bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring Vaccine Hesitancy Levels Among Turkish Parents in 2024 After Pandemic; Key Influencing Factors: A Cross‐Sectional Study
Authors: Kılınç Zehra , Beycur Işık Songül 
Published: February 2025

Objectives: This study aimed to evaluate the level of vaccine hesitancy and related factors regarding childhood vaccines among parents with children under 5 years of age receiving services from a health center in Turkey.Materials and Methods: This cross‐sectional study was conducted with parents with children under 5 years of age who applied to a primary care family health center in Diyarbakır province between 1 November and 1 December 2023. The number of children under 5 years of age registered at the family health center was approximately 800, and the minimum sample size was calculated as 219 using the Open Epi program with a 13% vaccine hesitancy frequency, 99% confidence interval, and 80% power. A total of 214 parents who had no communication problems and voluntarily agreed to participate were included in the study. Data were collected through face‐to‐face interviews using a data form including demographic information of parents and their children, vaccination knowledge, the impact of the COVID‐19 pandemic on vaccination attitudes, and the Parents’ Attitudes Toward Childhood Vaccines Scale (PACV) Scale. Data were analyzed using SPSS (Version 24.0).Findings: The mean age of the participants was 32.2 ± 5.9 years, 73.4% were mothers, 70.1% and 62.6% of their spouses had high school education or less, and 60.7% were not employed. A total of 65.9% of the parents were at the middle‐income level and 76.6% stated that they had sufficient knowledge about child vaccines. They mostly received vaccine information from family health center nurses or physicians (84.1%). The vaccine hesitation rate was 16.8% and the PACV Scale’s mean score was 34.38 ± 15.60. No significant difference was found between the hesitation levels of the parents. While the rate of hesitation was 36.1% in parents with sufficient knowledge about vaccination, this rate was 63.9% in those with insufficient knowledge, and this difference was found to be statistically significant (p = 0.01). In addition, vaccine hesitancy was found to be higher in parents who did not have a negative impact of the COVID‐19 pandemic on the vaccination decision. Parents with university and higher education level had higher and statistically significant safety‐effectiveness scale subdimension scores (p < 0.001).Conclusions: In this study, vaccine hesitation was found in 16.8% of the parents and the level of hesitation was found to be associated with knowledge and education levels. The hesitation rate was found to be lower in parents who had sufficient knowledge about childhood vaccines. The higher hesitation levels of parents who reported that the pandemic did not negatively affect their vaccination decisions suggest the effect of social and psychological factors. The findings emphasize the importance of education and awareness‐raising activities for parents to reduce vaccine hesitancy.
The Relationship Between Clinicopathological Features and Prognosis of 22 Cases of Tubular Breast Carcinoma
Authors: Tian Lin , Meng Xiangchao , Si Huiyan , Qiu Yue , Qu Rui , Chen Hongye 
Published: February 2025

Background: Breast tubular carcinoma is a special pathological type of invasive breast cancer, accounting for about 0.8% to 10.0% of breast cancer cases, and it is a rare type of breast cancer. Currently, there is still a lack of relevant diagnostic and treatment consensus. Exploring the relationship between the pathological characteristics, molecular subtypes, and prognosis of ductal breast cancer is of great scientific value and clinical significance for improving patients’ survival rate and quality of life.Methods: The clinical data of 22 patients with tubular breast carcinoma diagnosed by pathology in The First Medical Center of PLA General Hospital from January 2001 to December 2021 were collected, and their pathological features, molecular classification, and prognosis were analyzed retrospectively.Results: The clinicopathological features of 22 patients with tubular breast carcinoma were age ≥ 35 years, married, tumor ≤ 2 cm, single focal, mixed type, no lymph node metastasis, estrogen receptor (ER) positive, progesterone receptor (PR) positive, Ki‐67 ≤ 14%, CyclinD1 negative, less recurrence, and metastasis. Twenty‐two patients with breast tubular carcinoma were followed up for 5 years after surgery, and the survival rate of disease‐free survival (DFS) was 90.9% (20/22). The positive rates of ER, PR, and human epidermal growth factor receptor‐2 (HER‐2) are 100.0%, 100.0%, and 40.9%, respectively. The proportion of tumor cells expressing Ki‐67 is 45.4%. Among them, the difference of HER‐2 level, recurrence and metastasis, and postoperative comprehensive treatment showed different prognoses.Conclusion: Tubular breast carcinoma is a kind of tumor with a low malignant degree. The prognosis is significantly related to its HER‐2 level, recurrence and metastasis, and postoperative comprehensive treatment by univariate analysis, in which HER‐2 is an independent risk factor, postoperative comprehensive treatment is a protective factor, but postoperative recurrence and metastasis have nothing to do with the prognosis by the multivariate analysis.
Assessing the Relevance of the Kansas City Cardiomyopathy Questionnaire in Patients With Tricuspid Regurgitation: The Tri-QOL Qualitative Study
Authors: Olds Danielle M. , Smith Jamie L. , Spertus John A. , Dunlay Shannon M. , Bocell Fraser D. , Wu Changfu , Cohen David J. , Arnold Suzanne V. 
Published: February 2025

BACKGROUND:
Validly measuring disease-specific health status is critical in patients with severe tricuspid regurgitation (TR) to quantify the benefit of different interventions. The Kansas City Cardiomyopathy Questionnaire (KCCQ) has been used to assess health status in patients with severe TR, but its content validity in this patient population is unknown, including whether additional questions are needed to supplement the KCCQ.

METHODS:
Twenty participants with symptomatic severe TR from 2 midwestern clinical sites were interviewed in 2023 using a semistructured guide. The interview guide addressed symptoms, physical and social functioning, and quality of life concepts of the KCCQ, as well as other potential TR symptoms not represented in the KCCQ. Interview transcripts were analyzed using inductive and deductive coding and content analysis, with additional participants recruited until thematic saturation occurred.

RESULTS:
Mean age of the participants was 80 (41–89), and 75% were female. Shortness of breath and fatigue were reported by virtually all participants (n=20 and n=19, respectively) and had a marked negative impact on their physical and social functioning and quality of life. Lower limb edema was also reported by 10 participants. Although these concepts are captured by the KCCQ, other symptoms were also reported, including appetite loss (n=8) and upper body edema (n=4), but did not seem to markedly affect participants’ function or quality of life. In addition, all participants who experienced these other symptoms reported symptoms that were already captured by the KCCQ.

CONCLUSIONS:
All participants experienced symptoms captured by the KCCQ, and these symptoms had a substantial impact on their physical and social functioning and quality of life. Although some participants reported additional symptoms not assessed by the KCCQ, their incorporation would only marginally improve content validity. Thus, the current KCCQ appears to be appropriate for capturing the disease-specific health status of patients with severe TR.
Deciphering Automation Transparency: Do the Benefits of Transparency Differ Based on Whether Decision Recommendations Are Provided?
Authors: Gegoff Isabella , Tatasciore Monica , Bowden Vanessa K. , Loft Shayne 
Published: February 2025

Objective To better understand automation transparency, we experimentally isolated the effects of additional information and decision recommendations on decision accuracy, decision time, perceived workload, trust, and system usability. Background The benefits of automation transparency are well documented. Previously, however, transparency (in the form of additional information) has been coupled with the provision of decision recommendations, potentially decreasing decision-maker agency and promoting automation bias. It may instead be more beneficial to provide additional information without decision recommendations to inform operators’ unaided decision making. Methods Participants selected the optimal uninhabited vehicle (UV) to complete missions. Additional display information and decision recommendations were provided but were not always accurate. The level of additional information (no, medium, high) was manipulated between-subjects, and the provision of recommendations (absent, present) within-subjects. Results When decision recommendations were provided, participants made more accurate and faster decisions, and rated the UV system as more usable. However, recommendation provision reduced participants’ ability to discriminate UV system information accuracy. Increased additional information led to faster decisions, lower perceived workload, and higher trust and usability ratings but only significantly improved decision (UV selection) accuracy when recommendations were provided. Conclusion Individuals scrutinized additional information more when not provided decision recommendations, potentially indicating a higher expected value of processing that information. However, additional information only improved performance when accompanied by recommendations to support decisions. Application It is critical to understand the potential differential impact of, and interaction between, additional display information and decision recommendations to design effective transparent automated systems in the modern workplace.
Relationship of Neurotropin-3 Gene Polymorphism with Cognitive Impairment in Bipolar Disorder
Authors: Monisha Muralidharan , Keshri Neha , Nandeesha Hanumanthappa , Menon Vikas 
Published: February 2025

Background: Neurotropin-3 (NT-3), a marker of neural plasticity, is reported to be altered in bipolar disorder (BD). This study was designed to evaluate NT-3 gene polymorphism (rs 6489630, rs 6332, and rs 11063714) in BD and its association with disease severity and cognition. Methods: The study included 176 BD cases and 176 controls. All the participants were tested for NT-3 polymorphism and plasma NT-3. ACE-III scores were used to analyze cognition. Results: The NT-3 polymorphism (rs 6489630) was associated with cognitive impairment in BD ( P = .010). The attention score was found to be decreased in the CT genotype ( P = .028) when compared to the CC and TT genotypes of the rs6489630 variant. The visuospatial ability score was decreased in the GG genotype ( P = .044) compared to the AG genotype of the rs11063714 variant. BD patients with the maniac episode showed a decrease in levels of Neurotrophin-3 in comparison to both the control group ( P = .045) and the remission group ( P = .017). Plasma NT-3 was associated with the YMRS ( r = −0.221, P = .003), HDRS ( r = 0.209, P = .005) and visuospatial ability score ( r = 0.180, P = .017) in patients with BD. Conclusion: Single nucleotide polymorphisms of NT-3 are associated with cognitive dysfunction in BD.
The magnetic resonance imaging appearance of the normal anatomy and injury pattern of capsuloligamentous complex of the first metatarsophalangeal joint
Authors: Qian Zhan-hua , Wang Jin-e , Bai Rong-jie , Zhan Hui-li , Li Wen-ting , Wang Nai-li , Yin Yuming 
Published: February 2025

Background The capsuloligamentous complex injury of the first metatarsophalangeal joint (MTPJ) is a common cause of turf toe. Purpose To investigate whether high-resolution 3 T magnetic resonance imaging (MRI) could demonstrate all the normal anatomic structures and the MR features of the capsuloligamentous complex injury of the first MTPJ, and to evaluate the diagnostic performance of MRI in the diagnosis of the capsuloligamentous complex injuries of the first MTPJ. Material and Methods A total of 115 feet were included in this study, including 48 feet from 24 healthy volunteers and 67 feet from 67 patients with the capsuloligamentous complex of the first MTPJ injuries. All feet had MRI examination. The MRI features of the capsuloligamentous complex of the first MTPJ of the volunteers and patients were analyzed. Diagnostic sensitivity, specificity, and accuracy of MRI were calculated using the surgery as the standard of reference. The inter-observer agreement was assessed using kappa analysis. Results The central portion of the plantar plate and ligament injury manifested as discontinuity, with an indistinct appearance with hyperintense signal within the involved structures. The sensitivities, specificities, and diagnostic accuracy value of MRI for diagnosing most structures of the capsuloligamentous complex injuries of the first MTPJ were 67%–100%, 93%–100%, and 0.82–0.99, respectively, and overall good to perfect inter-observer agreements (kappa=0.63–0.95). Conclusion High-resolution MRI allows adequate visualization of normal anatomic structures of the first MTPJ. The best visualized structure is sesamoid phalangeal ligament and the most frequent injury is complete tear of the medial sesamoid phalangeal ligament.
Mediating Role of Service Quality in the Relationship Between Self-Determined Study Abroad Motivations and Satisfaction
Authors: Mucsi Attila , Malota Erzsébet 
Published: February 2025

This current research explores the relationships among self-determined study abroad motivations, perceived service quality and satisfaction in the field of international higher education. A sample of 426 international students from 56 countries was analyzed via PLS-SEM. The results show that self-determined motivations positively affect satisfaction, and that perceived service quality partially mediates the effect of self-determined motivations on satisfaction. This research is unique as it provides quantitative evidence that the influence of self-determined study abroad motivations on satisfaction through perceived service quality as a partial mediator is 70% stronger (ß=0.202) than the direct influence (ß=.119) of these motivations on satisfaction. Students who had a higher level of self-determined motivation rated service quality dimensions higher and subsequently were more satisfied with their experience at the host university and in the host country. Our insights may help higher education institutions customize their study abroad experience through understanding motivations and service quality requirements.
Transapical to Femoral Through-and-Through Wire Technique for Ruptured Aortic Arch Aneurysm Management: Case Report and Review of Literature
Authors: Ali Ahmed A. , Stana Jan , Becker Daniel , Pichlmaier Maximilian , Tsilimparis Nikolaos 
Published: February 2025

Aim: To present a case where the transapical and femoral accesses were used to establish a through-and-through guidewire to deliver branched arch endograft effectively. Case: An 86-year-old male presented with an aortic arch aneurysm rupture was treated with branched arch endograft. Due to tortuous anatomy, several attempts using femoral and axillary routes to navigate the endograft to the proximal landing zone failed. A through-and-through guidewire was established using transapical and femoral accesses to provide sufficient stability for subsequent advancement and delivery of the arch branch endograft. Conclusion: Transapical to femoral through-and-through approach is a feasible adjuvant for delivering aortic endografts in emergent cases, particularly in patients with trackability issues and challenging tortuous anatomy. This technique could be a valuable solution for carefully selected patients where conventional approaches are not viable. Clinical Impact Transapical access has been widely used in valvular and elective aortic interventions; however, its application in ruptured scenarios is seldom documented. This case report details the utilisation of transapical access in a ruptured aortic arch aneurysm with a tortuous aorta, where femoral and axillary access have proven inadequate. Establishing a transapical to transfemoral through-and-through wire has provided enhanced stability for precise endograft deployment. Procedural details and outcomes, alongside a review of the literature, underscore the use of transapical access and through-and-through wire in managing complex ruptured pathologies, addressing gaps in the literature concerning its efficacy and safety in urgent high-risk scenarios.
From Middle Jurassic extension to Late Jurassic obduction: sedimentary records from the Greater Adriatic margin of the Neotethys Ocean in NE Hungary
Authors: Kövér Szilvia , Haas János , Djerić Nevenka , Szives Ottilia , Ozsvárt Péter , Fodor László 
Published: February 2025

Abstract
A displaced segment of the Late Triassic–Late Jurassic Greater Adriatic margin of the Neotethy Ocean was investigated in NE Hungary. In this area, the Mesozoic basement is largely covered by the Palaeogene—Miocene infill of the North Hungarian Palaeogene Basin and the Pannonian Basin. Micropaleontological, sedimentological and structural investigation of more than thirty wells resulted in the detailed characterisation and 3D depositional model of the area, which may have formed in the eastern continuation of the Slovenian Basin or in a similar sub-basin. The sedimentation in its Bajocian–early Callovian extensional half-grabens was characterised by pelagic limestones followed by dark shales with sandstone intercalations. Mass-flow deposits derived from both the footwalls of graben-bounding normal faults and the Adriatic Carbonate Platform were frequent. The most basin-ward segment of the latter one was penetrated by the south-westernmost well of the area. Both the Middle Jurassic extension of the formerly extended continental crust and the lower plate source of the sediments have great importance, while they change the tectonic interpretation of the basins. In the overlying Tarna olistostrome sedimentation lasted at least until the Tithonian, as indicated by nannofossils. This is the oldest possible age for the overthrusting of the ophiolite nappe over this segment of the Greater Adriatic continental margin. The now eroded ophiolite nappe is underlain by the Darnóhegy Mélange, a typical sub-ophiolitic mélange, which was formed further to the south-east during the Callovian–Oxfordian, at an earlier, intraoceanic stage of the Neotethyan subduction.
Conventional type 1 dendritic cells in the lymph nodes aggravate neuroinflammation after spinal cord injury by promoting CD8+ T cell expansion
Authors: Wang Li-Qing , Wang Xiao-Yi , Ma Yue-Hui , Zhou Heng-Jun 
Published: February 2025

Abstract

Background
Adaptive immune response is at the core of the mechanism of secondary spinal cord injury (SCI). This study aims to explore the molecular mechanism by which classical dendritic cells (cDC1s) influence CD8+ T cell expansion in SCI.

Methods
Peripheral blood samples from patients with SCI and spinal cord tissues from SCI mice were collected, and the population of cDC1 subset was analyzed by flow cytometry. In vivo, the fms-like tyrosine kinase 3 (Flt3) inhibitor quizartinib was administered to deplete cDC1s, while intraperitoneal injection of recombinant Flt3L and immunosuppressive drug FTY-720 was used to expand cDC1s and prevent T cell egress from lymph nodes (LNs), respectively. In vitro, the conditioned medium (CM) of isolated LN fibroblastic stromal cells (FSCs) and pre-DCs were co-cultured. Subsequently, FSC CM-induced DCs were stimulated and co-cultured with CD8+ T cells for proliferation assay.

Results
The cDC1 subset was increased in the peripheral blood of SCI patients and in the injured spinal cord of SCI mice. Depletion of cDC1s decreased the proportion of infiltrating CD8+ T cells in the injured spinal cord of SCI mice and reduced the inflammatory response. The Basso Mouse Scale score of SCI mice was increased and the proportion of CD8+ T cells in blood and spinal cord tissue was decreased after FTY-720 injection. Both migratory cDC1s (CD103+) and resident cDC1s (CD8α+) were present in the LNs surrounding the injured spinal cord of SCI mice. Among them, CD103+ cells were derived from the migration of cDC1s in spinal cord tissues, and CD8α+ cDC1s were directionally differentiated from pre-DCs after co-culture with LN-FSCs. Interferon-γ promoted the secretion of Flt3L by LN-FSCs through the activation of JAK/STAT signaling pathway and enhanced the differentiation of pre-DCs into CD8α+ cells.

Conclusion
Migratory cDC1s and resident cDC1s promote the expansion of CD8+ T cells in LNs around the injured spinal cord and mediate the adaptive immune response to aggravate neuroinflammation in SCI.
NUAK1 acts as a novel regulator of PD-L1 via activating GSK-3β/β-catenin pathway in hepatocellular carcinoma
Authors: Yao Chao-Yan , Tao Hang-Tian , He Jin-Jin , Zhu Feng-Yi , Xie Cui-Qing , Cheng Yu-Na , Li Ji-Qin , Liu Zhuang-Zhuang , Hou Chun-Yu , Liu Xue-Li , Fan Yong-Li , Fang Dong , Lv Xin-Rui 
Published: February 2025

Abstract

Background
NUAK1 is associated with metastasis and drug resistance in hepatocellular carcinoma (HCC). However, little is known about the immune functions of NUAK1 in HCC. Therefore, the aim of this study was to elucidate the novel role of NUAK1 in facilitating immune evasion in HCC and to investigate the mechanisms underpinning this process.

Method
The levels of NUAK1 expression and the infiltration of CD8+ T cells were assessed in tumor tissues from HCC patients and mice xenograft model. HCC cell lines were used to validate the role of NUAK1 in regulating the transcription of PD-L1, the diethylnitrosamine-induced HCC model was established and the expression levels of NUAK1 and PD-L1 proteins in the rat livers were detected. Western blotting, immunofluorescence, real time PCR, and immunohistochemical staining were used to investigate the underlying mechanisms by which NUAK1 regulates PD-L1 expression in hepatocellular carcinoma.

Results
NUAK1 expression was negatively correlated with CD8+ T cell infiltration in tumor tissues from HCC patients and mice xenograft model. Both gain and loss of functions have identified NUAK1 promoted PD-L1 expression at transcriptional level in HCC cells. The increased expression of NUAK1 and PD-L1 proteins were observed in the rat livers of diethylnitrosamine-induced HCC model. Moreover, overexpression of NUAK1 promotes GSK3β Ser9 phosphorylation, β-catenin expression and nuclear accumulation in HCC cells. By contrast, knockdown of NUAK1 has opposite effects. Inhibition of GSK3β activity significantly promoted β-catenin expression and PD-L1 expression in HCC cells. IHC analyses of tumor tissues from HCC patients suggested that the levels of p-GSK3β and β-catenin were positively correlated with NUAK1 expression. Knockdown of β-catenin also reversed NUAK1-mediated PD-L1 expression in HCC cells.

Conclusions
This study revealed a novel role for NUAK1, which promotes the transcriptional expression of PD-L1 by activating GSK3β/β-catenin signaling pathway, leading to immune escape of hepatocellular carcinoma.

Registry and the registration no. of the study/trial: Not applicable.