bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supplemental Material: Rubidium (Rb) enrichment processes in a highly evolved granitic system: Insights from the petrology and geochemistry of the Guobaoshan Rb deposit in eastern Tianshan, NW China
Authors: Wu Shi-Bao , Lei Ru-Xiong , al. et 
Published: September 2024

<p>Table S1: LA-ICP-MS zircon U-Pb dating results of the biotite granite and columbite-group minerals from the amazonite granite. Table S2: In situ Rb-Sr isotope analysis results of amazonite-bearing granites, amazonite granite, amazonite pegmatite, and host rock minerals in the Guobaoshan granitic pluton. Table S3: Major- and trace-element compositions of the biotite granites, muscovite granites, amazonite-bearing granites, amazonite granite, and amazonite pegmatite. Table S4: Hf isotope composition of zircon and Nd isotope composition of bulk rock from the Guobaoshan granitic pluton. Table S5: Summary of age data for the Guobaoshan deposit in eastern Tianshan. </p>
Lean Six Sigma quality improvement approach to implement clinical practice guidelines for prescribing opiates for chronic pain in a primary care setting
Authors: Bakhai Smita , Mustafa Jawdat , Cloutier Meghan , Islam Farhana , Gudleski Gregory D , Reynolds Jessica L 
Published: September 2024

BackgroundImplementing guidelines for chronic opioid management during a clinic merger posed significant challenges. Our aim was to increase the percentage of chronic pain evaluations and urine toxicology tests in patients on chronic opioid therapy from the baseline rate of less than 20% to 50% within 1 year at an academic, primary care clinic.MethodsWe applied the Define, Measure, Analyze, Improve, Control (DMAIC) approach of Lean Six Sigma for this quality improvement (QI) project. The QI tools included the creation of stakeholder mapping, root cause analysis, process flow mapping and a driver diagram. Lack of patient and provider education emerged as a significant barrier. The outcome measures were percentage of chronic pain evaluations and urine drug toxicology with an increase in controlled substance agreement completion rates as our process measures. Major interventions included patient and provider education, leveraging health information technology, care coordination and implementing new clinic protocols. Data analysis was performed by monthly run charts. Descriptive statistics were used to summarise clinical variables, while χ2analyses were employed to determine statistically significant differences between preintervention and postintervention measures.ResultsWe observed an increase in completion rates of clinic visits for chronic pain, rising from 19.0% to 51.9% (p<0.001). During study period, we observed a steady increase in chronic pain evaluations with a median of 4.5. Urine toxicology completion rates increased from 19.9% to 65.8% (p<0.001) during the preintervention and postintervention periods. We observed variable changes in urine toxicology rates with a median of 5.19. Furthermore, we observed an increase in controlled substance agreement completion rates, increasing to 50% from the baseline rate of <10%.ConclusionsEducation to patients and providers, shared decision-making using a patient-centred approach, enhancement of health information technology and system-based interventions in clinic protocols and workflows contributed to the success of this QI project. The DMAIC approach may facilitate the implementation of practice guidelines for chronic opioid therapy and enhance providers’ opioid prescribing practices.
My culture soothes
Authors: Rodríguez-Zúñiga Karen Daniela , Pinzón-Segura María Camila 
Published: September 2024

In the poignant words of a 12-year-old indigenous girl from the Pijao ethnicity (Tolima, Colombia), who shared her perspective before succumbing to leukaemia, we gain a profound understanding of health from her unique cultural viewpoint. Growing up in El Escobal, indigenus community, with her sister, she experienced the spiritual strength and unity that their culture attributes to twins. For her, health was deeply intertwined with the traditions and rituals of her people, emphasising the healing powers of plants and spiritual harmonisation.She observed a stark contrast between indigenous and Western perspectives on medicine and spirituality. In her reflection, the young girl highlighted the universal language of mutual learning and support that transcends cultural differences. Her message underscores the importance of cultural harmony and the healing power of shared human experiences, advocating for a world where diverse beliefs and practices contribute to collective strength and understanding.This text was her response to the question, "What is health?" as part of one of the methodological exercises in the doctoral research of Pinzón-Segura MC. Teoría del Intersticio Afectivo: Un nuevo enfoque feminista decolonial de análisis de políticas públicas [Internet]. Bogotá: Repositorio virtual de la Universidad Nacional de Colombia; 2024. The thesis, awarded with the distinction of summa cum laude, included various methods such as participant observation, sociological interviews, and discourse analysis of government documents. The question "What is health?" specifically guided 40 creative narrative workshops, which were an integral component of the ethnography and arts-based research design.
Association of LEAF-Q and EDE-QS scores with cholesterol levels in Finnish female athletes
Authors: Silvennoinen Julia I K , Ihalainen Johanna K , Valtonen Maarit , Mjøsund Katja , Sipilä Pyry N 
Published: September 2024

ObjectiveLow energy availability (LEA) is common in athletes. Disturbances in sex hormone levels due to insufficient energy availability have been suggested to influence cholesterol metabolism and impact the overall risk for cardiovascular disease. We assessed the relationship between Low Energy Availability in Females Questionnaire (LEAF-Q) and Eating Disorder Examination Questionnaire Short (EDE-QS) scores with cholesterol levels in a cross-sectional study of female athletes.MethodFinnish national- to international-level female athletes self-reported physiological symptoms of LEA, including menstrual disturbances, using the LEAF-Q (n=176) and eating disorder symptoms using the EDE-QS (n=294). Serum cholesterol concentrations (mmol/L) were determined from venous blood samples. We analysed the relationship between the different variables using Pearson’s r and linear regression. We also studied separately participants representing lean sports, that is, sports that emphasise leanness (LEAF-Q, n=60; EDE-QS, n=80).ResultsLEA symptoms were common; 72 (41%) of 176 participants scored ≥8 points in the LEAF-Q, which is indicative of a high risk of problematic LEA. A one-point increase in LEAF-Q score was associated with a small, non-significant increase in low-density lipoprotein (LDL) cholesterol level (beta=0.024, 95% CI −0.0011 to 0.049, p=0.061). Higher EDE-QS scores were associated with higher LDL cholesterol levels (beta=0.028, 95% CI 0.0098 to 0.046, p=0.0029). These associations were somewhat stronger among athletes representing lean sports (LEAF-Q and LDL: beta=0.043, 95% CI 0.0041 to 0.08, p=0.031; EDE-QS and LDL: beta=0.036, 95% CI 0.0041 to 0.068, p=0.028).ConclusionIn this study, LEAF-Q and EDE-QS were associated with higher LDL cholesterol levels among athletes representing lean sports.
Many body gravity and the galaxy rotation curves
Authors: Ganesh S. 
Published: September 2024

AbstractA novel theory was proposed earlier to model systems with thermal gradients, based on the postulate that the spatial and temporal variation in temperature can be recast as a variation in the metric. Combining the variation in the metric due to the thermal variations and gravity, leads to the concept of thermal gravity in a 5-D space-time-temperature setting. When the 5-D Einstein field equations are projected on to a 4-D space, they result in additional terms in the field equations. This may lead to unique phenomena such as the spontaneous symmetry breaking of scalar particles in the presence of a strong gravitational field. This theory, originally conceived in a quantum mechanical framework, is now adapted to explain the galaxy rotation curves. A galaxy is not in a state of thermal equilibrium. A parameter called the “degree of thermalization” is introduced to model partially thermalized systems. The generalization of thermal gravity to partially thermalized systems, leads to the theory of many-body gravity. The theory of many-body gravity is now shown to be able to explain the rotation curves of the Milky Way and the M31 (Andromeda) galaxies, to a fair extent. The radial acceleration relation (RAR) for 63 galaxies, with their galactic masses spanning three orders of magnitude, has been replicated. Finally, the wide binary star (WBS) system is touched upon.
Environmental Factors for Sustained Telehealth Use in Mental Health Services: A Mixed Methods Analysis
Authors: Werkmeister Benjamin , Haase Anne M. , Fleming Theresa , Officer Tara N. 
Published: September 2024

Background: The mental health service delivery gap remains high globally. Appropriate telehealth use may increase capacity through flexible remote care provision. Despite the historical lack of telehealth integration into publicly funded mental health services, during COVID‐19 lockdowns, services rapidly switched to telephone and audiovisual care provision. In Aotearoa New Zealand (NZ), this was abandoned when no longer required by COVID‐19 restrictions. This study explores environmental factors associated with telehealth implementation and ongoing use or discontinuation across a multiregional outpatient mental health service. This work contributes to understanding system‐level factors influencing telehealth use and thus informs policy and practice in postpandemic environments.Methods: This mixed methods study applied an interpretive description methodology. Semistructured interviews with 33 mental health clinicians were thematically analysed. Qualitative findings were reframed and evaluated using time series analyses of population‐level quantitative data (prior to and throughout the pandemic). Findings were synthesised with qualitative themes to develop an understanding of environmental factors contributing to telehealth use.Results: Findings highlighted an increase in clients assessed by mental health services and declining clinician numbers, contributing to pressure placed on clinicians. There was a lack of culture supporting telehealth, including limited awareness, leadership, and champions to facilitate implementation. Some teams provided services suited to telehealth; other subspeciality teams had limited applications for telehealth. There was a general lack of policy and guidelines to support telehealth use and limited technical support for clinicians unfamiliar with audiovisual software.Conclusion: Disorganised telehealth adoption in the study regions provides insight into wider environmental drivers affecting telehealth uptake. For telehealth to become a workable service delivery mode following COVID‐19, stewardship and culture shifts are required, including policy development, technical support, and resources to support clinical teams. Telehealth may address growing service demand by improving interfaces with primary care and providing timely access to specialist input.
Key Influences on Oral Feeding Achievement in Preterm Infants: Insights From a Tertiary Hospital in Indonesia
Authors: Marsubrin Putri Maharani Tristanita , Aryadevi Ni Nyoman Berlian , Medise Bernie Endyarni , Devaera Yoga 
Published: September 2024

Objective: Effective oral feeding is one of the critical milestones that must be achieved by preterm infants. While gestational age and birth weight have been recognized as influential factors, recent studies have found additional variables impacting the achievement of full oral feeding (FOF). This study is aimed at describing factors associated with the attainment of FOF in preterm infants.Methods: This retrospective cohort study examines preterm infants born between 28 and 34 weeks’ gestation admitted to Dr. Cipto Mangunkusumo General Hospital in Jakarta between July and December 2016. Comparative analysis utilized the Kruskal–Wallis test, while Cox’s regression was employed for multivariate analysis to assess factors influencing the achievement of FOF.Results: This study included 87 preterm infants meeting the inclusion criteria. The median gestational age was 33 weeks (IQR: 3). The most common birth weight range was 1500–1999 g (51.7%). Median durations from birth to the first feed, full enteral feed, and FOF were observed to be 1 day (IQR: 1), 6 days (IQR: 10), and 14 days (IQR: 24), respectively. Notably, the duration of oxygen therapy, episodes of sepsis, and frequency of blood transfusions showed significant associations with the time taken to achieve FOF.Conclusion: This study found significant associations between the time to achieve FOF and factors such as oxygen therapy duration, sepsis episodes, and frequency of blood transfusion. These findings highlight the importance of considering these factors in managing preterm infants. However, a further prospective study is warranted to identify additional factors that influence feeding milestones in preterm infants.
Gender, Leadership and Career Advancement in Higher Education Institutions in Nigeria and Ghana
Authors: Olutayo Molatokunbo A.S. 
Published: September 2024

Abstract
Higher Education Institutions (HEIs) in most societies globally are perceived to be structured in an imbalanced way, such that one gender is of advantage over the other, most times the male gender. Extant research on gender and leadership has been criticised on different grounds, such as including a one-sided focus, the lack of gendered perspectives, and a neglect of structural, cultural and historical factors in research. This study interrogates the notion that the HEIs are gendered; examines the factors answerable for gender disparities in leadership positions in the selected universities in Nigeria and Ghana; and identifies ways leadership affects each gender’s career advancement in the selected institutions. The qualitative research method was adopted to elicit information from purposely selected men and women, who have held leadership positions, and those who aspired, but were denied in the selected universities. The study utilises the in-depth and key informant interview techniques. It concludes that women still remain under-represented in most male dominated higher education decision making positions, as a result of the institutional climate which does not give adequate room for gender equality and inclusiveness.
Prognostic Value of Easy Albumin-Bilirubin Score for Radical Surgery in Patients With Gallbladder Carcinoma
Authors: Xu Ming , Deng Chuanmin , Zhang Yanfang , Man Zhongran , Yang Song , Xu Song 
Published: September 2024

Background To investigate the clinical significance of the easy albumin-bilirubin (EZ-ALBI) score as a prognostic indicator in postoperative patients with gallbladder carcinoma (GBC). Methods The comprehensive clinical and pathological records of 140 patients with GBC who underwent radical resection between January 2015 and December 2020 were retrospectively examined. Based on the EZ-ALBI score, the 140 GBC patients were categorized into two groups: a low EZ-ALBI score group (score ≤ −34.4) consisting of 108 patients and a high EZ-ALBI score group (score > −34.4) consisting of 32 patients. The association between the EZ-ALBI score and clinicopathological factors was assessed. Survival analysis was performed using the Kaplan-Meier method, and the Cox proportional hazard model was utilized to evaluate the impact of clinicopathological factors on prognosis. Results Significant differences were observed between the low EZ-ALBI score group and the high EZ-ALBI score group in terms of serum total bilirubin, serum albumin, CA19-9 levels, liver metastasis, and tumor TNM stage. The 5-year survival rate was significantly lower in the high EZ-ALBI score group compared to the low EZ-ALBI score group. Univariate analysis indicated that serum total bilirubin, lymph node metastasis, TNM stage, and EZ-ALBI score were closely related to overall survival (OS). Multivariate analysis identified TNM stage and EZ-ALBI score as independent prognostic factors for OS. Conclusions The EZ-ALBI score is a significant independent prognostic factor for overall survival in GBC patient’s post-radical resection, highlighting its potential utility in clinical prognosis and patient management.
Does the calcar femorale affect the position of uncemented short stems?
Authors: Weidner Jan , Wyatt Michael , Beck Martin 
Published: September 2024

Background and purpose: Metaphyseal-stabilised short stems rely on sufficient metaphyseal fixation and are inserted by following the medial cortex. This type of stem is used extensively in our institution, and we observed on occasion unintended implant positioning with an increased distance between the implant and the medial cortex. A bony structure within the proximal femur which was first described in 1874 and named the calcar femorale, coincides with this phenomenon. The aim of this study was to investigate the impact of the calcar femorale on the position of a metaphyseal-stabilised short stem. Patients and methods: The frequency of cases with an increased distance between medial cortex and the implanted short stem was analysed in 52 consecutive patients. Additionally, we performed an anatomical CT study with 60 cadaveric femora to obtain more detailed information on the anatomy of the calcar femorale. Detailed measurements regarding the calcar femorale and its relationship to the proximal femur were obtained. From this, we derived implications for the implantation of a short stem prosthesis. Results: In 50% of all cases, we found an increased gap between the stem and the medial cortex. An increased gap did not significantly affect stem size, position, or subsidence rate, but in cases with an increased gap we found fewer stems with a radiologically optimum fit. The calcar could be identified in all 60 cadavers. The calcar femorale angle showed a high correlation with the mechanical antetorsion (0.87, p = 0.02) and the functional antetorsion (0.86, p = 0.05) of the femur. Conclusions: The calcar femorale is a consistent anatomical structure which may be the cause for an increased gap medial to the short stem in 50% of our cases. It limits the intramedullary space and influences both stem size and orientation. The CF angle which correlates with femoral antetorsion may influence the anteversion of the stem.
Conducting two evidence syntheses in six weeks – experiences with and evaluation of a pilot project
Authors: Ames Heather Melanie R. , Kornør Hege , Evensen Line Holtet , Lidal Ingeborg Beate , Hafstad Elisabet , Hestevik Christine Hillestad , Jardim Patricia Sofia Jacobsen , Hval Gyri 
Published: September 2024

Abstract
Background
Evidence synthesis organisations are trying to meet commissioners’ needs for rapid responses to their evidence synthesis commissions. In this project we piloted an intensive process, working to complete evidence syntheses within six-weeks, rather than the standard lead time of 4–6 months. Our objective was to explore how researchers experience working intensively, identify barriers and facilitators, and determine how a more intensive approach to evidence synthesis could be more systematically introduced in the future.

Methods
In a pre-planning phase, an intensive work group was established, and two commissions were selected for this pilot project. The evidence synthesis process was divided into two phases: planning and intensive. The planning phase, involved scheduling the intensive phase, exploring new digital tools, and identifying peer reviewers. The intensive phase encompassed the entire evidence synthesis process. Two review teams were formed, each with a team lead supported by a process lead and leadership contact point. Throughout the project, teams engaged in reflective meetings to evaluate and adjust processes as needed.

Results
During the planning phase, teams identified significant uncertainties regarding scopes, research questions, and inclusion criteria. To address this, they engaged with commissioners earlier than originally planned, clarified these aspects, and prepared protocols. Despite some minor deviations from the original plan, both reviews were completed on schedule, with one team expanding their scope due to the absence of eligible studies. Teams operated flexibly, held regular meetings, and found the process seamless due to fewer interruptions. Machine learning tools facilitated rapid study selection. The process lead role, created to guide and evaluate the project, proved beneficial, providing structure and support, although clearer role delineation with the leadership contact point could have improved efficiency.

Conclusions
Overall, the intensive process fostered focus and productivity, allowing teams to manage short-term deliverables effectively. The researchers preferred working intensively with one evidence synthesis over being involved with many projects at the same time. They felt that time use was more effective, and they were able to complete the tasks in a focused way. However, there are several implications that should be considered before implementing an intensive approach in future evidence syntheses.
The application value of support vector machine model based on multimodal MRI in predicting IDH-1mutation and Ki-67 expression in glioma
Authors: Liang He-Xin , Wang Zong-Ying , Li Yao , Ren An-Ning , Chen Zhi-Feng , Wang Xi-Zhen , Wang Xi-Ming , Yuan Zhen-Guo 
Published: September 2024

Abstract
Purpose
To investigate the application value of support vector machine (SVM) model based on diffusion-weighted imaging (DWI), dynamic contrast-enhanced (DCE) and amide proton transfer- weighted (APTW) imaging in predicting isocitrate dehydrogenase 1(IDH-1) mutation and Ki-67 expression in glioma.

Methods
The DWI, DCE and APTW images of 309 patients with glioma confirmed by pathology were retrospectively analyzed and divided into the IDH-1 group (IDH-1(+) group and IDH-1(-) group) and Ki-67 group (low expression group (Ki-67 ≤ 10%) and high expression group (Ki-67 > 10%)). All cases were divided into the training set, and validation set according to the ratio of 7:3. The training set was used to select features and establish machine learning models. The SVM model was established with the data after feature selection. Four single sequence models and one combined model were established in IDH-1 group and Ki-67 group. The receiver operator characteristic (ROC) curve was used to evaluate the diagnostic performance of the model. Validation set data was used for further validation.

Results
Both in the IDH-1 group and Ki-67 group, the combined model had better predictive efficiency than single sequence model, although the single sequence model had a better predictive efficiency. In the Ki-67 group, the combined model was built from six selected radiomics features, and the AUC were 0.965 and 0.931 in the training and validation sets, respectively. In the IDH-1 group, the combined model was built from four selected radiomics features, and the AUC were 0.997 and 0.967 in the training and validation sets, respectively.

Conclusion
The radiomics model established by DWI, DCE and APTW images could be used to detect IDH-1 mutation and Ki-67 expression in glioma patients before surgery. The prediction performance of the radiomics model based on the combination sequence was better than that of the single sequence model.