bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Influence of Tourist Facilities, Experiential Marketing and The Role of Tourism Ambassadors on Tourist Visiting Satisfaction
Authors: Wiska Mayroza , Ermawati Eka , Elida Putri Dini , Ferdinal Alex , Resty Fenisi , Deswita Yuhelvi 
Published: January 2025

The purpose of the study was to determine how much influence tourist facilities, experiential marketing and the role of tourism ambassadors on tourist visitor satisfaction of Alinia Farm &; Park Dharmasraya Regency in 2022. The method in this study is quantitative method and data collection using questionnaires assisted by SPSS version 20. Sampling in research is probability sampling which is a sampling technique that provides equal opportunities for each element (member) of the population to be selected as a member of the sample. The sampling technique used in this study is purposive sampling using accidental sampling method. Accidental sampling is a sampling technique based on chance. The population in this study was visitors to the Alinia Farm & Park tourist attraction, which was 73,142 visitors. The respondents sampled were 346 respondents. The results of the study showed that partially (t test) it was proven that tourist facilities had a positive and significant effect on visiting satisfaction with t value count > t table (5.633 > 1.966925), experiential marketing had a positive and significant effect on visit satisfaction with t value count > t table (4.659 > 1.966925) and the role of tourism ambassadors had a positive and significant effect on visiting satisfaction with t value calculate t > t table (6.398 > 1.966925) and simultaneously (test F) together with tourism facilities, experiential marketing and the role of tourism ambassadors have a significant effect on visit satisfaction with F value calculated > F table (79,443 > 2,398). The Adjusted R2 value is 0.406 which means that all independent variables can affect 40.6% of the dependent variable. The remaining 59.4% could be influenced by other factors not tested in the study.
Detecting the Black Hole Candidate Population in M51’s Young Massive Star Clusters: Constraints on Accreting Intermediate-mass Black Holes
Authors: Dage Kristen C. , Tremou Evangelia , Cuevas Otahola Bolivia , Koch Eric W. , Oh Kwangmin , Plotkin Richard M. , Tang Vivian L. , Aldhalemi Muhammad Ridha , Bustani Zainab , Fawaz Mariam Ismail , Harff Hans J. , Khalyleh Amna , McBride Timothy , Mason Jesse , Preston Anthony , Rinehart Cortney , Vinson Ethan , Anderson Gemma , Cackett Edward M. , Fu Shih Ching , Kamann Sebastian , Panurach Teresa , Pechetti Renuka , Saikia Payaswini , Sett Susmita , Urquhart Ryan , Usher Christopher 
Published: January 2025

Abstract
Intermediate-mass black holes (102 < M
BH < 105
M
⊙) are an open question in our understanding of black hole evolution and growth. They have long been linked to dense star cluster environments, thanks to cluster dynamics, but there are a limited number of secure detections. We leverage existing X-ray observations from the Chandra X-ray Observatory and optical catalogs from the Hubble Space Telescope (HST) as well as new radio observations from the Karl G. Jansky Very Large Array to search for any evidence of accreting black holes in young massive star clusters in the nearby galaxy M51. We find that of 44 bright (L
X > 1038 erg s−1) X-ray point sources in M51, 24 had probable matches to objects including possible associated star clusters in the HST Legacy Extragalactic UV Survey catalog, seven of which were classified as contaminants (background galaxies or foreground stars). We explore the optical properties of the remaining 17 sources, including cluster age and mass estimates, and search for radio counterparts in the 8–12 GHz band. The lack of radio counterparts to X-ray sources we know to be associated with young massive star clusters in M51 suggests that we do not significantly detect hard-state intermediate-mass black holes (IMBHs) ~104
M
⊙ or above. However, more sensitive radio facilities, like the Square Kilometre Array and next-generation Very Large Array, may be able to provide evidence for IMBHs with masses down to ~103
M
⊙.
Dermoscopic and Histopathological Association in Pyogenic Granuloma: A Case Series in Skin of Color
Authors: Ankad Balachandra Suryakant , Mallapur Anirudh A , Hurakadli Sahana S 
Published: January 2025

Introduction:
Pyogenic granuloma (PG) is a common benign vascular lesion, presenting as a rapidly growing papule or polyp that bleeds easily. Diagnosing PG can be challenging due to its clinical similarity to other tumors. Dermoscopy offers improved accuracy in identifying such vascular by demonstrating features. This study aims to explore dermoscopic features with their association to histopathological changes in PG in skin of color.

Materials and Methods:
A prospective observational case series study was conducted at S. Nijalingappa Medical College from January 2022 to November 2022. Patients with clinical signs of PG were included, while those with infected and oozing lesions were excluded. Demographic data, clinical evaluation, photographic documentation, dermoscopic examination, and histopathological analysis were performed. Statistical analysis was carried out using SPSS Statistics v20.0.

Results:
A total of 30 patients (13 males, 17 females) were included. Solitary red papule on face and scalp was common presentation. Dermoscopic features included reddish homogeneous areas (96.7%), white collarette (80%), white linear rail-lines (60%), hemorrhagic crust (30%), and rainbow phenomenon (30%). Dotted, linear irregular, and hairpin vessels were vascular patterns. Histopathology showed dilated blood vessels in a lobular arrangement (96.7%), hyperplastic epithelium forming a collarette (73.3%), and collagen bundles (56.7%). Statistically significant correlation was found in reddish homogeneous areas (P=0.001) white collarette (P=0.005) and white rail lines(P=0.001) with corresponding histopathological changes.

Conclusion:
Dermoscopy identifies characteristic features in PG effectively, aiding differentiation from similar lesions. The association with histopathological changes validates its diagnostic and monitoring relevance. Further studies with larger sample sizes are recommended.
A Phase-IV, Multi-centric, Open Label, Comparative Clinical Trial to Evaluate Safety, Tolerability, and Efficacy of Oral Tablets of Fixed-dose Combination of Alogliptin and Metformin Hydrochloride versus Alogliptin in the Treatment of Indian Type-2 Diabetes Mellitus Patients: CONFIDENCE Trial
Authors: Trailokya Abhijit A. , Shirsat Amar , Wankhede Shaijesh , Erande Suhas , Talware Avinash 
Published: January 2025

Introduction:
Dipeptidyl peptidase-4 inhibitors are widely used antidiabetic drugs due to their convenient dosing, modest HbA1C reduction, and minimal risk of hypoglycemia, commonly prescribed in combination with metformin. A phase-IV, multi-centric, open-label, randomized, comparative clinical trial aimed to evaluate the safety, efficacy, and tolerability of a fixed-dose combination (FDC) of alogliptin + metformin hydrochloride versus alogliptin oral tablet in the management of Indian patients with type-2 diabetes mellitus (T2DM).

Methods:
This was a multi-center, randomized, open-label, comparative, parallel-group, phase IV clinical study. The study duration was 180 days, with follow-ups conducted at 30, 60, 90, and 180 days. Safety evaluations included assessing adverse events (AEs), serious adverse events (SAE), laboratory tests, and vital parameters. Parameters such as HbA1C, fasting plasma glucose (FPG), and postprandial glucose (PPG) were analyzed at baseline and at the end of the study. The trial was registered at ClinicalTrials.gov: CTRI/2021/11/038226.

Results:
Out of 362 enrolled patients, 344 completed the study; 166 received the FDC of alogliptin + metformin and 178 received alogliptin only. After 6 months, the mean reduction in HbA1C from baseline was − 2.07 (P < 0.001) in the FDC of alogliptin + metformin group and − 1.29 (P < 0.001) in the alogliptin group. Mean FPG decreased significantly in both groups, with a greater reduction observed in the FDC of alogliptin + metformin group (−103.65, P < 0.001). Similarly, there was a significant reduction in mean PPG in both groups, with a greater reduction observed in the FDC of alogliptin + metformin group (−143.11, P < 0.001). Out of 166, 25 (15.10%) patients experienced 10 AE in the FDC of alogliptin + metformin group and 23 out of 178 (12.90%) patients experienced 10 AE in the alogliptin group. All the reported AE were mild in severity and resolved completely. No serious adverse events were reported in either treatment group.

Conclusions:
In this study, alogliptin and the FDC of alogliptin + metformin were well tolerated, without any serious adverse events reported. These findings suggest that both treatment options are promising for managing Indian T2DM patients in terms of safety, efficacy, and tolerability.
Understanding Early Diagnosis of Autism Spectrum Disorder in South Indian Children: A Multicentric Real World Data
Authors: Arun Prajna , Divya P. , Hariharan R. , Subramanian S. 
Published: January 2025

ABSTRACT

Background:
Global autism spectrum disorder (ASD) incidence is rising, emphasizing early diagnosis for improved outcomes. Most data are from developed nations, pointing to the need for information from developing nations like India.

Objectives:
The study aims to analyze the sociodemographic and clinical profiles of children with ASD, to assess ASD severity using Childhood Autism Rating Scale (CARS) and Indian Scale for Assessment of Autism (ISAA), to evaluate treatment outcomes with Autism Treatment Evaluation Checklist (ATEC), and to identify factors associated with early diagnosis.

Subjects and Methods:
A cohort study conducted in the outpatient departments of five centers in Tamil Nadu from May 1, 2022, to May 31, 2023, focused on children with ASD. SPSS Version 26 was used for analysis. Descriptive statistics included frequency, percentage, and mean ± standard deviation. Chi-squared or Fisher’s exact test (P < 0.05) examined factors associated with age at diagnosis, whereas Spearman’s rank correlation assessed associations among ATEC, CARS, and ISAA scores.

Results:
The male-to-female ratio was 7:3, with a mean diagnosis age of 3.2 years. 67.9% were from urban residence, 68.9% belonged to upper socio-economic class, and 6.6% had a history of consanguinity. Neonatal convulsions occurred in 35%, 23% required NICU, and 4.7% had a family history of ASD. Poor eye contact and solitary play were reported in 87% & 83%, respectively, Tantrums in 57%, and poor interaction in 64%.

Conclusion:
Urban residence, neonatal convulsions, and ASD severity were significantly associated with early diagnosis. There was no correlation of the ATEC scale with either the CARS or ISAA scale.
Meibomian Gland Loss and Dysfunction in Mild versus Moderate-Severe Thyroid Eye Disease
Authors: Aghaei Hossein , Zarastvand Fatemeh , Abdolalizadeh Parya , Karimi Nasser , Es’haghi Acieh , Clark Jeremy D. , Compton Christopher J. , West Nicole L. , Kashkouli Mohsen Bahmani 
Published: January 2025

Abstract

Purpose:
To compare meibomian gland (MG) loss and MG dysfunction (MGD) in patients with mild versus moderate-severe thyroid eye disease (TED).

Methods:
Consecutive patients with TED and no other causes of dry eye disease underwent meibography and meiboscore of each eyelid were graded as 0 (no MG loss), 1 (<33% loss), 2 (33%–66% loss), and 3 (>66% loss), with a total score of 0–6. MG expression score (0–3), eyelid margin signs of MGD, lipid layer thickness (LLT), ocular surface disease index (OSDI), tear secretion, noninvasive tear break-up time (NITBUT), and tear meniscus height (TMH) were also assessed by a masked observer.

Results:
Included were 21 eyes (21 patients) with mild and 19 eyes (19 patients) with moderate-severe TED. The two groups were not different except for a higher frequency of smoking (P < 0.01). Eyes with moderate-severe TED showed a higher upper eyelid meiboscore (P = 0.03), MG expression score (P < 0.01), and tear film osmolality (P = 0.02) as well as lower LLT (P = 0.03). Total meiboscore had a significantly positive correlation with OSDI (rs = 0.37) and tear film osmolality (rs = 0.50) as well as a negative correlation with NITBUT (rs = −0.55), TMH (rs = −0.44), and LLT (rs = −0.38). While older age, male gender, smoking, and longer duration of disease were significantly associated with the higher (≥3) meiboscore in univariate analysis, none remained significant in multivariate analysis.

Conclusion:
MG loss and MGD were significantly more severe in moderate-severe than mild TED.
Progressive Changes in a Torpedo Maculopathy Lesion Over a 6-Year Period
Authors: Chitturi Sai Prashanti , Prabhu Vishma , Chhablani Jay , Venkatesh Ramesh 
Published: January 2025

Abstract

Purpose:
To report the longitudinal changes on optical coherence tomography (OCT) in a patient with torpedo maculopathy (TM).

Methods:
Retrospective observational study.

Results:
A 37-year-old male, without any ocular symptoms, on dilated fundus examination showed a characteristic torpedo-shaped, flat, horizontally oriented, ovoid-shaped, hypopigmented chorioretinal lesion, temporal to the foveal center. At the most recent visit, after 6 years, the lesion exhibited changes on OCT, including the collapse of the subretinal cleft, the thinning of the retinal pigment epithelium (RPE) layer and inner choroidal layers, and the increased visibility of the underlying choroid and inner retinal excavation. The fundus autofluorescence demonstrated an increase in hypoautofluorescence in the center of the torpedo lesion, which was surrounded by a hyperautofluorescent boundary.

Conclusion:
This appears to be the first report of longitudinal changes in a classic case of TM, demonstrating changes in the RPE, inner choroidal, and outer retinal layers over time.
Ocular Manifestations of Coronavirus Disease 2019: A Hospital-Based Prospective Study at a Coronavirus Disease Dedicated Tertiary Center
Authors: Tripathi Anchal , Chaudhary Rajat , Kushwaha Saurabh , Pathak Lav 
Published: January 2025

Abstract

Purpose:
To investigate ophthalmic manifestations in coronavirus disease 2019 (COVID-19) patients admitted to a designated COVID-19 center in Northern India during the period from April 13, 2020, to April 13, 2022. This aims to provide a comprehensive understanding of ocular involvement in the context of the pandemic.

Methods:
This is a hospital-based prospective observational study. All COVID-19-positive (reverse transcriptase polymerase chain reaction positive – via pharyngeal and nasal swabs) patients, who were admitted to our hospital, were included in the study. Upon receiving ophthalmology referrals, patients were seen in the COVID-19 ward, with data collected on demographic distribution, presenting ocular symptoms, and specific ocular findings.

Results:
Out of 3278 patients admitted to our center, 287 developed ocular symptoms. The study revealed a mean age of 63.8 ± 13.9 years, with males constituting 61.3% of the cases. The mean logMAR best-corrected visual acuity was found to be 0.30 ± 0.60. The mean duration between COVID-19 diagnosis and development of the first ophthalmic symptom was 10.4 ± 9.8 days. The predominant ocular symptoms included redness, discharge, and watering. Anterior segment manifestations were predominant, with conjunctivitis being the most prevalent ocular pathology (74.21%), followed by episcleritis (9.41%) and subconjunctival hemorrhage (7.31%). Conjunctivitis presented bilaterally in 41.5% of these patients, emphasizing its significance in the spectrum of COVID-19 ocular manifestations.

Conclusions:
This research contributes substantial evidence regarding ophthalmic manifestations in COVID-19 patients. Ophthalmologists should remain vigilant, considering the potential for ocular symptoms to precede respiratory manifestations. The study emphasizes the need for comprehensive patient assessments and preventive measures in ophthalmic practices.
Outcome of hand hygiene audit in intensive care unit during COVID-19: An experience from a tertiary care centre
Authors: Arthi E. , Sujitha V. , Vidya J. , Shobana A. , Muthamizh N. , Devi C. Sheela 
Published: January 2025

Background:
Hand hygiene (HH) remains a simple, cost-effective method to prevent healthcare-associated infections. Although the recent COVID-19 pandemic has brought out the importance of HH, its compliance remains below the set standards. Hence, monitoring HH compliance in hospital setup through audits remains vital as part of hospital infection prevention and control practices.

Aim:
The present study was done with the aim of assessing HH compliance in critical care units during the COVID-19 pandemic.

Materials and Methods:
This prospective cross-sectional study was conducted in the COVID intensive care unit (ICU) of 750-bed tertiary care hospital for 6 months among the healthcare workers in ICU. The HH audit was conducted by direct observation method adapted and modified from the world health organization (WHO)’s HH audit tool through the hand hygiene audit App (Ibhar).

Results:
The HH complete adherence rate, HH partial adherence rate and HH adherence rate (HHAR, complete + partial) were determined. Profession-specific HHAR (e.g. doctors, nurses and others), gender-specific HHAR and moment-specific HHAR (for each WHO moment) were also calculated.

Conclusion:
This study highlights the differences in HH compliance between different groups of healthcare workers, and the need to address these gaps by adopting multimodal strategies to modify the behaviour and attitude.
SMAD specific E3 ubiquitin protein ligase 1 accelerates diabetic macular edema progression by WNT inhibitory factor 1
Authors: Liang Li-Fang , Zhao Jia-Qi , Wu Yi-Fei , Chen Hui-Jie , Huang Tian , Lu Xiao-He 
Published: January 2025

BACKGROUND
Diabetic macular edema (DME) is the most common cause of vision loss in people with diabetes. Tight junction disruption of the retinal pigment epithelium (RPE) cells has been reported to induce DME development. SMAD-specific E3 ubiquitin protein ligase (SMURF) 1 was associated with the tight junctions of cells. However, the mechanism of SMURF1 in the DME process remains unclear.
AIM
To investigate the role of SMURF1 in RPE cell tight junction during DME.
METHODS
ARPE-19 cells treated with high glucose (HG) and desferrioxamine mesylate (DFX) for establishment of the DME cell model. DME mice models were constructed by streptozotocin induction. The trans-epithelial electrical resistance and permeability of RPE cells were analyzed. The expressions of tight junction-related and autophagy-related proteins were determined. The interaction between insulin like growth factor 2 mRNA binding protein 2 (IGF2BP2) and SMURF1 mRNA was verified by RNA immunoprecipitation (RIP). SMURF1 N6-methyladenosine (m6A) level was detected by methylated RIP.
RESULTS
SMURF1 and vascular endothelial growth factor (VEGF) were upregulated in DME. SMURF1 knockdown reduced HG/DFX-induced autophagy, which protected RPE cell tight junctions and ameliorated retinal damage in DME mice. SMURF1 activated the Wnt/β-catenin-VEGF signaling pathway by promoting WNT inhibitory factor (WIF) 1 ubiquitination and degradation. IGF2BP2 upregulated SMURF1 expression in an m6A modification-dependent manner.
CONCLUSION
M6A-modified SMURF1 promoted WIF1 ubiquitination and degradation, which activated autophagy to inhibit RPE cell tight junctions, ultimately promoting DME progression.
Triglyceride-glucose related indices as predictors for major adverse cardiovascular events and overall mortality in type-2 diabetes mellitus patients
Authors: Liu Mao-Jun , Pei Jun-Yu , Zeng Cheng , Xing Ying , Zhang Yi-Feng , Tang Pei-Qi , Deng Si-Min , Hu Xin-Qun 
Published: January 2025

BACKGROUND
Recent studies have indicated that triglyceride glucose (TyG)-waist height ratio (WHtR) and TyG-waist circumference (TyG-WC) are effective indicators for evaluating insulin resistance. However, research on the association in TyG-WHtR, TyG-WC, and the risk and prognosis of major adverse cardiovascular events (MACEs) in type 2 diabetes mellitus (T2DM) cases are limited.
AIM
To clarify the relation in TyG-WHtR, TyG-WC, and the risk of MACEs and overall mortality in T2DM patients.
METHODS
Information for this investigation was obtained from Action to Control Cardiovascular Risk in Diabetes (ACCORD)/ACCORD Follow-On (ACCORDION) study database. The Cox regression model was applied to assess the relation among TyG-WHtR, TyG-WC and future MACEs risk and overall mortality in T2DM cases. The RCS analysis was utilized to explore the nonlinear correlation. Subgroup and interaction analyses were conducted to prove the robustness. The receiver operating characteristic curves were applied to analysis the additional predicting value of TyG-WHtR and TyG-WC.
RESULTS
After full adjustment for confounding variables, the highest baseline TyG-WHtR cohort respectively exhibited a 1.353-fold and 1.420-fold higher risk for MACEs and overall mortality, than the lowest quartile group. Similarly, the highest baseline TyG-WC cohort showed a 1.314-fold and 1.480-fold higher risk for MACEs and overall mortality, respectively. Each 1 SD increase in TyG-WHtR was significantly related to an 11.7% increase in MACEs and a 14.9% enhance in overall mortality. Each 1 SD increase in TyG-WC corresponded to an 11.5% in MACEs and a 16.6% increase in overall mortality. Including these two indexes in conventional models significantly improved the predictive power for MACEs and overall mortality.
CONCLUSION
TyG-WHtR and TyG-WC were promising predictors of MACEs and overall mortality risk in T2DM cases.
Risk factors and a predictive model of diabetic foot in hospitalized patients with type 2 diabetes
Authors: Li Ming-Zhuo , Tang Fang , Liu Ya-Fei , Lao Jia-Hui , Yang Yang , Cao Jia , Song Ru , Wu Peng , Wang Yi-Bing 
Published: January 2025

BACKGROUND
The risk factors and prediction models for diabetic foot (DF) remain incompletely understood, with several potential factors still requiring in-depth investigations.
AIM
To identify risk factors for new-onset DF and develop a robust prediction model for hospitalized patients with type 2 diabetes.
METHODS
We included 6301 hospitalized patients with type 2 diabetes from January 2016 to December 2021. A univariate Cox model and least absolute shrinkage and selection operator analyses were applied to select the appropriate predictors. Nonlinear associations between continuous variables and the risk of DF were explored using restricted cubic spline functions. The Cox model was further employed to evaluate the impact of risk factors on DF. The area under the curve (AUC) was measured to evaluate the accuracy of the prediction model.
RESULTS
Seventy-five diabetic inpatients experienced DF. The incidence density of DF was 4.5/1000 person-years. A long duration of diabetes, lower extremity arterial disease, lower serum albumin, fasting plasma glucose (FPG), and diabetic nephropathy were independently associated with DF. Among these risk factors, the serum albumin concentration was inversely associated with DF, with a hazard ratio (HR) and 95% confidence interval (CI) of 0.91 (0.88-0.95) (P < 0.001). Additionally, a U -shaped nonlinear relationship was observed between the FPG level and DF. After adjusting for other variables, the HRs and 95%CI for FPG < 4.4 mmol/L and ≥ 7.0 mmol/L were 3.99 (1.55-10.25) (P = 0.004) and 3.12 (1.66-5.87) (P < 0.001), respectively, which was greater than the mid-range level (4.4-6.9 mmol/L). The AUC for predicting DF over 3 years was 0.797.
CONCLUSION
FPG demonstrated a U -shaped relationship with DF. Serum albumin levels were negatively associated with DF. The prediction nomogram model of DF showed good discrimination ability using diabetes duration, lower extremity arterial disease, serum albumin, FPG, and diabetic nephropathy (Clinicaltrial.gov NCT05519163).