bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and Validation of the Socio-Ecological Scale for Identifying Delays in Treatment for Breast Cancer Patients
Authors: Jabeen Sadia , Zakar Rubeena , Fischer Florian 
Published: September 2023

Abstract

Background: The study was aimed at measuring the factors contributing to the delayed presentation of breast cancer patients within the socio-ecological context by developing a scale.
Methods: The study objectives were measured by developing the items on the basis of a five-point Likert-based scale named the Socio-Ecological Scale for Breast Cancer Patients (SES-BCP). The dimensionality of the measure and internal consistency were determined by collecting data from 350 breast cancer patients of five main hospitals in three main cities (Lahore, Multan, and Faisalabad) in the Punjab province of Pakistan. A simple random sampling technique was employed, and socio-demographic factors were kept in consideration. The confirmatory factor analysis was applied for the factor structure in the study by using a structural equation model.
Results: With the distinctive five factors of the SES-BCP, a total of 51 items were confirmed in the final scale with sound psychometric properties.
Conclusions: It can be concluded that this scale is a valuable addition to assess the underlying factors of delayed presentation in patients with breast cancer in the context of socio-ecological model in Pakistan.
Comparison of cardiac activated fibroblast imaging and magnetic resonance imaging in patients with COVID-19–related myocarditis
Authors: Su Yao , Liu Xin , Xie Boqia , Zhang Bowen , Yang Qi , Yang Min-Fu 
Published: September 2023

Abstract
Background This study aimed to explore the association of cardiac fibroblast activation and cardiac magnetic resonance (CMR) imaging parameters in patients with myocarditis following coronavirus disease 2019 (COVID-19) infection.
Methods In this prospective study, four patients with COVID-19–related myocarditis underwent 99mTc-labeled–hydrazinonicotinamide-fibroblast activation protein inhibitor-04 (99mTc-HFAPi) single photon emission computed tomography/computed tomography (SPECT/CT) and CMR imaging. Segmental 99mTc-HFAPi activity was quantified as the percentage of average segmental myocardial count × global left ventricular target-to-background ratio. T1/T2 values, extracellular volume (ECV), and late gadolinium enhancement (LGE) were analyzed at CMR. The consistency between myocardial 99mTc-HFAPi activity and CMR parameters was explored.
Results In patients with myocarditis, the proportion of segments with abnormal 99mTc-HFAPi activity was significantly higher than those with abnormal LGE (81.3% vs. 60.9%, p = 0.011), abnormal T2 (81.3% vs. 50.0%, p < 0.001), and abnormal ECV (81.3% vs. 59.4%, p = 0.007) but was similar in those with abnormal native T1 (81.3% vs. 73.4%, p = 0.291). Meanwhile, 99mTc-HFAPi imaging had good consistency with native T1 (kappa = 0.69).
Conclusion Increased cardiac 99mTc-HFAPi activity is present in COVID-19–related myocarditis, which is correlated with the native T1 values in CMR.
Professional values at the beginning of medical school: A quasi-experimental study
Authors: Vilagra Sandra , Vilagra Marlon , Giaxa Renata , Miguel Alice , Vilagra Lahis , Kehl Mariana , Martins Milton , Tempski Patricia 
Published: September 2023

Abstract
Background
Teaching professionalism in medical schools is central to medical education and society. We evaluated how medical students view the values of the medical profession on their first day of medical school and the influence of a conference about the competences of this profession on these students’ levels of reflection.
Methods
We studied two groups of medical students who wrote narratives about the values of the medical profession and the influence of the COVID-19 pandemic on these values. The first group wrote the narratives after a conference about the competences of the medical profession (intervention group), and the second group wrote the same narratives after a biochemistry conference (control group). We also compared the levels of reflection of these two groups of students.
Results
Among the 175 medical students entering in the 2022 academic year, 159 agreed to participate in the study (response rate = 90.8%). There were more references to positive than negative models of doctor‒patient relationships experienced by the students (58.5% and 41.5% of responses, respectively). The intervention group referred to a more significant number of values than the control group did. The most cited values were empathy, humility, and ethics; the main competences were technical competence, communication/active listening, and resilience. The students’ perspectives of the values of their future profession were strongly and positively influenced by the pandemic experience. The students realized the need for constant updating, basing medical practice on scientific evidence, and employing skills/attitudes such as resilience, flexibility, and collaboration for teamwork. Analysis of the levels of reflection in the narratives showed a predominance of reflections with a higher level in the intervention group and of those with a lower level in the control group.
Conclusions
Our study showed that medical students, upon entering medical school, already have a view of medical professionalism, although they still need to present a deeper level of self-reflection. A single, planned intervention in medical professionalism can promote self-reflection. The vision of medical professional identity was strongly influenced by the COVID-19 pandemic, positively impacting the formation of a professional identity among the students who decided to enter medical school.
Analysis of behavioral flow resolves latent phenotypes
Authors: Bohacek Johannes , von Ziegler Lukas , Rössler Fabienne , Sturman Oliver , Waag Rebecca , Privitera Mattia , Duss Sian , O'Connor Eoin 
Published: September 2023

Abstract

Preclinical biomedical research depends on accurately detecting and quantifying rodent behavior. Current data-driven approaches, which segment free exploratory behavior into clusters, suffer from low statistical power due to multiple-testing, exhibit poor transferability across experiments, and fail to exploit the rich behavioral profiles of individual animals. We introduce a pipeline to capture each animal’s behavioral flow, yielding a single metric based on all observed transitions between clusters. By stabilizing these clusters through machine learning, we ensure data transferability, while dimensionality reduction techniques facilitate detailed analysis of individual animals. We provide a unique dataset of 443 behavior recordings of freely moving mice - including stress exposures, pharmacological and brain circuit interventions - to identify hidden treatment effects, reveal subtle variations on the level of individual animals, and detect brain processes underlying specific interventions. Our pipeline, compatible with popular clustering methods, significantly enhances statistical power and enables predictions of an animal’s future behavior.
Assessing the outcomes of posterior thoracic para-aortic lymph node lymphadenectomy after induction chemotherapy in patients with esophageal squamous cell carcinoma
Authors: Shigeno Takashi , Otomo Mayuko , Kajiyama Daisuke , Sato Kazuma , Fujiwara Naoto , Kinugasa Yusuke , Daiko Hiroyuki , Fujita Takeo 
Published: September 2023

Abstract
Background: Posterior thoracic para-aortic lymph node (TPAN) metastasis is a distant metastasis of esophageal cancer. Several case reports have shown that radical esophagectomy and lymphadenectomy for posterior TPAN improve the prognosis of patients with cStage IVB esophageal cancer and solitary posterior TPAN metastasis; however, the true value of this procedure is unclear. The primary objective of this study was to evaluate the short- and long-term outcomes of lymphadenectomy for posterior TPAN after induction chemotherapy in esophageal cancer.
Methods: This study enrolled 15 patients who underwent radical esophagectomy for cStage IVB esophageal cancer with solitary posterior TPAN metastasis after induction chemotherapy between January 2013 and October 2022 at our hospital. The short-term (e.g., blood loss, operative time, pR0 rate, postoperative complications, and postoperative hospital stay) and long-term (e.g., overall survival and recurrence-free survival) of radical esophagectomy and lymphadenectomy for posterior TPAN were retrospectively evaluated.
Results:All patients who underwent radical esophagectomy and lymphadenectomy for posterior TPAN achieved a pR0 in this study. The median operative time and intraoperative blood loss were 385 minutes and 164 ml, respectively. Four patients (26.7%) had postoperative complications of Clavien-Dindo grade II or more. The median postoperative hospital stay was 15 days. The 5-year overall survival and recurrence-free survival rates were 55.6% (95% confidence interval: 23.1–79.0) and 55.0% (95% confidence interval: 25.3–77.2), respectively.
Conclusions: We showed that lymphadenectomy for posterior TPAN improved the prognosis of some patients with advanced esophageal cancer and could serve as a viable treatment option for patients who respond well to induction chemotherapy.
Prognostic Value of IGFBP6 in Breast Cancer: Focus on Glucometabolic
Authors: Lu Hang , Yu Xin , Xu Zhiliang , Deng Jingwen , Zhang Jingwen , Zhang Yimin , Sun Shengrong 
Published: September 2023

Abstract
IGFBP6, as a member of the IGF binding proteins (IGFBPs) family, is a specific inhibitor of insulin-like growth factor II (IGF-II) and can inhibit the growth of malignant tumors overexpressing IGF-II. Type 2 diabetes (T2D) is a basic disorder of glucose metabolism which is regulated by IGF-related pathways. IGFBP6 expression is downregulated in serum and tumor tissue of colorectal cancer patients with T2D. We analyzed the TCGA database by bioinformatics to explore the possible mechanism of IGFBP6 in breast cancer (BC) metabolism and prognosis, and collected clinical samples of BC patients with T2D and without T2D to compare and verify the prognostic effect of IGFBP6. The results showed that IGFBP6 was up-regulated in estrogen receptor (ER) positive BC. The results of validation cohort confirmed that IGFBP6 could be used as an independent prognosis predictor of BC. The expression of IGFBP6 was decreased in BC tissue, and the BC tissue with T2D had lower IGFBP6 expression level compared with the non-T2D BC tissue. IGFBP6 is mainly involved in the PI3K − Akt and TGF-β signal pathways and tumor microenvironment regulation. In terms of metabolism, the expression of IGFBP6 was negatively correlated with most glucose metabolism-related genes. IGFBP6 was mainly correlated with the mutation of TP53, PIK3CA, CDH1, MAP3K1. In addition, up-regulation of IGFBP6 in BC increased the drug sensitivity of docetaxel, paclitaxel and gemcitabine. Overall, high expression of IGFBP6 was associated with good prognosis of BC, especially in non-T2D BC patients. It was not only involved in tumor microenvironment maintenance of BC, but also inhibited the energy metabolism of cancer cells through glucose metabolism-related pathways. These findings may provide a new perspective on IGFBP6 as a potential prognosis marker for BC.
Rapid Deployment Biological Aortic Valve Replacement in Redo Operations: A Retrospective Real-Word Experience Report of Clinical and Echocardiographic Outcomes
Authors: Cummings Ian , Salmasi M Yousuf , Bulut Halil Ibrahim , Zientara Alicja , Alsheikh Mahmoud , Asimakopoulos George 
Published: September 2023

Abstract
Objective
This retrospective study aimed to compare the outcomes of rapid deployment aortic valve replacement (rdAVR) and conventional bioprosthetic sutured AVR (cAVR) in high-risk patients undergoing redo surgery.
Methods
A total of 79 patients who underwent redo AVR between 2014 and 2021 were included in the study. Of these, 27 patients underwent rdAVR and 52 underwent cAVR. Patient characteristics and clinical outcomes were analysed using multivariate regression and Cox-survival analysis.
Results
The groups were similar in terms of age, gender, left ventricular function, and number of previous sternotomies. In cases of isolated AVR, rdAVR had significantly lower cross clamp times than cAVR (71 vs. 86 minutes, p = 0.03). Postoperatively, 4 cAVR patients required pacemaker compared to zero patients in the rdAVR group. There were no significant differences between the two groups in terms of postoperative complications, intrahospital stay (median 9 days, IQR 7–20), or in-hospital mortality (1 rdAVR; 2 cAVR). The long-term survival rate was similar between the rdAVR (90%) and cAVR (92%) groups (log rank p = 0.8). The transvalvular gradients at follow-up were not affected by the type of valve used, regardless of the valve size (coef 2.68, 95%CI -3.14-8.50, p = 0.36).
Conclusion
The study suggests that rdAVR is a feasible and safe alternative to cAVR in high-risk patients undergoing redo surgery. The use of rdAVR offers comparable outcomes to cAVR, with reduced cross clamp times and a lower incidence of postoperative pacemaker requirement in isolated AVR cases. The
Spatial and temporal evolution of urban land use change in Nanchang by CA-Markov model
Authors: Fu Shuai , Xu Bingxian , Zhong Rui , Wang Hongbo 
Published: September 2023

Abstract
With the Rapid urban expansion and development, the contradiction between human and land has gradually emerged, and how to scientifically and rationally use land is an inescapable problem. Nanchang was selected to study in the study, land use change images of Landsat from 2005 to 2020 was analyzed, and predicted land use situation of Nanchang in 2035 by CA-Markov model, to analyze and evaluate the scientific and effective use of land resources in Nanchang. The results show that from 2005 to 2020, woodland continued to decrease, with a total decrease of 300.27 km2 in 15 years; unused land was developed into construction land and agricultural land, the proportion of unused land became less and less; the proportion of grassland and construction land increased, and the expansion rate of construction land increased. Agricultural land, woodland, grassland and water area are greatly affected by elevation slope; The construction land is greatly affected by the convenience of transportation, and the old construction land as the initial boundary of expansion has driven the transformation of surrounding land use. In 2035, agricultural land will remain largely stable; wood land will slightly decrease; both grassland and water area show a decreasing trend; the construction land increase by 306.31km2. Understanding the characteristics and laws of land use change in Nanchang is conducive to urban sustainable development planning. Simultaneous development and protection are conducive to the sustainable use of land resources and sustainable regional development.
A Modified IPT-PLL Technology for Single-phase Grid-connected Inverters in Complex Power Grid Conditions
Authors: Zhang Tao , Dong Dezhi 
Published: September 2023

Abstract
Aiming at the common problems of frequency variations and harmonics in complex power grids, an improved inverse Park transform phase locked loop (IPT-PLL) technology for single-phase converters suitable for micro grid systems is proposed. Firstly, in the phase detection of PLL, the α component of Park transformation is selected as the reference voltage, and its orthogonal component is constructed using a 1/4 fundamental period delay method. Secondly, Lagrange interpolation polynomials are introduced to approximate fractional delay to solve the problem of delay calculation errors caused by frequency changes. Thirdly, in order to compensate for the poor ability of traditional proportional integral (PI) regulators, multi resonant controllers are superimposed to suppress low order harmonic disturbances. Finally, the design method and system performance of the PI regulator and each resonant controller are analyzed theoretically. The experimental results show that the proposed improved IPT-PLL method has strong adaptability to complex power grids. It can significantly improve the tracking performance of power grid frequency, suppress the interference of low order harmonics and DC bias. And it has good dynamic and static performance.
Valorization of black carrot industrial residues for the anthocyanin pigment production
Authors: Hernández-Acosta Evelyn , Muro Claudia , Lezama-Guadarrama Andrea , Gutierez-Cortez Elsa , López-Solorzano Elizabeth 
Published: September 2023

Abstract
Black carrot industrial residues were valorized for their use as raw material for production of anthocyanin pigments, which were obtained as concentrated extracts and microcapsules. The anthocyanins were extracted by citric, tartaric, and lactic acids to maintain the anthocyanins. In turn, concentrated extracts were obtained by 80% of water reduction, whereas microcapsules were prepared through gum arabic and drying methods. The products were analyzed by the effect of pH and temperature on anthocyanins content and coloration. In addition, the shelf-life of pigment products was determined for 360 days of storage at 4°C and 20°C, measuring anthocyanins concentration, color, and phenols retention. Black carrot residues resulted in an excellent material for pigments products preparation. Concentrated extracts achieved up to 7000 mg/L of anthocyanins, high antioxidant activity and dark red color. In order, these products maintained high color stability at pH 2–7 ranges and temperature exposition ranges of 20–90°C. Furthermore, the concentrated extract storage showed 80% of anthocyanins preservation at 4°C and 90% of color retention for 360 days. Anthocyanin microcapsules exhibited 280 mg/L of anthocyanins with pink red coloration, maintaining 50% of anthocyanins for 180 days at temperature storage of 20°C.
Impact of different agitation methods on smear layer cleaning of mesial canals with accentuated curvature
Authors: DDs Abel Teves , Alcalde Murilo Priori , Klymus Michel Spinosa , Bonjardim Leonardo Rigoldi , Vivan Rodrigo Ricci , Duarte Marco Antonio Hungaro 
Published: September 2023

Abstract
Objectives The aim of this study was to evaluate the impact of different methods of irrigant agitation on smear layer removal in the apical third of curved mesial canals of 3D-printed mandibular molars.Material and Methods Sixty 3D-printed mandibular second molars with a 70° curvature and a Vertucci type II configuration in the mesial root were used. A round cavity was cut 2 mm from the apex using a trephine of 2 mm of diameter, 60 bovine dentin disks were made and a smear layer was formed. The dentin disks had the adaptation checked in the apical third of the teeth with wax. The dentin disks were evaluated in environmental Scanning Electron Microscope before and after the following irrigant agitation methods: G1(PIK Ultrasonic Tip), G2 (Passive Ultrasonic Irrigation with Irrisonic– PUI), G3 (Easy Clean), G4 (HBW Ultrasonic Tip), G5 (Ultramint X Ultrasonic tip), and G6 (conventional irrigation-CI) (n = 10). All groups were irrigated with NaOCl 2.5% and EDTA 17%. The data was statistically compared (P < 0.05).Results All dentin disks were 100% covered by smear layer before treatment, and all groups significantly reduced the percentage of smear layer after treatment. After the irrigation protocols, the Ultra-X group showed the lowest coverage percentage, statistically differing from the conventional, PIK, and HBW groups (P < 0.05). There was no significant difference among Ultramint X, PUI-Irrisonic, and Easy Clean (P > 0.05).Conclusion None of the agitation methods was able to completely remove the smear layer. The Ultramint X provided a completely clean specimens.Clinical relevance: Removing the smear layer favors better intradentinal antimicrobial action by the intracanal medication and greater penetrability of the filling material into de dentin. This study analyzed different methods and agitation apparatus in the removal of the smear layer in mesial canals of severely curved lower molars. All the agitation techniques employed were unable to fully eliminate the smear layer from all samples. Ultra X showed a higher smear layer removal compared to other experimental groups.
The effect of sediment mud content on primary production in seagrass and unvegetated intertidal flats
Authors: Flowers Georgina J L , Needham Hazel R , Bulmer Richard H , Lohrer Andrew M , Pilditch Conrad A 
Published: September 2023

Abstract

As a consequence of anthropogenic activities and climate change, accelerated terrestrial sediment runoff is causing the gradual mudification of soft sediment estuarine habitats worldwide. Increased sediment mud content (< 63 µm) has been recognised to alter seagrass morphology and cause declines in primary production in unvegetated habitats. However, the effect of increased mud content on primary production in seagrass meadows remains largely unknown. To address this, primary production in intertidal seagrass meadows (Zostera muelleri) and adjacent unvegetated habitats was measured in situ using benthic incubation chambers across an existing sedimentary gradient (nine sites spanning 5–33% mud content). An additional two unvegetated mudflat sites (39–49% mud content) were also sampled to expand the gradient. Seagrass net (NPP) and gross primary production (GPP) was greater than in the adjacent unvegetated habitat and did not vary with mud content, even after standardising GPP by photosynthesising biomass (i.e., photosynthetic efficiency). In contrast, in the adjacent unvegetated habitat, photosynthetic efficiency declined with increasing mud content. Inclusion of the additional mudflat sites negatively impacted NPP, GPP and photosynthetic efficiency in the unvegetated habitat. Thus, while primary production in seagrass meadows may have some resilience to future increases in mud content (up to 33%), further degradation and loss of seagrass habitat will result in the expansion of unvegetated habitats and ultimately lead to production losses; seen most acutely in areas with high mud content (≥ 39%).