bluuebunny/crossref_metadata_2025 huggingface dataset:
Stress Fallout: How Burnout Fuels Employee Turnover
Authors: Lasmi Ni Wayan , Putra P Komang Widhya Sedana
Published: October 2024

This study explores the impact of job stress, stress-induced exhaustion, and withdrawal on turnover intention, with a focus on the mediating role of stress-induced exhaustion and withdrawal in the relationship between job stress and turnover intention. Conducted at The Tanis Beach Resort, Nusa Lembongan, the research involved 70 employees selected through purposive sampling from a population of 170, targeting permanent employees with at least two years of experience. Data were collected via questionnaires and analyzed using the Partial Least Squares Structural Equation Modeling (PLS-SEM) method. The results reveal that job stress, exhaustion, and withdrawal positively and significantly influence turnover intention. Furthermore, stress-induced exhaustion and withdrawal were found to significantly mediate the relationship between job stress and turnover intention. These findings offer valuable insights for human resource management at The Tanis Beach Resort, suggesting strategies to reduce turnover intention by addressing job stress and fostering a supportive work environment.
Mastering Market Movements: Technical Indicators in IDX30 Stock Selection
Authors: Puji Lestari Novi , Aslama Bertyapati Agra
Published: October 2024

This study aims to analyze the role of trading volume, foreign money flows, and technical chart patterns in shaping investment decisions for IDX30 companies. Utilizing descriptive quantitative research, data was collected from Stockbit and IPOT, focusing on stock price charts, trading volume, and broker summaries from January 1, 2020, to December 31, 2022. The findings reveal that purchase decisions were made when stock prices broke out of a chart pattern, accompanied by increased trading volume and foreign accumulation. Conversely, sell decisions occurred when stock prices broke down from a pattern, followed by increased volume and foreign distribution. These results underscore the importance of technical analysis in guiding informed investment decisions, helping investors avoid irrational practices and potential losses. The study highlights the practical need for investors to integrate technical indicators, such as volume and foreign flows, into their decision-making processes to enhance investment outcomes.
Risk Governance Unlocks Islamic Banks’ Dual Performance Goals
Authors: Kurniawan Ferdian_Ari , Hanggraeni Dewi , Purnomo Gabriel
Published: October 2024

This study investigates the moderating effect of risk governance structures on the relationship between risk management—covering insolvency, financing, and operational risks—and the financial and social performance of Islamic banks in Indonesia. Using dynamic panel data regression, the analysis draws on annual report data from 11 Islamic commercial banks over the period from 2012 to 2021. The findings show that certain risk governance structures, such as the size and independence of the audit committee, the expertise of its members, the frequency of meetings, and the quality of external audits, significantly enhance the effectiveness of risk management in improving both financial and social outcomes. Moreover, unique Islamic banking structures, such as the size of the Shariah Supervisory Board and the frequency of its meetings, further strengthen these effects. These results highlight the importance of robust governance in optimizing risk management and improving the overall performance of Islamic banks, with implications for regulatory bodies and Islamic financial institutions aiming to improve governance frameworks.
Motivation Unlocks Gen Z’s Path to Workforce Success
Authors: Maharani Karula Yuan , Rini Hesty Prima , Sugito
Published: October 2024

This study looks into how learning motivation influences the relationship between self-efficacy, competence, and employment preparedness among Generation Z students. The study focuses on twelfth-grade accounting students at SMK Negeri 2 Buduran Sidoarjo in the academic year 2023/2024. The study intends to investigate how self-efficacy and competence influence job preparedness, as well as how learning motivation acts as a mediator in this relationship. A quantitative approach was used to collect data from a sample of 60 pupils from a population of 108, as calculated by Slovin's formula. A questionnaire was utilized to collect data, and the findings were assessed using Partial Least Squares (PLS) analysis. The findings show that self-efficacy and competence have a favorable and significant impact on students' work preparation, with learning motivation successfully moderating the link. These findings indicate that promoting self-efficacy, competence, and learning motivation in vocational education can improve students' preparedness for the workforce
Custos sociais da DPOC: o impacto sobre os anos de vida saudável e a perda de produtividade no Brasil entre os anos de 2017 e 2022
Authors: Nascimento Leon , Rabahi Marcelo , Souza Mônica , Kozlowsky Iury , Farjun Bruna , Fidalgo Antônio
Published: October 2024

Objetivo: Estimar as perdas de produtividade causadas pela doença pulmonar obstrutiva crônica (DPOC) na população brasileira. Métodos: O estudo utilizou dados obtidos do Datasus, IBGE, in­dicadores previdenciários, óbitos e aposentadorias precoces por DPOC no Brasil de 2017 a 2022. Para estimar o impacto da DPOC, foram utilizados: anos de vida saudável perdidos (DALYs) e anos de vida ajustados por produtividade (PALYs), assim como as métricas de perda de produtividade salarial (PPS) e perda de produtividade nacionalizada (PPN), que avalia a perda em função do PIB. Resultados: Mais de 196 milhões de dias de trabalho foram perdidos devido à DPOC. As principais fontes são: óbitos precoces (95.264.088), afastamentos permanentes (67.314.232) e aposentadoria precoce (30.304.490). Diárias hospitalares (3.221.591) têm uma contribuição minoritária. O valor total de DALYs observado no período do estudo foi de 2.819.332,63 anos de vida saudável perdidos cau­sados pela DPOC; um total de 14.997.166 PALYs foi perdido por conta da DPOC ou um valor anual equivalente de R$ 230,7 bilhões. Considerando a PPS, estimamos que a DPOC acarretou perdas de produtividade associadas à reposição da mão de obra de R$ 1,38 bilhão anual e, em relação à PPN, de R$ 8,28 bilhões por ano. Conclusões: Afastamentos de pacientes com DPOC podem acarretar maiores dispêndios com pagamentos de benefícios previdenciários. Este estudo atualiza e amplia correlações entre dados socioepidemiológicos, custos de saúde e previdenciários da DPOC no Brasil. Considerando todas as perdas, a DPOC pode causar perdas de R$ 240 bilhões por ano.
Development of a diagnostic model for acute ischemic stroke early identification based on SE-ResNeXt
Authors: Xu Jie , Shen Keren , Yu Zhuo , Lu Huizhe , Lin Te , Song Yaozi , Luo Likang
Published: October 2024

Background
Acute ischemic stroke (AIS) is a disease with high incidence rate and mortality. At present, the accuracy of AIS recognition based on Non contrast computed tomography (NCCT) images is not sufficient to meet clinical needs. We hope to develop and validate an AIS recognition model that can achieve timely and accurate recognition.
Methods
We retrospectively collected NCCT images of 287 patients from the Second Affiliated Hospital of Zhejiang University School of Medicine, and randomly divided them into a training set n = 230 and a testing set n = 57 according to a ratio of 8:2. We developed a deep learning AIS recognition model based on 3D SE-ResNeXt. The classification performance of the model was evaluated using the area under the receiver operating characteristic (ROC) curve (AUC), accuracy, sensitivity, specificity, and F1 score.
Results
The AUC, accuracy, sensitivity, specificity, and F1 of the model on the training set were 0.96, 0.94, 0.91, 0.94, and 0.92, respectively. The AUC, accuracy, sensitivity, specificity, and F1 on the test set were 0.90, 0.88, 0.82, 0.86, and 0.84, respectively. Compared with other deep learning models, the model used in this article has the best performance.
Conclusion
These results indicate that the proposed method can achieve early identification of acute ischemic stroke on NCCT images, which has high clinical significance.
Impact of the COVID-19 Pandemic on Breast Cancer Diagnosis and Treatment Trends in Japan
Authors: Miyashita Minoru , Kumamaru Hiraku , Hayashi Naoki , Kimura Fuyo , Yamamoto Hiroyuki , Niikura Naoki , Sagara Yasuaki , Jinno Hiromitsu , Toi Masakazu , Saji Shigehira
Published: October 2024

Background:
There is no comprehensive report regarding which patient groups were disrupted by the COVID-19 pandemic in Japan having universal health insurance system. To provide the guidance regarding how to act in future pandemics, we investigated the changes in breast cancer (BC) diagnosis and treatment after the COVID-19 pandemic.
Methods:
The trends of monthly data were analyzed in relation to the variables of a total of 291,018 primary BCs registered on the Japanese National Clinical Database between January 2018 and April 2021.
Results:
An analysis of the nationwide data after the pandemic showed 9% decrease of newly identified BC compared with before the pandemic. The impact was more relevant in the 40–50, 51–60 and 61–70-years age groups (13%, 8% and 9% decrease, respectively). The most substantial reduction was noted in patients identified through screenings without symptoms with a 17% decrease. These effects were also apparent in cT1, cN0, cStage 0, and cStage I (11%, 9%, 8% and 11% decrease, respectively). In breast surgery procedures, there was a notable decrease in breast-conserving surgery (13%) as well as post-operative radiation therapy (11%). During this period, strategies using neoadjuvant endocrine therapy or chemotherapy were implemented to avoid treatment delays for especially Stage I patients (1.5 folds increase).
Conclusions:
We have identified the patient groups that are more vulnerable to the effects of the pandemic. The changes during the pandemic would provide the guidance regarding how to act in future emergencies to minimize disadvantages for BC patients.
Needs assessment in surgical undergraduate teaching in a South Asian cohort; implications for cultural adaptations
Authors: Chandrasinghe Pramodh
Published: October 2024

Introduction
Student-centered learning has been accepted and adopted globally and the evidence for this is mainly derived from Western populations. Research in the recent past has identified the conflicts of implementing these concepts across different cultures.
Method
A needs assessment was carried out amongst a cohort of medical undergraduates regarding their lack of active participation in general learning activities and small group discussions using an anonymous online questionnaire.
Results
Majority of the students were in agreement that the active participation of medical students (54%) in learning activities and that their personal involvement during classes (61%) was inadequate. Deficiency in language skills (34%), anxiety to make mistakes in public (46%), and reluctance to address the teachers directly (41%) were the leading reasons for the lack of participation. Several structural, resource, and time-related local factors were identified as reasons for poor contributions to small group discussions. The student population was more interested in conceptual learning than assessment-oriented teaching.
Conclusion
Socio-cultural and personality-related anxieties such as addressing the teachers and making mistakes in front of peers were the leading causes for the lack of active participation. Deficiencies in English language skills contributed. Although novel learning methods have been shown to be effective in higher education there may be a need for cultural adaptations or student orientation prior to their implementation for the best results. More research in this area is needed.
WITHDRAWN: A Multi-Task Allocation Framework for Mobile Crowdsensing: Leveraging Mobility Prediction for Enhanced Task Distribution
Authors: Xu Jiantao , Xu Jianbo
Published: October 2024

The full text of this preprint has been withdrawn by the authors in order to comply with an institutional policy on preprints. Therefore, the authors do not wish this work to be cited as a reference.
Evaluating Preoperative Risk Factors for Deep Vein Thrombosis in Elderly Patients with Hip Fractures and Chronic Kidney Disease: A retrospective study
Authors: jia Ruili , Men Xiaoqian , ran Fang , li Xiaodong , Long Yubin
Published: October 2024

Background: Deep vein thrombosis (DVT) represents a significant and potentially lethal complication in bedridden elderly inpatients, leading to severe disability and mortality.
Purpose: This study aimed to identify determinants contributing to DVT incidence in elderly patients with concurrent hip fractures and chronic kidney disease (CKD).
Methods: We collected comprehensive data from elderly patients diagnosed with hip fractures and CKD at our hospital between November 2015 and January 2023. Patients were categorized into DVT and non-DVT groups. We conducted detailed demographic, comorbidity, and laboratory analyses using univariate and logistic regression methods. Receiver operating characteristic (ROC) curves were utilized to establish critical thresholds for predictive variables.
Results:The study revealed a 34.4% DVT rate among 180 patients. Univariate analysis identified significant associations between DVT and older age (p = 0.031), elevated white blood cell (WBC) count (p = 0.005), prolonged thrombin time (TT) (p = 0.030), and increased D-dimer levels (p < 0.001). Logistic regression showed that age (p = 0.009, odds ratio [OR] = 1.049), WBC count (p = 0.001, OR = 1.131), and D-dimer levels (p = 0.010, OR = 1.190) were independent predictors of DVT. ROC analysis established critical thresholds: age (73 years), D-dimer (3.3ng/mL), and WBC count (9.5 x 10^9/μL).
Conclusions: Age, D-dimer, and WBC levels independently predict DVT in elderly patients with hip fractures and CKD. Precise thresholds facilitate personalized DVT risk assessment, enabling early and targeted interventions.
Procalcitonin as a Biomarker for Postoperative Pneumonia: A Study on Dynamics Following Cardiopulmonary Bypass in Adults
Authors: MAO Guang-Xu , Wang Li-Yun , Chen Wen-Sen , Zang Feng
Published: October 2024

Objective
Postoperative pneumonia (POP) frequently complicates cardiac surgery that involves cardiopulmonary bypass (CPB). This study was aimed to assess the diagnostic utility of procalcitonin (PCT) for identifying pneumonia subsequent to CPB-assisted cardiac surgery.
Methods
Patients diagnosed with postoperative pneumonia were enrolled into the retrospective matched case-control study, who were admitted to a Grade III general hospital in Nanjing in 2023. POP diagnosis was determined based on a combination of clinical and microbiological criteria.PCT and white blood cell count (WBC) data were systematically collected from day 1 (T1) to day 5 (T5). Receiver operating characteristic (ROC) curve analysis and subject operating characteristics were utilized to evaluate the diagnostic performance of biomarkers,while a binary logistic regression model was developed to identify factors that influence the diagnosis of POP.
Results
The study included 220 age- and sex-matched patients, comprising 56 individuals with POP and 164 uninfected patients constituting the non-POP group. ROC curve analysis revealed that serum PCT concentration exhibited an AUC > 0.7 from day 2 to day 5, whereas other indices demonstrated AUCs < 0.7 at these time points.Univariate and multivariate analyses highlighted serum PCT concentration on day 2, WBC count on day 5, the PCTT4-T1 variation rate, and days of mechanical ventilation as significant predictive factors for POP diagnosis, each demonstrating statistical significance (P < 0.05). The calculated AUC was 0.837 (95%CI: 0.773–0.902). The absolute PCT value exhibited superior diagnostic performance relative to its variance rate and WBC count, with a cutoff value of 3.45 ng/ml yielding optimal diagnostic accuracy.
Conclusion
Serum PCT absolute value demonstrates higher sensitivity and specificity when compared to other indices, thereby offering superior diagnostic potential for predicting postoperative pneumonia.
Advancing Trunk Control and Balance in Rehabilitation: A Quantitative Approach Using VR Head-Mounted Display and Motion-Sensing Technologies
Authors: Zhang Xu , Zhao Xueqiang , Zhang Chi , Wu Xiaoqing , Zhang Ranran
Published: October 2024

Virtual reality (VR) technology is becoming increasingly vital across various sectors, including healthcare, engineering, and science. Its applications extend to training, education, clinical evaluations, and rehabilitation. Particularly in rehabilitation, VR is instrumental for assessing and treating a range of conditions. It holds promise for enhancing balance and gait in patients with neurological impairments and offers added benefits when integrated with conventional rehabilitation therapies. Despite its widespread use, there is a notable absence of methods and technologies for the functional quantification of training performance within current VR systems. This study addresses this gap by employing VR head-mounted displays and motion-sensing recognition technologies. This integration facilitates precise positioning and free movement within a VR environment, leveraging motion interaction functions to target trunk control and balance training. The study introduces a functional quantification framework that encompasses algorithms for analyzing movement trajectories, trunk activity, and three-dimensional spatial motion performance. This framework digitally records and updates the rehabilitation journey of participants in real-time, generating functional reports. Such reports enable medical professionals and patients to monitor rehabilitation progress continuously, thereby enhancing the overall efficacy of the treatment process.
KRAS and H1F1a expression in colorectal cancer and its association with the tumor clinicopathological features
Authors: Elmahdi Mohamed , Hosain Ahmed , Bayoumi Heba
Published: October 2024

Background: Colorectal cancer represents one of the commonest cancers worldwide. It is ranked as the fourth commonest one accounting for nearly 10 % of all cancers. Some tumor markers may help identify the prognosis of the Colorectal cancer . One of those markers is the Kirsten Rat Sarcoma Protein (KRAS). KRAS is one of the proteins important for the transduction cascade of the epidermal growth factor (EGF) and Hypoxia inducible factor HIF1a which is essential mediators of cellular response to hypoxia, regulate gene expression for tumor angiogenesis, glucose metabolism, and resistance to oxidative stress.
Aim: To study the expression of KRAS and H1F1a and its relationship with other clinical and histopathological prognostic factors in patients with Colorectal cancer .
Methods: This is a retrospective immunohistochemical study on 55 resection specimens from 55 Colorectal cancer cases. The pathology specimens were collected from July 2019 to February 2020. Tumor tissues were prepared as formalin-fixed, paraffin-embedded specimens. The paraffin blocks were sectioned at the 5 microns thickness. Then the collected sections were stained with hematoxylin & eosin (H&E) for histopathological revision and immune-histochemical staining for KRAS and H1F1a proteins.
Results: In our sample, only 54% of cases were positive for KRAS expression, and 50.9% were positive for H1F1a. KRAS and H1F1a expression showed no statistically significant relationship with the different clinical, and histopathological parameters including age groups, sex, histological variant, and tumor stages.
Conclusion: immune-histochemical staining staining with KRAS and H1F1a could be a promising modality for screening of mutations of Colorectal cancer with less cost and comparable results to molecular studies. However, the interpretation of our results is limited by the small sample size of our population.
Guideline-Guided Prognostic Models of Mortality Following First-Ever Ischemic Stroke
Authors: Mohammed Mustapha
Published: October 2024

This study aimed to develop and validate guideline-guided prognostic models for predicting mortality in patients with first-ever ischemic stroke. The study included 899 adult patients (≥ 18 years) with confirmed diagnosis of first-ever ischemic stroke from the National Stroke Registry (NSR) of Malaysia (2009–2020). The primary outcome assessed was post stroke mortality within 90 days. Multivariable regression was used to develop (75%, n = 674) and internally validated (25%, n = 225). Model performance was evaluated using discrimination [area under the receiver operating characteristic curve (AUROC) and calibration [Hosmer-Lemeshow test (HLT)]. The final prognostic model included age ≥ 60 years [adjusted odds ratio, aOR 2.39, 95% confidence interval, CI (1.37–4.18)], Glasgow Coma Scale (GCS) score of ≤ 8 [2.66, (1.31–5.40)], diabetes [2.42 (1.41–4.16)], and non-adherence to antiplatelet therapy within 48 hours [2.30 (1.26–4.20)], dysphagia screening [2.90 (1.63–5.17)], antiplatelet therapy at discharge [3.63 (2.07–6.36)], lipid-lowering therapy [2.09 (1.10-4.00)], stroke education [39.61 (21.92–71.57)] and rehabilitation [10.75 (6.00-19.25)]. The prognostic model demonstrated good validation performance, with an AUROC of 0.94 (HL p = 0.630). The study demonstrates that the guideline-guided prognostic models developed are effective in predicting mortality after a first-ever ischemic stroke. The model holds considerable promise for enhancing clinical decision-making and patient care. Additionally, risk scores generated from these models could be valuable for creating risk calculators, aiding healthcare providers, patients, and other stakeholders in making well-informed clinical decisions in managing patients with stroke.
Circular Economy Initiatives in Food Manufacturing Industry
Authors: Dip Hasnat Shishir
Published: October 2024

The case company is an European food manufacturer, building a plant-based meals product family, which is the focus of this thesis. With sustainability as a guiding concept, the company uses cutting-edge tactics to minimize its environmental impact and satisfy the growing demand for environmentally friendly eating options. The case company introduces an internship program with an emphasis on sustainability and environmental impact assessment to achieve more sustainability targets. To assess the company's carbon footprint, pinpoint opportunities for improvement, and carry out significant environmental projects, this effort seeks to leverage the experience of aspiring environmentalists. The company aims to foster an inventive and enduring corporate culture by working together with both internal and external stakeholders and promoting constructive transformation within the food industry. Performing thorough life cycle assessments (LCAs) of the company’s product line, with an emphasis on particular goods, is a top priority for the internship program. This allows participants to learn important information about the environmental impact of each stage of the product life cycle - manufacturing, distribution, usage, and disposal. The company will also be positioned as a pioneer in sustainable product creation, providing benchmarks and best practices, through industry reviews and comparative studies. A dashboard that will visualize key results and data in an understandable way is being worked on. Decision-makers in the organization will find this dashboard to be a useful tool as it will help them monitor developments, pinpoint areas for development, and effectively convey sustainability accomplishments. Moreover, sentiment analysis is essential for understanding customer perspective. Through the examination of reviews, social media comments, and other digital feedback, the organization can obtain profound insights into the opinions and emotional responses of its customers through sentiment analysis. With this knowledge, the company is better able to improve customer happiness overall, customize marketing techniques to better connect with their audience, and improve their products based on consumer preferences and problem issues. In the end, the company’s data-driven strategy helps it maintain its competitiveness in the market, strengthening client loyalty and accelerating long-term company growth.
Multi-scenario Simulation Analysis of the Impact of Land Use Change on Habitat Quality in Zhongwei Based on the PLUS Model Coupled with the InVEST Model
Authors: Wang Xiao , Liu Bing , Chen Jingzhong , Arash Malekian , Zhang Bo , Chang Qing , Liu Jing , You Wanxue
Published: October 2024

Land use change is a key factor affecting habitat quality. In order to reveal the impacts of urban land use changes on habitat quality, this paper uses the city of Zhongwei, China, as a case study. Based on the land use data from 1980, 2000 and 2020, the PLUS-InVEST coupled model was used to predict and assess the land use and habitat quality of Zhongwei. The results showed that from 1980 to 2020, the areas of construction land and woodland increased significantly, while the areas of water and unused land decreased slightly, and the other lands remained essentially unchanged. The main factors such as precipitation, temperature, population and distance from government distance influenced the land expansion. Moreover, the habitat quality in Zhongwei showed a decreasing trend. The overall area of low habitat quality increased, while the overall area of relatively low and medium habitat quality decreased, and the other remained essentially unchanged between 2000 and 2020. The predicted habitat quality of the study area in 2040 was compared under different development scenarios. The comparison of results showed that highest habitat quality and the lowest habitat degradation under the Ecological protection scenario. Although the afforestation and desertification control projects in Zhongwei have proved successful in increasing woodland and improving habitat quality, its ecological restoration measures have not yet completely counteracted the adverse effects of ongoing urbanization and industrialization on habitat quality, resulting in a persistent decline in overall habitat quality.
A Systematic Review and Meta-analysis on the Epidemiology of Early Childhood Caries in Nigeria
Authors: Okolo Chizoba , Aborisade Adetayo , Oguchi Chika , Alalade Olusegun , Adeyemo Yewande
Published: October 2024

Background
Early Childhood Caries (ECC) is a significant oral health issue affecting children under six years old. This study aimed to determine the prevalence and distribution of ECC in Nigeria through a systematic review and meta-analysis.
Methods
A systematic search was conducted across multiple databases for studies on ECC prevalence in Nigeria. The Joanna Briggs Institute (JBI) checklist was used to assess study quality. A random-effects model was employed to calculate pooled prevalence estimates and mean dmft scores. Subgroup analyses and meta-regression were performed to explore sources of heterogeneity.
Results
Twenty-three studies met the inclusion criteria, comprising 7,362 participants. The pooled ECC prevalence in Nigeria was 17% (95% CI: 11% – 24%), with significant heterogeneity (I2 = 97%). Subgroup analyses revealed variations across geopolitical zones and study settings. The pooled mean dmft score was 0.44 (95% CI: 0.24–0.74). Age group and gender showed minimal impact on ECC prevalence.
Conclusion
With a 17% prevalence rate, ECC remains a significant public health concern in Nigeria. The study highlights the need for targeted interventions, standardized national surveys, and further research into region-specific risk factors to address ECC effectively.
Sleep quality and psychological resilience mediate the association between child maltreatment and externalizing and internalizing problems: A longitudinal study based on an early adolescent cohort
Authors: Xie Faliang , Wang Xinhui , Tang Ting , Wang Fan , Zhu Dongxue , Tong Yingying , Wen Xue , Wang Gengfu , Su Puyu
Published: October 2024

Child abuse (CM) is considered to be an important risk factor for adolescent externalizing and internalizing problems (EIPs), but the mediating factors that mediate the relationship between the two are different. The purpose of this study was to explore the mediating role of sleep quality and psychological resilience in CM and adolescent EIPs, and to explore the timing of these two mediating variables. Longitudinal data were collected from all the 7th grade students (N = 1814) in a middle school in Huaibei City, Anhui Province. Baseline data were collected in September 2019, followed by two follow-up visits every other year. The main data collected include general demographics, CM, sleep quality, psychological resilience, and EIPs. Correlation analysis was performed using SPASS. Chain mediation analysis in Mplus. There was an association between any two of the four variables of CM, sleep quality, psychological resilience and EIPs. Mediation analysis showed that both sleep quality and psychological resilience independently mediated the association between CM and adolescent EIPs. In addition, when sleep quality and mental resilience continuously mediated the association between CM and EIPs in adolescents, they explained 2.5% (CM-sleep quality-psychological resilience-EIPs) and 2.1% (CM-psychological resilience-sleep quality EIPs) of the CM-EIPs association.
Analysis of the Influencing Factors of Dental Family Doctor Contracting Services Based on Survey Data (2021-2023) from Xi’an, China
Authors: Ge Wenhua , Dai Quan , Yu Dingyi , Li Min , Yuan Xuemin , Wang Ruidi , Si Hongling
Published: October 2024

Dental family doctor contracting plays a "gatekeeper" role in improving the population's oral health. This study focuses on analyzing the relevant contracting information obtained in the past three years since the implementation of this contracting service, studying the relevant factors affecting the contracting of dental family doctors. From 2021 to 2023, 3,000 questionnaires were distributed. After excluding the invalid questionnaires, 2,831 valid questionnaires were collected in the three years, of which 1,500 were selected using a simple random sampling method. Over the past three years, the number of oral family doctors signing up has increased annually. Patient preferences for dental family doctor services may vary. By studying the dental family doctor contracting service model based on specialty tertiary care hospitals for the three years from 2021–2023, we found that women, young people, high-income families, residents with urban residents' health insurance, residents with children, residents of Xi'an, residents who brushed their teeth more than or equal to 3 times a day, visited the dentist frequently, and used interdental brushes were more willing to sign up for dental family doctor services. These studies are useful for research and practice to ultimately achieve the goal of lifelong oral health management for the whole population. The publicity of the oral family doctor contract service can be strengthened to improve residents' awareness and recognition, cultivate residents' habit of seeking medical treatment for oral diseases through the valuable family doctor contract service. At the same time, we have also actively explored a reasonable compensation reimbursement mechanism.
Case report of a dog treated with radioactive iodine (I131) and stereotactic body radiation therapy (SBRT) for metastatic ectopic thyroid carcinoma
Authors: McGovern Felicity Anne , Zuber Richard Maxwell , Yu Sonya Kok-Chi
Published: October 2024

Background: Thyroid carcinoma is a rare malignancy in middle-aged to older, medium to large breed dogs. Most are carcinomas or adenocarcinomas and are often detected incidentally via palpation or advanced imaging, such as computed tomography. Up to 48% of dogs present with metastatic disease, primarily in lymph nodes and lungs. Preferred treatment is thyroidectomy, but many dogs are poor candidates due to tumour immobility and metastasis. Stereotactic body radiation therapy and radioactive iodine (I131) are emerging treatments with promising outcomes in these cases. This report describes a dog with metastatic ectopic thyroid carcinoma treated with both SBRT and I131.
Case presentation: This case describes a 10-year-old Jack Russell Terrier mix presenting with an ectopic thyroid carcinoma at the heart base and pericardial effusion. Initial treatment involved stereotactic body radiation therapy in three fractions totalling 22.5 Gy. Seven weeks later, with persistent tumour-related signs, a subcutaneous injection of 1600 MBq of I131 was administered. The dog clinically improved, while showing initial tumour reduction on cardiac ultrasound and thoracic radiographs. 37 months later, the dog presented again with recurrent pericardial effusion. Thoracic radiographs and ultrasound revealed metastatic nodules and increased size of the primary heart-based mass, indicating disease progression. A second dose of I131 (1600 MBq) was administered, but restrictive pericarditis and effusion necessitated a subtotal pericardectomy. Nine months after the second I131 treatment, the dog presented with similar signs and further disease progression evident on imaging including pleural effusion. Though treatment options, including a third I131 dose and a second SBRT course, were discussed, the owners chose to humanely euthanise the dog.
Conclusions: This case highlights an unusually prolonged survival in a dog with metastatic ectopic thyroid carcinoma, suggesting the potential for extended disease control with multimodal external beam radiation and I131 therapies.
Analysis of the association between hemoglobin and hyperuricemia by NHANES database and Mendel randomization
Authors: Wang Yajiao , Zheng Haoran , Xu Xia , Shi Shuqing , Li Yumeng , Zhang Bingxuan , Wu Huaqin , Song Qingqiao
Published: October 2024

Background The relationship between hemoglobin and hyperuricemia is still unclear. Objective To explore the association between hemoglobin and hyperuricemia. Methods The data for our cross-sectional study were obtained from the National Health and Nutrition Examination Survey (NHANES) 2011–2020. Weighted multivariate logistic regression was performed to examine the association between hemoglobin and hyperuricemia. Inverse variance weighted (IVW), weighted-median, weighted-mode and MR-Egger were used in MR analyses to assess the causal relationship between hemoglobin and hyperuricemia. Heterogeneity and horizontal pleiotropy were evaluated using Cochrane Q-test and MR Egger intercept test, respectively. Sensitivity analysis was conducted using Leave one out to evaluate the bias of individual SNPs in MR analysis. All analyses were carried out using IBM SPSS 24.0 and R version 4.3.1. Results A total of 21,855 NHANES participants were included in this study. After adjusting for all covariates, the association between hemoglobin and hyperuricemia was signifcant (P < 0.05). IVW estimates revealed that hemoglobin had signifcant efect on the risk of hyperuricemia (OR = 1.0329487, 95% CI = 1.005145–1.061521, P < 0.05). Findings of MR Egger regression, weighted median method and weighted mode were consistent with those from IVW (weighted median: OR = 1.056927, 95% CI = 1.029481–1.085105; P < 0.05; MR-Egger: OR = 1.0776376, 95% CI = 1.022953–1.135246, P < 0.05; Weighted mode: OR = 1.047532, 95% CI = 1.02109–1.074639, P < 0.05). The results of three MR Analyses methods also showed causal association between hemoglobin and hyperuricemia. Conclusions Our findings support a causal association between hemoglobin and hyperuricemia. This suggests that monitoring hemoglobin levels is equally important in preventing the occurrence of hyperuricemia.
Molecular characterisation and histopathological analysis of canine distemper virus in a Malayan tiger (Panthera tigris jacksoni)
Authors: Sadali Muhammad Farris Mohd , Razak Mariatulqabtiah Abdul , Salleh Annas , Zahli Nurul Izzati Uda , Azizan Tengku Rinalfi Putra Tengku , Ahmad Hafandi , Kaderi Mohd Arifin , Khor Kuan Hua , Wahab Ridhwan Abdul , Abdullah Lutfi , Gani Millawati , Mustaffa-Kamal Farina
Published: October 2024

Background
Canine distemper virus (CDV) has a broad host range, spanning carnivorous and non-carnivorous animals, often proving fatal. The detection of CDV in a Malayan tiger in Malaysia in 2019 marks the first such case in Malayan tigers, highlighting the potential domestic animal or wildlife circulation of the virus. Our study aimed to describe histological manifestations and characterise the CDV strain in the tiger to determine its molecular epidemiology and postulate viral pathogenicity.
Results
Notable histopathological changes were observed primarily in the central nervous system, lung, liver, kidney, spleen, and stomach, with viral antigens localised in the lung, liver, kidney, and stomach tissues. CDV-induced cell cytopathic effects with viral quantification yielding 4.27 x 106 TCID50/mL were observed at 48 h post-inoculation in CHO-SLAM cells. Phylogenetic analysis suggested that the virus originated from the Asia-1 region. Notably, 549H and 519I mutation combinations in the hemagglutinin protein were observed, indicating adaptation to a non-canid wildlife species.
Conclusion
This study delved into the molecular characterisation of CDV in the Malayan tiger, with information on the dynamics of virus transmission among wildlife in the case of future outbreaks. Such results underscore the need for a prevalence study to assess the spread of the virus. This can serve as a benchmark for developing effective preventative measures to protect Malayan tigers and mitigate their risk of extinction.
The oncogenic axis YAP/MYC/EZH2 impairs PTEN tumor suppression activity enhancing lung tumorigenicity
Authors: Blandino Giovanni , Sardo Federica Lo , Turco Chiara , Messina Beatrice , Sacconi Andrea , Auciello Francesca Romana , Pulito Claudio , Strano Sabrina , Lev Sima
Published: October 2024

The tumor suppressor PTEN (phosphatase and tensin homolog deleted in chromosome 10) is genetically deleted or downregulated in many cancer types. Loss of PTEN protein expression is frequently found in lung cancer while genetic alterations are less abundant. PTEN expression is regulated at multiple genetic and epigenetic levels and even partial reduction of its expression increases cancer occurrence. We show that YAP and TAZ cooperate with EZH2, and MYC to transcriptionally repress onco-suppressor genes, including PTEN, in Non-small cell lung cancer (NSCLC) cells. YAP/TAZ-EZH2-MYC transcriptional regulators form a nuclear complex that represses PTEN transcription, while their combinatorial targeting restores PTEN expression, attenuates NSCLC cell growth, and prevents compensatory responses induced by single treatments. Datasets analysis of NSCLC patients revealed that PTEN expression is negatively correlated to YAP/TAZ, EZH2 and MYC and that low expression of PTEN is predictive of poor prognosis, especially at earlier stages of the disease. These findings highlight the repressive role of the YAP/TAZ-EZH2-MYC axis on tumor suppressor genes and offer a potential therapeutic strategy for lung cancer patients with low PTEN levels.
P63 Expression in Primary Mediastinal Lymphomas
Authors: Houcine Yoldez , Mnif Omar , Yaiche Rahma , Jabr Dorra , Ayadi Aida
Published: October 2024

p63 protein is frequently used as an immunohistochemical marker in the pathologic diagnosis of non-hematological solid tumors. In malignant lymphoproliferative disorders, Primary mediastinal large B-cell lymphoma (PMLBCL) and classic Hodgkin lymphoma (CHL) represent two major types of mature B-cell lymphoma of the mediastinum. They have morphological and phenotypic overlap features, making this differential diagnosis challenging.
This study aims to evaluate the diagnostic utility of p63 immunohistochemistry (IHC) in distinguishing these entities.
In this single-center retrospective cohort study, we analyzed p63 expression using a tissue microarray approach in 44 cases of PMLBCL, 15 CHL cases and 7 Grey Zone Lymphoma (GZL). Diagnoses were made by experienced pathologists familiar with the nuances of lymphoma diagnosis, alongside clinical, morphological and immunohistochemical information. P63 expression was correlated with clinicopathological features.
P63 nuclear expression was found in 26/44 (59%) cases of PMLCBL, followed by only 4/7 cases of GZL and 1/15 cases CHL.
For PMLBCL, p63 demonstrated a sensitivity of 59%, specificity of 77%, a positive predictive value (PPV) of 83%, and a negative predictive value (NPV) of 49.7%.
Survival analysis revealed no significant differences in metastasis-free survival based on p63 expression across PMLBCL, CHL, and GZL.
These findings demonstrates that p63 has potential diagnostic value in differentiating PMLBCL from CHL and may be used as a potential tool in diagnosis of thoracic lymphoma. However, It has no prognostic value.
Explore the key genes and prognosis related to mitochondrial permeability transition driving necrosis gene in kidney renal clear cell carcinoma
Authors: Wang Yikai , Lv Dingyang , Zhang Wei , Shuang Weibing
Published: October 2024

Background: Mitochondrial permeability transition (MPT) driven necrosis may play a key role in the proliferation, death and spread of kidney renal clear cell carcinoma (KIRC). However, few studies have investigated key genes of MPT driven necrosis-related genes (MPTDNRGs) and KIRC using bioinformatics methods. Consequently, this study aims to create a precise prognostic tool for forecasting patient outcomes of KIRC patients.
Methods: First, differentially expressed genes (DEGs) were acquired from KIRC and control samples in TCGA-KIRC dataset, as well as between high and low MPTDNRGs scores groups. Then, candidate MPTDNRGs were acquired by overlapping both DEGs. Next, key MPTDNRGs were obtained by Cox regression analysis. Subsequently, risk model and nomogram were constructed, along with enrichment analysis, immune analysis, and regulatory network were completed. Finally, the expression of key MPTDNRGs was validated clinically using reverse transcription quantitative polymerase chain reaction (RT-qPCR).
Results: Three key MPTDNRGs, namely IL2RA, CD7, and CXCL13, were obtained to construct the risk model. The ROC analysis results showed that the AUC for 1 year, 3 years, and 5 years were 0.658, 0.614, and 0.625, respectively, indicating that the risk model has good effectiveness. Besides, risk score and age are independent prognostic factors. Next, we constructed a nomogram with a decent potential for clinical utility over risk score and age alone. Among the high-risk group, there was a significant concentration of pathways related to immune functions, particularly systemic lupus erythematosus, while the low-risk group was largely enriched in pathways associated with metabolic processes, such as butanoate metabolism. A sum of 25 immune cells exhibited significant differences from different risk groups, and high-risk group patients revealed significantly higher TIDE score, which indicated a higher likelihood of tumor immune escape in high risk group. Moreover, ceRNA network showed complex interaction pairs such as CXCL13-hsa-miR-670-5p-AL121985.1, IL2RA-hsa-miR-6088-AL513497.1, and in total 25 TFs were predicted for key MPTDNRGs.
Conclusion: In this study, three key genes (IL2RA, CD7 and CXCL13) were integrated into a newly constructed prognostic model for KIRC, which offers clinicians a novel framework for more accurately forecasting patient outcomes and also presents a fresh target and approach for the management of KIRC.
Machine learning identified the application of Disulfidoptosis-Related Ferroptosis Genes Guinness in Lung Adenocarcinoma
Authors: liu Zichen , Yan Rongdi , Pang Xuemeng , Luo Yingxu , Zheng Xin
Published: October 2024

Disulfidoptosis, a recently recognized form of Regulated Cell Death (RCD), is known to play a crucial role in the development and progression of lung adenocarcinoma (LUAD). This study employed correlation analysis to identify 21 ferroptosis-related genes associated with disulfidoptosis, subsequently utilizing these genes to distinguish between two distinct groups characterized by contrasting prognostic and immune cell infiltration features. A risk model consisting of 17 DFG-related genes (SOD1, AKT1S1, TMPRSS11E, EPHX3, CPS1, PAK1, PSMB1, CDH17, NLRP2, HSD17B14, MRPL16, LACTB2, DEDD2, MCEMP1, LCAL1, VSTM2L, FLNC) was constructed through univariate Cox analysis and Lasso regression analysis. Within the TCGA cohort, the prognostic significance of these risk features was established as independent factors. Furthermore, a nomogram was developed to predict individual overall survival rates at 1, 3, and 5 years; with an AUC value of 0.833 for the first year, indicating its marked clinical utility. Conversely, high-scoring attributed encompass tumors in advanced stages and lower levels of cell differentiation. Furthermore, our observations suggested that patients in the high-risk group may potentially derive benefits from the administration of drugs such as 5-Fluorouracil.In conclusion, DFG holds potential for assessing patient prognosis, immune characteristics, and treatment outcomes. The findings of this study offer novel insights for clinical application and immune-based therapies.
Blood flow velocity analysis in cerebral perforating arteries on 7T 2D phase contrast MRI with an open-source software tool (SELMA)
Authors: Pham S. D.T. , Chatziantoniou C. , Vliet J. T. , Tuijl R. J. , Bulk M. , Ronen I. , Ladd M. E. , Kraff O. , de Rochefort L. , Villringer A. , Pine K. , Siero J.C.W. , Costagli M. , Tosetti M. , Biessels G.J. , Zwanenburg J.J.M.
Published: October 2024

Blood flow velocity in the cerebral perforating arteries can be quantified in a two-dimensional plane with phase contrast magnetic imaging (2D PC-MRI). The velocity pulsatility index (PI) can inform on the stiffness of these perforating arteries, which is related to several cerebrovascular diseases. Currently, there is no open-source analysis tool for 2D PC-MRI data from these small vessels, impeding the usage of these measurements. In this study we present the Small vessEL MArker (SELMA) analysis software as a novel, user-friendly, open-source tool for velocity analysis in cerebral perforating arteries. The implementation of the analysis algorithm in SELMA was validated against previously published data with a Bland-Altman analysis. The inter-rater reliability of SELMA was assessed on PC-MRI data of sixty participants from three MRI vendors between eight different sites. The mean velocity (vmean) and velocity PI of SELMA was very similar to the original results (vmean: mean difference ± standard deviation: 0.1 ± 0.8 cm/s; velocity PI: mean difference ± standard deviation: 0.01 ± 0.1) despite the slightly higher number of detected vessels in SELMA (Ndetected: mean difference ± standard deviation: 4 ± 9 vessels), which can be explained by the vessel selection paradigm of SELMA. The Dice Similarity Coefficient of drawn regions of interest between two operators using SELMA was 0.91 (range 0.69–0.95) and the overall intra-class coefficient for Ndetected, vmean, and velocity PI were 0.92, 0.84, and 0.85, respectively. The differences in the outcome measures was higher between sites than vendors, indicating the challenges in harmonizing the 2D PC-MRI sequence even across sites with the same vendor. We show that SELMA is a consistent and user-friendly analysis tool for small cerebral vessels.