bluuebunny/crossref_metadata_2025_split huggingface dataset:
Expanding the Treatable Imaging Profile in Patients With Large Ischemic Stroke: Subanalysis From a Randomized Clinical Trial
Authors: Inoue Manabu , Yoshimoto Takeshi , Yamagami Hiroshi , Toyoda Kazunori , Sakai Nobuyuki , Matsumaru Yuji , Matsumoto Yasushi , Kimura Kazumi , Ishikura Reiichi , Uchida Kazutaka , Beppu Mikiya , Sakakibara Fumihiro , Morimoto Takeshi , Yoshimura Shinichi ,   for the RESCUE-Japan LIMIT Investigators
Published: May 2024

BACKGROUND:
We aimed to examine the boundary of the ischemic core volume in patients undergoing endovascular thrombectomy (EVT) versus those receiving medical management to determine the minimum optimal size for favorable treatment outcomes.

METHODS:
This is a prespecified substudy of the RESCUE-Japan LIMIT (Recovery by Endovascular Salvage for Cerebral Ultra-Acute Embolism-Japan Large Ischemic Core Trial). Patients with large vessel occlusion were enrolled between November 2018 and September 2021 with a National Institutes of Health Stroke Scale score of at least 6 on admission and an Alberta Stroke Program Early Computed Tomography Score value of 3 to 5. We investigated the correlation between optimal quantified ischemic core volume, assessed solely using magnetic resonance diffusion-weighted imaging, and functional outcomes (modified Rankin Scale score, 0–3) at 90 days by predictive marginal plots. Final infarct volume and safety outcomes (symptomatic intracerebral hemorrhage and mortality) were also assessed.

RESULTS:

Of the 203 cases, 168 patients (85 in the EVT group versus 83 in the medical management group) were included. The median (interquartile range) core volume was 94 (65–160) mL in patients with EVT and 115 (71–141) mL in the medical management group (
P
=0.72). The predictive marginal probabilities of the 2 groups intersected at 128 mL for estimating functional outcomes. Symptomatic intracerebral hemorrhage and mortality within 90 days had overlay margins through all core volumes in both groups. The median final infarct volume (interquartile range) was smaller in the EVT group (142 [80–223] mL versus 211 [123–289] mL in the medical management group;
P
<0.001).

CONCLUSIONS:
In this prespecified analysis of a randomized clinical trial involving patients with large ischemic strokes, patients with an estimated core volume of up to 128 mL on diffusion-weighted imaging benefit from EVT.

REGISTRATION:

URL:
https://www.clinicaltrials.gov
; Unique identifier: NCT03702413.
Judean Reception of the Elisha Narratives
Authors: Skaria Jobymon 
Published: May 2024

Abstract
Scholars have noted scribal attempts to undermine Elisha’s prophetic reputation in his promise to the Shunammite woman (2 Kgs 4:8–17). However, these readings fail to adequately consider the intertextual links between Elisha’s promise and Yahweh’s promise to Abraham (Gen 18:1–15): Why did the scribes link Elisha’s promise with Yahweh’s promise, especially when the narrative is largely hostile against Elisha? Paying attention to the possible context in Achaemenid Yehud, this article proposes a new interpretation of Elisha’s promise: It highlights scribal efforts to subjugate and silence Bethel, a northern Israelite cultic site believed to be the repository for Elisha traditions during this period. And it argues that the Judean scribes deliberately linked Elisha’s promise with Yahweh’s promise, as an “antithetical parallelism” to support their attempts to stigmatise Bethel’s traditions by pointing readers toward Elisha’s human weaknesses and limitations in his prophetic career.
Identifying potential provenances for climate-change adaptation using spatially variable coefficient models
Authors: Wesselkamp Marieke , Roberts David R. , Dormann Carsten F. 
Published: May 2024

Abstract
Background
Selection of climate-change adapted ecotypes of commercially valuable species to date relies on DNA-assisted screening followed by growth trials. For trees, such trials can take decades, hence any approach that supports focussing on a likely set of candidates may save time and money. We use a non-stationary statistical analysis with spatially varying coefficients to identify ecotypes that indicate first regions of similarly adapted varieties of Douglas-fir (Pseudotsuga menziesii (Mirbel) Franco) in North America. For over 70,000 plot-level presence-absences, spatial differences in the survival response to climatic conditions are identified.

Results
The spatially-variable coefficient model fits the data substantially better than a stationary, i.e. constant-effect analysis (as measured by AIC to account for differences in model complexity). Also, clustering the model terms identifies several potential ecotypes that could not be derived from clustering climatic conditions itself. Comparing these six identified ecotypes to known genetically diverging regions shows some congruence, as well as some mismatches. However, comparing ecotypes among each other, we find clear differences in their climate niches.

Conclusion
While our approach is data-demanding and computationally expensive, with the increasing availability of data on species distributions this may be a useful first screening step during the search for climate-change adapted varieties. With our unsupervised learning approach being explorative, finely resolved genotypic data would be helpful to improve its quantitative validation.
Deep learning for risk stratification of thymoma pathological subtypes based on preoperative CT images
Authors: Liu Wei , Wang Wei , Guo Ruihua , Zhang Hanyi , Guo Miaoran 
Published: May 2024

Abstract
Objectives
This study aims to develop an innovative, deep model for thymoma risk stratification using preoperative CT images. Current algorithms predominantly focus on radiomic features or 2D deep features and require manual tumor segmentation by radiologists, limiting their practical applicability.

Methods
The deep model was trained and tested on a dataset comprising CT images from 147 patients (82 female; mean age, 54 years ± 10) who underwent surgical resection and received subsequent pathological confirmation. The eligible participants were divided into a training cohort (117 patients) and a testing cohort (30 patients) based on the CT scan time. The model consists of two stages: 3D tumor segmentation and risk stratification. The radiomic model and deep model (2D) were constructed for comparative analysis. Model performance was evaluated through dice coefficient, area under the curve (AUC), and accuracy.

Results
In both the training and testing cohorts, the deep model demonstrated better performance in differentiating thymoma risk, boasting AUCs of 0.998 and 0.893 respectively. This was compared to the radiomic model (AUCs of 0.773 and 0.769) and deep model (2D) (AUCs of 0.981 and 0.760). Notably, the deep model was capable of simultaneously identifying lesions, segmenting the region of interest (ROI), and differentiating the risk of thymoma on arterial phase CT images. Its diagnostic prowess outperformed that of the baseline model.

Conclusions
The deep model has the potential to serve as an innovative decision-making tool, assisting on clinical prognosis evaluation and the discernment of suitable treatments for different thymoma pathological subtypes.

Key Points
• This study incorporated both tumor segmentation and risk stratification.
• The deep model, using clinical and 3D deep features, effectively predicted thymoma risk.
• The deep model improved AUCs by 16.1pt and 17.5pt compared to radiomic model and deep model (2D) respectively.
Knowledge level and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers attending Mkonze health center, Dodoma Region, Tanzania
Authors: Samila Immaculata Alphonce , Mboineki Joanes Faustine 
Published: May 2024

Abstract
Background
Unsafe abortion is now a global agenda because 45% of all global abortions are unsafe, and 97% are occurring in developing countries. In Tanzania, one million reproductive-aged women face unplanned pregnancies per year, and 39% end up with abortion. About 16% of maternal deaths are reported per year in Tanzania, and unsafe abortion takes the second position. There are several efforts to prevent and intervene unsafe abortions, such as equipping healthcare facilities across all levels of healthcare, approval of Misoprostol use, establishment of comprehensive post-abortion care (PAC), revising policy guidelines and standards, provision of emergency contraceptives, and capacity building of healthcare providers. There is little documentation about how the constructs of the theory of planned behaviour, knowledge, and sociodemographics influence the practice of abortion.

Objectives
To assess the association of knowledge level, sociodemographic characteristics, and constructs of the theory of planned behaviour (TPB) to the practice of unsafe abortion among postnatal mothers at Mkonze Health Center in the Dodoma region.

Methodology
It is an analytical cross-sectional study design conducted in Dodoma-Tanzania and involved 206 postnatal women. A validated questionnaire was used and analysis was performed in the Statistical Package for the Social Sciences (SPSS), through descriptive and inferential statistics.

Results
The practice of unsafe abortion in the current study is 28/206 (13.6%), influenced bytheir lower educational level and being single women. It was found that the majority had adequate knowledge of unsafe abortion 129 (62.6%), positive attitude 130 (63.1%), good subjective norms 113 (54.9%), and positive perceived behavioral control111 (53.9%). Knowledge, attitude, subjective norms, and perceived behavioral control were not significantly associated with the practice of unsafe abortion.

Conclusion
The majority of the respondents had high knowledge, attitudes, subjective norms, and perceived behavior control on unsafe abortion. This is an indicator that the implemented initiatives are effective. Maintaining the ongoing effort and improving strategies are promising to mitigate the burden of unsafe abortion. Future research needs to find out hidden factors associated with attitude and how health beliefs might influence someone’s attitude towards unsafe abortion.
Limited discectomy versus aggressive discectomy by spinal endoscopy with the transforaminal approach for lumbar disc herniation: a retrospective study
Authors: Reheman Sulaiman , Meng XiangYu , Abudurexiti Tuerhongjiang , Haibier Abuduwupuer , Sheng Weibin 
Published: May 2024

Abstract
Objective
To compare the clinical and radiological outcomes of limited discectomy (LD) and aggressive discectomy (AD) performed via spinal endoscopy using the transforaminal approach in patients with lumbar disc herniation(LDH)

Methods
We conducted a retrospective review of patients who underwent percutaneous endoscopic transforaminal discectomy (PETD) at the L4-L5 lumbar spine segments in our department from January 2017 to December 2020. The follow-up period extended to 24 months postoperatively. Patients were categorized into the LD and AD groups based on the extent of intraoperative disc removal. We retrospectively collected and analyzed clinical and radiological data.

Results
The study followed 65 patients, with 36 in the LD group and 29 in the AD group. No statistically significant differences were noted in recurrence rates, the excellent and good Macnab rates, preoperative Disc Height Index (DHI), and preoperative Modic changes between the groups (P >0.05). However, significant differences were observed in operation duration, postoperative DHI and postoperative Modic change (P<0.05). No significant differences in Visual Analog Scale (VAS) and Oswestry Disability Index (ODI) scores were detected between the groups preoperatively, or one and two years postoperatively (P>0.05). Nevertheless, notable differences in VAS and ODI scores were present one month postoperatively (P<0.05).

Conclusion
As a conventional surgical method for treating LDH, PETD can achieve satisfactory clinical results in both LD and AD, with no significant variance in recurrence rates. However, AD is associated with longer operation times, and greater postoperative reductions in DHI and greater postoperative Modic changes compared to LD.
Development, validation and reliability testing of the hospice care environment scale
Authors: Zhong Junping , Zhang Wei , Xu Rong , Wang Huifen , Zhao Jing , Huang Yingjuan , Chen Yanlin , Chen Xiaoli , Chen Jianfei , Zhang Qing , Zou Zhijie , Zhang Yingzi 
Published: May 2024

Abstract
Background
WHO stated the environment is an important factor affecting the development of hospice care. The environment is the sum of factors affecting behavior besides the individual factors. Currently, a scale to comprehensively assess the hospice environment of nurse is still lacking. This study aimed to develop an instrument to investigate the environmental factors affecting hospice care of nurses.

Methods
Literature review and a semi-structured interview were conducted to form the items pool of the Hospice Care Environment Scale. Two rounds of Delphi expert consultation were conducted by 16 experts to revise the scale dimensions and entries to form the Hospice Care Environment Scale. A psychometric evaluation was then performed among 530 oncology nurses in a large tertiary oncology hospital in Hubei Province. The 500 valid questionnaires were randomly divided into two groups in a 1:1 ratio, sample 1 (n1 = 250) for item screening and sample 2 (n2 = 250) for quality evaluation of the resulting scale. Item analysis, reliability analysis, validity analysis and acceptability analysis were performed.

Result
The Hospice Care Environment Scale consists of two dimensions and 13 entries. The Cronbach’s α coefficient of the Hospice Care Environment Scale was 0.970, and the Cronbach’s α coefficient of the two dimensions were 0.952 and 0.969, respectively, with the Item-content validity index and average Scale- content validity index of the scale was both 1.000. The validation factor analysis showed the standardized path coefficients of each item were basically above 0.5, and the factor structure model was stable and suitable. The average completion time of the scale was about 3 min, which had good feasibility.

Conclusion
The Hospice Care Environment Scale to assess the environment of hospice care services, has good content and construct validity and reliability. This scale can provide guidance to evaluate the hospice care environment.
Factors associated with work engagement among specialist nurses in china: a cross-sectional study
Authors: Xu Lichun , Lin Liyu , Guan Aixuan , Wang Qingqing , Lin Feng , Lin Weicong , Li Jing 
Published: May 2024

Abstract
Background
The positive impacts of work engagement among specialist nurses on retention, organizational commitment, and quality of care are well-documented. However, there is a lack of research on the specific differences in work engagement among specialist nurses. Therefore, the purpose of this study is to assess the level of work engagement among specialist nurses in China and identify its influencing factors.

Methods
A descriptive cross-sectional study was conducted in China from April to July, 2023, with 724 nurses selected from 22 hospitals through convenience sampling involved. The survey was conducted by using self-administered general information questionnaires and work engagement scales. Questionnaire Star was employed as the online data collection tool. The collected data was analyzed by using descriptive statistics and stepwise regression analysis to draw meaningful conclusions from the study.

Results
Among specialist nurses in Xiamen, China, who had a response rate of 97.10%, an average work engagement score is 140.35 (SD=18.17), with the highest score for the work attitude at 4.65 (SD=0.52) and the lowest score for the work recognition at 4.09 (SD=0.85). It was shown through regression analysis that factors such as career satisfaction, involvement in challenging case discussions, marital status, gender, presence of promotion advantage and title accounted for 14.5% of the total variance in the model and were significant explanatory variables that could predict work engagement.

Conclusion
It is shown that specialist nurses in Xiamen, China have a high level of work engagement. It is imperative for nursing managers to prioritize the work engagement of specialist nurses, provide the specialist nurses with ample development opportunities and room for growth, and effectively promote the overall development of specialist nurses by improving work engagement in various aspects.
Situational analysis of hypertension management at primary health care level in São Paulo, Brazil: population, healthcare professional and health system perspectives
Authors: Palmeirim Marta S. , Baxter Yara C. , Silveira Mariana , Maggion Rafael V. , Aquino Beatriz , Avezum Álvaro , Saric Jasmina , Morgan Louise , Drager Luciano F. , Bortolotto Luiz A. , Rollemberg Suely Miya S. , de Lima Marcia M. C. , Albuquerque Edmir P. R. , Jones Olivia , Steinmann Peter , Reiker Theresa , Boch Johannes 
Published: May 2024

Abstract
Background
Government-led, population-wide initiatives are crucial for advancing the management of hypertension − a leading cause of cardiovascular disease (CVD) morbidity and mortality. An urban population health initiative was conducted against this backdrop, focussing on hypertension in the primary health system in São Paulo, Brazil. Within the frame of the initiative and under the supervision and leadership of the municipal health authorities, a situational analysis was conducted on the needs in hypertension management, marking the first phase of a Design Thinking process. This article describes the situational analysis process and presents the identified elements to be strengthened considering hypertension diagnosis, treatment and control.

Methods
First, a mixed-methods approach was used, starting with a literature review of municipal hypertension data followed by meetings (N = 20) with the local public health administration to assess health system level components. To investigate activities on hypertension diagnosis, treatment and control, nine primary healthcare units were selected from two districts of São Paulo city– Itaquera and Penha– which received an online form addressed to managers, participated in conversation circles of staff and patients, and underwent shadowing of community health agents.

Results
Data gave rise to two main outputs: (i) a patient care journey map; and (ii) a matrix summarizing the identified needs at patient, healthcare professional and health system level for diagnosis, treatment and control of hypertension. Patient awareness and knowledge of hypertension was found to be insufficient and its management needs to be improved. For health professionals, disease awareness, technical training, more time dedicated to patients, and simplified guidelines and clinical decision-making tools for hypertension management were identified as principal needs. The situational analysis found that the healthcare systems efficiency might be improved by establishing defined treatment and care delivery goals with a focus on outcomes and implemented through action plans.

Conclusions
This situational analysis identified several needs related to hypertension control in São Paulo that are in line with global challenges to improve the control of CVD risk factors. Findings were also confirmed locally in an expansion phase of this situational analysis to additional primary care facilities. As a consequence, solutions were designed, promptly taken up and implemented by the municipal health secretariat.
Parental experiences of caring for preterm infants in the neonatal intensive care unit, Limpopo Province: a descriptive qualitative study exploring the cultural determinants
Authors: Nyaloko Madimetja J. , Lubbe Welma , Moloko-Phiri Salaminah S. , Shopo Khumoetsile D. 
Published: May 2024

Abstract
Background
Parent-infant interaction is highly recommended during the preterm infant hospitalisation period in the Neonatal Intensive Care Unit (NICU). Integrating culturally sensitive healthcare during hospitalisation of preterm infants is critical for positive health outcomes. However, there is still a paucity of evidence on parental experience regarding cultural practices that can be integrated into preterm infant care in the NICU. The study explored and described the cultural determinants of parents that can be integrated into the care of preterm infants in the NICU.

Methods
A descriptive qualitative research design was followed where twenty (n=20) parents of preterm infants were purposively selected. The study was conducted in the NICU in Limpopo using in-depth individual interviews. Taguette software and a thematic analysis framework were used to analyse the data. The COREQ guidelines and checklist were employed to ensure reporting standardisation.

Results
Four themes emerged from the thematic analysis: 1) Lived experienced by parents of preterm infants, 2) Interactions with healthcare professionals, 3) Cultural practices concerning preterm infant care, and 4) Indigenous healthcare practices for preterm infants.

Conclusions
The study emphasised a need for healthcare professionals to understand the challenges parents of preterm infants face in NICU care. Furthermore, healthcare professionals should know indigenous healthcare practices to ensure relevant, culturally sensitive care.
Specification curve analysis to identify heterogeneity in risk factors for dementia: findings from the UK Biobank
Authors: Luo Renhao , Zeraatkar Dena , Glymour Maria , Ellis Randall J. , Estiri Hossein , Patel Chirag J. 
Published: May 2024

Abstract
Background
In 2020, the Lancet Commission identified 12 risk factors as priorities for prevention of dementia, and other studies identified APOE e4/e4 genotype and family history of Alzheimer’s disease strongly associated with dementia outcomes; however, it is unclear how robust these relationships are across dementia subtypes and analytic scenarios. Specification curve analysis (SCA) is a new tool to probe how plausible analytical scenarios influence outcomes.

Methods
We evaluated the heterogeneity of odds ratios for 12 risk factors reported from the Lancet 2020 report and two additional strong associated non-modifiable factors (APOE e4/e4 genotype and family history of Alzheimer’s disease) with dementia outcomes across 450,707 UK Biobank participants using SCA with 5357 specifications across dementia subtypes (outcomes) and analytic models (e.g., standard demographic covariates such as age or sex and/or 14 correlated risk factors).

Results
SCA revealed variable dementia risks by subtype and age, with associations for TBI and APOE e4/e4 robust to model specification; in contrast, diabetes showed fluctuating links with dementia subtypes. We found that unattributed dementia participants had similar risk factor profiles to participants with defined subtypes.

Conclusions
We observed heterogeneity in the risk of dementia, and estimates of risk were influenced by the inclusion of a combination of other modifiable risk factors; non-modifiable demographic factors had a minimal role in analytic heterogeneity. Future studies should report multiple plausible analytic scenarios to test the robustness of their association. Considering these combinations of risk factors could be advantageous for the clinical development and evaluation of novel screening models for different types of dementia.