bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opioid prescribing practices in breast oncologic surgery—A retrospective cohort study
Authors: Di Lena Élise , Barone Natasha , Hopkins Brent , Do Uyen , Kaneva Pepa , Fiore Julio F. , Meterissian Sarkis 
Published: February 2024

AbstractBackgroundIn breast oncologic surgery, 75% of patients receive a postoperative opioid prescription at discharge, and 10%–20% will develop persistent opioid use. To inform future institutional guidelines, the objective of this study was to determine baseline opioid prescribing patterns in a single high‐volume, referral‐based breast center. We hypothesized that opioid prescribing practices varied between procedures and operating surgeons.MethodsA retrospective analysis of all women undergoing breast cancer surgery between January and December 2019. Opioid prescriptions at discharge were converted to morphine milligram equivalents (MME). The primary outcome of interest was MME prescribed at discharge. Multiple linear regression was used to identify factors independently associated with MME prescribed.Results392 patients met inclusion criteria; 68.3% underwent partial mastectomy. Median age was 61 (interquartile range [IQR] 51–70). Median MME prescribed at discharge was 112.5 (IQR 75–150); 83.9% of patients were prescribed co‐analgesia. The prescriber was a trainee in 37.7% of cases. 15 patients (3.8%) required opioid renewal. On multivariate analysis, axillary procedure was associated with increased MME (ß = 17, 95% CI 5.5–28 and ß = 32, 95% CI 17–47, for sentinel node and axillary dissection, respectively). However, the factor with the greatest impact on MME was operating surgeon (ß = 72, 95% CI 58–87). Residents prescribed less MME compared to attending surgeons (ß = 11, 95% CI −22; −0.06).ConclusionIn a tertiary care center, the operating surgeon had the greatest influence on opioid prescribing practices, and trainees tended to prescribe less MME. These findings support the need for a standardized approach to optimize prescribing and reduce opioid‐related harms after oncologic breast surgery.
Advancing complex hepato‐pancreato‐biliary surgery in Uganda: Challenges and outcomes
Authors: Michael Okello , Darshit Dave , Mary Kiconco , Mutekoba Umar , Timothy Mugabi , Francis Baseka Xavier , Denis Kakaire , Edward Kyomugisha , Machyo Okuku Fred , Henry Ddungu , William Buwembo , Ponsiano Ocama 
Published: February 2024

AbstractIntroductionUganda has until recently mostly referred patients for complex hepato‐pancreato‐biliary (HPB) surgery abroad due to lack of local expertize. We report indications and a spectrum of surgeries performed in the first 4 years following the establishment of a routine HPB service at Lubaga Hospital (LH), Kampala, Uganda. We also detailed the challenges encountered in setting up this service.MethodsDemographic, clinical parameters, surgery indications, procedures performed, and outcomes of consecutive patients that underwent HPB surgeries at LH from December 2018 to October 2022 were analyzed.ResultsMajority were females 72 (57.6%) with a median age of 50 (6–88) years. Forty‐one (32.8%) underwent surgery on the pancreas (PS), 34 (27.2%) on the liver (LS), and 50 (40.0%) on the bile ducts (CBS). The most common symptom was abdominal pain. Benign disease was present in 37 patients (29.6%) while 88 (70.4%) had malignancy. A total of 34 patients (27.2%) had unresectable pancreatic head cancer and distal cholangiocarcinoma missed at preoperative imaging and discovered intraoperatively thus underwent palliative hepaticojejunostomy. Only 34 (27.2%) patients received postoperative ICU care. In‐hospital mortality for this heterogenous group of patients was 6 (4.8%) for PS, 3 (2.4%) for LS, and 8 (6.4%) for CBS.ConclusionDespite many challenges like limited access to ERCP accessories, lack of endoscopic ultrasound scans and PET–CT scans in the whole country, late presentation, and low quality imaging especially in preoperative determination of resectability of hepato‐pancreato‐biliary cancers, we managed to establish a functional HPB service. Patient results achieved were good in spite of these limitations.
Determination of trace elements in titanium oxides by wavelength dispersive x‐ray fluorescence spectrometry (WD‐XRF)
Authors: Gazulla M. F. , Orduña M. , Rodrigo M. 
Published: February 2024

AbstractTiO2 is used in a great variety of industries (foods, medicines, cosmetics, etc.). In food industry, although the use of TiO2 as additive was banned by EU in 2022, it is still authorized in medicinal products, and is allowed as food ingredient in US and Canada. Focusing on cosmetics, regulations state some forbidden elements (As, Cd, Ni, Hg, Sb, and Pb), and others allowed with a specific limit (Co, Cr, and Se). Most researches about TiO2 characterization are focused on the purity determination and no studies analyzing trace metals in this material have been found. Due to the potential impact of those trace elements on health and safety, a robust method for determining them in TiO2 is required. A methodology for the determination of As, Cd, Co, Cr, Hg, Ni, Pb, Sb, and Se at trace level in TiO2 by WD‐XRF has been developed. Sample was prepared as pressed pellets to achieve low limits required by regulations, and the best conditions were established using n‐butyl methacrylate as binder and plastic spatula to avoid Cr contamination coming from the stainless‐steel one. An in‐depth inquiry conducted to get calibration and validation standards revealed a lack of reference materials; therefore, additions of pure oxides of each element were made to high‐purity TiO2. Validation was performed by two means: analyzing synthetic standards prepared as stated and analyzing two commercial TiO2 by an independent method (ICP‐OES). The developed methodology was suitable to be used as control method to assess whether the materials meet the regulations, since time required to undertake the analysis is much less than other methods.
Emotionen und Motivation in Lern- und Leistungskontexten
Authors: Barton Daniel 
Published: February 2024

ZusammenfassungIn diesem Kapitel wird der theoretische Rahmen hinsichtlich der emotions- und motivationsförderlichen Ausrichtung des geplanten Projekts gesetzt. Im Mittelpunkt stehen dabei die Phänomene Emotionen und Motivation sowie deren Einfluss auf das Lernen. Die Begriffe werden zunächst grundsätzlich definiert und erklärt, bevor sie anschließend auf Grundlage der Kontroll-Wert-Theorie nach Pekrun (2006) sowie der Selbstbestimmungstheorie nach Deci und Ryan (1985) im schulischen Kontext und insbesondere hinsichtlich des Mathematikunterrichts betrachtet werden.
Characteristics and demography of low energy fall injuries in patients > 60 years of age: a population-based analysis over a decade with focus on undertriage
Authors: Aarsland Martine A. , Weber Clemens , Enoksen Cathrine H. , Dalen Ingvild , Tjosevik Kjell Egil , Oord Pieter , Thorsen Kenneth 
Published: February 2024

Abstract
Background
An increasing group of elderly patients is admitted after low energy falls. Several studies have shown that this patient group tends to be severely injured and is often undertriaged.

Methods
Patients > 60 years with low energy fall (< 1 m) as mechanism of injury were identified from the Stavanger University Hospital trauma registry. The study period was between 01.01.11 and 31.12.20. Patient and injury variables as well as clinical outcome were described. Undertriage was defined as patients with a major trauma, i.e., Injury Severity Score (ISS) > 15, without trauma team activation. Statistical analysis was performed using the Chi-squared test for categorical variables and the Mann–Whitney U test for continuous variables.

Results
Over the 10-year study period, 388 patients > 60 years with low energy fall as mechanism of injury were identified. Median age was 78 years (IQR 68–86), and 53% were males. The location of major injury was head injury in 41% of the patients, lower extremities in 19%, and thoracic injuries in 10%. Thirty-day mortality was 13%. Fifty percent were discharged to home, 31% to nursing home, 9% in hospital mortality, and the remaining 10% were transferred to other hospitals or rehabilitation facilities. Ninety patients had major trauma, and the undertriage was 48% (95% confidence interval, 38 to 58%).

Conclusions
Patients aged > 60 years with low energy falls are dominated by head injuries, and the 30-day mortality is 13%. Patients with major trauma are undertriaged in half the cases mandating increased awareness of this patient group.
Multidimensionale Formate chirurgischer Anatomie in der studentischen Ausbildung der HNO-Heilkunde – ein Effektivitätsvergleich
Authors: Grajek Jan S. , Rettschlag Stefanie , Schneider Armin , Schraven Sebastian P. , Mlynski Robert , van Bonn Sara M. 
Published: February 2024

Zusammenfassung
Hintergrund
Der technologische Wandel im Gesundheitswesen und die digitale Transformation der Lehre erfordern Neuerungen in der studentischen Lehre im Bereich der Medizin. Neue Technologien sind nötig, um die Bereitstellung und Nutzung diverser Lehr- und Lernformate von Bildungseinrichtungen unabhängig von Zeit und Ort zu ermöglichen. Ziel der Studie ist die Analyse der Effektivität verschiedener multidimensionaler Formate in der studentischen Lehre in der chirurgischen HNO-ärztlichen Anatomie.

Material und Methoden
Während des Sommersemesters 2022 und des Wintersemesters 2022/2023 wurde das digitale Lehr- und Lernprogramm ausgeweitet, indem mit Studierenden unterschiedliche Visualisierungsformate (3-D-Brillen, Cardboards oder VR-Brille) im Rahmen eines hochstandardisierten Operationsverfahrens, der Cochleaimplantation, getestet wurden. Prä- und postinterventionell wurde in allen Gruppen eine Wissensstandserhebung und im Anschluss daran eine Evaluation durchgeführt.

Ergebnisse
Von 183 Studierenden nahmen 91 Studierende vollständig an der Studie teil. Die postinterventionelle Wissensstandserhebung ergab unabhängig vom Visualisierungsformat einen signifikanten Anstieg der korrekten Antworten. Im direkten Vergleich antwortete die Operationssaal(OP)-Gruppe signifikant häufiger richtig als die Cardboard-Gruppe (p = 0,0424). Ein Großteil der Studierenden wünscht sich 3‑D-Lehre als festen Bestandteil im Lehrprogramm (87,9 %) und ein größeres Streamingangebot von Live-Operationen (93,4 %). Sie sehen die Anwendung der verschiedenen Technologien als sehr gute Ergänzung zur herkömmlichen chirurgischen Lehre (72,5 %), da bei guter Anschaulichkeit (89 %) die Merkfähigkeit (74,7 %) und Motivation (81,3 %) steigt.

Schlussfolgerungen
Der Einsatz und die Nutzung neuer Visualisierungstechnologien im klinischen Alltag ist ein vielversprechender Ansatz zur Erweiterung der studentischen Ausbildung. Mobile, interaktive und personalisierte technische Formate sind an das Lernverhalten von Studierenden anpassbar. Nicht zuletzt wird durch den Einsatz neuer Medien die Lernmotivation beeinflusst. Eine Erweiterung digitaler Lehr- und Lernformate kann auf der Basis dieser Studie ausdrücklich empfohlen werden.
Morphological chest CT changes in cystic fibrosis and massive hemoptysis
Authors: Dohna Martha , Kühl Hilmar , Sutharsan Sivagurunathan , Bruns Nora , Vo Chieu Van Dai , Hellms Susanne , Kornemann Norman , Montag Michael J. 
Published: February 2024

Abstract
Background
Massive hemoptysis (MH) is a rare but potentially life-threatening condition of patients with mainly advanced cystic fibrosis (CF). Morphological lung changes are aggravated with disease progression. The aim of this study was to determine whether morphological lung changes differ between patients with CF (pwCF) who have MH and pwCF without MH.

Methods
Chest computed tomography (CT) scans of pwCF and MH acquired at a maximum of 4 months prior to MH (1/2008 to 2/2015) were evaluated for morphological changes and bronchial artery (BA) diameters. Lung lobes with MH were compared with lobes without MH and with matched control patients with end-stage CF and no hemoptysis using the Helbich scoring system.

Results
The study included 26 patients with MH (PMH; 15 female, median age 29 years, interquartile range [IQR]: 25–33.75) and 17 matched control patients (11 male, median age 24 years, IQR: 19.5–30). No difference in Helbich score was detected between lobes with MH and matched control patients (p = 0.051). Higher scores were detected in lobes with MH compared to lobes without MH in PMH (p = 0.021), but no difference was detected in the subscores. The BA diameters were larger in PMH (p = 0.02); 85% of PMH had unilateral MH, with 65% of MH involving only one or two lobes.

Conclusion
Morphological changes are more severe in lobes with MH in the same patient, but there is no difference when compared with matched control patients. Besides abscess/sacculation, no specific changes for MH were identified. Other factors such as BA hypertrophy might play a pivotal role in the pathogenesis of MH in pwCF. Commonly used scores to evaluate chest CT in pwCF cannot be used to assess MH, and other factors, e.g., hypertrophied BA, not represented and not measured in these scores, might be more suitable for assessing the risk for MH.
Automatic program bug fixing by focusing on finding the shortest sequence of changes
Authors: Yousofvand Leila , Soleimani Seyfollah , Rafe Vahid , Esfandyari Sajad 
Published: February 2024

AbstractAutomatic bug repair as the last step in program repair has attracted a lot of research attention. Various ideas and techniques have been presented in this field. Recent bug fixing techniques use machine learning and graphs to generate fixes. Despite the promising results of recent approaches, maintaining high speed and accuracy as well as recording a wide range of errors may still be a problem. In this paper, a new approach is presented in the field of automatic bug fixing based on graphs and model checking. For this purpose, we have used the graph transformation and model checking system to create a sequence of edits and produce fixes. Then, using meta-heuristic algorithms, we have selected the best solution and fix from the generated solutions. We use the extracted graphs from the buggy JavaScript code and their corresponding bug-free ones. In evaluating the effectiveness of the proposed method, we implement it in GROOVE, which is a toolbox used to design and check graph transformation systems. Experimental results on identical dataset demonstrate that the proposed method outperforms other related methods in generating fixes. Also, this method covers a wider range of bugs compared to previous methods.
Emergency response, and community impact after February 6, 2023 Kahramanmaraş Pazarcık and Elbistan Earthquakes: reconnaissance findings and observations on affected region in Türkiye
Authors: Şenol Balaban Meltem , Doğulu Canay , Akdede Nil , Akoğlu Haldun , Karakayalı Onur , Yılmaz Sarper , Yılmaz Serkan , Ajobiewe Tolulope , Güzel Selin , İkizer Gözde , Akin Muge , Ünal Yeşim , Karancı Ayşe Nuray 
Published: February 2024

AbstractTürkiye has a long history of devastating earthquakes, and on February 6, 2023, the region experienced two major earthquakes with magnitudes of 7.7 and 7.6, striking Pazarcık and Elbistan, Kahramanmaraş, respectively, on the East Anatolian Fault Zone. These earthquakes resulted in significant loss of life and property, impacting multiple cities across 11 cities, and leaving a lasting impact on the country. The 2023 Kahramanmaraş Earthquakes rank among the deadliest and most damaging earthquakes in Türkiye, alongside the historical significance of the 1939 Erzincan Earthquake and the 1999 Marmara Earthquake. Despite reforms following the 1999 Marmara Earthquake in disaster policy and preparedness, the scale of damage from the February 6 earthquakes has been shocking, necessitating further insights and lessons for future earthquake management. This paper presents the outcomes of immediate response efforts organized after the 2023 Kahramanmaraş earthquakes to elucidate emergency response activities and their impacts on communities, considering the substantial size and severity of the damages. The study focuses on evaluating the emergency response provided within the first 24 h, 3 days, and 2 weeks after the earthquakes, aiming to promptly identify the nature and effectiveness of these responses, as well as the conditions that hindered their efficacy. By shedding light on the specific experiences and challenges faced during these crucial timeframes, the research aims to offer valuable insights and lessons learned. These findings contribute to improved preparedness strategies and more efficient emergency response measures needed in responding to future disaster scenarios. Ultimately, this study provides a useful resource for all stakeholders involved in emergency response and disaster management, offering valuable guidance to enhance resilience and preparedness in the face of seismic hazards.
Mobile-assisted language learning and pronunciation instruction: A systematic literature review
Authors: Metruk Rastislav 
Published: February 2024

AbstractIn recent years, learners worldwide have expressed increasing interest in mobile learning and the utilization of mobile devices for language learning purposes. However, few research synthesis studies have focused on pronunciation development in relation to employing MALL (mobile-assisted language learning). This review article contributes to the discourse on how mobile learning aids in acquiring and practicing EFL (English as a foreign language) pronunciation since it is this language system that is both a crucial and frequently neglected aspect of English language learning. With the emergence of e-generation, it is necessary to investigate the influence of MALL on pronunciation acquisition. This paper provides a systematic literature review of the findings of 15 empirical studies published between 2015 and 2022, which is based on PRISMA 2020. The aim of the review is threefold: to investigate the effect of mobile devices on L2 learners’ pronunciation performance, examine learners’ attitudes toward employing mobile learning for pronunciation practice and development, and identify which mobile devices and apps are present in the process. The results indicate that overall, mobile learning exerts a beneficial impact on L2 pronunciation and that participants in the reviewed studies demonstrate positive attitudes toward MALL. Moreover, smartphones appear to be at the center of attention as the primary mobile device, and it was revealed that a variety of mobile apps and platforms have been employed in the studies. The article concludes with pedagogical implications and recommendations for potential research exploration in the future.
The influence of content-relevant background color as a retrieval cue on learning with multimedia
Authors: Meusel Felicia , Scheller Nadine , Rey Günter Daniel , Schneider Sascha 
Published: February 2024

AbstractColor has been investigated as a signaling cue in multimedia learning environments, guiding the learner’s attention and as an emotional design element, increasing the learner’s motivation and, thus, improving learning outcomes. Retrieval cues (e.g., visual cues, odor, sound) facilitating memory retrieval have been primarily investigated in learning simple word lists. Contrary to additional retrieval cues, the background color is a component that is always present in multimedia learning environments. This study investigates if the background color of learning texts as retrieval cue can enhance learning and affect cognitive load and motivation. Hypotheses are formulated according to the Cognitive-Affective Theory of Learning with Multimedia (CATLM) and in the setting of context-dependent memory, specifically the Information, associated Context, and Ensemble Theory (ICE). A 2 (related vs. unrelated background color) × 2 (with vs. without colors in the learning test) -factorial between-subjects design with an additional control group was utilized. For the control group, the background of the learning texts and learning questions was white. In total, 191 native German speakers were randomly assigned to the five groups. The findings indicate that relying solely on the background color as a retrieval cue is insufficient. Instead of facilitating memory retrieval, the background color remains context information stored separately from the item information. However, the results should be approached carefully as learning outcomes may be subject to ceiling and floor effects.
The Lighter Touch: Less-Restriction in Sequentially Implemented Behavioral Sleep Interventions for Children with Rare Genetic Neurodevelopmental Conditions
Authors: Woodford Emma C. , McLay Laurie K. , France Karyn G. , Blampied Neville M. 
Published: February 2024

Abstract

Purpose
The prevalence of sleep difficulties among children with rare genetic neurodevelopmental conditions (RGNC) is high. Behavioral interventions are commonly used in the treatment of sleep difficulties in children with neurodevelopmental conditions such as autism, however, research is scarce in children with RGNC. The range of co-occurring complexities within this population, means there is a need for research to not only determine the effectiveness of behavioral sleep interventions, but also which components might be the least restrictive (i.e., intensive/aversive) and minimally sufficient.

Methods
This study used a single-case multiple baseline design to investigate the effectiveness and acceptability of behavioral sleep interventions, indicated within a Functional Behavior formulation in eight children with RGNC (M = 7.3 years). Intervention components were sequentially administered across up to three phases, based on the principle of less restriction (from least to relatively more intensive) to determine what might be minimally sufficient.

Results
Results showed an improvement in sleep onset latency, night wakings, early morning waking and unwanted bed-sharing for 7/7, 6/7, 3/3 and 3/3 children respectively. Improvement was observed for most participants following the less restrictive phases of intervention (circadian modifications, antecedent modifications and positive reinforcement), however, more restrictive, albeit modified, extinction procedures were still implemented for five participants. Improvements were maintained at follow-up and interventions were deemed acceptable to parents.

Conclusions
Less restrictive function-based behavioral strategies are an effective, and in some cases sufficient, contribution to a sequence of interventions for a range of sleep difficulties. They should be implemented first, before more restrictive strategies.
To Evaluate the Age–Happiness Relationship, Look Beyond Statistical Significance
Authors: Bartram David 
Published: February 2024

AbstractThe persistent contentiousness of research on the age–happiness relationship is puzzling; it should be possible to gain clarity and consensus about how to address the question effectively. In this paper I show that a key reason for the lack of clarity consists of overreliance on statistical significance as a means of evaluating empirical results. The statistical significance of a quadratic specification (age plus age-squared) is often taken as evidence in support of a ‘u-shaped’ relationship between age and happiness. But statistical significance on its own cannot tell us whether the age–happiness relationship is ‘u-shaped’ (nor indeed whether it takes any other shape). On the contrary, statistical significance can mislead us about it: a set of quadratic age coefficients can be ‘significant’ even when the relationship is obviously characterised by a different shape. When we have clarity on how to construct the analysis so that we can ‘see’ the underlying patterns in the data, it becomes obvious that the age–happiness relationship in European countries commonly shows other patterns; a u-shape is evident only in a minority of countries.