bluuebunny/crossref_metadata_2025_split huggingface dataset:
Surgical choices and complications in elderly women: a single center retrospective analysis in frail vs. non frail breast cancer patients
Authors: Machado e Costa Patrícia , Debiasi Márcio , da Silva Reus Bruna , Cardoso André , Pinto David , Gouveia Pedro , Andres-Luna Rogelio , Mavioso Carlos , Anacleto João , Cardoso Fátima , Cardoso Maria João 
Published: September 2023

Abstract
Background
Early breast cancer (EBC) in the elderly is a major public health problem and a risk factor for undertreatment. The authors aim to describe surgical patterns and outcomes of an elderly population diagnosed with EBC treated in a BC-dedicated reference center.

Methods
Retrospective study for all EBC patients ≥70 years old submitted to breast surgery from 2018 to 2021. Patients were included if submitted to the G8 screening tool. Data on standard demographics, surgery performed, and outcomes were collected.

Results
Overall, 192 patients were included. Frail patients were significantly older (p<0.01), had worse Charlson Comorbidity Index (p<0.01) and ASA (p<0.01) scores and more comorbidities (p=0.09). In total, 199 breasts were operated; 173 breast conservative surgeries (BCS) and 26 mastectomies. In the frail population, oncoplastic surgery after BCS was more frequently mammoplasty; no reconstruction was reported after mastectomy. In the fit group, more diversity was seen in oncoplastic procedures; 13 breasts underwent direct-to-implant breast reconstruction (BR) after mastectomy. Frail patients were less likely to be offered BR (p<0.01). There was no association between frailty and postoperative complications, in-hospital length of stay, readmission, or reintervention.

Conclusions
Our results suggest that G8 frail patients are less likely to be offered BR. Even if there were no significant differences in surgical adverse outcomes between groups, this could have been masked by a higher proportion of BR among fit patients. G8 screening can be a useful instrument to support the surgeon’s decision to whether or not to consider BR in elderly breast cancer patients.
Level of Evidence: Level IV, Risk/Prognostic Study.
The significance of recent glacial history for the limno-terrestrial microfauna in Trygghamna (Svalbard, High Arctic)
Authors: Lukashanets Dzmitry , Petkuvienė Jolita , Barisevičiūtė Rūta 
Published: September 2023

AbstractThe diversity and spatial distribution of microscopic invertebrates in the Arctic have yet to be studied in detail. Knowledge of this is especially important in the context of glacier shrinking, one of the most visible environmental consequences of climate change. To understand how time since deglaciation shapes the communities of limno-terrestrial microfauna, we analysed samples of moss collected during the summer of 2021 in forefields of Trygghamna (Svalbard), where glaciers thought to have started to recede at the beginning of the twentieth century. We estimated the taxonomic and trophic composition and abundance of all microfauna groups (with a specific focus on little-known bdelloid rotifers) in two areas, which correspond to the different stages of the glacial retreat. The impact of 14 other environmental parameters (distance from the sea, moisture, moss structural complexity, soil nutrient, and isotopic composition) was considered. Thirty-seven microfauna taxa were found, wherein Dorylaimida nematodes (Dorylaimida, Nematoda) dominated both in frequency (present at all sites) and abundance (50 ± 21% from all individuals). Less prevalent bdelloid rotifers (Bdelloidea, Rotifera) were followed by tardigrades (Tardigrada), which, in contrast to others, were more abundant in the later deglaciated area. In general, environmental parameters explained 81.8% of the microfauna distribution. Time since deglaciation was the most significant factor (9.5%). Among the variables that act at a fine scale, the most important were moisture in the habitat (6%), presence of ground in the samples (4%), and δ15N (4%). The moss structural complexity did not have a significant effect, and neither did most of the variables characterising soil nutrient and isotopic composition. However, some variability was observed for different lower taxa.
Mechanisms of projected sea-level trends and variability in the Southeast Asia region based on MPI-ESM-ER
Authors: Jin Yi , Köhl Armin , Jungclaus Johann , Stammer Detlef 
Published: September 2023

AbstractThe low-lying and densely populated Southeast Asia (SEA) region is threatened by sea-level change. To better understand the mechanism of sea-level change in this region, the sea-level trends and variability in the SEA region are investigated over the historical period 1950–2014 and during 2015–2099 under Shared Socio-economic Pathway5-8.5 scenario forcing, based on the output of the high-resolution (~ 0.1° for ocean) global climate model MPI-ESM-ER. The results confirm that the SEA sterodynamic sea level and its components (i.e., thermosteric, halosteric, and manometric sea level) are rising with accelerations, which are superimposed on El Niño-Southern Oscillation (ENSO) driven variabilities. To understand changes of thermosteric and halosteric sea level, regional-mean ocean heat and freshwater contents are analysed based on physical processes of ocean transports and air-sea fluxes. We show that ENSO variability impacts the thermosteric sea level mainly through lateral ocean heat transports, while it impacts the halosteric sea level mainly through surface freshwater flux. In the projection, a decreased volume transport of the relatively cold water (with respect to the SEA average) from the Pacific warms the SEA region. At the same time, a freshening of the transported saline water (with respect to the SEA average) results in an increased ocean freshwater transport into the SEA region. Locally, the pathway of volume transport from the Pacific to the SEA region is shifting northward, which results in a weakened Indonesian throughflow and an enhanced South China Sea throughflow, both leading to changes of regional sea-level pattern.
Myeloid cell iron uptake pathways and paramagnetic rim formation in multiple sclerosis
Authors: Hofmann Annika , Krajnc Nik , Dal-Bianco Assunta , Riedl Christian J. , Zrzavy Tobias , Lerma-Martin Celia , Kasprian Gregor , Weber Claudia E. , Pezzini Francesco , Leutmezer Fritz , Rommer Paulus , Bsteh Gabriel , Platten Michael , Gass Achim , Berger Thomas , Eisele Philipp , Magliozzi Roberta , Schirmer Lucas , Hametner Simon 
Published: September 2023

AbstractIn multiple sclerosis (MS), sustained inflammatory activity can be visualized by iron-sensitive magnetic resonance imaging (MRI) at the edges of chronic lesions. These paramagnetic rim lesions (PRLs) are associated with clinical worsening, although the cell type-specific and molecular pathways of iron uptake and metabolism are not well known. We studied two postmortem cohorts: an exploratory formalin-fixed paraffin-embedded (FFPE) tissue cohort of 18 controls and 24 MS cases and a confirmatory snap-frozen cohort of 6 controls and 14 MS cases. Besides myelin and non-heme iron imaging, the haptoglobin-hemoglobin scavenger receptor CD163, the iron-metabolizing markers HMOX1 and HAMP as well as immune-related markers P2RY12, CD68, C1QA and IL10 were visualized in myeloid cell (MC) subtypes at RNA and protein levels across different MS lesion areas. In addition, we studied PRLs in vivo in a cohort of 98 people with MS (pwMS) via iron-sensitive 3 T MRI and haptoglobin genotyping by PCR. CSF samples were available from 38 pwMS for soluble CD163 (sCD163) protein level measurements by ELISA. In postmortem tissues, we observed that iron uptake was linked to rim-associated C1QA-expressing MC subtypes, characterized by upregulation of CD163, HMOX1, HAMP and, conversely, downregulation of P2RY12. We found that pwMS with $$\ge$$
≥
4 PRLs had higher sCD163 levels in the CSF than pwMS with $$\le$$
≤
3 PRLs with sCD163 correlating with the number of PRLs. The number of PRLs was associated with clinical worsening but not with age, sex or haptoglobin genotype of pwMS. However, pwMS with Hp2-1/Hp2-2 haplotypes had higher clinical disability scores than pwMS with Hp1-1. In summary, we observed upregulation of the CD163-HMOX1-HAMP axis in MC subtypes at chronic active lesion rims, suggesting haptoglobin-bound hemoglobin but not transferrin-bound iron as a critical source for MC-associated iron uptake in MS. The correlation of CSF-associated sCD163 with PRL counts in MS highlights the relevance of CD163-mediated iron uptake via haptoglobin-bound hemoglobin. Also, while Hp haplotypes had no noticeable influence on PRL counts, pwMS carriers of a Hp2 allele might have a higher risk to experience clinical worsening.
Recommendation and intake of dietary supplements periconceptional and during pregnancy: results of a nationwide survey of gynaecologists
Authors: Buhling Kai J. , Scheuer Marie , Laakmann Elena 
Published: September 2023

Abstract
Background
Micronutrient supplementation during pregnancy is a controversial issue. For some micronutrients, for example folic acid or iodine, the evidence regarding supplementation is clear, whereas for others, such as zinc or vitamin E, it is not. Studies show that a large number of pregnant women have deficient levels of folic acid and iodine. However, especially with folic acid, starting supplementation during the preconception period is crucial. It is, therefore, important that gynaecologists explain this to their pregnant or preconceptional patients. Our goal was to find out how gynaecologists make their recommendations on this topic, how they assess the compliance of their patients and which micronutrients they consider to be important before/during pregnancy and during breastfeeding.

Method and Results
We sent about 12,000 questionnaires to all registered resident gynaecologists in Germany, with a response rate of 12.2%. Regarding which micronutrients gynaecologists consider to be particularly important during pregnancy, there was a broad agreement for both folic acid and iodine (> 88% answered yes). According to the questionnaire, doctors rate other micronutrients, such as vitamin D and omega-3 fatty acids, as less essential. The controversial evidence level for many micronutrients certainly plays a role here. Overall, the intake rate, especially for preconceptional women, is classified as rather low (< 60%). The most widely valued reason is the high price of dietary supplements. It was also noticeable that doctors consider certain micronutrients to be particularly important but then do not include them in the products they recommend.

Conclusion
Overall, there seems to be uncertainty about micronutrients in pregnancy and their supplementation. The study situation is often ambiguous and there are no official guidelines, leading to ambiguous recommendations from doctors and therefore low intake rates for pregnant or preconceptional women.
Ecological momentary assessment (EMA) combined with unsupervised machine learning shows sensitivity to identify individuals in potential need for psychiatric assessment
Authors: Wenzel Julian , Dreschke Nils , Hanssen Esther , Rosen Marlene , Ilankovic Andrej , Kambeitz Joseph , Fett Anne-Kathrin , Kambeitz-Ilankovic Lana 
Published: September 2023

AbstractEcological momentary assessment (EMA), a structured diary assessment technique, has shown feasibility to capture psychotic(-like) symptoms across different study groups. We investigated whether EMA combined with unsupervised machine learning can distinguish groups on the continuum of genetic risk toward psychotic illness and identify individuals with need for extended healthcare. Individuals with psychotic disorder (PD, N = 55), healthy individuals (HC, N = 25) and HC with first-degree relatives with psychosis (RE, N = 20) were assessed at two sites over 7 days using EMA. Cluster analysis determined subgroups based on similarities in longitudinal trajectories of psychotic symptom ratings in EMA, agnostic of study group assignment. Psychotic symptom ratings were calculated as average of items related to hallucinations and paranoid ideas. Prior to EMA we assessed symptoms using the Positive and Negative Syndrome Scale (PANSS) and the Community Assessment of Psychic Experience (CAPE) to characterize the EMA subgroups. We identified two clusters with distinct longitudinal EMA characteristics. Cluster 1 (NPD = 12, NRE = 1, NHC = 2) showed higher mean EMA symptom ratings as compared to cluster 2 (NPD = 43, NRE = 19, NHC = 23) (p < 0.001). Cluster 1 showed a higher burden on negative (p < 0.05) and positive (p < 0.05) psychotic symptoms in cross-sectional PANSS and CAPE ratings than cluster 2. Findings indicate a separation of PD with high symptom burden (cluster 1) from PD with healthy-like rating patterns grouping together with HC and RE (cluster 2). Individuals in cluster 1 might particularly profit from exchange with a clinician underlining the idea of EMA as clinical monitoring tool.
Mathematical Modelling of Peak and Residual Shear Strength of Rough Rock Discontinuities Using Continued Fractions
Authors: Buzzi Olivier , Jeffery Michael , Moscato Pablo , Grebogi Rafael Bartnik , Haque Mohammad Nazmul 
Published: September 2023

AbstractEstimating the shear strength of large in situ rock discontinuities is often required to assess the stability of rock masses. This estimation is, however, complicated by the well-known scale effect and the fact that the discontinuity surfaces are only partially accessible through traces. A new approach, referred to as the stochastic approach for discontinuity shear strength (StADSS), was recently presented to address these two points. This approach relies on a random field model and a semi-analytical shear strength model, the latter of which is referred to as the NDSS (Newcastle discontinuity shear strength) model. The NDSS model has to be implemented as a numerical code, and because the StADSS model is a Monte Carlo approach with hundreds if not thousands of simulations, the computational time to obtain a shear strength distribution is not negligible. The objective of this study is to find an efficient alternative to the NDSS model in the form of a continued fraction model that can predict the sheared area within a rough discontinuity subjected to direct shearing under constant normal stress as a function of the material strength, effective normal stress applied to the discontinuity and the standard deviation of asperity gradients (defined as the difference in elevation of two points of the surface over the horizontal distance between these points) of the surface. Using a 10/90 training/testing split of the dataset, a memetic algorithm-based truncated continued fraction regression (CFR) model was formulated. The distribution of CFR predictions was found to be very close to that of the dataset used for training. Then, the CFR model was tested against experimental data of the sheared area and shear strength (peak and residual) obtained from small (90 mm per 90 mm) and large (2 m per 2 m) specimens. It was found that 75% of the predictions fall within 20% of the experimental values. The continued fraction regression model can be used as an efficient alternative to the semi-analytical NDSS model, provided that it is used within the bounds of variables used to establish it.
Evaluating the understandability and actionability of online CKD educational materials
Authors: Furukawa Emi , Okuhara Tsuyoshi , Okada Hiroko , Nishiie Yuriko , Kiuchi Takahiro 
Published: September 2023

Abstract
Background
Previous studies have not fully determined whether online education materials on chronic kidney disease (CKD) for Japanese patients are easy to understand and help change their behavior. Therefore, this study quantitatively assessed the understandability and actionability of online CKD education materials.

Methods
In September 2021, we searched Google and Yahoo Japan using the keywords “kidney,” “kidney disease,” “CKD,” “chronic kidney disease,” and “renal failure” to identify 538 webpages. We used the Japanese version of the Patient Education Materials Assessment Tool (PEMAT), ranging from 0 to 100%, to evaluate the understandability and actionability of webpages. We set the cutoff point to 70%.

Results
Of the 186 materials included, the overall understandability and actionability were 61.5% (± 16.3%) and 38.7% (± 30.6%), respectively. The materials were highly technical in their terminology and lacked clear and concise charts and illustrations to encourage action. Compared to lifestyle modification materials on CKD overview, symptoms/signs, examination, and treatment scored significantly lower on the PEMAT. In addition, the materials produced by medical institutions and academic organizations scored significantly lower than those produced by for-profit companies.

Conclusion
Medical institutions and academic organizations are encouraged to use plain language and to attach explanations of medical terms when preparing materials for patients. They are also expected to improve visual aids to promote healthy behaviors.
Bridging the gap between website accessibility and lexicography: information access in online dictionaries
Authors: Arias-Badia Blanca , Torner Sergi 
Published: September 2023

AbstractInformation access has been one of the main concerns of lexicography since the first dictionaries were compiled. This paper draws an explicit link between the proposals made from the fields of applied linguistics and website accessibility to enhance the users’ experience in consulting online dictionaries. The paper starts with a reflection on two intertwined notions that are relevant for the discussion: Access and accessibility. After that, it focuses on elements connected to two Web Content Accessibility Guidelines principles, namely perceivability and understandability. It reflects on real practices regarding the way in which information is structured in today’s dictionaries, the use of text alternatives, typographic choice, the writing of definitions, and the use of abbreviations, and proposes measures to tackle the identified challenges. The implementation of easy-to-understand language is highlighted as a relevant resource for prospective lexicographic projects.
Parenting and teaching styles in relation to student characteristics and self-regulated learning
Authors: Žerak Urška , Juriševič Mojca , Pečjak Sonja 
Published: September 2023

AbstractParents and teachers play a key role in developing students' self-regulated learning (SRL), which is closely linked to academic achievement and acts as a protective factor for students from low socioeconomic backgrounds. Research has shown that authoritative parenting style, parental responsiveness, emotional warmth, behavioural control, and autonomy support are associated with better academic performance. In addition, studies have shown that the quality of the teacher-student relationship plays an important role in the development of SRL. However, there is limited research on the relationship between school and home environmental factors, student characteristics, and SRL, especially in primary school. The present study examined the relationship between parenting styles, teaching styles, student characteristics, and SRL. The sample included 328 ninth-grade students in Slovenian primary schools. SRL, parenting styles, and teaching styles were assessed using student self-reports. Using latent profile analysis, three subtypes of parenting styles (discipline-oriented parenting, democratic parenting, and responsive parenting) and three subtypes of teaching styles (autonomy-supportive teaching, diverse teaching, and directive teaching) were identified. Results indicate that students who perceive autonomy-supportive teaching and responsive parenting styles exhibit higher levels of SRL. Autonomy-supportive teaching was positively associated with student achievement. This study highlights the importance of an authoritative parenting and teaching style for the development of SRL in primary school.
Production and Use of Ceramics in the First Millennium BC: Jebel Moya, Sudan
Authors: Valancius Mantas , Quinn Patrick , Brass Michael , Vella Gregory I. , Adam Ahmed , Dunne Julie , Evershed Richard P. 
Published: September 2023

AbstractThe site of Jebel Moya, situated in the center of the southern Gezira Plain in southcentral Sudan, has an occupational sequence spanning at least five millennia until around 2000 years ago. Renewed excavation is shedding new light on its occupational chronology and socioeconomic history, including activities such as burial, savanna herding, and domesticated sorghum cultivation practices dating to at least the mid-third millennium BC. In the present study, predominantly final phase pottery sherds from the first millennium BC to the start of the first millennium AD (Assemblage 3) have been analyzed via a combination of thin section petrography and instrumental geochemistry to determine their raw materials and place of manufacture and reconstruct their manufacturing technology. Organic residue analysis was also conducted to identify the products processed within vessels found at the site. The results suggest the existence of a well-developed local ceramic craft tradition that persisted for over one thousand years. Pots from Assemblage 3 were used to process, store, and consume animal and plant products, thus reinforcing emerging evidence for early agro-pastoral activities.
Realisation of Fractal Grid-Induced Turbulence Strength with PTFV: Effects of Grid Geometry
Authors: Lee Ted Sian , Ooi Ean Hin , Chang Wei Sea , Foo Ji Jinn 
Published: September 2023

AbstractThe unravelling of multilength-scale insert-generated turbulence, particularly, the induced-forcing plays critical role in the fundamental comprehension of energy formation and decay as a function of grid conformation. This study experimentally investigates the flow mechanical characteristics at ReDh = 4.1 × 104 for a regular-grid (RG), single-square-grid (SSG) and six 2D planar space-filling square-fractal-grids (SFG) of different fractal iterations (N), thickness ratios (tr) and blockage ratios (σ) via piezoelectric thin-film flapping velocimetry (PTFV). Thin-film’s tip-deflection (δrms) and voltage response (Vrms) analysis along the grids’ centreline reveals increasing flow fluctuation strength with increasing σ, tr and decreasing N, owing to higher shedding intensity of lower frequency, larger scale energy-containing vortices from thicker first iteration bar. However, higher: energy dissipation rate, centreline mean velocity decrement rate and local deceleration experienced in the turbulence decay region of larger tr grid, along with additional fractal scales lead to less potent flow-structure-interplay on thin-film undulation. More importantly, SSG-generated turbulence enables the generation of average (Vrms, δrms) and millinewton turbulence forcing Frms that are respectively, 9× and 5× larger than RG of similar σ, and 2× larger than the best performing N = 3 SFG. Our findings disclose the importance of grid geometrical management for effective utilisation of turbulence-generating grids in engineering applications.