmology education in medical schools is inadequate for nonophthalmologist residents in primary outpatient care. This article focuses on measuring ophthalmology learning in a clinical rotation of a Brazilian medical school that implemented a two-week ophthalmology rotation, with one week dedicated to online theoretical classes and the following week dedicated to outpatient practices. Therefore, our objective was to evaluate the modality, method, and established hours to determine their effectiveness in the training of generalist physicians.
Methods
This was a cross-sectional and quantitative study. All students eligible for the rotation were given a questionnaire before and after the rotation to assess their knowledge, understanding, and problem-solving abilities in the field. Each questionnaire contained 11 theme-paired questions developed according to the International Council of Ophthalmology curriculum and guidelines. The primary outcome was improvement in scores between the pre- and postrotation tests. Researchers defined 30% or higher as satisfactory. Data were anonymously analyzed using STATA BE 17 software. Questionnaire reliability was measured using Cronbach's alpha.
Results
In this study, 95 students were found to be eligible, and 37 of them answered both the pre- and postrotation tests correctly, constituting 38,94% of the eligible population. The average response time for the postrotation test was 34.04 ± 31.22 minutes, while the prerotation test took an average of 04:35 minutes, and the postrotation test took 07:02 minutes on average. Only 13 students (34%) showed a minimum improvement of 30% in their scores after the rotation. The average number of correct answers on the prerotation test was 6.756 ± 2.087, and on the postrotation test, it was 7.567 ± 2.128, with a mean difference of -0.81 ± 1.912 between them. There was no significant difference between the pretest and posttest scores.
Conclusions
Medical students’ learning in the ophthalmology rotation was not satisfactory. Therefore, it is essential to consider the implementation of more comprehensive and integrated educational approaches to enhance students' ophthalmological knowledge with an entirely in-person modality and increased practical hours.
Influence of Pulsating Internal Fluid Flow on the Nonlinear Dynamics of Marine Risers
Authors: Alfosail Feras Khaled , Cunha Americo , Zhao Wen , Younis Mohammad I. 
Published: December 2023

Abstract
In this work, we explore the dynamics of inclined marine risers subjected to pulsating internal fluid flow. The presence of geometric nonlinearities with static deflection makes the response of the inclined riser different from conventional top tension risers when subjected to pulsating flows. At first, the riser model is solved via the Galerkin method, and the results are compared and validated using perturbation analysis. Then, the response of the riser is studied under various parameters and pulsating flow frequencies. The excitation of the riser under pulsating flow fluctuations causes the riser to vibrate at primary and secondary parametric resonances simultaneously. In addition, the multifrequency parametric excitations interact with the inherit competing nonlinearities causing the response of the riser to exhibit a multi-state solution which is further analyzed via statistical analysis to examine the probability of the basin of attraction. The response of the riser reveals rich and complex nonlinear dynamics features such as quasiperiodic and chaotic behaviors.
Variability in exercise is linked to improved age-related dysfunctions: A potential role for the constrained-disorder principle-based second-generation artificial intelligence system
Authors: Ilan Yaron 
Published: December 2023

Abstract
Objective: Regular physical activity (PA) promotes mental and physical health. Nevertheless, inactivity is a worldwide pandemic, and methods to augment exercise benefits are required. The constrained disorder principle (CDP) characterizes biological systems based on their inherent variability. We aimed to investigate the association between intra-individual variability in PA and disability among non-athlete adults.
Methods: In this retrospective analysis of the longitudinal SHARE survey, we included non-disabled adults aged >50 with at least six visits over 14 years. Self-reported PA frequency was documented bi- to triennially. Low PA intensity was defined as vigorous PA frequency less than once a week. Stable PA was described as an unchanged PA intensity in all consecutive middle observations. The primary outcome was defined as a physical limitation in everyday activities at the end of the survey. Secondary outcomes were cognitive functions, including short-term memory, long-term memory, and verbal fluency.
Results: The study included 2,049 non-disabled adults with a mean age of 53 and 49.1% women. In the initially high PA intensity group, variability in PA was associated with increased physical disability prevalence (23.3% vs. 33.2%, stable vs. unstable PA; P<0.01; adjusted P<0.01). In the initially low PA intensity group, variability was associated with a reduced physical disability (45.6% vs. 33.3%, stable vs. unstable PA; P=0.02; adjusted P=0.03). There were no statistically significant differences in cognitive parameters between the groups. Among individuals with the same low PA intensity at the beginning and end of follow-up, variability was associated with reduced physical disability (56.9% vs. 36.5%, stable vs. unstable PA; P=0.02; adjusted P=0.04) and improved short-term memory (score change: -0.28 vs. +0.29, stable vs. unstable PA; P=0.05).
Conclusion: Incorporating variability into PA regimens of inactive adults may enhance their physical and cognitive benefits.
Antibiotic residues in commercial freshwater fish from southeast China: distribution and human health risk assessment
Authors: Shao Guo-Jian , Pan Xiao-Dong , Han Jian-Long 
Published: December 2023

Abstract
We investigated 14 antibiotic residues in 8 marketed freshwater fish species from southeast China and estimated the associated health risks to local consumers. The antibiotic residues were determined by UPLC-MS/MS. Our findings revealed widespread distribution of quinolones (QNs), tetracyclines (TCs), and chloramphenicols (CAPs) in the freshwater fish. Notably, the average concentrations of enrofloxacin and ciprofloxacin reached levels as high as 62.5 µg/kg wet weight (ww) and 11.7 µg/kg ww, respectively, and detection frequencies were 68.7% for enrofloxacin and 31.6% for ciprofloxacin. Additionally, we detected chloramphenicol, a prohibited antibiotic, in samples with a detection frequency of 0.76%. Among the fish species, the mean concentration of total antibiotic residues was highest in bluntnose black bream (263.3 µg/kg), followed by English perch (52.4 µg/kg), crucian carp (46.3 µg/kg), black carp (28.6 µg/kg), yellowcheek carp (21.0 µg/kg), grass carp (15.3 µg/kg), bighead carp (3.78 µg/kg), and mandarin fish (3.69 µg/kg). We estimated the daily intake values of these antibiotic residues which were lower than the acceptable daily intake values and hazard indexes were much less than 1. It indicates there is very low direct health risk to consumers. Despite that, investigation on the chronic impact, such as antibiotic-resistant bacteria, gut microbiota disruption and allergic reactions is urgently needed.
Antimicrobial activity of rare earth metal doped ZnO thin films prepared by low cost spray technique against fish pathogens
Authors: Balaji R. , Begum N. Jabena , Seenuvasakumaran P. , Anandhi R. , Saravanakumar K. , Vinodhini A. , Saravanan K , Baig A Ubaithulla 
Published: December 2023

Abstract
The global problem of antibiotic resistance endangers public health. Antibiotic resistance genes can be transmitted along by bacteria in humans, animals, and aquatic species and abuse of antibiotics causes the aforementioned problem. The widespread use of antibiotics in aquaculture has a number of detrimental consequences for both the industry and consumer health. ZnO-based nanoparticles may eventually replace some traditional antibiotics due to their antibacterial activity and low toxicity. The purpose of this study is to evaluate the antibacterial properties of yttrium-doped zinc oxide (ZnO:Y) nanoparticles against many important fish infections. In the current work, undoped and Yttrium (2, 4, and 6 at%) doped ZnO thin films were prepared using a simplified Spray pyrolysis technique and tested for antimicrobial efficacy against Aeromonashydrophila, Salmonella enterica, Lactococcusgarvieae, and Streptococcus agalactiae. Synthesised samples' structural, morphological, and optical properties were investigated. XRD spectrum revealed a well-organized crystallite hexagonal wurzite structure. The average transmittance of the undoped ZnO and ZnO:Y films in the 600 to 1200 nm wavelength range is 75%. In SEM, undoped ZnO thin films had evenly dispersed, spherical-shaped grains, whereas yttrium doped ZnO thin films had a tetra pod chain-like structure with an improved surface-to-volume ratio.Despite the fact that the complete Y doped film (2,4 and6 at. % of Y) was found as having robust antibacterial activity, the 4 at.% of Y doped ZnO sample displayed the highest activity against the tested pathogens. The current findings show that the zone of inhibition was greater against gram negative bacterial strains Aeromonashydrophila and Salmonella entericathan against gram positive strainsLactococcusgarvieae and Streptococcus agalactiae.
Synthesis of CO2-philic/hydrophilic surfactant with brush structure and its application in preparing monolithic material
Authors: Zhang Shoucun , Bian Yujing , Yang Chun 
Published: December 2023

Abstract
A new strategy was developed to build a CO2-philic/hydrophilic surfactant by combining the common free radical polymerization and the grafting modification technology, and a brush polymer was synthesized with poly(vinyl acetate)-based copolymer as the CO2-philic group (as the main chain) and the methoxy polyethylene glycols (MPEG) as the hydrophilic part (as the branched chain) (PVAc-g-MPEG). The CO2-philic ability can be controlled by adjusting the chain length of the PVAc fragment. The results indicate that PVAc-g-MPEG has excellent surfactant activity, and can emulsify the CO2/H2O system to obtain the CO2-in-water (C/W) high interval phase emulsion (HIPE 80%, v/v), which can remain stable for more than 20 hours. If using the monomers/crosslinking agent solution instead of water, the highly porous monolithic materials will be obtained after the continuous phase is polymerized. In this paper, polyacrylamide (PAM) and poly(acrylamide/diethyl aminoethyl methacrylate)-based porous monolithic materials(PADM) were prepared. These materials were used to separate the protein (BSA as the model matter) from the solution, and the results indicated that PAM-based porous monolithic materials had almost no enrichment capacity for protein, while PADM-based porous monolithic materials can adsorb BSA up to 129.3 mg/g.
3D Visualization Technology for Learning Human Anatomy among Medical Students and Residents: A Meta- and Regression Analysis
Authors: Wang Junming , Li Wenjun , Dun Aishe , Ye Zhen 
Published: December 2023

Abstract

Background
3D visualization technology applies computers and other devices to create a realistic virtual world for individuals with various sensory experiences such as 3D vision, touch, and smell to gain a more effective understanding of the relationships between real spatial structures and organizations. The purpose of this study was to comprehensively evaluate the effectiveness of 3D visualization technology in human anatomy teaching/training and explore the potential factors that affect the training effects to better guide the teaching of classroom/laboratory anatomy.
Methods
We systematically conducted a randomized controlled study on teaching human anatomy using 3D visualization technology. We extensively searched three authoritative databases, PubMed, Web of Science, and Embase; the main outcomes were the participants’ test scores and satisfaction, while the secondary outcomes were time consumption and enjoyment. Heterogeneity by I² was statistically determined because I² > 50%; therefore, a random-effects model was employed, using data processing software such as RevMan, Stata, and VOSviewer to process data, apply standardized mean difference and 95% confidence interval, and subgroup analysis to evaluate test results, and then conduct research through sensitivity analysis and meta-regression analysis.
Results
Thirty-nine randomized controlled trials (2,959 participants) were screened and included in this study. The system analysis of the main results showed that compared with other methods, including data from all regions 3D visualization technology moderately improved test scores as well as satisfaction and enjoyment; however, the time that students took to complete the test was not significantly reduced. Meta-regression analysis also showed that regional factors affected test scores, whereas other factors had no significant impact. When the literature from China was excluded, the satisfaction and happiness of the 3D virtual-reality group were statistically significant compared to those of the traditional group; however, the test results and time consumption were not statistically significant.
Conclusion
3D visualization technology is an effective way to improve learners’ satisfaction with and enjoyment of human anatomical learning, but it cannot reduce the time required for testers to complete the test. 3D visualization technology may struggle to improve the testers’ scores. The literature test results from China are more prone to positive results and affected by regional bias.
The free flap reconstruction of facial oncologic defects after squamous cell carcinoma excision
Authors: Cho Kyusang , Eun Seokchan 
Published: December 2023

Abstract
Background: Cutaneous squamous cell carcinoma is the second most common skin cancer. There are many methods for the reconstruction of the facial subunit defect after skin cancer excision. The face is vital for a person's life and should be reconstructed considering functional and aesthetic aspects. Despite a variety of flap types and techniques, it is still challenging to meet the various demands. The aim of the study was to compare free flaps for facial reconstruction after resection of cutaneous squamous cell carcinoma.
Methods: This study included 14 patients from January 2021 to June 2023. Patients who underwent facial SCC resection and subsequent reconstruction using free flap were analyzed retrospectively. Age, sex, localization was recorded. Follow-ups ranged from 5 to 21 months, with an average of 13 months.
Results: All free flaps survived well except two cases of partial flap necrosis. In most patients, good to excellent functional and aesthetic results were obtained. The donor site healed uneventfully in all patients.
Conclusions: Free flap reconstruction is an excellent choice in wide skin oncologic defects. In terms of color and texture, it also could be a good surgical method.
Hyponatremia unleashes neutrophil extracellular traps elevating life-threatening pulmonary embolism risk
Authors: Inoue Minoru , Takayama Kazuo , Hashimoto Rina , Enomoto Masahiro , Date Naoki , Ohsumi Akihiro , Mizowaki Takashi 
Published: December 2023

Abstract
Neutrophil extracellular traps (NETs), essential for controlling infections, can induce various pathologies when dysregulated. Known triggers for infection-independent NETs release exist, yet a comprehensive understanding of the conditions prompting such responses is lacking. In this study, we identify hyponatremia as an independent inducer of NETs release, a common clinical condition that disrupts sodium/calcium exchange within neutrophils. This disruption leads to an excess of intracellular calcium, subsequent elevation of reactive oxygen species, and the citrullination of histone H3, culminating in the activation of NETs-release pathways. Notably, under hyponatremic conditions, this mechanism is exacerbated during infectious states, leading to the deposition of NETs in the lungs and increasing the risk of life-threatening pulmonary embolism. Our findings underscore the critical role of sodium and calcium homeostasis in neutrophil functionality and provide novel insights into the pathogenesis of hyponatremia-associated diseases, highlighting potential therapeutic interventions targeting NETs dynamics.
Trends in the surgical treatment for metastatic spinal tumor in Japanese administrative data between 2012 and 2020.
Authors: Yamada Kentaro , Yoshii Toshitaka , Toba Mikayo , Egawa Satoru , Morishita Shingo , Matsukura Yu , Hirai Takashi , Kudo Atsushi , Fushimi Kiyohide 
Published: December 2023

Abstract

Background.
Both cancer diagnosis/treatment modality and surgical technique for the spine have been developed recently. Nationwide trends in the surgical treatment for metastatic spinal tumors have not been reported in the last decades. This study aimed to examine recent trends in the surgical treatment for spinal metastasis and in-hospital patient outcomes using nationwide administrative hospital discharge data.
Methods.
The Diagnosis Procedure Combination database from 2012 to 2020 was used to extract data from patients who underwent surgical procedures for spinal metastasis with the number of non-metastatic spinal surgery at the institutions that have performed metastatic spine surgeries at least one case in the same year. Trends in the surgical treatment for spinal metastasis, patients’ demographics, and in-hospital mortality/outcomes were investigated.
Results.
This study analyzed 10321 eligible patients with spinal metastasis. The surgical treatment for spinal metastasis increased 1.68 times from 2012 to 2020, especially in fusion surgery, whereas the proportion of metastatic spinal surgery retained with a slight increase in the 2%s. Distributions of the primary site did not change whereas age was getting older. In-hospital mortality and length of stay decreased over time (9.9–6.8%, p < 0.001; 37 days–30 days, p < 0.001). The postoperative complication and unfavorable ambulatory retained stable and slightly decreased, respectively.
Conclusion.
During the last decade, surgical treatment for spinal metastasis has increased in Japan. In-hospital mortality and length of stay decreased. The results of this study may provide useful information for healthcare policy or clinical research planning.
Application of modified multifunctional short peptide in the treatment of periodontitis
Authors: Zhang Xi , Song Meiyan , Wang Hongbo , Zhang Qian , Liu Zhiyang , Deng Jiayin 
Published: December 2023

Abstract
Periodontitis is a chronic inflammatory disease involving plaque biofilm as a pathogenic factor. Currently, it has been found that regulating local inflammatory homeostasis can achieve the goal of treating diseases. Potassium ion plays an important role in cellular homeostasis; a large outflow of potassium may lead to local inflammation progression. In this work, the multifunctional short peptide molecule BmKTX-33 was designed by modifying the BmKTX, a Kv1.3 potassium channel inhibitor. This study was to explore its antibacterial properties, capability of maintaining cell ion homeostasis, and bone-forming capacity. The results showed that BmKTX-33 had inhibitory effects on S. gordonii, F. nucleatum, and P. gingivalis. Moreover, BmKTX-33 also inhibited excessive potassium outflow in inflammatory environments. Finally, BmKTX-33 promoted MC3T3-E1's early osteogenesis while suppressing the NLRP3 inflammasome's production. In conclusion, BmKTX-33 not only had antibacterial properties but also inhibited excessive potassium ion outflow, thus inhibiting the production of NLRP3 inflammatory bodies and promoting early bone formation.
Effect of Er:YAG laser surface treatment on surface properties and shear-bond strength of resin-cement to three translucent zirconia: An in-vitro study
Authors: Abdullah Hager , Abdulsamee Nagy , Farouk Hanaa , Saba Dalia A 
Published: December 2023

Abstract
Achieving optimal bonding to translucent zirconia poses certain challenges as there is no consensus on ideal surface treatment method. Therefore, the aim of present investigation is to evaluate effect of Er:YAG laser treatment on wettability, surface roughness and shear-bond strength of three Yttrium oxide-stabilized zirconium-oxide polycrystal translucent zirconias. 120 specimens (n = 40 /zirconia type) were prepared from three commercially-available translucent zirconias (Dentsply Sirona, USA); Translucent, High-Translucent and Ultra-Translucent zirconia. Specimens were sub-divided (n = 20/surface-treatment) into control and Er:YAG laser surface-treated groups. Regarding water wettability test; goniometer was used to measure contact angle before and after laser treatment. Surface roughness was measured using atomic force microscope. For shear-bond strength (SBS) test; the control group was sandblasted. All resin-bonded zirconia specimens were thermocycled for 5000 cycle and subjected to shear force using universal testing machine with 0.5mm/min crosshead-speed. Results were statistically analyzed using two-way-analysis-of- variance (p ≤ 0.05). There was significant decrease in average contact angles (p-value < 0.001) in all zirconia groups after laser treatment. For roughness test; insignificant difference in average Ra in Translucent zirconia group. However, significant increase in mean Ra was revealed after laser treatment for High and Ultra-Translucent zirconias. For SBS test, results revealed insignificant difference in average bond strength after laser treatment in Translucent and High-translucent zirconia groups. Significant increase in mean bond strength of Ultra-Translucent zirconia was recorded. Er: YAG laser treatment significantly affected surface properties and shear-bond strength of Ultra-Translucent zirconia. Er:YAG laser irradiation may be a promising zirconia surface treatment method.