bluuebunny/crossref_metadata_2025_split huggingface dataset:
Detection of malignant lesions in cytologically indeterminate thyroid nodules using a dual-layer spectral detector CT-clinical nomogram
Authors: Ren Xiaofang , Zhang Jiayan , Song Zuhua , Li Qian , Zhang Dan , Li Xiaojiao , Yu Jiayi , Li Zongwen , Wen Youjia , Zeng Dan , Zhang Xiaodi , Tang Zhuoyue 
Published: May 2024

PurposeTo evaluate the capability of dual-layer detector spectral CT (DLCT) quantitative parameters in conjunction with clinical variables to detect malignant lesions in cytologically indeterminate thyroid nodules (TNs).Materials and methodsData from 107 patients with cytologically indeterminate TNs who underwent DLCT scans were retrospectively reviewed and randomly divided into training and validation sets (7:3 ratio). DLCT quantitative parameters (iodine concentration (IC), NICP (IC nodule/IC thyroid parenchyma), NICA (IC nodule/IC ipsilateral carotid artery), attenuation on the slope of spectral HU curve and effective atomic number), along with clinical variables, were compared between benign and malignant cohorts through univariate analysis. Multivariable logistic regression analysis was employed to identify independent predictors which were used to construct the clinical model, DLCT model, and combined model. A nomogram was formulated based on optimal performing model, and its performance was assessed using receiver operating characteristic curve, calibration curve, and decision curve analysis. The nomogram was subsequently tested in the validation set.ResultsIndependent predictors associated with malignant TNs with indeterminate cytology included NICP in the arterial phase, Hashimoto’s Thyroiditis (HT), and BRAF V600E (all p &lt; 0.05). The DLCT-clinical nomogram, incorporating the aforementioned variables, exhibited superior performance than the clinical model or DLCT model in both training set (AUC: 0.875 vs 0.792 vs 0.824) and validation set (AUC: 0.874 vs 0.792 vs 0.779). The DLCT-clinical nomogram demonstrated satisfactory calibration and clinical utility in both training set and validation set.ConclusionThe DLCT-clinical nomogram emerges as an effective tool to detect malignant lesions in cytologically indeterminate TNs.
Pediatric schwannoma of the hypoglossal nerve: a case report and narrative literature overview
Authors: Marcandella Elena Sofia , Boscarelli Alessandro , Murru Flora-Maria , Abbracciavento Giuseppe , Spazzapan Peter , Schleef Jurgen 
Published: May 2024

Schwannomas are benign, slow-growing tumors originating from the Schwann cells of nerve sheaths. Extracranial schwannomas are rare, particularly in pediatric populations. Here, we report the case of a hypoglossal schwannoma in a 15-year-old male who experienced tongue paresthesia and fasciculations and difficulty swallowing two years before hospital admission. Magnetic resonance imaging showed an oval mass with sharp and regular limits of approximately 45 × 29 × 25 mm in the cranial portion of the right carotid adipose space, caudal to the right carotid and lateral foramen. The patient underwent surgery, and a histological examination confirmed a schwannoma of the hypoglossal nerve. Six months after surgery, the patient was symptom-free. The literature on schwannomas of the hypoglossal nerve is scarce, with only a few previously reported cases in the adult population. Despite their rarity, schwannomas should be considered in the differential diagnosis of masses located in the neck that present with lingual and occasionally auditory symptoms, even in pediatric patients. Surgical resection is recommended and has a low risk of long-term recurrence.
Protective effect of dexmedetomidine against delayed bone healing caused by morphine via PI3K/Akt mediated Nrf2 antioxidant defense system
Authors: Lou Yani , Zou Linfang , Shen Zhenyu , Zheng Jianwei , Lin Yuanqu , Zhang Zhe , Chen XuanKuai , Pan Jun , Zhang Xutong 
Published: May 2024

BackgroundAs a class of analgesics, opioids are frequently used to treat both acute and chronic moderate to severe pain. Patients frequently receive opioid painkillers after orthopedic accidents or surgeries. Evidence suggests that opioid drug users have a 55.1% higher risk of fracture and poor bone repair than non-users of opioid drugs. The key pathogenic alterations in the incidence and progression of poor bone repair are over apoptosis and aging of osteoblasts due to the stress caused by oxidation. Dexmedetomidine (Dex) has been proven to protect against a variety of degenerative illnesses by reducing oxidative stress. However, nothing is known about how it affects bone repair.MethodsPI3K/Akt/Nrf2 pathway was detected by immunofluorescence and Western blot. SOD, CAT, JC-1, dihydroethidium and mitosox were used in the Oxidative Stress. Micro-CT, H&amp;E and Masson’s staining, immunohistochemically were performed to evaluate the therapeutic effects of DEX on calvarial defects in the morphine-induced rat model.ResultsWe found that morphine-induced an imbalance in the metabolism and catabolism of primary rat Osteoblasts. However, these conditions could be inhibited by DEX treatment. In the meantime, DEX induced the expression of Nrf2-regulated antioxidant enzymes such as NQO1, HO-1, GCLm, GCLc, and TrxR1. DEX-mediated Nrf2 activation is linked to the PI3K/Akt signaling system. Furthermore, it has been established that intravenous DEX enhanced the growth of bone healing in a model of a surgically produced rat cranial lesion.ConclusionThis is the first description of the unique DEX mechanism acting as a Nrf2 activator against morphine-mediated oxidative harm, raising the possibility that the substance may be used to prevent bone defects.
Comprehensive analysis of the Spartina alterniflora WD40 gene family reveals the regulatory role of SaTTG1 in plant development
Authors: Yang Maogeng , Chen Shoukun , Geng Jiahui , Gao Shuqiang , Chen Shihua , Li Huihui 
Published: May 2024

IntroductionThe WD40 gene family, prevalent in eukaryotes, assumes diverse roles in cellular processes. Spartina alterniflora, a halophyte with exceptional salt tolerance, flood tolerance, reproduction, and diffusion ability, offers great potential for industrial applications and crop breeding analysis. The exploration of growth and development-related genes in this species offers immense potential for enhancing crop yield and environmental adaptability, particularly in industrialized plantations. However, the understanding of their role in regulating plant growth and development remains limited.MethodsIn this study, we conducted a comprehensive analysis of WD40 genes in S. alterniflora at the whole-genome level, delving into their characteristics such as physicochemical properties, phylogenetic relationships, gene architecture, and expression patterns. Additionally, we cloned the TTG1 gene, a gene in plant growth and development across diverse species.ResultsWe identified a total of 582 WD40 proteins in the S. alterniflora genome, exhibiting an uneven distribution across chromosomes. Through phylogenetic analysis, we categorized the 582 SaWD40 proteins into 12 distinct clades. Examining the duplication patterns of SaWD40 genes, we observed a predominant role of segmental duplication in their expansion. A substantial proportion of SaWD40 gene duplication pairs underwent purifying selection through evolution. To explore the functional aspects, we selected SaTTG1, a homolog of Arabidopsis TTG1, for overexpression in Arabidopsis. Subcellular localization analysis revealed that the SaTTG1 protein localized in the nucleus and plasma membrane, exhibiting transcriptional activation in yeast cells. The overexpression of SaTTG1 in Arabidopsis resulted in early flowering and increased seed size.DiscussionThese outcomes significantly contribute to our understanding of WD40 gene functions in halophyte species. The findings not only serve as a valuable foundation for further investigations into WD40 genes in halophyte but also offer insights into the molecular mechanisms governing plant development, offering potential avenues in molecular breeding.
Pattern transitions in diary data of MDD patients: a mixed-methods multiple case study of psychotherapy dynamics
Authors: Nordholt Sontje , Garrison Philipp , Aichhorn Wolfgang , Ochs Matthias , Schiepek Günter 
Published: May 2024

AimMixed-methods approaches promise a deep understanding of psychotherapeutic processes. This study uses qualitative and quantitative data from daily diary entries and daily self-assessments during inpatient treatment. The aim of the study is to get an insight into the similarities and differences between both types of data and how they represent self-organized pattern transitions in psychotherapy. While a complete correlation of results is not expected, we anticipate observing amplifying and subsidiary patterns from both perspectives.Materials and methodsDaily, five MDD patients wrote diaries and completed self-assessments using the Therapy Process Questionnaire, a questionnaire for monitoring the change dynamics of psychotherapy. The data were collected using the Synergetic Navigation System, an online tool for real-time monitoring. Diary entries of the patients described their experiences in everyday life. The qualitative text analysis was conducted using Mixed Grounded Theory, which provided categories representing the patients’ ongoing experiences of transformation and stagnation. The time series data was analyzed using the dynamic complexity algorithm and the pattern transition detection algorithm. Results from qualitative and quantitative analyses were combined and compared. Following the process of data triangulation, the leading perspective came from the theory of self-organization. In addition to presenting the overall results for all five patients, we delve into two specific case examples in greater detail.ResultsSpecific and highly diversified diary entries of 5 patients were classified into the categories of perceived pattern stability, noticing improvement, broadening the perspective, critical instability, and experiencing moments of Kairos. Patients reported problems not only related to their disorder (e.g., lack of energy and hopelessness) but also to phases and steps of change, which could be related to the theory of self-organization (e.g., problem attractors, critical fluctuations, pattern transitions, and Kairos). Qualitative and quantitative analysis provide important supplementary results without being redundant or identical.ConclusionData triangulation allows for a comprehensive and multi-perspective understanding of therapeutic change dynamics. The different topics expressed in the diary entries especially help to follow micro-psychological processes, which are far from being a simple reaction to interventions. The way patients experience themselves being in stability or instability and stagnation or transformation is surprisingly close to the general features of self-organizing processes in complex systems.
Machine learning models for assessing risk factors affecting health care costs: 12-month exercise-based cardiac rehabilitation
Authors: Hautala Arto J. , Shavazipour Babooshka , Afsar Bekir , Tulppo Mikko P. , Miettinen Kaisa 
Published: May 2024

IntroductionExercise-based cardiac rehabilitation (ECR) has proven to be effective and cost-effective dominant treatment option in health care. However, the contribution of well-known risk factors for prognosis of coronary artery disease (CAD) to predict health care costs is not well recognized. Since machine learning (ML) applications are rapidly giving new opportunities to assist health care professionals’ work, we used selected ML tools to assess the predictive value of defined risk factors for health care costs during 12-month ECR in patients with CAD.MethodsThe data for analysis was available from a total of 71 patients referred to Oulu University Hospital, Finland, due to an acute coronary syndrome (ACS) event (75% men, age 61 ± 12 years, BMI 27 ± 4 kg/m2, ejection fraction 62 ± 8, 89% have beta-blocker medication). Risk factors were assessed at the hospital immediately after the cardiac event, and health care costs for all reasons were collected from patient registers over a year. ECR was programmed in accordance with international guidelines. Risk analysis algorithms (cross-decomposition algorithms) were employed to rank risk factors based on variances in their effects. Regression analysis was used to determine the accounting value of risk factors by entering first the risk factor with the highest degree of explanation into the model. After that, the next most potent risk factor explaining costs was added to the model one by one (13 forecast models in total).ResultsThe ECR group used health care services during the year at an average of 1,624 ± 2,139€ per patient. Diabetes exhibited the strongest correlation with health care expenses (r = 0.406), accounting for 16% of the total costs (p &lt; 0.001). When the next two ranked markers (body mass index; r = 0.171 and systolic blood pressure; r = − 0.162, respectively) were added to the model, the predictive value was 18% for the costs (p = 0.004). The depression scale had the weakest independent explanation rate of all 13 risk factors (explanation value 0.1%, r = 0.029, p = 0.811).DiscussionPresence of diabetes is the primary reason forecasting health care costs in 12-month ECR intervention among ACS patients. The ML tools may help decision-making when planning the optimal allocation of health care resources.
The relationship between health behaviors and quality of life: the mediating roles of activities of daily living and psychological distress
Authors: Wu Yuhang , Xu Jianqiang , Gao Yang , Zheng Juan 
Published: May 2024

ObjectiveThe aim of this study is to examine the role of activities of daily living performance (ADLs) and psychological distress in mediating the process by which health behaviors affect QOL.MethodsA non-probabilistic study was conducted among 1,065 older adult people older than 60 years. Participants were assessed using the Barthel Index, Functional Activities Questionnaire (FAQ), Kessler Psychological Distress Scale (K10), Australian Active Survey, and EQ-VAS score. The SPSS22.0 software was used to analyze the differences in QOL scores among older adults with different demographic characteristics. Pearson correlation analysis was used to analyze the correlation between health behaviors, psychological distress, ADLs, and QOL. Amos23.0 software was used to construct structural equation model (SEM) to analyze the path of health behavior affecting QOL and the mediating role of BADLs, IADLs and psychological distress.Results(1) The direct effect of health behaviors on QOL was not significant in the model; (2) ADLs had multiple mediating effects on the relationship between health behaviors and QOL, and the incidence of ADL limitation was negatively correlated with the reported QOL in the older adult; (3) Psychological distress had a significant mediating effect on the relationship between health behaviors and QOL.ConclusionThe results of this study elucidated the mechanisms of the correlation between health behaviors and QOL, and added to the existing literature. In addition, these mediating factors and indirect pathways have been identified as targets for intervention to improve the QOL of older adult individuals, which is important for achieving healthy aging.
How patients experience discussing couple relationship problems with GPs: an interview study
Authors: Berge Siri Dalsmo , Brekke Mette , Meland Eivind , Mildestvedt Thomas 
Published: May 2024

Background
Couple relationship satisfaction is related to good physical health, good mental health, and longevity. Many patients have discussed or wish to discuss their couple relationship with their GP and look for personalised care and support when discussing topics they perceive as sensitive.

Aim
To explore patient experiences of discussing couple relationship problems in GP consultations.

Design & setting
Qualitative study employing semi-structured interviews with patients from general practice in Norway.

Method
Individual interviews with 18 patients who had discussed their couple relationship with their GP. Participants were recruited through both social media and traditional media, and all interviews were digitally recorded. The purposive sample comprised 13 women and five men, representing diverse age groups, backgrounds, and relationship problems. All participants identified as heterosexual. We analysed interview data thematically using systematic text condensation.

Results
Three main themes emerged: 1) GPs in a facilitating role, not on an assembly line; 2) navigating the 'elephant in the room'; and 3) GPs as biomedically competent life witnesses. GP continuity was vital in fostering the trust required to discuss sensitive topics, such as relationship issues. Participants valued a biopsychosocial approach that incorporated knowledge of close relationships into medical consultations. They appreciated both GP support and constructive challenges that prompted them to take responsibility for relationship improvements.

Conclusion
Patients value their GPs’ holistic, supportive, and direct approach in addressing couple relationship problems, although they perceive that GPs do not always have sufficient time. They welcome relevant challenges that can drive positive change.
Análise de danos e impactos ambientais por meio de rede de interação em colheita florestal / Analysis of environmental damage and impacts through forest harvest interaction network
Authors: Albuquerque Ferraz Camila Porfirio , Ribeiro Admilson Írio , Da Silva Manoel Marcia Pereira , Sperandio Fabricio Camillo , Fengler Felipe Hashimoto 
Published: May 2024

O aumento na produtividade do setor florestal, bem como maior demanda por produtos e mão de obra, contribuiu de maneira significativa para o desenvolvimento e a necessidade da mecanização na silvicultura. Nesse processo, a colheita florestal foi modificada devido a inserção de máquinas florestais como tratores para corte e extração de madeira. A escolha do sistema de colheita deve levar em consideração diferentes fatores para sucesso e equilíbrio na produtividade. A falta de consideração de alguma das variáveis em problemas operacionais e ineficiência do processo, como por exemplo, a fragilização de ecossistemas bem com os danos e impactos ambientais adversos podem comprometer a sustentabilidade da atividade. O presente estudo teve como objetivo, avaliar impactos e danos ambientais em operações de colheita florestal (em plantios comerciais com interface de áreas de conservação - Mata Atlântica e Cerrado). Para tanto, foi aplicada a metodologia redes de interações. O método utilizado demonstrou interação de parâmetros em diferentes desdobramentos interativos que possibilitaram a análise de critérios qualitativos e a visualização geométrica dos danos e impactos envolvidos. Desta forma, tornou-se possível avaliar quais destes parâmetros necessitam destaque para a priorização na gestão ambiental da atividade. Palavras-chave: avaliação de impacto ambiental, colheita florestal, silvicultura, impactos ambientais da colheita florestal. ABSTRACTIncreased productivity in the forest sector, as well as increased demand for products and labor, have significantly contributed to the development and need for mechanization in forestry. In this process, the forest harvest was modified due to the insertion of forest machines as tractors for logging. The choice of harvesting system must take into account different factors for success and balance in productivity. The lack of consideration of any of the variables in operational problems and process inefficiencies, such as the fragility of ecosystems as well as the damage and adverse environmental impacts may compromise the sustainability of the activity. This study aimed to evaluate environmental impacts and damages in forest harvesting operations (in commercial plantations with interface of conservation areas - Atlantic Forest and Cerrado). To this end, the interaction networks methodology was applied. The method used demonstrated interaction of parameters in different interactive developments that allowed the analysis of qualitative criteria and the geometric visualization of the damages and impacts involved. Thus, it became possible to evaluate which of these parameters need to be emphasized for prioritizing the environmental management of the activity.
THE FUNCTIONAL POSITION IN THE INDONESIAN NATIONAL POLICE
Authors: Setyawan Nugroho Ari , Purnomo Joko Agung , Pranata Andi Yudha , Prasetyo Dedy 
Published: May 2024

This paper describes the implementation of functional position conception by the INP. The literature discussing the concept in specific and near terms is investigated. The functional position is widely discussed in the Indonesian literature. However, the direct term (the functional position) is hardly found in Western literature. The near term is the professional. The term discussion is associated with changing from a hierarchical to a flat and agile organisation. The flat and agile structure facilitates the work of cross-functional project teams (CFTs) and professionals.
Moreover, the flat and agile structure means fewer managers, enlarging the professionals' roles. However, the police of some countries have not yet streamlined their structures to flat and agile organisations (including the Indonesian National Police [INP]).Â
This study is conducted through a literature review and document analysis. The global literature is reviewed narratively to explore the functional position concept. Subsequently, the functional position application in the INP is studied from the act, regulations and other documents.Â
The INP has developed various functional positions within the organisation since the inception of the Police Act 2002. Besides, the INP develops supporting elements for functional positions. The INP's units, officers, and CFTs may be more capable of handling policing problems by applying for the functional position initiative.Â Â
This study introduces the concept of the functional position of the INP to the global literature. The concept may be studied further to understand its mechanism and effectiveness in improving policing.
البدايات الأولـــى لنشـــوء الشــعر الأندلسـي
Authors: لؤي صيهود فواز  , هالة بدري داوود  
Published: May 2024

الشخصية الأندلسية وعوامل ظهورها:
ظهرت الشخصية الأندلسـية ونمت وترعرت بعـد أن استقر العـرب في الأندلس واندمجوا في المجتمع الجديد فقـد فتح العـرب الأندلس سـنة ( 92هـ ) ، وقد تعـرض النشاط الفكري في الأندلس عامة والأدبي خاصة في انتهاء القرنين الأول والثاني إلى تأثيرين أسـاسـيين هما :-
الظروف المحلية التي أحاطت بالعـرب في الأندلس ، والتأثير المشرقي .
Study the effect of oxazepine derivatives of alkaline phosphatase in normal persons sera
Authors: Azhar Abbas Ismael Al –mulla.  
Published: May 2024

تم دراسة تأثير مركب 2 ( p-toyl) 3 – (2- traizole ) -2,3 dihydro {1,3} – oxazepine – 4,7 dione
وهو من مشتقات مركب oxazepine في فعالية انزيم الفوسفاتيز القاعدي في مصول الاشخاص الاصحاء مختبريا .
اعطى مشتق oxazepine نسبة تثبيط بين (22.5 - 69) % .
3
درس نوع التثبيط من خلال تثبيت تركيز الماده العضوية وتغير تركيز الماده الاساس m mol/L (10¯3 × 6 10¯3 ×7 , 10¯3 × 8, 10¯3 ×9 , 10¯3 × 10)

وعند رسم معادلة line weaver – burk plot وجد ان التثبيط من نوع تنافسي حيث بقيت السرعه القصوى vmax ثابتة بمقدار U/L 6.66 بينما حصل تغير في قيمة ثابت السرعه لمايكل Km وقد كان للتفاعل بدون وجود المثبط mol/L m 10 m mol/L بينما في حالة وجوده mol/L m 9 .
تحضير مشتقات جديدة من 1,3 oxazepine 4-7 dion من المتوقع ان تكون لها فعالية بايولوجية في معالجة التشنجات العصبية .
توظيف الحقائب التعليمية كوسيلة لتعزيز المناهج الدراسية في الكليات االنسانية
Authors: م.م بشرى فاضل زبون  
Published: May 2024

يشهد العالم تنافس تعليمي حيث تسعى الدول المتقدمة من خلاله الى وضع التعليم في اولى اهتماماتها جراء التسارع لمواكبة التطورات الهائلة في المناهج التربوية وضمنها الوسائل التعليمية المعاصرة ولعل الحقائب التعليمية احدى هذة الوسائل المساعدة في الوصول الى تحقيق الاهداف التربوية .