bluuebunny/crossref_metadata_2025_split huggingface dataset:
Now you see me: lights on Merkel Cell Carcinoma
Authors: Pini Cristiano , Matassa Giovanni , Gelardi Fabrizia , Antunovic Lidija 
Published: March 2023

AbstractMerkel Cell Carcinoma (MCC) is a rare primary cutaneous cancer with aggressive behaviour and poor prognosis. Although MCC cells express somatostatin receptors (SSTR), SSTR-targeted PET/CT is not routinely performed in clinical practice. In contrast, the use of [18F]FDG PET/CT is more widespread and its prognostic role is well established. We present the case of an MCC patient suspected recurrence who underwent restaging with both [18F]FDG and [68 Ga]Ga-DOTA-TOC PET/CT. [18F]FDG PET/CT showed pathological uptake only in mediastinal lymph nodes, but SSTR imaging also revealed multiple liver and skeletal metastases, leading to significant disease upstaging and relevant changes in the therapeutic management.
Design and implementation of a secure mobile phone-based route navigator (mGuide), adapted for the visually challenged people
Authors: Onkoba Nicholas Ososi , Karimi Patrick , Nyangaresi Paul Onkundi 
Published: March 2023

AbstractThis paper is focused on the development of a turn-by-turn voice navigation mobile application “mGuide” adapted for visually challenged people (VCP). The application was developed in response to the challenges of outdoor navigation by VCP. The application optimizes five map servers to give not only the best real-time routing at any instance but also faster loading and retrieval of route data into the phone’s storage. The destination points of the user are obtained in real time using open street maps and stored in the database. Once the destination has been set and mode of travel chosen, the software gives turn-by-turn voice navigation till the destination is reached. In addition, the application can be able to read inbox messages as they are received. Furthermore, the application gives an audio alert to the user in case of lost route and redirects the user using alternative route. Testing of the application was done using 9 totally blind students and 1 partially blind student from Kenyatta University in Kenya, who were successfully guided. In testing the performance of the whole system, no sound alerts between 0 and 10 m from the middle of the road were heard. However, as the user deviated more than the 10 m from the path, sound alerts are heard. In conclusion, sound alert due to wrong turn is averagely 5.23 s.
Revisitar y recrear la huelga
Authors: Vega Cristina 
Published: March 2023

Resumen
Desde el 2016, las movilizaciones feministas han reactivado la práctica de la huelga. En algunos países se han vivido expresiones masivas de la misma; en otros, simplemente se adoptó el término y con él una idea fuerza: el poder de la disrupción social. En todo el mundo se llevaron a cabo huelgas parciales con distintos grados de apoyo, así como sentadas, marchas, acciones y convocatorias para detener los distintos circuitos productivos y reproductivos en los que las mujeres están involucradas a diario. Para las feministas, la convocatoria de una huelga conlleva una serie de cuestiones acuciantes, ya que los modelos tradicionales de huelga no tienen en cuenta el trabajo reproductivo y otras formas de trabajo no asalariado o marginado. La cuestión se convierte entonces en qué tipo de huelga serviría mejor a quienes realizan incansablemente el trabajo de reproducción social y que, al mismo tiempo, son los más denigrados y desvalorizados. Sin embargo, al repasar la historia de la huelga, recordamos que muchas estaban relacionadas con elementos de la vida de la clase trabajadora que no tenían que ver directamente con la producción. Este artículo trata de ampliar la concepción feminista de la huelga al descubrir cómo las mujeres la han utilizado en sus propios términos y por sus propios medios para lograr el cambio.
Pump the brakes! The hindlimbs of three-toed sloths decelerate and support suspensory locomotion
Authors: McKamy Andrew J. , Young Melody W. , Mossor Angela M. , Young Jesse W. , Avey-Arroyo Judy A. , Granatosky Michael C. , Butcher Michael T. 
Published: March 2023

ABSTRACT
Modern tree sloths are one of few mammalian taxa for which quadrupedal suspension is obligatory. Sloth limb musculature is specialized for slow velocity, large force contractions that stabilize their body below branches and conserve energy during locomotion. However, it is unknown whether two- and three-toed sloths converge in their use of limb kinetics and if these patterns are comparable to how primates perform arboreal suspensory locomotion. This study addressed this need by collecting limb loading data in three-toed sloths (Bradypus variegatus; N=5) during suspensory walking. Sloths performed locomotor trials at their preferred speed on an instrumented beam apparatus with a force platform as the central supporting segment. Peak forces and impulses of the forelimb and hindlimb were recorded and analyzed in three dimensions. The hindlimbs of B. variegatus apply large braking forces greater in magnitude than peak forces generated by the forelimbs in propulsion, a pattern consistent with that observed in two-toed sloths. However, B. variegatus exhibits hindlimb-biased body weight support in vertical peak forces and impulse, with appreciable laterally directed forces in each limb pair, both of which vary from limb loading distributions in two-toed sloths. Moreover, body weight distribution between limb pairs is opposite to that employed by primates during quadrupedal suspension. Thus, there appear to be multiple strategies for achieving suspensory locomotion in arboreal mammals. These differences may be attributable to anatomical variation or phylogenetic position, but as of yet an explanation remains unknown. Future EMG analyses are expected to provide insight into how specific hindlimb muscle groups contribute to braking forces and stabilizing the center of mass of sloths during suspension.
The chemotherapeutic activity of areca nut extract increased stromal tumor-infiltrating lymphocytes in 4-nutriquinoline-1-oxide-tumor-induced Sprague-Dawley rats
Authors: Sari Liza Meutia , Novita Cut Fera , Andriany Poppy , Sari Dina Keumala 
Published: March 2023

Background: Oral squamous cell carcinoma (OSCC) is one of the most common oral cancers with a high mortality rate. The biodiversity source in Indonesia makes areca nut a potential antioxidant in treating disease. Objective: The study aimed to evaluate the chemotherapeutic effect of areca nut extract in 4-nutriquinoline-1-oxide (NQO)-tumor-induced rats. Methods: Twenty-eight male Sprague-Dawley rats were divided into four groups. Group 1 served as the control group, group 2 was 4NQO-induced rats without treatment, and groups 3 and 4 were given 4NQO-tumor inducer with 500 and 1000 mg/kg BW of areca nut extract, respectively. The rats in groups 2,3, and 4 received 30 ppm of 4NQO tumor inducer in drinking water for 12 weeks. In the end, all rats were euthanized and the tongue was removed. The body, liver, kidney, heart, and lungs weights were measured. Tongue tumor volume and dysplasia lesions were analyzed. The tumor-infiltrating lymphocytes (TILs) in the tumor and stromal area were scored semi-quantitatively associating the infiltrate grade (0-3) and analyzed histologically. Results: There were significant differences in body weight loss between the initial and final phases in groups 1 and 2 (p<0.05). The areca nut at doses of 500 and 1000 mg/kg BW significantly reduced the tumor size compared with groups 1 and 2 (p<0.05). The incidence of OSCC in rats with 500 and 1000 mg/kg BW of areca nut extract after 22 weeks was 0%, but the dysplasia lesions were observed at 28.57% and 85.71%, respectively. The highest mean of stromal TILs was in group 3 and there were significant differences in stromal TILs between groups 2 and 3 (p<0.05). Conclusion: Areca nut extract exerts a chemotherapeutic activity in 4NQO-induced rats by inducing infiltrating lymphocytes in the stromal tumor area on the OSCC lesion of the tongue.
Lycium barbarum (Goji berry) mouthwash is a viable alternative to 0.2% chlorhexidine gluconate for managing chronic periodontitis: a randomized clinical trial
Authors: Sanghavi Amee , Shettigar Laasya , Chopra Aditi , Shah Ashmeet , Lobo Richard , Shenoy Padmaja A , Gadag ShivaPrasada , Nayak Usha Y , Shravya S Mangalore , Kamath Shobha Ullas , Nayak Prajna P 
Published: March 2023

Background: Removal of the microbial deposits (plaque and calculus) by performing effective scaling and root planing (SRP) is the primary and fundamental requirement for managing periodontal disease. Various adjuncts with antimicrobial, antioxidant, and anti-inflammatory properties are used as adjuncts to SRP for managing chronic periodontitis. However, with a rapid rise in antimicrobial resistance to several antimicrobial agents along with the increased risk of adverse effects, the use the conventional chemotherapeutic agents for managing periodontal disease is slowly declining. Hence, there is a urgent need to explore new plant-based products for treating periodontal disease. Lycium barbarum (L. barbarum), or goji berry, has recently gained popularity for managing chronic inflammatory and infectious diseases. However, its efficacy in managing periodontal diseases has never been explored. Hence the present study aims to evaluate the efficacy of L. barbarum mouthwash along with SRP compared to chlorhexidine for managing chronic periodontitis. Methods: The study is designed as a randomized clinical trial with 57 adult participants (Males:29; Females:28) with chronic periodontitis. The participants were divided randomly into two groups: One group used L. barbarum mouthwash and the other group used ‘0.2% chlorhexidine gluconate’ mouthwash. The changes in the gingival index (Gi), plaque index (Pi), bleeding on probing (BOP), clinical attachment loss (CAL), probing pocket depth (PPD), microbial load, and antioxidant levels (protein thiol) in saliva were noted at the baseline, at 15 days and one month. Results: A statistically significant difference was noted in the Pi (P-value = 0.791), Gi (P-value= 0.594), PPD (with P-value= 0.134), and microbial levels (P-value = 0.188) in both groups from the baseline. The protein thiol levels in saliva were increased only in the goji berry group. Conclusion: L. barbarum mouthwash along with SRP was found to be effective in managing periodontal disease.
Assessment of neonatal referral infrastructure and clinical characteristics of referred neonates in three first referral hospitals in Nairobi County, Kenya
Authors: Wainaina John , Irimu Grace , English Mike , Mbaire Emily , Waiyego Mary , Manyasi Christine , Kimutai David , Emadau Caren , Muturi Celia , Aluvaala Jalemba 
Published: March 2023

Background Almost one in five newly born babies in Nairobi County, Kenya, may need some form of inpatient neonatal care. Prior work showed many facilities are inadequately prepared to provide sick newborn care, however, only 16.6% of babies from facilities were referred to a better-equipped facility. We sought to examine referrals to and from three busy first-level referral public hospitals in Nairobi and what infrastructure and systems are available to support neonatal transport from these first-referral level hospitals to the main tertiary care center. Methods Patient-level data of newborns over 13 months were retrospectively abstracted from routinely collected patient data and examined to characterize those referred into and out of three newborn units in the study hospitals. Structural assessments using a checklist completed during hospital visits were used to describe hospitals’ readiness to support newborn referral and transport. Results Five percent (398/7720) of the cohort studied were referrals either out or to the hospitals. 68% (272/398) were referred to these hospitals. A majority (397/398) and two-thirds (268/398) of patients had their sex and gestation age documented respectively. Among both referrals in and out, 63% (251/397) were male and 44% (118/268) were preterm infants. Among those referred in, 26% (69/272) died and 2.6% (7/272) were further referred to a tertiary-care newborn unit in Nairobi County. Equipment, drugs, and medical supplies needed to provide safe in-transit care in the ambulance, including oxygen and infant warmers were unavailable. Conclusion Neonatal transport from first-referral hospitals to the tertiary center in Nairobi County is poor and likely to be unsafe for newborn transfer services. This jeopardizes their well-being and survival. There is a need to develop, equip and maintain a high-quality referral and newborn transport system which can support the continuum of newborn care across referral care pathways into and from first-referral level hospitals.
Motivos de adesão, aderência e desistência de adultos com obesidade em um programa de exercícios físicos
Authors: Streb Anne Ribeiro , Tozetto Willen Remon , Bertuol Cecília , Benedet Jucemar , Del Duca Giovani Firpo 
Published: March 2023

O estudo teve como objetivo determinar os motivos de adesão, aderência e desistência de adultos com obesidade em um programa de intervenção de exercícios físicos. Trata-se de uma estudo descritivo com 69 adultos com obesidade, os quais estiveram envolvidos em um ensaio clínico controlado. Nos grupos de exercícios físicos, as sessões continham treinamento aeróbio e de força, totalizando 60 minutos, durante 16 semanas. Os motivos de adesão, aderência e desistência foram determinados por questionário e uma análise descritiva (quanti-qualitativa) foi realizada, de acordo com a frequência em que os motivos foram relatados pelos participantes. Verificou-se baixa aderência ao treinamento, bem como altos índices de desistência. A saúde, a qualidade de vida e a estética foram os principais motivos de adesão. Para a aderência, os aspectos mais prevalentes foram a saúde, o comprometimento e à motivação. Contudo, para a desistência, trabalho e a desmotivação foram mais relatados. É importante a intervenção profissional no campo da atividade física e saúde considere estes diferentes motivos e as mudanças neles durante o processo e direcione ações a fim de aumentar a adesão e a aderência e reduzir as desistências.
Practice Summary: Seminar Assignments in a University—MATLAB-Based Decision Support
Authors: Dellnitz Andreas , Pozo Damian , Bauer Jochen , Kleine Andreas 
Published: March 2023

Universities follow a long tradition of assigning students to courses based on student preferences while taking into account constraints such as the rooms to be used. In this context, theoretical approaches aid us in developing algorithms that can be helpful in practice. Our contribution to this subject is a practice summary in which we discuss the most important findings of a project to develop a MATLAB-based stand-alone software system to solve the seminar assignment problem at the FernUniversität in Hagen, Germany. The use of our software at three departments has already enabled annual savings of nearly 20,000 euros in personnel costs, which corresponds to a reduction of around 500 person-hours per year. Apart from important technical aspects of our work, the reported savings potential provides valuable information for making decisions on future similar software projects. History: This paper was refereed.
A First-Order Primal-Dual Method for Nonconvex Constrained Optimization Based on the Augmented Lagrangian
Authors: Zhu Daoli , Zhao Lei , Zhang Shuzhong 
Published: March 2023

Nonlinearly constrained nonconvex and nonsmooth optimization models play an increasingly important role in machine learning, statistics, and data analytics. In this paper, based on the augmented Lagrangian function, we introduce a flexible first-order primal-dual method, to be called nonconvex auxiliary problem principle of augmented Lagrangian (NAPP-AL), for solving a class of nonlinearly constrained nonconvex and nonsmooth optimization problems. We demonstrate that NAPP-AL converges to a stationary solution at the rate of [Formula: see text], where k is the number of iterations. Moreover, under an additional error bound condition (to be called HVP-EB in the paper) with exponent [Formula: see text], we further show the global convergence of NAPP-AL. Additionally, if [Formula: see text], then we furthermore show that the convergence rate is in fact linear. Finally, we show that the well-known Kurdyka-Łojasiewicz property and the Hölderian metric subregularity imply the aforementioned HVP-EB condition. We demonstrate that under mild conditions, NAPP-AL can also be interpreted as a variant of the forward-backward operator splitting method in this context. Funding: This work was supported by the National Natural Science Foundation of China [Grant 71871140].
MULTILIGAMENT KNEE INJURIES: GOOD FUNCTIONAL OUTCOMES AFTER RECONSTRUCTIVE SURGERY
Authors: Smith M.B. , Silvestre S. , Leow J.M. , Hall A.J. , White T.O. 
Published: March 2023

Multiligament knee injuries (MLKI) are associated with significant morbidity and healthcare requirements. The primary aim of this study is to report the patient reported outcomes measures (PROMs) after reconstructive surgery.Patients undergoing surgery for MLKI between 2014 and 2018 in the single large-volume trauma centre were included. Electronic patient records were reviewed for demographic data, details of surgery and complications. PROMs collected were EQ-5D-5L, Lysholm Knee Score (LKS), UCLA Activity and Sport and patient satisfaction.Thirty-five patients were included. Mean age was 31 years (range 16-66), and 71% were male. The most common mechanism of injury was sports-related (71%). Obesity was present in eight (23%) patients. No vascular injuries were recorded and four patients sustained nerve injuries. PROMs were available for 18 patients (51%) with a median follow up of 4.5 years. Median EQ-5D-5L was 0.78 (IQR 0.14). Median LKS was 84.5 (IQR 21) and there was no correlation with time to surgery (p=0.43). Grade of MLKI did not impact LKS (p=0.09). Fifteen patients (83%) saw a reduction in their activity level. All patients were satisfied with their surgical treatment. Recurrent instability was noted in four patients (11%). Three patients (8%) required further surgery (one revision reconstruction, one meniscectomy, one conversion to a hinged knee replacement.This study demonstrates two groups of patients who sustain MLKI: the sporting population and obese patients. Health related quality of life, functional outcomes and satisfaction are high after surgery. Time to surgery did not impact on functional outcomes.
Assessing environmental enteric dysfunction via multiplex assay and its relation to growth and development among HIV-exposed uninfected Tanzanian infants
Authors: Lauer Jacqueline M. , Kirby Miles A. , Muhihi Alfa , Ulenga Nzovu , Aboud Said , Liu Enju , Choy Robert K. M. , Arndt Michael B. , Kou Jianqun , Fawzi Wafaie , Gewirtz Andrew , Sudfeld Christopher R. , Manji Karim P. , Duggan Christopher P. 
Published: March 2023

Background
Environmental enteric dysfunction (EED) may contribute to poor growth and development in young children. While validated EED biomarkers are currently lacking, multiplex assays are able to capture multiple domains of the condition. The purpose of this exploratory study was to examine the relationship between biomarkers of EED and subsequent growth and development among Tanzanian HIV-exposed uninfected (HEU) infants.

Methodology
We enrolled 467 infants of mothers living with HIV who had participated in a trial of vitamin D3 supplementation during pregnancy. Infant serum samples collected at 6 weeks (n = 365) and 6 months (n = 266) were analyzed for anti-flagellin and anti-lipopolysaccharide (LPS) IgA and IgG via ELISA as well as the 11-plex Micronutrient and EED Assessment Tool (MEEDAT), which incorporates two biomarkers of EED [intestinal fatty acid-binding protein (I-FABP) and soluble CD14 (sCD14)]. Outcomes were 12-month growth [length-for-age z-score (LAZ), weight-for-length z-score (WLZ), and weight-for-age z-score (WAZ)] and development [Caregiver Reported Early Development Instruments (CREDI) z-scores] and were assessed using linear regression.

Findings
In primary analyses, higher quartiles of 6-month anti-LPS IgG concentrations were significantly associated with lower LAZ at 12 months (ptrend = 0.040). In secondary analyses, higher log2-transformed 6-week anti-flagellin IgA and 6-month anti-LPS IgA concentrations were significantly associated with lower LAZ at 12 months. No associations were observed between I-FABP or sCD14 and infant growth. However, higher log2-transformed 6-week sCD14 concentrations were significantly associated with lower overall CREDI z-scores, while higher log2-transformed 6-month I-FABP concentrations were significantly associated with higher overall CREDI z-scores.

Conclusions
Unlike anti-flagellin and anti-LPS Igs, MEEDAT’s biomarkers of EED (I-FABP and sCD14) were not associated with subsequent linear growth among HEU infants in Tanzania. The relationship between EED and infant development warrants further study.
Physician burnout and symptom of anxiety and depression: Burnout in Consultant Doctors in Ireland Study (BICDIS)
Authors: Crudden Genevieve , Margiotta Fabio , Doherty Anne M. 
Published: March 2023

Background
Burnout is a work related syndrome comprising three major dimensions: emotional exhaustion, depersonalisation and reduced professional efficacy. It is recognised that burnout may be associated with psychopathological sequelae, such as symptoms of anxiety and depression.

Aims
This study aimed to examine the relationship between burnout and symptoms of depression and anxiety in senior doctors in Ireland. We examined personality traits as a mediating factor on burnout, in relation to work related stress among the participants.

Methods
This study was a national cross sectional survey of consultants. Data included basic demographic data, work-related data, burnout as measured by the Maslach Burnout Inventory, personality traits, and symptoms of depression and anxiety from the Depressive Anxiety Stress Scale [DASS].

Results
Results were obtained from 477 consultants, yielding a response rate 21.9%. Nearly half (42%) reported high burnout levels. Over one-quarter (25.8%) screened positive for depression and 13.8% for anxiety. After controlling for gender and age, depressive symptoms were associated with high levels of emotional exhaustion (p<0.001) and a higher clinical workload, and stress with cynicism and reduced professional efficacy (p<0.001).

Conclusions
The this study reported a high level of work-related burnout, associated with symptoms of depression and anxiety in senior doctors. This is concerning, and strategies are required that consider the relationship between symptoms of depression/anxiety and burnout. Further research to evaluate strategies to ensure physician wellbeing and optimal delivery of patient care are required to address this serious problem.