bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correct and Incorrect Recommendations for or against Fine Needle Biopsies of Hypofunctioning Thyroid Nodules: Performance of Different Ultrasound-based Risk Stratification Systems
Authors: Petersen Manuela , Schenke Simone A. , Seifert Philipp , Stahl Alexander R. , Görges Rainer , Grunert Michael , Klemenz Burkhard , Kreissl Michael C. , Zimny Michael 
Published: October 2023

Abstract
Purpose To evaluate the recommendations for or against fine needle biopsy (FNB) of hypofunctioning thyroid nodules (TNs) using of five different Ultrasound (US) -based risk stratification systems (RSSs).
Methods German multicenter study with 563 TNs (≥ 10 mm) in 534 patients who underwent thyroid US and surgery. All TNs were evaluated with ACR TI-RADS, EU-TIRADS, ATA, K-TIRADS 2016 and modified K-TIRADS 2021. A correct recommendation was defined as: malignant TN with recommendation for FNB (appropriate) or benign TN without recommendation for FNB (avoided). An incorrect recommendation was defined as: malignant TN without recommendation for FNB (missed) or benign TN with recommendation for FNB (unnecessary).
Results ACR TI-RADS demonstrated the highest rate of correct (42.3 %) and lowest rate of incorrect recommendations (57.7 %). The other RRSs showed similar results for correct (26.5 %–35.7 %) and incorrect (64.3 %–73.5 %) recommendations. ACR TI-RADS demonstrated the lowest rate of unnecessary (73.4 %) and the highest rate of appropriate (26.6 %) FNB recommendation. For other RSSs, the rates of unnecessary and appropriate FNB were between 75.2 %–77.1 % and 22.9 %–24.8 %. The lowest rate of missed FNB (14.7 %) and the highest rate of avoided FNB (85.3 %) was found for ACR TI-RADS. For the other RSSs, the rates of missed and avoided FNB were between 17.8 %–26.9 % and 73.1 %–82.2 %. When the size cutoff was disregarded, an increase of correct recommendations and a decrease of incorrect recommendations was observed for all RSSs.
Conclusion The RSSs vary in their ability to correctly recommend for or against FNB. An understanding of the impact of nodule size cutoffs seems necessary for the future of TIRADS.
DGN-Handlungsempfehlung (S1-Leitlinie): Radiojodtherapie bei benignen Schilddrüsenerkrankungen (Stand 6/2022 – AWMF-Registernummer: 031-003)
Authors: Dietlein M. , Grünwald F. , Schmidt M. , Kreissl M. C. , Luster M. ,   Deutsche Gesellschaft für Allgemein- und Viszeralchirurgie e. V. (DGAV),   Chirurgische Arbeitsgemeinschaft Endokrinologie (CAEK) der DGAV,   Deutsche Gesellschaft für Chirurgie e. V. (DGCH),   Deutsche Gesellschaft für Endokrinologie e. V. (DGE)
Published: October 2023

ZusammenfassungDiese Version der Leitlinie zur Radiojodtherapie bei benignen Schilddrüsenerkrankungen ist ein Update der Version, die im Jahr 2015 durch die Deutsche Gesellschaft für Nuklearmedizin (DGN) in Abstimmung mit der Deutschen Gesellschaft für Endokrinologie (DGE, Sektion Schilddrüse) und der Deutschen Gesellschaft für Allgemein- und Viszeralchirurgie (DGAV) publiziert worden war. Die Leitlinie ist mit den Empfehlungen der European Association of Nuclear Medicine (EANM) harmonisiert worden. Nach der „Richtlinie Strahlenschutz in der Medizin“ ist die „rechtfertigende Indikation“ zur Radiojodtherapie durch einen fachkundigen Arzt („Fachkunde in der Therapie mit offenen radioaktiven Stoffen“) zu stellen. Daher werden Indikationen zur Radiojodtherapie und alternative Behandlungsmöglichkeiten in dieser Leitlinie diskutiert. Die Leitlinie wurde von einer Expertengruppe im informellen Konsens verabschiedet und entspricht damit einer Verfahrensanweisung der ersten Stufe (S1) nach den Kriterien der Arbeitsgemeinschaft der Wissenschaftlichen Medizinischen Fachgesellschaften (AWMF).
Benchmarks for Pediatric Surgical Registries: Recommendations for the Assessment and Grading of Complications
Authors: Madadi-Sanjani Omid , Ure Benno M. 
Published: October 2023

AbstractProcedure-related registries in general surgical practice offer a platform for prospective trials, the pooling of data, and detailed outcome analysis. Recommendations by the Idea, Development, Exploration, Assessment, and Long-term follow-up (IDEAL) collaboration and Outcome4Medicine have further improved the uniform reporting of complications and adverse events.In the pediatric surgical network, disease-specific registries for rare and inherited congenital anomalies are gaining importance, fostering international collaborations on studies of low-incidence diseases. However, to date, reporting of complications in the pediatric surgical registries has been inconsistent. Therefore, the European Reference Network for Rare Inherited and Congenital Anomalies (ERNICA) recently endorsed the validation of the first severity grading system for children. The planned reform of the European Paediatric Surgical Audit (EPSA) registry, which includes the implementation of the Clavien–Madadi classification, represents a further effort to establish uniform outcome reporting.This article provides an overview of experiences with surgical registries and complication reporting, along with the potential application of this knowledge to future pediatric surgical practice.
Development Methodology, Availability, and Implementation of Core Outcome Sets in Pediatric Surgery
Authors: Allin Benjamin S.R. , Bethell George S. , Hall Nigel J. 
Published: October 2023

AbstractCore outcome sets (COSs) provide a mechanism to guide researchers and clinicians when deciding which outcomes to report in research related to a specific clinical condition or intervention. The intention behind creating a COS for a specific condition is to improve the reporting of important and meaningful outcomes, thus enhancing the relevance of research. Additionally, a COS helps facilitate comparison of outcomes between different clinical studies and reduces research waste. In this paper, we discuss the availability of COSs in the field of pediatric general surgery. We provide an overview of the methodologies used to develop a COS, including common pitfalls, and finally, we discuss COS uptake and implementation. An understanding of all these aspects is important for researchers considering developing a new COS and for those reading research where a COS has been developed or used within a study. Failure to adequately appreciate the nuances of COS development, in particular, risks fundamental flaws that may jeopardize COS validity and subsequently hinder COS uptake and implementation.
Spinal Hypotension and Time from Spinal-to-Delivery in Scheduled Cesarean Deliveries: Association with Neonatal Acidosis
Authors: Kazzi Nayla G. , Chen Han-Yang , Lee Linden , Nazeer Sarah A. , Brown Kendra , Sibai Baha M. , Chauhan Suneet P. 
Published: October 2023

Objective This work aimed to study the effect of sustained hypotension after spinal on neonatal acidosis and adverse outcomes in those undergoing scheduled cesarean delivery (CD) with universal prophylactic vasopressor exposure and to examine differences in spinal-to-delivery time by neonatal acidosis status.
Study Design This retrospective cohort study conducted at a quaternary care center from January 2019 to December 2021 included singleton, term, nonanomalous pregnancies, with scheduled CD under spinal anesthesia. Hypotension was defined as a systolic blood pressure (SYS-BP) < 100 mm Hg (SYS-BP100) or a >20% drop from baseline blood pressure (SYS-BP20). Both the occurrence of hypotension and its magnitude and duration were studied; the latter through the development of a hypotension index. The 90th and 95th percentiles of the hypotension index for SYS-BP20 and SYS-BP100, respectively, were used to define sustained hypotension. The primary outcome was neonatal acidosis (umbilical artery pH ≤ 7.1 or base excess ≤ −12 mmol). Secondary outcomes were composites of neonatal (CNAO) and maternal (CMAO) adverse outcomes. Multivariable Poisson regression models with robust error variance analysis was used to estimate adjusted relative risks (aRRs) and 95% confidence intervals (CIs).
Results Our study included 332 individuals who underwent scheduled CD; among them 330 (99.4%) received prophylactic vasopressors. The rate of neonatal acidosis was 4.2%. Sustained hypotension after spinal anesthesia, which occurred in 12.3% of the cohort, was associated with increased risk for neonatal acidosis (aRR 3.96, 95% CI 1.21–12.98), but was not associated with CNAO or CMAO. Time from spinal-to-delivery was not different in those with and without neonatal acidosis.
Conclusion Despite universal exposure to prophylactic vasopressors, sustained hypotension after spinal anesthesia was still associated with neonatal acidosis, but no other adverse perinatal outcomes. Our findings may provide additional support for the adoption of prophylactic vasopressors to reduce spinal hypotension and downstream effects on the neonate from intraoperative hemodynamic instability.
Key Points
Orofacial Myofunctional Aspects of Nursing Infants and Preschoolers
Authors: Medeiros Andréa Monteiro Correia , Assis Herick Santos , Alves Maria Vanessa Martins , Silva Santana Yasmin Fernandes , Silva-Filho William José e , Barreto Íkaro Daniel de Carvalho , Berretin-Felix Giédre 
Published: October 2023

Abstract
Introduction Clinical assessment in orofacial motricity is required for the speech therapist to diagnose and treat disorders involving the stomatognathic system. Validated tools can help establish a prognosis and outline intervention methods connected to human development.
Objective The goal of the present study was to examine the domains of the oromyofunctional assessment of nursing infants and preschoolers according to sex and age group, as well as the application of the MMBGR Protocol – Nursing Infants and Preschool Children.
Methods A quantitative technique was used to conduct an analytical and cross-sectional investigation. The present study included a total of 214 healthy breastfeeding infants and preschoolers of both sexes. The Mann-Whitney test was used to compare the medians. The Spearman correlation of each test domain was determined. R Core Team 2021 (R Foundation, Vienna, Austria) was used, and the significance threshold was set at 5%.
Results In intraoral and extraoral examinations, there was a difference between sexes for tongue scores in nursing infants (d = - 0.428; p = 0.045), worse in males. When the orofacial functions were considered in nursing infants, there were differences between the sexes for the liquid/solid/semisolid deglutition scores (d = 0.479; p = 0.031), with females performing worse. There were sex differences in solid/semisolid deglutition (d = - 0.335; p = 0.043), and speech in preschoolers (d = - 0.478; p = 0.034), including the production of phones/phonemes (d = - 0.599; p = 0.007), which were always worse in males.
Conclusion The research revealed sex disparities and related the domains of oromyofunctional assessment, according to scores, of the domains of myofunctional assessment, as recorded in a standardized oromyofunctional assessment protocol by age group.
Influence of Breathing Modes and Facial Growth Patterns on Electromyographic Fatigue of Masticatory Muscles in Children
Authors: Gomez Yulieth Paulina Stave , Rockenbach Nathalisa de Morais , Moraes Anaelena Bragança de , Corrêa Eliane Castilhos , Silva Ana Maria Toniolo da , Busanello-Stella Angela Ruviaro 
Published: October 2023

Abstract
Introduction Changes in breathing patterns affect the harmonious development of the structures of the craniofacial system, leading to changes in posture, occlusion, and facial growth patterns. However, little is known about how these changes influence the muscle contraction patterns, either at rest or while functioning, and either in a normal or unbalanced condition.
Objective To study the masseter and anterior temporal muscles fatigue during mastication in nasal- and mouth-breathing children, also considering their facial growth patterns. Methods: A total of 70 children aged 6 to 12 years old who met the study criteria were assessed. Speech-language-hearing, otorhinolaryngologic, and cephalometric assessments were performed to divide them into groups. In the electromyographic assessment, the children were asked to chew gum following a metronome until they felt fatigued. The median frequency of the muscles was analyzed at 15, 30, 45, and 60 seconds of mastication. The reported time of fatigue perception was recorded. The data were analyzed with analysis of variance (ANOVA) and the Kruskal-Wallis and the Mann-Whitney U tests.
Results There were no median frequency decrease patterns nor differences in the myoelectric manifestations and reported time of fatigue between the groups.
Conclusion The masticatory muscles did not reveal fatigue in the electromyographic analysis; however, the fatigue time was reported, despite the absence of physiological fatigue. The breathing mode, the facial growth pattern, and the association between them did not interfere with the behavior of the median frequency of the electromyographic signal and the fatigue time perception.
Medical Research Disparities in Latin America
Authors: Barrera Juana V. , Bayona Molano María del Pilar , Kumar Vishal , Cruz Luis , Arrieta Micaela , Landinez Gina 
Published: October 2023

AbstractClinical research is an essential aspect of advancing medical knowledge, improving patient outcomes, and reducing the burden of diseases. However, there are significant discrepancies in access to high-quality research worldwide, particularly in Latin American countries. Despite being crucial for evidence of efficacy in clinical research, randomized controlled trials are relatively scarce in Latin America compared with developed countries like the United States. This article explores the challenges and limitations that Latin American researchers face when conducting health-related clinical trials, including lack of economic resources, political instability, language barriers, and scarcity of indexed journals. Moreover, this article sheds light on the challenges in the fields of diagnostic radiology and interventional radiology in Latin America, such as limited resources, inadequate infrastructure, low awareness of the importance of imaging for accurate diagnoses and treatment, lack of specialized training programs, few opportunities for research, and insufficient funding. Addressing these challenges is crucial for Latin American researchers to produce high-quality clinical research and contribute to global medical knowledge, ultimately improving health outcomes and quality of life for people worldwide.
Perivascular Innervation in the Nasal Mucosa and Clinical Findings in Patients with Allergic Rhinitis and Idiopathic Rhinitis
Authors: Carvalho Thiago , Mello Jr João Ferreira de , Caldini Elia Tamaso Espin Garcia , Salgado Daniel Calduro , Carvalho Nicole Mary Garcia de , Damaceno-Rodrigues Nilsa Regina , Voegels Richard Louis 
Published: October 2023

Abstract
Introduction The nonspecific hyperreactivity of rhinitis has been attributed to neurotrophins activating sensory nerves and inflammatory cells. The relationship between these markers and the intensity of the symptoms is not well established and few studies have evaluated individuals with idiopathic rhinitis.
Objective The present study aims to evaluate whether perivascular innervation and nerve growth factor (NGF) are related to the intensity of the clinical conditions in allergic rhinitis (AR) and idiopathic rhinitis (IR).
Methods A total of 15 patients with AR and 15 patients with IR with the indication for inferior turbinectomy (associated or not with septoplasty) were selected. The patients received a score according to their signs and symptoms. After the surgery, we quantified eosinophils, mast cells, NGF, and nerve fibers in the nasal turbinate.
Results The score of the signs and symptoms was higher in the AR group. Nerve growth factor was found in the cytoplasm of inflammatory cells in the submucosa in greater quantity in the AR group. The nerve fibers were distributed throughout the tissue, mainly in the subepithelial, glandular, and vascular regions, and there was no difference between the groups. Greater perivascular innervation was associated with a higher signs and symptoms score.
Conclusions We concluded that these findings suggest that the NGF produced by submucosal inflammatory cells stimulates increased perivascular innervation in rhinitis, thus directly reflecting in more intense clinical conditions, especially in AR.
A uses and gratifications approach to examining users’ continuance intention towards smart mobile learning
Authors: Gao Biao 
Published: October 2023

AbstractSmart mobile learning (SML), an online learning system built on artificial intelligence technology, signifies a key development trajectory for mobile learning. However, the current literature reveals a research deficit in introducing specific constructs that represent the categorical level of gratification towards SML, and a new gratification for the intelligent dimension of SML has yet to be identified. Utilising the uses and gratifications (U&G) framework, this study identifies five categories of user gratification. These are derived from five theoretical perspectives, including the incentive theory of motivation, learning theory, diffusion of innovation theory, self-determination theory, and flow theory. Hence, this research integrates aspects of technology, content, social, utilitarian, and hedonic gratification to examine their influence on users’ continuance intention towards SML. This study focuses on Liulishuo, an SML app, as a typical research object and incorporates data from 495 valid samples. The analysis via partial least-squares structural equation modelling (PLS-SEM) indicates the hierarchical significance of various gratifications influencing continuance intention. The empirical findings suggest that in the realm of SML, users’ expectations surpass basic intrinsic needs in importance. For the first time, this study introduces the intelligence construct to investigate users’ technology gratification concerning SML, thereby empirically establishing the validity of this construct. This study reveals that technology gratification, embodied in the notion of intelligence, is the most critical determinant of continuance intention towards SML, a relationship that has previously remained unexplored.
Seeing is believing
Authors: Keevallik Leelo , Amon Marri 
Published: October 2023

Abstract
Verbs of perception are known for their prolific use in various non-literal functions that are usually argued to have developed from their denotational semantics (San Roque, Kendrick, Norcliffe & Majid 2018). In this study we document interactional practices involving the Estonian 2nd person verb form näed ’you see’ to demonstrate that its usage is anchored in face-to-face situations where the speaker guides a co-present other’s visual attention. Through multimodal analysis we show how näed is coordinated with the participants’ body orientations, gestures, and gazes to point to visually available proof for one’s current arguments, rendering it an evidential meaning even in its most “literal” uses of seeing, when a co-participant is invited to consider the visual evidence. We argue that the spatially anchored uses constitute a natural habitat of verbs of seeing, as visual perception is a mutually calibrated interactional accomplishment. Relevant syntactic constructions emerge in real time conversation where näed, calling for a visual orientation, is either preceded or followed by clausal specifications of what is to be seen, which makes it look like a particle. This challenges the argument that perception verbs start out as syntactic predicates in full clauses to then develop other uses.
The relativistic Euler equations: ESI notes on their geo-analytic structures and implications for shocks in 1D and multi-dimensions
Authors: Abbrescia Leonardo , Speck Jared 
Published: October 2023

Abstract
In this article, we provide notes that complement the lectures on the relativistic Euler equations and shocks that were given by the second author at the program Mathematical Perspectives of Gravitation Beyond the Vacuum Regime, which was hosted by the Erwin Schrödinger International Institute for Mathematics and Physics in Vienna in February 2022. We set the stage by introducing a standard first-order formulation of the relativistic Euler equations and providing a brief overview of local well-posedness in Sobolev spaces. Then, using Riemann invariants, we provide the first detailed construction of a localized subset of the maximal globally hyperbolic developments of an open set of initially smooth, shock-forming isentropic solutions in 1D, with a focus on describing the singular boundary and the Cauchy horizon that emerges from the singularity. Next, we provide an overview of the new second-order formulation of the 3D relativistic Euler equations derived in Disconzi and Speck (2019 Ann. Henri Poincare
20 2173–270), its rich geometric and analytic structures, their implications for the mathematical theory of shock waves, and their connection to the setup we use in our 1D analysis of shocks. We then highlight some key prior results on the study of shock formation and related problems. Furthermore, we provide an overview of how the formulation of the flow derived in Disconzi and Speck (2019 Ann. Henri Poincare
20 2173–270) can be used to study shock formation in multiple spatial dimensions. Finally, we discuss various open problems tied to shocks.
Fermion mass hierarchy and mixing in simplified grand gauge–Higgs unification
Authors: Maru Nobuhito , Takahashi Haruki , Yatagai Yoshiki 
Published: October 2023

Abstract
Grand gauge–Higgs unification of five-dimensional SU(6) gauge theory on an orbifold S
1/Z
2 with localized gauge kinetic terms is discussed. The Standard Model (SM) fermions on the boundaries and some massive bulk fermions coupling to the SM fermions are introduced. Compared to the previous model, the number of bulk fermions is reduced, which reproduces the generation mixing of SM fermions and SM fermion mass hierarchy by mildly tuning the bulk masses and parameters of the localized gauge kinetic terms.
Fault diagnosis method of multi-rotor UAV based on one-dimensional convolutional neural network with adaptive batch normalization algorithm
Authors: Yang Pu , Li Wanting , Wen Chenwan , Liu Peng 
Published: October 2023

Abstract
In this paper, we propose a one-dimensional convolutional neural network model based on the adaptive batch normalization (AdaBN) algorithm to improve the CNN model, which is difficult to extract features from multi-rotor unmanned aerial vehicle (UAV) rotor structural faults under variable conditions and has poor fault diagnosis performance. The method accomplishes fault diagnosis and classification by feature extraction from lower dimensional multi-rotor UAV data. The AdaBN algorithm adjusts the parameters of the BN layer in the model during the testing phase to improve the domain adaptive capability of the model in scenarios with variable operating conditions. Also, to improve the robustness of the model under noisy conditions, the first layer of convolutional kernel dropout operation is introduced to improve the noise immunity of the model. To reduce the complexity of manual tuning and to find the optimal combination of hyperparameters for the network model more effectively, the grey wolf optimizer algorithm is used to optimize the hyperparameters and further improve the model performance. Finally, the effectiveness of the proposed method is verified through comparison tests, and it shows good diagnostic effects in noise and variable conditions compared with several commonly used fault diagnosis methods.