bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of clinicopathological and prognostic features of breast cancer patients younger than 40 years and older than 65 years
Authors: Culha Yaşar , Davarci Sena Ece , Ünlü Beyza , Özaşkin Duygu , Demir Hacer , Baykara Meltem 
Published: April 2024

Abstract
Purpose
This study aims to compare the clinicopathological and prognostic features of women aged 40 years and younger and 65 years and older with breast cancer.

Methods
Between January 2011 and December 2021, 136 female cases aged 40 years and younger and 223 female cases aged 65 and over were identified among all cases (1395 cases) registered as breast cancer in the file archives of Afyonkarahisar Health Sciences University Faculty of Medicine, Department of Medical Oncology for the study. A Chi-square (× 2) test was used for categorical variables, and an independent sample t-test for continuous variables. Log-rank test and Kaplan–Meier plots were used for survival analysis. For the statistical evaluation, p < 0.05 was considered significant.

Results
Both overall survival (p < 0.01) and breast cancer-specific survival (BCSS) (p = 0.01) were significantly worse in the older group. BCSS were significantly worse in the older group in Luminal B (HER2−) (p = 0.013) and HR− HER2+ (p = 0.015) subtypes detected. In multivariate Cox regression analysis, only the presence of metastases at diagnosis or follow-up (p < 0.001) and ECOG PS 2–3 status (p = 0.001) were associated with an increased risk of breast cancer-specific death.

Conclusion
To our knowledge, no study directly compares these two groups. In our study, similar to many studies, more aggressive tumor features were found in young patients, but unlike many studies, mortality was found to be significantly higher in older patients. The presence of metastasis and poor ECOG PS were found to be the most influential factors in breast cancer-specific death risk.
The Emergency Medical Team Operating System — a vision for field hospital data management in following the concepts of predictive, preventive, and personalized medicine
Authors: Gaebel Jan , Schreiber Erik , Neumuth Thomas 
Published: April 2024

AbstractIn times where sudden-onset disasters (SODs) present challenges to global health systems, the integration of predictive, preventive, and personalized medicine (PPPM / 3PM) into emergency medical responses has manifested as a critical necessity. We introduce a modern electronic patient record system designed specifically for emergency medical teams (EMTs), which will serve as a novel approach in how digital healthcare management can be optimized in crisis situations. This research is based on the principle that advanced information technology (IT) systems are key to transforming humanitarian aid by offering predictive insights, preventive strategies, and personalized care in disaster scenarios. We aim to address the critical gaps in current emergency medical response strategies, particularly in the context of SODs. Building upon a collaborative effort with European emergency medical teams, we have developed a comprehensive and scalable electronic patient record system. It not only enhances patient management during emergencies but also enables predictive analytics to anticipate patient needs, preventive guidelines to reduce the impact of potential health threats, and personalized treatment plans for the individual needs of patients. Furthermore, our study examines the possibilities of adopting PPPM-oriented IT solutions in disaster relief. By integrating predictive models for patient triage, preventive measures to mitigate health risks, and personalized care protocols, potential improvements to patient health or work efficiency could be established. This system was evaluated with clinical experts and shall be used to establish digital solutions and new forms of assistance for humanitarian aid in the future. In conclusion, to really achieve PPPM-related efforts more investment will need to be put into research and development of electronic patient records as the foundation as well as into the clinical processes along all pathways of stakeholders in disaster medicine.
A novel reservoir classification method for sandstone reservoir evaluation using multi-scale digital rock method
Authors: Chen Ming , Gao Yongde , Wang Guanqun , Shao Haipeng , Chen Feifei , Long Wei 
Published: April 2024

AbstractThe formulation of an effective development plan, optimizing exploitation efficiency, relies heavily on accurate reservoir characterization. However, existing reservoir classification methodologies, which rely on macroscopic geological observations and well-logging data, have limitations in data availability and fail to capture micro-scale pore structure characteristics accurately. The emerging technology of digital rock, widely employed in the petroleum industry, also faces challenges in accurately capturing reservoir heterogeneity due to its single-scale nature and limited application for reservoir classification. To overcome these challenges, this study presents an innovative reservoir classification approach based on the multi-scale digital rock method. This approach integrates qualitative assessment of micro-CT images for particle contact relationships and pore types with quantitative evaluation of multi-scale characteristic parameters, obtained from micro-CT and scanning electron microscopy (SEM) images. The proposed classification method demonstrates excellent agreement with the prioritization of development and production data for offshore sandstone reservoirs. By establishing a robust evaluation methodology, this classification method facilitates exploration potential assessment and development strategy optimization within the field.
Dynamic livelihoods, gender and poverty in marine protected areas: Case study from Zanzibar, Tanzania
Authors: Pike Felicity , Lindström Lars , Ekstedt Josefin , Jiddawi Narriman S. , de la Torre-Castro Maricela 
Published: April 2024

AbstractLivelihood initiatives are common within marine protected areas (MPAs) aiming for poverty alleviation or higher income opportunities. However, results can be mixed in reality, as well as change over time. Furthermore, who benefits is a key consideration, as results can vary based on inequalities, including gender. Here, the monetary outcomes of different livelihood strategies were investigated across three MPA regions in Zanzibar, Tanzania. Using a quantitative approach, the results show that livelihoods have shifted in a six-year period, with livelihood strategies differing in poverty incidence and income. Livelihood initiatives, namely seaweed farming and tourism, did not provide significantly higher monetary returns compared to long-standing livelihoods, such as fisheries. Seaweed farming showed income stability but a high poverty incidence predominantly within women-headed households. During the study period, men primarily remained in fisheries, whilst women shifted to small-scale businesses and fisheries, largely exiting seaweed farming. This underscores a need for adaptive, gender sensitive management within fast changing coastal contexts.
Fatigue and failure behaviour of friction welded steel joints under normal and shear stresses
Authors: Baumgartner Jörg , Uhlenberg Lorenz , Trommer Frank , Hesse Ann-Christin , Köhler Markus , Dilger Klaus 
Published: April 2024

AbstractRotary friction welding is a fast and efficient joining process with the possibility to join materials that are not weldable by conventional GMAW-processes. If done properly, the welds have a static and fatigue strength higher than the base material. However, in literature, there exists only sparse information on the design and assessment of these joints in terms of fatigue. The fatigue strength of two material combinations, S355-S355 and S355-1.4301, is investigated based on two specimen conditions, (1) with flash and (2) with flash mechanically removed. In the majority of tests, failure occurred outside the weld zone, in the base material. The derived endurable nominal stresses are compared to the design S-N curve of conventionally welded specimens and show a more than 50% higher fatigue strength.
Supervised Versus Unsupervised Exercise for the Improvement of Physical Function and Well-Being Outcomes in Older Adults: A Systematic Review and Meta-analysis of Randomized Controlled Trials
Authors: Gómez-Redondo Paola , Valenzuela Pedro L. , Morales Javier S. , Ara Ignacio , Mañas Asier 
Published: April 2024

Abstract
Background
Unsupervised exercise intervention (UNSUP) appears to be a practical and beneficial strategy for older adults, although its feasibility and effectiveness compared to supervised exercise intervention (SUP) remains unknown. We aimed to compare the safety, attendance/adherence rates, and effectiveness of SUP versus UNSUP on physical function and well-being outcomes in older adults.

Methods
A systematic search was conducted in PubMed, Web of Science, CINAHL, SPORTDiscus, and APA PsycINFO up to September 2022 for randomized controlled trials comparing SUP versus UNSUP in older adults (≥ 60 years). Safety and attendance/adherence rates were registered as indicators of feasibility, and meta-analyses were performed for physical function and well-being outcomes. Sub-analyses were performed for those studies that applied a similar intervention in both groups and for those studies where participants performed ≥ 66% of the sessions in the assigned condition.

Results
Thirty-four studies were included (n = 2830). No serious adverse events were reported, with similar attendance rates (81%) for both SUP and UNSUP. Compared with UNSUP, SUP induced significant higher benefits on knee extension strength (standardized mean difference (SMD) = 0.18, p = 0.002), sit-to-stand test (STS, SMD = 0.25, p = 0.050), timed-up-and-go test (TUG, SMD = 0.21, p = 0.035), usual gait speed (SMD = 0.29, p = 0.026), lean mass (mean difference = 1.05 kg, p < 0.001) and health-related quality of life (HRQoL, SMD = 0.21, p = 0.035), albeit only knee extension strength remained significant in sensitivity analyses. Sub-analyses revealed superior benefits of SUP on knee extension strength when only considering those studies that applied a similar intervention in both SUP and UNSUP groups. However, no significant benefits were found for the remaining outcomes. Beneficial effects of SUP over UNSUP were also observed for knee extension strength, STS, functional reach test, TUG, usual gait speed, lean mass, and HRQoL when separately analyzing those studies in which participants performed ≥ 66% of the sessions in the assigned condition.

Conclusions
Current evidence suggests that both SUP and UNSUP programs are safe and could exert benefits on physical function and HRQoL. However, despite being associated with similar attendance rates, SUP might offer some additional benefits, although further high-quality research (i.e., accounting for confounding factors such as presence of supervised sessions in UNSUP or vice versa, as well as equating the exercise dose) is necessary to confirm these findings.

PROSPERO Registration Number
CRD42022326420.
Plasma neurological biomarkers as a measure of neurotoxicity in pediatric dental general anesthesia: a prospective observational feasibility study
Authors: Chakithandy S. , Nazzal H. , Matoug-Elwerfelli M. , Narasimhan S. , Uddin S. , Prabhu K. S. , Zarif L. , Mumtaz N. , Sharma A. , Al-Khelaifi M. 
Published: April 2024

Abstract
Purpose
Neurotoxicity concerns have been raised over general anesthesia and sedation medication use in children. Such concerns are largely based on animal studies, historical anesthetic agents, and assessment tools, thus warranting further investigations. Blood biomarkers in detecting neuronal inflammation and apoptosis are novel methods for detecting neuronal damage. Therefore, the aim of this feasibility study was to assess the usefulness of the levels of four plasma biomarkers in dental general anesthesia (DGA) as surrogate markers of neurotoxicity in children. The secondary aim was to compare changes in motor manipulative skills pre- and post-anesthetic exposure.

Methods
This single-center prospective observational study included 22 healthy children aged between 3 and 6 years old who underwent DGA. Subclinical neurotoxicity was measured with a panel of four plasma biomarkers: Caspase-3, neuron-specific enolase (NSE), neurofilament light chain, and S100B at three time points (1; at start, 2; end and 3; on recovery from DGA). The Skillings–Mack test was used to identify the difference in the biomarker levels at three time points. Motor manipulative score assessment, prior and two weeks after DGA was also performed.

Results
A total of 22 study participants (mean age = 5 ± 1 years) were included with a median DGA duration of 106 ± 28 min. A reduction in Caspase-3 levels was recorded, with pairwise comparison over three time points, reporting a statistical significance between time point 2 vs. 1 and time point 3 vs. 1. Although fluctuations in NSE levels were recorded, no significant changes were found following pairwise comparison analysis. Among other biomarkers, no significant changes over the three periods were recorded. Furthermore, no significant changes in manipulative motor scores were reported.

Conclusion
Caspase-3 reduced significantly in the short time frames during day-care DGA; this might be due to the relatively short anesthesia duration associated with dental treatment as compared with more extensive medical-related treatments. Therefore, further studies on Caspase-3 as a potential biomarker in pediatric DGA neurotoxicity are required to further ascertain results of this study.
Mechanism of cross-level settlements and void accumulation of wide and conventional sleepers in railway ballast
Authors: Nabochenko Olga , Sysyn Mykola , Krumnow Norman , Fischer Szabolcs 
Published: April 2024

AbstractThe cross-level and twist irregularities are the most dangerous irregularity types that could cause wheel unloading with the risk of derailments and additional maintenance expenses. However, the mechanism of the irregularities initiation and development is unclear. The motivation of the present study was the previous experimental studies on the application of wide sleepers in the ballasted track. The long-term track geometry measurements with wide sleepers show an enormous reduction of the vertical longitudinal irregularities compared to the conventional track. However, wide sleepers had higher twist and cross-section level irregularities. The present paper aims to explain the phenomenon by discrete element method (DEM) modeling the development process of sleeper inhomogeneous support at cross-level depending on the sleeper form. The DEM simulations show that the maximal settlement intensity is up to 3.5 times lower for a wide sleeper in comparison with the conventional one. Nevertheless, the cross-level differential settlements are almost the same for both sleepers. The particle loading distribution after all loading cycles is concentrated on the smaller area, up to the half sleeper length, with fully unloaded zones under sleeper ends. Ballast flow limitation under the central part of the sleeper could improve the resilience of wide sleepers to the development of cross-level irregularities. The mechanism of initiation of the cross-level irregularity is proposed, which assumes the loss of sleeper support under sleeper ends. The further growth of inhomogeneous settlements along the sleeper is assumed as a result of the interaction of two processes: ballast flow due to dynamic impact during void closing and on the other side high pressure due to the concentration of the pressure under the middle part of the sleeper. The DEM simulation results support the assumption of the mechanism and agree with the experimental studies.
A large-scale multi-attribute group decision-making method with R-numbers and its application to hydrogen fuel cell logistics path selection
Authors: Cheng Rui , Fan Jianping , Wu Meiqin , Seiti Hamidreza 
Published: April 2024

AbstractThe large-scale multi-attribute group decision-making (LSMAGDM) problem has become a hot research topic in the field of decision science. An R-numbers large-scale multi-attribute group decision-making (R-LSMAGDM) model is proposed to be constructed in this paper based on the advantages of R-numbers in capturing risks. First, the most commonly used clustering method, k-means, is introduced to determine the sub-groups. Then, a new sub-group weighting determination model is constructed by considering sub-group size and sub-group entropy. Next, we also build an optimized consensus-reaching model by improving the calculation method of the mean value. Then, the R-numbers weighted Hamy mean (RNWHM) operator is proposed to aggregate the sub-group information. In addition, the logarithmic percentage change-driven objective weighting (LOPCOW) method and the compromise ranking of alternatives from distance to ideal solution (CRADIS) method are used for attribute weighting calculation and alternative ranking, respectively. Finally, the effectiveness of the model is verified by an application example of hydrogen fuel cell logistics path selection.
The Anticipatory, Short-Term, and Long-Term Effects of Parental Separation and Parental Death on Adolescent Delinquency
Authors: Kroese Janique , Bernasco Wim , Liefbroer Aart C. , Rouwendal Jan 
Published: April 2024

AbstractStudies investigating the role of single-parent families in adolescent delinquency have seldom differentiated between types of single-parent families. Furthermore, they have typically assumed that parental disruption is a discrete event marking an abrupt change between dual-parenthood and single-parenthood. Using Dutch longitudinal population register data, we estimated fixed-effects panel models to assess (1) whether the event of parental disruption, either by parental separation or by parental death, increases subsequent adolescent delinquency and (2) whether parental disruption, either by parental separation or by parental death, has anticipatory, immediate, or delayed effects on adolescent delinquency. Our results showed that both parental separation and parental death seem to boost adolescent delinquency, and we found no difference between these types of single-parent families. However, when distinguishing between anticipatory, short-term, and long-term effects, we found a short-term increase in adolescent delinquency after a parental separation and an anticipatory reduction in adolescent delinquency before a parental death. Future research should pay more attention to diversity in the composition of single-parent families, as well as to the anticipatory, short-term, and long-term consequences.
How Do We Flip Our Language Classroom? Reassessing the Flipped Method
Authors: Gondra Ager , Aguiló-Mora Francisca 
Published: April 2024

AbstractThis study has a twofold purpose. First, from an action research approach, the study re-visits how the flipped method is implemented in a Spanish Second Language program at a United States university, and contributes to the literature on the potential benefits and challenges when adopting the flipped method in Second Language programs. Through the analysis of data obtained from a questionnaire, which consists of an agreement-based survey and open-ended questions, we report on how participants and co-researchers—261 Spanish language students and 11 teachers—are affected by the outcomes of this pedagogical implementation. Participants report three benefits and three areas for improvement. Second, based on students and teachers’ experiences, we conclude with a re-assessment of the method and a set of recommendations for language educators interested in integrating the flipped method in their teaching. This study contributes to the ongoing debate about the effects of a flipped classroom in language learning, and proposes a reevaluation of the most common applications of the flipped method.
Enhancing the Phytoextraction of Cd, Cu, Pb, and Zn by Portulaca oleracea in a Heavily Contaminated Soil Using Low Molecular Weight Organic Substances: Is Phytoremediation Viable?
Authors: Thalassinos Georgios , Levizou Efi , Rinklebe Jörg , Shaheen Sabry M. , Vasileios Antoniadis 
Published: April 2024

AbstractPhytoremediation can be accelerated if contaminated soils are amended with releasing agents. We tested four such materials, citric acid (CA), EDTA, oxalic acid (OA), and tartaric acid (TA) at two doses, 20 and 40 mmol kg−1, amended in a pot experiment to a heavily contaminated soil cultivated with purslane (Portulaca oleracea). We found that Cd extracted with DTPA remained unchanged in all treatments compared to the control except for the treatment of added EDTA at 40 mmol kg−1 (“EDTA-40”). Similar was the case with Cu, Pb, and Zn. As a consequence, Cd in the aboveground plant material increased significantly from 1.21 (control) to 3.84 at EDTA-40 and 3.55 at EDTA-20 (mg kg−1). Similar was the case with all other metals, with Pb exhibiting an impressive fivefold increase to 280.35 mg kg−1 at EDTA-40 from the control. We conclude that EDTA was the most successful releasing agent among those tested, especially for Pb and Zn. However, we come to the conclusion that, based on calculations of the required time to meaningfully reduce soil metals contents, phytoremediation is not a practical option for extremely metal-elevated soils. These findings should be verified under field conditions.
Metagenomic analysis of the effects of salinity on microbial community and functional gene diversity in glacial meltwater estuary, Ny-Alesund, Arctic
Authors: Yang Fan , Li Qinxin , Yin Xiaofei 
Published: April 2024

AbstractDue to the inflow of meltwater from the Midre Lovénbreen glacier upstream of Kongsfjorden, the nutrient concentration of Kongsfjorden change from the estuary to the interior of the fjord. Our objective was to explore the changes in bacterial community structure and metabolism-related genes from the estuary to fjord by metagenomic analysis. Our data indicate that glacial meltwater input has altered the physicochemical properties of the fjords, with a significant effect, in particular, on fjords salinity, thus altering the relative abundance of some specific bacterial groups. In addition, we suggest that the salinity of a fjord is an important factor affecting the abundance of genes associated with the nitrogen and sulfur cycles in the fjord. Changes in salinity may affect the relative abundance of microbial populations that carry metabolic genes, thus affecting the relative abundance of genes associated with the nitrogen and sulfur cycles.