bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunohistochemical panel of glypican-3, hepatocyte paraffin antigen-1, arginase-1, cytokeratin-19, and human epithelial membrane antigen for the differential diagnosis of liver tumors*
Authors: Zhu Dongling , Kuang Dong , Zou Sijuan , Chen Lixing , Zhu Yuanli , Zhu Xiaohua 
Published: June 2023

Abstract

Objective
Clinical immunohistochemistry plays an increasingly important role in pathologic diagnosis. We investigated the usefulness of an immunohistochemical panel of glypican-3 (GPC3), hepatocyte paraffin antigen-1 (HepPar-1), arginase-1 (Arg-1), cytokeratin-19 (CK19), and human epithelial membrane antigen (EMA) for the differential diagnosis of liver tumors.

Methods
Two hundred and thirty-five immunohistochemical sections of hepatocellular carcinoma (HCC; 120 cases), intrahepatic cholangiocarcinoma (ICC; 50 cases), combined hepatocellular and cholangiocarcinoma (CHC; 17 cases), metastatic adenocarcinoma (20 cases), and benign liver lesions (28 cases) were obtained from the Department of Pathology at Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China. The sensitivity and specificity of the combined biomarkers GPC3/HepPar-1/Arg-1/CK19/EMA for the differential diagnosis of HCC, ICC, and CHC were calculated and analyzed retrospectively.

Results
The combined biomarkers GPC3+/CK19- had the highest specificity (98.3%) for diagnosing HCC, with a sensitivity of 60.0%. The specificity of GPC3-/HepPar-1-/Arg-1-/CK19+/EMA+ for diagnosing ICC was 93.0%, with a sensitivity of 76.0%. The specificity of GPC3+/HepPar-1+/Arg-1+/CK19+/EMA+ for diagnosing CHC was 95.9%, with a sensitivity of 52.9%.

Conclusion
The combined biomarkers GPC3/HepPar-1/Arg-1/CK19/EMA greatly improved the specificity of liver tumor diagnosis. We believe that clinical pathological work could improve the original determination of liver nodules.
Glioblastoma multiforme with metastasis to lung, bone, and chest wall: a case report
Authors: Du Guobo , Zhou Qian , He Xinyao , Cheng Long , Zhou Jing 
Published: June 2023

Abstract
Glioblastoma multiforme (GBM) is a common brain tumor that rarely metastasizes extra-cranially. We present the case of a 40-year-old male with left temporal GBM who underwent craniotomy followed by radiotherapy and chemotherapy. Postoperative MRI scans at different time intervals demonstrated a good response. Eleven months after the initial diagnosis, there were no clinical or radiological signs suggesting recurrence. However, the tumor showed metastasis simultaneously to the chest wall, lungs, and bone, despite 2 cycles of chemotherapy. The patient developed paraplegia 14 months after the initial diagnosis and died due to systemic failure 19 months after diagnosis. Extracranial metastasis of GBM is extremely rare. We present the unusual case of a patient with GBM who showed simultaneous metastasis to the lungs, bone, and chest wall. The prognosis of patients with extracranial metastasis of glioblastomas is very poor, regardless of chemoradiotherapy. Newer approaches, such as immunotherapy and anti-angiogenic therapy, need to be further studied.
Study protocol: glycaemic outcomes in people with type 2 diabetes initiating continuous glucose monitoring: the 2GO-CGM study
Authors: Lever Claire S. , Williman Jonathan A. , Boucsein Alisa , Watson Antony , Sampson Rachael S. , Sergel-Stringer Oscar T. , Keesing Celeste , Chepulis Lynne , Wheeler Benjamin J. , de Bock Martin I. , Paul Ryan G. 
Published: June 2023

Abstract
Purpose
Improving glycaemic control in type 2 diabetes (T2D) is essential to reducing social and health-economic burden of diabetes-related complications. Continuous glucose monitoring (CGM) has been established as beneficial in improving glycaemic control and reducing hypoglycaemia in people with type 1 diabetes, however data in T2D is limited. This study has been designed to assess the effect of initiating real-time CGM (rtCGM) on glycaemic control in a high-risk population of adults with T2D. Secondary objectives are to assess the cost-effectiveness and safety of rtCGM, and the effects of rtCGM on diet/lifestyle and the burden of diabetic complications, including cardiovascular risk.

Methods
This multicentre randomised controlled trial (RCT) will be conducted at three sites in New Zealand (Waikato, Christchurch and Dunedin). Eighty adults with T2D on insulin with suboptimal glycaemic control (HbA1c > 8.0% or 64 mmol/mol) will be randomised 1:1 to rtCGM or routine care with self-monitoring of blood glucose levels (SMBG) for three months. This intervention phase will be followed by a three-month continuation phase where SMBG group crossover to use rtCGM. Participants will then be invited to join the extension phase with continued use of rtCGM for a further 12 months. During the extension phase, both groups will independently titrate their insulin under the remote supervision of prescribing diabetes nurse specialists following an insulin titration algorithm. The primary outcome of the study is time in target glucose range (3.9–10 mmol/L or 70–180 mg/dL; TIR). Secondary outcomes include CGM metrics as per consensus statement recommendations, and HbA1c. Additional planned analyses include cardiovascular risk profile, incremental cost-effectiveness analyses, dietary patterns, and qualitative analyses.

Trial registration number
The trial was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12621000889853) on 8 July 2021 and the World Health Organisation International Clinical Trial Registry Platform (Universal Trial Number U1111–1264-5822).
On-Campus vs Distance Tutorials in Preparatory Courses for Mathematics Student Teachers – Performance Gains and Influencing Factors
Authors: Kirsten Katharina , Greefrath Gilbert 
Published: June 2023

AbstractDue to COVID-19 pandemic restrictions, new instructional designs for mathematics courses have recently been developed. Unlike traditional e-learning courses, distance learning via videoconferencing contains more synchronous elements and is therefore more closely related to classroom instruction. Since theories of person-environment fit suggest that course modality may have an impact on learning processes, this study compares the effectiveness of on-campus (in-person) and synchronous distance tutorials as essential components of a mathematics preparatory course. Using a within-between-subject design, we examined performance gains of first-year student teachers (primary and lower secondary level) during a two-week preparatory course in relation to (1) tutorial variation, (2) students’ prior knowledge, and (3) general and specific affective factors. Overall, our results indicate that preparatory courses with on-campus and distance tutorials can be similarly effective. However, considering students’ prior knowledge as measured by an entrance test, the course variant proved to be a decisive factor for students with higher test scores: While students with lower scores showed comparable performance gains in both on-campus and distance tutorials, students with higher scores increased their mathematics performance only in on-campus tutorials. Furthermore, the results indicate that the impact of affective factors on course performance differs in the two tutorial variants. While students’ self-efficacy and engagement predict learning outcomes in on-campus tutorials, mathematics performance in distance tutorials is positively influenced by self-efficacy and satisfaction and negatively influenced by procrastination and social relatedness. Thus, the results shed light on how instructors can design on-campus and distance tutorials to promote effective learning.
Innovative hydrogeophysical approach for detecting the spatial distribution of hydraulic conductivity in Bahri city, Sudan: A comparative study of Csókás and Heigold methods
Authors: Mohammed Musaab A. A. , Abdelrahman Moataz M. G. , Szabó Norbert P. , Szűcs Péter 
Published: June 2023

Abstract Hydraulic conductivity is one of the crucial parameters used to identify the potentiality and productivity of groundwater aquifers. This research employs an integrated approach using geophysical well logging, exploratory factor analysis and surface electrical resistivity methods to detect the vertical and horizontal variation of hydraulic conductivity in Bahri city, Sudan. Based on the geophysical well logs of Spontaneous potential (SP), natural gamma ray (GR), and electrical resistivity (RS), Csókás method is used to determine the continuous variation of hydraulic conductivity along the aquifer. Csókás method is an experimentally modified version of the Kozeny–Carman equation and is based on the formation factor of the groundwater aquifer and the effective grain size. This approach is performed in three groundwater boreholes, and the obtained hydraulic conductivities showed a close agreement with that of the pumping test analysis. Furthermore, the hydraulic conductivity is measured using multivariate statistical factor analysis. This statistical approach relies on the correlation between the extracted factors and petrophysical and hydrogeological parameters. In this research, a strong negative linear correlation between the first factor and hydraulic conductivity is indicated. Consequently, a site-specific equation is suggested for continuous estimation of hydraulic conductivity along the aquifer. In the last stage, the results obtained from the Csókás method are interpolated with vertical electrical sounding (VES) measurements using to detect the horizontal variation of hydraulic conductivity throughout the studied area. This was achieved by combining the hydraulic conductivities of geophysical well logging and vertical electrical soundings to obtain a consistent estimation. As a result, the variation of hydraulic conductivity is obtained, and the average was 1.9 m/day which shows a close agreement with the average of the previous investigations (1.5 m/day). This approach is highly recommended since it can enhance data coverage, cutting down the expense of hydrogeological investigations and lowering the uncertainty of the hydrogeological models.
Die Transvaginalsonographie ist entscheidend bei Diagnose und Bedrohung durch die ektope Schwangerschaft
Authors: Pape Janna , Bajka Michael 
Published: June 2023

ZusammenfassungDie ektope Schwangerschaft („ectopic pregnancy“ [ECP]) ist weltweit immer noch die wichtigste mütterliche Todesursache im ersten Trimenon. Eine zuverlässige Diagnose vor Eintreten lebensbedrohlicher Umstände ist essenziell. Die Transvaginalsonographie (TVS) bietet hierfür ausgezeichnete Möglichkeiten: Die Suche nach den fünf sonomorphologischen Typen („blob sign“, „bagel sign“, Dottersack, Embryo ohne Herzschlag, Embryo mit Herzschlag) zeigte in einer grossen Kohortenstudie mit 321 Patientinnen einen sehr hohen positiven prädiktiven Wert (PPV 99,1 %, 95 %-KI 97,2–99,7 %). Dabei überwogen das „blob sign“ und das „bagel sign“ (75 % aller Fälle); der Embryo mit Herzschlag (11 %) war eher die Ausnahme. Das wohl wichtigste, weil auch häufigste Piktogramm in der Diagnostik der ECP ist die Suche nach einem „blob sign“ oder „bagel sign“ neben dem Ovar. Nur in einem Bruchteil der Fälle (3 %) war keine sonographische Diagnose möglich. Dies aufgrund grosser ovarieller Zysten, multipler Myome, eines ausgedehnten Hämatoperitoneums oder starker Schmerzen. Bei der Beurteilung der Dringlichkeit stimmte die sonographische Einschätzung von freier Flüssigkeit mit der intraoperativen Blutmenge gut überein. Durch die alleinige Bestimmung von freier Flüssigkeit in der TVS ist mit Abstand die beste Voraussage einer Niedrigrisikosituation (freies Blut < 100 ml) oder einer Hochrisikosituation (freies Blut ≥ 300 ml) möglich. Die genauen Grenzwerte sind noch in prospektiven Studien festzulegen. Bis dahin sollte ein mit freier Flüssigkeit gefüllter Douglas-Raum (hoch bis zur Funduskante) als rund 300 ml freies Blut im Bauch betrachtet werden, was in der Regel eine hohe Gefährdung bedeutet und eine dringende Intervention erfordert.
The K-functional and saturated linear approximation processes
Authors: Trebels Walter 
Published: June 2023

AbstractIt is shown that already the knowledge of the saturation class $$\, {{\mathfrak {F}}}(J_t, L^p) $$

F
(

J
t

,

L
p

)

of a saturated convolution approximation process $$\, \{J_t\}$$

{

J
t

}

on $$\, L^p({{\mathbb {R}}}^n),\, 1\le p< \infty ,$$

L
p

(

R

n

)

,

1
≤
p
<
∞
,

completely determines its norm approximation behavior. This is achieved by using the $$\, K$$

K

-functional $$\, K(t,f;L^p,{{\mathfrak {F}}}(J_t, L^p)) $$

K
(
t
,
f
;

L
p

,
F

(

J
t

,

L
p

)

)

as a comparison scale, which relates on the one hand the approximation process and on the other appropriate moduli of smoothness. This implies that simultaneously one gets the so-called direct and inverse theorems. There are open problems if the saturation order is slightly perturbed, e.g., by a $$\, |\log t|^\lambda $$

|
log
t
|

λ

-factor, $$\, \lambda >0.$$

λ
>
0
.

Proofs are mainly based on the Fourier transformation.
Continuity of essential health services amidst COVID-19 pandemic in Tanzania: a pre and post implementation support assessment
Authors: Hokororo Joseph , Katembo Anna-Grace , Kinyenje Eric , Amani Davis , Ndjovu Anthony , Eliakimu Eliudi , Mutayoba Rita , Kiremeji Michael 
Published: June 2023

Abstract
Background
The COVID-19 pandemic has potentially caused disruptions in provision of routine, regular essential health services in different ways; through overwhelming the health system in responding to COVID-19; some of the intervention used to slow transmission of COVID-19 may inhibit access to essential services; and through supplies of medicine being interrupted.. In Tanzania, unlike many other countries, which did not follow strict lockdown measures, disruption of access to and utilization of EHS due to anxiety and fear of contact with the infection while seeking medical care was observed.

Method
This was a cross-section study conducted in October 2022 to evaluate trends of utilizing essential health services before and after implantation of continued essential services (CES) project among 297 Amref supported facilities from Mainland Tanzania and Zanzibar. It involved the use of secondary data from the district health information system 2 (DHIS2), and extracted variable included; facility type and name, number of individuals using the antenatal, post-natal, immunization and delivery services. Through using STATA version 14, the data was cleaned, and quarterly and yearly average number of clients using either of the services was computed for the period between 2019 and 2021. Findings were presented in form of graphs, and comparison were made for the period before and after the implementation of the project.

Results
It was found that all key indicators that were assessed were maintained following the implementation of the project interventions that aimed at maintaining EHS during the COVID-19 pandemic.

Conclusion
The study found that project interventions have remained relevant to the needs of communities as demonstrated by the maintenance of the essential MNCH services, as seen in a number of the key EHS indicators which were tracked. This calls for joint efforts between the government and partners on resource mobilization for scale-up so that the EHS is maintained and the country is prepared for these pandemics.
Sensitivity of ICD coding for sepsis in children—a population-based study
Authors: Endrich Olga , Triep Karen , Schlapbach Luregn J. , Posfay-Barbe Klara M. , Heininger Ulrich , Giannoni Eric , Stocker Martin , Niederer-Loher Anita , Kahlert Christian R. , Natalucci Giancarlo , Relly Christa , Riedel Thomas , Aebi Christoph , Berger Christoph , Agyeman Philipp K. A. ,   on behalf of the Swiss Pediatric Sepsis Study, Bär Walter , Bernhard-Stirnemann Sara , Hasters Paul , Konetzny Gabriel , Leone Antonio 
Published: June 2023

Abstract
Background
International Classification of Diseases 10th edition (ICD-10) is widely used to describe the burden of disease.

Aim
To describe how well ICD-10 coding captures sepsis in children admitted to the hospital with blood culture-proven bacterial or fungal infection and systemic inflammatory response syndrome.

Methods
Secondary analysis of a population-based, multicenter, prospective cohort study on children with blood culture-proven sepsis of nine tertiary pediatric hospitals in Switzerland. We compared the agreement of validated study data on sepsis criteria with ICD-10 coding abstraction obtained at the participating hospitals.

Results
We analyzed 998 hospital admissions of children with blood culture-proven sepsis. The sensitivity of ICD-10 coding abstraction was 60% (95%-CI 57–63) for sepsis; 35% (95%-CI 31–39) for sepsis with organ dysfunction, using an explicit abstraction strategy; and 65% (95%-CI 61–69) using an implicit abstraction strategy. For septic shock, the sensitivity of ICD-10 coding abstraction was 43% (95%-CI 37–50). Agreement of ICD-10 coding abstraction with validated study data varied by the underlying infection type and disease severity (p < 0.05). The estimated national incidence of sepsis, inferred from ICD-10 coding abstraction, was 12.5 per 100,000 children (95%-CI 11.7–13.5) and 21.0 per 100,000 children (95%-CI 19.8–22.2) using validated study data.

Conclusions
In this population-based study, we found a poor representation of sepsis and sepsis with organ dysfunction by ICD-10 coding abstraction in children with blood culture-proven sepsis when compared against a prospective validated research dataset. Sepsis estimates in children based on ICD-10 coding may thus severely underestimate the true prevalence of the disease.
The Precedent set by Unprecedented Rainfall: Lessons to be Learnt From Disastrous Flooding in Pakistan
Authors: Fatimi Asad S. , Anwar Eman , Shaikh Taha 
Published: June 2023

Abstract
Pakistan has suffered heavy losses due to the torrential monsoon rains of 2022. With obliterated infrastructure and rising disease burden, the nation is still reeling from the dismal aftermath. It is critical to understand that such catastrophes are not a 1-time calamity but are likely to become more frequent with growing severity of the climate crisis. These losses point to a more systemic problem that is a lack of preparedness, and without sustainable long-term measures in place, the nation remains just as vulnerable to the next ‘unpredictable’ weather contingency. Prior planning and effective allocation of resources can help develop a proactive response to future disasters of this magnitude.
Stone masonry design automation via reinforcement learning
Authors: Kang SungKu , Dy Jennifer G. , Kane Michael B. 
Published: June 2023

Abstract
The use of local natural and recycled feedstock is promising for sustainable construction. However, unlike versatile engineered bricks, natural and recycled feedstock involves design challenges due to their stochastic, sequential, and heterogeneous nature. For example, the practical use of stone masonry is limited, as it still relies on human experts with holistic domain knowledge to determine the sequential organization of natural stones with different sizes/shapes. Reinforcement learning (RL) is expected to address such design challenges, as it allows artificial intelligence (AI) agents to autonomously learn design policy, that is, identifying the best design decision at each time step. As a proof-of-concept RL framework for design automation involving heterogeneous feedstock, a stone masonry design framework is presented. The proposed framework is founded upon a virtual design environment, MasonTris, inspired by the analogy between stone masonry and Tetris. MasonTris provides a Tetris-like virtual environment combined with a finite element analysis (FEA), where AI agents learn effective design policies without human intervention. Also, a new data collection policy, almost-greedy policy, is designed to address the sparsity of feasible designs for faster/stable learning. As computation bottleneck occurs when parallel agents evaluate designs with different complexities, a modification of the RL framework is proposed that FEA is held until training data are retrieved for training. The feasibility and adaptability of the proposed framework are demonstrated by continuously improving stone masonry design policy in simplified design problems. The framework can be generalizable to different natural and recycled feedstock by incorporating more realistic assumptions, opening opportunities in design automation for sustainability.
A low-power ankle-foot prosthesis for push-off enhancement
Authors: Mazzarini Alessandro , Fantozzi Matteo , Papapicco Vito , Fagioli Ilaria , Lanotte Francesco , Baldoni Andrea , Dell’Agnello Filippo , Ferrara Paolo , Ciapetti Tommaso , Molino Lova Raffaele , Gruppioni Emanuele , Trigili Emilio , Crea Simona , Vitiello Nicola 
Published: June 2023

Abstract
Passive ankle-foot prostheses are light-weighted and reliable, but they cannot generate net positive power, which is essential in restoring the natural gait pattern of amputees. Recent robotic prostheses addressed the problem by actively controlling the storage and release of energy generated during the stance phase through the mechanical deformation of elastic elements housed in the device. This study proposes an innovative low-power active prosthetic module that fits on off-the-shelf passive ankle-foot energy-storage-and-release (ESAR) prostheses. The module is placed parallel to the ESAR foot, actively augmenting the energy stored in the foot and controlling the energy return for an enhanced push-off. The parallel elastic actuation takes advantage of the amputee’s natural loading action on the foot’s elastic structure, retaining its deformation. The actuation unit is designed to additionally deform the foot and command the return of the total stored energy. The control strategy of the prosthesis adapts to changes in the user’s cadence and loading conditions to return the energy at a desired stride phase. An early verification on two transtibial amputees during treadmill walking showed that the proposed mechanism could increase the subjects’ dorsiflexion peak of 15.2% and 41.6% for subjects 1 and 2, respectively, and the cadence of about 2%. Moreover, an increase of 26% and 45% was observed in the energy return for subjects 1 and 2, respectively.
Focusing Effects of Teleseismic Wavefields by the Subducting Plate Beneath Cascadia
Authors: Pang Guanning , Abers Geoffrey A. , van Keken Peter E. 
Published: June 2023

AbstractSeismic wave amplitudes have tremendous sensitivity to subduction structure; however, they are affected by attenuation, scattering and focusing, and have therefore been sparsely used compared with traveltimes. We measure and model teleseismic body wave amplitudes recorded at a dense broadband array in the Washington Cascades. These data show anomalous amplitude variations with complex azimuthal dependence at frequencies as low as 0.05 Hz, accompanied by significant multipathing. We demonstrate using spectral‐element numerical simulations that focusing of the teleseismic wavefield by the Juan de Fuca slab is responsible for some of the amplitude anomalies. The focusing effects can contaminate the apparent differential attenuation measurements and produce at least 20% of the inferred attenuation signal. Our results indicate that the amplitudes are sensitive to the subducting slab geometry and subduction structure, and can be used to refine seismic images. Ubiquitous and consistent amplitude anomalies are observed along the arc, suggesting that the Juan de Fuca slab may be continuous from Canada to northern California.