bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Students Attitude Towards Mathematics on their Mathematical Achievement at Secondary School Level
Authors: Shah Nazir Haider , Nazir Nadia , Arshad Mahek , Akhter Khatiba , Shaheen Abdul Khaliq , Younas Sidra , Ghazanfar Faheem 
Published: June 2023

The effect of student’s attitude on mathematical achievement has gathered tremendous attention from various researchers. However, there is a degree of inconsistency in the findings regarding these effects. The aim of the study was to find out the effect of students’ attitude towards Mathematics on their mathematical achievement at secondary schools in AJ&K. The objectives of the study were; to analyze students’ attitude in Mathematics at secondary level, to compare students’ attitude and academic achievement in Mathematics (gender wise) in AJ&K and to find out the effect of students’ attitude on Mathematical achievement at secondary level in AJ&K. The research was descriptive and quantitative in nature and cross-sectional survey was used to collect the data. All the students of 10th class of Govt. Secondary Schools in District Bagh AJ&K were the population of the study. There were 1076 students (458 boys and 618 girls) studying in 10th class in Government Secondary Schools of District Bagh. Sample was taken using Stratified random sampling technique. The researcher selected 444 students (192 male and 252 female) using proportionate stratified random sampling technique. The researcher developed five-point Likert scale questionnaire to collect the data. It was concluded that attitude had an impact on the mathematical achievements of the students. Parents’ education, qualification and social status had positive effect on academic achievements of students. It is recommended that students may be encouraged to achieve mathematical goals.
Retinoic Acid Signaling Is Required for Dendritic Cell Maturation and the Induction of T Cell Immunity
Authors: Farazuddin Mohammad , Ludka Nicholas , Friesen Leon , Landers Jeffrey J , O’Konek Jessica J , Kim Chang H , Baker James R 
Published: June 2023

Abstract
Vitamin A and its biologically active metabolites, all-trans and 9-cis retinoic acid (RA), are thought to be important in generating and modulating immune function. However, RA modulates the function of many types of immune cells, and its specific role in dendritic cell (DC) activation, Ag presentation, and T cell effector function has not been fully characterized. Because RA works primarily through RA receptor (RAR)α, we examined mice with a myeloid cell–specific defect in RA signaling. These transgenic mice have a CD11c-cre–driven expression of a truncated form of RARα that specifically blocks the signaling of all forms of RARs in myeloid cells. This defect results in abnormal DC function, with impaired DC maturation and activation, and reduced Ag uptake and processing. These DC abnormalities were associated with a reduced ability to mount Ag-specific T cell responses to immunization despite having normally functioning T cells. In contrast, the loss of DC-specific RA signaling did not significantly alter levels of Ag-specific Abs postimmunization and resulted in an increase in bronchial IgA. Our findings indicate that RA signaling in DCs is crucial for immune activation, and its absence impairs the development of Ag-specific effector functions of T cell immunity.
NK Cells from Human Cytomegalovirus–Seropositive Individuals Have a Distinct Metabolic Profile That Correlates with Elevated mTOR Signaling
Authors: Lozada John R , Zhang Bin , Miller Jeffrey S , Cichocki Frank 
Published: June 2023

Abstract
CMV can elicit adaptive immune features in both mouse and human NK cells. Mouse Ly49H+ NK cells expand 100- to 1000-fold in response to mouse CMV infection and persist for months after exposure. Human NKG2C+ NK cells also expand after human CMV (HCMV) infection and persist for months. The clonal expansion of adaptive NK cells is likely an energy-intensive process, and the metabolic requirements that support adaptive NK cell expansion and persistence remain largely uncharacterized. We previously reported that NK cells from HCMV-seropositive donors had increased maximum capacity for both glycolysis and mitochondrial oxidative phosphorylation relative to NK cells from HCMV-seronegative donors. In this article, we report an extension of this work in which we analyzed the metabolomes of NK cells from HCMV-seropositive donors with NKG2C+ expansions and NK cells from HCMV seronegative donors without such expansions. NK cells from HCMV+ donors exhibited striking elevations in purine and pyrimidine deoxyribonucleotides, along with moderate increases in plasma membrane components. Mechanistic target of rapamycin (mTOR) is a serine/threonine protein kinase that, as a part of mTOR complex 1 (mTORC1), bridges nutrient signaling to metabolic processes necessary for cell growth. Signaling through mTORC1 induces both nucleotide and lipid synthesis. We observed elevated mTORC1 signaling on activation in both NKG2C− and NKG2C+ NK cells from HCMV+ donors relative to those from HCMV− donors, demonstrating a correlation between higher mTORC1 activity and synthesis of key metabolites for cell growth and division.
CD103 Regulates Dermal Regulatory T Cell Motility and Interactions with CD11c-Expressing Leukocytes to Control Skin Inflammation
Authors: Norman M Ursula , Chow Zachary , Hall Pam , Le Anne Cao , O’Sullivan Kim M , Snelgrove Sarah L , Deane James A , Hickey Michael J 
Published: June 2023

Abstract
Dermal regulatory T cells (Tregs) are essential for maintenance of skin homeostasis and control of skin inflammatory responses. In mice, Tregs in the skin are characterized by high expression of CD103, the αE integrin. Evidence indicates that CD103 promotes Treg retention within the skin, although the mechanism underlying this effect is unknown. The main ligand of CD103, E-cadherin, is predominantly expressed by cells in the epidermis. However, because Tregs are predominantly located within the dermis, the nature of the interactions between E-cadherin and CD103-expressing Tregs is unclear. In this study, we used multiphoton intravital microscopy to examine the contribution of CD103 to Treg behavior in resting and inflamed skin of mice undergoing oxazolone-induced contact hypersensitivity. Inhibition of CD103 in uninflamed skin did not alter Treg behavior, whereas 48 h after inducing contact hypersensitivity by oxazolone challenge, CD103 inhibition increased Treg migration. This coincided with E-cadherin upregulation on infiltrating myeloid leukocytes in the dermis. Using CD11c-enhanced yellow fluorescent protein (EYFP) × Foxp3-GFP dual-reporter mice, inhibition of CD103 was found to reduce Treg interactions with dermal dendritic cells. CD103 inhibition also resulted in increased recruitment of effector CD4+ T cells and IFN-γ expression in challenged skin and resulted in reduced glucocorticoid-induced TNFR-related protein expression on Tregs. These results demonstrate that CD103 controls intradermal Treg migration, but only at later stages in the inflammatory response, when E-cadherin expression in the dermis is increased, and provide evidence that CD103-mediated interactions between Tregs and dermal dendritic cells support regulation of skin inflammation.
Strategie di insegnamento del pensiero critico nella pratica clinica infermieristica avanzata: protocollo di una scoping review
Authors: Giuffrida Silvia , Ramacciati Nicola , Silano Verdian , Baldon Alessia , Bianchi Monica , Prandi Cesarina 
Published: June 2023

Introduzione: Il progetto di ricerca nasce da unâ€™esperienza formativa nellâ€™ambito del Master of Science in Cure infermieristiche della Scuola Universitaria Professionale della Svizzera Italiana (SUPSI) che si prefigge di ampliare le competenze professionali nellâ€™ambito della pratica infermieristica avanzata. Lâ€™obiettivo Ã© quello di preparare professionisti che raggiungano un alto livello di competenza nella pratica clinica per fronteggiare le sfide del sistema sanitario, caratterizzato da complessitÃ , cronicitÃ e multimorbiditÃ . La capacitÃ dellâ€™infermiere di migliorare la qualitÃ dellâ€™assistenza dipende in gran parte dallo sviluppo delle competenze di ragionamento clinico e pensiero critico essenziali al processo decisionale. Entrambi questi concetti descrivono il processo mentale che lâ€™infermiere compie nel fare le scelte migliori per il proprio assistito. Emerge lâ€™importanza di rinforzare lâ€™apprendimento di queste competenze attraverso specifiche metodiche didattiche. Ãˆ presentato il protocollo di ricerca per lo sviluppo di una scoping review, con lâ€™obiettivo di rilevare gli studi in letteratura relativi alle migliori strategie di insegnamento relative al ragionamento clinico. Metodi e analisi: La scoping review sarÃ svolta sul modello di Arksey e Oâ€™Malley, con il supporto delle linee guida Preferred Reporting Items for Systematic Reviews and Meta-Analysis â€“ Scoping Reviews del Joanna Briggs Institute. La revisione della letteratura sarÃ condotta nei database: PubMed, CINAHL, Cochrane Library, Scopus e OVID. Saranno considerate le pubblicazioni degli ultimi 5 anni, in lingua inglese, italiana, francese e tedesca. Secondo specifici criteri di inclusione tre autori valuteranno in modo indipendente gli articoli per titoli, abstract e full-text. I risultati saranno riportati in forma narrativa e attraverso il supporto di grafici e tabelle. Diffusione dei risultati: questa review fornirÃ una visione attuale e completa delle strategie didattiche piÃ¹ efficaci per lo sviluppo del ragionamento clinico nella pratica clinica avanzata. I dati raccolti verranno condivisi con la comunitÃ scientifica professionale. Parole chiave: infermieristica clinica avanzata, formazione infermieristica, insegnamento, ragionamento clinico, pensiero critico.
Valutazione del delirium nellâ€™anziano in pronto soccorso: una revisione narrativa della letteratura
Authors: Ramacciani Isermann Christian , Rosati Moris , Marzocchi Katia , Righi Lorenzo 
Published: June 2023

Introduzione: Il delirium Ã¨ un problema tuttâ€™altro che raro in pronto soccorso (PS): in letteratura emerge che un paziente su dieci sperimenti questa sindrome. Gli strumenti di screening propri di altri setting di cura raramente sono utilizzati in PS sia per la loro complessitÃ che per la scarsa formazione. Anche fattori ambientali caratteristici del PS, come il sovraffollamento e lâ€™elevato flusso di lavoro, possono contribuire a un loro ridotto utilizzo. Lâ€™obiettivo di questo lavoro, pertanto, Ã¨ quello di ricercare in letteratura le evidenze piÃ¹ aggiornate e verificare quale metodo di valutazione, adoperabile dal personale non specialistico, sia il piÃ¹ efficace nellâ€™identificare precocemente il Delirium nelle persone anziane in Pronto Soccorso. Materiali e metodi: Ãˆ stata effettuata una revisione della letteratura consultando le banche dati MEDLINE (interfaccia PubMed) e CINAHL nel periodo che 13/04/2019-28/04/2019, limitando la ricerca con retroattivitÃ di 5 anni, lingua inglese o italiana e disponibilitÃ del full text. Risultati: Negli 11 studi inclusi nella revisione sono state analizzate le scale Confusion Assessment Method (CAM), le sue versioni modificate mCAM-ED, bCAM e CAM-ICU, lâ€™Assessment Test for delirium and cognitive impairment (4AT), la Richmond Agitation and Sedation Scale (RASS) e la sua versione â€œModifiedâ€. Due lavori hanno valutato strumenti diversi dalle scale: lo screening di fragilitÃ clinica e fattori di rischio. Conclusioni: La 4AT sembra emergere come piÃ¹ idonea per la valutazione del delirium in pronto soccorso: ha un tempo di somministrazione pari a 2 minuti, puÃ² essere eseguita dal personale infermieristico e mostra delle buone prestazioni diagnostiche sia in presenza che in assenza di decadimento cognitivo. Sono necessari perÃ² ulteriori studi per testarne lâ€™utilizzo in PS, anche in comparazione con altri strumenti. Parole chiave: Delirium; Scores; Pronto Soccorso.
Lâ€™aspirazione endotracheale del neonato intubato: indagine conoscitiva sui criteri decisionali infermieristici
Authors: Da Rin Della Mora Roberta , Calza Simona , Brizzolara Erica , Serveli Simona , Subbrero Milvia , Scelsi Silvia 
Published: June 2023

Introduzione: La gestione delle vie aeree Ã¨ cruciale per il supporto vitale; lâ€™aspirazione endotracheale, che consente di rimuovere le secrezioni presenti in trachea e nei bronchi principali, rappresenta uno degli aspetti piÃ¹ critici dellâ€™attivitÃ infermieristica. Dati i potenziali effetti dannosi, Ã¨ importante identificare i criteri sulla base dei quali viene effettuata e le modalitÃ di effettuazione. Obiettivo: Descrivere i criteri decisionali relativi allâ€™aspirazione endotracheale del nato a termine e pretermine da parte del personale infermieristico di due UU.OO. di area critica di un ospedale pediatrico italiano di terzo livello. Metodo: Survey con questionario validato. Risultati: I criteri sulla base dei quali identificare il bisogno di aspirazione endotracheale considerati piÃ¹ importanti riguardano gli indicatori di ostruzione del tubo endotracheale da parte di secrezioni, anche se una minoranza ritiene molto importante lâ€™aspirazione a orari fissi, modalitÃ sconsigliata e, pur trattandosi di una procedura infermieristica, un terzo dei rispondenti ritiene importantissima lâ€™indicazione/prescrizione del medico; il calibro del tubo endotracheale Ã¨ ritenuto importante/importantissimo nella scelta della dimensione del catetere da utilizzare, e la lunghezza del tubo endotracheale Ã¨ considerata molto importante/importantissima nel determinare la profonditÃ di aspirazione. Il peso del neonato e le caratteristiche delle secrezioni sono considerati importanti nel determinare la pressione negativa; la comparsa di desaturazione, cianosi e alterazioni emodinamiche sono considerati i criteri piÃ¹ importanti per determinare la durata della procedura. Lâ€™iperossigenazione Ã¨ effettuata piÃ¹ nel nato a termine che nel pretermine; le instillazioni con soluzione fisiologica, aspetto controverso in letteratura, sono effettuate a volte dalla maggioranza dei rispondenti; lâ€™igiene orale Ã¨ effettuata dalla quasi totalitÃ dei rispondenti. Conclusioni: Non emergono differenze sostanziali relativamente alla maggior parte dei criteri decisionali tra nato a termine e pretermine, anche se i risultati dimostrano uniformitÃ per alcuni criteri e carenza di uniformitÃ per altri. Parole chiave: criteri decisionali, aspirazione endotracheale, neonato a termine, pretermine.
Intrathyroidal thymic carcinoma not so indolent a neoplasm?
Authors: Anila KR , Nair Iswarya S. , Nair Lekha M. , Thomas Shaji 
Published: June 2023

ABSTRACT
Intrathyroidal thymic carcinoma (ITC) is a very rare malignant epithelial tumor of the thyroid gland with thymic epithelial differentiation. Here, we are reporting the case of an eighty-year-old man who at presentation had extrathyroidal spread to the larynx and metastasis to regional lymph nodes. Though the tumor had a relatively low-grade morphology, there were areas of high mitotic activity with areas of necrosis. The classically described ivory-white gross appearance of the tumor, histomorphology of thick bands dividing the tumor into lobules, squamous cell differentiation, tight whorls of cells resembling Hassall’s corpuscle, and areas showing dense lymphocytic infiltration, together with an immunoprofile of CD5, Ckit, Tumor protein 63 (p63), and B-cell lymphoma 2 gene (bcl2) positivity, helped in diagnosing this rare entity. Though classically ITC is said to have a good prognosis, cases with spread to adjacent organs and lymph node metastasis may not have an indolent course.
Assessment of the Adherence of Radiologists in Reporting the Ovarian Cysts to the 2010 Society of Radiologists in Ultrasound Guidelines
Authors: Zarei Fariba , Khatamizadeh Nargessadat , Zeinali-Rafsanjani Banafsheh 
Published: June 2023

Background:
The objective of this study was to determine the adherence of radiologists to the guideline of the Society of Radiologists in Ultrasound (SRU)-2010 for the follow-up of ovarian cysts in patients during 2015–2016.

Methods:
The patients’ data, referring for transvaginal and pelvic ultrasonography, suffering from ovarian cyst were assessed in terms of menopause status, cyst size, and type, as well as follow-ups recommended by radiologist to assess the adherence of reports to SRU-2010.

Results:
Three hundred and sixty-four sonography reports were investigated. Seventy-seven percent of the reports had adhered to SRU-2010, 9.9% and 9.1% had under/overmanagement, and 4.1% was incomplete. 94.2% and 5.8% of cases were in pre/postmenopause status, respectively. The highest adherence belonged to cysts in size <1 cm, 1–3 cm, 5–7 cm. The highest adherence, over/undermanagement, and incomplete reports belonged to corpus luteum, hemorrhagic, dermoid cysts, and nodules without flow. The adherence of sonography reports to SRU-2010 for accidental ovarian cysts was 76.9%.

Conclusion:
The tendency for overmanagement of simple cysts in premenopausal women and the tendency for undermanagement in simple cysts and in postmenopausal women were higher, respectively. It is expected that more training of the guideline to radiologists will lead to the reduction of unnecessary follow-up, which in turn leads to reduced patient’s anxiety and cost of treatment.
Adhesions Detection and Staging Classification for Preoperative Assessment of Difficult Laparoscopic Cholecystectomies: A Prospective Case–Control Study
Authors: Kapoor Atul , Sidhu Bholla Singh , Singh Jasdeep , Brar Navjot , Singh Paramjit , Kapur Aprajita 
Published: June 2023

Background:
Laparoscopic cholecystectomy (LC) is the treatment of choice for cholelithiasis; however, there are procedural difficulties in determining preoperative detection of a difficult LC. The current methods using clinical and sonographic variables to identify difficult LCs have limitations to identify gallbladder adhesions which form the most common cause. We present a new method of evaluation using acoustic radiation force impulse (ARFI)-based virtual touch imaging (VTI) for the detection and classification of these patients.

Methods:
Fifty consecutive patients of cholelithiasis were evaluated preoperatively using conventional scoring system (CSS) and by new adhesion detection and staging (ADS) system, and patients were classified into three classes (I–III) with class I being easy, II and III being moderate-to-high difficulty LCs. Peroperative classification was done based on the difficulty level during surgery after visualization of gallbladder adhesions. The sensitivity, specificity, and area under the curves (AUCs) of both systems were compared.

Results:
Out of 50 patients, 72% and 54% of patients were in class I by CSS and ADS classification, while 28% and 46% were in class II and III, respectively, and were labeled as difficult LC cases; differences being two classifications were statistically significant (P = 0.02). Sensitivity, specificity, negative predictive value, and accuracy for ADS were 91%, 100%, 93.1%, and 96.0%, and for CSS, 60.9%, 100%, 75%, and 82% with AUCs of 1.0 and 0.63, respectively.

Conclusion:
ARFI-based VTI accurately detects gallbladder adhesions and can determine the difficult cases of LCs preoperatively using ADS classification and shows higher accuracy than CSS classification, which results in lower operative time and risk of complications.
Validation of wound healing property of Siddha herbal extractive preparation Ellukai Thol Uppu (salt extraction from pericarp of Sesamum indicum)
Authors: Cholarajan Rahini Nivedhidha , Thiraviasundaram Sasi Priya , Sahnthirappan Sivakkumar , Ramasamy Meenakumari 
Published: June 2023

Background:
The belief of general public and globalization on Siddha medicine led to the stable growth of Indian traditional medicine, thereby necessitating the standardization of Siddha formulation and pharmacopeia standards for their quality control. Ellukai Thol Uppu (ETU) is a Siddha formulation extracted from Sesamum indicum by Siddha traditional method used for excision wound. The present study aimed to study the standardization parameters and screen the antimicrobial and wound-healing properties.

Objective:
The present study aimed to study the standardization parameters and screen the antimicrobial and wound-healing properties.

Materials and Methods:
ETU was prepared from Sesamum indicum as per the literature, and subjected to study the standardization parameters such as physicochemical analysis and heavy metal analysis were done by using AYUSH testing protocol, and screening of acute toxicity was done by organisation for economic co-operation and development method, and wound healing property was done by using excision wound method.

Result:
The study results revealed that the drug ETU is free from any microbial contaminations and has no toxicity effect. The drug ETU possesses antimicrobial and wound-healing properties.

Conclusion:
The derived results could serve as a ready reference for quality control and pharmacological property assessment of the drug.
Characterization and screening of antidiabetic property of Siddha drug Puttransoru by using in vitro alpha-amylase and alpha-glucosidase inhibition assay
Authors: Sundaram Sasi Priya Thiravia , Cholarajan Rahini Nivedhidha , Sahnthirappan Sivakkumar , Ramasamy Meenakumari 
Published: June 2023

Background:
Diabetes mellitus is a major noncommunicable disease worldwide. According to the World Health Organization, it is a chronic, metabolic disease characterized by elevated levels of blood glucose, which leads over time to serious damage to the heart, blood vessels, eyes, kidneys, and nerves. Many researchers were presently aiming to establish novel drugs from natural resources.

Objective:
The present study aimed to analyze the physico chemical properties and nutritional value and to screen the glucose uptake activity (antidiabetic) of Puttransoru (PS) using in vitro prohibition assay.

Materials and Methods:
The in vitro antidiabetic assay was carried out by inhibition of alpha-amylase and alpha-glucosidase method.

Results:
The results of in vitro antidiabetic assay revealed that PS showed significant inhibition against alpha-glucosidase enzyme with a maximum inhibition of about 41.3% and the corresponding IC50 is 1009 μg/mL, a similar pattern of activity were observed against alpha-amylase enzyme with the inhibition of 55.91%, and the corresponding IC50 is 539.7 μg/mL.

Conclusion:
It was concluded from the results that the test drug PS reveals potential antidiabetic activity by effective inhibition of both alpha-amylase and alpha-glucosidase enzymes. However, the principle nutrient and components that are responsible for the inhibitory action need to be further identified and characterized.