bluuebunny/crossref_metadata_2025_split huggingface dataset:
How has medical student learning changed with the pivot to online delivery of ophthalmology in the pandemic?
Authors: Ní Gabhann-Dromgoole Joan , Murphy Conor C. , Boland Fiona , Doyle Andrea J. , Pawlikowska Teresa 
Published: March 2023

Purpose
This study aimed to measure stakeholder satisfaction with our usual delivery format, which previously relied on a blend of didactic lectures and clinical skills sessions compared to a revised format, which had more emphasis on online learning. We hypothesised that the online flipped classroom (OFC) would facilitate delivery of content in the wake of the pandemic, and result in improved levels of student satisfaction and knowledge gain.

Design
Non randomised intervention study. Group 1 = Traditional delivery (TD) and Group 2 = OFC group.

Methods
A validated course evaluation questionnaire (CEQ) compared perspectives of teaching faculty (n = 5) and students with the traditional delivery (TD) of the 4th year ophthalmology clinical attachment and an OFC approach (TD n = 129 v OFC n = 114).

Results
The OFC group (n = 114; response rate = 24.6%) reported significantly reduced satisfaction with staff motivation of students and provision of feedback, compared to TD (n = 129; response rate = 17.8%). OFC students also felt it was harder to determine what standard of work was expected and found the course less beneficial at helping develop problem-solving skills. Students were dissatisfied with the level of choice afforded by the OFC, specifically how they would learn and assessment options. No significant difference in exam score was observed between the TD and OFC groups. For faculty (n = 5), there was no evidence of a difference between OFC and TD.

Conclusions
Students indicated a preference for the TD compared to the OFC approach. However, both delivery approaches led to comparable student performances as determined by MCQ examination.
Whole body insulin sensitivity is increased in systemic sclerosis
Authors: Ciaffi Jacopo , Ruscitti Piero , Di Cola Ilenia , Pavlych Viktoriya , Italiano Noemi , Gentile Martina , Huizinga Tom , de Vries-Bouwstra Jeska K. , Ursini Francesco , Cipriani Paola 
Published: March 2023

Objectives
In the present study, we aimed to evaluate whole-body insulin sensitivity in systemic sclerosis (SSc) patients and to compare the results with controls with no autoimmune rheumatic disease (non-ARD) and with patients affected by rheumatoid arthritis (RA).

Methods
In all patients and controls, oral glucose tolerance test (OGTT) was performed according to the World Health Organization (WHO) recommendations. Plasma glucose and insulin concentrations were measured at time 0 and then after 30, 60, 90, and 120 minutes. Whole-body insulin sensitivity (ISI), insulinogenic index (IGI), oral disposition index (ODI), and insulin resistance (HOMA-IR) were estimated accordingly.

Results
A total of 41 SSc patients were evaluated and, for comparison, 41 individuals with RA and 82 non-ARD control patients were recruited. OGTT yielded a proportion of normotolerant individuals among SSc patients higher than in RA controls (p = 0.040) but lower than in the non-ARD group (p = 0.028). The ISI was significantly higher in SSc patients compared with RA controls (p <0.001) and with non-ARD patients (p <0.001). Significant differences emerged also when analysing the HOMA-IR, which was lower in SSc patients than in RA (p <0.001) and non-ARD (p <0.001) groups. Additionally, IGI was lower in SSc patients compared with RA (p = 0.011) and with non-ARD controls (p <0.001), whereas ODI was not significantly different between groups.

Conclusions
Interestingly, we found that SSc patients are more insulin sensitive than those with RA and even than individuals without inflammatory diseases. In contrast, no significant difference was found in terms of β-cell function.
Initial mean arterial blood pressure (MABP) measurement is a risk factor for mortality in hypertensive COVID-19 positive hospitalized patients
Authors: Yangchen Tenzin , Koraishy Farrukh M. , Xu Chang , Hou Wei , Rohatgi Rajeev 
Published: March 2023

Background
Hypertension (HTN) is associated with severe COVID-19 infection; however, it remains unknown if the level of blood pressure (BP) predicts mortality. We tested whether the initial BP in the emergency department of hospitalized patients portends mortality in COVID-19 positive(+) patients.

Methods
Data from COVID-19(+) and negative (-) hospitalized patients at Stony Brook University Hospital from March to July 2020 were included. The initial mean arterial BPs (MABPs) were categorized into tertiles (T) of MABP (65–85 [T1], 86–97 [T2] and ≥98 [T3] mmHg). Differences were evaluated using univariable (t-tests, chi-squared) tests. Multivariable (MV) logistic regression analyses were computed to assess links between MABP and mortality in hypertensive COVID-19 patients.

Results
1549 adults were diagnosed with COVID-19 (+) and 2577 tested negative (-). Mortality of COVID-19(+) was 4.4-fold greater than COVID-19(-) patients. Though HTN prevalance did not differ between COVID-19 groups, the presenting systolic BP, diastolic BP, and MABP were lower in the COVID-19(+) vs (-) cohort. When subjects were categorized into tertiles of MABP, T2 tertile of MABP had the lowest mortality and the T1 tertile of MABP had greatest mortality compared to T2; however, no difference in mortality was noted across tertiles of MABP in COVID-19 (-). MV analysis of COVID-19 (+) subjects exposed death as a risk factor for T1 MABP. Next, the mortality of those with a historic diagnosis of hypertension or normotension were studied. On MV analysis, T1 MABP, gender, age, and first respiratory rate correlated with mortality while lymphocyte count inversely correlated with death in hypertensive COVID-19 (+) patients while neither T1 nor T3 categories of MABP predicted death in non-hypertensives.

Conclusions
Low-normal admitting MABP in COVID-19 (+) subjects with a historical diagnosis of HTN is associated with mortality and may assist in identifying those at greatest mortality risk.
Detecting CTP truncation artifacts in acute stroke imaging from the arterial input and the vascular output functions
Authors: de la Rosa Ezequiel , Sima Diana M. , Kirschke Jan S. , Menze Bjoern , Robben David 
Published: March 2023

Background
Current guidelines for CT perfusion (CTP) in acute stroke suggest acquiring scans with a minimal duration of 60-70 s. But even then, CTP analysis can be affected by truncation artifacts. Conversely, shorter acquisitions are still widely used in clinical practice and may, sometimes, be sufficient to reliably estimate lesion volumes. We aim to devise an automatic method that detects scans affected by truncation artifacts.

Methods
Shorter scan durations are simulated from the ISLES’18 dataset by consecutively removing the last CTP time-point until reaching a 10 s duration. For each truncated series, perfusion lesion volumes are quantified and used to label the series as unreliable if the lesion volumes considerably deviate from the original untruncated ones. Afterwards, nine features from the arterial input function (AIF) and the vascular output function (VOF) are derived and used to fit machine-learning models with the goal of detecting unreliably truncated scans. Methods are compared against a baseline classifier solely based on the scan duration, which is the current clinical standard. The ROC-AUC, precision-recall AUC and the F1-score are measured in a 5-fold cross-validation setting.

Results
The best performing classifier obtained an ROC-AUC of 0.982, precision-recall AUC of 0.985 and F1-score of 0.938. The most important feature was the AIFcoverage, measured as the time difference between the scan duration and the AIF peak. When using the AIFcoverage to build a single feature classifier, an ROC-AUC of 0.981, precision-recall AUC of 0.984 and F1-score of 0.932 were obtained. In comparison, the baseline classifier obtained an ROC-AUC of 0.954, precision-recall AUC of 0.958 and F1-Score of 0.875.

Conclusions
Machine learning models fed with AIF and VOF features accurately detected unreliable stroke lesion measurements due to insufficient acquisition duration. The AIFcoverage was the most predictive feature of truncation and identified unreliable short scans almost as good as machine learning. We conclude that AIF/VOF based classifiers are more accurate than the scans’ duration for detecting truncation. These methods could be transferred to perfusion analysis software in order to increase the interpretability of CTP outputs.
Identification of cancer-related genes FGFR2 and CEBPB in choledochal cyst via RNA sequencing of patient-derived liver organoids
Authors: Ye Yongqin , Lui Vincent Chi Hang , Babu Rosana Ottakandathil , Wu Zhongluan , Wu Weifang , Chung Patrick Ho Yu , Wong Kenneth Kak Yuen , Wang Bin , Tam Paul Kwong Hang 
Published: March 2023

Background
Choledochal cysts (CC) are congenital bile duct anomalies with 6–30% risk for developing bile duct cancer. However, the molecular mechanisms underlying cancer risk of CC are unknown. We sought to identify the gene expression changes underlying the cancer risk of CC patients.

Methods
Liver organoids (n = 51) were generated from liver/bile duct biopsies of CC (n = 7; type I) and hepatoblastoma (n = 5; HB: non-tumor & tumor) for RNA sequencing. Bioinformatics analysis was conducted to identify differentially expressed cancer-related genes in CC and controls. We compared CC with non-cancerous and cancerous controls, normal adjacent non-tumor region of hepatoblastoma (HB) liver as non-cancerous control and tumor region as non-CC cancer control (HB-tumor). Reverse transcription real-time quantitative PCR (RT-qPCR) verification and immunohistochemistry of selected genes was conducted in additional CC and HB liver biopsies.

Findings
HB non-tumor and HB tumor organoids displayed distinct gene expression profiles. Expression profiling separated CC organoids into two clusters, one overlapping with HB non-tumor and the other one with HB tumor organoids. Genes selected based on their log2FoldChange values for RT-qPCR verification in 31 CC and 11 HB non-tumor liver tissues revealed significantly elevated expression of FGFR2 in 7 and CEBPB in 2 CC liver tissues (CC vs HB: 4.082 vs. 0.7671, p<0.01; 2.506 vs. 1.210, p<0.01). Distinctive positive staining in bile ducts were seen in CC, HB tumor and non-tumor liver tissues for FGFR2 and CEBPB. Percentages of CEBPB-immuno-positive or FGFR2-immuno-positive bile duct cells in CC and HB-tumor liver were higher than that in HB non-tumor liver.

Interpretation
The study identified dysregulated genes related to cancer pathways in CC patients suggesting cancer risk. The findings suggest that the elevated expression of FGFR2 and CEBPB in liver may contribute to cancer development in CC patients.
Intracellular cGMP increase is not involved in thyroid cancer cell death
Authors: Alessandro Sara D’ , Paradiso Elia , Lazzaretti Clara , Sperduti Samantha , Perri Carmela , Antoniani Francesco , Righi Sara , Simoni Manuela , Brigante Giulia , Casarini Livio 
Published: March 2023

Introduction
Type 5 phosphodiesterase (PDE5) inhibitors (PDE5i) lead to intracellular cyclic-guanosine monophosphate (cGMP) increase and are used for clinical treatment of erectile dysfunction. Studies found that cGMP may up/downregulate the growth of certain endocrine tumor cells, suggesting that PDE5i could impact cancer risk.

Aim
We evaluated if PDE5i may modulate thyroid cancer cell growth in vitro.

Materials and methods
We used malignant (K1) and benign (Nthy-ori 3–1) thyroid cell lines, as well as the COS7 cells as a reference model. Cells were treated 0–24 h with the PDE5i vardenafil or the cGMP analog 8-br-cGMP (nM-μM range). cGMP levels and caspase 3 cleavage were evaluated by BRET, in cGMP or caspase 3 biosensor-expressing cells. Phosphorylation of the proliferation-associated extracellularly-regulated kinases 1 and 2 (ERK1/2) was evaluated by Western blotting, while nuclear fragmentation by DAPI staining. Cell viability was investigated using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay.

Results
Both vardenafil and 8-br-cGMP effectively induced dose-dependent cGMP BRET signals (p≤0.05) in all the cell lines. However, no differences in caspase 3 activation occurred comparing PDE5i-treated vs untreated cells, at all concentrations and time-points tested (p>0.05). These results match those obtained upon cell treatment with 8-br-cGMP, which failed in inducing caspase 3 cleavage in all the cell lines (p>0.05). Moreover, they reflect the lack of nuclear fragmentation. Interestingly, the modulation of intracellular cGMP levels with vardenafil or the analog did not impact cell viability of both malignant and benign thyroid tumor cell lines, nor the phosphorylation of ERK1/2 (p>0.05).

Conclusions
This study demonstrates that increased cGMP levels are not linked to cell viability or death in K1 and Nthy-ori 3–1 cell lines, suggesting that PDE5i do not impact the growth of thyroid cancer cells. Since different results were previously published, further investigations are recommended to clarify the impact of PDE5i on thyroid cancer cells.
Assessment of Tear Film Parameters in Patients with Type 2 Diabetes Mellitus
Authors: Amruthlal Yellamelli  , Nitin Batra  , Gurvinder Kaur  , Samson Rajpal  
Published: March 2023

BACKGROUND
Dry eye is a condition of tear film which occurs either due to tear deficiency or excessive evaporation of tears which causes damage to the interpalpebral ocular surface and is associated with ocular discomfort symptoms. This ocular disorder is common among general population with a prevalence of 28% among adults. Although diabetic retinopathy and diabetic cataracts are commonly known complications of diabetes, dry eye syndrome or keratoconjunctivitis sicca is also prevalent in diabetic individuals. The prevalence of dry eye in patients with type 2 diabetes mellitus has been reported to be 54%. The diagnosis of dry eye can be determined by decreased tear film stability, assessed by the tear film break up time (TBUT), and reduced tear secretion evaluated by Schirmer’s test.
Aims and Objectives

To assess the tear film parameters in patients with type 2 diabetes mellitus.
To assess the co-relation of tear film parameters with duration of diabetes and HbA1c levels.

METHODS
A total of 100 eyes of patients with type 2 diabetes mellitus subjects and 100 eyes of non-diabetic age group and gender matched controls, were included in the study. The study was conducted from October 2021 to August 2022. Duration of diabetes mellitus and HbA1c values were documented on all subjects.
RESULTS
The mean age of the study group and the control group was 60.24 years and 58.32 years respectively. There were more males enrolled than females in both the study group and the control group. Among the study group, the mean values of Schirmer’s test-1 and Schirmer’s test-2 were 20.81±7.2 mm and 12.88±6.01 mm respectively. The values of both Schirmer’s test-1 and Schirmer’s test-2 were lower in the diabetics as compared to the controls. The mean value of TBUT (8.7±3.1 sec) was significantly reduced in diabetic patients as compared to the controls. There was a strong negative correlation of Schirmer’s test-1, Schirmer’s test-2 and TBUT with the duration of diabetes mellitus and with the levels of HbA1c.
CONCLUSIONS
The incidence of diabetes and dry eye syndrome as separate disease entities is on the rise at present. Dry eye syndrome in diabetes further compromises the quality of life of the patients and thus, should be diagnosed and treated early.
Quality of Life in Patients With Definite Chronic Pancreatitis: A Nationwide Longitudinal Cohort Study
Authors: de Rijk Florence E.M. , van Veldhuisen Charlotte L. , Kempeneers Marinus A. , Issa Yama , Boermeester Marja A. , Besselink Marc G. , Kelder Johannes C. , van Santvoort Hjalmar C. , de Jonge Pieter Jan F. , Verdonk Robert C. , Bruno Marco J. ,   for the Dutch Pancreatitis Study Group
Published: March 2023

INTRODUCTION:
Chronic pancreatitis (CP) has a negative impact on quality of life (QoL). Because CP is a chronic condition, multiple assessments of QoL are required to obtain a thorough understanding of its impact on patients. Such studies are currently lacking. This study aims to gain insight into the course and predictors of QoL in patients with CP using prospective longitudinal data from a large cohort of patients.

METHODS:
Post hoc analysis of consecutive patients with definite CP registered in a prospective database between 2011 and 2019 in the Netherlands. Patient and disease characteristics, nutritional status, pain severity, medication usage, pancreatic function, and pancreatic interventions were assessed from medical records and through standard follow-up questionnaires. The physical and mental component summary scales of the Short-Form 36 were used to assess physical and mental QoL at baseline and during follow-up. The course of both physical and mental QoL and their associated factors were longitudinally assessed by using generalized linear mixed models.

RESULTS:
Overall, 1,165 patients with definite CP were included for this analysis. During 10-year follow-up, generalized linear mixed model analyses revealed improvements in both physical (41.6–45.2, P < 0.001) and mental (45.9–46.6, P = 0.047) QoL. Younger age, current alcohol consumption, employment, no need for dietetic consultation, no steatorrhea, lower Izbicki pain score, and pain coping mechanism were positively associated with physical QoL (P < 0.05). For mental QoL, a positive correlation was found between employment, nonalcoholic CP, no need for dietetic consultation, no steatorrhea, lower Izbicki pain score, pain coping mechanism, and surgical treatment. No association was observed between disease duration and longitudinal QoL per patient.

DISCUSSION:
This nationwide study provides insight into the dynamics of physical and mental QoL in patients with CP over time. Important and potentially influenceable factors to improve QoL are nutritional status, exocrine pancreatic function, employment status, and patients' coping strategy.
Aristotle on Perception and Perception-like Appearance: De Anima 3.3, 428b10–29a9
Authors: Keeling Evan 
Published: March 2023

Abstract
It is now common to explain some of incidental perception’s features by means of a different capacity, called phantasia. Phantasia, usually translated as ‘imagination,’ is thought to explain how incidental perception can be false and representational by being a constitutive part of perception. Through a close reading of De Anima 3.3, 428b10–29a9, I argue against this and for perception first: phantasia is always a product of perception, from which it initially inherits all its characteristics. No feature of perception is explained directly by phantasia, and phantasia is never a part of perception. Phantasia is not imagination or representation, as many have thought, but perception-like appearance. Aristotle thus recognizes alongside three different types of perception three different types of perception-like appearance.
Implicit-Explicit Finite Difference Approximations of a Semilinear Heat Equation with Logarithmic Nonlinearity
Authors: Paraschis Panagiotis , Zouraris Georgios E. 
Published: March 2023

Abstract
We formulate an initial and Dirichlet boundary value problem for a semilinear heat equation with logarithmic nonlinearity over a two-dimensional rectangular domain.
We approximate its solution by employing the standard second-order finite difference method for space discretization, and a linearized backward Euler method, or, a linearized BDF2 method for time stepping.
For the linearized backward Euler finite difference method, we derive an almost optimal order error estimate in the discrete

L
t
∞

⁢

(

L
x
∞

)

L^{\infty}_{t}(L^{\infty}_{x})

-norm without imposing mesh conditions, and for the linearized BDF2 finite difference method, we establish an almost optimal order error estimate in the discrete

L
t
∞

⁢

(

H
x
1

)

L^{\infty}_{t}(H^{1}_{x})

-norm, allowing a mild mesh condition to be satisfied.
Finally, we show the efficiency of the numerical methods proposed, by exposing results from numerical experiments.
It is the first time in the literature where numerical methods for the approximation of the solution to the heat equation with logarithmic nonlinearity are applied and analysed.
The theta cycles for modular forms modulo prime powers
Authors: Kim Jigu , Lee Yoonjin 
Published: March 2023

Abstract
Recently, Chen and Kiming studied the theta operator on modular forms modulo prime powers

p
m

{p^{m}}

, where

p
≥
5

{p\geq 5}

and

m
≥
2

{m\geq 2}

. In this paper, we study mod

p
m

{p^{m}}

filtrations and mod

p
m

{p^{m}}

theta cycles. We give a bound on some elements in the mod

p
m

{p^{m}}

theta cycle (

m
≥
2

{m\geq 2}

), and we exactly compute those values in the case that

m
=
2

{m=2}

.
Relations among Ramanujan-type congruences II: Ramanujan-type congruences in half-integral weights
Authors: Raum Martin 
Published: March 2023

Abstract
We link Ramanujan-type congruences, which emerge abundantly in combinatorics, to the Galois- and geometric theory of modular forms. Specifically, we show that Ramanujan-type congruences are preserved by the action of the shallow Hecke algebra, and discover a dichotomy between congruences originating in Hecke eigenvalues and congruences on arithmetic progressions with cube-free periods. The latter provide congruences among algebraic parts of twisted central

L

{\mathrm{L}}

-values. We specialize our results to integer partitions, for which we investigate the landmark proofs of partition congruences by Atkin and by Ono. Based on a modulo

ℓ

{\ell}

analogue of the Maeda conjecture for certain partition generating functions, we conclude that their approach by Hecke operators acting diagonally modulo

ℓ

{\ell}

on modular forms is indeed close to optimal. This work is enabled by several structure results for Ramanujan-type congruences that we establish. In an extended example, we showcase how to employ them to also benefit experimental work.
Cryoslash as an effective pre-treatment to obtain nanofibrillated cellulose using ultra-fine friction grinder with kraft pulp
Authors: de Lima Gabriel G. , Aggio Bruno , Matos Mailson , de Lima Tielidy A. M. , Pereira Bruno L. , Pedro Alessandra Cristina , Magalhães Washington L. E. 
Published: March 2023

Abstract
Approaches to obtain nanocellulose have been extensively suggested, and among the most competitive methodologies includes mechanical defibrillation, which results in a nanocellulose gel suspension that can be used in a variety of applications. However, standard procedures results in inhomogeneous fibre sizes due to its physical approach. Pre-treatments have been suggested, such as enzymes, but their cost is a disadvantage. In this work, we suggest the use of cryoslash for bleach kraft pulp using a simple methodology of embedding the dry kraft pulp in distilled water following by freezing at −80 °C, which was slashed using a common blender and submitted to an ultra-fine friction grinder. Samples were studied at various grinding steps 5, 15, 30, 60 and 120. Overall, the energy difference required to defibrillate with cryoslash was ∼3.26 kWh/kg at 30 steps and ∼6 at 120 steps, which was similar to enzymatic pre-treatment with nanofibrils significantly smaller. Cryoslash presented a unique C–H in plane structure from nanocellulose, related to a decrease in average size of fibrils, while crystallinity and thermal properties of nanocellulose remained stable at 60 steps, but mechanical properties increased until 120 steps along with the transmittance values related to the energy consumption curve.