bluuebunny/crossref_metadata_2025_split huggingface dataset:
Long working hours and increased risks of lean non-alcoholic fatty liver disease among Korean men and women
Authors: Lim Ga-Young , Chang Yoosoo , Kim Inah , Ryu Seungho , Kwon Ria , Song Jaechul 
Published: July 2023

AbstractDespite the increasing prevalence of lean nonalcoholic fatty liver disease (NAFLD), its risk factors are not well established. We examined the association between long working hours and incident NAFLD in lean Korean workers with emphasis on sex-based effect modification. This cohort study involved 46,113 non-overweight (BMI < 23 kg/m2) and NAFLD-free Korean workers (mean age, 35.5 years). Working hours were categorized into 35–40 (reference), 41–52, and ≥ 53 h. The presence of fatty liver and its severity were determined using ultrasonography and NAFLD fibrosis score (NFS), respectively. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using parametric proportional hazards models. Incident cases of 5901 lean NAFLD developed over a median follow-up of 3.8 years. The incidence of lean NAFLD increased with increasing working hours with a stronger association in men than in women (P for interaction < 0.001). For men, multivariable-adjusted HRs (95% CIs) for lean NAFLD in time-dependent models comparing working hours of 41–52 and ≥ 53 h compared to the reference category were 1.17 (1.07–1.28) and 1.25 (1.12–1.39), respectively. The excess relative risk of developing lean NAFLD with intermediate/high NFS was observed in working hours of 41–52 and ≥ 53 h with a corresponding HR of 1.66 (1.13–2.43) and 1.54 (0.94–2.51), respectively. Conversely, no significant associations were found between working hours and incidence of lean NAFLD in women. In conclusion, long working hours were significantly associated with an increased incidence of lean NAFLD and its severe form in men but not in women.
Highly sensitive asymmetric and symmetric cancer sensors with ultra-high-quality factor and resolution power
Authors: Sovizi Mahdi , Aliannezhadi Maryam 
Published: July 2023

AbstractIn the paper, we proposed two new highly sensitive and compact biosensors with ultra-high-quality factors based on the 1-D binary photonic crystal (silicon/air thin layer) with a defect layer. The proposed asymmetric and symmetric biosensors have just a few periods (two to five) on both sides of the defect layer and the normal cell group (INOK) and cancer cells group (YD-10B) are considered for the studies. The effects of different parameters including silicon layer thickness, air layer thickness, defect layer thickness, substrate position, number of periods, and light incident angle are considered in the biosensor operation and the biosensors are optimized based on the sensitivity. The results demonstrate that the sensitivity and defect mode wavelength of the sensors are independent of the substrate position. However, the quality factor and FOM of the sensors significantly depend on the substrate position and they are improved significantly in the symmetric sensor (~ 37% improvement in optimum condition). Also, the high sensitivities of the sensors are maintained over a wide range of silicon and air thicknesses, which is a valuable achievement in the manufacturing process. Furthermore, the sensitivity of the optimized biosensors with a defect layer thickness of 10 microns and only two periods reaches S ~ 2811 nm/RIU which is an excellent sensitivity for an optical biosensor.
Structure, dynamics and transferability of the metal-dependent polyhistidine tetramerization motif TetrHis for single-chain Fv antibodies
Authors: Healey Robert D. , Couillaud Louise , Hoh François , Mouhand Assia , Fouillen Aurelien , Couvineau Pierre , Granier Sébastien , Leyrat Cédric 
Published: July 2023

AbstractThe polyhistidine (6XHis) motif is one of the most ubiquitous protein purification tags. The 6XHis motif enables the binding of tagged proteins to various metals, which can be advantageously used for purification with immobilized metal affinity chromatography. Despite its popularity, protein structures encompassing metal-bound 6XHis are rare. Here, we obtained a 2.5 Å resolution crystal structure of a single chain Fv antibody (scFv) bearing a C-terminal sortase motif, 6XHis and TwinStrep tags (LPETGHHHHHHWSHPQFEK[G3S]3WSHPQFEK). The structure, obtained in the presence of cobalt, reveals a unique tetramerization motif (TetrHis) stabilized by 8 Co2+ ions. The TetrHis motif contains four 6 residues-long β-strands, and each metal center coordinates 3 to 5 residues, including all 6XHis histidines. By combining dynamic light scattering, small angle x-ray scattering and molecular dynamics simulations, We investigated the influence of Co2+ on the conformational dynamics of scFv 2A2, observing an open/close equilibrium of the monomer and the formation of cobalt-stabilized tetramers. By using a similar scFv design, we demonstrate the transferability of the tetramerization property. This novel metal-dependent tetramerization motif might be used as a fiducial marker for cryoelectron microscopy of scFv complexes, or even provide a starting point for designing metal-loaded biomaterials.
An efficient deep multi‐task learning structure for covid‐19 disease
Authors: Kordnoori Shirin , Sabeti Maliheh , Mostafaei Hamidreza , Banihashemi Saeed Seyed Agha 
Published: July 2023

AbstractCOVID‐19 has had a profound global impact, necessitating the development of infection detection systems based on machine learning. This paper presents a Multi‐task architecture that addresses the classification and segmentation tasks for COVID‐19 detection. The model comprises an encoder for feature representation, a decoder for segmentation, and a multi‐layer perceptron for classification. Evaluations conducted on two datasets demonstrate the model's performance in both classification and segmentation. To enhance efficiency and diagnosis accuracy, CT‐scan images undergo pre‐processing using image processing algorithms like histogram equalization, median filtering, and mathematical morphology operations. The combination of the median filter pre‐processing and the proposed model yields impressive results in the classification task, achieving high accuracy, sensitivity, and specificity, with values of 0.97, 0.97, and 0.96, respectively, for dataset 1, and 0.96 in mentioned metrics for dataset 2. For segmentation, the proposed model, particularly with the average morphology pre‐processing, exhibits excellent performance with high accuracy, low mean squared error, high peak signal‐to‐noise ratio, high structural similarity index, and a mean dice coefficient of 88.86 ± 0.05 for dataset 1, and 87.97 ± 0.02 for dataset 2. Furthermore, the pre‐trained models consistently demonstrate the superiority of the median filter and proposed model in the classification task on the same datasets. In conclusion, the proposed multi‐task model, incorporating image processing techniques, achieves remarkable results in both classification and segmentation. The utilization of pre‐processing algorithms and the multi‐task framework significantly contribute to superior performance metrics. This study encourages further exploration of combining diverse image processing algorithms to advance infection diagnosis and treatment.
Distributed predictive control design to achieve economically optimal power flow for DC microgrid clusters
Authors: Liu Sucheng , Ma Jin , Zhou Taohu , Zhang Qianjin , Fang Wei , Liu Xiaodong 
Published: July 2023

AbstractDC microgrid clusters are a collection of interconnected microgrids that allow for flexible power flow, leading to economic benefits and improved resilience from distributed generation. However, managing power flow among interconnected microgrids with different components such as photovoltaic, wind turbine, and battery energy storage systems, as well as various dynamic operation scenarios, presents a significant challenge for proportional‐integral (PI)‐based controllers. To address this challenge, this paper proposes a distributed predictive control design in the hierarchical control paradigm that aims to achieve economically optimal power flow (EOPF) for DC microgrid clusters. The predictive controller considers multiple objectives optimisation, including generation cost models, converter losses, and transmission losses over both local lines and tie‐lines, and design and implementation of the two‐layer tertiary control for the EOPF of DCMGCs are presented. Hardware‐in‐the loop (HIL) experimental results demonstrate the effectiveness of the controller design.
Degree conditions for the existence of a {P2, P5}-factor in a graph
Authors: Wang Sufang , Zhang Wei 
Published: July 2023

A subgraph of a graph G is spanning if the subgraph covers all vertices of G. A path- factor of a graph G is a spanning subgraph H of G such that every component of H is a path. In this article, we prove that (i) a connected graph G with δ(G) ≥ 5 admits a {P2, P5}-factor if G satisfies δ(G) > 3α(G)-1/4; (ii) a connected graph G of order n with n ≥ 7 has a {P2, P5}-factor if G satisfies max{dG(x), dG(y)} ≥ 3n/7 for any two nonadjacent vertices x and y of G.
Brauchen wir mehr Ehrenamt in der Medizin? Projektbeispiele aus der Unfallchirurgie
Authors: Prokop Axel , Reinauer Karl-Michael , Koebler Manfred , Stojinov L. , Prokop Jan , Chmielnicki Marc 
Published: July 2023

ZusammenfassungDer Pflegemangel, gesetzliche Vorgaben und die Finanzierungsdefizite führen zu einer
zunehmend schlechteren Patientenversorgung in deutschen Krankenhäusern.Ehrenamtliche Patientenbegleiter können hier eine sinnvolle Unterstützung bei der
Unterhaltung und Betreuung der Patienten sein. Durch die Betreuung der Patienten wird auf den
Stationen das medizinische Fachpersonal entlastet und den Patienten Ängste und Sorgen
genommen.Die Begleiter besuchten ausgesuchte, einsame und somit delirgefährdete Patienten auf den
Stationen und verbrachten ca. 1 h Zeit mit Gesprächen, spielen, vorlesen oder meistens nur
zuhören. Zusätzlich wurde eine OP-Begleitung angeboten, bei der die Patienten am Vortag den
Begleiter kennenlernten, der sie dann bis in den OP und später vom Aufwachraum wieder auf die
Station begleitete. Zur Unterstützung nach der Entlassung wurden Übergangsbegleiter
eingesetzt. Sie nahmen vor der Entlassung Kontakt zu den Patienten auf und unterstützten die
Patienten bei der Organisation des häuslichen Umfeldes und der weiteren sozialen und
medizinischen Betreuung.Vom 01.07.2017 bis 01.04.2023 wurden 12000 Patientenbegleitungen in 4 Krankenhäusern in 14
Stationen durchgeführt. Die Bewertung der Ehrenamtlichen nach Schulnoten zum Erfolg ihrer
Arbeit lag im Mittel bei 1,3, die Bewertung der Patienten betrug im Mittel 1,2. Seit November
2020 wurden in der Unfallchirurgie 120 OP-Begleitungen durch Ehrenamtliche vorgenommen, die so
erfolgreich waren, dass wir dies bei allen alten Patienten auch grundsätzlich bei einem
Familienangehörigen anbieten. Seit 2022 konnten in einem Pilotprojekt 30 Übergangsbegleiter
die Patienten erfolgreich zu Hause unterstützen.Ehrenamtliches Engagement im und um das Krankenhaus ist eine wichtige Unterstützung bei
alten und alleinstehenden Patienten und entlastet das medizinische Personal im Krankenhaus. Es
ist eine „Win-win-win-win-Situation“ für die Patienten, Begleiter, Personal und
Geschäftsführung.
The Pattern of Nutritional and Inflammatory Parameters in Children with Acute Appendicitis
Authors: Atef Abdelsattar Ibrahim Hoda , Kaddah Sherif , El-Asheer Osama M. , Mahmoud Manal , Wishahy Ahemd 
Published: July 2023

Abstract
Background Surgical procedures in children with overweight and obesity have many difficulties due to the high incidence of postoperative complications. This impact on comorbidity has a great interest in various surgical pathologies, such as acute appendicitis, since it is the most frequent surgical emergency in all age and sex groups. However, there are few studies assessing the effect of body mass index (BMI) and other parameters like the Glasgow Prognostic Score (GPS) and C-reactive protein (CRP)/albumin ratio on the course of acute appendicitis in children.
Objectives Identify the impact of BMI and other biomarkers like CRP/albumin ratio and GPS on the clinical course of acute appendicitis in children.
Patients (Materials) and Methods This is a prospective study conducted on 90 pediatric patients of acute appendicitis (30 high BMI and 60 non-high BMI) admitted at Pediatric Surgery Department, Children Hospital Cairo University (CHCU) during the period from March 2022 to September 2022. All patients had preoperative laboratory tests, intraoperative assessment regarding the type of surgery, duration of surgery, and type of appendicitis, then the postoperative assessment.
Results Among the 90 patients, the mean age of participants was 8.74 (2.23) years and there was a male predominance. Frequencies of open surgeries were higher in overweight and obese children (children with high BMI). There was a significant positive correlation between the preoperative CRP/albumin ratio and GPS, and an inverse significant correlation of preoperative albumin with the postoperative hospital length of stay, duration of surgery (operation time), and duration of postoperative fever.
Conclusion There is a significant relationship between the preoperative inflammatory and nutritional markers and postoperative hospital length of stay, duration of surgery (operation time), and duration of postoperative fever.
A New Clinical Classification for Gynecomastia Management and Predictive Outcome
Authors: Punia Sudhanshu , Gupta Amit 
Published: July 2023

Abstract
Aim and objectives The aim of this study is to propose a new clinical classification for gynecomastia management based on our experience.
Introduction We believe that the prevalent gynecomastia classifications need to be more detailed. Several key aspects that we noticed have either been incompletely represented or not mentioned at all, leaving them unclassified.
Materials and Methods This study was conducted at the authors' center over 24 months from May 2020 to May 2022, and included 1,571 patients who were classified and treated as per our new classifications and small iterations were done to strengthen the classification.
Results We were able to better classify our patients and previously unclassified situations. Skin sagging or a potential for skin sagging and puffy nipples were managed better. This classification allowed recommendation of each step of the procedure, resulting in high patient satisfaction, as all problem areas were sorted and outcome that was explained to them preoperatively was clearly visible postoperatively.
Conclusion The new clinical classification for gynecomastia is a simple, clinical, straightforward, comprehensive, grading system, the use of which has helped the authors and the team in achieving precise and predictable results while ensuring patient satisfaction.
The Burden of Anabolic Androgenic Steroid-Induced Gynecomastia
Authors: Beniwal Meenu , Singh Kuldeep , Singh Paritev , Sharma Abhishek , Beniwal Sonu 
Published: July 2023

Abstract
Introduction Gynecomastia is benign proliferation of male breast tissue that can be idiopathic or secondary to hormonal imbalance. Consumption of steroids plays a major role in the development of gynecomastia. The increased consumption of anabolic androgenic steroid (AAS) in youngsters to boost the physical strength and improve appearance is associated with increased prevalence of gynecomastia. True estimation of AAS-associated gynecomastia is difficult to calculate and prone to underestimation because of low social acceptance. Accurate estimation is required to assess future healthcare, for prevention and to give appropriate treatment.
Aims and Objectives The aim of this study was to calculate the steroid consumption in gynecomastia patients accurately so that appropriate treatment can be given and their response to treatment could be analysed.
Methods This is a prospective study done in a tertiary care hospital from June 2019 to June 2022. All the gynecomastia patients treated during this period in Burns & Plastic Surgery Department of PGIMS Rohtak were included in the study. Patient's detailed history was recorded and also after 3 months of surgery patients were again enquired about their history to record any change.
Results Real prevalence of AAS-associated gynecomastia (39.19%) was much higher than that recorded in preoperative period (4.05%). Also, AAS users were having higher body mass index and a greater proportion of patients were bodybuilders.
Conclusion Patients with high body mass index, athletic body, and history of recent weight gain should raise the suspicion of anabolic steroid intake. Surgery is not always indicated in AAS-associated gynecomastia. If gynecomastia persisted, surgery necessitates and it involves meticulous intraoperative hemostasis and careful glandular excision to minimize recurrence and achieve low complication rates.
Management of Gastric Varices: IR Perspective
Authors: Dervishi Mario , Sutter Christopher , Varma Rakesh K. 
Published: July 2023

AbstractGastric varices are a sequela of portal hypertension. If left untreated, life-threatening bleeding can occur. While endoscopic treatment is traditionally considered as a first-line interventional option, endovascular techniques have emerged to become the superior option in certain clinical scenarios, either as a first-line therapy or a salvage therapy. Endovascular techniques for managing gastric varices include transjugular intrahepatic portosystemic shunt (TIPS) placement, balloon-occluded retrograde transvenous obliteration (BRTO), coil, and plug-assisted retrograde transvenous obliteration, as well as a combination of both. Studies have shown that endovascular techniques can effectively control bleeding from gastric varices, with high success rates and low complication rates, and significantly reduce recurrence. TIPS placement has shown to be more effective in controlling bleeding from gastroesophageal varices, while BRTO, coil, or plug-assisted embolizations are more suitable for patients with isolated gastric varices. Endovascular interventions are a valuable option for managing gastric varices, especially in patients who are not candidates for endoscopic treatment or who have failed previous endoscopic interventions. In this two-part series editorial, we aim to initially review the complex anatomy and classification of gastric varices, medical management, and current endovascular interventional techniques, and how they compare with one another. In part 2, we draw a parallel between endovascular versus endoscopic techniques, and highlight and critically review current literature as it pertains to gastric variceal management.
Two Puzzling Cases of Headache: A Case Series
Authors: Singh Jasmine , Azad Chandrika 
Published: July 2023

AbstractMigraine and epilepsy are important causes of morbidity in adolescents and young adults. Mostly the diagnosis is readily made by using the predefined criteria. However, in extremely rare cases, children who present with typical symptoms of migraine with aura or familial hemiplegic migraine might have an underlying etiology of epilepsy. We hereby present the case of two children who presented with migraine-like symptoms but on detailed workup revealed an underlying epilepsy. Both patients responded to antiepileptic medications. These cases highlight the importance of a detailed history and comprehensive investigation plan for such patients to prevent erroneous diagnosis and migraine prophylaxis.
Hostile Hemodynamics in Distal Stent Graft–Induced New Entry Prior to Aortic Rupture: A Comparison of Transient versus Steady-State CFD Simulations
Authors: Osswald Anja , Tsagakis Konstantinos , Demircioglu Ender , Weymann Alexander , Zubarevich Alina , Ruhparwar Arjang , Karmonik Christof 
Published: July 2023

Abstract
Background Computational fluid dynamics (CFD) simulations model blood flow in aortic pathologies. The aim of our study was to understand the local hemodynamic environment at the site of rupture in distal stent graft–induced new entry (dSINE) after frozen elephant trunk with a clinically time efficient steady-flow simulation versus transient simulations.
Methods Steady-state simulations were performed for dSINE, prior and after its development and prior to aortic rupture. To account for potential turbulences due geometric changes at the dSINE location, Reynolds-averaged Navier–Stokes equations with the realizable k-ε model for turbulences were applied. Transient simulations were performed for comparison. Hemodynamic parameters were assessed at various locations of the aorta.
Results Post-dSINE, jet-like flow due to luminal narrowing was observed which increased prior to rupture and resulted in focal neighbored regions of high and low wall shear stress (WSS). Prior to rupture, aortic diameter at the rupture site increased lowering WSS at the entire aortic circumference. Concurrently, WSS and turbulence increased locally above the entry tear at the inner aortic curvature. Turbulent kinetic energy and WSS elevation in the downstream aorta demonstrated enhanced stress on the native aorta. Results of steady-state simulations were in good qualitative agreement with transient simulations.
Conclusion Steady-flow CFD simulations feasible at clinical time scales prior to aortic rupture reveal a hostile hemodynamic environment at the dSINE rupture site in agreement with lengthy transient simulations. Consequently, our developed approach may be of value in treatment planning where a fast assessment of the local hemodynamic environment is essential.
Collaboration and cooperation systems to prevent suicide among children in Japan: effective use of the Observe–Orient–Decide–Act loop
Authors: Okada Michiyo , Suzue Takeshi , Katayama Harumi , Nakadoi Yoshihiro , Fujikawa Ai 
Published: July 2023

AbstractSuicide among school-age children is a serious issue in Japan, exacerbated by the coronavirus disease 2019 pandemic. Collaboration and cooperation between schools—where children spend much of their time—and medical/welfare services are indispensable. However, teachers are overworked, and intensified stress levels have led to high absenteeism. We propose the effective use of the Observe–Orient–Decide–Act (OODA) loop for timely collaboration and cooperation between schools and medical institutions to manage high-risk children as a measure to prevent suicide. We administered questionnaires to 205 teachers who worked with children, nurses, welfare professionals, and school counsellors in schools and related facilities; 171 respondents with valid responses were included. We examined their self-rated health, attitudes towards the OODA loop, levels of depressive symptoms, satisfaction/dissatisfaction with the current status of collaboration and cooperation, and reasons for this. When we compared those satisfied/dissatisfied with the current status of collaboration and cooperation, we found no significant differences in the level of depressive symptoms, but the self-rated health of the latter was poorer. We identified three factors in the attitude survey on the OODA loop—flexible and independent situational assessment, group monitoring and sharing, and self-monitoring—and those who were dissatisfied showed lower scores for all items. We classified the reasons into three categories—details of collaboration and cooperation, methods of collaboration and cooperation, and organisations for collaboration and cooperation—revealing marked differences. The level of satisfaction with the current status of collaboration and cooperation was correlated with the level of mental health. Satisfied participants were more positive about adopting OODA perspectives. Raising awareness of the OODA concept among teaching personnel, creating an organisational structure, establishing systems for appropriate and organic collaboration between schools and medical/welfare institutions, and reviews by external institutions are necessary to effectively use the OODA loop.