bluuebunny/crossref_metadata_2025_split huggingface dataset:
The importance of intraoperative echocardiography in the early detection of mitral regurgitation as a postsurgical sequel of aortic valve replacement: a case report
Authors: Fesharaki Mehrdad Jafari , Akbari Tooba , Bayat Fariba , Ghadirzadeh Erfan , Charkazi Elham 
Published: November 2023

Abstract
Background
Mitral leaflet perforation (MLP) can rarely be a consequence of aortic valve replacement (AVR), resulting in mitral regurgitation (MR). Determining the cause and severity of MLP following AVR is crucial in preventing hemodynamic consequences, such as pulmonary hypertension and biventricular remodeling. However, the diagnosis of this rare complication requires detailed echocardiographic evaluations.

Case presentation
In this paper, we report a 37-year-old Persian male with progressive dyspnea on exertion diagnosed with severe MR caused by anterior MLP following AVR and discuss the importance of intraoperative transesophageal echocardiography (TEE) in the proper and on-time diagnosis of this rare complication.

Conclusion
During AVR procedure, an evaluation with TEE could be beneficial for identifying and treating such condition. Echocardiography is beneficial in providing real-time guidance during surgery, early detection of potential complications, treatment of such complications if present, and prevention of adverse outcomes.
The emerging roles of N6-methyladenosine RNA modifications in thyroid cancer
Authors: Xu Xiaoxin , Zhao Jiayao , Yang Mingyue , Han Lutuo , Yuan Xingxing , Chi Wencheng , Jiang Jiakang 
Published: November 2023

AbstractThyroid cancer (TC) is the most predominant malignancy of the endocrine system, with steadily growing occurrence and morbidity worldwide. Although diagnostic and therapeutic methods have been rapidly developed in recent years, the underlying molecular mechanisms in the pathogenesis of TC remain enigmatic. The N6-methyladenosine(m6A) RNA modification is designed to impact RNA metabolism and further gene regulation. This process is intricately regulated by a variety of regulators, such as methylases and demethylases. Aberrant m6A regulators expression is related to the occurrence and development of TC and play an important role in drug resistance. This review comprehensively analyzes the effect of m6A methylation on TC progression and the potential clinical value of m6A regulators as prognostic markers and therapeutic targets in this disease.
Implementing process-genre approach, feedback, and technology in L2 writing in higher education
Authors: Peungcharoenkun Tipaya , Waluyo Budi 
Published: November 2023

AbstractThe process-genre approach, varied feedback types, and technology integration have been shown to improve students' writing skills, but there is little research on how these three variables interact when implemented together in writing instruction. This study applied a quasi-experimental design with a sequential explanatory design to integrate the process-genre approach, teacher and peer oral and written feedback, and an online technology platform into a Thai university's English writing course. The experimental group received interventions, whereas the control group received standard writing instruction with papers and teacher and peer feedback. Writing pre- and post-tests, formative writing assignments, teacher, peer, oral, and written feedback surveys, and semi-structured interviews were the evaluation instruments. Descriptive statistics, the Wilcoxon Signed Rank Test, the Mann–Whitney–Wilcoxon test, Spearman's correlation, and Kendall–Theil regression were used to examine quantitative data. A thematic analysis examined qualitative data. The experimental group scored higher on post-tests than pre-tests, indicating that they valued instructor feedback more than other types of feedback. Task response and lexical resource showed substantial gains, although coherence and cohesion, grammatical range, and accuracy did not. The control group had no significant changes in pre- and post-test scores except for task responsiveness. Written feedback was significantly associated with post-test scores and certain post-test criteria in the experimental group. The findings emphasize the importance of a process-genre approach, constant feedback, and technology to improve students' writing.
Effect of Dioscorea extract on Bax and Bcl-2 gene expression in MCF-7 and HFF cell lines
Authors: Bojar Doulaby Fatemeh , Kavousi Mahsa , Jamshidian Faranak 
Published: November 2023

Abstract
Background
In cancer cells, the balance between proliferation and apoptosis is disturbed. There is a direct relationship between gene expression and the process of apoptosis. The two genes involved in apoptosis are Bax and Bcl-2, and it is now well established that some plant compounds can alter the expression of genes. The aim of this study is to determine the rate of change in the expression of these genes in the cell line MCF-7 treated with Dioscorea extract for 24, 48 and 72 h. For this purpose, the plant extract was prepared by Soxhlet method and diluted in different concentrations. MCF-7 and HFF cell lines were treated in three replicates with different concentrations of the extract at intervals of 24, 48, and 72 h. To evaluate the toxicity of the extract, the MTT assay was performed and the IC50 value was calculated. Both cell types were cultured at IC50 concentration with three treatments and three replicates. RNA extraction, cDNA synthesis and real-time PCR were then performed. Flow cytometry was performed to further confirm apoptosis.

Results
MTT results showed that 72 h treatment with Dioscorea extract in IC50 concentration had the greatest effect on the death of MCF-7 cancer cells, while the cells of the control cell line remained healthy. The results of the study of gene expression changes showed that when treated with the plant extract for 24 h, the increase in Bax gene expression and the decrease in Bcl-2 gene expression were not statistically significant. At 48-h treatment, the decrease in Bcl-2 expression was not statistically significant, whereas the increase in Bax expression, which was 2.1 times, was statistically significant. When treated with the plant extract for 72 h, Bax expression increased 2.72 times and Bcl-2 gene expression decreased 0.67 times. Flow cytometry showed that 72-h treatment with plant extract at a concentration of 438.35 µg/ml was the most effective treatment for MCF-7 cancer cell death.

Conclusions
The expression ratio of Bax gene to Bcl-2 is equal to 4.06, which indicates the induction of more apoptosis by treatment with plant extract.
Biliary atresia with rare associations: a case report
Authors: Sabra Tarek Abdelazeem , Abdelmohsen Sarah Magdy , Abdelazeem Basel 
Published: November 2023

Abstract
Background
It is not often written in medical journals that preduodenal portal vein, biliary atresia, intestinal malrotation, and situs inversus totalis are all related. This is a rare association.

Case reports
A 2-month-old female infant had biliary atresia type III, situs inversus totalis, midgut malrotation, and a preduodenal portal vein. She had been operated on by the Kasai procedure (hepato-portoenterostomy).

Discussion
It is important to carefully look into the relationship between the preduodenal portal vein and biliary atresia because the patient is at risk of injury from this aberrant vein during operative intervention.

Conclusion
The relationship between biliary atresia and other congenital anomalies like preduodenal portal vein, intestinal malrotation, and situs inversus must be taken into consideration to avoid other diverse effects during surgical intervention.
Barriers and facilitators of physical activity, sedentary and sleep behaviours in 3 to 4-year-old children from low-income families: a study protocol
Authors: Dalziell Andrew , Janssen Xanne 
Published: November 2023

Abstract
Background
This study will evaluate the barriers and facilitators that families experience in adhering to the 24-hour movement behaviours guidelines as outlined by World Health Organisation (WHO).

Methods
The study is a mixed-methods study and will recruit between 20 to 30 low-income families with children aged 3- to 4-years living in Scotland. For the quantitative part, children will be asked to wear an Actigraph (GT3X +) accelerometer to measure physical activity, sedentary behaviour, and sleep. Parents/guardians will be asked to keep an activity diary outlining when their child has had to remove the device (i.e., showering, bathing, swimming) and record the child’s screen time each day. Once the data has been analysed, a unique activity profile chart will be sent out to each family illustrating their child’s 24-hour movement behaviours (i.e., time spent active, time spent sedentary and on screens, time spent sleeping). The activity profile will provide a day-by-day output as well as a weekly average for each of the 24-hour movement behaviours. Qualitative data will be collected using the Asynchronous Remote Communities method (ARC). The ARC involves participants completing activities using an online closed Facebook group. Parents/guardians of 3- to 4-year-old children will be asked to engage in group discussion tasks using the private and closed-group online platform (a minimum of 6 and a maximum of 8 families per discussion group). The quantitative data collated from the questionnaire and activity monitor will be presented through descriptive analysis and after the 6-week asynchronous process is complete, qualitative data will be collated and analysed using Braun and Clarke’s reflexive approach to thematic analysis.

Discussion
The data collected will provide an understanding of what barriers and facilitators parent’s/guardians’ experience in relation to adhering to the 24-hour movement behaviour guidelines. This could potentially lead to the design and implementation of support and interventions to help families struggling to adhere to the guidelines.
First-Line Pembrolizumab + Chemotherapy Versus Placebo + Chemotherapy for Persistent, Recurrent, or Metastatic Cervical Cancer: Final Overall Survival Results of KEYNOTE-826
Authors: Monk Bradley J. , Colombo Nicoletta , Tewari Krishnansu S. , Dubot Coraline , Caceres M. Valeria , Hasegawa Kosei , Shapira-Frommer Ronnie , Salman Pamela , Yañez Eduardo , Gümüş Mahmut , Olivera Hurtado de Mendoza Mivael , Samouëlian Vanessa , Castonguay Vincent , Arkhipov Alexander , Tekin Cumhur , Li Kan , Keefe Stephen M. , Lorusso Domenica ,   on behalf of the KEYNOTE-826 Investigators
Published: November 2023

Clinical trials frequently include multiple end points that mature at different times. The initial report, typically based on the primary end point, may be published when key planned co-primary or secondary analyses are not yet available. Clinical Trial Updates provide an opportunity to disseminate additional results from studies, published in JCO or elsewhere, for which the primary end point has already been reported. The phase III, double-blind KEYNOTE-826 trial of pembrolizumab 200 mg or placebo once every 3 weeks for up to 35 cycles plus platinum-based chemotherapy, with or without bevacizumab, showed statistically significant survival benefits with the addition of pembrolizumab for patients with persistent, recurrent, or metastatic cervical cancer (primary data cutoff: May 3, 2021). This article reports the protocol-specified final overall survival (OS) results tested in the PD-L1 combined positive score (CPS) ≥1, all-comer, and CPS ≥10 populations. At the final data cutoff (October 3, 2022), the median study follow-up duration was 39.1 months (range, 32.1-46.5 months). In the PD-L1 CPS ≥1 (N = 548), all-comer (N = 617), and CPS ≥10 (N = 317) populations, median OS with pembrolizumab–chemotherapy versus placebo–chemotherapy was 28.6 months versus 16.5 months (hazard ratio [HR] for death, 0.60 [95% CI, 0.49 to 0.74]), 26.4 months versus 16.8 months (HR, 0.63 [95% CI, 0.52 to 0.77]), and 29.6 months versus 17.4 months (HR, 0.58 [95% CI, 0.44 to 0.78]), respectively. The incidence of grade ≥3 adverse events was 82.4% with pembrolizumab–chemotherapy and 75.4% with placebo–chemotherapy. These results show that pembrolizumab plus chemotherapy, with or without bevacizumab, continued to provide clinically meaningful improvements in OS for patients with persistent, recurrent, or metastatic cervical cancer.
Doing what matters in times of stress: No-nonsense meditation and occupational well-being in COVID-19
Authors: Van de Velde Justine , Levecque Katia , Weijters Bert , Laureys Steven 
Published: November 2023

While the COVID-19 pandemic challenged the general public’s health and well-being, it exacerbated the pre-existing well-being issues in the educational sector in many countries. Mindfulness-based interventions are often applied to protect and promote occupational well-being. To investigate how the well-being benefits of these interventions arise, we selected one accessible technique that is used in most of them: focused attention meditation. In the middle of the COVID-19 pandemic, 199 teachers voluntarily practiced five to ten minutes of meditation together with their pupils, every morning for six months. We employed a three-wave longitudinal design to follow any changes in the meditating teachers’ well-being and compared these changes to a waitlist control condition of 42 teachers. Three dimensions of well-being were measured at baseline, half-time, and post-intervention: emotional, cognitive, and physical well-being. Latent growth curve models revealed that the meditation technique not only improves well-being but also prevents the development of well-being problems. The practice of focused attention meditation resulted in improvements in emotional and physical well-being and prevented the development of cognitive well-being problems that were observed within the control condition. The effects were strongest for emotional and cognitive well-being and followed a linear trend. This paper shows that the well-being effects of mindfulness-based interventions are at least in part due to the focused attention meditation that is practiced in them. Occupational groups that experience emotional, cognitive, or physical well-being issues can benefit from a few minutes of focused attention meditation per day.
Trial registration: ISRCTN ISRCTN61170784 (https://doi.org/10.1186/ISRCTN61170784).
Factors associated with compliance with Infection Prevention and Control measures during the COVID-19 pandemic among healthcare workers in Kampala City, Uganda
Authors: Limenyande Mitima Jean-Marie , Kobusingye Joyce Owens , Tindyebwa Tonny , Akongo Dorothy , Isunju John Bosco , Musoke David 
Published: November 2023

Background
In the context of the COVID-19 pandemic that originated from China in December 2019 and spread around the world, Kampala City witnessed a high number of infections and deaths among healthcare workers (HCWs). This study assessed the level of compliance with Infection Prevention and Control (IPC) measures and its associated factors among HCWs during the COVID-19 pandemic, in Kampala City, Uganda.

Methodology
A cross-sectional study was conducted in Nakawa Division, Kampala City, among 240 HCWs and used multistage sampling in government and private not-for-profit (PNFP) healthcare facilities. The outcome variable was self-reported IPC compliance which was composed of the use of masks, gloves, and hand hygiene. These were assessed using a 4-scale tool: always as recommended, most of the time, occasionally, and rarely. Only HCWs who responded “always as recommended” were considered compliant while the rest were considered non-compliant. Data was analyzed in STATA 14.0 using Modified Poisson regression to obtain factors associated with IPC compliance at 95% confidence interval (CI).

Results
Forty-six (19.2%) respondents were compliant with all the three IPC measures, and this was associated with the presence of a COVID-19 patients’ ward in the healthcare facility (Adjusted Prevalence Ratio, APR: 2.51, 95%CI: 1.24–5.07). Factors associated with the use of masks were being of the Muslim religion (APR: 1.31, CI: 1.05–1.65), and working in a healthcare facility that has COVID-19 patients’ ward (APR: 1.29, CI: 1.06–1.59). Factors associated with the use of gloves were the age of the HCW, those above 40 years old being less complaint (APR: 0.47, CI: 0.24–0.93), working in the diagnosis department (APR: 2.08, CI: 1.17–3.70), and working in a healthcare facility that has COVID-19 patients’ ward (APR: 1.73, CI: 1.13–2.64). Factors associated with hand hygiene were working in a health center (HC) IV (PR: 1.7, CI: 1.26–2.30) or a HC II (PR: 1.68, CI: 1.28–2.21).

Conclusion
Considering the elevated risk of disease transmission in health settings, IPC compliance was low; indicating an increased risk of COVID-19 infection among health care workers in Kampala City.
Quality Control Using Convolutional Neural Networks Applied to Samples of Very Small Size
Authors: Chatzimichail Rallou A. , Hatjimihail Aristides T. 
Published: November 2023

Abstract
Artificial neural networks (NNs) have been extensively studied for their application to quality control (QC) to monitor the conformity of processes to quality specifications. However, the requirement of at least five QC measurements increases the associated costs. This study explores the potential of using NNs on samples of QC measurements of very small size. To achieve this, three one-dimensional (1-D) convolutional NNs (CNNs) were designed, trained, and tested on datasets of n-tuples of simulated, standardized, normally distributed QC measurements, where

2
≤
n
≤
4

{2\leq n\leq 4}

.
The performance of the designed CNNs was compared to that of statistical QC functions applied to samples of equal sizes, maintaining equal probabilities for false rejection. The results demonstrated that for n-tuples of QC measurements distributed as

𝒩
⁢

(
0
,

s
2

)

\mathscr{N}(0,s^{2})

, where

1.2
<
s
≤
9.0

1.2<s\leq 9.0

, the designed CNNs outperformed their statistical QC functions counterparts. Therefore, the use of 1-D CNNs applied to samples of two to four QC measurements can effectively enhance the detection of nonconformity of a process to quality specifications. This approach has the potential to significantly reduce the costs of QC measurements and improve the overall efficiency of the QC process.
The Reidemeister spectrum of direct products of nilpotent groups
Authors: Senden Pieter 
Published: November 2023

Abstract
We investigate the Reidemeister spectrum of direct products of nilpotent groups.
More specifically, we prove that the Reidemeister spectra of the individual factors yield complete information for the Reidemeister spectrum of the direct product if all groups are finitely generated torsion-free nilpotent and have a directly indecomposable rational Malcev completion.
We show this by determining the complete automorphism group of the direct product.
Latent Acidification of Books Composed of Alkaline Text Papers
Authors: Mochizuki Yukiko , Itsumura Hiroshi , Enomae Toshiharu 
Published: November 2023

Abstract
The current study conducted in March–April 2021 elucidated the acidification process of books using alkaline text paper and improved the method of pH measurement in a previous study from 2016. The pH was measured on various positions of Japanese books published in 2000–2020 using the same type of pH-indicator strip as used in 2016; however, a wetted pH-indicator strip was kept pressed to the text paper with fingers at approximately 5 kgf for 90 s to secure the transfer of water-extracted components for four times while a 250 g paperweight was mounted and kept for 60 s for two times in the 2016-study. This time, the pH was found to decrease faster in positions more readily exposed to outside air compared to the 2016-study. Immediately after publication of the book, the pH was approximately 7.8 in every position. The pH of the top edge corner and the surface near the top edge corner later decreased to a neutral pH 7.0 4–6 years and 7–9 years after publication, respectively. Approximately 20 years after publication, the centre of the page in the interior of the book also dropped to pH 7.1, suggesting that acidification steadily progressed, albeit slightly, even on alkaline paper.
Vitreomacular interface: A case series of adhesion and traction
Authors: Curry Jeffery T , Wingard Michael 
Published: November 2023

The vitreomacular interface has historically been difficult to clinically evaluate. However, with the advent of optical coherence tomography (OCT), pathology at this interface is becoming easier to diagnose and monitor. Vitreomacular interface attachment can range from adhesions without foveal architectural changes such as in a vitreomacular adhesion (VMA) to tractions leading to architectural changes such as in vitreomacular traction (VMT). Many of these cases can be observed and managed by optometry without consult to a retina specialist. The following is a presentation of three cases of vitreomacular pathology, with a review of grading system, presentations that have shown to present a higher incidence of spontaneous release, and treatment options.
Interaction entre la dermatologie et l’ophtalmologie : méta-analyse et recension systématique des écrits sur la lumière pulsée intense utilisée pour traiter le dysfonctionnement des glandes de Meibomius
Authors: Sambhi Raman-Deep Singh , Sambhi Gagan Deep Singh , Monali Malvankar-Mehta 
Published: November 2023

Objectifs : Examiner, au moyen d’une méta-analyse, l’efficacité de la thérapie à lumière pulsée intense dans le traitement des symptômes de la sécheresse oculaire.
Méthodologie : Cette étude a été réalisée en suivant la grille PRISMA. Les sources documentaires consultées comprennent MEDLINE, Embase, la bibliothèque Cochrane et des résumés de réunions de la SCO, d’ARVO, de l’American Academy of Optometry et de l’American Academy of Ophthalmology. Les articles ont subi trois étapes de tri avant l’extraction des données et la méta-analyse.
Résultats : Au départ, nous avons recensé 495 études. Nous en avons retenu 52 après la présélection des titres et 23 après la présélection des résumés. Huit ont été sélectionnées en vue de l’extraction des données. La méta-analyse indique une augmentation importante du temps de rupture du film lacrymal (TRFL) après une thérapie à lumière pulsée (TLP) dans le suivi à moins d’un mois (différence moyenne standardisée [DMS]=1,45; IC :[0,33, 2,57]), le suivi à 1,5 ou 2 mois (DMS=2,08; IC : [1,14, 3,01]) et le suivi à 3 mois (DMS=3,28; IC :[2,78, 3,78]) et aucun changement significatif dans le TRFL dans le suivi à 6 mois (DMS=1,90; IC :[-0,18, 3,98]) ou le suivi à 12 mois des groupes d’une seule étude (DMS=0,0; IC :[-0,48, 0,48]). La méta-analyse indique également une augmentation importante des valeurs du test de Schirmer pendant la période de suivi à moins d’un mois (DMS = 0,91; IC : [0,50, 1,31]) et à six mois (DMS = 0,65; IC : [0,25, 1,04]) et aucun changement significatif des valeurs du test de Schirmer pendant la période de suivi à 1,5 ou 2 mois (DMS=0,41; IC :[-0,93, 1,75]).
Conclusions : Les résultats indiquent une augmentation importante du TRFL jusqu’à 5 mois et aucun changement important à 6 mois après une TLP. Ils indiquent également une augmentation importante des valeurs du test de Schirmer au suivi à moins d’un mois et à six mois et aucun changement important de ces valeurs au suivi à un mois. Au bout du compte, la TLP semble prometteuse pour soulager les symptômes de la sécheresse oculaire, mais d’autres études comprenant des périodes de suivi plus longues sont nécessaires.
Chirurgie réfractive : Partie 1. Résultats à long terme
Authors: Eltis Mark 
Published: November 2023

Bien que le LASIK et la PKR soient utilisés depuis vingt ans, il y a eu peu
d’études à long terme sur la chirurgie réfractive. La présente étude a examiné
les résultats à long terme du LASIK et de la PKR et a analysé les risques, les
avantages et les percées technologiques de ces procédures. Les taux et les
causes de la satisfaction des patients sont discutés en détail. Les autres possibilités
telles que l’extraction d’un lenticule par petite incision (SMILE) et les
options chirurgicales pour la presbytie sont également explorées.