bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unexpected contralateral axillary lymph node metastasis without ipsilateral involvement in triple-negative breast cancer: A case report and review of literature
Authors: Lin Yun-Ting , Hong Zhi-Jie , Liao Guo-Shiou , Dai Ming-Shen , Chao Tai-Kuang , Tsai Wen-Chiuan , Sung Yu-Kai , Chiu Chuang-Hsin , Chang Cheng-Kuang , Yu Jyh-Cherng 
Published: February 2025

BACKGROUND
Breast cancer is a leading cause of cancer-related mortality among women worldwide, with invasive ductal carcinoma (IDC) being the most prevalent subtype. Lymph node metastasis is the primary prognostic indicator, typically evaluated via biopsy of the ipsilateral sentinel or axillary lymph nodes. Contralateral axillary metastasis (CAM) without ipsilateral involvement is exceedingly rare, particularly in early-stage breast cancer. This report presents a case of CAM in a patient with triple-negative breast cancer (TNBC), underscoring diagnostic and therapeutic complexities.
CASE SUMMARY
A 73-year-old female presented with left-sided early-stage IDC in February 2023. Despite a modified radical mastectomy and pathologically negative ipsilateral lymph nodes, a postoperative positron emission tomography (PET) scan detected fluorodeoxyglucose-avid nodes in the contralateral axilla. Biopsy confirmed metastatic ductal carcinoma with triple-negative status, resulting in an upstaged diagnosis of metastatic breast cancer, stage IV, M1. The patient underwent six cycles of adjuvant chemotherapy, with follow-up PET imaging showing regression of the contralateral lesion. This case highlights the importance of advanced imaging in TNBC for precise staging and treatment optimization.
CONCLUSION
This case highlights the aggressive nature of TNBC and the need for advanced imaging to ensure accurate staging and effective management.
New surgical approach for distal clavicle fractures: A case report
Authors: Hu Wen-Tao , Zhang Zi-Yan , Qu Ji , Piao Cheng-Dong 
Published: February 2025

BACKGROUND
Clavicle fractures are a common type of fracture that often occurs after high-energy trauma. The treatment methods for clavicle fractures remain controversial. Both locking compression and hook plates are recommended.
CASE SUMMARY
A 44-year-old male suffered an injury during skiing. Radiography revealed a right-sided distal clavicular fracture. The fracture was treated using a hook plate due to its small size. During the surgical procedure, Kirschner wires were used to drill holes in the acromion. The end of the hook plate was inserted into the hole rather than below the edge of the acromion.
CONCLUSION
One year later, imaging revealed complete healing of the fracture, and the hook plate was removed. The patient was satisfied with the course and treatment results. Additionally, a new classification system was proposed based on the degree of injury to the distal clavicle joint surface. The incidence of postoperative complications associated with the use of hook plates for clavicular fracture treatment is relatively high. Complications can be reduced by changing the hook plate placement.
La actividad electroencefalográfica asociada a la relación carga cognitiva, estrés y reconocimiento de emociones en un grupo focal de profesores universitarios de ciencias experimentales
Authors: González Velásquez Carolina María , Vázquez Bernal Bartolomé , De las Heras Pérez María Ángeles , Mena Salcedo Johnatan Alexander , Osorio Higuita Mateo , Murillo Escobar Juan Pablo 
Published: February 2025

Este artículo presenta el registro y análisis de la actividad eléctrica de señales EEG en situaciones de carga cognitiva, estrés y reconocimiento de emociones como parte de una investigación doctoral que se llevó a cabo con un grupo focal de profesores universitarios de ciencias experimentales colombianos. Uno de los propósitos del estudio fue analizar los cambios fisiológicos de la actividad eléctrica del cerebro debido a las actividades de enseñanza que implican la carga cognitiva, el estrés y el reconocimiento de las emociones que desencadena este proceso para el grupo de profesores. Para la adquisición de los ritmos de las señales EEG se utilizó el dispositivo Emotiv EPOC+ y un grupo de pruebas psicométricas adaptadas para inducir señales en relación con labores asociadas al ejercicio docente, como son la atención y la memoria. Se utilizó la densidad de potencia espectral como función matemática y las señales con PSD, entropía de permutación y entropía aproximada y se realizó una clasificación con k-NN vecinos más cercanos. Se concluye que hubo un predominio de ritmos theta-alfa en la mayoría de los docentes del estudio, además se identificaron actividades de atención, memoria de trabajo y otras funciones ejecutivas con un rendimiento del 75.1 ± 3.05% con el clasificador y, finalmente, se reconocen emociones mixtas, algunas predictoras de estrés laboral como fueron ansiedad y tensión que inciden en el ejercicio docente y en el desarrollo profesional.
Dificultad en la aplicación de la atención paliativa en un servicio de medicina interna en Murcia, España
Authors: Sabater Martinez Violeta 
Published: February 2025

El envejecimiento de la población, junto a la dependencia y comorbilidades han provocado que los cuidados en fase avanzada de enfermedad tomen una especial relevancia. En muchas ocasiones los sanitarios no se sienten lo suficientemente formados para poder brindar unos cuidados paliativos de calidad, que ofrezcan una atención activa e integral. Es por ello que los objetivos del presente estudio fueron: a) averiguar si los profesionales sanitarios tienen conocimientos específicos en cuidados paliativos; b) analizar si el equipo sanitario conoce el plan de actuación que debe realizar con un paciente en fase terminal; c) identificar si el equipo de sanitarios dispone de herramientas para los cuidados al final de la vida. Han participado 58 profesionales sanitarios del Hospital Los Arcos del Mar Menor a los que se les pasa el cuestionario validado Palliative Care Difficulties Scale (PCDS)” con el fin de averiguar su opinión sobre los cuidados paliativos. Aparecen diferencias significativas (p<0.05) en las siguientes variables: a) Es difícil establecer una comunicación entre los miembros del equipo, respecto al alivio de síntomas del paciente; b) Cuando un paciente expresa ansiedad, es difícil darle una respuesta; c) No hay equipos de expertos a los que consultar, sobre el control de síntomas del paciente en domicilio. Entre las conclusiones destaca que existen carencias en la puesta en práctica de forma unánime y homogénea de los protocolos en cuidados paliativos, por lo cual sería necesario que se implementen programas de formación continuada para el personal sanitario y que se desarrollen procedimientos normalizados.
What are Deaf sign language users’ experiences as patients in healthcare services? A scoping review
Authors: Rogers Katherine D. , Lovell Karina , Bower Peter , Armitage Christopher J. , Young Alys 
Published: February 2025

Background
Deaf people who use a signed language experience poorer physical and mental health outcomes and inequalities in access and delivery of health services.

Objectives
A scoping review was conducted to identify and synthesise current knowledge on the perspectives of Deaf people and their experience of healthcare.

Search strategy
Databases PsycINFO, PubMed, Web of Science, and CINAHL were used for this review.

Inclusion criteria
Any studies internationally of any design that involve Deaf signing populations that reported on patient experience within healthcare settings from a Deaf perspective were included in the review.

Data extraction and synthesis
The abstract, title, and initial screening was followed by full text screening completed by two screeners independently. The extracted data included descriptive data and study findings. The Crowe Critical Appraisal Tool (CCAT) was applied, and findings were summarised using narrative synthesis.

Main results
Across the 51 included papers, problems with language, communication and interaction featured prominently. Failure to meet Deaf people’s needs has adverse impacts; examples of these include negative emotional state, disempowerment through lack of knowledge, and lack of confidence in healthcare systems.

Discussion and conclusions
The review uniquely focused on data generated from Deaf people regarding their experience, rather than third party commentary. It confirmed a less than optimal Deaf patient experience, clinical impacts of poor experience, and negative patient and healthcare systems outcomes. This supports the case for a reliable and valid measure in a signed language to capture Deaf patients’ experience in healthcare.
Early-stage immunoexpression of inflammatory, angiogenic, and survival markers in tongue epithelium of mice exposed to hookah smoke
Authors: Pereira Aldini Beuting , Michels Arieli Carini , Pilati Sarah Freygang Mendes , Modolo Filipe , Martins Ana Paula Camargo , De Paula Caroline Busatta Vaz , Nagashima Seigo , Noronha Lúcia , Fonseca Ana Clara Prado , Turmina Ariane Jéssica Torres , De Meira Heloisa Franco , Ramos Luisa Gabriela Carneiro , Da Rosa Thaís Grupp , Eckhardt Thais Maria Dos Santos , Ignácio Sérgio Aparecido , Alanis Luciana Reis Azevedo , Souza Paulo Henrique Couto , Rached Rodrigo Nunes , Jham Bruno Correia , Carneiro Everdan , Dos Santos Emanuela Carla , Johann Aline Cristina Batista Rodrigues 
Published: February 2025

Objective
The objective was to evaluate the early-stage immunoexpression of markers (COX-2, NF-kB, VEGFR-1 and apoptotic index) related to inflammation, angiogenesis, and cell survival in the tongue dorsum epithelium of mice exposed to hookah smoke.

Materials and methods
The sample consisted of Swiss mice (N = 20), female gender, aged 2 months, and approximately 25g each, four groups (n = 5) mice: group exposed to fresh air and groups exposed to hookah smoke for 7, 15, and 30 days. Tongues were embedded in paraffin. A tissue microarray was constructed, and immunohistochemistry was performed for Cyclooxygenase 2, NF-kappa B, Vascular Endothelial Growth Factor Receptor 1, and terminal deoxynucleotidyl transferase dUTP nick-end labeling (TUNEL) for apoptotic analysis. The positive and negative cells were quantified in the epithelium of the mid-dorsal tongue region. Kruskal-Wallis and Dunn tests was made.

Results
The apoptotic index was higher at 30 days of smoke exposure (20.38% basal/ 19.63%/ suprabasal) compared to the group exposed to air (9.55%/ 11.88%), The expression of Vascular Endothelial Growth Factor Receptor 1 was higher at 30 days of smoke exposure (30.15%/ 38.15%) compared to the group exposed to air (18.25%/ 3.60%).

Conclusion
Hookah smoke induced greater apoptosis and increased expression of Vascular Endothelial Growth Factor Receptor 1 in the epithelium of the tongue at 30 days, potentially playing a role in the initial stages of carcinogenesis, in the early stages of hookah use.
Extensive Esophageal Papillomatosis: A Rare Disease With Difficult Diagnosis
Authors: Chinzon Miriam , Barbosa Marques Sergio , Guimarães Hourneaux de Moura Eduardo 
Published: February 2025

ABSTRACT
Extensive esophageal papillomatosis is a rare condition with uncertain pathophysiology. We present a case involving a 78-year-old woman, with no notable habits or addictions, who presented with dysphagia and weight loss. She was diagnosed with extensive esophageal papillomatosis, causing esophageal substenosis. Diagnosis of dysplasia in such cases are challenging, and management of the risk of malignant transformation remains uncertain.
Financial Inclusion, Financial Depth, and Macroeconomic Fluctuations
Authors: Tufail Saira , Aljarallah Ruba , Munir Madiha , Alvi Shahzad , Ul Hassan Mehboob 
Published: February 2025

Abstract
The study bridges the gap between growth and business cycle literature by addressing two critical issues related to the connection between financial development (FD) and macroeconomic fluctuations (MF). First, it explores strategies for achieving FD in an emerging economy. Second, it examines the extent to which FD can occur while maintaining system stability. To address the first problem, the research evaluates the impact of two main components of FD, financial inclusion and financial depth, on fluctuation, while the second issue examines the impact of different degrees of financial inclusion and depth on macroeconomic volatility. The analysis is extended to consider the influence of demand and supply-side drivers of FD on MF. By introducing theoretical underpinnings of financial depth and access in a large-scale new Keynesian model, the study indicated that the financial sector with low depth and access intensifies fluctuations caused by all shocks, whether real, nominal, or financial. The study also found that for macroeconomic stability in the face of diverse shocks, a medium to high level of depth with a moderate degree of inclusion is essential. Furthermore, it is encouraged to reach a greater degree of FD using supply-side drivers rather than demand-side variables.
Street play as occupation for pre-teens in Belhar, South Africa
Authors: Brackmann Amanda , Ramugondo Elelwani , Daniels Adrienne , Galeni Fezeka , Awood Michael , Hosking Tessa 
Published: February 2025

Street play is often overlooked as an important activity for young people and can have negative connotations associated with it. There is currently no documented research which describes the meaning children and young people ascribe to street play. What people do everyday - which may promote meaning, health and well-being - is regarded as occupation within occupational science and occupational therapy. This paper explores the experiences of pre-teens who engage in street play within the context of Belhar, South Africa. It reports on a study conducted to gain insight into street play from the perspectives of this group of young people, with the purpose of informing occupation-focussed occupational therapy with this population in contexts similar to Belhar. The findings of the study support an occupational justice approach to occupational therapy, which reqauires interdisciplinary research and practice, in order to inform policies such as the Open Streets initiatives that should promote children and young people's meaningful participation in society. They also challenge the traditional treatment modalities and recommend further research and discussion into rhetoric(s) such as play as power and identity.
Key words: street play; phenomenology; pre-teens; occupational justice; play space
Legal Basis of the Food Security Doctrine of the Russian Federation
Authors: Shapovalov N. I. 
Published: February 2025

Aim. Formation of scientific knowledge on ways to create a mechanism for managing the pricing of essential food products by legal means.Methodology. The trend of increasing legal regulation of the market has been traced. The work uses general scientific research methods, which allows you to take into account foreign experience in solving food security problems, as well as service tools, Overton windows, which allow you to identify trends in the development of modern legal consolidation of the foundations of the Food Security Doctrine. Analysis of the structure of market legal relations allows us to determine the direction of the formation of the legal doctrine for managing the pricing of essential food products.Results. The analysis showed the theoretical possibility of creating a mechanism for managing the pricing of essential food products by legal means.Research implications. Proposals were presented on the formation of a legal doctrine for managing the pricing of essential food products. The author’s edition of the concept of legal technology for the formation of pricing by manufacturers of essential food products has been introduced.
The Civil Consequences of the Affiliation of Legal Entities
Authors: Gordopolov Yu. V. , Petrova V. Yu. 
Published: February 2025

Aim. Identification, analysis and clarification of the civil consequences of affiliation of legal entities.Methodology. The work is based on the disclosure of the concept of affiliation through the civil consequences of the affiliation of legal entities. The main method of research is a theoretical and methodological analysis of sources on this topic, as well as a comparative analysis of various points of view in the context of the problems of the work.Results. The article examines the specifics of affiliation in relation to legal entities, as well as the civil law consequences of this phenomenon in modern legal practice. The authors disclose the content of the legal category of affiliation, as well as the concept and characteristics of affiliated legal entities.Research implications. Logically justifying the importance of affiliation in the context of civil law consequences, the main part of the study is devoted to the author’s definition of this phenomenon and its impact on legal entities.
DETERMINANTS OF POTENTIAL PARKING FEE FRAUD IN THE CITY OF MATARAM
Authors: Majdi Alfin Haerul , Inapty Biana Adha 
Published: February 2025

ABSTRACTParking levy is one of the official sources of revenue for local governments that are collected and managed to improve the social welfare of the people in their area. The potential for parking levy revenue in Mataram City is quite large, but for the last five years the realization of parking levy revenue has never been achieved. The goals of this study were to find out the factors that result in the non-realization of parking levy revenue in Mataram City. The research population is all parking attendants who are officially registered on the parking attendant information system application (Sijukir) with a sample size of 40 parking attendants, sampling using purposive sampling. This research is in the form of quantitative research through questionnaires with multiple linear regression analysis. The theoretical basis used is to use the hexagon fraud theory developed by Vousanis in 2019. The research results state that the variables of economic pressure, supervision and rationalization have a positive effect on the potential parking fee fraud. The ability variable has negative effect on the potential for parking fee fraud, while the arrogant attitude and collusion variables have no effect on the potential for parking fee fraud in Mataram City.Keywords: Fraud Hexagon Theory, Potential Fraud, PAD, Parking Levy
ABSTRAKRetribusi parkir adalah satu dari sekian sumber pendapatan resmi pemerintah daerah yang dipungut dan dikelola untuk meningkatkan kesejahteraan sosial masyarakat di daerahnya. Potensi penerimaan retribusi parkir di Kota Mataram cukup besar, tetapi selama lima tahun terakhir realisasi penerimaan retribusi parkir belum pernah tercapai. Tujuan penelitian ini yaitu guna meninjau faktor-faktor yang menyebabkan kegagalan realisasi pendapatan retribusi parkir di Kota Mataram. Populasi penelitian adalah semua juru parkir yang terdaftar secara resmi pada aplikasi Sistem Informasi Juru Parkir (Sijukir) dengan jumlah sampel yaitu 40 juru parkir, pengambilan sampel menerapkan purposive sampling. Penelitian ini berupa penelitian kuantitatif melalui kuesioner dengan analisis regresi linier berganda. Landasan teori yang digunakan yaitu menggunakan theory fraud hexagon yang digagaskan oleh Vousanis pada tahun 2019. Hasil penelitian menyatakan bahwa variabel tekanan ekonomi, pengawasan dan rasionalisasi berpengaruh positif terhadap potensi fraud retribusi parkir. Variabel kemampuan berpengaruh negatif terhadap potensi fraud retribusi parkir, sedangkan variabel sikap arogan dan kolusi tidak berpengaruh terhadap potensi fraud retribusi parkir di Kota Mataram.Kata Kunci: Fraud Hexagon Theory, Potensi Fraud, PAD, Retribusi Parkir
Analisis Risk Maturity Level ISO 31000:2018 pada BUMN Karya di Indonesia
Authors: Yanto Heri , Purba Humiras Hardi , Amin Mawardi 
Published: February 2025

The current environment, with lots of fast changes, is full of uncertain strings and risks. Therefore, it is necessary to make the correct and fast decisions necessary for survival and success in the world of construction. This study aims to analyze the application and gaps (gap analysis) and identify steps that companies need to take (action plans) for the gaps that occur so that they can increase the application of risk maturity level ISO 31000: 2018 in state-owned construction companies in Indonesia where this research is conducted. The system consists of 8 variables, each of which is associated with 55 parameters. The review's discoveries explain that BUMN Development Tasks in Indonesia line up with Hazard The Board Standards, Structures, and Cycles, showing their suitability. Overall, the highest average risk maturity level is at PT. Hutama Karya (Persero) Tbk, namely at level 4.43, and the lowest is at PT. Brantas Abipraya (Persero) at level 3.83. The ISO 31000-based risk maturity level is referred to in the action plan, which is adjusted for each attribute's risk maturity level. In 2018, this activity plan is a significant direct that must be finished by expanding the gamble development level to one level higher than the ongoing level.
ABSTRAK
Lingkungan saat ini dengan banyak perubahan cepat penuh dengan ikatan dan risiko yang tidak pasti. Oleh karena itu, diperlukan pengambilan keputusan yang benar dan cepat diperlukan untuk keberlangsungan hidup dan kesuksesan di dalam dunia konstruksi. Penelitian ini bertujuan untuk menganalisis penerapan, kesenjangan (gap analysis) serta mengidentifikasi langkah-langkah yang perlu diambil perusahaan (action plan) atas kesenjangan yang terjadi agar dapat dilakukan peningkatan penerapan risk maturity level ISO 31000:2018 pada perusahan BUMN konstruksi di Indonesia dimana penelitian ini terdiri dari 8 variabel dengan 55 parameter. Hasil dari penelitian menjelaskan bahwa BUMN Karya Konstruksi di Indonesia dinilai sudah sesuai berdasarkan Prinsip, Kerangka Kerja, dan Proses Manajemen Risiko. Secara umum, tingkat perkembangan tipikal judi yang paling menonjol di PT. Hutama Karya (Persero) Tbk, khususnya pada level 4.43 dan yang paling turun adalah PT. Brantas Abipraya (Persero) pada level 3,83. Rencana kegiatan diubah sesuai dengan tingkat pengembangan taruhan untuk setiap fitur dan mengacu pada tingkat pengembangan perjudian berdasarkan ISO 31000: 2018 di mana rencana kegiatan ini merupakan petunjuk penting yang harus diselesaikan dengan memperluas tingkat pengembangan perjudian ke satu tingkat lebih tinggi dari tingkat yang sedang berlangsung.
Plastic Burning Particulate Matter as a Source of Environmentally Persistent Free Radicals and Reactive Oxygen and Chlorine Species
Authors: Salim Rizana , Kapur Sukriti , Schervish Meredith , Gerritz Lena , Edwards Kasey , Ruis-Armenta Luis , Varghese Emil , Ravikrishna Raghunathan , Nizkorodov Sergey , Gunthe Sachin , Shiraiwa Manabu 
Published: February 2025

Abstract

Burning plastic waste releases massive amounts of atmospheric particulate matter (PM), but its chemical composition and health-related properties are largely unelucidated. Here we characterize chemical composition of PM generated from burning common types of plastics and quantify reactive oxygen/chlorine species and PM oxidative potential (OP). We find that plastic burning PM contains high levels of environmentally persistent free radicals (EPFRs), transition metals, and polycyclic aromatic hydrocarbons. In the aqueous phase, PM generates hydrogen peroxide, •OH radicals, and carbon-centered organic radicals, exhibiting high levels of OP as characterized by DTT and OH assays. Remarkably, plastic burning PM is associated with high concentrations of hypochlorous acid. Kinetic model simulations demonstrate that the PM respiratory deposition leads to •OH formation via complex redox reactions among its constituents and antioxidants in lung lining fluid. Our study highlights significant atmospheric and health implications for unregulated plastic burning, particularly common in many areas of developing countries.