bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical characteristics of inpatients with diabetic foot ulcer admitted with non-ulcer complaints: a retrospective study
Authors: Li Lan , Li Yue , Qin Shuang , Zeng Jing , Ma Wanxia , Wei Dong 
Published: December 2023

Abstract
Background: Patients with diabetic foot (DF) typically have other diabetic complications and comorbidities. DF inpatients admitted with non-ulcer complaints are a neglected group, that might suffer from more non-standard treatments. This study intends to address their clinical characteristics, and clarify the problems existing in the diagnosis and treatment process.
Methods: This study was retrospective. Subjects were eligible inpatients with diabetic foot ulcer (DFU) identified through the relevant International Classification of Disease tenth revision (ICD-10) codes. A structured questionnaire was designed and constructed in sections to collect medical records data. Admission complaints were determined by combining final diagnosis and clinical documentation, and categorized as: ulcer-related or non-ulcer complaints. All discharged patients were followed for readmission and death.
Results: A total of 264 DFU inpatients were included in the final analysis, of which, 80 (30.3%) were admitted with non-ulcer complaints. A total of 82.5% of the DFU inpatients with non-ulcer complaints were admitted to departments without DF specialists. IWGDF/IDSA grade, cerebrovascular diseases, chronic kidney disease, infection in other parts, glycosylated hemoglobin A1c and source of hospitalization expenses were the independent influencing factors for admission with non-ulcer complaints (all P < 0.05). Only 11.3% of the patients with non-ulcer complaints had ever been treated by a DF specialist and/or in a clinical setting with DF specialists, and up to 81.4% had never sought medical help before admission. After admission, 75.0% of the DFU inpatients with non-ulcer complaints received local wound care, and only 12.5% received symptomatic analgesic treatment. There was no significant difference in clinical outcomes between the two groups either in or out-of hospital after discharge (all P > 0.05).
Conclusions: Approximately one-third of inpatients with DFU were admitted with non-ulcer complaints and most of them were admitted to departments without DF specialists. Inpatients with non-ulcer complaints had a milder wound severity but more and heavier comorbidities and worse organ function. These patients did not receive standardized diagnosis and treatment for DFU either before or after admission. They and the medical staff in related departments should receive more attention, education and training.
Sciatica? Eh-lers think again
Authors: Gowdy Adam , Tweedie Adam , Collum Niall 
Published: December 2023

Abstract
Background
Vascular Ehlers-Danlos syndrome (vEDS) is a rare disease with life-threatening complications. We present a case of a patient with a known history present to the ED with a seemingly benign case of sciatica.
Ehlers–Danlos syndrome (EDS) is a rare group of inherited connective tissue disorders with a total of 13 different subtypes. Symptoms are typically of increased joint mobility, easily stretched skin, recurrent dislocations, hernias and prolapses.
vEDS (previously type IV EDS) is the most dangerous subtype and is rarer than the more common EDS subtypes (Classical and hypermobile) and is thought to affect 1 in 200,000 people. It is autosomal dominant affecting the COL3A1 or COL1A1 genes. Symptoms include those above alongside being easily bruised, visible blood vessels on chest, unusual facial features and crucially aneurysms/dissections, bowel perforation and uterine perforation and late miscarriage
Case Presentation
A young woman with a history of vEDS presented to ED with acute onset back pain radiating down her right leg after bending over to pick up a heavy object. Her assessment was in keeping with sciatica, she was written up for analgesia and at that point a red trauma (another patient) arrived, delaying her discharge.
One hour later the patient had deteriorated and was noted to be hypotensive and tachycardic and subsequently she was transferred to resus.
She underwent a CT angiogram which revealed a ruptured external iliac aneurysm. She underwent emergency repair that night and thankfully has had no serious long term sequalae.
Conclusions
Thankfully the patient made a full recovery, but had her discharge not been delayed she may very well have been sent home and had a much worse outcome.
Our case serves to highlight the potential dangers of vEDS and act as a reminder to all clinicians to be aware of such patients and treat them with extreme caution.
This case is also a clear example of how younger patients can compensate for illness/haemorrhage with minimal changes in vital signs until a late stage in the presentation.
There may be benefit in the extension of PoCUS in emergency medicine beyond the traditional “core competencies”.
Inadequate Annotation and Its Impact on Pelvic Tilt Measurement in Clinical Practice
Authors: Chai Yuan , Maes Vincent , Boudali A. Mounir , Rackel Brooke , Walter William 
Published: December 2023

Abstract
Purpose
Accurate pre-surgical templating of the pelvic tilt (PT) angle is pivotal for hip and spine surgeries. Yet, the reliability of these annotations is often questioned due to human errors, inherent subjectivity, and variations in radiographic quality. This research delves into the precision of PT annotations, identifies challenges leading to suboptimal annotations, and evaluates their impact on PT parameters.
Methods
126 consecutive sagittal pelvic radiographs were recruited, with 11 excluded for various reasons. A team of five annotators performed PT measurements based on two definitions: one using the anterior pelvic plane and the other connecting the center of the femoral head to the midpoint of the sacral plate. Images annotated by all five annotators underwent a secondary assessment to identify inadequacies. The complete dataset was then statistically compared with a subset containing only adequate annotations.
Results
Over 60% of the cases had at least one landmark annotation deemed inadequate by two or more assessors. Notably, the ASIS and femoral head center, when determined by estimation, often had subpar annotations (over 30%). Annotations derived from clear anatomical contours proved more reliable than estimated ones. While inadequate annotations led to PT discrepancies between − 2° to 2°, their overall influence on data interpretation was minimal.
Conclusion
This study underscores the high occurrence of suboptimal annotations in pelvic tilt radiographic measurements. Such inaccuracies, although showing minimal impact on a broader scale, can cause significant deviations in individual cases, potentially affecting clinical outcomes. Emphasizing precise annotation and anatomical contour identification is crucial for both orthopedic education and the development of more accurate deep learning models for landmark localization. Addressing these annotation challenges is key to enhancing clinical decision-making and improving patient care.
Simulation application study of different fixation materials in nephrostomy tube fixation
Authors: Qin Qiuxia , Wang Hongjiao , Yang Ting , Liu Juan , Chen Xiaoqin 
Published: December 2023

Abstract
Objective
We are aiming to compare the three kinds of tapes of medical adhesive plaster, medical athletic tape, medical non-woven tape on their fixing strengths of renal fistula and harm to the skin.
Methods
In February 2022, 30 healthy people from a community activity center in Wuhan were selected to conduct a randomized block experiment with their ages used as the block factor. Three different fixation materials were used: medical rubber paste, medical breathable tape and medical non-woven tape for nephrostomy tube fixation. The extubation force and skin redness of three kinds of medical tapes were compared to evaluate the fixation strength and skin injury severity of three kinds of medical tapes.
Results
The experimental results show that the three medical tapes have significant differences in their fixing strength and damage size on the skin (p < 0.05). The medical adhesive plaster has the largest fixation strength and the maximum damage to the skin (p < 0.05), and the medical athletic tape and medical non-woven tape show no obvious statistic difference in the fixing strength and damage size to the skin (p > 0.05).
Conclusion
The randomized block experiment was used to study the fixation strength and skin damage of different fixation materials of nephrostomy tube.The experiment was carried out under the simulated experiment of force display.The operation was simple and intuitive, which could provide reference and basis for the selection of clinical tube fixation scheme.
Sulfur Amino Acid Restriction alters mitochondrial function depending on tissue, sex, and Methionine sulfoxide reductase A (MsrA) status.
Authors: Thyne Kevin M. , Camones Raechel , Salmon Adam B. 
Published: December 2023

Abstract
Methionine restriction (MR) has been shown to affect mitochondrial function including altering oxygen consumption, reactive oxygen species (ROS) generation, Complex expression, and oxidative damage. The sulfur-containing amino acid methionine can become oxidized forming methionine sulfoxide which can lead to changes in protein function and signaling. Methionine sulfoxide reductases are endogenous enzymes capable of reducing methionine sulfoxide, with Methionine sulfoxide reductase A (MsrA) being ubiquitously expressed in mammals. Here we investigated if the effects of MR on mitochondrial function required functional MsrA in the liver and kidney which are the major tissues involved in sulfur biochemistry and both highly express MsrA. Moreover, MsrA is endogenously found in the mitochondria thereby providing potential mechanisms linking diet to mitochondrial phenotype. We found sex-specific changes in oxygen consumption of isolated mitochondria and females showed changes with MR in a tissue-dependent manner – increased in liver and decreased in kidney. Loss of MsrA increased or decreased oxygen consumption depending on the tissue and which portion of the electron transport chain was being tested. In general, males had few changes in either tissue regardless of MR or MsrA status. Hydrogen peroxide production was increased in the kidney with MR regardless of sex or MsrA status. However, in the liver, production was increased by MR in females and only slightly higher with loss of MsrA in both sexes. Mitochondrial Complex expression was found to be largely unchanged in either tissue suggesting these effects are driven by regulatory mechanisms and not by changes in expression. Together these results suggest that sex and MsrA status do impact the mitochondrial effects of MR in a tissue-specific manner.
Influence of the reaction conditions on the degree of substitution of carboxymethyl seriguela gum for application as a flocculant aid
Authors: Pinheiro Henety Nascimento , Almeida João Lucas Isídio Oliveira , Veloso Flavia Freitas , Abreu Flavia Oliveira Monteiro da Silva 
Published: December 2023

Abstract
Seriguela gum is a barely explored polysaccharide, whose carboxymethylation can expand its applications for water treatment by the increase of negative charges in the chain. This work aimed to extract gum from seriguela’s exudate and to produce carboxymethyl derivatives under different reaction condition, aiming for increased substitution degree to apply as a flocculation aid in water treatment. The derivatives were characterized by titration, FTIR, NMR and GPC techniques. The reaction condition parameters, NaOH concentration and chloroacetic acid molar ratio, were significant on the degree of substitution, with values between 0.35 and 0.51. Optimal results were achieved using lower levels of NaOH and intermediate chloroacetic acid levels. Based on the results, the derivative with the highest degree of substitution was used as a flocculation aid, combined with Aluminum Sulfate, where tests demonstrated that the use of 5 mg.L− 1 of the carboxymethyl seriguela gum achieved a maximum turbidity removal rate of 99.62%, reducing turbidity to levels accepted by legislation, being more efficient than Aluminum Sulfate. The study showed that carboxymethylated seriguela gum with increased negative charges can be obtained with a high degree of substitution by a simple and high-yield process, and the tests showed high potential for application as a flocculation aid in water treatment processes.
Infinite Horizon Forward-Backward Stochastic Evolution Equations in Hilbert Space and Application to LQ Optimal Control Problems
Authors: Xu Maozhong , Tang Maoning , Meng Qingxin 
Published: December 2023

Abstract
This paper focuses on the study of infinite horizon forward-backward stochastic evolution equations (FBSEEs) in Hilbert spaces. By imposing a restriction on the unbounded operators A and B, that is, both operators are maximal dissipative, the Itô inequality can be utilized to address the problem that Itô's formula is not directly applicable. Based on this, a pair of priori estimates for the solution to (forward) stochastic evolution equations (SEEs) and backward stochastic evolution equations (BSEEs), respectively are established. In the study of infinite horizon FBSEEs, for wider applicability, we apply a set of domination-monotonicity conditions that are more relaxed compared to general conditions. Within this framework, we employ the method of continuation to establish the unique solvability result and provide a pair of solution estimates. Notably, to address the challenges posed by the infinite-dimensional setting, we employ an approximation technique to obtain the dual relationship between x and y. Actually, these results find application in various linear- quadratic (LQ) problems, where the stochastic Hamiltonian systems precisely correspond to the FBSEEs satisfying the aforementioned domination-monotonicity conditions under certain assumptions. Consequently, by solving the corresponding stochastic Hamiltonian systems, we can obtain explicit expressions for the unique optimal controls. Finally, due to the features of the stochastic evolution systems, two specific examples are given to further demonstrate the application of our results.
Design, Analysis and Optimization of Plasmonic Nanoparticles for Steam and Heat Generation Application under Solar Irradiance
Authors: bagheri Mahdi Aghlmandi sadig , Yadipour Reza , Asgharian Amir 
Published: December 2023

Abstract
Metal nanoparticles (NPs) with subwavelength dimensions exhibit plasmonic phenomena in resonance frequency and can absorb a portion of light non-radiatively and thermally. This property of NPs can be used in various applications such as seawater desalination, where the thermal power generated by them can be utilized. In this paper, we have designed and analyzed NPs to achieve maximum absorption and heat generation under solar irradiance. The NPs were arranged on a glass substrate in the most optimal pattern to obtain the highest possible absorption and heat generation. We utilized a numerical method to determine the total absorbed power of the NPs under solar irradiance. The shape, material, size and arrangement and interaction of the NPs determine their optical behavior, and, as a result, their thermal behavior. Therefore, we designed cylindrical, cubic, triangular, and hexagram-shaped NPs with the same volume of metal, choosing the material from noble metals such as Ag, Au, Cu, and Al. In the first step, we calculated the absorption cross-section of NPs using the Finite Difference Time Domain (FDTD) method. We then multiplied the solar irradiance intensity by the cross-section obtained in the first step. In the final step, we integrated the graph obtained in the solar spectrum to obtain the total absorbed power of the NPs. To determine the best arrangement period of the NPs, we utilized the Particle Swarm Optimization (PSO) method. This algorithm helped us find the period with the highest absorbed power. Aluminum hexagram nanoparticles, having the highest absorbed power and cost-effectiveness in manufacturing, were considered as the main candidates for the structure.
A national survey of the impact of Covid-19 pandemic on training and wellbeing of Restorative and Monospecialty Specialist Trainees in the UK and Ireland
Authors: Mylonas Petros , Spicer Olivia , Chin J. S. 
Published: December 2023

Abstract
Introduction
Covid-19 emergency and associated measures across the UK and Ireland during first and third waves of the pandemic disrupted mainstream dental services and training across all specialties.
Aims
Investigate effect of COVID-19 pandemic on training, mental health, and wellbeing of specialty trainees (STs) in Restorative Dentistry and associated monospecialties across the United Kingdom and Ireland.
Materials and Methods
A cross-sectional survey was conducted exploring the experiences of STs in Restorative Dentistry, Prosthodontics, Endodontics, and Periodontics (n=101) across the United Kingdom and Ireland during the first (March 2020) and third (July 2021) waves of the pandemic. Results were analysed quantitatively and qualitatively.
Results
From 101 postgraduate trainees invited, 28 responded:yielding 28% response rate. 81% (n=22) STs in March 2020 and 64% STs (n=18) in July 2021 felt concern regarding impact on training. 36% (n=10) STs were redeployed at any point between March 2020 and July 2021; 100% (n=10) redeployed to urgent dental care duties. Reduction in speciality-level clinical activities was reported by 75% (n=21) in March 2020 compared to 46% (n=13) in July 2021. Negative impact on mental health and wellbeing was reported during March 2020 (58%, n=15) and July 2021 (57% n=16), with stress reported by 81% (n=21) in March 2020 and 68% (n=19) in July 2021. 43% (n=12) STs felt Covid-19 negatively impacted their future careers.
Conclusion
COVID-19 pandemic negatively impacted clinical training and mental health of STs in restorative dentistry and associated monospecialties across the United Kingdom and Ireland. Increased flexibility and accounting for lost clinical activities could have improved ST morale and wellbeing.
Good syndrome combined with neutropenia and multiple microbial pulmonary infections: case report and review of the literature
Authors: Ye Yucai , Wang Juan , Bao Bahu , Chen Guorong , Hu Aoyan , Sun Jingzi , Liu Weiying 
Published: December 2023

Abstract

Introduction
Good syndrome (GS) is a rare acquired immunodeficiency disease characterized primarily by thymoma and hypogammaglobulinemia that predisposes to the risk of recurrent infections with multiple pathogens.
Case representation
We describe the case of a 37-year-old male GS with a history of thymoma resection who was hospitalized for multiple pulmonary infections with neutropenia and whose empirical antimicrobial therapy and promotion of granulopoiesis resulted in the resolution of the pulmonary infections and return of the neutrophil count to normal. The patient was hospitalized again for lung infection with neutropenia. Experienced antimicrobial treatment and promotion of granulocytosis were ineffective, and the alveolar lavage fluid was detected by high-throughput sequencing (NGS) to be infected with Bordetella parapertussis, Streptococcus pneumoniae, cytomegalovirus, Torque teno virus, Candida albicans, and Pneumocystis jirovecii, and the patient's neutrophil counts returned to normal after targeted anti-infective treatment and immunity-enhancing therapy. After targeted anti-infection and immunity-boosting treatment, the patient's lung infection subsided and his neutrophil count normalized.
Conclusion
When patients with thymoma have recurrent abnormal infections, immunologic testing should be performed to clarify whether GS is present, and anti-infective therapy should be aggressively administered.
Guduru District in Western Ethiopia as Assessing the Status of Biogas Use and Its Contributions to Greenhouse Gas Reduction
Authors: Hirbo Hirbo Geremu , Bacho Sori Sima , Kuse Kenenisa Abdisa 
Published: December 2023

Abstract
More than twenty (20) biogas digesters have been recently installed in the rural area of ​​Guduru. However, there is no information yet on the legal use of biogas and its contribution to reducing greenhouse gases. The study investigated the status of twenty (20) biogas digesters in rural areas of four kebeles (Hula Guto, Guto Abay, Illamu) using primary data (survey, interview and observation) and secondary data using SPSS Software version. 21 analysis Tarako and Kanani in Guduru District. All twenty digesters (20) are SINDU type fixed dome digesters. Although there are other animals in the study area, the use of the substrate is limited to cow dung. This includes reductions in CO2 emissions from biogas plants. According to calculations, all 18 biogas facilities can save 118.8 tons of carbon dioxide per year. Even if the quantities are small, when used widely throughout the country, the overall reduction of emissions from biogas plants will have a significant impact on the environment; it will primarily reduce carbon monoxide emissions while also reducing the burden on the country's natural forests. Before establishing the biogas plant, the research family used 3072 kg of fuel wood/HH/year and emitted 4806 kg of carbon dioxide equivalent (CO2e) gas/year. Carbon dioxide equivalent (CO2e) fuel (50%) can reduce fuel consumption by 1536 kg. In the biogas study area, families use biogas for cooking and lighting. Research shows that when investing in domestic biogas, some of the greenhouse gas emissions (such as fire and gas) in the home are reduced and completely replaced, saving 4697.72 kg CO2e/household/year by reducing gas in the home.