bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization of Contrast‐Enhanced Ultrasound in Diagnosis of Focal Liver Lesions
Authors: Salama Fady , Thakral Nimish , Leyson Christina Delacruz , Konjeti Venkata , Benrajab Karim , Hawk Gregory , Fouch Harrison , Gedaly Roberto , Khurana Aman 
Published: October 2024

Background and aims: Focal liver lesions (FLL) are one of the most common indications for hepatology and hepatobiliary surgery consultation. In this retrospective study, we aim to assess if contrast‐enhanced ultrasound (CEUS) can address diagnostic dilemmas in the evaluation of indeterminate liver lesions by identifying characteristics of indeterminate FLL on CEUS and correlating these with cross‐sectional imaging and pathology findings.Methods: We retrospectively reviewed all patients who underwent CEUS evaluation for liver lesions over a 28‐month period (Oct 2020 to Jan 2023) at the University of Kentucky. To assess the relationship between CEUS results and the corresponding CT, MRI, and/or pathologic findings, the McNemar–Bowker tests were performed.Results: Twenty‐nine patients were included (after two exclusions from a total n of 31). Mean age was 54 years, 62% were female, and 48% had underlying cirrhosis. Of the 29 patients with initial cross‐sectional imaging, the initial results showed malignancy or likely malignant lesion in 6 patients and benign or likely benign lesion in 6 patients. The remaining 17 patients had inconclusive/indeterminate results. CEUS clarified an “indeterminate” CT/MRI result 15 times out of 17 (88.2%), moving the diagnosis to “benign” 11 times while suggesting “malignant” only four times. When aggregating indeterminate cross‐sectional results with either benign or malignant categories suggested by CEUS, CEUS never reversed a benign CT/MRI diagnosis but often reversed a malignant CT/MRI diagnosis.Conclusion: CEUS provided a definitive diagnosis of indeterminate liver lesions in approximately 90% of patients and avoided the need for biopsy in most patients. In cases where the liver lesions were biopsied, CEUS accurately distinguished malignant versus benign lesions as confirmed by biopsy findings. CEUS, therefore, has the potential to provide a precise diagnosis for the majority of indeterminate lesions.
Effect of Educational Intervention by Application of PRECEDE‐PROCEED Model on Lifestyle Change in Hypertensive Patients
Authors: Ghannadi Alireza , Mohammadkhah Fatemeh , Harsini Pooyan Afzali , Ghasemi Afsaneh , Kamyab Amirhossein , Jeihooni Ali Khani 
Published: October 2024

Background: One of the most important causes of cardiovascular disease is hypertension. Lifestyle modification has been emphasized in preventing and controlling blood pressure. This research aimed to determine the effect of educational intervention by application of PRECEDE‐PROCEED model on lifestyle change in hypertensive patients in the villages of Fasa City, Fars Province, Iran.Methods: This research is a quasi‐experimental study that was conducted on 300 hypertensive patients in 2020–2021. Data gathering tools were a demographic information questionnaire, a questionnaire based on the PRECEDE‐PROCEED model, and a lifestyle questionnaire (LSQ). The educational intervention consisted of ten sessions lasting 45 or 50 min. Before and 6 months after the educational intervention, the two groups each completed a questionnaire. The systolic and diastolic blood pressure (DBP) levels, as well as physical exercise and health variables, nutrition and weight control, mental health, and spiritual health were measured before and 6 months after the educational intervention.Results: The results showed that there was no significant difference between the two groups before in cues of PRECEDE‐PROCEED model; however, the experimental group had a significant increase in cues of PRECEDE‐PROCEED model 6 months after the intervention. The results showed that the experimental group had a significant increase 6 months after the intervention in terms of physical exercise and health variables, nutrition and weight control, mental health, and spiritual health. The mean blood pressure (both diastolic and systolic) in the experimental group was significantly reduced after the intervention.Conclusions: The study’s results showed the effectiveness of an educational intervention based on the PRECEDE‐PROCEED model on lifestyle change in hypertensive patients. It also highlights the need to pay further attention to the education aimed at controlling hypertension through a healthy lifestyle and correct behavioral habits.
The COVID‐19 Pandemic and Changes in Nursing Care Interventions in 2020 and 2021 in the Brazilian Amazon
Authors: Nicolau Mônica Borchart , Vigário Patrícia dos Santos , Faria Alvaro Camilo Dias , Mafort Thiago Thomaz , Jesus Igor Ramathur Telles de , Lopes Agnaldo José 
Published: October 2024

Background: Since March 2020, when the World Health Organization classified COVID‐19 (coronavirus disease 2019) as a pandemic, nurses in Brazil have been reviewing procedures and changing the way they treat patients with the disease. This study aimed to assess the changes in nursing care between the pandemic years of 2020 and 2021 in hospitals in Marabá, a municipality in the Brazilian Amazon.Methods: This retrospective observational study separately evaluated 499 and 572 medical records from 2020 and 2021, respectively. The nursing care protocols (NCPs) consisted of a checklist with nursing tasks for treating critically ill patients with acute COVID‐19. The data from 27 nursing protocols were divided into five organ system groups: neurological, cardiovascular, respiratory, digestive/urinary, and musculoskeletal systems.Results: With respect to the neurological, cardiovascular, respiratory, and digestive/urinary system protocols, 14 of the 16 nursing care interventions were practised significantly more often in 2021 than in 2020 (p < 0.0001 for all). Aspiration of the upper airways was performed significantly less often (p < 0.0001), and vital signs were monitored in 100% of the subjects in both years. With respect to the musculoskeletal system, in 2021, seven protocols were practised at significantly higher rates than in 2020, and four interventions showed no significant differences between the years. In 2021, care across all organ systems was significantly greater than it was in 2020 (p < 0.0001). Among the 27 NCPs evaluated, the percentage of care performed by nurses was significantly greater in 2021 than in 2020 (69.2% ± 9.4% versus 56.2% ± 15.3%, p < 0.0001).Conclusion: Patients with COVID‐19 experienced an increase in nursing care from 2020 to 2021 across all evaluated organ systems, indicating that nursing care improved as knowledge about the pandemic was gained.
АНТИОКСИДАНТНО-ПРООКСИДАНТНИЙ БАЛАНС ПЕЧІНКИ В ДИНАМІЦІ КРАНІОСКЕЛЕТНОЇ ТРАВМИ У ЩУРІВ РІЗНОГО ВІКУ
Authors: Сушко Ю. І. 
Published: October 2024

Вступ. Зростання рівня травматизму є характерною ознакою третього тисячоліття і стосується постраждалих усіх вікових груп. За умов краніоскелетної травми (КСТ) виникає травматичний шок, значно погіршується кровопостачання органів і тканин, віддалених від місця безпосереднього ураження, в тому числі й печінки, що сприяє поглибленню гіпоксії, посиленій генерації активних форм оксигену та прозапальних медіаторів. Компенсаторно активізується антиоксидантний захист, спрямований на забезпечення антиоксидантно-прооксидантного гомеостазу.
Мета дослідження – зʼясувати динаміку антиоксидантно-прооксидантного балансу в печінці щурів різного віку за умов експериментальної краніоскелетної травми.
Методи дослідження. В експериментах використано 147 білих щурів-самців лінії Вістар різного віку. До 1-ї дослідної групи ввійшли статевонезрілі тварини віком 100–120 днів, до 2-ї – статевозрілі щури віком 6–8 місяців, до 3-ї – старі тварини віком 19–23 місяці. В усіх дослідних групах за умов використання тіопентал-натрієвого наркозу моделювали КСТ. Контрольних тварин тільки вводили у тіопентал-натрієвий наркоз. З експериментів щурів виводили під наркозом через 1, 3, 7, 14, 21 і 28 діб методом тотального кровопускання із серця. У 10 % екстракті гомогенату печінки визначали каталазну активність і вміст реагентів до тіобарбітурової кислоти, за співвідношенням яких розраховували антиоксидантно-прооксидантний індекс (АПІ).
Результати й обговорення. Під впливом КСТ у щурів різного віку, порівняно з контролем, протягом 1–28 діб посттравматичного періоду суттєво зменшувалася величина АПІ. У статевонезрілих тварин показник досягав мінімальної величини через 7 діб і поступово зростав до 28-ї доби, у статевозрілих і старих щурів він досягав мінімальної величини через 3 доби посттравматичного періоду, залишався на такому ж рівні до 14-ї доби з подальшим збільшенням. Величина АПІ в усі досліджувані терміни посттравматичного періоду була суттєво меншою у старих щурів порівняно з тваринами інших дослідних груп, а через 1, 3, 21 та 28 діб експерименту – в статевозрілих щурів порівняно зі статевонезрілими. Ступінь зниження АПІ в усі терміни посттравматичного періоду виявився суттєво більшим у старих щурів порівняно з тваринами інших дослідних груп. Виявлена вікова відмінність розвитку оксидативного стресу у відповідь на КСТ свідчить про меншу антиоксидантну спроможність старих щурів за умов травми, що вимагає додаткової антиоксидантної терапії.
Висновки. Моделювання КСТ у щурів різного віку супроводжується розвитком оксидативного стресу, про це свідчить зниження, порівняно з контролем, АПІ печінки, що у статевонезрілих тварин стає мінімальним через 7 діб експерименту, в статевозрілих і старих – через 3–14 діб з наступним зростанням до 28-ї доби, що не досягає рівня контролю. У всі терміни посттравматичного періоду ступінь зменшення величини АПІ у старих щурів суттєво більший, ніж у статевонезрілих і статевозрілих.
ДІАГНОСТИЧНЕ ЗНАЧЕННЯ КОРТИЗОЛУ В ПАЦІЄНТІВ ІЗ ЦУКРОВИМ ДІАБЕТОМ
Authors: Кривко Ю. Я. , Щурко М. М. , Сойка Л. Д. , Любінська О. І. , Нечипор Н. О. 
Published: October 2024

Вступ. Цукровий діабет (ЦД) – пандемія, що охоплює мільйони осіб у всьому світі. Однією з ланок його патогенезу є активація гіпоталамо-гіпофізарно-наднирковозалозної системи. Кортизол відіграє важливу роль у підтримці рівня енергії і метаболічних процесів, але його тривала секреція призводить до негативних наслідків. Він активує глюкокортикоїдні рецептори, що запускає механізм негативного зворотного зв’язку, пригнічуючи подальшу секрецію адренокортикотропного гормону. Однак при хронічному стресі ця система може розладнатися, що спричинить постійне підвищення рівня кортизолу. Така дисрегуляція може викликати метаболічні зміни, включаючи розвиток метаболічного синдрому й ожиріння, що часто є фоном для ЦД. Високий рівень кортизолу впливає на накопичення жиру, особливо в абдомінальній ділянці, підвищення інсулінорезистентності, артеріальну гіпертензію, дисліпідемію, що є основними складовими метаболічного синдрому.
Мета дослідження – оцінити вміст кортизолу в периферійній крові хворих на цукровий діабет залежно від рівня глікемії.
Методи дослідження. Досліджено периферійну кров хворих на ЦД віком від 45 до 75 років (середній вік – (55±5) років). Контрольну групу становили 20 практично здорових осіб. До 1-ї групи ввійшли 20 па­цієнтів із ЦД, рівень глюкози в яких не перевищував ниркового порога (<8,0 ммоль/л), до 2-ї – 20 хворих на ЦД, рівень глюкози в яких перевищував нирковий поріг (>8,0 ммоль/л). Вміст кортизолу визначали методом імуноферментного аналізу за допомогою набору реактивів “ДС-ІФА-Стероїд-Кортизол” із застосуванням моноклональних антитіл.
Результати й обговорення. Рівень кортизолу в сироватці крові пацієнтів 1-ї групи ((198,47±0,47) нг/мл) в 1,3 раза перевищував показник контрольної групи ((157,68±0,12) нг/мл, р<0,05). Середня його концентрація у сироватці крові хворих 2-ї групи становила (296,68±0,48) нг/мл, що в 1,9 раза більше за контрольне значення, та перевищувала показник пацієнтів 1-ї групи в 1,4 раза (р<0,05).
Висновки. Зміна концентрації кортизолу підтверджує патогенетичне значення в розвитку ЦД. ­Зокрема, високий його рівень пов’язаний із центральним ожирінням – одним з основних компонентів розвитку ЦД. Надмірна кількість кортизолу гальмує транслокацію транспортерів глюкози GLUT4 до плазматичної мембрани клітин у відповідь на інсулін, що обмежує поглинання глюкози тканинами. Це спричиняє зниження чутливості до інсуліну і підвищення рівня глюкози у крові. Визначення кортизолу може бути одним з маркерів метаболічних порушень.
Revisiting the Samanid Mausoleum in Bukhara: A New Perspective on New Materials
Authors: Tosheva Dilrabo 
Published: October 2024

Abstract
This article revisits the Samanid mausoleum in Bukhara (circa tenth century, Uzbekistan) to shed new light on the historical context of this canonical monument of Islamic architecture. First, it documents the architectural properties of the Samanid mausoleum and integrates available archaeological and textual data, such as the site plan of the building, inscriptions, endowment deeds (waqf), and the recently discovered Khuttalon votive as a new prototype. These new sources allow one to sketch a more nuanced historical context that helps to better understand the mausoleum’s broader societal function, the tenth-century Bukharan patron’s intention in supporting this building’s construction, and his choice of style. It is argued that the building reflects the transitional nature of the period, before the “Persian Renaissance” under Nasr b. Ahmad (r. 914–43). Stylistic discussion suggests that it is simplistic to attribute this building to the influence of any single tradition. The Khuttalon votive challenges the Persian- and Sogdian-centered views that have dominated the study of the monument, pointing to the limitations of these perspectives.
Architecture of Triumph, Jihad, and Mediterranean Dialogue in the Alhambra: The House of Paintings and Its Mural, Part I
Authors: Akef Walid 
Published: October 2024

Abstract
On the western side of the palace of the Partal Bajo (Palace of the Portico or of the Summer Retreat), likely built by Muhammad III (r. 1302–9) and located within the palatine city of the Alhambra of Granada (Spain), stands a group of houses that, albeit formally connected, are structurally and chronologically distinct both to each other and to the palace. One of these is typologically unique, in relation to previous Andalusi residential architecture, and considered the smallest surviving Andalusi house. In 1908, outstanding figurative mural paintings were discovered on its second floor, conferring on it the name it still bears: the House of Paintings. This study consists of two articles, the first of which, in the present volume, examines the architecture of the House of Paintings and the history of its restorations, and offers a hypothesis for its original design.
The second article in this study (forthcoming in Muqarnas 41) addresses the exceptional figurative paintings on the second floor of the house, including historiographical matters, the history of their visual documentation until today, and the artistic techniques with which they were executed. After an iconographical and iconological analysis of these works, I briefly consider the hypotheses that have been offered regarding the artist responsible for them and their relation to the function of the house itself. I argue that the House of Paintings is an architectural translation of a royal military tent, probably meant to memorialize one of the most resounding victories in the history of the Andalusi jihad, when the Nasrid army defeated a Christian coalition at the Battle of the Vega in 1319 outside Granada, a battle likely visible from what would become known as the House of Paintings. In the mural paintings, this battle is depicted alongside other military and hunting scenes, where reality may be interwoven with allegory. This study thus situates representations of war within an old Mediterranean tradition that seems to have been revived during the Crusades, when Islamic jihad and Christian holy war ideologically confronted one another.
Representations of the Palace and Cityscape of Shahjahanabad in the Pādishāh-nāma (Book of the Emperor) of Shaykh Muhammad Waris, with Edited Persian Text and Translation by Wheeler M. Thackston
Authors: Khan Gulfishan 
Published: October 2024

Abstract
This paper seeks to describe a significant imperial project: the establishment of the city of Shahjahanbad and its monuments, laid out from 1639 onwards in the area of Delhi, as described in the Padishāh-nāma of Shaykh Muhammad Waris, an official historiographer of Emperor Shah Jahan, the fifth Indo-Timurid ruler of India. Waris emphatically connected the foundation of the city to the personal involvement of the emperor. The monumental fortress palace, Jama Masjid, Akbarabadi Mosque, and Fatehpuri Mosque, along with the royal bazaars formed the backbone of the urban master plan conceived and executed by the emperor with a team of dedicated experts knowledgeable in the art of building (kār agāhān-i-ʿimārat). In the founding of a new city, abundance of water and a temperate climate (muʿtadil hawā) were major criteria. The River Yamuna and the system of canals and reservoirs were always vital to the landscape of urban life in the Delhi area. The existing waterways were used and transformed through the laying out of formal gardens such as the Hayatbakhsh Garden, Jahanara Garden, and Shalimar Gardens into a sophisticated water system derived from Nahr-i Bihisht. The appendix contains selected passages from Shaykh Muhammad Waris’s Pādishāh-nāma, translated by Wheeler M. Thackston.
Remote Influence of Southern Tibetan Plateau Heating on North Pacific Atmospheric Rivers
Authors: Zhao Yang , Lu Mengqian , Zhang Lujia , Cheng Tat Fan 
Published: October 2024

Abstract
This study examines the remote influence of the Tibetan Plateau (TP) diabatic heating on atmospheric river (AR) activity in the North Pacific. First, we identify a sensitive heating region on the southern TP establishing a positive correlation between its heating and AR frequency. This correlation is attributed to latent heat release supported by a substantial moisture supply. Further analysis reveals that the dynamic effect of the eastward-propagating Rossby waves, originating from the Atlantic Ocean and modulated by the TP, facilitates upward moisture lifting. Using the Water Accounting Model-2Layers, we demonstrate that this anomalous heating is primarily due to increased moisture from the Indian Ocean, the Arabian Sea, and the Bay of Bengal, amplified by the westward extension of the western North Pacific subtropical high (WNPSH). Additional moisture contributions are observed from Eurasia. Moreover, Rossby wave activity over the TP propagates to the east of Japan, enhancing westerlies with upper-level divergence field which develops a cyclonic and anticyclonic vortex structure. This structure attracts abundant moisture to the North Pacific, thereby increasing AR activity. This study also highlights a positive feedback mechanism involving the southern TP heating and the eastward-propagating upper-level anticyclone, which enhance the western extension of the WNPSH. These findings underscore the global climatic impacts of the TP, emphasizing its role as a critical factor in AR dynamics across the North Pacific.

Significance Statement
This study explores the remote impact of the Tibetan Plateau (TP) heating on the atmospheric river (AR) in the North Pacific. Our findings indicate that southern TP heating resulting from remote moisture contribution, quantitatively assessed using Water Accounting Model-2Layers, coupled with the western extension of the western North Pacific subtropical high (WNPSH) and sea surface temperature warming anomaly as well as the eastward-propagating Rossby waves derived from the Atlantic Ocean, plays a crucial role in AR activity in the North Pacific. TP heating affects Rossby waves propagating east of Japan enhancing the westerlies and the easterlies. Moreover, the coupled divergence and cyclonic vortex structures attract more moisture toward the North Pacific fostering AR activity. Additionally, the interplay between southern TP heating and WNPSH builds a positive feedback mechanism.
Influence of deformation constraints of core cells on the bending stiffness of single-face honeycomb core sandwich
Authors: Ayanoglu Mustafa O , Carlsson Leif A 
Published: October 2024

This study is focused on the influence of core cell deformation constraints on the bending stiffness of honeycomb core sandwich with a single face sheet. Constraints on the deformation of core cell walls develop in sandwich structures due to bonding of the cell walls to rigid face sheets. The constraint prevents bending of flexible cell walls and the large transverse deformation of unconstrained honeycomb core under in-plane axial loading. Such constraints elevate the effective in-plane modulus of the core to a large extent. The bending stiffness of a single-face sandwich beam with a one-sided constrained core is approached using a gradient core modulus model implemented in laminate beam theory. The model includes two parameters, that is the factor of core modulus magnification and the size of the constrained region (decay length). The one-sided constraint is shown to greatly increase the bending stiffness. Single-face sandwich beam specimens with a honeycomb core were prepared and tested in flexure. Experimentally measured bending stiffness results verify that the core constraints significantly elevates the bending stiffness, by a factor close to four. The experimental results agree with the model for a constraint decay length of about 7 mm. The core constraints must be considered in fracture toughness analysis of ENF and MMB debond tests.
The ‘Missing Middle’: How to Provide 350 Million Indians with Health Coverage?
Authors: Mahal Ajay , Panwar Vivek , Tiwari Arun , Reddy Rahul , Kane Sumit 
Published: October 2024

Despite recent expansion in its population covered by public-funded insurance, a large section of India’s population remains at major financial risk from health shocks. This segment of the population, sometimes referred to as the ‘missing middle’, typically consists of population groups that are, or have been, engaged in informal sector work, and are not poor enough to be eligible for state-subsidised contributions to insurance premiums; and potentially includes many even among those who satisfy the eligibility criteria. We estimate that the missing middle number is at least 300–350 million in India, with large variations in their economic circumstances. Using extensive international and India-based evidence, we assess two approaches to cover the missing middle: an expansion in public sector health delivery and a contributory demand-side financing system, that is currently popular in India. We conclude that a mix of the two approaches appears to be the most feasible in the short run, given limited regulatory and management capacity and resource constraints, with a longer-run emphasis on integrated systems. The approach proposed in the paper is also likely to help address the problem of shallow coverage of existing health insurance coverage that concerns large numbers of people extending beyond the group comprising the missing middle. JEL codes: I13, I14, I18