bluuebunny/crossref_metadata_2025_split huggingface dataset:
Relationship between nursing students’ levels of liking children and self-efficacy in paediatric medication administration
Authors: Bulduk Mehmet , Can Veysel , Muhafiz Eda Nur 
Published: November 2024

Abstract
Background
Medication management is a critical aspect of nursing, in particular with respect to paediatric patients, in whom medication errors are prevalent. Enhancing competence in this area requires not only general nursing skills but also targeted educational interventions and emotional support. This study aims to examine the relationship between nursing students’ levels of liking children and their self-efficacy in paediatric medication administration, thereby exploring the impact of emotional factors on clinical competence.

Methods
This descriptive study was conducted with 308 nursing students in their second, third and fourth years of study at a state university in eastern Turkey between December 2022 and February 2023. Data were collected using the Student Descriptive Information Form, the Barnett Liking of Children Scale and the Medication Administration Self-Efficacy Scale. Statistical analysis included the Mann–Whitney U test, the Kruskal–Wallis H test, Dunn’s test for multiple comparisons and Spearman’s rho correlation coefficient.

Results
The mean age of the participants was 21.82 ± 1.94 years, and 68.8% were female. The mean Medication Administration Self-Efficacy Scale score was 52.97 ± 15.27, and the mean Liking of Children Scale score was 66.65 ± 15.8. No significant relationship was found between the total score on the Liking of Children Scale and the score on the drug preparation subdimension (p > 0.05). However, a positive but weak correlation was found between the total score on the Liking of Children Scale and the score on the drug administration subdimension (r = 0.137; p < 0.05). Similarly, a positive but weak relationship was identified between the total score on the Liking of Children Scale and the score on the Medication Administration Self-Efficacy Scale (r = 0.123; p < 0.05).

Conclusions
Nursing students’ liking of children is positively, although weakly, associated with their self-efficacy in paediatric medication administration. This result suggests that emotional factors, such as affinity for children, may be relevant when designing nursing education programmes, particularly in paediatric care settings .
Machine learning predicts pulmonary Long Covid sequelae using clinical data
Authors: Cordelli Ermanno , Soda Paolo , Citter Sara , Schiavon Elia , Salvatore Christian , Fazzini Deborah , Clementi Greta , Cellina Michaela , Cozzi Andrea , Bortolotto Chandra , Preda Lorenzo , Francini Luisa , Tortora Matteo , Castiglioni Isabella , Papa Sergio , Sona Diego , Alì Marco 
Published: November 2024

Abstract
Long COVID is a multi-systemic disease characterized by the persistence or occurrence of many symptoms that in many cases affect the pulmonary system. These, in turn, may deteriorate the patient’s quality of life making it easier to develop severe complications. Being able to predict this syndrome is therefore important as this enables early treatment. In this work, we investigated three machine learning approaches that use clinical data collected at the time of hospitalization to this goal. The first works with all the descriptors feeding a traditional shallow learner, the second exploits the benefits of an ensemble of classifiers, and the third is driven by the intrinsic multimodality of the data so that different models learn complementary information. The experiments on a new cohort of data from 152 patients show that it is possible to predict pulmonary Long Covid sequelae with an accuracy of up to

$$94\%$$

94
%

. As a further contribution, this work also publicly discloses the related data repository to foster research in this field.
Australian general practice registrars’ billing patterns: a cross-sectional analysis from the Registrars Clinical Encounters in Training (ReCEnT) study
Authors: Fisher Katie , Tapley Amanda , Ralston Anna , Davey Andrew , Holliday Elizabeth , Dizon Jason , Wearne Susan , Fielding Alison , van Driel Mieke , Spike Neil , Clarke Lisa , Magin Parker 
Published: November 2024

Abstract
Background
In Australia, a government insurance scheme (Medicare) pays set rebates for a range of distinct general practitioner (GP) services. GPs may ‘bulk-bill’ and accept the Medicare rebate fee directly, or ‘privately-bill’ by charging the patient a higher fee that is partially reimbursed by Medicare. The billing behaviour of Australian GP registrars (trainees) and their decision to bulk- or privately-bill patients is an evidence gap. This study aimed to establish the prevalence and associations of registrars’ bulk-billing versus private-billing.

Methods
A cross-sectional analysis of data from the ReCEnT study, 2010–2021. The primary analysis used univariable and multivariable logistic regression, with the outcome factor being whether a consultation was bulk-billed versus privately-billed. The primary analysis excluded practices that universally bulk-bill or universally privately-bill all patients. A secondary analysis included all practices regardless of billing policy to provide an overall perspective of billing across the breadth of GP vocational training.

Results
For the primary analysis, 3,086 GP registrars recorded details of 316,141 consultations. Bulk-billing accounted for 61.8%, [95% CI:61.6%, 62.0%] of consultations. Significant positive associations of bulk-billing included: younger and older patient age (compared to patients aged 15–34 years, aOR 5.45; CI: [5.06, 5.87] for patients aged 0–14 years, aOR 2.36; 95% CI: [2.24, 2.49] for patients aged 65–74 years, and aOR 4.48; CI: [4.13, 4.85] for 75 years-and-older). Significant negative associations of bulk-billing included patients new to the practice (aOR 0.39; CI: [0.37, 0.41]) and patients new to the registrar (aOR 0.56; CI: [0.55, 0.58]), compared to existing patients of the registrar and practice; and practices with lesser socio-economic disadvantage (aOR 0.91; CI: [0.89, 0.93] per decile decrease in socioeconomic disadvantage). Bulk-billed consultations were positively associated with arranging patient follow-up (with the registrar aOR 1.06; CI: [1.03, 1.09]; or with another GP in the practice aOR 1.40; CI: [1.33, 1.46]).

Conclusions
Registrar billing decisions may, in part, reflect government bulk-billing incentives but our findings suggest other factors may contribute, including the provision of affordable care recognising patient need (children and elderly, and those living in areas of greater socioeconomic disadvantage) and continuity of care. Further research is needed to better understand how, and why, registrars make billing decisions.
Using a blend of oilseed meals in the diets of Nile tilapia (Oreochromis niloticus): effects on the growth performance, feed utilization, intestinal health, growth, and metabolic-related genes
Authors: Badran Ahmed A. , Magouz Fawzy I. , Zaineldin Amr I. , Abdo Safaa E. , Amer Asem A. , Gewaily Mahmoud S. , Dawood Mahmoud A.O. 
Published: November 2024

AbstractIn this study, Nile tilapia were fed a blend of oilseed meals (BOM) that includes cottonseed meal (CSM), linseed meal (LSM), sesame meal (SSM), and sunflower meal (SFM) at a ratio of 1 CSM: 1 LSM: 1 SSM: 1 SFM. Six diets were formulated where the first diet included FM and SBM as protein sources and considered the positive control diet (FM). Another five FM-free diets were formulated, where SBM was substituted with BOM and included at 0, 100, 200, 300, and 400 g/kg diet. After 90 days, the FBW, WG, and PER were markedly increased while FCR decreased by FM-based diet and BOM at 0, 100, or 200 g/kg compared to fish-fed BOM at 300, and 400 g/kg (P < 0.05). The groups treated with BOM at 100–200 g/kg demonstrated considerable impairments, followed by those treated with BOM at 300 g/kg. Furthermore, fish given BOM at 400 g/kg had significantly less intestinal histological characteristics than the other groups. The relative expression of the IGF-1, GHR1, FABP, and CCK genes were downregulated in tilapia-fed BOM at 200, 300, and 400 g/kg compared to fish-fed FM-based diet (P < 0.05). The relative cost of feed per kg fish gain showed 4.42, 7.11, 8.14, 10.32, and 8.10% reduction rates in fish-fed SBM, or BOM at 100, 200, 300, and 400 g/kg. In conclusion, dietary BOM can be incorporated in Nile tilapia diets at up to 200 g/kg without affecting growth performance or feed utilisation. High inclusion levels (300 and 400 g/kg) may impair growth performance and feed utilisation by disrupting intestinal histological characteristics and reducing expression of growth and metabolic genes (GHR1, IGF-1, FABP, and CCK) in the liver.
Low molecular weight heparin dosing regimens after total joint arthroplasty: a prospective, single-center, randomized, double-blind study
Authors: Shang Jingjing , Wang Liangliang , Gong Jinhong , Liu Xinru , Su Dan , Zhou Xindie , Wang Yuji 
Published: November 2024

Abstract
Background
Low molecular weight heparin (LMWH) has been the standard treatment for preventing venous thromboembolism after total joint arthroplasty. However, the evidence supporting specific LMWH dosing regimens is limited.

Objectives
This study assessed the efficacy and safety of three enoxaparin dosing regimens to prevent venous thromboembolism.

Methods
Participants undergoing hip or knee replacement were randomly assigned to receive 20 mg of enoxaparin 6 h postoperatively (Group A), 40 mg 6 h postoperatively (Group B), or 40 mg 12 h postoperatively (Group C). The primary outcomes included thromboembolic and major bleeding events within 3 months, while the secondary outcomes comprised ecchymosis, wound exudation, drainage volume, allogeneic red blood cell transfusion, and first postoperative day hemoglobin levels.

Results
A total of 536 patients were analyzed. The occurrence of thromboembolic events was comparably low across all groups. Group C exhibited the lowest postoperative ecchymosis rate at 19.3%, significantly less than Group A (32.8%, p = 0.004) and Group B (37.7%, p < 0.001). Ecchymosis rates were about double in Group A and 1.5 times higher in Group B compared to Group C. Significant differences were also observed in 24-hour and total postoperative drainage volumes, with Group B having higher volumes than the other groups.

Clinical trial registration
This trial was prospectively registered at the China Clinical Trials Registry (registration date: November 14, 2021; registration number: ChiCTR2100053191).

Conclusion
No significant differences in venous thromboembolism rates were seen between the tested enoxaparin dosing regimens after total joint arthroplasty. The 40 mg dose administered 12 h after surgery was associated with reduced postoperative ecchymosis and drainage volumes without an increased thrombosis risk, suggesting it is a safer and more effective option than earlier or lower dosages.

Graphical Abstract
Trauma team activation and triage of severely injured patients at one non-trauma-center hospital in Stockholm
Authors: Lapidus Oscar , Bäckström Denise , Hammarqvist Folke , Wladis Andreas , Rubenson Wahlin Rebecka 
Published: November 2024

Abstract
Background
In 2017 the Swedish public insurance company Löf published national guidelines for in-hospital trauma team activation (TTA), which are now widely adopted in Sweden. No studies have examined triage accuracy at non-trauma-center hospitals in the Stockholm trauma system since the implementation of the new TTA criteria.

Aim
To assess trauma triage accuracy at one non-trauma-center hospital in Stockholm.

Methods
3528 trauma patients treated at Södersjukhuset during 2019–2022 were acquired from the Swedish Trauma Registry (SweTrau) to calculate TTA triage accuracy. Undertriage was defined in accordance with national guidelines as patients with a New Injury Severity Score > 15 who did not prompt level 1 TTA on arrival to hospital.

Results
In total there were 849 severely injured patients during the study period, of which 2.2% (n = 19) prompted TTA level 1, corresponding to an undertriage of 98% (n = 830). Of the 849 severely injured patients, 41% (n = 348) prompted TTA level 2 whereas the remaining 57% (n = 482) prompted no TTA on arrival to hospital. There were a total of 3046 patients prompting TTA during the study period, but only 19% (n = 19) of level 1 and 12% (n = 348) of level 2 patients were severely injured, and 45% had a NISS ≤ 3.

Conclusion
Undertriage of severely injured trauma patients was 98% according to the definition specified by Swedish trauma triage guidelines, higher than reasonably acceptable. There is considerable overtriage with non-severely injured patients prompting TTA. However, the suitability of using NISS > 15 to retrospectively define the need for TTA is debatable as this does not always correlate with the fulfillment of the TTA criteria. Further investigation of adherence to trauma triage guidelines in clinical practice may be of value to improve triage accuracy in organized regional trauma systems.
Mortality in septic patients treated with short-acting betablockers: a comprehensive meta-analysis of randomized controlled trials
Authors: Alexandru Mihai-Gabriel , Niewald Patrick , Krüger Stefan , Borgstedt Rainer , Whitehouse Tony , Singer Mervyn , Rehberg Sebastian , Scholz Sean S. 
Published: November 2024

Abstract
Background
Treatment with short-acting betablockers in septic patients remains controversial. Two recent large multicenter trials have provided additional evidence on this therapeutic approach. We thus performed a meta-analysis, including the most recent data, to evaluate the potential impacts of treatment with short-acting betablockers on mortality in adult septic patients.

Methods
The data search included PubMed, Web of Science, ClinicalTrials.gov and the Cochrane Library. A meta-analysis of all eligible peer-reviewed studies was performed in accordance with the PRISMA statement. Only randomized, controlled studies with valid classifications of sepsis and intravenous treatment with short-acting betablockers (landiolol or esmolol) were included. Short-term mortality served as the primary endpoint. Secondary endpoints included effects on short-term mortality regarding patient age and cardiac rhythm.

Results
A total of seven studies summarizing 854 patients fulfilled the predefined criteria and were included. Short-term mortality as well as pooled mortality (longest period of data on mortality) was not significantly impacted by treatment with short-acting betablockers when compared to the reference treatment (Risk difference, − 0.10 [95% CI, − 0.22 to 0.02]; p = 0.11; p for Cochran’s Q test = 0.001; I2 = 73%). No difference was seen when comparing patients aged < 65 versus ≥ 65 years (p = 0.11) or sinus tachycardia with atrial fibrillation (p = 0.27). Despite statistical heterogeneity, no significant publication bias was observed.

Conclusion
Administration of short-acting betablockers did not reduce short-term mortality in septic patients with persistent tachycardia. Future studies should also provide extensive hemodynamic data to enable characterization of cardiac function before and during treatment.
Metastatic recurrence in women diagnosed with non-metastatic breast cancer: a systematic review and meta-analysis
Authors: Morgan Eileen , O’Neill Colette , Shah Richa , Langselius Oliver , Su Yaqi , Frick Clara , Fink Hanna , Bardot Aude , Walsh Paul M. , Woods Ryan R. , Gonsalves Lou , Nygård Jan F. , Negoita Serban , Ramirez-Pena Esmeralda , Gelmon Karen , Antone Nicoleta , Mutebi Miriam , Siesling Sabine , Cardoso Fatima , Gralow Julie , Soerjomataram Isabelle , Arnold Melina 
Published: November 2024

Abstract
Background
To assess proportions of metastatic recurrence in women initially diagnosed with non-metastatic breast cancer by stage at diagnosis, breast cancer subtype, calendar period and age.

Methods
A systematic search of MEDLINE and Web of Science databases (January 2010–12 May 2022) was conducted. Studies reporting the proportion of distant metastatic recurrence in women with non-metastatic breast cancer were identified and outcomes and characteristics were extracted. Risk of bias was assessed independently by two reviewers. Random-effects meta-analyses of proportions were used to calculate pooled estimates and 95% confidence intervals (CIs).

Results
193 studies covering over 280,000 patients were included in the main analysis. Pooled proportions of metastatic recurrence increased with longer median follow-up time from 12.2% (95% CI 10.5–14.0%) at 1–4 years post diagnosis, 14.3% (95% CI 12.9–15.7%) at 5–9 years to 23.3% (95% CI 20.1–26.8) at 10 years or more. Regional variation was observed with pooled estimates ranging from 11.0% (95% CI 8.5–13.7%) in Europe to 26.4% (95% CI 16.7–37.4%) in Africa (1–4 years follow-up). Proportions of recurrence were higher in studies with diagnosis before 2000 (22.2%, 95% CI 15.1–30.3) compared to studies with diagnosis from 2000 onwards (12.8%, 95% CI 11.7–14.0). At 1–4 years median follow-up, pooled proportions of metastatic recurrence were higher in women with hormone receptor negative (15.2%, 95% CI 12.0–18.7%) compared with receptor positive disease (9.6%, 95% CI 6.2–13.6%) and in women with locally advanced (33.2%, 95% CI 24.7–42.3%) relative to early disease at initial diagnosis (4.8%, 95% CI 2.5–7.8%). Proportions were higher in those under 50 years compared with 70+ years, 18.6% (95% CI 15.9–21.4%) versus 13.3% (95% CI 9.2, 18.0%), respectively. Heterogeneity was high in all meta-analyses and results should be interpreted with caution.

Conclusions
Higher proportions of metastatic recurrence in patients initially diagnosed at an advanced stage and in earlier calendar period emphasises the importance of early detection and treatment advancements. As the global number of breast cancer survivors increases, research and health policy efforts should be directed towards timely diagnosis and access to effective treatments and care.
Study registration: PROSPERO CRD42022314500.
CAFs-derived lactate enhances the cancer stemness through inhibiting the MST1 ubiquitination degradation in OSCC
Authors: Zhang Shuzhen , Wang Jingjing , Chen Yang , Liang Weilian , Liu Hanzhe , Du Ruixue , Sun Yunqing , Hu Chuanyu , Shang Zhengjun 
Published: November 2024

Abstract
Background
Cancer-associated fibroblasts (CAFs), a predominant stromal cell type in the tumor microenvironment, significantly affect the progression of oral squamous cell carcinoma (OSCC).

Results
The specific mechanisms through which CAFs influence the cancer stem cell phenotype in OSCC are not fully understood. This study explored the effects of lactic acid produced by CAFs on the cancer stem cells (CSCs) phenotype of OSCC cells. Our results demonstrated that CAFs exhibit increased glycolysis and lactic acid production. Lactic acid treatment enhances CSCs-related markers expression, sphere formation, and clonogenic ability of OSCC cells. RNA sequencing revealed that lactic acid treatment elevates Discs Large Homolog 5 (DLG5) expression and markedly affects the Hippo pathway. Further investigation revealed that DLG5 mediates the effects of lactic acid on the CSCs phenotype. DLG5 knockdown results in elevated expression of E3 ubiquitin ligase Cullin 3, which can promote the ubiquitination and degradation of MST1, but the expression of phosphorylated MST1 remains unchanged. This leads to enhanced binding of phosphorylated MST1 to YAP1, increasing YAP1 phosphorylation and activating the Hippo pathway.

Conclusion
Collectively, our findings suggest that lactic acid from CAFs promotes the CSCs phenotype in OSCC through the DLG5/CUL3/MST1 axis. Therefore, targeting lactic acid exchange between CAFs and tumor cells may provide a novel therapeutic approach to suppress the CSCs phenotype in OSCC.
Down syndrome frontal cortex layer III and layer V pyramidal neurons exhibit lamina specific degeneration in aged individuals
Authors: Alldred Melissa J. , Ibrahim Kyrillos W. , Pidikiti Harshitha , Chiosis Gabriela , Mufson Elliott J. , Stutzmann Grace E. , Ginsberg Stephen D. 
Published: November 2024

AbstractSelective vulnerability of neuronal populations occurs in both Down syndrome (DS) and Alzheimer’s disease (AD), resulting in disproportional degeneration of pyramidal neurons (PNs) affecting memory and executive function. Elucidating the cellular mechanisms underlying the selective vulnerability of these populations will provide pivotal insights for disease progression in DS and AD. Single population RNA-sequencing analysis was performed on neurons critical for executive function, prefrontal cortex Brodmann area 9 (BA9) layer III (L3) and layer V (L5) excitatory PNs in postmortem human DS and age- and sex-matched control (CTR) brains. Data mining was performed on differentially expressed genes (DEGs) from PNs in each lamina with DEGs divergent between lamina identified and interrogated. Bioinformatic inquiry of L3 PNs revealed more unique/differentially expressed DEGs (uDEGs) than in L5 PNs in DS compared to CTR subjects, indicating gene dysregulation shows both spatial and cortical laminar projection neuron dependent dysregulation. DS triplicated human chromosome 21 (HSA21) comprised a subset of DEGs only dysregulated in L3 or L5 neurons, demonstrating partial cellular specificity in HSA21 expression. These HSA21 uDEGs had a disproportionally high number of noncoding RNAs, suggesting lamina specific dysfunctional gene regulation. L3 uDEGs revealed overall more dysregulation of cellular pathways and processes, many relevant to early AD pathogenesis, while L5 revealed processes suggestive of frank AD pathology. These findings indicate that trisomy differentially affects a subpopulation of uDEGs in L3 and L5 BA9 projection neurons in aged individuals with DS, which may inform circuit specific pathogenesis underlying DS and AD.
The spatial differentiation mechanism of intangible cultural heritage and its integration with tourism development based on explainable machine learning and coupled coordination models: a case study of the Jiang-Zhe-Hu in China
Authors: Shao Dandan , Zoh KyungJin , Xie Yanzhao 
Published: November 2024

Abstract
As a vital carrier of traditional culture, Intangible Cultural Heritage (ICH) not only preserves historical value but also fosters cultural identity and confidence. This study utilizes explainable machine learning and coupled coordination models to analyze the spatial distribution and formation mechanisms of ICH resources in the Jiangsu-Zhejiang-Shanghai (Jiang-Zhe-Hu). The results indicate that (1) ICH resources in the Jiang-Zhe-Hu exhibit a clustered distribution pattern characterized by “three primary cores and two secondary cores.” The primary core areas are Shanghai, Hangzhou, and Suzhou, while the secondary core areas are Yangzhou and Nanjing. (2) Population, number of religious places, and GDP have a significant positive impact on the distribution of ICH in the Jiang-Zhe-Hu. NDVI and road mileage have relatively minor effects on ICH distribution. (3) In terms of ICH resources, Zhejiang Province overall has a higher level than Jiangsu Province, with Lishui having the highest evaluation value and the most abundant resources. Regarding the level of tourism industry development, Shanghai has the highest comprehensive evaluation value, followed by Suzhou, Nanjing, Hangzhou, Wuxi, and Changzhou, all of which have relatively high levels of tourism development. (4) According to the coupled coordination model analysis, Shanghai demonstrates the best coupling degree between ICH resources and the tourism industry, achieving a good coordination level. In Jiangsu Province, the integration of ICH resources and the tourism industry is relatively better in the southern (e.g., Nanjing, Suzhou), but there are still imbalances in development in the northern. Zhejiang Province has an overall higher degree of integration between ICH and the tourism industry compared to Jiangsu, with more balanced development. However, there is still room for improvement in the deep integration of ICH resources with the tourism industry.