bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the psychological profile: A cross-sectional study of 1185 pulmonary nodules patients in the out-patient clinic
Authors: Zhuang Weitao , Wu Junhan , Xu Haijie , Deng Cheng , Li Shaopeng , Tian Dan , Ben Xiaosong , Xu Wei , Tang Yong , Qiao Guibin 
Published: May 2022

Abstract
Purpose
To identify the potential risk or protective factors for psychological burdens in patients with pulmonary nodules (PNs) and to explore how the patients’ psychological status affect their treatment preferences.
Methods
This questionnaire-based study evaluated 1185 out-patients using the Hospital Anxiety and Depression Scale (HADS) and explored the correlations between psychological burdens and their sociodemographic and clinical characteristics.
Results
Prevalence of anxiety and depression was 42.1% and 27.0%, respectively, among patients with PNs. Binary logistic regression analysis revealed that age ≥ 60 years (OR = 0.57, 95% CI = 0.36–0.89), CT scan due to physical discomfort (OR = 1.58, 95% CI = 1.11–2.24), multiple PNs (OR = 1.60, 95% CI = 1.26–2.04), family history of malignancy (OR = 1.29, 95% CI = 1.02–1.64), and subjective symptoms (OR = 1.73, 95% CI = 1.35–2.22) were independent influencing factors of anxiety, while CT scan due to physical discomfort (OR = 1.46, 95% CI = 0.96–2.23), multiple PNs (OR = 1.71, 95% CI = 1.27–2.31), subjective symptoms (OR = 1.71, 95% CI = 1.24–2.34) and indeterminate nodules (OR = 2.02, 95% CI = 1.08–3.77) were independently associated with depression. There was a tendency for patients with anxiety and depression to choose more aggressive management strategies (P༜0.001 and P = 0.001, respectively).Univariate analysis showed that symptomatic patients (χ2 = 9.696, p = 0.021) and those with progressive nodules (χ2 = 18.198, p = 0.033) choose more aggressive treatment strategies.
Conclusion
Anxiety and depression are common in patients with pulmonary nodules, which might result in nonnegligible overtreatment. The presence of subjective symptoms can significantly exacerbate the psychological burden and influence the treatment preference. Taking psychological issue into consideration in outpatient clinic might facilitate the patient-centered communication and promote judicious decision-making.
The prevalence and subtype distribution of Blastocystis sp. in humans and domestic animals in family units in Heilongjiang Province, China
Authors: Chen Hongshuang , Hao Yaru , Liu Yuqing , Xu Mingqi , Liu Aqin , Zhang Weizhe , Li He , Yang Fengkun 
Published: May 2022

Abstract
Background: Blastocystis is an enteric protozoan infecting humans and animals all over the world. Domestic animals play an important role in transmitting parasites to other domestic animals and humans. In the present study, a survey was conducted on Blastocystis among humans and domestic animals sharing habitats in northeastern China’ s Heilongjiang Province, in order to investigate the prevalence, the subtype distribution, as well as to evaluate the risk of the zoonotic transmission of Blastocystis isolates.Methods: A total of 314 (57 humans, 257 domestic animals) fecal samples were collected from 33 family households in three villages. The corresponding sequences of the barcode region of the SSU rRNA gene obtained in this study were subject to molecular analysis for subtype and allele identification of Blastocystis sp.Results: The prevalence of Blastocystis was 14.0% (8/57) in humans and 17.9% (46/257) in domestic animals. Eight PCR-positive human samples, 100% (8/8) were successfully subtyped, allowing the identification of the ST3, followed by ST1 and ST2. The 46 PCR-positive animal samples, 65.2% (30/46) were successfully subtyped, ST5 followed by ST1 in pigs, ST5 in goats; ST10, ST14 followed by ST3 in cattle; ST7 in chickens. Phylogenetic analysis showed that Blastocystis ST3 sequences from humans in two geographical locations formed two distinct clades. Alleles were identified using the Blastocystis 18S database and a total of 10 different alleles were found in six STs.Conclusions: The present study is the first description of the prevalence and subtype (allele) distribution of Blastocystis sp. by molecular analysis in humans and domestic animals in family units in China. Blastocystis ST2 in humans and ST5 in goats were reported in Heilongjiang Province for the first time. ST1 (a4) and ST3 (a34) overlaps were observed in humans and some domestic animal species (pig and cattle). The findings of potentially zoonotic subtypes in domestic animals suggest that these animals may serve as reservoirs of human Blastocystis sp. infections, thus help develop more efficient, targeted control strategies against human blastocystosis.
Efficacy of immune checkpoint inhibitors in post-TKI NSCLC patients harboring EGFR-mutations
Authors: Sun Si , Duan Chunyan , Yu Songxia , Zhang Qiao , Xu Nana , Hu Xingjiang , Yu Hui 
Published: May 2022

Abstract
Objective: Immune checkpoint inhibitors (ICIs) have been validated in epidermal growth factor receptor (EGFR) wild-type advanced non-small cell lung cancer (NSCLC) patients. However, there exists no evidence regarding EGFR-mutated NSCLC patients, especially in EGFR-TKI (tyrosine kinase inhibitor) treatment failure. To address this, we collected clinical information from two cohorts and conducted a time series-based meta-analysis to determine the efficacy and safety of ICIs in patients harboring EGFR mutations.Methods: Two cohorts of 22 NSCLC patients with EGFR mutations were selected from two different hospitals. The treatment strategies and main clinical outcomes were collected and further analyzed. Meanwhile, Pubmed, Embase, and Cochrane Library were searched for relevant literature published until December 31, 2021. Endpoint outcomes included mortality and progression-free survival (PFS) at different times of follow-up. Survival rates and curve data were pooled for further analysis. To detect the data heterogeneity, subgroup analyses were conducted according to treatment strategies. Results: The two cohorts showed that the median PFS was 2.3 months (range, 1.3~6 months); and in ICI+Chemotherapy, the median PFS was 5 months (range, 0.75~9 months) (Log rank P = 0.037). Fifteen studies, including 4 trials, 10 controlled cohorts, and 1 real-world study were assessed, involving a total of ICI-treated NSCLC patients with EGFR mutation after TKI failure. The 6-month survival rate and PFS were 0.71 (95%CI: 0.62~0.78) and 0.53 (95%CI: 0.23~0.81), respectively. ICI+chemotherapy showed the best survival outcome among these groups, as demonstrated by the 12-month survival rate and PFS. Conclusions: ICI therapy may be associated with an improved prognosis of patients with EGFR mutation, especially when combined with chemotherapy. Nevertheless, current research presented a limited data size. Multicenter randomized trials are required validate ICI-based therapies for better outcome of patients harboring EGFR mutation.
Initial Misdiagnosis and Subsequent Disastrous Events in an Adult with Neurofibromatosis Type I Complicated by Vascular Involvement
Authors: Pan Ruonan , Duan Lijun , Lu Xiaoqian , Cao Dianbo 
Published: May 2022

Abstract
Background: Neurofibromatosis type 1(NF1) is a hereditary neurocutaneous syndrome caused by the mutation in NF1 gene with a very low incidence. Neurofibroma, Café-au-lait spot and osseous deformity are the most common clinical findings, however, uncommon vascular involvement in NF1 is the second most common cause of mortality following after malignancy.Case presentation: We report a patient with NF1 who suffered a rupture of his internal thoracic artery aneurysm and subclavian artery branch aneurysm in the setting of an intact extracranial vertebral artery aneurysm, which was ever mistaken for neurofibroma and subsequently underwent right brachial plexus nerve bundle separation due to conspicuous pain of his right upper arm and hand.Conclusions: This case highlights synchronous multiple aneurysms of NF1 presenting with life-threatening aneurysm rupture after surgery. Contrast-enhanced CT precisely defines its location and anatomic relationship with adjacent organs. Additionally, endovascular treatment has become the mainstay for vascular lesions or aneurysm rupture in those patients with NF1.
Evaluation of Quality Of Life in Endometriosis Patients Before and After Surgical Treatment Using the EHP30 Questionnaire
Authors: Tiringer Denise , Pedrini Alexandra , Gstöttner Manuela , Husslein Heinrich , Küssel Lorenz , Perricos Alexandra , Wenzl René 
Published: May 2022

Abstract
Background: Endometriosis is one of the most common gynaecological illnesses causing extensive psychological, physical and social impact on patient´s life and exerts negative effects on health-related quality of Life (HRQoL). However, the effects of surgery on the postoperative HRQoL in the different endometriosis subgroups have not been fully evaluated.Methods: We performed a comparative retrospective study between 2014 and 2018 at the Medical University of Vienna, including all patients with surgically confirmed endometriosis who had completed the standardized Endometriosis Health Profile - 30 (EHP-30) questionnaire one day after surgery (the questions refer to the four weeks preoperatively) and six to ten weeks postoperatively. Results: Compared to preoperative values, we found significant benefits, regarding postoperative conditions, in our study group (n=115) in all five categories, “pain” (HR 0.78, p<0.001); “self-determination” (HR 0,92, p<0.001); “emotional health” (HR 0,83, p<0.001);” social environment” (HR 0,67, p<0.001); and “self-image” (HR 0,47, p<0,001). Patients with only peritoneal endometriosis had the lowest preoperative clinical symptoms and there were no significant changes in any of the categories. In the subgroups deep infiltrating endometriosis (DIE) and DIE + ovarian endometrioma, surgical intervention results in a significantly greater improvement in all categories of EHP 30 compared to ovarian endometrioma without DIE or peritoneal endometriosis.Conclusion: Our study shows, that especially women with DIE - with or without ovarian endometrioma - demonstrate a more pronounced benefit from surgical therapy compared to patients with peritoneal endometriosis or endometrioma without DIE.
Assessment of ICT-based Tools in the Teaching and Learning of Fine and Applied Arts in Colleges of Education in North-Central Nigeria
Authors: Ifeanyi Christopher Ibenegbu , Angu Bih Juliet 
Published: May 2022

Abstract
The study assessed the ICT-based tools in the teaching and learning of fine and applied arts in colleges of education in North Central Nigeria. Three research questions and two hypotheses were formulated for the study. The population comprised 109 respondents. A sample size of 69 respondents was used for the study. A structured questionnaire of 0.77 reliability was used for data collection. Data collected were analyzed using Mean and t-test. Results showed that the majority (71.0%) of the ICT tools itemized were available in colleges of education, and they are; computer sets, video cameras, digital cameras, camcorders, PowerPoint presentation packages, magic boards, overhead projectors, internet connections, open reed projector, among others. Of the ICT tools available, only 41.7% were used in the teaching of fine and applied arts in the various colleges. The study found that instructors’ poor ICT proficiency affected the utilization of ICT-based tools in the teaching of fine and applied arts in colleges of education. t-test analysis on the responses of lecturers from state and federal colleges of education on the availability of ICT-based tools, their utilization and lecturers’ proficiency of ICT-based tools in the teaching of fine and applied arts did not detect significant differences at p < 0.05. The paper recommends that education authorities should periodically, through workshops, conferences and seminars, retrain the trainers in fine and applied arts in colleges of education to update them on the recent developments in information and communication technology.
Nucleation of Th-rich cerianite on halloysite surface in a regolith-hosted rare earth elements deposit in South China
Authors: Cui Xiangjie , Liu Huan , Lu Xiancai , Li Juan , Chen Jiani , Chan Ting-Shan , Liu Xiandong , Wang Rucheng 
Published: May 2022

AbstractThe ion-adsorption rare earth element (REE) deposit, a valuable type of REE deposit, has been thought to be derived from the release and enrichment of REE during granite weathering. Understanding the REE occurrence in regolith-hosted deposits is crucial for more efficient extraction. We investigated a weathering granite profile of a regolith-hosted REE deposit located in South China. X-ray diffraction (XRD) and X-ray absorption near edge structure (XANES) analysis of the clay fractions reveal that the highest Ce(IV) content located in intensely weathered layers and cerianite nanoparticles (CeNPs) can be observed, besides invisible adsorbed REEs. Interestingly, most of the CeNPs scatter on halloysite basal surface and exhibit preferred orientation. Detailed analysis demonstrates that the diagonal plane of cerianite matches with the exposed basal surfaces (Si-O tetrahedron) of halloysite. Such a lattice match may contribute to the nucleation and growth of CeNPs after oxidation of the adsorbed Ce(III), which results in great REE enrichment by clays. The findings provide new insight into the mechanism of Ce precipitation and REE mineralization during granite weathering.
Ultrasonic studies of alkali-rich hydrous silicate glasses: Elasticity, density, and implications for water dissolution mechanisms
Authors: Liu Bohan , Liu Qiong , Li Baosheng , Behrens Harald , Lange Rebecca A. 
Published: May 2022

AbstractThe acoustic velocities of three series of alkali-rich hydrous silicate glasses were determined at ambient conditions using ultrasonic interferometry. The sound velocities and calculated elastic properties are nearly linear functions of dissolved water content. The water content derivatives of both compressional [d(VP)/d(XH2O)] and shear wave velocity [d(VS)/d(XH2O)] decrease with increasing Na2O content, which suggests that increasing sodium content might weaken the effect of water on acoustic velocities. For each glass series, the shear modulus decreases with increasing water content, whereas the adiabatic bulk modulus (KS) varies little with water content. By comparing our results of KS to previously published data on hydrous alkalic (rhyolite, phonolite, and trachyte) glasses, we speculate that H2O may have a negligible effect on the compressibility of alkalic glasses/melts. The measured densities of each series of glasses were converted to molar volumes and extrapolated to the hypothetical pure water component to derive the partial molar volume of water (VH2O). The resulting VH2O at room pressure and temperature was found to be independent of composition for the three series of glasses, with a value of 10.4 ± 0.5 cm3/mol, whereas the partial molar bulk modulus (KS) of water is composition-dependent, suggesting that VH2O may depend on composition at elevated pressures. Furthermore, the Poisson’s ratio (ν) increases linearly with increasing water content for all three composition series. Therefore, the similar behavior of Al-free and Al-bearing glasses implies that water depolymerizes melts in both systems. The decrease of water content derivative of the Poisson’s ratio [d(ν)/d(XH2O)] with increasing Al/(Al+Si) indicates that water interaction with Al-O bonds to produce Al-OH depolymerizes peralkaline silicate melts less effectively than with Si-O bonds to form Si-OH. Hence, we speculate that water prefers to interact with Si-O bonds rather than Al-O bonds in peralkaline silicate systems. The dissolution mechanisms of water between peraluminous and peralkaline melts might be different, which merits further research.
Understanding Design Approaches and Evaluation Methods in mHealth Apps Targeting Substance Use: Protocol for a Systematic Review
Authors: Kunchay Sahiti , Linden-Carmichael Ashley N , Lanza Stephanie T , Abdullah Saeed 
Published: May 2022

Background
Substance use and use disorders in the United States have had significant and devastating impacts on individuals and communities. This escalating substance use crisis calls for urgent and innovative solutions to effectively detect and provide interventions for individuals in times of need. Recent mobile health (mHealth)–based approaches offer promising new opportunities to address these issues through ubiquitous devices. However, the design rationales, theoretical frameworks, and mechanisms through which users’ perspectives and experiences guide the design and deployment of such systems have not been analyzed in any prior systematic reviews.

Objective
In this paper, we systematically review these approaches and apps for their feasibility, efficacy, and usability. Further, we evaluate whether human-centered research principles and techniques guide the design and development of these systems and examine how the current state-of-the-art systems apply to real-world contexts. In an effort to gauge the applicability of these systems, we also investigate whether these approaches consider the effects of stigma and privacy concerns related to collecting data on substance use. Lastly, we examine persistent challenges in the design and large-scale adoption of substance use intervention apps and draw inspiration from other domains of mHealth to suggest actionable reforms for the design and deployment of these apps.

Methods
Four databases (PubMed, IEEE Xplore, JMIR, and ACM Digital Library) were searched over a 5-year period (2016-2021) for articles evaluating mHealth approaches for substance use (alcohol use, marijuana use, opioid use, tobacco use, and substance co-use). Articles that will be included describe an mHealth detection or intervention targeting substance use, provide outcomes data, and include a discussion of design techniques and user perspectives. Independent evaluation will be conducted by one author, followed by secondary reviewer(s) who will check and validate themes and data.

Results
This is a protocol for a systematic review; therefore, results are not yet available. We are currently in the process of selecting the studies for inclusion in the final analysis.

Conclusions
To the best of our knowledge, this is the first systematic review to assess real-world applicability, scalability, and use of human-centered design and evaluation techniques in mHealth approaches targeting substance use. This study is expected to identify gaps and opportunities in current approaches used to develop and assess mHealth technologies for substance use detection and intervention. Further, this review also aims to highlight various design processes and components that result in engaging, usable, and effective systems for substance use, informing and motivating the future development of such systems.

International Registered Report Identifier (IRRID)
DERR1-10.2196/35749
“Paradise Lost” and Epic Tradition
Authors: Di Cesare Mario A. 
Published: May 2022

ABSTRACT
To study epic tradition is to study not “influences” (which may serve to buttress preconceived notions) but rather the ways in which major poets modified the tradition. Such study can be a way into meaning, particularly in poems as complex as the Aeneid and Paradise Lost. In both poems, the epic strategy relies on modification in the catalogue and battle conventions. In Vergil's catalogue (Book VII), language and imagery embody the conflict which informs the whole poem, arma-virum. The battle scenes (IX, X) develop this conflict. On both the Latin and the Trojan side, strategy fails and bloodlust triumphs. Aeneas’ rampage (X) climaxes the ascendancy of power over justice (or fortitudo over sapientia). In Paradise Lost, in the catalogue and Mulciber passages of Book I, syntax and imagery develop the theme of specious identity; in II and IV, Milton exploits the potential of epic battle, then deliberately aborts the battle with modified “recognition scenes.” The War in Heaven develops the fortitudo-sapientia motif. But it is only in the love to which Michael firmly leads Adam's understanding (XII) that fortitudo and sapientia are reconciled.
Written Records and Truths of Spirit in “Paradise Lost”
Authors: Hardison O. B. 
Published: May 2022

ABSTRACT
Milton considered scripture (“written records pure”) man's fundamental source of truth. His fundamentalism is qualified by the belief that scripture must be read in the light of the Spirit and that the truth reveals itself in different ways to different readers. Hence his treatment of Creation in Book VII departs emphatically from the surface meaning of the biblical account. There is a strong suggestion that Creation is begun by a sexual impregnation of unformed matter, followed by an organic, almost evolutionary development of the visible world. The development completes itself in man, whose sexuality in Book IV is the culmination of a motif that begins with the initial impregnation of Chaos by the Spirit. Milton's view is similar to views found in Philo Judaeus, the pseudo-Dionysius, and several Renaissance Platonists. It illustrates the latitude of interpretation permitted those who read scripture in the light of the Spirit.
Milton's Uncouth Swain
Authors: Baker Stewart A. 
Published: May 2022

ABSTRACT
The redemptive vision of Lycidas depends upon the imaginative qualities implicit in the pastoral speaker, Milton's “uncouth swain.” The swain's youth indicates his ingenuous and reductive point of view. The theme of youthful friendship explores the origins of his Orphic sensibility and prophetic vision. While tracing his growth into the roles of poet and prophet, his style through its range and variety reflects the evolution of pastoral into a comprehensive and encyclopedic form. The swain's voice unifies the diverse modes of pastoral by translating the images of naturalistic and libertine pastoral into the symbols of Christian pastoral, and by employing a principle of inverse reduction, as defined by J. C. Scaliger. The unity of his style expresses itself as an orderly continuum of stylistic levels within a single stylistic mode, as illustrated by Scaliger's analysis of the low, middle, and high styles within the florid mode. This unity of the swain's style, voice, and vision within a comprehensive form of pastoral provides a structural and stylistic model, as well as a thematic paradigm, for the speakers of Milton's epics.
Milton's Samson and the Jewish Tradition
Authors: Stollman Samuel S. 
Published: May 2022

ABSTRACT
Milton's Samson is significantly different from the Samson of Jewish tradition. The rabbinic interpretation depicts Samson as a sensualist, but one who observed the Law by converting Dalila to Judaism before marrying her. His passion for Philistine women was punished by “an eye [blinding] for an eye” (sensuality). Milton's Samson, on the other hand, is guided by “intimate impulse,” associated with “right reason” and the “law of nature,” rather than Mosaic Law. He married Dalila in her gentile state (contrary to the Law). His sin was the failure of reason, and led to the loss of liberty. He is regenerated when he recovers his reason. His fellow Israelites, however, are depicted as bound by the Mosaic Law and as incapable of comprehending the import of freedom. Milton did not borrow from the Rabbis; his organizing principle in Samson Agonistes is his antinomian view of the Mosaic Law. Milton reads the Mosaic Law as superseded by reason—equated with liberty—with Samson as the Old Testament precursor of Christian liberty.