bluuebunny/crossref_metadata_2025_split huggingface dataset:
Switchable memristor-based Hindmarsh-Rose neuron under electromagnetic radiation
Authors: jing Zhang , Li Zhijun 
Published: December 2023

Abstract
Memristors are prevalently used to simulate biological neuronal synapses due to their unique memductance plasticity and memory effects. A new switchable memristor, which can be configured as a nonvolatile discrete memristor, a nonvolatile continuum memristor or a volatile memristor by adjusting its internal parameter, is proposed to mimic the autapse of the Hindmarsh-Rose (HR) neuron. In the meantime, a flux-controlled memristor is introduced to simulate the effect of external electromagnetic radiation on the HR neuron, thus, an improved 4D HR neuron model without equilibrium points is developed in this study. The hidden firing activities related to the strength of autapse and the electromagnetic radiation intensity are revealed through phase diagrams, time series, bifurcation diagrams, Lyapunov exponent spectrums, and two-parameter dynamical maps. More interestingly, it is found that the memory attributes of memristive autapse play an important role in the firing activities of the neuron, which can induce the mutual transition among periodic spiking with different frequencies and chaotic firing. Additionally, the transition between periodic and chaotic firing induced by the initial value of the switchable memristor is also discovered when it is configured as three different types of memristors. Finally, a neuron circuit is designed with the current-mode devices to improve accuracy and reduce power consumption. The Multisim simulation results are provided to validate the correctness of the neuron model and the effectiveness of numerical analysis.
Endoscopic and trans-anal local excision vs. radical resection in the treatment of early rectal cancer: a systematic review and network meta-analysis
Authors: Kwik Charlotte , El-Khoury Toufic , Pathma-Nathan Nimalan , Toh James Wei Tatt 
Published: December 2023

Abstract
Purpose
The management of early-stage rectal cancer in clinical practice is controversial. The aim of this network meta-analysis was to compare oncological and postoperative outcomes for T1T2N0M0 rectal cancers managed with local excision in comparison to conventional radical resection.
Methods
A systematic review of Medline, EMBASE and Cochrane electronic databases was performed. Relevant studies were selected using PRISMA guidelines. The primary outcomes measured were 5-year local recurrence and overall survival. Secondary outcomes included rates of postoperative complication, 30-day mortality, positive margin, and permanent stoma formation.
Results
Three randomized controlled trials and 27 observational studies contributed 8570 patients for analysis. Radical resection was associated with reduced 5-year local recurrence in comparison to local excision. This was statistically significant in comparison to trans-anal local excision (odds ratio (OR) 0.23; 95% confidence interval 0.16–0.30) and favourable in comparison to endoscopic techniques (OR 0.40; 95% confidence interval 0.13–1.23) although this did not reach clinical significance. Positive margin rates were lowest for radical resection. However, 30-day mortality rates, perioperative complications and permanent stoma rates all favoured local excision with no statistically significant difference between endoscopic and trans-anal techniques.
Conclusion
Radical resection of early rectal cancer is associated with the lowest 5-year local recurrence rates and the lowest rate of positive margins. However, this must be balanced with its higher 30-day mortality and complications rates as well as the increased risk of permanent stoma.
Exploring a Shared Vision for Success in Permanent Supportive Housing A Community Partnered Study
Authors: Podewils Laura Jean , Loh Ryan , Gray Tom , Witzke Deanne , Stella Sarah A. , Farrell Ed 
Published: December 2023

Abstract
Nationally and within Colorado, the number of persons experiencing homelessness (PEH) has continued to rise in recent years, with over half a million PEH counted on a single night in 2022. Our community-partnered study aimed to combine existing data from electronic health records, the justice system, and case management records to create a multidimensional measure for success in permanent supportive housing (PSH), and identify individual factors associated with housing success. The partnership included healthcare experts, housing providers, and a dedicated community advisory panel of persons with lived experience to guide and conduct the study. Metrics of housing success were expanded beyond housing retention to include multiple life domains, including engagement in care, wellness, adherence to housing rules and safety, level of care match, and overall success. Our analysis matched individual records across disparate data systems, which contributed to a loss in data fidelity and an inability to identify predictors associated with housing success. Our findings revealed the adaptability of case managers to harness additional resources for clients and highlights the need for systematic collection of dynamic indicators of client progress over time. This study is a clarion call for a social-health information exchange, which would support an informed, equitable, and just approach to the provision and support of PSH for PEH. Establishment of a robust cross-sector and community partnership through this study has provided the foundation for ongoing work dedicated to improving access to and success within supportive housing.
Literacy-Related Factors and Knowledge of Patient Rights Charter: Evidence from Nurses in Selected Hospitals in Ghana
Authors: Foster Atta-Doku John , Abekah-Nkrumah Gordon , Nkrumah Jacqueline , Adoma Prince Owusu 
Published: December 2023

Abstract
Background
Over the last few decades, most member countries of the United Nations have developed and implemented patient rights policies to protect and improve the provider-patient relationship, as guaranteed by Article 25 of the Universal Declaration of Human Rights (1948–1998). The Ghana Health Service developed the Patient Charter in 2002 to improve service quality and protect patients' rights. However, it is not yet known whether those at the frontline of healthcare delivery and patients can read and understand the contents of the charter. While studies have explored the socioeconomic and institutional level factors related to awareness and knowledge of the Patient Rights Charter of Ghana, there is a lack of literature on its readability and comprehensibility among patients and nurses. This study assesses nurses’ knowledge of the Patient Rights Charter of Ghana and associated literacy-related factors.
Method
An exploratory cross-sectional design and quantitative methods were used to collect data on knowledge, comprehension, and readability of the Patient Rights Charter. Two hundred and five (205) nurses from four district hospitals in the Central Region of Ghana were recruited using proportional and total enumeration sampling. Data were collected using structured questionnaires and were processed using SPSS (version 26) and an online text readability consensus calculator (version 2.0). Descriptive and inferential statistical analyses were performed, and data were presented using simple frequencies, readability statistics, and regression output.
Results
The results show the charter is written at a higher reading grade level; Flesch-Kincaid Grade Level (13.36), Simple Measure of Gobbledygook (11.57), Coleman-Liau Readability Index (14.2). The average reading grade level score was 14. The Gunning Fox Index (15.40) and the Flesch Reading Ease Score (34%) show the patient charter is difficult to read and will require at least 14 years of education to be able to read. Eighty-seven percent (87.3%) of nurses were able to read and comprehend the charter. Very few (8.3%) read at frustration level. Nurses' actual comprehension of the charter was the only significant predictor of knowledge of the charter.
Conclusion
Comprehension of the Patient Rights Charter is an important predictor of its knowledge. The results emphasize the need to enhance the readability and comprehensibility of the patient charter for providers. Hospitals can stimulate nurses’ knowledge of the charter by simplifying the charter’s language and deliberately educating nurses on its content.
Reduction of animal testing - Influence of the orientation of constructed blood vessels during the 3D printing on the measurement of the pseudo-oxygen saturation of an artificial blood substitute using conventional oxygen sensors: a test series
Authors: Jung Svenja , Hoffmann Martin , Winkler Dirk , Güresir Erdem , Kropla Fabian , Scholz Sebastian , Grunert Ronny 
Published: December 2023

Abstract
Background
The development of phantoms to reduce animal testing or to validate new instruments or operation techniques is of increasing importance. On this account, a blood circulation-phantom was developed and used to evaluate conventional oxygen sensors for a newly developed spatula for direct measurement of the blood oxygen saturation at the parenchyma.
Methods
A solution of copper and nickel sulfate was used as blood substitute. A total of seven different solutions with a pseudo-saturation between 50% and 100% were created. To evaluate the solution as a suitable blood substitute, a two-stage feasibility study was conducted. This study consisted of capturing the absorption spectra of the two sulfate solutions and calibrating the used oxygen sensor. Additionally, blood vessels with a simplified geometry were designed and manufactured using an elastic material (Elastic 50A) with a 3D printer (Formlabs Form 2). To determine the orientation during the printing process, various vessels were printed. Measurements to assess the effects of disturbance (rotation of the vessels during measurements) on the sensor readouts were prepared.
Results
Upon analyzing the absorption spectra of the blood substitute and ordinary blood, it was observed that the components of the solution behaved similarly to oxygenated and deoxygenated blood, confirming the suitability of copper and nickel sulfate as a blood substitute. The impact of disturbances was also verified through the rotation of the 3D-printed vessels. It was shown that a measurement directly on the disturbances led to outliers and higher values. An optimal orientation was determined to be a lateral placement (90° or 270°) of the sensor. Regarding the orientation of the vessels within the printing space, an orientation of 45° yielded the best results, as the individual layers least affected the light emitted and received by the oxygen sensor. All results pertain to constructed vessels developed using a Formlabs Form 2 printer and Elastic 50A material by Formlabs.
Conclusion
The achieved results demonstrate the influence of the orientation of the vessel during 3D printing as well as the influence of the position of the vessel during the measurement using a conventional oxygen sensor.
Seizure Freedom Without Seizure Medication Following Stereoelectroencephalography Implantation: A Case Report of Drug-Resistant Post-Traumatic Epilepsy
Authors: Tran Alexander , Bunch Marjorie 
Published: December 2023

Abstract

Background:
Achieving seizure freedom following failure of several antiseizure medications (ASMs) is rare, with the likelihood of achieving further control decreasing with each successive ASM trial. When cases of drug-resistant epilepsy arise, a diagnostic procedure known as stereoelectroencephalography (sEEG) can be used to identify epileptogenic zones (EZ) within the brain. After localization of these zones, they can be targeted for future surgical intervention. Here, we describe a case of complete seizure freedom off medication after stereo EEG without resection or other therapeutic intervention.
Case Presentation:
In 2017, a 36-year-old right-handed male presented with drug-resistant epilepsy stemming from prior traumatic brain injury. Typical seizures were described as a behavioral arrest with oral automatisms or automatic speech, head and eye deviation to the left, sometimes preceded by olfactory aura of smoke with rare progression to bilateral tonic clonic seizures. Nine typical seizures and one subclinical seizure were captured during video EEG and showed regional right temporal onset. Interictal EEG showed right temporal epileptiform discharges and focal slowing. Due to ongoing drug resistance, in 2020 a robotic-assisted sEEG electrode placement procedure was employed to localize the seizure onset zone. The patient underwent a 13-day video sEEG monitoring study with the goal of localizing the seizure onset zone for potential surgical resection.
During sEEG monitoring, a single clinical event was captured where the patient had dysarthric speech, left arm dystonic flexion, and difficulty responding to questioning. Notably, this event had no sEEG correlate, suggesting seizure occurrence in a region not monitored by implanted electrodes, which prompted the placement of scalp electrodes following this event. However, no further clinical events consistent with seizure were provoked through the remainder of recording. Following the 13-day admission, the patient chose to self-discontinue all seizure medications and has remained seizure free as of October 2023, more than 3.5 years later.
Conclusion:
While sEEG is considered a relatively safe procedure for seizure localization in drug resistant epilepsy, the possibility of microlesions created by sEEG depth electrodes remains largely unexplored. Further evaluation should be performed into potential tissue injury produced by depth electrode insertion.
Innovating Shrimp Harvesting: The Role of Centrifugal Techniques in Boosting Efficiency and Quality
Authors: Thoetrattanakiat Songphon , Samseemoung Grianggai , Sangpradit Kiattisak 
Published: December 2023

Abstract
Efficient shrimp harvesting methods are crucial for sustainable aquaculture, so that, this study is to compared the traditional netting method with an innovative centrifugal technique for white shrimp harvesting in commercial ponds. The primary aim was to assess efficiency, labor needs, shrimp quality, and potential damage reduction within two harvesting methods. Conducted in Thailand over 67 days, the study scrutinized both methods' manpower requirements, shrimp quality, and impact on damage. The traditional netting involved 19 workers and processed 500 kg/hour, showing varied shrimp quality and notable damage. Conversely, the centrifugal method required only 4 workers and achieved the same capacity in 30 minutes, significantly reducing damage percentages. Notably, it displayed minimal damage (0.0171%) for specific shrimp categories like number 4, indicating increased profitability potential. However, further optimization is required for specific categories, such as shrimp number 3 with a soft-shelled condition (1.37%). This study highlights the centrifugal technique's promise for enhancing the aquaculture industry.
A Deep Dive into Academic Excellence: Using Deep Learning to Evaluate and Improve Engineering Students' Performance
Authors: Kandula Neha , Kumar Ram 
Published: December 2023

Abstract
In recent years, there has been an increasing need to develop effective systems for analyzing student performance in educational institutions. This study presents a deep learning-based system for comprehensive student performance analysis that focuses on calculating students' performance and determining which ones are eligible for placements, in need of support, or at risk of dropping out. A type of recurrent neural network (RNN) called a Long Short-Term Memory (LSTM) model is used in the proposed system to predict how well students will do in their fourth year. The system is able to learn the temporal patterns and dependencies in the data thanks to the use of three years' worth of student marks data as the input to the LSTM model. The LSTM model's efficacy in predicting student performance has been evaluated through extensive testing and evaluation. The outcomes show a surprising exactness of 99.9% in distinguishing understudies' presentation levels. By utilizing the force of profound learning, the created framework empowers instructive establishments to actually recognize and separate between great entertainers, unfortunate entertainers, and understudies needing extra help. In addition, it makes it easier to identify students who are qualified for placements, which aids in career planning and provides opportunities. Additionally, the system facilitates timely support and intervention for students at risk of dropping out by assisting in early intervention. By utilizing the capabilities of deep learning methods, specifically LSTM models, this study contributes to the field of student performance analysis by providing useful insights and accurate predictions. The developed system has the potential to improve educational institutions' decision-making processes, enabling students to receive individualized guidance and targeted interventions, resulting in improved educational outcomes and student success.
NIVO-TIL: Combination anti-PD-1 and adoptive T-cell transfer in metastatic melanoma: a proof of concept
Authors: L’ORPHELIN Jean-Matthieu , Lancien Ugo , NGUYEN Jean-Michel , Coronilla Francisco Javier Saenz , Saiagh Soraya , Cassecuel Julie , Boussemart Lise , DOMPMARTIN Anne , DRENO Brigitte 
Published: December 2023

Abstract
Introduction: Metastatic melanoma patients responding to anti-PD-1 therapy showed proliferation of intra tumoral CD8+ T-cells directly correlated with clinical response, making Tumor-infiltrating lymphocytes (TILs) a potential curative treatment with adoptive cell transfer (ACT). The aim of this trial is therefore to evaluate the safety and efficacy of a sequential combination therapy of Nivolumab (PD-1 inhibitor) and TIL adoptive T-cells in patients with metastatic melanoma.
Materials and methods: We performed an explorative, prospective, single-center, open-label, non-randomized, uncontrolled phase I/II study. We enrolled 10 patients with advanced melanoma. Treatment regimen was anti-PD-1 neoadjuvant followed by 2 injections of TILs and a second sequence of anti-PD-1.
Results and discussion: Among the 4 patients who received the autologous TILs + Nivolumab combination, 3 (75%) showed an objective response (2 PR at the end of the study followed by 2 CR) and 1 CR at the end of the study. Of these 3, one was PR, and 2 were SD after Nivolumab course and before any TIL administration, reinforcing the value of tumor response after TILs injection. These responses were persistent, from 9 months to 3.4 years.
Air Pollution and Trans-regional Tourism flow: Empirical Evidence from China's Inbound Tourism
Authors: Li Guangqin , Pu Kangyun , Long Minghui 
Published: December 2023

Abstract
Based on regional air pollution disparity and the trans-regional flow of inbound tourists in 31 provinces of China, this paper examines the impact of air pollution disparity on the trans-regional flow of inbound tourists. The results show that more severe air pollution in a region significantly discourages the flow of inbound tourists from other regions to the region, and the results remain robust after a series of tests and using wind speed as an instrumental variable for air pollution to deal with the potential endogeneity problem; the negative impact of air pollution on inbound tourism in the central-eastern region is greater than in the western region, and is stronger in regions with higher tourism endowments; industrial structure upgrading can weaken the effect of air pollution on the trans-regional movement of inbound tourists, and urbanization level enhances the inhibitory effect of air pollution on the trans-regional movement of inbound tourists.
Polypharmacy, drug-drug interactions, anticholinergic burden and cognitive outcomes: a snapshot from a community-dwelling sample of older men and women in northern Italy
Authors: Perdixi Elena , Ramusino Matteo Cotta , Costa Alfredo , Bernini Sara , Conti Silvia , Jesuthasan Nithiya , Severgnini Marco , Prinelli Federica 
Published: December 2023

Abstract
Introduction
Polypharmacy (PP) use is very common in older people and may lead to anticholinergic burdens that affect cognitive impairment. We aimed to determine the occurrence of PP, drug-drug interactions (DDIs) and anticholinergic burden (ACB) and their role in cognitive outcomes in Italian older population.
Methods
Cross-sectional data from 636 community-dwelling adults (73.2±6.0 SD, 58.6% women) participating in the NutBrain study (2019-2023) were analyzed. Participants were asked about their medication use, and data on DDIs and ACB were extracted. The association of PP (≥ 5 drugs/day), DDIs, and ACB with mild cognitive impairment (MCI) and specific cognitive domains was assessed using logistic regression adjusted for confounders. Sex-stratified analysis was performed.
Results
Overall, 27.2% of the participants were exposed to PP, 42.3% to DDIs and 19% to cumulative ACB. Women were less exposed to PP and more exposed to ACB than men. In multivariate analysis, the odds of having MCI (24%) were three times higher in those with severe ACB ( ≥ 3) (OR 3.34, 95%CI 1.35-8.25). ACB was positively associated with poor executive function (OR 4.45, 95%CI 1.72-11.49) and specifically with FAB and phonological and semantic fluency. In a stratified analysis by sex, ACB was statistically significantly associated with MCI and executive function in women and with memory in men.
Conclusions
PP, DDIs and anticholinergic (AC) use are very common in community-dwelling older people. AC exposure is associated with MCI, especially poor executive function. Further sex-stratified longitudinal neuroimaging studies are warranted. Clinicians are encouraged to be vigilant when prescribing anticholinergics.
Trial registration: Trial registration number NCT04461951, date of registration July 7, 2020 (retrospectively registered, ClinicalTrials.gov).
An Analysis of the Community Impact of Charity Medical Clinics in North Texas
Authors: Mills Logan G , Newsom Barbara , Lewis Abigail , Pottorff Alexandra , Wu Ashley Wallace , Onuigbo Chiamaka C , Smith Cory , Castro Erika , Morgan Kelsi , Wu Lawrence , Phan Hiep S , Tran Bau P , Lake Katherine , Guirguis Mina , Wagner James M , Kindratt Tiffany Billmeier , Gimpel Nora 
Published: December 2023

Abstract
The cost of medical services continues to be a major barrier to healthcare accessibility for many individuals in America. Community charity medical clinics help address this disparity by providing free or reduced-cost care for the medically underinsured; however, their economic and public health contributions have yet to be well analyzed. This cross-sectional study was conducted to investigate the services provided in four primary-care charity clinics in North Texas. Only encounters completed within the study period by a physician or physician assistant with sufficient documentation to assign a level of service were reviewed for this study. Centers for Medicare and Medicaid Services Evaluation and Management Standards were used to identify the level of service provided for each encounter, and their subsequent value was determined based on Centers for Medicare and Medicaid Services fee-for-service schedules at the time service was provided. Common conditions managed during these encounters were identified using ICD-10 codes documented with each encounter. 3942 encounters were identified, and 2148 (54.5%) were audited. The most prevalent diagnoses encountered were hypertension, diabetes, hyperlipidemia, and major depressive disorder. We estimate the total value of services and medications provided for one year is between $840,278.30 to $845,737.41. Findings indicated that community, charity clinics provide a significant economic impact through a high level of care and a broad scope of services for a vulnerable patient population. The results of this study may be used in the development and implementation of future services to meet the needs of the medically underinsured.