bluuebunny/crossref_metadata_2025_split huggingface dataset:
Structural and Functional Alterations of Hippocampal Subfields in Patients With Adult-Onset Primary Hypothyroidism
Authors: Zhang Taotao , Zhao Lianping , Chen Chen , Yang Chen , Zhang Huiyan , Su Wenxiu , Cao Jiancang , Shi Qian , Tian Limin 
Published: February 2024

Abstract

Context
Hypothyroidism is often associated with cognitive and emotional dysregulation; however, the underlying neuropathological mechanisms remain elusive.

Objective
The study aimed to characterize abnormal alterations in hippocampal subfield volumes and functional connectivity (FC) in patients with subclinical hypothyroidism (SCH) and overt hypothyroidism (OH).

Methods
This cross-sectional observational study comprised 47 and 40 patients with newly diagnosed adult-onset primary SCH and OH, respectively, and 53 well-matched healthy controls (HCs). The demographics, clinical variables, and neuropsychological scale scores were collected. Next, the hippocampal subfield volumes and seed-based FC were compared between the groups. Finally, correlation analyses were performed.

Results
SCH and OH exhibited significant alterations in cognitive and emotional scale scores. Specifically, the volumes of the right granule cell molecular layer of the dentate gyrus (GC-ML-DG) head, cornu ammonis (CA) 4, and CA3 head were reduced in the SCH and OH groups. Moreover, the volumes of the right molecular layer head, CA1 body, left GC-ML-DG head, and CA4 head were lower in SCH. In addition, the hippocampal subfield volumes decreased more significantly in SCH than OH. The seed-based FC decreased in SCH but increased in OH compared with HCs. Correlation analyses revealed thyroid hormone was negatively correlated with FC values in hypothyroidism.

Conclusion
Patients with SCH and OH might be at risk of cognitive decline, anxiety, or depression, and exhibited alterations in volume and FC in specific hippocampal subfields. Furthermore, the reduction in volume was more pronounced in SCH. This study provides novel insights into the neuropathological mechanisms of brain impairment in hypothyroidism.
Contemporary Analysis of Reexcision and Conversion to Mastectomy Rates and Associated Healthcare Costs for Women Undergoing Breast-Conserving Surgery
Authors: Kim Youngran , Ganduglia-Cazaban Cecilia , Tamirisa Nina , Lucci Anthony , Krause Trudy Millard 
Published: February 2024

Abstract
Purpose
This study was designed to provide a comprehensive and up-to-date understanding of population-level reoperation rates and incremental healthcare costs associated with reoperation for patients who underwent breast-conserving surgery (BCS).

Methods
This is a retrospective cohort study using Merative™ MarketScan® commercial insurance data and Medicare 5% fee-for-service claims data. The study included females aged 18–64 years in the commercial cohort and females aged 18 years and older in the Medicare cohort, who underwent initial BCS for breast cancer in 2017–2019. Reoperation rates within a year of the initial BCS and overall 1-year healthcare costs stratified by reoperation status were measured.

Results
The commercial cohort included 17,129 women with a median age of 55 (interquartile range [IQR] 49–59) years, and the Medicare cohort included 6977 women with a median age of 73 (IQR 69–78) years. Overall reoperation rates were 21.1% (95% confidence interval [CI] 20.5–21.8%) for the commercial cohort and 14.9% (95% CI 14.1–15.7%) for the Medicare cohort. In both cohorts, reoperation rates decreased as age increased, and conversion to mastectomy was more prevalent among younger women in the commercial cohort. The mean healthcare costs during 1 year of follow-up from the initial BCS were $95,165 for the commercial cohort and $36,313 for the Medicare cohort. Reoperations were associated with 24% higher costs in both the commercial and Medicare cohorts, which translated into $21,607 and $8559 incremental costs, respectively.

Conclusions
The rates of reoperation after BCS have remained high and have contributed to increased healthcare costs. Continuing efforts to reduce reoperation need more attention.
Clinical utility of CLL-IPI scoring system in Pakistani Chronic Lymphocytic Patients: A single center experience
Authors: Hameed Aisha , Nadia Sajid  , Muhammad Fayyaz  , Khaliq Shagufta 
Published: February 2024

Objectives: To determine validity of the CLL International prognostic index (IPI) scoring system in Pakistani chronic lymphocytic leukemia patients, as the validity and universal applicability of various prognostic scoring systems such as the CLL-IPI remains a challenge, particularly in under-developed countries like Pakistan.
Methods: This prospective single center study was conducted at Department of Hematology, University of Health Sciences, Lahore and included sixty patients with CLL diagnosed between July, 2019 to July, 2022. Patients were followed for a period of two years and 02 year overall survival (OS) was noted. Risk stratification was conducted according to CLL-IPI prognostic model.
Results: Among 60 patients, the mean age was 60±11years. Advanced Binet stage B+C and elevated β2-microglobulin >3.5mg/L was observed in 73.3% and 38.3% patients respectively. The estimated median 02 years OS was 16.5 months (95% CI: 10-20 months). In total, 40 of 60 CLL patients (67%) were accessible for follow-up analyses. For the present CLL cohort, 25% patients (n = 10) were classified as CLL-IPI low risk and intermediate risk group, 35% (n = 14) as high risk and 15% (n = 06) as very high-risk group. However, this classification of patients according to CLL-IPI did not yield significant differences in terms of OS (p = 0.24), although the median OS of CLL-IPI very high-risk group was noted as only six months and was not reached for low and intermediate risk groups.
Conclusion: To conclude, clinical validation of CLL-IPI scoring system could not be established for the present CLL cohort and needs to be evaluated in further studies with larger sample size.
doi: https://doi.org/10.12669/pjms.40.4.8703
How to cite this: Hameed A, Sajid N, Fayyaz M, Khaliq S. Clinical utility of CLL-IPI scoring system in Pakistani Chronic Lymphocytic Patients: A single center experience. Pak J Med Sci. 2024;40(4):701-705. doi: https://doi.org/10.12669/pjms.40.4.8703
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Critical Review of the Metallurgical Operation of the Greek Nickel Industry and Perspectives, based on the recent Industrial Experience on Smelting Reduction Process
Authors: Zografidis Charalabos , Betsis Konstantinos , Xenidis Anthimos 
Published: February 2024

The mining and industrial production of Greek ferronickel industry LARCO have ceased since 30.07.2022. The last LME nickel price crisis, exclusion from bank loaning, extremely high cost of electrical energy, management issues, resulted inter alia, in a prohibitive operational cost. Nevertheless, LARCO faces the challenge of restructuring and reoperation in the future, given that privatization is in progress, including the acquisition of the company’s assets to a joint venture enterprise.
Within this framework, the current paper aims to contribute to the discussion for developing a new management strategy for the optimization of pyrometallurgical process, focusing on the critical step of smelting reduction. Based on industrial experience concerning open bath submerged arc electric furnaces, factors which critically affect the safety and cost-effectiveness of smelting reduction are detected and presented by means of case studies, being mainly classified as following: i) Optimal raw materials’ feed management, including laterite ores (domestic or not), solid fuels and electrode paste. Moreover, taking for granted the need for Ni-rich ‘foreign’ ores to increase the recovery and reduce the cost of the process, the extent of dependence on Fe-rich domestic ores is investigated, in order a safe and stable operation to be ensured. ii) Focus on preventive maintenance management. Substantial increase of the facilities’ operational index and cost saving is obtained, as proved by operational case studies. iii) Modern human resources management strategy. Their economical footprint is further discussed.
How to Control Waste Incineration Pollution? Cost-Sharing or Penalty Mechanism—Based on Two Differential Game Models
Authors: Li Huijie , Tan Deqing 
Published: February 2024

This study explores whether the government should implement a cost-sharing or penalty mechanism to control waste incineration pollution and investigates which policy can best incentivize incineration plants to invest in pollution control. We design two differential game models, one based on a cost-sharing approach and one on a penalty system, to model the interactions between the government and incineration plants. We then compare and analyze the equilibrium outcomes in both scenarios. Our findings reveal that when incineration pollution significantly impacts the government, both the cost-sharing and penalty mechanisms are effective in stimulating incineration plants to enhance their pollution control efforts. However, when incineration pollution significantly affects the incineration plants themselves, the cost-sharing mechanism proves to be more effective in terms of pollution control. Furthermore, we find that the government derives greater utility under the cost-sharing mechanism compared with the penalty mechanism, especially as the amount of municipal solid waste (MSW) increases. In contrast, incineration plants tend to generate higher profits under the cost-sharing mechanism. These findings and their accompanying managerial implications may provide valuable guidance for government agencies in formulating policies to manage incineration pollution and encourage waste incineration plants to invest in improving their pollution control systems. Funding: This work was supported by the National Natural Science Foundation of China [Grant 71571149], Humanities and Social Sciences Foundation for Youth Scholars of Ministry of Education of China [Grant 22YJC630171], and Natural Science Foundation of Sichuan Province of China [Grant 2023NSFSC1055].
Variability of the femoral mechanical-anatomical axis angle and its implications in primary and revision total knee arthroplasty
Authors: Jang Seong J. , Kunze Kyle N. , Casey Jack C. , Steele Jack R. , Mayman David J. , Jerabek Seth A. , Sculco Peter K. , Vigdorchik Jonathan M. 
Published: February 2024

AimsDistal femoral resection in conventional total knee arthroplasty (TKA) utilizes an intramedullary guide to determine coronal alignment, commonly planned for 5° of valgus. However, a standard 5° resection angle may contribute to malalignment in patients with variability in the femoral anatomical and mechanical axis angle. The purpose of the study was to leverage deep learning (DL) to measure the femoral mechanical-anatomical axis angle (FMAA) in a heterogeneous cohort.MethodsPatients with full-limb radiographs from the Osteoarthritis Initiative were included. A DL workflow was created to measure the FMAA and validated against human measurements. To reflect potential intramedullary guide placement during manual TKA, two different FMAAs were calculated either using a line approximating the entire diaphyseal shaft, and a line connecting the apex of the femoral intercondylar sulcus to the centre of the diaphysis. The proportion of FMAAs outside a range of 5.0° (SD 2.0°) was calculated for both definitions, and FMAA was compared using univariate analyses across sex, BMI, knee alignment, and femur length.ResultsThe algorithm measured 1,078 radiographs at a rate of 12.6 s/image (2,156 unique measurements in 3.8 hours). There was no significant difference or bias between reader and algorithm measurements for the FMAA (p = 0.130 to 0.563). The FMAA was 6.3° (SD 1.0°; 25% outside range of 5.0° (SD 2.0°)) using definition one and 4.6° (SD 1.3°; 13% outside range of 5.0° (SD 2.0°)) using definition two. Differences between males and females were observed using definition two (males more valgus; p < 0.001).ConclusionWe developed a rapid and accurate DL tool to quantify the FMAA. Considerable variation with different measurement approaches for the FMAA supports that patient-specific anatomy and surgeon-dependent technique must be accounted for when correcting for the FMAA using an intramedullary guide. The angle between the mechanical and anatomical axes of the femur fell outside the range of 5.0° (SD 2.0°) for nearly a quarter of patients.Cite this article: Bone Jt Open 2024;5(2):101–108.
Psychophysical determination of boundaries and smoothness of color gradients
Authors: Xiong Nian , Shamey Renzo 
Published: February 2024

Color gradients constitute an important component in the evaluation of the color quality of multicolored patterns that contain color transitions. A two-part psychophysical study was designed and employed to test the appearance of a set of hue-, chroma-, or lightness-based color gradients. The influence of several parameters on the visual determination of gradients’ boundaries and perceived smoothness was tested. These parameters included gradient type, e.g., transitions based on hue, chroma, lightness or their combination, orientation, slope, and quantization step size of color transitions. The influence of these parameters on intra- and interobserver variability in responses was calculated using the standardized residual sum of squares metric. In the first part of the experiment, the perceived boundaries of color gradient stimuli as well as observer confidence ratings in performing these visual tasks were determined. In the second part, the perceived smoothness ratings of the stimuli and visual confidence ratings in assessments were examined. Four binary color transition images, i.e., brown-green, brown-tan, green-olive, and light sage-olive, were generated. Three different linear-gradient slopes were applied to each transition, and each stimulus was shown to observers, separately, in four orientations: horizontal, vertical, right diagonal, and left diagonal. Results indicate that the gradient slopes influence perceived boundaries and smoothness ratings. When determining smoothness ratings, observers were found to be more tolerant to changes in chroma and lightness than in hue.
Flexible 2 × 2 multiple access visible light communication system based on an integrated parallel GaN/InGaN micro-photodetector array module
Authors: Xu Zengyi , Lin Xianhao , Luo Zhiteng , Lin Qianying , Zhang Jianli , Wang Guangxu , Wang Xiaolan , Jiang Fengyi , Li Ziwei , Shi Jianyang , Zhang Junwen , Shen Chao , Chi Nan 
Published: February 2024

In recent studies, visible light communication (VLC) has been predicted to be a prospective technique in the future 6G communication systems. To suit the trend of exponentially growing connectivity, researchers have intensively studied techniques that enable multiple access (MA) in VLC systems, such as the MIMO system based on LED devices to support potential applications in the Internet of Things (IoT) or edge computing in the next-generation access network. However, their transmission rate is limited due to the intrinsic bandwidth of LED. Unfortunately, the majority of visible light laser communication (VLLC) research with beyond 10 Gb/s data rates concentrates on point-to-point links, or using discrete photodetector (PD) devices instead of an integrated array PD. In this paper, we demonstrated an integrated PD array device fabricated with a Si-substrated GaN/InGaN multiple-quantum-well (MQW) structure, which has a 4×4 array of 50  μm×50  μm micro-PD units with a common cathode and anode. This single-integrated array successfully provides access for two different transmitters simultaneously in the experiment, implementing a 2×2 MIMO-VLLC link at 405 nm. The highest data rate achieved is 13.2 Gb/s, and the corresponding net data rate (NDR) achieved is 12.27 Gb/s after deducing the FEC overhead, using 2.2 GHz bandwidth and superposed PAM signals. Furthermore, we assess the Huffman-coded coding scheme, which brings a fine-grain adjustment in access capacity and enhances the overall data throughput when the user signal power varies drastically due to distance, weather, or other challenges in the channel condition. As far as we know, this is the first demonstration of multiple visible light laser source access based on a single integrated GaN/InGaN receiver module.
Barriers and Challenges Against the Utilization of Novel Teaching Methods for Nursing Students: Perspectives of Nursing Instructors
Authors: Bijani Mostafa , Moradi Zahra , Karimi Shahnaz , Fereidouni Zhila , Nikrouz Leila , Hatami Mahmood , Naghizadeh Mohammad Mehdi 
Published: February 2024

Background: The first step in effectively applying novel teaching methods is identifying barriers and challenges to implementing appropriate interventions. A literature review revealed no studies exploring nursing instructors’ viewpoints on the reasons for not using novel teaching methods.Purpose: The present study aimed to explore the challenges and executive barriers against using novel approaches in instructing nursing students from the perspective of nursing instructors. Methods: In this descriptive-analytical study, 163 nursing instructors from three nursing schools in Fars Province, Southwest Iran, were selected using convenience sampling. A researcher-developed questionnaire comprising 17 items scored on a five-point Likert scale was utilized to collect data. These items were categorized into three domains: challenges related to students (n=4), instructors (n=8), and structural-managerial aspects (n=5). The questionnaire’s reliability coefficient was found to be 0.89 using the test-retest method. The Kolmogorov–Smirnov test was used to test the normality of variables and the independent t-test was employed to examine the relationship between genders and educational degrees across all three domains. Results: The mean scores for challenges and barriers related to the instructors, students, and structural-managerial aspects were 33.24(7.16), 16.31(3.93), and 22.14(3.64), respectively. A significant relationship between gender and educational degree was observed across all three domains (p<0.001).Conclusion: The barriers and challenges against using novel teaching methods for nursing students from the perspective of nursing instructors included challenges related to instructors, students, and structural-managerial aspects. The support and encouragement of educational institution managers in executing these methods could help promote the utilization of these techniques and improve the quality of education.
Sex Does Not Affect Changes in Body Composition and Insulin-Like Growth Factor-I During US Army Basic Combat Training
Authors: Roberts Brandon M. , Staab Jeffery S. , Caldwell Aaron R. , Sczuroski Cara E. , Staab Janet E. , Lutz Laura J. , Reynoso Marinaliz , Geddis Alyssa V. , Taylor Kathryn M. , Guerriere Katelyn I. , Walker Leila A. , Hughes Julie M. , Foulis Stephen A. 
Published: February 2024

Abstract
Roberts, BM, Staab, JS, Caldwell, AR, Sczuroski, CE, Staab, JE, Lutz, LJ, Reynoso, M, Geddis, AV, Taylor, KM, Guerriere, KI, Walker, LA, Hughes, JM, and Foulis, SA. Sex does not affect changes in body composition and insulin-like growth factor-I during US Army basic combat training. J Strength Cond Res 38(6): e304–e309, 2024—Insulin-like growth factor 1 (IGF-I) has been implicated as a biomarker of health and body composition. However, whether changes in body composition are associated with changes in IGF-I is unclear. Therefore, we examined the relationship between body composition changes (i.e., fat mass and lean mass) and total serum IGF-I levels in a large cohort of young men (n = 809) and women (n = 397) attending US Army basic combat training (BCT). We measured body composition using dual energy x-ray absorptiometry and total serum IGF-I levels during week 1 and week 9 of BCT. We found that pre-BCT lean mass (r = 0.0504, p = 0.082) and fat mass (r = 0.0458, p = 0.082) were not associated with pre-BCT IGF-I. Body mass, body mass index, body fat percentage, and fat mass decreased, and lean mass increased during BCT (all p < 0.001). Mean (±SD) IGF-I increased from pre-BCT (176 ± 50 ng·ml−1) to post-BCT (200 ± 50 ng·ml−1, p < 0.001). Inspection of the partial correlations indicated that even when considering the unique contributions of other variables, increases in IGF-I during BCT were associated with both increased lean mass (r = 0.0769, p = 0.023) and increased fat mass (r = 0.1055, p < 0.001) with no sex differences. Taken together, our data suggest that although changes in IGF-I weakly correlated with changes in body composition, IGF-I, in isolation, is not an adequate biomarker for predicting changes in body composition during BCT in US Army trainees.
Cholinergic control of GnRH neuron physiology and luteinizing hormone secretion in male mice: involvement of ACh/GABA co-transmission
Authors: Vastagh Csaba , Farkas Imre , Csillag Veronika , Watanabe Masahiko , Kalló Imre , Liposits Zsolt 
Published: February 2024

GnRH-synthesizing neurons orchestrate reproduction centrally. Early studies have proposed the contribution of acetylcholine (ACh) to hypothalamic control of reproduction, although the causal mechanisms haven't been clarified. Here, we report thatin vivopharmacogenetic activation of the cholinergic system increased the secretion of luteinizing hormone (LH) in orchidectomized mice. 3DISCO immunocytochemistry and electron microscopy revealed the innervation of GnRH neurons by cholinergic axons. Retrograde viral labeling initiated from GnRH-Cre neurons identified the medial septum and the diagonal band of Broca as exclusive sites of origin for cholinergic afferents of GnRH neurons. In acute brain slices, ACh and the ACh receptor (AChR) agonist carbachol evoked a biphasic effect on the firing rate in GnRH neurons, first increasing and then diminishing it. In the presence of tetrodotoxin, carbachol induced an inward current, followed by a decline in the frequency of mPSCs, indicating a direct influence on GnRH cells. RT-PCR and whole-cell patch-clamp studies revealed that GnRH neurons expressed both nicotinic (α4β2, α3β4, and α7) and muscarinic (M1-M5) ACh receptors. The nicotinic AChRs contributed to the nicotine-elicited inward current and the rise in firing rate. Muscarine via M1 and M3 receptors increased, while via M2 and M4 reduced the frequency of both miniature postsynaptic currents (mPSCs) and firing. Optogenetic activation of channelrhodopsin-2-tagged cholinergic axons modified GnRH neuronal activity and evoked co-transmission of ACh and GABA from a subpopulation of boutons. These findings confirm that the central cholinergic system immensely regulates GnRH neurons and activates the HPG-axis via ACh and ACh/GABA neurotransmissions in male mice.Significance statementCholinergic drugs influence reproduction centrally, although the exact neuronal targets and regulatory mechanisms remain unsettled. We found that pharmacogenetic activation of the cholinergic systemin vivoevoked an augmented LH release in male mice. The study also identified cholinergic cell groups in the mouse forebrain that innervate gonadotropin-releasing hormone (GnRH) neurons, the main hypothalamic regulators of reproduction. We also determined the subtypes of nicotinic and muscarinic receptors involved in neuronal information transfer and explored how their ligands affect the electrophysiological activity of GnRH neurons. A subset of cholinergic neurons was found to co-transmit GABA which excites GnRH cells via GABA-A receptors. The findings suggest a novel, cholinergic regulation of the GnRH system activating the pituitary-gonadal axis in adult male mice.