bluuebunny/crossref_metadata_2025_split huggingface dataset:
Health professionals’ acceptance of mobile-based clinical guideline application in a resource-limited setting: using a modified UTAUT model
Authors: Demsash Addisalem Workie , Kalayou Mulugeta Hayelom , Walle Agmasie Damtew 
Published: June 2024

Abstract
Introduction
Clinical guidelines are crucial for assisting health professionals to make correct clinical decisions. However, manual clinical guidelines are not accessible, and this increases the workload. So, a mobile-based clinical guideline application is needed to provide real-time information access. Hence, this study aimed to assess health professionals’ intention to accept mobile-based clinical guideline applications and verify the unified theory of acceptance and technology utilization model.

Methods
Institutional-based cross-sectional study design was used among 803 study participants. The sample size was determined based on structural equation model parameter estimation criteria with stratified random sampling. Amos version 23 software was used for analysis. Internal consistency of latent variable items, and convergent and divergent validity, were evaluated using composite reliability, AVE, and a cross-loading matrix. Model fitness of the data was assessed based on a set of criteria, and it was achieved. P-value < 0.05 was considered for assessing the formulated hypothesis.

Results
Effort expectancy and social influence had a significant effect on health professionals’ attitudes, with path coefficients of (β = 0.61, P-value < 0.01), and (β = 0.510, P-value < 0.01) respectively. Performance expectancy, facilitating condition, and attitude had significant effects on health professionals’ acceptance of mobile-based clinical guideline applications with path coefficients of (β = 0.37, P-value < 0.001), (β = 0.44, P-value < 0.001) and (β = 0.57, P-value < 0.05) respectively. Effort expectancy and social influence were mediated by attitude and had a significant partial relationship with health professionals’ acceptance of mobile-based clinical guideline application with standardized estimation coefficients of (β = 0.22, P-value = 0.027), and (β = 0.19, P-value = 0.031) respectively. All the latent variables accounted for 57% of health professionals’ attitudes, and latent variables with attitudes accounted for 63% of individuals’ acceptance of mobile-based clinical guideline applications.

Conclusions
The unified theory of acceptance and use of the technology model was a good model for assessing individuals’ acceptance of mobile-based clinical guidelines applications. So, enhancing health professionals’ attitudes, and computer literacy through training are needed. Mobile application development based on user requirements is critical for technology adoption, and people’s support is also important for health professionals to accept and use the application.
Factors influencing fatigue, mental workload and burnout among Chinese health care workers during public emergencies: an online cross-sectional study
Authors: Xiong Qian , Luo Feng , Chen Yue , Duan Yi , Huang Jie , Liu Hong , Jin Pengjuan , Li Rong 
Published: June 2024

Abstract
Objectives
The purpose of this study was to investigate fatigue, mental workload, and burnout among health care workers (HCWs) and explore the possible underlying factors.

Materials and methods
An online cross-sectional survey design was used to collect data from HCWs in Chongqing, China. The online survey included the Fatigue Severity Scale, NASA Task Load Index, and Chinese version of the Maslach Burnout Inventory-General Survey to assess fatigue, mental workload, and burnout, respectively, and was conducted from February 1 to March 1, 2023.

Results
In this study, the incidence of fatigue and burnout among HCWs was 76.40% and 89.14%, respectively, and the incidence of moderate to intolerable mental workloads was 90.26%. Work–family conflict, current symptoms, number of days of COVID-19 positivity, mental workload, burnout and reduced personal accomplishment were significantly associated with fatigue. Mental workload was affected by fatigue and reduced personal accomplishment. Furthermore, burnout was influenced by marital status and fatigue. Moreover, there was a correlation among mental workload, fatigue, and burnout.

Conclusions
Fatigue, mental workload and burnout had a high incidence and were influenced by multiple factors during COVID-19 public emergencies in China.
The relationship between organizational support, professional quality of life, decent work, and professional well-being among nurses: a cross-sectional study
Authors: Zheng Jie , Feng Shengya , Gao Rong , Gong Xiaoyan , Ji Xinyu , Li Yuling , Wang Xiangli , Xue Bowen 
Published: June 2024

AbstractBackgroundNurses often face challenges such as inadequate welfare protection, injustice, and workplace adversity including violence, bullying, and sexual harassment. In this context, providing sufficient support to nurses is crucial for the promotion of their professional well-being. This study examines the direct and indirect effects of perceived organizational support on nurses’ well-being, particularly highlighting the mediating roles of professional quality of life and the perception of decent work.MethodsA cross-sectional survey design was employed in this study. Convenience sampling was used to survey 792 nurses from five tertiary A-grade hospitals in Shanxi Province in January 2024. Data collection tools included a custom demographic survey, the Perceived Organizational Support Scale, Professional Quality of Life Scale, Decent Work Perception Scale, and Nurse Occupational Well-being Questionnaire. Descriptive statistics, correlation analysis, and mediation effect analyses were performed.ResultsThe findings demonstrate that perceived organizational support has a direct impact on nurses’ occupational well-being (β = 0.323,p < 0.001). Additionally, professional quality of life and the perception of decent work play chain mediating roles between perceived organizational support and nurses’ well-being (β = 0.019, BootLLCI = 0.010, BootULCI = 0.030).ConclusionsThis study highlighted the importance of organizational support in enhancing nurses’ well-being. Professional quality of life and decent work were key mediators. Healthcare institutions should prioritize support measures to improve nurses’ well-being. Future research should explore additional mediators and mechanisms to develop effective strategies for nursing policymakers and administrators.
Advancing arrhythmia education through the CDIO approach: a new paradigm in nursing student training
Authors: Chen Yu , Wen Heling , Huang Zheng , Zhang Rui , Peng Lei 
Published: June 2024

Abstract
Background
The accurate diagnosis and effective management of arrhythmias are crucial, with nurses playing a key role in the early detection and treatment, significantly impacting patient outcomes. Improving education on arrhythmias among nurses, especially in critical care and perioperative settings, can enhance patient safety and the quality of care.

Methods
A total of 116 trainee nurses were randomly divided into two groups: one utilizing the conceive-design-implement-operate (CDIO) model and the other employing a traditional lecture-based learning (LBL) method, to undergo arrhythmia training. The studyassessed the effects of the two teaching methods and investigated the students’ attitudes toward these educational practices, with all participants completing pre- and post-course tests.

Results
The CDIO model significantly enhances nursing students’ arrhythmia proficiency, yielding higher test scores and sustained improvement after 24-week compared to the traditional LBL method, alongside markedly better self-learning enthusiasm, understanding, satisfaction with the teaching approach and effectiveness, and interest in learning arrhythmia. The CDIO model in nursing arrhythmia courses boosts theoretical knowledge and application, showing potential in clinical skill enhancement.

Conclusions
Our study introduces the CDIO model in nursing arrhythmia courses, with improvement in knowledge and skills, and promise for broader application.
Association of maternal ultra-processed food consumption during pregnancy with atopic dermatitis in infancy: Korean Mothers and Children’s Environmental Health (MOCEH) study
Authors: Jang Won , Kim Minji , Ha Eunhee , Kim Hyesook 
Published: June 2024

Abstract
Background
Maternal diet during pregnancy might influence the development of childhood allergic disorders. There are few studies on the association between processed food intake and infant atopic dermatitis (AD) during pregnancy. The aim of the present study was to investigate the association of ultra-processed food (UPF) intake during pregnancy with infantile AD.

Methods
This study involved 861 pairs of pregnant women and their offspring from the Mothers’ and Children’s Environmental Health (MOCEH) study, a multi-center birth cohort project conducted in Korea. Dietary intake was estimated using a 24-h recall method at 12−28 weeks gestation. The NOVA classification was used to identify UPF, and UPF intake was calculated as the percentage of total energy consumption and categorized into quartiles. Infantile AD was assessed based on medical history and the criteria of the International Study of Asthma and Allergies in Childhood (ISAAC). Associations were assessed by logistic regression with adjustment for confounding factors.

Results
Children born to mothers in the highest quartile of UPF consumption (15.5% or more of the total energy) compared to the lowest quartile (6.8% or less) showed a higher risk of AD within 12 months [odds ratio (OR) = 1.69; 95% confidence interval (CI): 1.07−2.66, P for trend 0.0436]. After adjustment for the confounding factors under study, the association was strengthened; the adjusted OR between extreme quartiles was 2.19 (95% CI: 1.11–4.32, P for trend = 0.0418). This association was maintained even after an additional adjustment based on the Korean Healthy Eating Index (KHEI), an indicator of diet quality.

Conclusions
Higher maternal consumption of UPF during pregnancy was associated with a greater risk of infantile AD within the first year of life.
Magnesium malate-modified calcium phosphate bone cement promotes the repair of vertebral bone defects in minipigs via regulating CGRP
Authors: Xu Hailiang , Tian Fang , Liu Youjun , Liu Renfeng , Li Hui , Gao Xinlin , Ju Cheng , Lu Botao , Wu Weidong , Wang Zhiyuan , Zhu Lei , Hao Dingjun , Jia Shuaijun 
Published: June 2024

AbstractActive artificial bone substitutes are crucial in bone repair and reconstruction. Calcium phosphate bone cement (CPC) is known for its biocompatibility, degradability, and ability to fill various shaped bone defects. However, its low osteoinductive capacity limits bone regeneration applications. Effectively integrating osteoinductive magnesium ions with CPC remains a challenge. Herein, we developed magnesium malate-modified CPC (MCPC). Incorporating 5% magnesium malate significantly enhances the compressive strength of CPC to (6.18 ± 0.49) MPa, reduces setting time and improves disintegration resistance. In vitro, MCPC steadily releases magnesium ions, promoting the proliferation of MC3T3-E1 cells without causing significant apoptosis, proving its biocompatibility. Molecularly, magnesium malate prompts macrophages to release prostaglandin E2 (PGE2) and synergistically stimulates dorsal root ganglion (DRG) neurons to synthesize and release calcitonin gene-related peptide (CGRP). The CGRP released by DRG neurons enhances the expression of the key osteogenic transcription factor Runt-related transcription factor-2 (RUNX2) in MC3T3-E1 cells, promoting osteogenesis. In vivo experiments using minipig vertebral bone defect model showed MCPC significantly increases the bone volume fraction, bone density, new bone formation, and proportion of mature bone in the defect area compared to CPC. Additionally, MCPC group exhibited significantly higher levels of osteogenesis and angiogenesis markers compared to CPC group, with no inflammation or necrosis observed in the hearts, livers, or kidneys, indicating its good biocompatibility. In conclusion, MCPC participates in the repair of bone defects in the complex post-fracture microenvironment through interactions among macrophages, DRG neurons, and osteoblasts. This demonstrates its significant potential for clinical application in bone defect repair.
Diagnosis and treatment status of inoperable locally advanced breast cancer and the application value of inorganic nanomaterials
Authors: Wu Linxuan , He Chuan , Zhao Tingting , Li Tianqi , Xu Hefeng , Wen Jian , Xu Xiaoqian , Gao Lin 
Published: June 2024

AbstractLocally advanced breast cancer (LABC) is a heterogeneous group of breast cancer that accounts for 10–30% of breast cancer cases. Despite the ongoing development of current treatment methods, LABC remains a severe and complex public health concern around the world, thus prompting the urgent requirement for innovative diagnosis and treatment strategies. The primary treatment challenges are inoperable clinical status and ineffective local control methods. With the rapid advancement of nanotechnology, inorganic nanoparticles (INPs) exhibit a potential application prospect in diagnosing and treating breast cancer. Due to the unique inherent characteristics of INPs, different functions can be performed via appropriate modifications and constructions, thus making them suitable for different imaging technology strategies and treatment schemes. INPs can improve the efficacy of conventional local radiotherapy treatment. In the face of inoperable LABC, INPs have proposed new local therapeutic methods and fostered the evolution of novel strategies such as photothermal and photodynamic therapy, magnetothermal therapy, sonodynamic therapy, and multifunctional inorganic nanoplatform. This article reviews the advances of INPs in local accurate imaging and breast cancer treatment and offers insights to overcome the existing clinical difficulties in LABC management.
Graphical Abstract
Mitochondrial GCN5L1 acts as a novel regulator for iron homeostasis to promote sorafenib sensitivity in hepatocellular carcinoma
Authors: Hu Xiuya , Zhang Peiyu , Li Sai , Zhang Jiaqi , Wang Danni , Wang Zihan , Zhu Lu , Wang Lingdi 
Published: June 2024

Abstract
Background
Sorafenib resistance is becoming increasingly common and disadvantageous for hepatocellular carcinoma (HCC) treatment. Ferroptosis is an iron dependent programmed cell death underlying the mechanism of sorafenib. Iron is crucial for synthesis of cofactors essential to mitochondrial enzymes and necessary for HCC proliferation, while mitochondrial iron overload and oxidative stress are associated with sorafenib induced ferroptosis. However, the crosstalk among iron homeostasis and sorafenib resistance is unclear.

Methods
We conducted bioinformatics analysis of sorafenib treated HCC datasets to analyze GCN5L1 and iron related gene expression with sorafenib resistance. GCN5L1 deleted HCC cell lines were generated by CRISPR technology. Sorafenib resistant HCC cell line was established to validate dataset analysis and evaluate the effect of potential target.

Results
We identified GCN5L1, a regulator of mitochondrial acetylation, as a modulator in sorafenib-induced ferroptosis via affecting mitochondrial iron homeostasis. GCN5L1 deficiency significantly increased sorafenib sensitivity in HCC cells by down-regulating mitochondrial iron transporters CISD1 expression to induce iron accumulation. Mitochondrial iron accumulation leads to an acceleration in cellular and lipid ROS. Sorafenib resistance is related to CISD1 overexpression to release mitochondrial iron and maintaining mitochondrial homeostasis. We combined CISD1 inhibitor NL-1 with sorafenib, which significantly enhanced sorafenib-induced ferroptosis by promoting mitochondrial iron accumulation and lipid peroxidation. The combination of NL-1 with sorafenib enhanced sorafenib efficacy in vitro and in vivo.

Conclusions
Our findings demonstrate that GCN5L1/CISD1 axis is crucial for sorafenib resistance and would be a potential therapeutic strategy for sorafenib resistant HCC.
Completion of tuberculosis preventive therapy and associated factors among clients on antiretroviral therapy at Debre Berhan town health facilities, North Shoa Zone, Ethiopia
Authors: Tegegnework Alebachew Zewdu , Aemiro Muluken Tessema , Bilchut Awraris Hailu , Mekuria Abinet Dagnaw , Yehualashet Sisay Shewasinad 
Published: June 2024

Abstract
Background
Tuberculosis preventive therapy is vital in caring for HIV-positive individuals, as it prevents the progression from latent tuberculosis infection to tuberculosis disease. The aim of the study is to assess the completion of tuberculosis preventive therapy and associated factors among clients receiving antiretroviral therapy in Debre Berhan town, Ethiopia, in 2022.

Method
Institutional based cross sectional study was conducted. Random sampling methods were used to select both study participants and health facilities. Both bivariate and multivariate logistic regression analyses were performed. P-values less than 0.05 were statistically significant.

Result
The study found that, 83% of participants were completed tuberculosis preventive therapy. Completed tuberculosis preventive therapy was associated with no adverse drug events, taking first-line ART, and good ART adherence.

Conclusion
According to the Ethiopian ART guidelines, the study found a low completion rate of tuberculosis preventive therapy among HIV-positive clients on antiretroviral therapy. Factors like no adverse drug events, first-line antiretroviral regimen, and good adherence were significantly associated with completing tuberculosis preventive therapy.
A feedback loop driven by H3K9 lactylation and HDAC2 in endothelial cells regulates VEGF-induced angiogenesis
Authors: Fan Wei , Zeng Shuhao , Wang Xiaotang , Wang Guoqing , Liao Dan , Li Ruonan , He Siyuan , Li Wanqian , Huang Jiaxing , Li Xingran , Liu Jiangyi , Li Na , Hou Shengping 
Published: June 2024

AbstractBackgroundVascular endothelial growth factor (VEGF) is one of the most powerful proangiogenic factors and plays an important role in multiple diseases. Increased glycolytic rates and lactate accumulation are associated with pathological angiogenesis.ResultsHere, we show that a feedback loop between H3K9 lactylation (H3K9la) and histone deacetylase 2 (HDAC2) in endothelial cells drives VEGF-induced angiogenesis. We find that the H3K9la levels are upregulated in endothelial cells in response to VEGF stimulation. Pharmacological inhibition of glycolysis decreases H3K9 lactylation and attenuates neovascularization. CUT& Tag analysis reveals that H3K9la is enriched at the promoters of a set of angiogenic genes and promotes their transcription. Interestingly, we find that hyperlactylation of H3K9 inhibits expression of the lactylation eraser HDAC2, whereas overexpression of HDAC2 decreases H3K9 lactylation and suppresses angiogenesis.ConclusionsCollectively, our study illustrates that H3K9la is important for VEGF-induced angiogenesis, and interruption of the H3K9la/HDAC2 feedback loop may represent a novel therapeutic method for treating pathological neovascularization.
Robust coherent and incoherent statistics for detection of hidden periodicity in models with non-Gaussian additive noise
Authors: Żuławiński Wojciech , Antoni Jerome , Zimroz Radosław , Wyłomańska Agnieszka 
Published: June 2024

AbstractWe address the issue of detecting hidden periodicity when the signal exhibits periodic correlation, but is additionally affected by non-Gaussian noise with unknown characteristics. This scenario is common in various applications. The conventional approach for identifying periodically correlated (PC) behavior involves the frequency domain-based analysis. In our investigation, we also employ such an approach; however, we use a robust version of the discrete Fourier transform incorporating the Huber function-based M-estimation, unlike the classical algorithm. Building upon this approach, we propose robust coherent and incoherent statistics originally designed to identify hidden periodicity in pure PC models. The novelty of this paper lies in introducing robust coherent and incoherent statistics through the application of the robust discrete Fourier transform in classical algorithms and proposing a new technique for period estimation based on the proposed methodology. We explore two types of PC models and two types of additive noise, resulting in PC signals disturbed by non-Gaussian additive noise. Detecting hidden periodicity in such cases proves to be significantly more challenging than in classical scenarios. Through Monte Carlo simulations, we demonstrate the effectiveness of the proposed robust approaches and their superiority over classical. To further substantiate our findings, we analyze three datasets in which hidden periodicity had previously been confirmed in the literature. Among them, two datasets correspond to the condition monitoring area, being a main motivation of our research.
Synergy of LIDAR and hyperspectral remote sensing: health status assessment of architectural heritage based on normal cloud theory and variable weight theory
Authors: Guo Ming , Shang Xiaoke , Zhao Jiawei , Huang Ming , Zhang Ying , Lv Shuqiang 
Published: June 2024

Abstract
Architectural heritage health assessment is the basis of scientific repair and maintenance. However, existing methods do not adequately take into account the fuzziness, randomness and uncertainties unique to architectural heritage assessment. In this paper, a new evaluation model of VM-NCM is constructed by combining variable weight theory and normal cloud model theory. The model enables the combination of qualitative ratings and quantitative calculation, deals with the fuzziness in the assessment process, and resolves the randomness and reflects the uncertainty to a certain extent. Based on constructing the index system combining qualitative and quantitative indexes, the structural index values are acquired by the synergistic coupling of the fine laser point cloud model and finite element structural analysis model. The acquisition of surface index values is completed by the hyperspectral intelligent detection technology of surface materials and diseases. These reduce the generation of ambiguous information in the index detection process. An evaluation study is conducted using the Yingxian wooden pagoda in China as an example. The results show that this method takes into account the fuzziness and randomness in the evaluation process, and obtains more scientific and reliable evaluation results, which provides a research paradigm for assessing the architectural heritage health status.
Examining the roles of spiritual motivation, religiosity, and L2 WTC in English
Authors: Sarwari Kawita , Pishghadam Reza , Shayesteh Shaghayegh 
Published: June 2024

AbstractRecognizing the importance of students’ attitudes in enhancing their educational achievements, this study aimed to examine the roles of spiritual motivation, religiosity, and L2 WTC (Willingness to Communicate) in students’ English language achievements. The study aimed to create a scale to assess students’ spiritual motivation. Additionally, it scrutinized the relationship between spiritual motivation, religiosity, and L2 WTC. The data was collected from 194 students (97 males; 97 females) coming from both social and non-social sciences who completed three questionnaires: spiritual motivation, religiosity, and L2 WTC scales. Descriptive and inferential statistics were obtained using SPSS (Statistical Package for Social Sciences), and AMOS (Analysis of a Moment Structure). The analysis confirmed that both spiritual motivation and religiosity scales have reliable psychometric properties. SEM (Structural Equation Modeling) also revealed that spiritual motivation and religiosity are positively associated with L2 WTC. However, neither of the dependent variables emerged as predictors of English language acquisition. Notably, when mediated by spiritual motivation, SEM revealed that religiosity can predict L2 WTC. The study concludes with a discussion of the results and implications for research.