bluuebunny/crossref_metadata_2025_split huggingface dataset:
Linking leadership development programs for physicians with organization-level outcomes: a realist review
Authors: Debets Maarten , Jansen Iris , Lombarts Kiki , Kuijer-Siebelink Wietske , Kruijthof Karen , Steinert Yvonne , Daams Joost , Silkens Milou 
Published: July 2023

Abstract
Background
Hospitals invest in Leadership Development Programs (LDPs) for physicians, assuming they benefit the organization’s performance. Researchers have listed the advantages of LDPs, but knowledge of how and why organization-level outcomes are achieved is missing.

Objective
To investigate how, why and under which circumstances LDPs for physicians can impact organization-level outcomes.

Methods
We conducted a realist review, following the RAMESES guidelines. Scientific articles and grey literature published between January 2010 and March 2021 evaluating a leadership intervention for physicians in the hospital setting were considered for inclusion. The following databases were searched: Medline, PsycInfo, ERIC, Web of Science, and Academic Search Premier. Based on the included documents, we developed a LDP middle-range program theory (MRPT) consisting of Context-Mechanism-Outcome configurations (CMOs) describing how specific contexts (C) trigger certain mechanisms (M) to generate organization-level outcomes (O).

Results
In total, 3904 titles and abstracts and, subsequently, 100 full-text documents were inspected; 38 documents with LDPs from multiple countries informed our MRPT. The MRPT includes five CMOs that describe how LDPs can impact the organization-level outcomes categories ‘culture’, ‘quality improvement’, and ‘the leadership pipeline’: 'Acquiring self-insight and people skills (CMO1)', 'Intentionally building professional networks (CMO2)', 'Supporting quality improvement projects (CMO3)', 'Tailored LDP content prepares physicians (CMO4)', and 'Valuing physician leaders and organizational commitment (CMO5)'. Culture was the outcome of CMO1 and CMO2, quality improvement of CMO2 and CMO3, and the leadership pipeline of CMO2, CMO4, and CMO5. These CMOs operated within an overarching context, the leadership ecosystem, that determined realizing and sustaining organization-level outcomes.

Conclusions
LDPs benefit organization-level outcomes through multiple mechanisms. Creating the contexts to trigger these mechanisms depends on the resources invested in LDPs and adequately supporting physicians. LDP providers can use the presented MRPT to guide the development of LDPs when aiming for specific organization-level outcomes.
Nutritional, health and socio-demographic determinants of anaemia in adolescent girls in Kumbungu District, Ghana
Authors: Wemakor Anthony , Kwaako Matilda , Abdul-Rahman Adinan 
Published: July 2023

Abstract
Background
Anaemia is a serious health problem among adolescent girls in Ghana. The aims of this study were to measure the prevalence and identify the nutritional, health, and socio-demographic determinants of anaemia in adolescent girls in Kumbungu District, Northern Region, Ghana.

Method
An analytical cross-sectional study involving 370 adolescent girls residing in Kumbungu district, selected using multi-stage sampling procedure, was conducted. A semi-structured questionnaire, 24-hr dietary recall, food frequency questionnaire, Food Insecurity Experience scale, and anthropometry were used to gather information on socio-demographic characteristics, nutrition knowledge, dietary diversity score, food consumption score, food consumption frequency, household food insecurity, and waist and hip circumferences. Haemoglobin was measured using a portable HemoCue hg 301 + Analyzer. Anaemia in the adolescent girls was defined as haemoglobin concentration less than 12 g/dl. Chi-square test and binary logistic regression analysis were used to identify the determinants of anaemia.

Results
The mean (± SD) age was 13.95 (± 2.94) years, and the majority of the girls were in school (79.5%) and lived in a rural area (81.1%). The mean (± SD) haemoglobin was 11.27 (± 1.19) g/dl, and 74.6% of the respondents had anaemia, with 1.6% having severe anaemia. The health determinant of anaemia was frequency of feeling nervous in the past 6 months [Adjusted Odds Ratio (AOR): 2.12: 95% Confidence Interval (CI): 1.17–3.89; p: 0.014], and the socio-demographic determinants were residential community status (AOR: 0.42; 95% CI: 0.24–0.75; p: 0.003), and fathers’ educational qualification (AOR: 2.57, 95% CI: 1.17–5.65, p: 0.019). No nutritional determinants of anaemia were identified for this study population.

Conclusion
The prevalence of anaemia was very high and the frequency of feeling nervous in the past 6 months, residential community status, and fathers’ educational qualification were associated with anaemia among adolescent girls in Kumbungu district, Ghana. The prevalence of anaemia measured highlights the need for intensification of anaemia prevention and management interventions in the district.
Does Low-Grade Versus High-Grade Bilsky Score Influence Local Recurrence and Overall Survival in Metastatic Spine Tumor Surgery?
Authors: Bendfeldt Gabriel A. , Chanbour Hani , Chen Jeffrey W. , Gangavarapu Lakshmi Suryateja , LaBarge Matthew E. , Ahmed Mahmoud , Jonzzon Soren , Roth Steven G. , Chotai Silky , Luo Leo Y. , Abtahi Amir M. , Stephens Byron F. , Zuckerman Scott L. 
Published: July 2023

BACKGROUND AND OBJECTIVES:
Spinal cord compression caused by spinal tumors is measured using the epidural spinal cord compression scale, also known as the Bilsky score. Whether Bilsky score predicts short-/long-term outcomes remains unknown. The objectives were to determine the correlation of Bilsky score 0–1 vs 2–3 with regards to (1) preoperative presentation, (2) perioperative variables, and (3) long-term outcomes.

METHODS:
A single-center, retrospective evaluation of a cohort of patients undergoing metastatic spine surgery was performed between 01/2010 and 01/2021. Multivariable logistic/linear/Cox regression were performed controlling for age, body mass index, race, total decompressed levels, tumor size, other organ metastases, and postoperative radiotherapy/chemotherapy.

RESULTS:
Of 343 patients with extradural spinal metastasis, 92 (26.8%) were Bilsky 0–1 and 251 (73.2%) were Bilsky 2–3. Preoperatively, patients with Bilsky 2–3 lesions were older (P = .008), presented more with sensory deficits (P = .029), and had worse preoperative Karnofsky Performance Scale (KPS) (P = .002). Perioperatively, Bilsky 2–3 patients had more decompressed levels (P = .005) and transpedicular decompression (P < .001), with similar operative time (P = .071) and blood loss (P = .502). Although not statistically significant, patients with Bilsky 2–3 had more intraoperative neuromonitoring changes (P = .412). Although rates of complications (P = .442) and neurological deficit (P = .852) were similar between groups, patients with Bilsky 2–3 lesions had a longer length of stay (P = .007) and were discharged home less frequently (P < .001). No difference was found in 90-day readmissions (P = .607) and reoperation (P = .510) Long-term: LR (P=.100) and time to LR (log-rank; P=0.532) were not significantly different between Bilsky 0-1 and Bilsky 2-3 lesions. However, patients with Bilsky 2–3 lesions had worse postoperative KPS (P < .001), worse modified McCormick scale score (P = .003), shorter overall survival (OS) (log-rank; P < .001), and worse survival at 1 year (P = .012). Bilsky 2–3 lesions were associated with shorter OS on multivariable Cox regression (hazard ratio = 1.78, 95% CI = 1.27-2.49, P < .001), with no significant impact on time to LR (hazard ratio = 0.73, 95% CI = 0.37-1.44, P = .359).

CONCLUSION:
Bilsky 2–3 lesions were associated with longer length of stay, more nonhome discharge, worse postoperative KPS/modified McCormick scale score, shorter OS, and reduced survival at 1 year. Higher-grade Bilsky score lesions appear to be at a higher risk for worse outcomes. Efforts should be made to identify metastatic spine patients before they reach the point of severe spinal cord compression..
Total Hip Arthroplasty in Patients with Bilateral Upper-Limb Amelia
Authors: Gibian Joseph T. , Youngman Tyler R. , Clohisy John C. 
Published: July 2023

Case:
We report two patients, a 43-year-old man and a 26-year-old woman, with bilateral absence of the upper extremity and severe hip osteoarthritis. The involved hip was the dominant extremity for both patients. Total hip arthroplasty (THA) was performed using a posterior approach with dual-mobility implants. Both patients report satisfactory outcomes including the ability to perform the significant range of motion required for daily activities such as toe-to-head motion.

Conclusion:
In patients with extreme range of motion requirements such as those affected with bilateral upper-limb amelia, a posterior THA with a dual-mobility implant may be safely and successfully performed to treat disabling hip osteoarthritis.
Incorporation of CEUS and SWE Parameters into a Multivariate Logistic Regression Model for the Differential Diagnosis of Benign and Malignant TI-RADS4 Thyroid Nodules
Authors: Li hong jing , sui guo qing , teng deng ke , lin yuan qiang , wang Hui 
Published: July 2023

Abstract

Purpose: To investigate the diagnostic value of contrast-enhanced ultrasound (CEUS) quantitative analysis parameters combined with shear wave elastography (SWE) quantitative parameters in the differentiation of benign and malignant ACR TI-RADS category 4 thyroid nodules and to provide a more effective reference for clinical work.
Methods: We analyzed 187 category 4 nodules, including 132 nodules in the development cohort and 55 nodules in the validation cohort, divided the development cohort into benign and malignant groups, and analyzed the differences in all CEUS and SWE quantitative parameters between the two groups. We selected the highest AUC of the two parameters, performed binary logistic regression analysis with the ACR TI-RADS score and constructed a diagnostic model. ROC curves were applied to evaluate their diagnostic efficacy.
Results: The diagnostic model had an AUC of 0.926, sensitivity of 87.5%, specificity of 86.8%, diagnostic threshold of 3, accuracy of 87.12%, positive predictive value of 86.15%, and negative predictive value of 88.06%. 2) The diagnostic model had an AUC of 0.890 in the validation cohort, sensitivity of 81.5%, specificity of 79.6%, and accuracy of 80.00%.
Conclusion: The combined multiparameter construction of the nodule diagnostic model can effectively improve the diagnostic efficacy of 4 types of thyroid nodules and provide a new reference index for clinical diagnostic work.
Efficacy of aqueous Aegle marmelos leaf extract for the control of Megacopta cribraria
Authors: Modak Moutushi , Begum Rubina Azmeera , Saikia Santana , Naorem Anjana Singha 
Published: July 2023

Abstract

Megacopta cribraria (F.), a pest of concern worldwide, has been extensively studied for control using synthetic pesticides. However, this study focuses on the efficacy of a plant-based extract derived from A. marmelos leaves. The ovicidal potential of crude A. marmelos leaf extract was tested at five concentrations (1.25%, 2.5%, 5%, 7.5%, and 10%), resulting in a maximum of 30% ovicidal action at the 10% concentration. The extract also exhibited deterrence activity against adult bugs. At all concentrations, significant deterrence was observed in terms of time spent on the treated surface and the frequency of visits. Bug activity decreased with increasing concentrations, spending only 2.5% of time on the treated surface at 10% concentration. Bug preference for the treated surface also decreased with concentration, with only 14% of visits on the treated surface at 10% concentration. This deterrence activity was supported by frequent grooming and avoidance behavior exhibited by the bugs, helping them cleanse their body receptors. The study concludes that A. marmelos shows potential as a biopesticide for controlling M. cribraria populations globally. These findings emphasize the need for eco-friendly alternatives to synthetic pesticides for effective pest control.
Phytochemical Analysis of Dragon Fruit (Hylocereus Spp.) and Carica Papaya Stems
Authors: Bassiag Sarrah Kirstine R. , Aguinaldo Kate R. , Singson Zanaya Adaline , Guzman Rodel 
Published: July 2023

Abstract
Recent research has unveiled the potential therapeutic effects of plants, emphasizing their significance in medicinal applications. Numerous studies have indicated that certain plants harbor bioactive compounds, rendering them suitable for medicinal purposes. In this particular study, the researchers focused on Carica papaya and dragon fruit (Hylocereus spp.) with the aim of identifying the present bioactive compounds present in their stems and evaluating their potential therapeutic effects. To determine the presence of certain bioactive compounds, the researchers conducted a preliminary phytochemical screening method based on established protocols by Cagayan State University-Andrews. Mayer's test was used to detect alkaloids, the alkaline reagent test for anthocyanins, Shinoda's test for flavonoids, the Ferric chloride test for phenols, the Froth test for saponins, Guevara’s Method for steroids, the Lead acetate test for tannins, and the Salwoski test for terpenoids. The results revealed that both Carica papaya and dragon fruit (Hylocereus spp.) contained similar bioactive compounds, including alkaloids, phenols, saponins, steroids, and tannins. However, dragon fruit (Hylocereus spp.) possessed an additional bioactive compound, namely terpenoids, which provided it with a comparative advantage over Carica papaya. Additionally, the researchers conducted a literature review on the therapeutic effects associated with the identified bioactive compounds. In the case of Carica papaya, its metabolites were found to contribute to various therapeutic effects, such as antiplatelet, anesthetic, antifungal, antiviral, anabolic, cholesterol-lowering, antidiabetic, analgesic, anthelmintic, anticarcinogen, antimutagenic, styptic, astringent, antiadhesive, antimicrobial, anticancer, antibacterial, anti-inflammatory, and antioxidant properties. Similarly, dragon fruit exhibited therapeutic effects, including antiplatelet, anesthetic, antifungal, antiviral, anabolic, cholesterol-lowering, antidiabetic, anthelmintic, anticarcinogen, antimutagenic, styptic, astringent, antiadhesive, antihyperglycemic, antiparasitic, anticancer, antibacterial, anti-inflammatory, antioxidant, and analgesic properties. Overall, both Carica papaya and dragon fruit stems demonstrated potential therapeutic effects on human health, with dragon fruit exhibiting a slight advantage due to the presence of terpenoids. This study suggests that these plants hold promise for the development of natural medicines. However, further research is warranted to comprehensively understand the effects of the identified bioactive compounds on human health.
Solitary metastasis to the skull as the first sign of hepatocellular carcinoma in a patient in long-term remission
Authors: Bernstein Zachary , Adamson David Cory 
Published: July 2023

Background:
Hepatocellular carcinoma (HCC) is a common malignant tumor with a 5-year survival rate of 10%, presenting with extrahepatic metastases in 15–17% of patients. HCC-bone metastases represent approximately one-quarter of all HCC metastases, most frequently in the spine, pelvis, ribs, or femur. HCC-skull metastases, however, make up 0.4–1.6% of all HCC- bone metastases. Furthermore, solitary HCC-skull metastasis without known active primary HCC is an unusual presentation warranting further review and consideration.

Case Description:
Here, the authors report a unique case of a solitary HCC-skull metastasis in a patient without known active cancer but in long-term remission for HCC. The patient is a 69-year-old male with past HCC who presented with a nontender skull mass. A computed tomography scan showed a heterogeneously enhancing mass centered in the high left parietal bone with intracranial extension. There was a noted mass effect on the left posterior frontoparietal region without worrisome midline shift. Pathology ultimately revealed the mass to be metastatic HCC. To aid in the understanding and clinical management of this rare presentation, we reviewed the literature regarding clinical presentation, radiological features, pathology, and outcome.

Conclusion:
Ultimately, early detection of the primary source of cancer is pivotal to successful treatment and prognosis, and skull lesions such as these must include HCC in the differential diagnosis.
A MODEL OF A COMPREHENSIVE SOLUTION TO THE PROBLEM OF STRATIFICATION CONFLICTS OF YOUNGER ADOLESCENTS IN THE EDUCATIONAL ENVIRONMENT
Authors: Суханова И.В. 
Published: July 2023

Рассматривается проблема стратификационных конфликтов школьников, которая представляет собой риск психологической безопасности в образовательной среде. Обозначаются признаки эмоционального неблагополучия ребенка, которые возникают и проявляются по причине стратификации. Предложены меры преодоления рисков социального неравенства в школьном окружении. Представлена модель комплексного решения проблемы стратификационных конфликтов младших подростков, которая предполагает психолого-социально-педагогическое взаимодействие субъектов образовательного процесса для сохранения психологической безопасности образовательной среды.
This article deals with the problem of stratification conflicts of schoolchildren, which is a risk of psychological security in the educational environment. The signs of emotional distress of the child, which arise and manifest themselves due to stratification, are indicated. Measures to overcome the risks of social inequality in the school environment are proposed. A model of a comprehensive solution to the problem of stratification conflicts of younger adolescents is presented, which assumes psychological, socio-pedagogical interaction of subjects of the educational process to preserve the psychological safety of the educational environment.
Extraction of Essential Oils from Citrus By-Products Using Microwave Steam Distillation
Authors: Shakir Ibtehal K. , Salih Sarah J. 
Published: July 2023

The main objectives of this research is to extract essential oil from: orange ( citrus sinensis), lemon( citrus limon) and mandarin( citrus reticulata) peels by two methods: steam distillation (SD) and microwave assisted steam distillation (MASD), study the effect of extraction conditions (weight of the sample, extraction time, and microwave power, citrus peel type) on oil yield and compare the results of the two methods, the resulting essential oil was analyzed by Gas Chromatography (GC).
Essential oils are highly concentrated substances used for their flavor and therapeutic or odoriferous properties, in a wide selection of products such as foods, medicines and cosmetics. Extraction of essential oil is one of the most time and effort consuming process. Microwave-assisted extraction is a green technique for the extraction of natural products. (MASD) was better than (SD) in terms of rapidity, energy saving and yield. (MASD) gave higher yield than (SD) with shorter extraction time, yield of orange oil extracted by (MASD) was (1.150%) in (35min.) compared to (1.095%) in (45min.) by (SD) process, same results obtained for lemon and mandarin.
The optimal microwave power was (135W) gave oil yield: (1.150%, 1.115%, 0.940%) for orange, lemon and mandarin respectively, (MASD) increased extraction temperature in short time and to a higher level compared to (SD). The optimal weight was (398.56gm) gave yield in (SD): (1.095%) and MASD (1.091%) for orange oil, same results obtained for lemon and mandarin. The best citrus peel type which gave the highest yield was orange followed by lemon then mandarin in both processes.
Limonene is the most abundant component in citrus essential oil, (GC) analysis showed that (SD) was more convenient to give high amount of limonene because of the graduate temperature rise, while in microwave extraction exposure to low microwave
Concurrent influence of geological parameters on the integrated nano-pore structure and discretized pore families of the petroliferous Cambay shale assessed through multivariate dependence measure
Authors: Bal Abinash , Misra Santanu , Mukherjee Manab , Dutta Tapas Kumar , Sen Debasis , Patra Abhijit , Raja Elangovan 
Published: July 2023

Heterogeneous nanopore structure and distribution regulate the gas trapping, desorption kinetics, and diffusion in shale matrices. In shale, pores range from continuous micro- and mesopore size distributions, varying with organic (total organic matter-TOC) and inorganic constituents (clay content, Fe-bearing minerals, quartz, etc.). Previous research only showed a linear relationship of pore parameters with these intrinsic properties of shale, which limits our understanding of the concurrent influence of multiple intrinsic rock properties. As a result, in this work, we established multivariate dependency of nanopore structure, distribution, and complexity (from low-pressure N2 and CO2 sorption and small-angle scattering; SAXS/MSANS) in the previously little-studied Cambay shales and provided a better tool (partial least square regression) for analyzing the simultaneous effect of intrinsic shale properties on multiply connected pore-parameters. Furthermore, we discretized continuous pore-size distribution into individual pore families using deconvolution to understand the pore space better. Additionally, predicted shale formation environment in terms of deposition probability (P+) and dissolution probability (P−) using a dynamic model of the fractal interface by precipitation and dissolution. Our findings indicate that the Cambay shales have a high potential for future hydrocarbon exploration (S2: 2.42–12.04 mg HC/g rock), “very good” (2-4 wt.%) to “excellent” (&gt;4 wt.%) TOC content, and thermally mature type II–III admixed and type III kerogen. Deconvolution of the micro- and mesopore size distributions reveals that pore width (w) ranges ∼15.30–35 nm occupies greater than 50% of the total pore volume, and its pore volume increases with the presence of quartz, Fe-bearing minerals, and clay content. However, pores with w∼ 3.60–15.30 nm increase exclusively with TOC. In the micro- and early mesopore region, pore volume decreases with TOC from w∼ 0.30–0.75 nm and increases with TOC from w∼ 0.75–3.60 nm. Furthermore, TOC in shale increases the specific surface area and pore volume (micro-, meso-, and total pores), enhancing both sorption and free gas storage capacities. Cambay shales were likely deposited in three distinct environments, with precipitation probability (P+) values of 1, 0.7–0.8, and 0.5, as revealed by a fractal dimension (Ds) analysis of multiple samples.