bluuebunny/crossref_metadata_2025_split huggingface dataset:
Progress testing of an objective structured clinical examination during undergraduate clinical clerkship: A mixed-method pilot study
Authors: Shimizu Ikuo , Mori Junichiro , Yamauchi Aiga , Kato Sawako , Masuda Yuichi , Nakazawa Yuichi , Kanno Hiroyuki 
Published: September 2023

Abstract
Background:
Progress testing is an assessment method in which an examination reflecting competencies at graduation is regularly administered to students over multiple years, thereby facilitating self-directed learning. However, the significance of the objective structured clinical examination as a progress test in undergraduate education, needs to be determined. This study provides evidence of the role of the objective structured clinical examination for progress testing and optimal scoring methods for assessing students in different academic years.
Methods:
We conducted a mixed-method pilot study. Participants were assessed using the Item Rating Scale, the year-adjusted Global Rating Scale, and the Training Level Rating Scale. The characteristics of each scale were compared quantitatively. In addition, the influence of the objective structured clinical examination as a progress test on learning attitudes was examined. Qualitative data from a post-examination questionnaire were analyzed, using content analysis to explore influences on self-directed learning.
Results:
Sixth- and fifth-year clinical students (n = 235) took the objective structured clinical examination progress test. The total Item Rating Scales were recorded (%) as 59.03 ± 5.27 and 52.64 ± 5.08 (p < 0.01); Training Level Rating Scale was 3.94 ± 0.39 vs 3.22 ± 0.42 (p < 0.01); and the year-adjusted Global Rating Scale was 4.25 ± 0.44 vs 4.32 ± 0.52 (no significant difference), for the sixth- and fifth-year students, respectively. The correlations across stations and the reliability of each station were satisfactory. Four categories were identified in the qualitative analysis: “motivation to learn during the clinical clerkship was promoted,” “dissatisfied with being asked about things they had not experienced,” “confusion about being unable to use conventional test-taking strategies,” and “insufficient understanding of competencies at graduation.” The scores were highly reliable, indicating significant differences in performance according to training year.
Conclusions:
This study provides evidence that the objective structured clinical examination can be used as a progress testing tool for undergraduate clinical clerkships. Further enhancement of training opportunities and dissemination of performance competency goals in clerkship curricula are required if we intend to promote self-directed learning through progress testing.
Preoperative diagnosis of cervical cystic lesions by magnetic resonance imaging
Authors: Omi Makiko , Tanaka Yumiko Oishi , Kurihara Nozomi , Sugiyama Yuko , Tonooka Akiko , Kanno Motoko , Fusegi Atsushi , Aoki Yoichi , Netsu Sachiho , Abe Akiko , Tanigawa Terumi , Okamoto Sanshiro , Nomura Hidetaka , Kanao Hiroyuki 
Published: September 2023

Abstract

Background
To clarify the magnetic resonance imaging (MRI) characteristics of lobular endocervical glandular hyperplasia (LEGH) and Nabothian cysts.
Methods
This study included 48 patients who underwent hysterectomy at our institution between 2016 and 2020 for suspected LEGH. Histopathology confirmed the presence of 25 Nabothian cysts and 23 cases of LEGH. We retrospectively analyzed five characteristic MRI findings: (1) located at the upper cervical canal; (2) positioned within the cervical stroma; (3) not circumscribing the cervical canal; (4) low- to iso-intensity on T1-weighted images (T1WI) (5) a “cosmos” or “microcystic” pattern. We compared the diagnostic accuracy of these findings for LEGH and Nabothian cysts using sensitivity, specificity, and predictive values. Combinations of findings were also calculated.
Results
The characteristics “cosmos” or “microcystic” pattern, lesion not circumscribing the cervical canal, and low/iso-intensity on T1WI had a sensitivity and specificity greater than 50%. Sensitivity was 73.9% and specificity was 84.0% when a combination of “cosmos” or “microcystic” pattern and lesion not circumscribing the cervical canal was present.
Conclusion
The coexistence of a “cosmos” or “microcystic” pattern and not circumscribing the cervical canal is the most characteristic finding to distinguish LEGH from Nabothian cysts. When neither of these findings is present, Nabothian cyst can be suspected.
Highly efficient three-photon excited red emission in the Yb3+-Er3+ upconversion system at low excitation intensities for non-invasive anti-counterfeiting
Authors: Zhang Jiahua , Wu Hao , Wang Kexiu , Zhang Liangliang , Luo Yongshi , Pan Guohui , Wu Huajun , Liu Feng , Wang Xiaojun 
Published: September 2023

Abstract
Upconversion (UC) phosphors exhibiting luminescence color tuning (LCT) through variations in infrared excitation intensity offer great potential for high-security anti-counterfeiting applications. However, the current LCT capability is limited to high excitation intensities, hindering the development of non-invasive counterfeit detection methods. In this study, we achieve a remarkable two orders of magnitude reduction in excitation intensities for LCT in Yb3+ and Er3+ codoped orthorhombic YF3, accomplished by attaining an unprecedentedly efficient three-photon excited red emission for mixing with the two-photon excited green emission. To enable this breakthrough, we employ deoxygenation techniques during sample preparation, which surprisingly prevented concentration quenching of the sensitizer Yb3+, facilitating efficient three-photon excitation of the red emission for Yb3+ concentrations ≥ 30% even at excitation intensities as low as 10 mW cm-2. At excitation intensities of 100 mW cm-2, the three-photon excitation contributes to 91~94% of the red emission, resulting in an 11~17-fold increase in the red-to-green intensity ratio. This low-excitation-induced LCT, shifting from green to orange, showcases its potential for anti-counterfeiting applications. Furthermore, the present YF3:Yb/Er phosphors demonstrate an impressive UC quantum yield of 7.8%, surpassing the 5.6% quantum yield of the popular hexagonal NaYF4:Yb/Er phosphor under the same excitation intensity of 31.8 W cm-2. These findings represent a significant advancement in highly efficient UC fluoride phosphors, promising diverse applications across various fields.
Superconductivity in unconventional metals
Authors: Wang Zhijun , Yang Zhilong , Sheng Haohao , Guo Zhaopeng , Zhang Ruihan , Wu Quansheng , Weng Hongming , Fang Zhong 
Published: September 2023

Abstract
In this work, we define unconventional metals, where a set of low-energy bands belong to an elementary band representation (EBR) on an empty site. The characteristic could give rise to soft phonon modes and strong electron-phonon coupling, yielding charge-density wave (CDW) or/and superconductivity (SC). Based on the first-principles calculations, we demonstrate that 1H/2H-phase transition metal dichalcogenides MX2 (M = Nb, Ta; X = S, Se, Te) are unconventional metals, which have a single band of A′1@1e EBR at the Fermi level (EF). The computed phonon dispersions indicate the stability of the system at high temperatures, while the presence of soft phonon modes suggests a phase transition to the CDW state at low temperatures. Based on the Bardeen-Cooper- Schrieffer (BCS) theory and computed electron-phonon coupling, our calculations show that the SC in NbSe2 is mainly attributed to the soft phonon modes. In the end, the SC has been predicted in unconventional metal TaNS monolayer and 2H-TaN2 bulk with estimated TC = 10 K and 26 K respectively. These results demonstrate that the unconventional metals offer an attractive platform for studying the interplay between the empty-site EBR and correlated states.
Anharmonic Strong-Coupling Effects at the Origin of the Charge Density Wave in CsV3Sb5
Authors: He Ge , Peis Leander , Cuddy Emma , Zhao Zhen , Li Dong , Stumberger Ramona , Moritz Brian , Yang Haitao , Gao Hong-Jun , Devereaux Thomas , Hackl Rudi 
Published: September 2023

Abstract
The formation of charge density waves (CDW) is a long-standing open problem particularly in dimensions higher than one. Various observations in the vanadium antimonides discovered recently, such as the missing Kohn anomaly in the acoustic phonons or the latent heat at the transition TCDW = 95 K, further underpin this notion. Here, we study the Kagome metal CsV3Sb5 using polarized inelastic light scattering. The electronic energy gap 2Δ as derived from the redistribution of the continuum is much larger than expected from mean-field theory and reaches values above 20 for 2Δ/kBTCDW. The A1g phonon has a discontinuity at TCDW and a precursor starting 20 K above TCDW. Density functional theory qualitatively reproduces the redistribution of the electronic continuum at the CDW transition and the phonon energies of the pristine and distorted structures. The linewidths of all A1g and E2g phonon lines including those emerging below Tcdw were analyzed in terms of anharmonic symmetric decay revealing strong phonon-phonon coupling. In addition, we observe two CDW amplitude modes (AMs): one in A1g symmetry and one in E2g symmetry. The temperature dependence of both modes deviates from the prediction of mean-field theory. The A1g AM displays an asymmetric Fano-type lineshape, suggestive of strong electron-phonon coupling. The asymmetric A1g AM, along with the discontinuity of the A1g phonon, the large phonon-phonon coupling parameters and the large gap ratio, indicate the importance of anharmonic strong phonon-phonon and electron-phonon coupling for the CDW formation in CsV3Sb5.
Forget about memory: disentangling the amnestic syndrome in idiopathic Normal Pressure Hydrocephalus.
Authors: Lingenberg Alma , Herrmann François R. , Armand Stéphane , Péron Julie Anne , Assal Frédéric , Allali Gilles 
Published: September 2023

Abstract
Background: idiopathic normal pressure hydrocephalus (iNPH) can present with both an episodic amnestic syndrome (or so-called hippocampal profile) and biomarkers of Alzheimer’s pathology. However, it remains unknown if both are related and if an amnestic syndrome accounts for less reversibility after a cerebrospinal fluid derivation.
Methods: we used the Free and Cued Selective Reminding Test to divide iNPH into two groups: the amnestic and non-amnestic patients were compared on their clinical, biological, and radiological characteristics using independent samples t-tests, Chi-Squared or Fisher’s exact tests, as appropriate, as well as the reversibility of gait spatiotemporal parameters and neuropsychological performances before and after a spinal tap test. The association between the memory performances (dependent variable) and the clinical and biological characteristics (independent variables) was examined using univariate and multiple linear regression models.
Results: sixty-two non-amnestic patients (mean age 77.0 ± 7.0 years, 38.7% female) and thirty-eight amnestic patients (mean age 77.0 ± 5.9 years, 36.8% female) presented similar levels of biomarkers for Alzheimer’s disease in the cerebrospinal fluid and clinical-radiological profile. However, global cognition and education levels were lower in the amnestic iNPH. We found no association between Alzheimer’s biomarkers and memory performances (total tau: β = -4.50; 95% CI [-11.96;2.96]; p= 0.236; beta-amyloid (1-42): β = 8.60, 95% CI [-6.30;23.50]; p = 0.240). At baseline, amnestic iNPH performed worse on executive functions, attention, and gait speed but improved similarly to the non-amnestic iNPH after the tap test.
Conclusions: in our clinical sample of iNPH patients, the amnestic syndrome was not related to Alzheimer’s disease pathology, confirming recent studies and the lack of specificity of the amnestic profile for predicting Alzheimer’s pathology. Since amnestic and non-amnestic iNPH patients improve similarly after the tap test, clinicians should not preclude amnestic patients from undergoing an invasive procedure of cerebrospinal fluid derivation.
Effects of the COVID pandemic on the use of urban green spaces: A systematic review
Authors: Kleinschroth Fritz , Savilaakso Sini , Kowarik Ingo , Martinez Paloma , Chang Yuyang , Jakstis Kristen , Fischer Leonie 
Published: September 2023

Abstract
The COVID-19 pandemic disrupted urban resilience. Studies on urban green spaces (UGS) lack consensus whether their use increased or decreased during COVID-19 and how this related to policy and economic conditions. In a systematic review, we screened >3000 articles in Chinese, English, French, German, and Spanish and identified 178 articles with information on UGS use in 61 countries. We find that the world was divided in places with increased and decreased use of UGS. Decreases happened where COVID-19 policies were stricter and the GDP per capita was lower. 77% of studies conducted on public parks showed decreased, while all on private gardens and 63% on forests and natural areas showed increased uses. Evidence from the Global South is limited, but our findings indicate that economic wealth significantly influences access to UGS, and this disparity was exacerbated during COVID-19. Green infrastructure for healthy cities needs to extend beyond public parks.
Establishment of a prognostic model of hepatocellular carcinoma based on inflammatory factor-related genes and prognosis-related characteristics
Authors: 窦 港 , Liu Guan , Bai Liangliang , Li Zhimei , Tan Kai , He Xiaojun , Yang Zhenyu , Lei Shixiong , Du Xilin , Shao Junjie 
Published: September 2023

Abstract
Background:This study established oneprognostic prediction model for hepatocellular carcinoma (HCC) using inflammatory factor-associatedgenes to forecast the HCC patients’ clinical prognosis more accurately.
Methods: From Gene Expression Omnibus (GEO), the Cancer Genome Atlas (TCGA), as well asInternational Cancer Genome Consortium (ICGC), gene expression profiles of HCC patients were acquired, and from gene set enrichment analysis (GSEA) database, inflammatory factors-associated genes were downloaded. Through weighted gene co-expression network analysis (WGCNA), key genes were identified. Through Univariate Cox as well as the least absolute shrinkage and selection operator (LASSO) regression analyses, prognostic inflammatory factors-associated gene signatureswere identified. The predictive value of prognostic features was verified via the Kaplan-Meier (K-M) and receiver operating characteristic (ROC) curve analyses. CIBERSORT analysis was conducted for assessing associations of risk models with immune cells. Line-and-trace plots were drawn for predicting the HCC patients’ survival probability according to risk models.
Results: Totally 6 genes (ATP2A3, CMTM7, EFEMP1, GMIP, HLA. Prognostic characteristics of DPB1, and LAMB1) were selected for establishing predictive models and verifying their prognostic value and their correlation with clinical features. The K-M curve verified the area under the curve (AUC) of TCGA and two GEO and ICGC-JP datasets (P<0.0001, P=0.0086, 0.00013, and 0.00093, respectively). The prediction accuracy of the risk model was also verified. A line plot was drawn for predicting the HCC patients’ survival, and the calibration curve revealeda satisfactory predictability. Lastly, the functional analysis also revealed immune state differencebetween two different risk groups.
Conclusion: This study established and validated one new inflammatory factor-associated prognostic gene trait that could contribute to a more accurate individualized prediction of HCC patients’ survival.
Utility of flash glucose monitoring to determine glycemic load induced by different doughs in type 2 diabetic patients
Authors: Taras Maria Antonietta , Cherchi Sara , Campesi Ilaria , Margarita Valentina , Carboni Gavino , Rappelli Paola , Tonolo Giancarlo 
Published: September 2023

Abstract
Background
It has been previously showed that sourdough bread, compared to commercial yeast bread, elicits a lower postprandial glycemic and insulinemic response patients with Impaired Glucose Tolerance (IGT).
Aims
To evaluate in type 2 diabetic patients (T2DM): 1) Glucose load (GL) to three different doughs: X = prepared with functional alkaline biocrystal water, Y = Sourdough leavened bread, and W = baker yeast bread; 2) the utility of flash glucose monitoring (FGM) to measure GL.
Methods
Ten T2DM on diet (6 Males, diabetes duration 10.8 ± 1.2 years with no complications, Hba1c < 7.0%), after 12 hours fasting, consumed 180 grams study bread leavened/matured for 48 (X),8 (Y), and 4 hours (W) at room temperature with 200 ml water, in random order, single-blind, in three different days. All patients had a FGM running for the entire period of the experiments. Insulin was determined by capillary blood obtained at basal and at the peak glucose concentration.
Results
Peak glucose and peak insulin concentration were significantly (p < 0.05) higher for W versus both X and Y, without significant differences between X and Y. Glucose Load over 240 minutes was significantly higher in W than X (p < 0.01) and Y (p < 0.05), without significant differences between X and Y.
Conclusions
1) bread prepared with biocrystal water has the same lower GL of Sourdough Bread compared to baker yeast bread with an easier management of the leavening/maturation period; 2) FGM is a reliable method for determining the GL in response to a carbohydrate meal in type 2 diabetic patients.
Robust denoising FCM clustering via L2,1 NMF and local constraint
Authors: Fan Xuezhen , Li Xiangli , Lu Xiyan 
Published: September 2023

Abstract
The Fuzzy C-Means (FCM) algorithm is widely used in data mining and machine learning. However,the sensitivity of FCM to the initial value and noise inevitably leads to the decline of the clusteringeffect. In this paper, a new improved fuzzy clustering algorithm is proposed— Robust denoising FCMclustering via L2,1 NMF and local constraint (RFCM-L 2,1NMF). Firstly, RFCM-L 2,1NMF combinesthe L 2,1NMF that has noise residual estimation with FCM, using the robustness and noise constraintterms of the L 2,1NMF to attenuate the effect of noise on data clustering. Secondly, RFCM-L 2,1NMFuses the low-dimensional representation of L 2,1NMF as the initial value of FCM, which reduces thedefects of FCM caused by the initial value to a certain extent, and makes the clustering effect morestable. Furthermore, since the low-dimensional representation of L 2,1NMF is the hub connecting L 2,1NMF and FCM, to obtain a more accurate low-dimensional representation, we construct a newlocal constraint term in this paper. Finally, experiments on data sets validate that RFCM-L 2,1NMFis superior compared to other state-of-the-art methods.
The predictive value of neurally adjusted ventilatory assist indexes for the prognosis of patients with severe cerebral hemorrhage
Authors: Yao Lin , Zhou Zihao , Yu Tao , Wang Guiliang , Fan Zhen , Tang Yun 
Published: September 2023

Abstract
Objective
This study assessed the predictive value of electrical activity of the diaphragm (EAdi) and the EAdi-derived monitoring index in the prognosis of patients with severe cerebral hemorrhage.
Methods
Ninety patients with severe cerebral hemorrhage were admitted to the neurosurgery intensive care unit of Yijishan Hospital from April 2019 to June 2021 and were divided into the good prognosis group (Glasgow Outcome Scale [GOS] ≥ 4) and poor prognosis group (GOS ≤ 3). The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to evaluate prediction accuracy.
Results
EAdi, neuro-ventilatory efficiency (NVE), and neuro-muscular efficiency (NME) in patients with good prognosis were significantly higher than those in patients with poor prognosis (4.707 µV vs 2.80 µV, P < 0.001; 141.85 ml/µV vs 66.01 ml/µV, P = 0.000; 2.57 cm H2O/µV vs 1.37 cm H2O/µV, P = 0.000). The area under the ROC curve for the EAdi score was 0.719, with sensitivity of 69.70% and specificity of 68.42% when EAdi was 3.6 µV. The AUC for NVE score was 0.793, with sensitivity of 75.76% and specificity of 77.19% when the NVE value was 95.32 ml/µV. The AUC for NME score was 0.792, with sensitivity of 69.70% and specificity of 78.95% when the NME value was 2.06 H2O/µV. The 6-month survival time of patients with higher EAdi, NVE, and NME was significantly longer than that of patients with lower EAdi, NVE, and NME.
Conclusion
EAdi, NVE, and NME can be used as indices for predicting the prognosis of patients with severe cerebral hemorrhage.
Trial registration
No.ChiCTR1900022861. Registered April 28, 2016, http://www.chictr.org.cn
Pyridine-mediated B–B bond cleavage of tetrahydroxydiboron to synthesize n-doped SWCNTs with long-term air stability
Authors: Tanaka Naoki , Hamasuna Aoi , Yamaguchi Itsuki , Kato Koichiro , Fujigaya Tsuyohiko 
Published: September 2023

Abstract
Neutral radicals, including carbon radicals, are highly useful chemical species for the functionalization of semiconducting materials to change their electrical and optical properties owing to their high reactivity. However, boron radicals have been limited to synthetic and reaction chemistry, with rare utilization in materials science. In this study, a mixture of tetrahydroxydiboron (B2(OH)4) and pyridine derivatives was found to act as an electron dopant for single-walled carbon nanotubes (SWCNTs) because of the electron transfer from pyridine-mediated boron radicals generated by B–B bond dissociation to neutral radicals. In particular, the radical formed from a mixture of B2(OH)4 and 4-phenylpyridine ((4-Phpy)B(OH)2•) efficiently doped electrons into the SWCNT films; thus, n-type SWCNTs with long-term air stability for more than 50 days at room temperature were prepared. Furthermore, the experimental and theoretical surface analyses revealed that the formation of stable cations from ((4-Phpy)B(OH)2•) and the efficient interaction with SWCNTs due to their high planarity served as the mechanism for their stable doping.