bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structural behavior of ultra-high performance concrete corner beam-column joint under bidirectional loading
Authors: Nadir Wissam , Ali Ammar Yasir 
Published: March 2023

Abstract
In the past few decades, extensive experimental research has been focused on studying the performance of beam-column joints under cyclic load due to their involvement in the collapse of several reinforced concrete structures during earthquakes. However, the behavior of beam-column joints under monotonic load, especially bidirectional monotonic load, has not been well-described. This study aims to enhance the performance of reinforced concrete corner beam-column joints subjected to bidirectional monotonic loads by utilizing ultra-high performance concrete (UHPC). Four scaled RC corner beam-column joints were constructed, with two made entirely of normal strength concrete (NSC) and the other two utilizing UHPC in the joint region. The variables were the material and the spacing of transverse reinforcement in the joint region. In all tested specimens, the transverse reinforcement in the joint region was eliminated to reduce the congestion of steel reinforcement in this region. The results indicate that utilizing UHPC in the joint region significantly improves the performance of the corner beam-column joint. The main result was a shift in the failure mode of the tested specimen from brittle failure caused by joint shear failure to flexural failure by the development of a plastic hinge at the joint-beam interface. Additionally, the UHPC joint showed superior performance in terms of joint shear capacity, load carrying capacity, energy absorption, and damage tolerance, despite the removal of transverse reinforcement in the joint core. Furthermore, using UHPC in the joint region allows for a reduction in the transverse reinforcement in beams and columns, thus eliminating the congestion of steel reinforcement in the joint region.
Optimized nutrition in mitochondrial disease correlates to improved muscle fatigue, strength, and quality of life
Authors: DiVito Donna , Wellik Amanda , Burfield Jessica , Peterson James , Flickinger Jean , Tindall Alyssa , Albanowski Kimberly , Vishnubhatt Shailee , MacMullen Laura , Martin Isaac , Muraresku Colleen , McCormick Elizabeth , Ibrahim-Sankoh George , McCormack Shana , Goldstein Amy , Ganetzky Rebecca , Yudkoff Marc , Xiao Rui , Falk Marni J. , Mascarenhas Maria , Zolkipli-Cunningham Zarazuela 
Published: March 2023

Abstract
We sought to prospectively characterize the nutritional status of adults ≥ 19 years (n=22, 27% males) and children (n=38, 61% male) with genetically-confirmed primary mitochondrial disease (PMD) to guide development of precision nutritional support strategies to be tested in future clinical trials. We excluded subjects who were exclusively tube-fed. Daily caloric requirements were estimated using World Health Organization (WHO) equations to predict resting energy expenditure (REE) multiplied by an activity factor (AF) based on individual activity levels. We developed a Mitochondrial Disease Activity Factors (MOTIVATOR) score to encompass fatigue typical of PMD. PMD cohort daily diet intake was estimated to be 1,143 ± 104.1 Kcal in adults (mean ± SEM, 76.2% of WHO-MOTIVATOR predicted requirement), and 1,114 ± 62.3 Kcal in children (86.4% predicted). A total of 11/22 (54.5%) adults and 18/38 (47.4%) children with PMD consumed ≤75% predicted daily Kcal needs. Malnutrition was identified in 16/60 (26.7%) PMD subjects. Increased protein and fat intake correlated with improved muscle strength in those with insufficient daily Kcal intake (£75% predicted); higher protein and fat intake correlated with decreased muscle fatigue; and higher protein, fat and CHO intake correlated with improved quality of life (QoL). These data demonstrate the frequent occurrence of malnutrition in PMD and emphasize the critical need to devise nutritional interventions to optimize clinical outcomes.
Impact of 2020 COVID-19 pandemic on bystander reaction to and outcomes of pediatric out-of-hospital cardiac arrest in Japan: a population-based, nationwide cohort study
Authors: Nakajima Kento , Ushimoto Tomonori , Murasaka Kenshi , Nunokawa Chika , Inaba Hideo 
Published: March 2023

Abstract
Background
To clarify the impact of the 2020 COVID-19 pandemic on bystanders’ response to and outcomes of pediatric out-of-hospital cardiac arrest (OHCA)| in Japan.
Methods
Prospectively collected nationwide population-based data, including detailed location information, of 9,212 pediatric (age ≤ 18 years) OHCA cases recorded between 2017 and 2020 were combined with another database. After excluding 610 emergency medical service (EMS)- and physician-witnessed cases, 62 cases without any prehospital resuscitation effort, and 430 newborns, 7,582 patients were finally analyzed. The primary outcome was neurologically favorable 1-month survival (cerebral performance category = 1 or 2). We examined detailed variations in OHCA characteristics and outcomes between the pre-pandemic and pandemic years with consideration of phase, and witness status.
Results
The pandemic year 2020 was considerably associated with higher rates of neurologically favorable 1-month survival rate, bystander cardiopulmonary resuscitation (BCPR), advanced compliance to DA-CPR (dispatcher-assisted CPR), and higher proportions of witnessed OHCA, outdoor OHCA, and compression-only BCPR. The pandemic year was associated with a lower incidence of DA-CPR attempt in care/education facilities, and a higher incidence of DA-CPR during the temporary school closure. The association of the pandemic year with better outcomes and higher bystander’s own activities for CPR in witnessed OHCA were statistically stronger than those in unwitnessed OHCA. Improvements in the survival rate in 2020 were significant in locations other than childcare/education facilities and for witnessed OHCA and OHCA during days other than temporary school closure. Worsening of outcomes was not observed in any subgroup. he superiority of conventional BCPR to compression-only BCPR in neurologically favorable outcomes were enhanced in 2020.
Conclusions
The COVID-19 pandemic in 2020 was associated with better outcomes of OHCA in children. Significant enhancements of favorable outcomes were observed in witnessed cases. The heightened preparedness for health crises in communities may have contributed to better outcomes during this pandemic compared to pre-pandemic years. In addition, during this pandemic, the benefits of conventional CPR were further enhanced.
Distribution and characteristics of colonic diverticula in northern China
Authors: Yang Fang , Sun Xueyue , Jiang Kui 
Published: March 2023

Abstract
Background

The increasing prevalence of colonic diverticula likely correlated with aging and shift to western lifestyle in Oriental countries over past decades. However, limited data about the distribution and endoscopic characteristics of colonic diverticula are available until now. We aimed to evaluate the number, size, depth and location of colonic diverticula in our study population.

Methods

We collected data from patients who underwent colonoscopy at the endoscopy center of Tianjin Medical University General Hospital and Bao Di Clinical College of Tianjin Medical University. Any colon diverticula was carefully assessed and recorded. Associations between participant characteristics and colonic diverticula were determined by using logistic regression model.

Results

A total of 27021applicable patients were retrieved from our colonoscopy database, with 1529 participants (5.67%) present with one or more diverticulosis. Patients with colonic diverticula (mean age: 58.6) were significantly older and showed male preponderance than those without diverticula. Right-sided, left-sided and bilateral diverticulosis were found in 1161 (76.0%), 170 (11.1%) and 198cases (12.9%), respectively. The patients with right-sided diverticula (mean age: 55.2) which were frequently in male were younger than those with left-sided diverticula (mean age: 67.1, P < 0.05) which were frequently in female (P<0.001). Participants represented aged ≥ 60years old (OR:4.32, P<0.001) and bilateral diverticulosis (OR:21.2,P<0.001) had an increased odds of having a greater burden .

Conclusion

the colonic diverticula were predominantly right-sided, male, and older age in northern China. Of these, patients with right-sided diverticulosis were younger than those with left-sided ones. The emergence of crowed was more likely observed in the individuals with aged over than 60 years old and bilateral distributed pattern.
Use and Cost of Skin Biopsy Procedures in the Medicare Part B Fee-for-Service Population, 2017 to 2020
Authors: Li Yiwen , Blalock Travis , Duszak Richard , Yeung Howa 
Published: March 2023

Abstract
The Center for Medicare and Medicaid Services noted skin biopsies have high expenditures and changed biopsy billing codes in 2018 to better align procedure type and associated billings. We examined associations between billing code updates and skin biopsy utilization and reimbursement across provider specialties. While dermatologists perform most skin biopsies, the proportion of skin biopsies performed by dermatologists has continuously decreased, but the proportion of skin biopsies performed by nonphysician clinicians has increased from 2017-2020. After the code update, the non-facility national payment amount decreased for first tangential biopsy but increased for first punch, first incisional, additional tangential, additional punch and additional incisional biopsy compared to the corresponding amount for first and additional biopsy before the code update. The allowable charges and Medicare payment per skin biopsy increased across provider specialties but has increased the most for primary care physicians from 2018-2020.
FixedSum: An improved algorithm for generation of weight vectors for decomposition-based multiobjective optimization
Authors: Qasim Syed Zaffar , Ismail Muhammad Ali 
Published: March 2023

Abstract
Many multiobjective optimization algorithms employ weight vectors for decomposing a problem into multiple subproblems by associating each subproblem with a single weight vector (WV). These weight vectors should be uniformly spread in the space so as to get a diversified set of solutions along the Pareto front. In the recent past, different studies involving the development of decomposition-based multiobjective evolutionary algorithms (including MOEA/D and MOEA/DD) have adopted different methods for generating weight vectors. However these WVs lack the needed diversity and are either biased near the boundary or the inner regions of the search space. In this paper, we have proposed an improved algorithm, FixedSum, for the generation of weight vectors and graphically compared its results with other methods on 2-, 5-, 8- and 10-D weight vectors. For further validation of our approach, we have applied our weight vectors along with WVs of two other methods for solving the DTLZ4 problem using a popular decomposition-based algorithm MOEA/DD. All the results are graphically shown which demonstrate the improved spread ability of our approach as compared to the competing approaches.
Knowledge Framework Construction, Question Bank Promotion and Case Collection Driving in GPA and Medical Licensing Exam
Authors: Li Zhuoquan , Qu Xiaoying , Cao Jinfeng , Huang Xiaoming 
Published: March 2023

Abstract
Objectives:Passing the medical licensing exam is a primary objective of MBBS (Bachelor of Medicine and Bachelor of Surgery) education and a major milestone in medical careers. This study aimed to explore the influence of various learning methods on the participation and pass rate of the license exam.
Methods: Three different study tactics were employed among two grades (A: n=15 and B: n=23) of MBBS students. These tactics were Knowledge framework construction (KFC), Question bank promotion (QBP) and Case collection driving (CCD).
Results: The percentage distribution of KFC, QBP and CCD at the 1st AY in grade A was 40.0%, 40.0% and 20.0%, respectively, while at the 6th AY, it was 33.3%, 40.0% and 26.7%. At the 1st AY in grade B, the distribution was 52.2%, 21.7% and 26.1%, and at the 6th AY, it was 13.1%, 47.8% and 39.1%. The overall participation and pass rates in grade A were higher than in grade B (73.3% to 78.3%, 53.3% to 60.9%). The pass rates of participants in KFC, QBP and CCD in grade A were 50.0%, 100.0%, 66.7%, respectively, and in grade B were 0.0%, 100.0%, 57.1%. The grade point average (GPA) was significantly higher in QBP (4.2 ± 0.4) than in KFC (3.8 ± 0.2), but not in CCD (3.9 ± 0.4).
Conclusions: The pass rate of MBBS students in the license exam was higher in grade A than in grade B, and the study method of QBP had a better effect on the passing rate and GPA than KFC and CCD.
Prevalence of Functional Disability and Associated Factors Among the Patients With Schizophrenia Attending Psychiatry Outpatient Clinics at Muhimbili National Hospital, Dar Es Salaam, Tanzania. Cross-sectional Survey
Authors: Kitomary Nuruel Robert , Likindikoki Samuel 
Published: March 2023

Abstract

BackgroundThe available literatures worldwide, mention the functional disability as the one of dangerous corollary of schizophrenia, while it is among the intrinsic complications of schizophrenia. Functional disability among the patients with schizophrenia is of greater concerns because patients remain dependent with hopeless life. Many factors are associated with functional disability such as age, sex, marital status, level of education, age at the diagnosis of schizophrenia, regimen of antipsychotics on use, frequency of admission and psychotherapy in among the patients with schizophrenia.ObjectiveThe study aimed to determine the prevalence of functional disability and associated factors among patients with schizophrenia attending psychiatric outpatient clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.DesignA cross-sectional surveySettingApsychiatric outpatient clinic at Muhimbili National Hospital, Dar es Salaam, Tanzania.Participants281 adults were confirmed to have diagnosis of schizophrenia using MINI International neuropsychiatric interview for psychotic disorders studies (MINI version 7.0.2). World Health Organization Disability Scale-short version 12-items (WHODAS-12) used to measure functional disability among participants.ResultsThe overall prevalence of functional disability was 71.9%. About a third (33.5%), (30.6%) and about 1 in every 13 participants (7.8%) had mild, moderate, and severe functional disability, respectively. Increased odds of functional disability was independently associated with; the frequency of admission; 1-5 times (AOR=16.76, 95%CI: 4.74-59.33), ≥6times (AOR= 9.34 95%CI: 2.38-38.28), typical (AOR=2.76 95%CI: 1.29-5.89), mixed (atypical and typical) antipsychotics (AOR=13.92 95%CI: 2.20-80.04); Not receiving psychotherapy during treatment (AOR=2.62 95%CI: 1.27-5.41) and substance use for the past twelve months (AOR=3.00 95%CI: 1.24-7.24) but male participants had decreased odds (AOR=0.40 95%CI: 0.18-0.87) of functional disability.ConclusionPatients with schizophrenia have relatively higher prevalence of functional disability. Frequency of admission, male gender, using typical antipsychotics and mixed antipsychotics, not getting psychotherapy were independent predictors of functional disability. Routine assessment of functional disability among patients with schizophrenia attending clinic with early occupational therapy interventions is highly recommended.
Geometric magnetism and new enantio-sensitive observables in photoionization of chiral molecules
Authors: Ordonez Andres F. , Ayuso David , Decleva Piero , Smirnova Olga 
Published: March 2023

Abstract
Chiral molecules are instrumental for molecular recognition in living organisms. Distinguishing between two opposite enantiomers, the mirror twins of the same chiral molecule, is both vital and challenging. Geometric magnetism enables a broad class of phenomena in solids including the anomalous electron velocity, the Hall effect, and related topological observables. Here we show that ultrafast electron currents excited in chiral molecules can generate geometric fields which enable a new class of extremely efficient enantio-sensitive observables in phtoionization. Next, we introduce the first member of this new class: enantio-sensitive orientation of chiral molecules via photoionization. This effect opens new routes to both enantio-separation and imaging of chiral dynamics on ultrafast time scales. Our work suggests that geometric magnetism in photoionization provides the bridge between the two geometrical properties, chirality and topology.
Real-Time video-assisted intraoperative neuromonitoring in vestibular schwannoma surgery, Observational 10-year Iranian experience
Authors: Shahmohammadi Mohammadreza , Zandpazandi Sara , Behnaz Faranak 
Published: March 2023

Abstract
Background
Vestibular schwannoma is an extra-axial, benign tumor that is mostly located in the cerebellopontine angle. The goal of vestibular schwannoma surgery is gross total resection of the tumor along with preservation of the cranial nerves’ function. Intraoperative nerve monitoring is mainly rewarding in VS surgery.
Method
This study was observed prospectively from 2011–2021. Patients were divided into two groups; group one 19 patients underwent resection of the tumor with intraoperative neuromonitoring and group two without neuromonitoring based on patients’ ability to economically afford neuromonitoring. In the neuromonitoring group, SSEP is evaluated and recorded throughout the whole surgery. MEP is recorded at regular intervals as well. In this study, we benefit from the cooperation of a trained neurophysiologist. We compare tumor size, hemorrhage volume during surgery, length of surgery, and facial nerve preservation (HB score), with the follow-up of 1* year (0, 2, 6 months, 1y).
Result
FN anatomical preservation rate in the neuromonitoring group was 100% and in the control group was 75%. The rate of GTR in patients operated on using neuromonitoring was 78.9%. The rate of STR and PR in procedures without neuromonitoring was 50.0% and 12.5% respectively. In 100% of patients with intraoperative neuromonitoring, the HB level was evaluated as good. 68.8% of patients without neuromonitoring had poor HB.
Conclusion
IONM in VS surgery helps increase anatomical nerve preservation rate and facial nerve outcome. The value of coordination of an anatomically trained neurophysiologist along with real-time video-assisted nerve monitoring is to avoid and lower any delay in nerve recognition.
Fluoride-Induced Oxidative Stress in Non-Skeletal Tissues: A Systematic Review and Meta-Analysis
Authors: Angwa Linet Musungu , Masinde David 
Published: March 2023

Abstract
Several studies have investigated the oxidative stress parameters in non-skeletal tissues of animals exposed to fluoride, however, the findings from these studies are inconsistent. We conducted a systematic review and meta-analysis to evaluate the levels of oxidative stress biomarkers in experimental animals treated with fluoride compared with the control group. The PubMed, Cochrane Library, EBSCO, and JSTOR databases were searched for studies reporting oxidative stress biomarkers in non-skeletal tissues of animals exposed to fluoride. A random effects model with the standardized mean difference (SMD) was used for meta-analyses. The heterogeneity of the studies was evaluated using Higgin’s I2 statistics. The risk of bias was assessed using the SYRCLE’s risk of bias tool and publication bias using Egger’s test. Compared to the control, the levels of ROS, LPO, and NO were significantly elevated and the levels of SOD, CAT, GSH-Px, and GSH significantly reduced in the studied tissues. The level of GST however showed no significant difference. The test for subgroup differences suggested that different animal species and tissues have varying susceptibilities and tolerance to fluoride. Furthermore, the extent of fluoride-induced oxidative stress damage can be modified by the intervention period. Meta-regression analysis indicated that the studies’ effect size for LPO was influenced by animal species. This meta-analysis’s findings demonstrated the presence of oxidative stress and depletion of antioxidants in the non-skeletal tissues of experimental animals exposed to fluoride.
Bronchial foreign body presenting as pneumothorax and pneumomediastinum in a young child
Authors: Shilpakar Rajendra , Shrestha Nipun , Shrestha Dhruba 
Published: March 2023

Abstract

Pneumomediastinum (PM) and Subcutaneous emphysema (SCE) following foreign body aspiration is very rare. Pneumomediastinum (PM) occurs due to alveolar rupture whereas subcutaneous emphysema occurs if air leak persists. It is benign in nature but in some cases, it might be fatal. Therefore, proper assessment and management is required to limit the life-threatening complications and FB should always be suspected whenever spontaneous PM and SCE is seen. We describe an 18-month-old boy who was presented with cough, fever and respiratory distress to Siddhi Memorial Hospital (for women and children), Emergency Department. On examination, there was decreased air entry over supra-mammary and infra-axillary region on left side of the lung field. He had foreign body in left distal bronchus with PM and SCE with in radiography. The patient was treated with oxygen, antibiotics and planned for bronchoscopy but the child self-expectorated bean seed while coughing. PM and SCE are very rare presentations of foreign body aspiration in children of age less than 3 years and in such circumstances, the possibility of foreign body should be considered.
Treatment of early postpartum metritis in a dairy herd
Authors: Callahan C. J. , Horstman L. A. 
Published: March 2023

Infection of the uterus or the metritis complex is a commonly diagnosed disorder of the postpartum period in dairy cows. Rates of 32-80% have been reported in dairy herds. The effect of metritis on milk production is not well documented, however, in one study cows classified as having severe metritis had a significant decline in production compared to cows identified as normal or having a mild infection. Most investigations have been directed towards the effect metritis has on reproductive efficiency. When metritis was classified as mild or severe, the mild cases had no detrimental effect while those classed as severe had reduced fertility. In reports where there was no attempt to grade the infections, cows with metritis had lower reproductive efficiency.
In some cases the accuracy of making a diagnosis of metritis can be questioned, likewise, the need to treat all cases can be disputed, and the treatment strategy to follow is not clear. Over time thee has been a wide array of treatments used with generally a high degree of clinical recovery. There is no doubt that a high percentage of early postpartum metritis cases make a spontaneous recovery, and this must be considered when evaluating treatments. Unfortunately, there are few controlled trials to judge treatment efficacy.
In the past few years a better understanding of the postpartum period has been gained. The postpartum period has been characterized and classified into 3 periods. The bacteriology and endocrinology have been investigated, and the pathogenesis of pyometra outlined. The role that prostaglandins may have on the postpartum uterus and the involutionary process has been studied, and the various treatment options for uterine infections have been detailed.
The purpose of this study was to make a retrospective analysis from reproductive health records of postpartum metritis in a dairy herd.