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Exploring postoperative nasal airflow dynamics and impact on crust formation and mucosal healing after endoscopic tumor resection using computational fluid dynamics analysis
Background Postoperative observations in patients undergoing radical endoscopic resection surgery for sinonasal tumors have frequently noted the occurrence of mucosal crusts or bleeding on the nasal epithelial surface. This study employs computational fluid dynamics (CFD) techniques to elucidate the critical fluidic factors associated with these postoperative morbidities. Methods Three-dimensional models of the postoperative nasal cavities were constructed using thin-section computed tomography data from nine patients who underwent radical resection surgery for sinonasal tumors, encompassing endoscopic medial maxillectomy (N = 3), endoscopic craniofacial resection (N = 3), and endoscopic resection with septectomy (N = 3). Simulations of inspiratory airflow, assuming turbulent flow, were conducted to analyze airflow and air conditioning characteristics at sites where crust formation occurred. Results Frequent sites of crusting or bleeding were associated with the maxillary or sphenoidal sinuses (five out of nine subjects), where the ostia were substantially enlarged due to the surgery. Two distinct fluid dynamic features contributing to crust formation were identified. In five cases, crusts formed where local wall shear stress was elevated, while in four cases, crusts were observed in regions characterized by stagnant flow. Additionally, the relative humidity in the nasopharynx decreased to an unsatisfactory range (83.8‒85.7%). Conclusion This study demonstrated that two distinct fluid dynamic environments conducive to postoperative crust formation are possible, indicating that the wall shear stress level alone is insufficient for crust formation. Additionally, impaired humidification function observed following the surgery underscores the necessity of providing adequate moisturization for post-surgical care.
Enhanced bioconversion of kitchen food waste into aquaculture feed using a mixed culture of Bacillus licheniformis and Yarrowia lipolytica
Supporting infants and parents in the perinatal period (SIPP): Co-creating an improved journey
There has been a 70% increase in infant A&E attendance across England in the last decade, much of it non-urgent, highlighting the need to improve parental confidence and services for infant care. A multidisciplinary group of healthcare professionals was established with the aim of understanding and evaluating the support given to new parents in the early postnatal period. We recruited parents and caregivers of infants born in a large district hospital. Participants were recruited in the postnatal ward and neonatal unit. Participants were offered face-to-face or virtual interviews with an interpreter where required. Seventeen semi-structured interviews were conducted between February and September 2022 (16 virtual, 1 face-to-face). Thematic content analysis was used to manually identify codes and refined to develop a common coding framework which was used to identify final themes and subthemes. Following the initial set of interviews, a focus group with 12 different participants was held to validate the themes. Two main themes were identified: (1) service access, continuity, consistency, and personalisation of care are highly valued, and (2) preparation and support during transition is important and individual. Within theme 1, we identified facilitators (health literacy, consistent messaging, telephone line), barriers (staff shortages, communication between healthcare workers, discrimination), and person-centred care as sub-themes. In theme 2, participants highlighted the importance of their expectations of normal, support from family and friends, and experiences using applications and social media. Effective support and care in the postnatal period are vital for ensuring and promoting the health and wellbeing of mothers and their babies. These findings were presented to local maternity services and service users by the research team, resulting in local service improvements.
Latent profile analysis of factors influencing sleep quality in ICU nurses cross-sectional study
Analysis of axial shortening induced by orthokeratology lenses and its mechanical mechanisms
Purpose This study aims to examine the short-term axial shortening effects of orthokeratology (ortho-K) lenses and investigate their mechanical mechanisms. Methods We conducted a retrospective analysis on 80 myopic children, aged 8–18, who wore ortho-K lenses for one week. Axial lengths were measured pre- and post-treatment using AL-Scan Optical Biometer. We developed a finite element model of the eye using ABAQUS software to explore mechanical changes. Results A significant reduction in axial length was observed after one week of ortho-K lens wear, with an average decrease of 0.028 ± 0.032 mm (P = 4.02 x 10-11). Approximately 82.5% of participants exhibited axial length reduction. The biomechanical model indicated that ortho-K lenses exerted forces altering the tension dynamics within the ocular structure, notably decreasing tension in the posterior ciliary muscle-lens complex. This differential change in tension may account for the mechanical basis of the observed short-term reduction in axial length. Conclusion Orthokeratology lenses induce a short-term shortening in axial length, likely due to mechanical changes in ocular tension dynamics. The finite element model suggests that these lenses decrease posterior ciliary-lens complex tension, leading to axial shortening. These findings enhance comprehension of the mechanical basis for myopia control via ortho-K treatment, highlighting potential avenues for further applied research in myopia management.
New approach to predict wastewater quality for irrigation utilizing integrated indexical approaches and hyperspectral reflectance measurements supported with multivariate analysis
Abstract Irrigation water quality is critical to maintaining agricultural output. Reusing wastewater is a global activity that serves as an alternative water resource in agriculture. This study integrates water quality indices and hyperspectral reflectance measurements to assess and predict the drain water quality for irrigation in Egypt. For that, 50 drain water samples were collected surrounding Rosette Branch in Egypt. Four major findings emerge from this Nile Delta wastewater irrigation study: First, the integrated index approach revealed significant spatial variability, with 4% of drains (IWQI < 60) requiring pretreatment and 94% showing low metal contamination (PI < 1), except for Zn hotspots near industrial areas. Second, the newly developed spectral indices such RSI566, 1140 and RSI564, 1140 were strongly related to Total Chlorophyll with R2 = 0.73, and RSI456,422 was strongly related to irrigation water quality index (IWQI) with R2 = 0.67. As well as RSI500, 400 had good relationship with Biochemical Oxygen Demand (BOD) with R2 = 0.75. Third, optimized PLSR models demonstrated higher accuracy in estimating WQIs. For instance, the PLSR model produced reliable estimates of T Chl., achieving R2 = 0.87 and 0.77 for the calibration and validation dataset. Similarly, the model provided accurate predictions for BOD, with R2 = 0.96 and 0.81 for calibration and validation. Finally, hydrochemical analysis established evaporation dominance (Gibbs ratio > 0.8) in 72% of samples, explaining the Ca-Mg-SO4 facies prevalence. While currently validated for Nile Delta conditions, the methodology’s 89% cross-region accuracy in preliminary tests suggests broad applicability to wastewater irrigation schemes. Future implementation should focus on: (1) farmer-adoptable spectral sensors for the identified optimal bands (566–570 nm, 1140 nm), (2) targeted filtration for Zn/Mn reduction in high-PI drains, and (3) seasonal model calibration to account for Nile flow variations. This work establishes a new paradigm for combining precision spectroscopy with traditional water quality assessment in water-scarce agricultural systems.
Rabies vaccination induces a CD4+ TEM and CD4+CD8+ TEMRA TH1 phenotype in dogs
The canine rabies vaccine consists of the whole killed rabies virus and an alum adjuvant. While it is known to provide immunological protection in dogs, its effects on cell-mediated responses remain largely uncharacterized. Here, we analyzed blood and spleen samples from vaccinated dogs to understand adaptive immune responses ex vivo following restimulation with rabies vaccine antigens. Our results showed that recombinant rabies virus glycoprotein (RABV-G) elicited higher antibody titers and IFNγ production compared to recombinant rabies virus nucleoprotein (RABV-N). CD4+ and CD4+CD8+ double-positive (DP) T cells proliferate robustly after five days of RABV-G stimulation, which was inhibited by an anti-canine MHC class II blocking antibody. Both RABV-G-specific CD4+ and DP T cells demonstrated a polarized TH1 phenotype, with minor subsets showing TH1/TH17 hybrid and pathogenic TH1/TH17 hybrid cell features. CD4+ T cells were primarily effector memory T cells (TEM), while DP T cells exhibited a terminally differentiated effector memory phenotype that re-expressed CD45RA (TEMRA). Both RABV-G-specific CD4+ and DP T cells were detectable up to 1,024 days post-vaccination in spleen samples and their proliferative capacities were unaffected by age. Our results provide the first characterization of canine RABV-G-specific T cell phenotypes in the spleen and blood following rabies vaccination.
Retraction Note: Topical antibiotics reduce CD11c+ cell numbers in the healthy murine cornea and modulate their response to contact lens wear
Integrating temporal convolutional networks with metaheuristic optimization for accurate software defect prediction
The increasing importance of deep learning in software development has greatly improved software quality by enabling the efficient identification of defects, a persistent challenge throughout the software development lifecycle. This study seeks to determine the most effective model for detecting defects in software projects. It introduces an intelligent approach that combines Temporal Convolutional Networks (TCN) with Antlion Optimization (ALO). TCN is employed for defect detection, while ALO optimizes the network’s weights. Two models are proposed to address the research problem: (a) a basic TCN without parameter optimization and (b) a hybrid model integrating TCN with ALO. The findings demonstrate that the hybrid model significantly outperforms the basic TCN in multiple performance metrics, including area under the curve, sensitivity, specificity, accuracy, and error rate. Moreover, the hybrid model surpasses state-of-the-art methods, such as Convolutional Neural Networks, Gated Recurrent Units, and Bidirectional Long Short-Term Memory, with accuracy improvements of 21.8%, 19.6%, and 31.3%, respectively. Additionally, the proposed model achieves a 13.6% higher area under the curve across all datasets compared to the Deep Forest method. These results confirm the effectiveness of the proposed hybrid model in accurately detecting defects across diverse software projects.
Automated generation of discharge summaries: leveraging large language models with clinical data
Abstract This study explores the use of open-source large language models (LLMs) to automate generation of German discharge summaries from structured clinical data. The structured data used to produce AI-generated summaries were manually extracted from electronic health records (EHRs) by a trained medical professional. By leveraging structured documentation collected for research and quality management, the goal is to assist physicians with editable draft summaries. After de-identifying 25 patient datasets, we optimized the output of the LLaMA3 model through prompt engineering and evaluated it using error analysis, as well as quantitative and qualitative metrics. The LLM-generated summaries were rated by physicians on comprehensiveness, conciseness, correctness, and fluency. Key results include an error rate of 2.84 mistakes per summary, and low-to-moderate alignment between generated and physician-written summaries (ROUGE-1: 0.25, BERTScore: 0.64). Medical professionals rated the summaries 3.72 ± 0.89 for comprehensiveness and 3.88 ± 0.97 for factual correctness on a 5-point Likert-scale; however, only 60% rated the comprehensiveness as good (4 or 5 out of 5). Despite overall informativeness, essential details—such as patient history, lifestyle factors, and intraoperative findings—were frequently omitted, reflecting gaps in summary completeness. While the LLaMA3 model captured much of the clinical information, complex cases and temporal reasoning presented challenges, leading to factual inaccuracies, such as incorrect age calculations. Limitations include a small dataset size, missing structured data elements, and the model’s limited proficiency with German medical terminology, highlighting the need for large, more complete datasets and potential model fine-tuning. In conclusion, this work provides a set of real-world methods, findings, experiences, insights, and descriptive results for a focused use case that may be useful to guide future work in the LLM generation of discharge summaries, perhaps especially for those working with German and possibly other non-English content.
Correction: Introducing effective parameters for predicting job burnout using a self-organizing method based on group method of data handling neural network
Morphological variations of the interatrial septum and potential implications in equine cardiology
A super resolution generative adversarial networks and partition-based adaptive filtering technique for detect and remove flickers in digital color images
Eliminating flickering from digital images captured by cameras equipped with a rolling shutter is of paramount importance in computer vision applications. The ripple effect observed in an individual image is a consequence of the non-synchronized exposure of rolling shutters utilized in CMOS sensor-based cameras. To date, there have been only a limited number of studies focusing on the mitigation of flickering in single images. Furthermore, it is more feasible to eliminate these flickers with prior knowledge, such as camera specifications or matching images. To solve these problems, we present an unsupervised framework Super-Resolution Generative Adversarial Networks and Partition-Based Adaptive Filtering Technique (SRGAN-PBAFT) trained on unpaired images from end to end Deflickering of a single image. Flicker artifacts, which are commonly caused by dynamic lighting circumstances and sensor noise, can severely reduce an image’s visual quality and authenticity. To enhance image resolution SRGAN is used, while Partition based Adaptive Filtering technique detects and mitigates flicker distortions successfully. Combining the strengths of deep learning and adaptive filtering results in a potent approach for restoring image integrity. Experimental results shows that the Proposed SRGAN-PBAFT method is effective, with major improvements in visual quality and flicker aberration reduction compared to existing methods.
The study on risk assessment of carotid plaques in the Northern Chinese population based on LASSO regression
‘I was like, this is gonna hurt’: Implementing self-sampling of dried blood spots to measure HIV viral load
Background Sexual minority men (SMM) with HIV who use stimulants may experience greater difficulties with antiretroviral therapy adherence which amplifies risk for unsuppressed HIV viral load (VL). Remote monitoring of VL could support efforts to rapidly respond to sub-optimal adherence. Methods This qualitative study enrolled 24 SMM with HIV who use stimulants to examine experiences with two different dried blood spots (DBS) self-sampling devices (i.e., Tasso-M20 vs. HemaSpot HD) to measure VL. Participants were asked to complete self-sampling of DBS using both devices, and then participated in a 45-minute semi-structured interview. Interviews focused on ease of use, device preference, experiences with receiving and mailing kits, and barriers to participating in research. A thematic analysis was conducted to analyze interview transcripts. Results Twenty-two participants (92%) returned the Tasso-M20 and 21 (88%) returned the Hemaspot HD devices. Among the 22 participants that completed qualitative interviews, twenty-three codes were identified and collapsed within seven themes. Preferences for devices were based on convenience, pain and prior experiences with finger-pricking technology. Participants emphasized that clearer instructions with contingency plans for self-sampling of DBS would improve the user experience with self-sampling of DBS. Intersectional stigma (e.g., HIV, sexual minority status, and substance use) was noted as an important consideration in implementing self-sampling of DBS. Promoting decision making, or the option to choose sampling method based on personal preferences, may improve engagement and likelihood of DBS completion. Conclusions Findings will guide the broader implementation of self-sampling of DBS to optimize VL monitoring in SMM with HIV who use stimulants. Routine HIV viral load (VL) testing is recommended to assess the success of anti-retroviral therapy (ART) and identify individuals who may be experiencing difficulties with adherence to optimize rates of viral suppression [1]. The U.S. Department of Health and Human Services (HHS) Panel on Antiretroviral Guidelines for Adults and Adolescents recommends routine VL monitoring every three to six months after initiating ART. For those with optimal ART adherence and consistently suppressed VL for more than one year, VL monitoring is recommended every six months [2]. A convenience sample of SMM with HIV who use stimulants were recruited via email using an existing consent-to-contact database of individuals interested in potential research participation. Recruitment included up to three emails, sent between March and June 2022, which detailed the study purpose and provided a link to the online study screener. Interested individuals who clicked on the provided link were directed to a brief screener consent page before reaching the screener survey. Eligible individuals were a) cisgender man, b) aged 18 or older, c) comfortable reading and speaking English, d) US residency, e) reported ever having anal sex with a man, f) self-reported HIV diagnosis at least 90 days prior to screening, g) an active ART prescription AND < 90% past-month adherence on the 3-item Wilson measure in the past 30 days [21], h) screened positive for a moderate or severe stimulant use disorder (i.e., cocaine or methamphetamine) in the past 3 months with an abbreviated version of the National Institute on Drug Abuse (NIDA)-modified Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) [22], and i) ownership of an iPhone or Android smartphone. Individuals who met the eligibility criteria were contacted by study staff to schedule a Zoom assessment, where they received information about the study, completed informed consent, and provided contact information so that self-sampling DBS collection devices could be mailed to their homes.
MicroRNA changes with macro potential contribute to secondary immunodeficiency in chronic lymphocytic leukemia during epstein barr virus reactivation
Abstract Chronic lymphocytic leukemia (CLL) is characterized by immune dysfunctions driven by miRNA deregulation and the activation of immune checkpoint pathways, which contribute to disease progression and secondary immunodeficiency (SID). This study examines the interplay between miRNA expression profiles, Epstein-Barr virus (EBV) reactivation, and immune checkpoint pathways in the context of small intestine disease (SID) development in chronic lymphocytic leukemia (CLL). Patients were stratified into groups based on the presence of SID and EBV reactivation. Comprehensive analyses included miRNA profiling, EBV infection markers, and the expression of PD-1, PD-L1, CTLA-4, CD200, and CD86 on CD4 + and CD8 + T cells, as well as CD19 + B cells. The results revealed significant suppression of tumor-suppressive miRNAs (e.g., miR-15a, miR-181a, and miR-29a) in the SID EBV + group, correlating with enhanced immunosuppression. The highest expression of exhaustion markers (PD-1, PD-L1, CTLA-4) and immunosuppressive molecules (CD200/CD200R) was observed in the SID EBV⁺ group compared to all other groups, including SID EBV⁻, which may reflect the enhanced mechanisms of immunosuppression and lymphocyte exhaustion accompanying EBV reactivation in the course of secondary immunodeficiencies. Correlation analyses underscored significant associations between miRNA levels, EBV reactivation markers, and immune checkpoint activation. These findings highlight the dual role of miRNA deregulation and immune checkpoint activation in the immunosuppressive microenvironment of CLL. The study underscores the diagnostic and therapeutic potential of miRNAs and immune checkpoints in managing SID and EBV-associated immune dysregulation in CLL.
Correction: What does heritability of Alzheimer’s disease represent?
Assessment of the radiological situation near a mothballed uranium mining facility in North-East Kazakhstan
The educational pathway to Advanced Practice for the physiotherapist: A systematic mixed studies review
Background Advanced Practice Physiotherapy (APP) is a higher level of practice grounded in 4 pillars: clinical practice, leadership, education and research. A critical step toward successful integration and sustainability of APP in healthcare systems is understanding the educational pathway to APP. Objectives 1) To describe the post-licensure educational pathways that physiotherapists engage in to advance their level of practice. 2) To evaluate demonstration of the pillars of APP by the physiotherapist after traversing a post-licensure educational pathway. Methods This systematic mixed studies review is reported in accordance with PRISMA and pre-registered (PROSPERO: CRD42024499563). 8 databases plus the grey literature were searched. 2 independent reviewers determined eligibility, extracted data, assessed quality (QuADS) and determined the overall confidence in the cumulative evidence (GRADE-CERQual). Results 81 studies (18 qualitative, 17 mixed methods, 46 quantitative) were included in a data based convergent qualitative synthesis. 6 distinct post-licensure educational pathways were described and evaluated: Masters level education, residency and fellowship programs, accredited area of practice education, mentorship, multiple encounter courses and single encounter courses. Conclusion There is a high level of confidence (GRADE-CERQual) in the finding that Masters level education consistently resulted in all 4 pillars demonstrated by the physiotherapist. Masters level education appears to be the optimal pathway to APP.