bluuebunny/crossref_metadata_2025_split huggingface dataset:
A critical evaluation, challenges, and future perspectives of using artificial intelligence and emerging technologies in smart classrooms
Authors: Dimitriadou Eleni , Lanitis Andreas 
Published: February 2023

AbstractThe term "Smart Classroom" has evolved over time and nowadays reflects the technological advancements incorporated in educational spaces. The rapid advances in technology, and the need to create more efficient and creative classes that support both in-class and remote activities, have led to the integration of Artificial Intelligence and smart technologies in smart classes. In this paper we discuss the concept of Artificial Intelligence in Education and present a literature review related to smart classroom technology, with an emphasis on emerging technologies such as AI-related technologies. As part of this survey key technologies related to smart classes used for effective class management that enhance the convenience of classroom environments, the use of different types of smart teaching aids during the educational process and the use of automated performance assessment technologies are presented. Apart from discussing a variety of technological accomplishments in each of the aforementioned areas, the role of AI is discussed, allowing the readers to comprehend the importance of AI in key technologies related to smart classes. Furthermore, through a SWOT analysis, the Strengths, Weaknesses, Opportunities, and Threats of adopting AI in smart classes are presented, while the future perspectives and challenges in utilizing AI-based techniques in smart classes are discussed. This survey targets educators and AI professionals so that the former get informed about the potential, and limitations of AI in education, while the latter can get inspiration from the challenges and peculiarities of educational AI-based systems.
Successful surgical management of massive hemoretroperitoneum caused by spontaneous rupture of retroperitoneal lymph node metastases in a patient with advanced mixed germ cell tumor: a COVID-19 pandemic-related surgical challenge
Authors: Vasiliadis Konstantinos , Simou Chrysanthi , Tzotzou Anastasios , Kalinderis Nikolaos , Valoukas Dimitrios , Pazarli Elsa , Drakontaidis Paulos , Papavasiliou Christos 
Published: February 2023

Abstract
Background
Spontaneous rapture of a germ cell tumor (GCT) metastases causing massive hemoretroperitoneum in a patient without choriocarcinoma component who has not received previous systemic chemotherapy is an exceedingly rare event. In such a devastating case scenario, a high index of clinical suspicion for early diagnosis and appropriate management is crucial.

Case presentation
We report on a 25-year-old male patient with a 4-month history of orchiectomy for testicular GCT (tGCT), who presented in the emergency department with acute abdomen and hemodynamic instability. Urgent computed tomography scan depicted a retroperitoneal mass measuring approximately 13 × 11.4 × 15 cm and massive intraperitoneal hemorrhage. Hemoperitoneum caused by spontaneous rapture of the metastatic retroperitoneal mass was suspected. COVID-19 pandemic-related deviation from the oncologic surveillance standards combined with COVID-19-related patient’s emotional distress and self-neglect had led to loss of opportunity for appropriate adjuvant chemotherapy, obviously leading to the development of this devastating complication. An emergency, surgical exploration was decided. The bleeding mass was adequately exposed following a Cattell–Braasch maneuver and active bleeding was controlled by a challenging resection of approximately 80% of the lymph node mass volume. Pathological evaluation of the specimen revealed teratoma with low volume of yolk sac tumor component and extensive necrosis, findings compatible with the patient’s history. Postoperative recovery was uneventful, followed by early start of adjuvant chemotherapy. Two years after the operation the patient is doing well with no evidence of recurrent disease.

Conclusions
Massive hemoperitoneum is a devastating event that exceedingly rarely can complicate the clinical course of patients with advanced tGCT. Emergency surgical intervention is usually necessary however, sound judgement and careful surgical techniques are required for a positive and uneventful outcome. During COVID-19 pandemic, first-line medical personnel push their limits further not only to ensure health care services standards but also, to manage unpredictable, life-threatening cancer-related complications, associated with COVID-19-related deviation from appropriate oncologic surveillance and care.
Unmet need for family planning and associated factors among adolescent girls and young women in Ethiopia: a multilevel analysis of Ethiopian Demographic and Health Survey
Authors: Asmamaw Desale Bihonegn , Negash Wubshet Debebe 
Published: February 2023

Abstract
Background
Unmet need for family planning among adolescent girls and young women (AGYW) is a common cause of the low contraceptive utilization in developing countries, including Ethiopia. To address problems associated with unmet for family planning among adolescent girls and young women nationally available evidences are essential. However, there is limited evidence regarding factors associated with the unmet need for family planning among adolescent girls and young women in Ethiopia. Hence, this study aims to assess the prevalence and associated factors of unmet need for family planning among adolescent girls and young women in Ethiopia.

Methods
Our analysis was based on secondary data using the 2016 Ethiopian Demographic and Health Survey data. A total weighted sample of 1086 adolescent girls and young women was included in this study. A multi-level mixed-effect logistic regression analysis was fitted. Adjusted odds ratios with 95% confidence intervals were used to show the strength and direction of the association. Statistical significance was declared at a p-value less than 0.05.

Results
The prevalence of unmet need for family planning was 28.3% (95% CI: 25.7, 31.0). Adolescent girls and young women age 15–19 years (aOR: 2.4, 95%CI: 1.3, 4.3), household wealth quantile; poor (aOR: 5.6, 95%CI: 2.8, 11.1) and middle (aOR: 2.9, 95%CI: 1.4, 6.0), had no media exposure (aOR: 2.1, 95%CI: 1.1, 4.1), and adolescent girls and young women from developing regions (aOR: 5.1, 95%CI: 1.1, 14.5) were significantly associated with unmet need for family planning.

Conclusions
Unmet need for family planning was high among adolescent girls and young women when compared to the national average and the United Nations sphere standard of unmet need for family planning. Age, wealth quantile, media exposure, and region were significantly associated with unmet need for family planning. Hence, there is the need to implement consistently effective family planning policies among AGYW living in developing regions of Ethiopia. Moreover, Public health policies and interventions that improve the existing strategies to improve media exposure of AGYW on family planning issues and increase the wealth status of households should be designed and implemented to reduce the unmet need for family planning in Ethiopia.
Extreme dependencies and spillovers between gold and stock markets: evidence from MENA countries
Authors: Mensi Walid , Maitra Debasish , Selmi Refk , Vo Xuan Vinh 
Published: February 2023

AbstractThis study addresses whether gold exhibits the function of a hedge or safe haven as often referred to in academia. It contributes to the existing literature by (i) revisiting this question for the principal stock markets in the Middle East and North Africa (MENA) region and (ii) using the copula-quantile-on-quantile and conditional value at risk methods to detail the risks facing market participants provided with accurate information about various gold and stock market scenarios (i.e., bear, normal, bull). The results provide strong evidence of quantile dependence between gold and stock returns. Positive correlations are found between MENA gold and stock markets when both are bullish. Conversely, when stock returns are bearish, gold markets show negative correlations with MENA stock markets. The risk spillover from gold to stock markets intensified during the global financial and European crises. Given the risk spillover between gold and stock markets, investors in MENA markets should be careful when considering gold as a safe haven because its effectiveness as a hedge is not the same in all MENA stock markets. Investors and portfolio managers should rebalance their portfolio compositions under various gold and stock market conditions. Overall, such precise insights about the heterogeneous linkages and spillovers between gold and MENA stock returns provide potential input for developing effective hedging strategies and optimal portfolio allocations.
Volume embolization ratio of coiled cerebral aneurysms, does awake technique affect the results?
Authors: Eldawoody Hany A. Fikry , Aziz Mohamed Mostafa , Abouhashem Safwat 
Published: February 2023

Abstract
Background
Despite the great innovations in the neuroendovascular techniques and related materials, there are still notable percentages of recurrent cerebral aneurysms after aneurysm coiling. Aneurysm packing density is well known to affect the initial angiographic result of aneurysm embolization and has a crucial role in the stability of aneurysm obliteration. Although aneurysm coiling is commonly performed under general anesthesia, it could be performed under local anesthesia in certain circumstances.

Objective
The purpose of this study is to compare the volume embolization ratio (VER) and angiographic results of cerebral aneurysm embolization performed under local and general anesthesia.

Materials and methods
This is a retrospective cohort analysis of 20 consecutive cases of coiled cerebral aneurysms that were coiled under LA. Further, 15 cerebral aneurysm coil embolization cases have been collected from our data as matched control group.

Results
Embolization was performed under local anesthesia (Group A) in 20 patients (57.1%) and under general anesthesia (Group B) in 15 patients (42.9%). At the end of the procedure, control angiogram revealed complete obliteration in 13 patients (37.1%), while incomplete obliteration was detected in 22 patients (62.9%). The mean VER 27.9 ± 11.8 without a significant difference between both groups of the study as the VER of Group (A) was 26.05 ± 8.4 and that of Group B was 30.44 ± 15.2. Follow-up angiography at 1 year revealed complete obliteration in 17 (48.6%) of the coiled aneurysms, while incomplete obliteration was detected in 18 patients (51.4%).

Conclusions
Endovascular coiling of cerebral aneurysms under local anesthesia is a safe and feasible procedure without significant effects on the VER.
Antibiotics profile map of clinical A. baumannii strains isolated from health institutions in Turkey: a database search study and analysis of publications from 2011 to 2022
Authors: Abed Ahmed Badri , Korcan Safiye Elif , Güngör Serdar 
Published: February 2023

Abstract
Background
Acinetobacter baumannii is recognized as a major threat that causes healthcare-associated infections and causes a huge challenge to the health system worldwide. This research study was designed to detect the types and profiles of antibiotics tested against A. baumannii clinical strains in Turkey to evaluate their effectiveness and reevaluate their usage.

Main body of the abstract
The study depended on data search strategy using the online electronic database. We carried out a detailed analysis to all original research articles from 2011 to 2022 all conducted in Turkey. The study involved 91 articles and revealed about 40 antibiotics tested from 2006 to 2021 against A. baumannii with a different frequency. The more frequency antibiotics tested by health institutions in Turkey during this period included 15 antibiotics which are (Amikacin, Gentamicin, Imipenem, Meropenem, Cefoperazone–sulbactam, Ceftazidime, Cefepime, Ampicillin/sulbactam, Piperacillin, Piperacillin/tazobactam, Ciprofloxacin, Levofloxacin, Trimethoprim–Sulfamethoxazole, Colistin and Tigecycline). The frequency of resistance rate with percentage of (80–100%) shown by A. baumannii against these antibiotics was as follows (40.96%, 50.64%, 77.77%, 78.31%, 46.15%, 94.11%, 88.23%, 80.85%, 95.46%, 91.93%, 93.42%, 82.85%, 53.57%, 2.66%, 3.70%), respectively. From 2016 to 2021, an increase in resistance rates by A. baumannii against Colistin and Tigecycline was indicated noticeably. The 0% resistance rates during this period against Colistin were reported in a percentage of 16.6%, while the appearance of highly noticeable resistance (from 80 to 100 = 3.70%) against Tigecycline and the continuous elevation of resistance rates against this drug was worrisome.

Short conclusion
Stability in high resistance rates against some antibiotics for the last 10 years and the increase in resistance rates against effective antibiotics by A. baumannii should undergo for more studies and re-evaluation.
Decreasing delays in the diagnosis and treatment of rheumatoid arthritis in Brazil: a nationwide multicenter observational study
Authors: de Albuquerque Cleandro Pires , Reis Ana Paula Monteiro Gomides , Santos Ana Beatriz Vargas , Bértolo Manoel Barros , Júnior Paulo Louzada , Giorgi Rina Dalva Neubarth , Radominski Sebastião Cezar , Resende Guimarães Maria Fernanda B. , Bonfiglioli Karina Rossi , da Cunha Sauma Maria de Fátima L. , Pereira Ivânio Alves , Brenol Claiton Viegas , da Mota Licia Maria Henrique , Santos-Neto Leopoldo , Castelar Pinheiro Geraldo R. 
Published: February 2023

Abstract
Background
Management delays imply worse outcomes in rheumatoid arthritis (RA) and, therefore, should be minimized. We evaluated changes in diagnostic and treatment delays regarding RA in the last decades in Brazil.

Methods
Adults fulfilling the ACR/EULAR (2010) criteria for RA were assessed. Delays in diagnosis and treatment, and the frequencies of early management initiation within thresholds (windows of opportunity) of 3, 6, and 12 months from symptoms onset were evaluated. The Mann–Kendall trend test, chi-squared tests with Cramer’s V effect sizes and analysis of variance were conducted.

Results
We included 1116 patients: 89.4% female, 56.8% white, mean (SD) age 57.1 (11.5) years. A downward trend was found in diagnostic (tau = − 0.677, p < 0.001) and treatment (tau = − 0.695, p < 0.001) delays from 1990 to 2015. The frequency of early management increased throughout the period, with ascending effect sizes across the 3-, 6-, and 12-month windows (V = 0.120, 0.200 and 0.261, respectively). Despite all improvements, even in recent years (2011–2015) the diagnostic and treatment delays still remained unacceptably high [median (IQR): 8 (4–12) and 11 (5–17) months, respectively], with only 17.2% of the patients treated within the shortest, 3-month window.

Conclusion
The delays in diagnosis and treatment of RA decreased during the last decades in Brazil. Improvements (effect sizes) were greater at eliminating extreme delays (≥ 12 months) than in attaining really short management windows (≤ 3 months). Very early treatment was still an unrealistic goal for most patients with RA.
The association between comorbid body dysmorphic disorder and depression: moderation effect of age and mediation effect of body mass index and body image among Pakistani students
Authors: Haider Arsalan , Wei Zhang , Parveen Shagufta , Mehmood Arshad 
Published: February 2023

Abstract
Background
American Psychological Association defined body dysmorphic disorder as being obsessed with observed (preoccupied) flaws in one’s appearance. The observed flaws cause ample distress and/or worsening in the quality of life, isolation, lessening in social or professional functioning, while also being linked to depression and attempt suicide. Generally, younger individuals are more displeased and anxious about defects that can be seen or unseen. The study aimed to explore the predictive role of body mass index and body image in the relationship between comorbid body dysmorphic disorder and depressive symptoms among adults. A cross-sectional study used self-report measures; for depression, body apperception, and body dysmorphic disorder scale were administered to 281 undergraduate and post-graduate adults of Hazara division, Khyber Pakhtunkhwa, Pakistan, consisting male (54.80%) and women (45.19%).

Results
Results indicated that body dysmorphic disorder was positively associated with body image and negatively with depression. As males are prone to stressors in Pakistani society, stressors overwhelm them more than females (Cohen’s d = .436). On body mass index categories, depression, age, and gender were substantially different in three categories. Structural equation modeling evidenced that body dysmorphic disorder indirectly predicts depression when age is used as a moderator and mediation effect of body mass index.

Conclusions
It is concluded that body dysmorphic disorder is prevalent at a younger age, overweight and underweight among adults. Therefore, the complexity of body dysmorphic disorder and its similarity with body image can be better understood within the specific context. The potential implication is it make easy to understand for the researchers and mental health care practitioners.
Pulmonary embolism presenting as delirium: an acute confusional state in an elderly patient—a case report
Authors: Ahaneku Chidimma A. , Akpu Benard B. , Njoku Chibueze H. , Elem David E. , Ekeng Bassey E. 
Published: February 2023

Abstract
Background
Large numbers of elderly patients are admitted to hospitals in acute confusional states. In many, the underlying causes are easily found; in some, correct diagnosis is difficult. Pulmonary embolism (PE), the most serious clinical presentation of venous thromboembolism, is often misdiagnosed because of its non-specific features including delirium.

Case presentation
A 73-year-old woman was admitted to our hospital in a confused state with no obvious risk factors of PE. D-dimer levels were elevated and contrast-enhanced high-resolution computed tomography (HRCT) of the chest confirmed the diagnosis of PE. She was treated with enoxaparin and discharged on dabigatran. Her symptoms had resolved at the time of discharge, and she has been stable for over three month’s follow-up visit.

Conclusion
PE should be regarded as a differential in elderly patients with an acute confusional state despite the absence of obvious risk factors. Investigating for and treating when confirmed may save a life.
Autism: social care, reasonable adjustments and the personal passport
Authors: Tromans Samuel , Stewart Zandrea , Brugha Traolach 
Published: February 2023

SUMMARYAutism is a neurodevelopmental condition associated with differences in social communication and interaction, as well as a restricted, repetitive repertoire of behaviours and interests. Autistic people will have areas of interest and can possess abilities that are of potential benefit to both themselves and wider society. However, many find that their opportunities are limited. Here, we will discuss how a social model of care can help meet the needs of autistic people.
miR-223 Plays a Key Role in Obesogen-Enhanced Adipogenesis in Mesenchymal Stem Cells and in Transgenerational Obesity
Authors: Chang Richard C , Joloya Erika M , Li Zhuorui , Shoucri Bassem M , Shioda Toshi , Blumberg Bruce 
Published: February 2023

Abstract
Exposure of pregnant F0 mouse dams to the obesogen tributyltin (TBT) predisposes unexposed male descendants to obesity and diverts mesenchymal stem cells (MSCs) toward the adipocytic lineage. TBT promotes adipogenic commitment and differentiation of MSCs in vitro. To identify TBT-induced factors predisposing MSCs toward the adipocytic fate, we exposed mouse MSCs to TBT, the peroxisome proliferator activated receptor gamma (PPARγ)-selective agonist rosiglitazone, or the retinoid X receptor (RXR)-selective agonist LG-100268. Then we determined their transcriptomal profiles to determine candidate microRNAs (miR) regulating adipogenic commitment and differentiation. Of the top 10 candidate microRNAs predicted by Ingenuity Pathway Analysis, miR-21, miR-33, and miR-223 were expressed consistent with an ability to differentially regulate target genes during adipogenesis. We found that 24-hour exposure to 50nM TBT caused miR-223 levels in MSCs to increase; expression of its target genes ZEB1, NFIB, and FOXP1 was decreased. Rosiglitazone and TBT increased miR-223 levels. This induction was inhibited by the PPARγ antagonist T0070907 but not by the RXR antagonists HX531 or UVI3003, placing miR-223 downstream of PPARγ. Chromatin immunoprecipitation confirmed TBT-induced binding of PPARγ to regulatory elements in the miR-223 promoter. miR-223 levels were elevated in white adipose tissue of F2 and F3 male descendants of pregnant F0 mouse dams exposed to 50nM TBT throughout gestation. miR-223 levels were potentiated in males fed an increased fat diet. We infer that TBT induced miR-223 expression and increased adipogenesis in MSCs through the PPARγ pathway and that transgenerationally increased expression of miR-223 plays an important role in the development of obesity caused by TBT exposure.
Altered Expression of Several Molecular Mediators of Cerebrospinal Fluid Production inHypMice
Authors: Kaplan Jared , Tommasini Steven , Yao Gang-Qing , Zhu Meiling , Nishimura Sayoko , Ghazarian Sevanne , Louvi Angeliki , Insogna Karl 
Published: February 2023

AbstractContextX-linked hypophosphatemia (XLH) is a genetic disease, causing life-long hypophosphatemia due to overproduction of fibroblast growth factor 23 (FGF23). XLH is associated with Chiari malformations, cranial synostosis, and syringomyelia. FGF23 signals through FGFR1c and requires a coreceptor, α-Klotho, which is expressed in the renal distal convoluted tubules and the choroid plexus (ChP). In the ChP, α-Klotho participates in regulating cerebrospinal fluid (CSF) production by shuttling the sodium/potassium adenosine triphosphatase (Na+/K+-ATPase) to the luminal membrane. The sodium/potassium/chloride cotransporter 1 (NKCC1) also makes a substantial contribution to CSF production.ObjectiveSince CSF production has not been studied in XLH, we sought to determine if there are changes in the expression of these molecules in the ChP of Hyp mice, the murine model of XLH, as a first step toward testing the hypothesis that altered CSF production contributes to the cranial and spinal malformations seen this disease.MethodsSemi-quantitative real-time PCR was used to analyze the level of expression of transcripts for Fgfr1c, and thee key regulators of CSF production, Klotho, Atp1a1 and Slc12a2. In situ hybridization was used to provide anatomical localization for the encoded proteins.ResultsReal-time polymerase chain reaction (RT-PCR) demonstrated significant upregulation of Klotho transcripts in the fourth ventricle of Hyp mice compared to controls. Transcript levels for Fgfr1c were unchanged in Hyp mice. Atp1a1 transcripts encoding the alpha-1 subunit of Na+/K+-ATPase were significantly downregulated in the third and lateral ventricles (LV). Expression levels of the Slc12a2 transcript (which encodes NKCC1) were unchanged in Hyp mice compared to controls. In situ hybridization (ISH) confirmed the presence of all 4 transcripts in the LV ChP both of WT and Hyp mice.ConclusionThis is the first study to document a significant change in the level of expression of the molecular machinery required for CSF production in Hyp mice. Whether similar changes occur in patients with XLH, potentially contributing to the cranial and spinal cord abnormalities frequently seen in XLH, remains to be determined.