bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence of Persistent Mild Hypercortisolism in Patients Medically Treated for Cushing Disease: the Haircush Study
Authors: Mohammedi Kamel , Bertherat Jerome , Raverot Gerald , Drui Delphine , Reznik Yves , Castinetti Frederic , Chanson Philippe , Fafin Manon , Brossaud Julie , Tabarin Antoine 
Published: May 2023

Abstract

Context
Cortisol-lowering drugs may not restore a normal cortisol secretion in Cushing disease (CD).

Objective
This work aimed to assess the long-term cortisol exposure in medically treated CD patients using hair-cortisol (HF) and hair-cortisone (HE) measurement.

Methods
This multicenter prospective study included 3 groups of female patients: CushMed = 16 treated with a stable cortisol-lowering drug dosage and normal urinary free cortisol (UFC); CushSurg = 13 cured by pituitary surgery; CushBla = 15 receiving stable recommended doses of hydrocortisone following bilateral adrenalectomy. Patients were evaluated for 3 months with their usual treatments. Two late-night saliva and 24-hour urine samples were collected monthly in CushMed, and at study end in CushSurg and CushBla patients. A 3-cm hair sample was collected at study end from all patients. Main outcome measures included clinical score and centralized measurement of UFC, late-night salivary cortisol (LNSF), late-night salivary cortisone (LNSE), HE, HF.

Results
Despite having almost all UFCs normalized, CushMed patients exhibited increased HE as compared to CushSurg controls (P = .003). CushMed patients also had increased clinical score (P = .001), UFC (P = .03), LNSF, LNSE (P = .0001), and variability in the latter parameters (P = .004). CushBla patients had increased HF and HE, contrasting with LNSEs similar to CushSurg patients. Six of 15 CushMed patients exhibited increased HE concentrations and had increased antihypertensive drug dosage compared to CushMed patients with normal HE (P = .05).

Conclusion
Despite normalized UFCs, a subset of medically treated CD patients displays an altered circadian rhythm of serum cortisol. A single HE measurement identifies chronic mild persistent hypercortisolism and could replace multiple saliva analyzes to monitor medical treatments in CD patients once UFC is normalized.
Project SPRUCE: Saving Our Planet by Reducing Carbon Emissions, a Pediatric Anesthesia Sustainability Quality Improvement Initiative
Authors: Hansen Elizabeth E. , Chiem Jennifer L. , Righter-Foss Kimberly , Zha Yuanting , Cockrell Hannah C. , Greenberg Sarah L. M. , Low Daniel K. , Martin Lynn D. 
Published: May 2023

BACKGROUND:
Children are particularly vulnerable to adverse health outcomes related to climate change. Inhalational anesthetics are potent greenhouse gasses (GHGs) and contribute significantly to health care–generated emissions. Desflurane and nitrous oxide have very high global warming potentials. Eliminating their use, as well as lowering fresh gas flows (FGFs), will lead to reduced emissions.

METHODS:
Using published calculations for converting volatile anesthetic concentrations to carbon dioxide equivalents (CO2e), we derived the average kilograms (kg) CO2e/min for every anesthetic administered in the operating rooms at our pediatric hospital and ambulatory surgical center between October 2017 and October 2022. We leveraged real-world data captured from our electronic medical record systems and used AdaptX to extract and present those data as statistical process control (SPC) charts. We implemented recommended strategies aimed at reducing emissions from inhalational anesthetics, including removing desflurane vaporizers, unplugging nitrous oxide hoses, decreasing the default anesthesia machine FGF, clinical decision support tools, and educational initiatives. Our primary outcome measure was average kg CO2e/min.

RESULTS:
A combination of educational initiatives, practice constraints, protocol changes, and access to real-world data were associated with an 87% reduction in measured GHG emissions from inhaled anesthesia agents used in the operating rooms over a 5-year period. Shorter cases (<30 minutes duration) had 3 times higher average CO2e, likely due to higher FGF and nitrous oxide use associated with inhalational inductions, and higher proportion of mask-only anesthetics. Removing desflurane vaporizers corresponded with a >50% reduction of CO2e. A subsequent decrease in anesthesia machine default FGF was associated with a similarly robust emissions reduction. Another significant decrease in emissions was noted with educational efforts, clinical decision support alerts, and feedback from real-time data.

CONCLUSIONS:
Providing environmentally responsible anesthesia in a pediatric setting is a challenging but achievable goal, and it is imperative to help mitigate the impact of climate change. Large systems changes, such as eliminating desflurane, limiting access to nitrous oxide, and changing default anesthesia machine FGF rates, were associated with rapid and lasting emissions reduction. Measuring and reporting GHG emissions from volatile anesthetics allows practitioners to explore and implement methods of decreasing the environmental impact of their individual anesthesia delivery practices.
Shielding individuals at high risk of COVID-19: A micro-simulation study
Authors: Van Zandvoort Kevin , Favas Caroline , Checchi Francesco 
Published: May 2023

Background: One proposed intervention for mitigating COVID-19 epidemics, particularly in low-income and crisis-affected settings, is to physically isolate individuals at high risk of severe disease and death. This intervention, known as ‘shielding’, could be implemented in various ways. If shielding is imperfect, any introduction of infections within the shielding group could cause substantial mortality and negate the intervention’s benefits. We explored the effectiveness of shielding under various modalities of implementation and considered mitigation measures to reduce possible harms. Methods: We used an individual-based model to simulate a COVID-19 epidemic in a population where a fraction above a given age are relocated to shielding residences. We set our simulation with the context of an internally displaced persons’ camp in Somaliland, for which we had previously collected data on demographics and social mixing patterns. We compared an unmitigated epidemic with a shielding intervention accompanied by various risk-mitigating measures. We explored the impact of parameters such as residence size, reduction in contacts, basic reproduction number, and prior immunity in the population. Results: Shielded residences are likely to be breached with infection during the outbreak. Nonetheless, shielding can be effective in preventing COVID-19 infections in the shielded population. The effectiveness of shielding is mostly affected by the size of the shielded residence, and by the degree by which contacts with the outside world are reduced. Reductions in contacts between shielded individuals are only effective in larger shielded residences. In epidemics with a lower reproduction number, the effectiveness of shielding could be negative. Conclusions: Shielding could be an effective method to protect the most at-risk individuals. It should be considered where other measures cannot easily be implemented, but with attention to the epidemiological situation. Shielding should only be implemented through small to medium-sized shielding residences, with appropriate mitigation measures to prevent subsequent spread.
Celiac disease and non-celiac gluten sensitivity – characteristics and differences
Authors: Kulik Kacper , Fryska Zuzanna , Wołejko Adam , Kuciński Jakub , Semeniuk Paweł , Matusz Krystian , Burczyk Rafał , Górna Natalie , Łabuda Adam 
Published: May 2023

Introduction
Celiac disease is a quite common condition resulting from the interaction of genetic, immunological, and environmental factors, with the main environmental factor being exposure to gluten. Non-celiac gluten sensitivity (NCGS) affects individuals without celiac disease or wheat allergy and is characterized by intestinal and extraintestinal symptoms related to the consumption of grain products, without accompanying damage to the intestinal mucosa.
Discussion
Gluten is a grain protein that is resistant to digestive enzymes and accumulates in the intestines, leading to tissue damage and the release of tissue transglutaminase 2 (tTG2) enzyme, which increases gluten immunogenicity. The presence of HLA-DQ2 or HLA-DQ8 gene variants in the genome is a necessary condition for the development of the disease, but it does not always lead to celiac disease. The pathomechanism of non-celiac gluten sensitivity is not yet fully understood. Diagnosis of celiac disease involves serological tests, genetic tests, and histological examination.
Conclusions
The only effective treatment for celiac disease is a strict gluten-free diet, which involves eliminating wheat, rye, barley, and triticale from one's diet. Further research is necessary to search for effective therapies. The approach for NCGS involves introducing an appropriate diet - either low FODMAP or gluten-free.
Midwives' knowledge, education and training in providing care to women with female genital mutilation
Authors: Musse Ladan Abdirashid 
Published: May 2023

Background/Aims Around 200 million women have undergone some type of cut, change or removal of the outer part of their genitalia. Midwives play a central role in recognising and providing support to women who have suffered from female genital mutilation. The aim of this study was to understand midwives' role in supporting women with female genital mutilation by exploring their knowledge, education and training. Methods A systematic review of both qualitative and quantitative research published between 2010 and 2020 was carried out. A total of nine articles were selected, following screening and quality assessment, for inclusion in the review. Results Midwives' lack of knowledge and confidence regarding appropriate care for women with female genital mutilation highlights the urgent need for evidence-based research. Furthermore, midwives' knowledge and training needs to be improved to enhance care for women with female genital mutilation. Conclusions Female genital mutilation affects a variety of countries, and, in recent times, has developed into a global public health concern. Midwives play a crucial role in recognising and providing support to women who have experienced female genital mutilation.
A cognitive approach to the allegedly left-headed prefix verbs in German:
Authors: Baeskow Heike 
Published: May 2023

In this article, the much discussed problem of apparently left-headed German prefix verbs (e. g. besohlen ‘sole’, erschneidern ‘obtain by tailoring’, verschimmeln ‘become mouldy’) will be addressed from a cognitive perspective. It will be argued that nominal bases are metonymically reconceptualized as events inside the derivatives. This proposal has two advantages over previous approaches. First, it is not necessary to assign verbal or verbalizing properties to the prefixes be-, ent-, er-, ver-, and zer-, which have their origin in prepositions or adverbs. Secondly, an overgeneration of virtual verbs, i. e. of verbs which are not or no longer attested (e. g. *dachen ‘roof’, †sohlen ‘sole’) is avoided because the metonymic and hence purely conceptual verbalization process takes place in the context of the inseparable prefixes. The prefixes neither change the word-class of their bases nor provide argument structures, which are predicted by a small set of conceptual event schemata. The function of the prefixes is rather to add semantic or aspectual information. Synchronic support for the proposal to be presented first of all comes from the fact that conversion, which historically preceded prefixation in German, is still active. Contrastive analyses of English and German non-derived denominal verbs will illustrate this point. Moreover, many prefix verbs still co-exist with non-derived denominal verbs (e. g. schottern (< Schotter ‘gravel, ballast’) vs. beschottern, entschottern, verschottern). A more general observation is that the compatibility of denominal verbs with the holistic (or ‘synoptic’) perspective conveyed by the inseparable prefixes depends on the metonymic patterns underlying these verbs.
Digitale Übersetzungsprogramme und Online-Wörterbücher im Fremdsprachenunterricht:
Authors: Udry Isabelle , Berthele Raphael 
Published: May 2023

This survey investigates teacher and student perceptions and beliefs relating to the use of digital translation tools and online dictionaries (e. g. Google Translate, DeepL, Leo, Pons) in the foreign language classroom. Over the past few years, these tools have become increasingly popular, a development that has given rise to questions about their benefits for foreign language learning and teaching. A total of 1187 participants (985 students and 202 teachers) took part in the study. They came from primary schools, lower and upper secondary schools (Gymnasium and Fachmatura, vocational schools), as well as tertiary education and professional development classes. The survey was conducted in French (n=834) and German (n=353) in the cantons of Bern, Fribourg, Geneva, Jura, Neuchâtel and Solothurn. Participation was voluntary. Results show that regardless of language background and educational context, participants perceive of the tools as a normal and largely established part of their everyday practices. Compared to their teachers, students are more optimistic about the tools’ potential contribution to foreign language learning and less concerned about possible pitfalls linked to using the tools. Students in lower secondary school use digital translation aids less frequently and rate their contribution to language learning and motivation less favourably than the other learner groups. Many teachers would like to use digital translators and online dictionaries in their classroom, but they express uncertainty about how to do so meaningfully. Teachers voice concerns over certain student practices, namely the lack of cognitive involvement when simply translating text without considering the output. Teachers also highlight the gap between curricular/institutional prescriptions and the way the tools are commonly used, a mismatch that can affect their teaching. Overall, our findings emphasize the need for a) empirical evidence on the effects of digital translation tools on foreign language acquisition, b) pedagogical scenarios for implementing the tools, and 3) alignment of policy with practice.
Supervised breast cancer prediction using integrated dimensionality reduction convolutional neural network
Authors: Xu HuanQing , Shao Xian , Hui Shiji , Jin Li 
Published: May 2023

Objectives
Breast cancer is a major health problem with high mortality rates. Early detection of breast cancer will promote treatment. A technology that determines whether a tumor is benign desirable. This article introduces a new method in which deep learning is used to classify breast cancer.

Methods
A new computer-aided detection (CAD) system is presented to classify benign and malignant masses in breast tumor cell samples. In the CAD system, (1) for the pathological data of unbalanced tumors, the training results are biased towards the side with the larger number of samples. This paper uses a Conditional Deep Convolution Generative Adversarial Network (CDCGAN) method to generate small samples by orientation data set to solve the imbalance problem of collected data. (2) For the high-dimensional data redundancy problem, this paper proposes an integrated dimension reduction convolutional neural network (IDRCNN) model, which solves the high-dimensional data dimension reduction problem of breast cancer and extracts effective features. The subsequent classifier found that by using the IDRCNN model proposed in this paper, the accuracy of the model was improved.

Results
Experimental results show that IDRCNN combined with the model of CDCGAN model has superior classification performance than existing methods, as revealed by sensitivity, area under the curve (AUC), ROC curve and accuracy, recall, sensitivity, specificity, precision,PPV,NPV and f-values analysis.

Conclusion
This paper proposes a Conditional Deep Convolution Generative Adversarial Network (CDCGAN) which can solve the imbalance problem of manually collected data by directionally generating small sample data sets. And an integrated dimension reduction convolutional neural network (IDRCNN) model, which solves the high-dimensional data dimension reduction problem of breast cancer and extracts effective features.
Lipoprotein subfraction profiling in the search of new risk markers for myocardial infarction: The HUNT study
Authors: Sperstad Sigri Bakken , Sæther Julie Caroline , Klevjer Marie , Giskeødegård Guro Fanneløb , Bathen Tone Frost , Røsbjørgen Ragnhild , Dalen Håvard , Bye Anja 
Published: May 2023

Background
Traditional biomarkers used to measure risk of myocardial infarction (MI) only explain a modest proportion of the incidence. Lipoprotein subfractions have the potential to improve risk prediction of MI.

Aim
We aimed to identify lipoprotein subfractions that were associated with imminent MI risk.

Methods
We identified apparently healthy participants with a predicted low 10-year risk of MI from The Trøndelag Health Survey 3 (HUNT3) that developed MI within 5 years after inclusion (cases, n = 50) and 100 matched controls. Lipoprotein subfractions were analyzed in serum by nuclear magnetic resonance spectroscopy at time of inclusion in HUNT3. Lipoprotein subfractions were compared between cases and controls in the full population (N = 150), and in subgroups of males (n = 90) and females (n = 60). In addition, a sub analysis was performed in participants that experienced MI within two years and their matched controls (n = 56).

Results
None of the lipoprotein subfractions were significantly associated with future MI when adjusting for multiple testing (p<0.002). At nominal significance level (p<0.05), the concentration of apolipoprotein A1 in the smallest high-density lipoprotein (HDL) subfractions was higher in cases compared to controls. Further, in sub analyses based on sex, male cases had lower lipid concentration within the large HDL subfractions and higher lipid concentration within the small HDL subfractions compared to male controls (p<0.05). No differences were found in lipoprotein subfractions between female cases and controls. In sub analysis of individuals suffering from MI within two years, triglycerides in low-density lipoprotein were higher among cases (p<0.05).

Conclusion
None of the investigated lipoprotein subfractions were associated with future MI after adjustment for multiple testing. However, our findings suggests that HDL subfractions may be of interest in relation to risk prediction for MI, especially in males. This need to be further investigated in future studies.
Prevalence, characteristics, consequences, and awareness of work-related musculoskeletal pain among cardiac sonographers compared with other healthcare workers in Saudi Arabia: A cross sectional study
Authors: Al Saikhan Lamia 
Published: May 2023

Background
Evidence related to work-related musculoskeletal pain (WRMSP) among cardiac sonographers is incomplete. This study aimed to investigate the prevalence, characteristics, consequences, and awareness of WRMSP among cardiac sonographers compared with other healthcare workers in different healthcare settings in Saudi Arabia.

Methods
This was a descriptive, cross-sectional, survey-based study. An electronic self-administered survey using a modified version of the Nordic questionnaire was distributed to cardiac sonographers and control participants of other healthcare professions exposed to different occupational hazards. The χ2 test and logistic regression were performed to compare groups.

Results
In total, 308 participants completed the survey (mean age: 32.1±8.4; females: 207(68.1%)): 152(49.4%) sonographers and 156(50.6%) controls. WRMSP was more prevalent among cardiac sonographers than controls(84.8% vs 64.7%, p<0.0001), even after adjustment for age, sex, height, weight, BMI, education, years in current position, work-setting, and regular exercise(odds ratio [95% CI]: 3.0[1.54, 5.82], p = 0.001). Pain was more severe(p = 0.020) and lasted longer among cardiac sonographers(p = 0.050). The most affected body regions were the shoulders(63.2% vs 24.4%), hands(55.9% vs 18.6%), neck(51.3% vs 35.9), and elbows(23% vs 4.5%; p<0.01 for all). Pain in cardiac sonographers interfered with daily and social activities and interrupted their work-related activities(p<0.05 for all). More cardiac sonographers had plans to change profession(43.4% vs 15.8%; p<0.0001). A higher proportion of cardiac sonographers were aware of WRMSP(81% vs 77%) and its potential risks(70% vs 67%). However, cardiac sonographers infrequently utilised recommended preventative ergonomic measures for improving work practices, received insufficient ergonomics education and training on the risks and prevention of WRMSP, and had insufficient ergonomic work environment and support from employers.

Conclusions
WRMSP was more frequent and more severe in cardiac sonographers than in controls and adversely impacted their daily, social, and work-related activities, and future employment plans. Despite high awareness of WRMSP and its potential risks, cardiac sonographers infrequently utilised recommended preventative ergonomic measures and had insufficient ergonomic work environment and support from employers.
empirical study of air transport demand forecast in Nigeria
Authors: Reuben Nwaogbe Obioma , Monday Adebayo , Wokili-Yakubu Huwa 
Published: May 2023

The aim of the study is to estimate the air travel demand forecast of domestic passengers’ travels in Nigeria from 2002-2016. Data wesourced from Central Bank of Nigeria, National Bureau of Statistics, and Federal Airport Authority of Nigeria. The study utilized multiple regressions model using Stata-Graphic software solver to analyze the data. From the analysis, the result shows that there is significant relationship between the explanatory variable (passengers) and unexplanatory variables National Disposable Income, Population, Average Airfare, Gross Domestic Product, Exchange Rate, Total Expenditure, and Crude oil price, accounted for adjusted R of 93.624% relationship with demand for domestic air travel of passenger. The R-square statistic shows that the fitted model explains the variability in Number of passenger (NPAX) which is 96.8124%. The Hypothesis testing reveals that National Disposable Income and Air fare have strong statistically significant relationship with the demand for domestic air travel with P-value of 0.0013. Moreso, there is statistically significant relationship for National Disposable Income, Average Airfare, and Crude oil price with P-value of 0.0017 and 0.0445 respectively. Furthermore, forecast of the number of passengers and average airfare was carried out using ARIMA (1,0,0) model which made available the future predicted values for the number of passenger movement and average airfare for the next 10-12 years to come. Thus, the study recommends that stakeholders in the air transport sector should work towards improving the capacity and infrastructure to accommodate the growth of air travel demand for domestic air travel in Nigeria. Policy implications were made on how to regulate the sector by having a good pricing policy to control the air fare for the industry.