bluuebunny/crossref_metadata_2025_split huggingface dataset:
Students’ technological skills and attitudes toward HyFlex learning: the mediating role of online self-regulated learning, blended learning perception, and preferred learning modes
Authors: Amiruddin Amiruddin , Sunardi Sunardi , Setialaksana Wirawan 
Published: January 2024

IntroductionHyFlex learning has been used and researched in colleges in developing countries. The main challenges in HyFlex adaptation in college are technology related variables. However, the investigations about HyFlex and the factors affect it were limited.MethodsThe current study aims to explore student technological skills effect on their attitudes toward HyFlex learning using 738 Indonesian college students. The mediating role of online self-regulated learning (SRL), perceptions on blended learning, and student’s preferred learning modes were also investigated. The relationship between variables were analyzed using structural equation modelling with partial least square parameter estimations (PLS-SEM).ResultsResults of structural equation modeling analysis show that student technological skills have significant effect on their attitude toward HyFlex learning. Mediation analysis revealed that student technological skills have indirect significant effect on their attitude toward HyFlex learning, i.e., online self-regulated learning, perceptions on blended learning, and online asynchronous and face to face learning preference partially mediated the effect of student technological skills on their attitude toward HyFlex learning. PLS-SEM conducted also shows that student technological skills have direct effect on their online self-regulated learning and perceptions on blended learning. Online self-regulated learning and perceptions on blended learning were also shown to have direct effect on student’s attitude toward HyFlex learning.DiscussionBy comprehending the factors that influence student attitudes towards HyFlex learning, educators and policymakers can endeavor to create a more conducive environment that enhances students’ motivation and engagement in this flexible learning approach.
Endocrine and metabolic factors and the risk of idiopathic pulmonary fibrosis: a Mendelian randomization study
Authors: Jiang Yan , Chen Rumeng , Xu Shuling , Ding Yining , Zhang Mengling , Bao Meihua , He Binsheng , Li Sen 
Published: January 2024

BackgroundPrevious observational studies have investigated the association between endocrine and metabolic factors and idiopathic pulmonary fibrosis (IPF), yet have produced inconsistent results. Therefore, it is imperative to employ the Mendelian randomization (MR) analysis method to conduct a more comprehensive investigation into the impact of endocrine and metabolic factors on IPF.MethodsThe instrumental variables (IVs) for 53 endocrine and metabolic factors were sourced from publicly accessible genome-wide association study (GWAS) databases, with GWAS summary statistics pertaining to IPF employed as the dependent variables. Causal inference analysis encompassed the utilization of three methods: inverse-variance weighted (IVW), weighted median (WM), and MR-Egger. Sensitivity analysis incorporated the implementation of MR-PRESSO and leave-one-out techniques to identify potential pleiotropy and outliers. The presence of horizontal pleiotropy and heterogeneity was evaluated through the MR-Egger intercept and Cochran’s Q statistic, respectively.ResultsThe IVW method results reveal correlations between 11 traits and IPF. After correcting for multiple comparisons, seven traits remain statistically significant. These factors include: “Weight” (OR= 1.44; 95% CI: 1.16, 1.78; P=8.71×10-4), “Body mass index (BMI)” (OR= 1.35; 95% CI: 1.13, 1.62; P=1×10-3), “Whole body fat mass” (OR= 1.40; 95% CI: 1.14, 1.74; P=1.72×10-3), “Waist circumference (WC)” (OR= 1.54; 95% CI: 1.16, 2.05; P=3.08×10-3), “Trunk fat mass (TFM)” (OR=1.35; 95% CI: 1.10,1.65; P=3.45×10-3), “Body fat percentage (BFP)” (OR= 1.55; 95% CI: 1.15,2.08; P=3.86×10-3), “Apoliprotein B (ApoB)” (OR= 0.78; 95% CI: 0.65,0.93; P=5.47×10-3). Additionally, the sensitivity analysis results confirmed the reliability of the MR results.ConclusionThe present study identified causal relationships between seven traits and IPF. Specifically, ApoB exhibited a negative impact on IPF, while the remaining six factors demonstrated a positive impact. These findings offer novel insights into the underlying etiopathological mechanisms associated with IPF.
A family case report of parathyroid carcinoma associated with CDC73 mutation in hyperparathyroidism-jaw tumor syndrome
Authors: Gu Yian , Ye Yuanyuan , Shu Hua , Chang Lina , Xie Yinghui , Li Fengao , Zhu Tiehong , Liu Ming , He Qing 
Published: January 2024

BackgroundHereditary primary hyperparathyroidism (PHPT) accounts for 5-10% of all PHPT cases, necessitating genetic testing for diagnosis and management. Among these, hyperparathyroidism-jaw tumor syndrome (HPT-JT) is an autosomal dominant disorder caused by CDC73 mutations with variable clinical presentations and incomplete symptoms.Case summaryThe proband, diagnosed with PHPT, underwent parathyroidectomy at the age of 41 with pathological examination of parathyroid carcinoma (PC). Hereditary PHPT was initially suspected due to the early-onset PHPT and family history. Genetic testing identified a heterozygous CDC73 mutation, NM_024529.4: c. 687_688delAG (p. Arg229Serfs*37). Even in the absence of jaw tumors, the diagnosis of HPT-JT was confirmed based on the discovery of renal cysts. A secondary thyroidectomy was performed to reduce the risk of recurrence.ConclusionGenetic testing is strongly recommended in cases of early-onset PHPT, family history, jaw tumors, renal and uterine involvement, atypical parathyroid tumors, and PC. This testing provides valuable information for personalized management, and counseling is available for affected families.
Relationship between bisphenol A and autoimmune thyroid disease in women of childbearing age
Authors: Yuan Ning , Sun Jianbin , Zhao Xin , Li Wei 
Published: January 2024

BackgroundAutoimmune thyroid disease (AITD) is the main cause of hypothyroidism in women of childbearing age. Bisphenol A (BPA) is an environmental factor affecting AITD. This study aims to investigate relationship between BPA and AITD in women of childbearing age, thereby contributing novel evidence for the prevention of hypothyroidism in this specific demographic.MethodsA total of 155 women of childbearing age were enrolled in this study, including the euthyroid group comprised 60 women with euthyroidism and thyroid autoantibodies negativity and the AITD group consisted of 95 women with euthyroidism and at least one thyroid autoantibody positivity. The general information, thyroid function, thyroid autoantibodies, and thyroid ultrasound results of the two groups of women of childbearing age were recorded. Urinary BPA and urinary BPA/creatinine were detected. The difference of BPA levels between the two groups was compared. logistic regression was used to analyze the correlation between BPA and AITD.ResultsThe proportion of multiparous and serum thyroid stimulating hormone levels were significantly higher in the AITD group compared to the euthyroid group. Logistic regression analysis revealed that BPA levels did not exhibit a statistically significant association with AITD. Spearman correlation analysis revealed a statistically significant correlation between BPA and urinary iodine levels (r=0.30, P &lt; 0.05), as well as a correlation between urinary BPA and free tetraiodothyronine (FT4) levels (r=0.29, P &lt; 0.05).ConclusionThis study revealed a correlation between urinary BPA levels and FT4 levels. However, it did not establish a relationship between BPA and AITD in women of childbearing age.
Coordinated development of rural ecological construction and carbon neutrality: a deep learning approach for enhanced sustainability
Authors: Li Tong , Feng LiangXing 
Published: January 2024

IntroductionIn recent years, the world has faced increasingly severe climate change and ecological environmental problems. As an important part of the ecological system, rural areas also face many challenges. Rural ecological construction and carbon neutrality, as a solution, have attracted widespread attention. However, achieving the coordinated development of rural ecological construction and carbon neutrality requires more in-depth research and effective methods.MethodsThis study aims to explore how to promote the coordinated development of rural ecological construction and carbon neutrality through the combination of a Transformer-RNN model and cross-attention mechanism. We propose a deep learning framework that combines the parallelism and global dependency capturing capabilities of the Transformer model with the temporal information handling capabilities of the RNN model. By integrating these two models, we leverage their respective strengths to improve the performance of the model. Furthermore, we introduce a cross-attention mechanism that enables the model to simultaneously focus on the relationship between rural ecological construction and carbon neutrality. Through cross-attention, the model accurately captures the impact of rural ecological construction measures on carbon neutrality and the feedback effect of carbon neutrality on the rural ecological environment. In our experiments, we collected relevant data on rural ecological construction and carbon neutrality, including environmental indicators, socio-economic factors, land use patterns, energy consumption, and carbon emissions.Results and discussionWe preprocess the data and train the combined Transformer-RNN model with the cross-attention mechanism. The trained model demonstrates promising results in capturing the complex dependencies and relationships between rural ecological construction and carbon neutrality. The significance of this study lies in deepening the understanding of the coordinated development relationship between rural ecological construction and carbon neutrality and providing a novel deep learning-based method to solve related problems. By introducing the Transformer-RNN model with a cross-attention mechanism, we provide decision-makers with more scientific and accurate decision support, promoting the improvement of the rural ecological environment and the achievement of carbon neutrality goals.
The impact of pulmonary artery to ascending aorta diameter ratio progression on the prognosis of NSCLC patients treated with immune checkpoint inhibitors
Authors: Gong Bingxin , Li Yi , Guo Yusheng , Wang Jing , Liu Weiwei , Zhou Guofeng , Song Jiyu , Pan Feng , Yang Lian , Liang Bo 
Published: January 2024

BackgroundImmunotherapy, represented by immune checkpoint inhibitors (ICIs), is a major breakthrough in cancer treatment. Studies have reported that the use of ICIs is associated with an increase in the pulmonary artery to ascending aorta diameter (PAD/AoD) ratio. However, the impact of PAD/AoD ratio progression on the prognosis of patients is unclear.MethodsThis retrospective cohort study included patients with stage III or IV non-small cell lung cancer (NSCLC) treated with ICIs at the Wuhan Union Hospital between March 1, 2020, and September 1, 2022. The baseline and post-treatment PAD/AoD ratios of patients were evaluated through chest CT scans. The primary outcome of this study was overall survival (OS), while the secondary outcomes included progression-free survival (PFS), objective response rate (ORR) and disease control rate (DCR).ResultsThe PAD/AoD ratio increased after the initiation of ICIs (from 0.75 to 0.78; P &lt; 0.001). A total of 441 patients were divided into severe group (n=221) and non-severe group (n=220) according to the median increase of PAD/AoD ratio (1.06). Compared with the non-severe group, the severe group had a lower DCR (87.8% vs. 96.0%, P = 0.005) and ORR (87.5% vs. 96.0%, P = 0.063). Over the entire duration of follow-up (median 22.0 months), 85 (38.5%) patients in the severe group and 30 (7.3%) patients in the non-severe group died. An increased PAD/AoD ratio was associated with shorter PFS (Hazard ratio (HR): 1.48 [95% CI, 1.14 to 1.93]; P = 0.003) and OS (HR: 3.50 [95% CI, 2.30 to 5.30]; P &lt; 0.001). Similar results were obtained across subgroups.ConclusionsICI treatment exacerbates an increase in the PAD/AoD ratio in patients with cancer, and greater increase in the PAD/AoD ratio was associated with a worse prognosis. PAD/AoD ratio could be a biomarker to stratify prognosis of NSCLC patients treated with ICIs.
Quantitative assessment of retinal vasculature changes in systemic lupus erythematosus using wide-field OCTA and the correlation with disease activity
Authors: Meng Lihui , Chen Lulu , Zhang Chenxi , Chen Huan , Yang Jingyuan , Wang Yuelin , Zhang Wenfei , Cheng Shiyu , Zhao Qing , Zhao Xinyu , Chen Youxin 
Published: January 2024

PurposeTo assess the retinal vasculature changes quantitatively using wide-field optical coherence tomography angiography (OCTA) in systemic lupus erythematosus (SLE), and explore its correlation with systemic clinical features.DesignProspective, cross-sectional, observational study.Participants and controlsPatients with SLE who presented to the Ophthalmology Department of Peking Union Medical College Hospital from November 2022 to April 2023 were collected. The subjects were divided into retinopathy and without retinopathy groups. Age and gender-matched healthy subjects were selected as controls.MethodsPatients with SLE and control subjects were imaged with 24×20 mm OCTA scans centered on the fovea and 6×6 mm OCTA scans centered on the optic disc. The sub-layers of OCTA images were stratified by the built-in software of the device and then the retinal thickness and vessel density were measured automatically. The characteristics of retinal OCTA parameters of SLE and its correlation with systemic clinical indicators of patients without retinopathy were analyzed.Main outcome measuresOCTA parameters, visual acuity, intraocular pressure, and systemic clinical indicators of patients such as disease activity index, autoimmune antibodies, and inflammatory marker levels were collected.ResultsA total of 102 SLE patients were included, 24 of which had retinopathy, and 78 had unaffected retina. Wide-field OCTA could effectively detect retinal vascular obstruction, non-perfusion area, and morphological abnormalities in patients with lupus retinopathy. SLE patients without retinopathy had significantly higher retinal superficial vessel density (SVD) in foveal (P=0.02), para-foveal temporal (P=0.01), nasal (P=0.01), peripheral foveal temporal (P=0.02), and inferior areas (P=0.02), as well as subregion temporal (P=0.01) and inferior areas (P=0.03) when compared with healthy controls (n=65 eyes from 65 participants). The area under curve (AUC) value of subregion inferior SVD combined parafoveal temporal SVD was up to 0.70. There was a significantly positive correlation between SVD and disease activity in SLE without retinopathy group. Patients with severe activity had the most significant increase in SVD.ConclusionWide-field OCTA can provide a relatively comprehensive assessment of the retinal vasculature in SLE. In the absence of pathological changes of the retina, the SVD was significantly increased and was positively correlated with the disease activity of SLE.
Hypervirulent clonal complex (CC) of Listeria monocytogenes in fresh produce from urban communities
Authors: Amarasekara Nirosha Ruwani , Swamy Amrita Subramanya , Paudel Sumit Kumar , Jiang Wentao , Li KaWang , Shen Cangliang , Zhang Yifan 
Published: January 2024

IntroductionThis study aimed to determine the prevalence and virulome of Listeria in fresh produce distributed in urban communities.MethodsA total of 432 fresh produce samples were collected from farmer’s markets in Michigan and West Virginia, USA, resulting in 109 pooled samples. Listeria spp. were isolated and L. monocytogenes was subjected to genoserogrouping by PCR and genotyping by pulsed-field gel electrophoresis (PFGE). Multi-locus sequence typing (MLST) and core-genome multi-locus sequence typing (cgMLST) were conducted for clonal identification.ResultsForty-eight of 109 samples (44.0%) were contaminated with Listeria spp. L. monocytogenes serotype 1/2a and 4b were recovered from radishes, potatoes, and romaine lettuce. Four clonal complexes (CC) were identified and included hypervirulent CC1 (ST1) and CC4 (ST219) of lineage I as well as CC7 (ST7) and CC11 (ST451) of lineage II. Clones CC4 and CC7 were present in the same romaine lettuce sample. CC1 carried Listeria pathogenicity island LIPI-1 and LIPI-3 whereas CC4 contained LIPI-1, LIPI-3, and LIPI-4. CC7 and CC11 had LIPI-1 only.DiscussionDue to previous implication in outbreaks, L. monocytogenes hypervirulent clones in fresh produce pose a public health concern in urban communities.
Study protocol of a double-blind randomized control trial of transcranial direct current stimulation in post-stroke fatigue
Authors: Tang Wai Kwong , Lu Hanna , Leung Thomas Wai Hong , Kim Jong S. , Fong Kenneth Nai Kuen 
Published: January 2024

RationalePost-stroke fatigue (PSF) is a frequent problem in stroke survivors and often hinders their rehabilitation. PSF is difficult to treat, and pharmacological therapy is often ineffective. Transcranial direct current stimulation (tDCS) can modulate motor, sensory, cognitive and behavioral responses, as it alters neuronal activity by delivering a small amount of current via the scalp to the cortex, resulting in prolonged alterations to brain function. tDCS has been studied for the treatment of fatigue associated with other neurological diseases, namely, multiple sclerosis, Parkinson’s disease and post-polio syndrome.AimsThis proposed project will examine the effect of tDCS on PSF.Sample size estimatesWe will recruit 156 participants aged 18 to 80 with chronic stroke and allocate them equally to two groups (i.e., n = 78 per group).Methods and designThis proposed project will be a double-blind randomized control trial. The participants will be randomly divided into two groups. The control group will receive sham tDCS, and the treatment group will receive active tDCS. The latter treatment will involve application of a constant 2-mA current via one 5 × 5-cm anodal electrode positioned on the scalp over the C3 or C4 positions (motor cortex) of the lesioned hemisphere and one cathodal electrode positioned at the ipsilateral shoulder in two 20-min sessions per day for 5 days. The period of follow-up will be 4 weeks.Study outcome(s)The primary outcome measure will be a change in fatigue severity, as measured using the modified fatigue impact scale (MFIS). The participants’ scores on the MFIS (total score and physical, cognitive and psychosocial subscores) will be collected before treatment (T0), after 10 treatment sessions, i.e., 1 day after the fifth treatment day (T1), and 1 week (T2), 2 weeks (T3) and 4 weeks (T4) thereafter. Both per-protocol analysis and intention-to-treat analysis will be performed.DiscussionThis proposed project will provide proof-of-concept, i.e., demonstrate the benefits of tDCS for the treatment of PSF. The beneficiaries are the subjects participated in the study. This will stimulate further research to optimize tDCS parameters for the treatment of PSF.Clinical trial registrationwww.Chictr.org.cn, identifier: ChiCTR2100052515.
Phosphosulindac (OXT-328) prevents and reverses chemotherapy induced peripheral neuropathy in mice
Authors: Basu Aryah , Yang Jennifer Y. , Tsirukis Vasiliki E. , Loiacono Andrew , Koch Gina , Khwaja Ishan A. , Krishnamurthy Mahila , Fazio Nicholas , White Emily , Jha Aayushi , Shah Shrila , Takmil Cameron , Bagdas Deniz , Demirer Aylin , Master Adam , Natke Ernest , Honkanen Robert , Huang Liqun , Rigas Basil 
Published: January 2024

BackgroundChemotherapy-induced peripheral neuropathy (CIPN), a side effect of chemotherapy, is particularly difficult to treat. We explored whether phosphosulindac (PS), a modified NSAID, could treat CIPN.MethodsCIPN was induced in male C57BL/6 J mice by paclitaxel, vincristine or oxaliplatin. Mechanical allodynia was measured with the von Frey test and cold allodynia with the acetone test. To determine the preventive effect of PS, it was administered 2 days before the induction of CIPN. Mouse Lewis lung carcinoma xenografts were used to determine if PS altered the chemotherapeutic efficacy of paclitaxel. Cultured cell lines were used to evaluate the effect of PS on neuroinflammation.ResultsTreatment with each of the three chemotherapeutic agents used to induce CIPN lowered the mechanical allodynia scores by 56 to 85% depending on the specific agent. PS gel was applied topically 3x/day for 16–22 days to the hind paws of mice with CIPN. This effect was dose-dependent. Unlike vehicle, PS returned mechanical allodynia scores back to pre-CIPN levels. PS had a similar effect on paclitaxel-induced CIPN cold allodynia. Sulindac, a metabolite of PS, had no effect on CIPN. PS significantly prevented CIPN compared to vehicle. Given concomitantly with paclitaxel to mice with lung cancer xenografts, PS relieved CIPN without affecting the anticancer effect of paclitaxel. The enantiomers of PS were equally efficacious against CIPN, suggesting the therapeutic suitability of the racemate PS. There were no apparent side effects of PS. PS suppressed the levels of IL-6, IL-10, CXCL1, and CXCL2 induced by paclitaxel in a neuroblastoma cell line, and macrophage activation to the M1 proinflammatory phenotype.ConclusionTopically applied PS demonstrated broad therapeutic and preventive efficacy against CIPN, preserved the anticancer effect of paclitaxel, and was safe. Its anti-CIPN effect appears to be mediated, in part, by suppression of neuroinflammation. These data support further evaluation of topical PS for the control of CIPN.
Association of major dietary patterns with socioeconomic status, obesity, and contracting COVID-19 among Iranian adults
Authors: Maharat Maryam , Rahimlou Mehran , Sioofi Ali , Sajjadi Seyedeh Forough , Moosavian Seyedeh Parisa 
Published: January 2024

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic clearly affected the lifestyle and dietary habits of millions of people worldwide. The purpose of this study was to evaluate the association of major dietary patterns with socioeconomic status, obesity, and contracting COVID-19.MethodsWe conducted a cross-sectional study using an online survey for data collection with a total of 1,187 participants (over the age of 18 years) who reported their sociodemographic details, anthropometric index (weight and height), and dietary intake. Multivariable logistic regression models were applied to assess the association between major dietary patterns and study outcomes.ResultsA total of 1,106 adults were included in the current analysis. We identified three major dietary patterns (plant-based, meat, and Western dietary patterns). The mean age of participants was significantly higher in the upper tertile of plant-based dietary patterns (DPs) compared to the first tertile, while it was lower in the top tertile of meat and Western DPs. The percentage of participants who lived in urban areas was significantly higher in the third tertile of meat DP than in the first tertile (p &lt; 0.001). Moderate adherence to Western DP was significantly associated with increased odds of obesity (OR: 1.79; 95% CI: 1.17, 2.74). In addition, high adherence to Western DP was significantly related to increased odds of obesity after controlling for confounders. Subjects in the second tertile of the Western DP had higher odds (95% Cl: 1.04, 1.92) for COVID-19 infection than the first tertile.ConclusionThis study showed that moderate and high adherence to a Western dietary pattern was associated with a higher risk of obesity and COVID-19 infection during the pandemic. Future studies are needed to confirm these findings.