bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving Skin Cancer Diagnostics Through a Mobile App With a Large Interactive Image Repository: Randomized Controlled Trial
Authors: Nervil Gustav Gede , Ternov Niels Kvorning , Vestergaard Tine , Sølvsten Henrik , Chakera Annette Hougaard , Tolsgaard Martin Grønnebæk , Hölmich Lisbet Rosenkrantz 
Published: July 2023

Background
Skin cancer diagnostics is challenging, and mastery requires extended periods of dedicated practice.

Objective
The aim of the study was to determine if self-paced pattern recognition training in skin cancer diagnostics with clinical and dermoscopic images of skin lesions using a large-scale interactive image repository (LIIR) with patient cases improves primary care physicians’ (PCPs’) diagnostic skills and confidence.

Methods
A total of 115 PCPs were randomized (allocation ratio 3:1) to receive or not receive self-paced pattern recognition training in skin cancer diagnostics using an LIIR with patient cases through a quiz-based smartphone app during an 8-day period. The participants’ ability to diagnose skin cancer was evaluated using a 12-item multiple-choice questionnaire prior to and 8 days after the educational intervention period. Their thoughts on the use of dermoscopy were assessed using a study-specific questionnaire. A learning curve was calculated through the analysis of data from the mobile app.

Results
On average, participants in the intervention group spent 2 hours 26 minutes quizzing digital patient cases and 41 minutes reading the educational material. They had an average preintervention multiple choice questionnaire score of 52.0% of correct answers, which increased to 66.4% on the postintervention test; a statistically significant improvement of 14.3 percentage points (P<.001; 95% CI 9.8-18.9) with intention-to-treat analysis. Analysis of participants who received the intervention as per protocol (500 patient cases in 8 days) showed an average increase of 16.7 percentage points (P<.001; 95% CI 11.3-22.0) from 53.9% to 70.5%. Their overall ability to correctly recognize malignant lesions in the LIIR patient cases improved over the intervention period by 6.6 percentage points from 67.1% (95% CI 65.2-69.3) to 73.7% (95% CI 72.5-75.0) and their ability to set the correct diagnosis improved by 10.5 percentage points from 42.5% (95% CI 40.2%-44.8%) to 53.0% (95% CI 51.3-54.9). The diagnostic confidence of participants in the intervention group increased on a scale from 1 to 4 by 32.9% from 1.6 to 2.1 (P<.001). Participants in the control group did not increase their postintervention score or their diagnostic confidence during the same period.

Conclusions
Self-paced pattern recognition training in skin cancer diagnostics through the use of a digital LIIR with patient cases delivered by a quiz-based mobile app improves the diagnostic accuracy of PCPs.

Trial Registration
ClinicalTrials.gov NCT05661370; https://classic.clinicaltrials.gov/ct2/show/NCT05661370
A posição do falante em relação ao valor facultativo instaurado no português do Ceará
Authors: Lima Liliane Viana , Pessoa Prata Nadja Paulino 
Published: July 2023

Segundo Hengeveld e Mackenzie (2008), a modalidade facultativa é uma categoria semântica que diz respeito a habilidades e capacidades de um indivíduo (quando orientada-para-o-participante) ou a condições físicas circunstanciais de ocorrência de um determinado evento (quando orientada-para-o-evento). Com base nessa premissa, objetivamos, com esta pesquisa, descrever e analisar aspectos da modalidade facultativa que mantenham relação com os parâmetros de inclusão do falante no português cearense, tendo em vista as relações existentes entre os níveis Interpessoal e Representacional e Morfossintático na GDF (HENGEVELD; MACKENZIE, 2008) Para esta análise, utilizamos o subprojeto do corpus PROFALA intitulado “O português falado no Ceará”, do qual escolhemos uma amostra de 60 entrevistas do tipo DID. Após a leitura das entrevistas e a análise quali-quantitativa, identificamos a existência de um continuum de uso do posicionamento do falante em relação valor facultativamente modalizado, que pode permitir-lhe (i) incluir-se totalmente no valor modal facultativo (eu; nós); (ii) incluir-se indiretamente no valor modal facultativo por meio de termos generalizadores (todo mundo; ninguém; você genérico, etc.); (iii) não se incluir no valor modal facultativo (terceira pessoa; sujeito indeterminado). Consequentemente, esta inclusão está diretamente ligada à orientação da modalidade facultativa, de modo que, quanto maior a inclusão do falante, maior a tendência a ocorrer a modalidade facultativa orientada-para-o-participante. Por outro lado, a tendência a não-inclusão propiciaria a modalidade facultativa orientada-para-o-evento.
Features of the Parameters of 24-Hours pH-Impedance and High-Resolution Esophageal Manometry in Patients with Barrett's Esophagus on Proton Pump Inhibitors
Authors: Maev I. V. , Bordin D. S. , Barkalova E. V. , Ovsepyan M. A. , Valitova E. R. , Kalashnikova N. G. , Andreev D. N. 
Published: July 2023

Аim: to identify predictors of insufficient effectiveness of proton pump inhibitors based on the evaluation of the results of 24-hour pH-impedance and high-resolution esophageal manometry in patients with Barrett's esophagus.Materials and methods. 52 patients with histologically confirmed Barrett's esophagus who are on therapy with proton pump inhibitors were examined. All patients underwent daily pH-impedance and high-resolution esophageal manometry.Results. According to daily pH-impedance, group 1 consisted of 37 patients who responded satisfactorily to antisecretory therapy, group 2 of 15 patients who demonstrated insufficient response to acid-suppressive therapy, 11 of whom had no clinical manifestations. The total number of reflux averaged 55 in group 1 and 106 in group 2. The average number of acid reflux in group 1 was 5.68, in group 2 — 48.5. The average number of non-acid reflux prevailed in patients of group 2 and averaged 58, in group 1 the indicator averaged 47. Evaluation of the results of high-resolution esophageal manometry showed that violations of the structure and function of the esophago-gastric junction were detected in 21 patients out of 52. Disorders of the motility of the thoracic esophagus were detected in 31 patients out of 52. When comparing the frequency of motor disorders from the thoracic esophagus in groups 1 and 2, no significant differences were obtained. However, significantly more frequent registration of violations of the structure and/or function of the esophago-gastric junction was found in the group with unsatisfactory effectiveness of proton pump inhibitors.Conclusion. In a number of patients with Barrett's esophagus, there is an insufficient effect of acid-suppressive therapy and at the same time an asymptomatic course of the disease, which may increase the risk of its progression. Predictors of insufficiently successful treatment of patients with Barrett's esophagus may be both insufficient pharmacological effect of proton pump inhibitors themselves, and motility disorders that cause the presence of non-acid reflux, decreased esophageal clearance, which in turn may cause the patient's symptoms to persist and adversely affect the condition of the esophageal mucosa.
Physical Activity and Gallstone Disease
Authors: Grigor’eva I. N. , Notova T. E. , Romanova T. I. 
Published: July 2023

Аim: to present data of Russian and foreign studies about association between physical activity (PA) and gallstone disease (GSD).Key point. A low PA level is one of the four major risk factors for chronic non-infectiuos diseases. The frequency of low PA in men and women of the Russian Federation (according to the medical examination in 2016) is 19 %. The global prevalence of GSD is up to 20 % among adults. Many systematic reviews and meta-analyses have confirmed an inverse association between GSD and PA in the world, regardless of potential risk factors for GSD, with a clear dose-dependent effect — the relative risk (RR) of GSD was 0.87 (95 % CI 0.83–0.92) per 20 metabolic equivalents (MET) of PA per week. According to our results of an epidemiological survey in the framework of the WHO MONICA program in Novosibirsk (n = 870) among women aged 25–64 with low total PA (less than 800 MET/min/week), as well as with the first class of PA in leisure-time, GSD occurred much more often (class 1 — 33 %, classes 2–4 — 8.7–11.0 %, p < 0.01). PA favorably affects almost all mechanisms of gallstone formation: improves cholesterol metabolism in bile, increases serum HDL cholesterol, bile acid synthesis, stimulates the release of cholecystokinin, reduces mucin hypersecretion, increases the diversity and richness of the intestinal microbiota. Daily PA serves as a preventive measure for GSD: the risk of GSD is reduced by 66 % (95 % CI 0.18–0.86).Conclusion. EASL has recognized PA as a protective agent against gallstone formation.
153-OR: Genetically Supported Therapeutic Targets for Coronary Artery Disease in Diabetes—Evidence from Proteome-Wide Mendelian Randomization
Authors: HUANG CHUIGUO , SHI MAI , YU GECHANG , CHAN JULIANA C. , MA RONALD C. 
Published: July 2023

Coronary artery disease (CAD) remains a major burden in people with diabetes. Genome-wide association studies (GWASs) have identified multiple genetic loci, yet most have yet to translate to clinical applications. The aim of this study was to leverage on genetic data to identify novel drug targets for CAD in diabetes. We applied Mendelian randomization (MR) to investigate the causal association of 1677 plasma proteins from 6 large GWASs, and a recently published GWAS of 15,666 individuals with diabetes (including 3968 CAD cases and 11698 controls). 5 of the 6 proteomic studies were selected as discovery MR analysis, and the remaining one as replication MR to validate the top findings. We employed sensitivity analyses, Bayesian colocalization and transcriptome-wide association study (TWAS) to test the validity of MR assumptions and meanwhile prioritized candidates of drug targets using multi-omics layers. We further integrated phenome-wide MR using the summary data from UK Biobank (N≤408 961) studies and clinical evidence based on DrugBank database to detect potential side effects associated with hypothetical therapeutic agents for CAD in diabetes and prioritize them. Our primary discovery MR analysis identified 4 prioritized proteins (F5, LPA, NPPB and TNFRSF11B) with both MR and colocalization evidence. NPPB and TNFRSF11B could be verified by replication MR analysis. Multi-tissue TWAS analysis revealed all 4 targets whose imputed expression was associated with the outcome. No adverse side effects were found for LPA via phenome-wide MR. By combining the putative causal MR signals with clinical evidence, we suggested these 4 drug repurposing opportunities for the treatment of CAD with diabetes that warranted further investigation. In summary, we prioritized 4 potential drug targets for CAD in diabetes. In particular, LPA might represent a promising target for the treatment of CAD in diabetes, with no predicted adverse side effects.

Disclosure
C.Huang: None. M.Shi: None. G.Yu: None. J.C.Chan: Board Member; Asia Diabetes Foundation, Consultant; Bayer Inc., Celltrion, Boehringer Ingelheim and Eli Lilly Alliance, Sanofi, Research Support; AstraZeneca, Servier Laboratories, Viatris Inc., Hua Medicine, Merck KGaA, Applied Therapeutics Inc., Lee Powder, Pfizer Inc., Speaker's Bureau; Novartis, Stock/Shareholder; GemVCare Ltd. R.C.Ma: Advisory Panel; AstraZeneca, Merck & Co., Inc., Other Relationship; Bayer Inc., Boehringer-Ingelheim, Research Support; Tricida, Inc., Roche Diagnostics, Novo Nordisk.

Funding
Research Grants Council of the Hong Kong Special Administrative Region (CU R4012-18); Croucher Foundation
Digital-Based Flash Card to Increase Social Studies Learning Outcomes for Elementary School Students in The Fourth Grade
Authors: Sudrajat Ajat , Salsabila Fhadya Giaani , Marini Arita 
Published: July 2023

The development of innovative learning media is needed to provide a different and varied learning experience. This is required to stimulate student interest in learning to achieve maximum learning outcomes. The aim of this study is to develop and analyze the effect of digital-based flashcard media to improve social studies learning outcomes for fourth-grade elementary school students. This research uses R&D (Research and Development) methods and adapts the ADDIE development model. The population in this study were fourth-grade students. This study randomly took a sample of 126 fourth-grade students and calculated using the Slovin formula with a margin of error of 5%. The results of this study show that the results of material expert validation 83.3% in the worthy category. The results of media experts 93.3% in the very worthy category, and the results of the effectiveness of learning media are obtained through a questionnaire given to students at the pretest and posttest. This study concludes that digital-based flashcard media positively impacts social studies learning outcomes for fourth-grade elementary school students.
Los hábitos de consumo del estudiante universitario. El caso de estudio Centro Universitario UAEM Temascaltepec
Authors: Ramires Hernández Pablo , Dorantes Coronado Ernesto Joel , Bahena Castro Gisela Regina 
Published: July 2023

Las condiciones económicas de los estudiantes mexicanos determinan en gran medida las posibilidades de realizar sus estudios universitarios. Especialmente los alumnos provenientes de municipios con mayores índices de pobreza son los que tienen menos oportunidades de cursar estudios superiores. Dado que la pobreza en México se estima entre el 34.9% y el 36.2%, es de gran importancia contar con una estimación sólida de los gastos necesarios para cubrir los bienes y servicios requeridos en la educación superior. Esto permitirá que los futuros estudiantes universitarios tengan una comprensión más clara y precisa de los gastos que deberán afrontar durante su vida universitaria.
En este estudio de caso realizado con los alumnos de licenciaturas del Centro Universitario UAEM Temascaltepec, se identificaron los bienes y servicios que los estudiantes requieren. Como resultado, se encontró que los estudiantes destinan en promedio $8,607.76 pesos mexicanos al mes para cubrir estas necesidades. El análisis estadístico (ANOVA) reveló que los gastos realizados por los alumnos son estadísticamente iguales (p>0.05) en las diferentes licenciaturas. Sin embargo, se encontraron diferencias significativas (p<0.05) en los gastos realizados por los estudiantes provenientes de los municipios analizados. La comparación múltiple de medias mostró que los alumnos provenientes del municipio de Valle de Bravo incurren en mayores gastos, con un monto medio de $15,206.77 pesos mexicanos.
Esta información será útil para los futuros estudiantes universitarios, ya que les permitirá planificar un ahorro y tomar acciones que les permitan cubrir los gastos necesarios, facilitando así su ingreso y culminación de los estudios.
Rethinking Offa’s Dyke as a Hydraulic Frontier Work
Authors: Williams Howard 
Published: July 2023

Building upon a fresh interpretation of Wat’s Dyke as a component of an early medieval hydraulic frontier zone rather than primarily serving as a symbol of power, a fixed territorial border or a military stop-line (Williams 2021), here, I refine and apply this approach to its longer and better-known neighbour: Offa’s Dyke. This linear earthwork’s placement, alignments and landscape context are evaluated afresh using a simple but original comparative mapping methodology. First, on the local level, I show that Offa’s Dyke was carefully and strategically positioned to connect, overlook and block a range of watercourses and wetlands at key transverse and parallel crossing points, thus observing and choreographing mobility on multiple axes. Second, I address the regional scale, showing how Offa’s Dyke interacted with, and controlled, biaxial movement through and between water catchments parallel and transverse to the monument’s principal alignments. Both these arguments inform how the Dyke might have operated on the supra-regional scale, ‘from sea to sea’ and also ‘across the sea’, by controlling the estuarine and maritime zones of the Dee Estuary in the north and the Wye/Severn confluence to the south. Integrating military, territorial, socio-economic and ideological functionality and significance, Offa’s Dyke, like its shorter neighbour Wat’s Dyke (in an as-yet uncertain relationship), configured mobilities over land and water via its hydraulic dimensions and interactions. Together, the monuments can be reconsidered as elements of a multi-functional hydraulic frontier zone constructed by one or more rulers of the middle Anglo-Saxon kingdom of Mercia and operative both in times of peace and conflict.
Рolylactide composite materials possesing fungibactericidal properties
Authors:   Lviv Polytechnic National University, Dudok G. D. , Semenyuk N. B. ,   Lviv Polytechnic National University, Parfonov Y. О. ,   Lviv Polytechnic National University
Published: July 2023

The regularities of obtaining polylactide film composite materials with simultaneous silver nanoparticles formation were researched. The influence of the nature of polylactide and its structure (amorphous and amorphous-crystalline), of the glycerin plasticizer on the solvent evaporationkinetics was determined. To give polylactide composites fungicidal properties, the silver reduction reaction by the interaction of argentum salts with polyvinylpyrrolidone was applied. A main technological scheme for obtaining films based on polylactide with fungicidal properties is proposed. Above mentioned provides effective practical usage of the films as packaging materials for food products and medicines.
PENERAPAN MEDIA BERBASIS ETNOMATEMATIKA UNTUK MENINGKATKAN KEMAMPUAN ANALITIS PESERTA DIDIK KELAS IV
Authors: Windy Istiani Mufida , Yuni Listiani Iva , Puspita Sri Wulandari Dyah 
Published: July 2023

Ethnomathematics-based media is a learning media that combines cultural values in the environment into learning activities, especially mathematics. Ethnomathematical media in this study came from the Reog Ponorogo Art Show, one of the arts that came from the environment where the research was carried out. The purpose of using ethnomathematics-based media is to improve the analytical ability of grade IV students. The type of research used is collaborative classroom action research (PTK) with two cycles. Each cycle consists of stages of planning, execution, observation, and reflection. The subjects in this study were all grade IV students at SDN 1 Jurug consisting of 15 students. Data collection techniques in this study through observation and tests of student learning outcomes. The results of the analysis show that the application of ethnomathematics-based media is effective in improving the analytical ability of students. This is known based on the results of observations of the learning process and the results of analytical ability tests of students which show significant improvement when compared to pre-cycle, cycle I and cycle II.
FITOSSOCIOLOGIA DE DOIS FRAGMENTOS DE FLORESTA ESTACIONAL SEMIDECIDUAL NO PONTAL DO PARANAPANEMA, SP
Authors: Durigan Giselda , Santos João Dagoberto dos , Gandara Flavio Bertin 
Published: July 2023

Para efetuar o levantamento fitossociológico do componente arbóreo da floresta em fragmentos remanescentes no Pontal do Paranapanema, adotou-se um método alternativo, na tentativa de reunir os aspectos positivos e eliminar os aspectos negativos de dois métodos amplamente utilizados: quadrantes e parcelas. Foram amostrados dois fragmentos, distantes cerca de 1100 m entre si, com históricos de perturbação diferentes. Em cada fragmento foram amostrados 400 indivíduos, com DAP mínimo de 10 cm, em l 00 pontos de amostragem pelo método de quadrantes, a partir dos quais obtiveram-se os parâmetros relativos de densidade, freqüência e âominância. Uma vez que o método de quadrantes tem se mostrado inadequado para estimativa de densidade absoluta em áreas perturbadas, optou-se por uma estimativa independente da densidade da floresta, utilizando.,, em cada fragmento, 20 parcelas de 100 m- (4 x 25 m), em que foram apenas contabilizados os indivíduos acima do diâmetro mínimo de inclusão. A floresta apresentou, coincidentemente, densidade absoluta de 405 indivíduos por hectare (DAP ≥ 10 cm), em ambos os fragmentos. Obteve-se área basal bçistante diferente entre {ragmentos: 21,6 m2/ha (Agua Sumida) e 13,8 m2/ha (Estrela), refletmdo diferentes níveis de impacto sobre a floresta nas duas áreas. A análise conjunta dos dois fragmentos apontou a presença de 78 espécies. No fragmento Estrela foram amostradas 6) espécies (H' = 3,35, J = 80,3%), sendo as primeiras em ordem decrescente de IVI: Plinia rivularis, Croton floribundus, Ficus insipida, Duguetia lanceqlata e Astronium graveolens. No fragmento Agua Sumida foram amostradas 62 espécies (H' = 3,51, J = 85,0%), destacando-se em ordem decrescente de IVI: Plinia rivularis, Chysophyllwn gonocarpum, Garcinia gardneriana, Astronium graveolens e Ficus guaranitica. Embora haJa diferenças na ordem de importância das espécies, obteve-se alta similaridade ilorística entre os fragmentos (63% pelo índice de Jaccard). O método utilizado mostrou-se de fácil aplicação no campo e nos cálculos. Os resultados atenderam ao objetivo principal deste estudo, que foi conhecer a estrutura e a flora da comunidade arbórea da floresta, para subsidiar programas de restauração da Mata Atlântica na região do Pontal do Paranapanema.
Antimicrobial Susceptibility of Pasteurella multocida Isolated from Sheep with Fibrinous Pneumonia
Authors: Galecio Juan Sebastián , Badillo Elena , Escudero Elisa , Corrales Juan Carlos , Yuste María Teresa , Marín Pedro 
Published: July 2023

Abstract
Ovine respiratory complex is a significant cause of death in sheep flocks, where Pasteurella multocida is the most frequent microorganisms isolated from animals with pneumonia. There is an urgent need to refine the use of different antimicrobials to avoid the problem of antimicrobial resistance and optimize the control of this disease in ovine livestock. The first step in approaching this problem is gaining an insight into the antimicrobial susceptibility of ovine pathogens. This study evaluated the in vitro activity of tildipirosin, gamithromycin, oxytetracycline, and danofloxacin against Pasteurella multocida strains isolated from sheep with fibrinous pneumonia. The strains were incubated following Clinical and Laboratory Standards Institute (CLSI) standard conditions and also with a modified method by 25% supplementation with sheep serum. Minimum inhibitory concentrations (MIC) were determined using the broth microdilution technique. The lowest MIC90 under standard conditions and by supplementation with sheep serum was obtained with tildipirosin. Sheep serum significantly reduced tildipirosin, gamithromycin, and danofloxacin MIC values for Pasteurella multocida strains. In brief, the potency of tildipirosine, gamithromycin, and danofloxacin against Pasteurella multocida increases when sheep serum is added to the culture media.