bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring the ‘citizen organization’: an evaluation of a regional Australian community-based palliative care service model
Authors: Rosenberg John , Flynn Trudi , Merollini Katharina , Linn Josie , Nabukalu Doreen , Davis Cindy 
Published: June 2024

Background: Little Haven is a rural, community-based specialist palliative care service in Gympie, Australia. Its goals are to provide highest quality of care, support and education for those experiencing or anticipating serious illness and loss. Families and communities work alongside clinical services, with community engagement influencing compassionate care and support of dying people, their families and communities. Public Health Palliative Care promotes community engagement by community-based palliative care services and is grounded in equal partnerships between civic life, community members, patients and carers, and service providers. This takes many forms, including what we have termed the ‘citizen organization’. Objectives: This paper reports on an evaluation of Little Haven’s model of care and explores the organization’s place as a ‘citizen’ of the community it services. Design: A co-designed evaluation approach utilizing mixed-method design is used. Methods: Multiple data sources obtained a broad perspective of the model of care including primary qualitative data from current patients, current carers, staff, volunteers and organizational stakeholders (interviews and focus groups); and secondary quantitative survey data from bereaved carers. Thematic analysis and descriptive statistics were generated. Results: This model of care demonstrates common service elements including early access to holistic, patient/family-centred, specialized palliative care at little or no cost to users, with strong community engagement. These elements enable high-quality care for patients and carers who describe the support as ‘over and above’, enabling good quality of life and care at home. Staff and volunteers perceive the built-in flexibility of the model as critical to its outcomes; the interface between the service and the community is similarly stressed as a key service element. Organizational stakeholders observed the model as a product of local activism and accountability to the community. Conclusion: All participant groups agree the service model enables the delivery of excellent care. The construction of a community palliative care service as a citizen organization emerged as a new concept.
Characterising fragmentation of compostable bioplastic: releasing microplastics or small bioplastic debris
Authors: Fang Cheng , Zhang Xian , Zhang Zixing , Naidu Ravi 
Published: June 2024

Abstract
Background
Plastic is generating global pollution and the replacement such as bioplastic has been developed to mitigate the pollution. To this end, the fate, transformation and pathway of bioplastics need more research. For example, the fragmentation of bioplastic can release small debris that can be categorised as microplastics, which is tested herein by taking an example of a compostable plastic that is used as a bin bag on our kitchen table to collect the food residues.

Results
First, we employ matrix-assisted laser desorption/ionisation mass spectrometry (MALDI-MS) to identify the main components of the bioplastic bag as polymer and starch. Next, we use Raman imaging to monitor the stability under laser illumination, in an oven at ~ 60 °C for ~ 2 weeks, or in the presence of tap water for half a year. Basically, the compostable plastic is stable under these conditions. Thirdly, however, once used as table-bin bag with involvement of food residues, within ~ 1 week, the bioplastic bag is broken and biodegraded to release debris. The derivate surface groups are effectively monitored and directly visualised via Raman imaging, and cross-checked with scanning electron microscope (SEM). The yielded small molecule such as formic acid is also identified, along with the released debris of microplastics, with the help of on-site extraction of the fragmented sample and imaging analysis algorithm of the hyper spectrum.

Conclusions
After one week, the bag in the waste bin fragments, releasing a significant amount of debris. This could pose a functional issue if users intend to use the bag for at least a week, and could become a potential environmental problem if the waste is dispersed uncontrollably. In general, further research is needed to potentially distinguish the persistent conventional microplastics from the bioplastic fragments, to effectively mitigate the plastic pollution.

Graphical Abstract
Altered pupil light and darkness reflex and eye-blink responses in late-life depression
Authors: Lee Yao-Tung , Chang Yi-Hsuan , Tsai Hsu-Jung , Chao Shu-Ping , Chen David Yen-Ting , Chen Jui-Tai , Cherng Yih‐Giun , Wang Chin-An 
Published: June 2024

Abstract
Background
Late-life depression (LLD) is a prevalent neuropsychiatric disorder in the older population. While LLD exhibits high mortality rates, depressive symptoms in older adults are often masked by physical health conditions. In younger adults, depression is associated with deficits in pupil light reflex and eye blink rate, suggesting the potential use of these responses as biomarkers for LLD.

Methods
We conducted a study using video-based eye-tracking to investigate pupil and blink responses in LLD patients (n = 25), older (OLD) healthy controls (n = 29), and younger (YOUNG) healthy controls (n = 25). The aim was to determine whether there were alterations in pupil and blink responses in LLD compared to both OLD and YOUNG groups.

Results
LLD patients displayed significantly higher blink rates and dampened pupil constriction responses compared to OLD and YOUNG controls. While tonic pupil size in YOUNG differed from that of OLD, LLD patients did not exhibit a significant difference compared to OLD and YOUNG controls. GDS-15 scores in older adults correlated with light and darkness reflex response variability and blink rates. PHQ-15 scores showed a correlation with blink rates, while MoCA scores correlated with tonic pupil sizes.

Conclusions
The findings demonstrate that LLD patients display altered pupil and blink behavior compared to OLD and YOUNG controls. These altered responses correlated differently with the severity of depressive, somatic, and cognitive symptoms, indicating their potential as objective biomarkers for LLD.
Time trends in proximal humeral fractures from 1944 to 2020 – A cohort study in Malmö, Sweden
Authors: Cederwall Anton , Karlsson Magnus K , Rosengren Björn E 
Published: June 2024

Abstract
Background
Most studies infer increasing incidence of proximal humeral fractures (PHF) from the 1950´s until the 1990´s. Recent time trends are less clear.

Objectives
Our primary objective was to identify time trends in the age- and sex-adjusted adult incidence of PHF in Malmö, Sweden, from year 1944 until 2020. Our secondary objectives were to describe the variation in incidence according to age, the monthly distribution, and to compare data from the two most recent decades with earlier.

Study design and methods
Malmö has one emergency hospital where acute fractures are treated. We identified PHF in adult patients (≥ 18 years) by reviewing relevant radiology examinations during 17 sample years from year 1944 to 2020. We used jointpoint analyses to estimate time trends.

Results
We identified 3 031 PHF during the study period (3 231 161 person years), 73% were sustained by women with mean age of 69 years (mean age in men 59). Joinpoint analyses indicated an increase in the age- and sex-adjusted incidence of PHF from year 1944 (52 per 100 000 person years) until 1977 (120 per 100 000) and thereafter a decrease until 2020 (85 per 100 000). A seasonal variation with more fractures during winter months, was apparent in earlier but not recent decades.

Conclusions
The age- and sex-adjusted incidence of PHF increased in Malmö, Sweden, from the 1940´s until year 1977 and thereafter decreased until 2020. More fractures were seen during winter months in earlier but not recent decades.
Expression of epithelial growth factor receptor as a protein marker in oral reticular and erosive lichen planus
Authors: Keshani Forooz , Kargahi Neda , Nikbakht Mohammad Hossein , Najafi Shekufe , Fallah Fateme 
Published: June 2024

Abstract
Background
Oral lichen planus (OLP) is a chronic inflammatory mucosal disease that is classified as a premalignant condition. Epithelial growth factor receptor (EGFR) is associated with tumorigenesis and tumor progression and is overexpressed in several oral malignant disorders. Despite the association of EGFR overexpression with oral potentially malignant lesions, few studies have analyzed its expression in OLP, showing controversial results. This study aimed to compare the expression of EGFR as a protein marker in Reticular and Erosive OLP.

Methods
This descriptive-analytical cross-sectional was conducted on 15 paraffin blocks of reticular lichen planus lesions, 16 paraffin blocks of erosive OLP lesions, and 8 paraffin blocks of inflammatory fibrous hyperplasia lesions as the control group (39 in total). After immunohistochemical staining for EGFR, samples were simultaneously observed by two maxillofacial pathologist, and the percentage of stained cells, intensity of staining, pattern of staining, and the location of stained cells were obtained.

Results
The Mann-Whitney-U test showed that there was no significant difference in the mean percentage of stained cells between erosive OLP and reticular OLP (P-value = 0.213) and between reticular OLP and control group (P-value = 0.137), but there was a significant difference between erosive OLP and control group (P-value = 0.035). Fisher’s exact test showed that there was no significant difference between the frequency distribution of staining patterns in three types of lesions (P-value = 0.90). Kruskal-Wallis test showed that there was no significant difference between the intensity of staining in the three groups (P-value = 0.19) and also there was no significant difference between the location of stained cells in different layers of the epithelium in the three groups (P-value = 0.90).

Conclusions
The results of this study showed that in comparison of reticular OLP, erosive OLP, and the control group there was a significant difference just between erosive OLP and control group in the percentage of stained cells.
Risk factors for residual lesions after total hysterectomy in patients with high-grade cervical intraepithelial neoplasia
Authors: Wang Jing , Wang Chao , Su Tao 
Published: June 2024

Abstract
Background
The purpose of this study was to predict the risk factors for residual lesions in patients with high-grade cervical intraepithelial neoplasia who underwent total hysterectomy.

Methods
This retrospective study included 212 patients with histologically confirmed high-grade cervical intraepithelial neoplasia (CIN2-3) who underwent hysterectomy within 6 months after loop electrosurgical excision procedure (LEEP). Clinical data (e.g., age, menopausal status, HPV type, and Liquid-based cytology test(LCT) type), as well as pathological data affiliated with endocervical curettage (ECC), colposcopy, LEEP and hysterectomy, were retrieved from medical records. A logistic regression model was applied to estimate the relationship between the variables and risk of residual lesions after hysterectomy.

Results
Overall, 75 (35.4%) patients had residual lesions after hysterectomy. Univariate analyses revealed that positive margin (p = 0.003), glandular involvement (p = 0.017), positive ECC (p < 0.01), HPV16/18 infection (p = 0.032) and vaginal intraepithelial neoplasia (VaIN) I-III (p = 0.014) were factors related to the presence of residual lesions after hysterectomy. Conversely, postmenopausal status, age ≥ 50 years, ≤ 30 days from LEEP to hysterectomy, and LCT type were not risk factors for residual lesions. A positive margin (p = 0.025) and positive ECC (HSIL) (p < 0.001) were identified as independent risk factors for residual lesions in multivariate analysis.

Conclusions
Our study revealed that positive incisal margins and ECC (≥ CIN2) were risk factors for residual lesions, while glandular involvement and VaIN were protective factors. In later clinical work, colposcopic pathology revealed that glandular involvement was associated with a reduced risk of residual uterine lesions. 60% of the patients with residual uterine lesions were menopausal patients, and all patients with carcinoma in situ in this study were menopausal patients. Therefore, total hysterectomy may be a better choice for treating CIN in menopausal patients with positive margins and positive ECC.
Development of a quantitative index system for evaluating the quality of electronic medical records in disease risk intelligent prediction
Authors: Zhou Jiayin , Hao Jie , Tang Mingkun , Sun Haixia , Wang Jiayang , Li Jiao , Qian Qing 
Published: June 2024

Abstract
Objective
This study aimed to develop and validate a quantitative index system for evaluating the data quality of Electronic Medical Records (EMR) in disease risk prediction using Machine Learning (ML).

Materials and methods
The index system was developed in four steps: (1) a preliminary index system was outlined based on literature review; (2) we utilized the Delphi method to structure the indicators at all levels; (3) the weights of these indicators were determined using the Analytic Hierarchy Process (AHP) method; and (4) the developed index system was empirically validated using real-world EMR data in a ML-based disease risk prediction task.

Results
The synthesis of review findings and the expert consultations led to the formulation of a three-level index system with four first-level, 11 second-level, and 33 third-level indicators. The weights of these indicators were obtained through the AHP method. Results from the empirical analysis illustrated a positive relationship between the scores assigned by the proposed index system and the predictive performances of the datasets.

Discussion
The proposed index system for evaluating EMR data quality is grounded in extensive literature analysis and expert consultation. Moreover, the system’s high reliability and suitability has been affirmed through empirical validation.

Conclusion
The novel index system offers a robust framework for assessing the quality and suitability of EMR data in ML-based disease risk predictions. It can serve as a guide in building EMR databases, improving EMR data quality control, and generating reliable real-world evidence.
Differences in trajectories of quality of life according to type of dementia: 6-year longitudinal findings from the IDEAL programme
Authors: Martyr Anthony , Gamble Laura D. , Hunt Anna , Quinn Catherine , Morris Robin G. , Henderson Catherine , Allan Louise , Opdebeeck Carol , Charlwood Catherine , Jones Roy W. , Pentecost Claire , Kopelman Michael D. , Thom Jeanette M. , Matthews Fiona E. , Clare Linda 
Published: June 2024

Abstract
Background
People with different types of dementia may have distinct symptoms and experiences that affect their quality of life. This study investigated whether quality of life varied across types of dementia and over time.

Methods
The participants were 1555 people with mild-to-moderate dementia and 1327 carers from the IDEAL longitudinal cohort study, recruited from clinical services. As many as possible were followed for up to 6 years. Diagnoses included were Alzheimer’s disease, vascular dementia, mixed Alzheimer’s and vascular dementia, Parkinson’s disease dementia, dementia with Lewy bodies, and frontotemporal dementia. Self- and informant-rated versions of the Quality of Life in Alzheimer’s Disease scale were used. A joint model, incorporating a mixed effects model with random effects and a survival model to account for dropout, was used to examine whether quality of life varied by dementia type at the time of diagnosis and how trajectories changed over time.

Results
The strongest associations between dementia type and quality of life were seen around the time of diagnosis. For both self-ratings and informant ratings, people with Parkinson’s disease dementia or dementia with Lewy bodies had lower quality of life scores. Over time there was little change in self-rated scores across all dementia types (− 0.15 points per year). Informant-rated scores declined over time (− 1.63 points per year), with the greatest decline seen in ratings by informants for people with dementia with Lewy bodies (− 2.18 points per year).

Conclusions
Self-rated quality of life scores were relatively stable over time whilst informant ratings showed a steeper decline. People with Parkinson’s disease dementia or dementia with Lewy bodies report particularly low levels of quality of life, indicating the importance of greater attention to the needs of these groups.
‘Small volume—big problem’: culturing Yarrowia lipolytica in high-throughput micro-formats
Authors: Celińska Ewelina , Gorczyca Maria 
Published: June 2024

AbstractWith the current progress in the ‘design’ and ‘build’ stages of the ‘design-build-test-learn’ cycle, many synthetic biology projects become ‘test-limited’. Advances in the parallelization of microbes cultivations are of great aid, however, for many species down-scaling leaves a metabolic footprint. Yarrowia lipolytica is one such demanding yeast species, for which scaling-down inevitably leads to perturbations in phenotype development. Strictly aerobic metabolism, propensity for filamentation and adhesion to hydrophobic surfaces, spontaneous flocculation, and high acidification of media are just several characteristics that make the transfer of the micro-scale protocols developed for the other microbial species very challenging in this case. It is well recognized that without additional ‘personalized’ optimization, either MTP-based or single-cell-based protocols are useless for accurate studies of Y. lipolytica phenotypes. This review summarizes the progress in the scaling-down and parallelization of Y. lipolytica cultures, highlighting the challenges that occur most frequently and strategies for their overcoming. The problem of Y. lipolytica cultures down-scaling is illustrated by calculating the costs of micro-cultivations, and determining the unintentionally introduced, thus uncontrolled, variables. The key research into culturing Y. lipolytica in various MTP formats and micro- and pico-bioreactors is discussed. Own recently developed and carefully pre-optimized high-throughput cultivation protocol is presented, alongside the details from the optimization stage. We hope that this work will serve as a practical guide for those working with Y. lipolytica high-throughput screens.
Investigating the impact of training programs on work-life balance of women teachers in secondary schools using PLS-SEM approach
Authors: Dwivedi Prerna , Shrivastava Urvashi , Nair Sindhu J. 
Published: June 2024

AbstractThe primary aim of this study is to investigate the factors influencing work-life balance among women teachers in secondary schools, with a focus on the role of training programs, emotional intelligence, stress management and supportive work environments. A cross-sectional research design was employed, and data were collected from 422 women teachers in Durg district, Chhattisgarh, using an online survey during period July to December 2023. Through Partial Least Squares Structural Equation Modeling (PLS-SEM) analysis, the study found that high-quality training programs play a significant role in enhancing work-life balance, with emotional intelligence and stress management acting as crucial mediating factors. Additionally, a supportive work environment was identified as a key moderator in the relationship between training programs and work-life balance. These findings highlight the importance of holistic approaches that integrate training programs, emotional intelligence development, stress management, and supportive work environments to foster a healthy work-life balance among women educators. The implications of these findings for policy and practice in the education sector highlight the necessity of investing in teacher development programs and organizational initiatives aimed at supporting teacher well-being.
Towards the diagnosis of osteoporosis – contributions from coincidental diagnostic imaging findings in chiropractors' practice
Authors: Uhrenholt Lars , Bakkegaard Jakob Hermannsen , Hansen Kasper , Doktor Klaus Knarberg 
Published: June 2024

Abstract
Background
Osteoporosis is significantly associated with fractures and burdens the health of especially older people. Osteoporotic fractures cause pain, disability, and increased mortality. Early diagnosis of osteoporosis allows earlier initiation of treatment, thereby reducing the risk of osteoporotic fractures. Chiropractors encounter potential osteoporotic patients daily, and perform radiological evaluation of these and other patients, including evaluation of X-rays done for other purposes than osteoporosis. Therefore, chiropractors may identify vertebral fractures, vertebral deformity or osteopenia not otherwise suspected or recorded.

Methods
This study examines procedures available to the chiropractor to describe conventional X-rays with the focus of osteoporosis related findings. We review the indications for radiological examination in chiropractic practice, and in the realm of osteoporosis we describe radiological methods available for examination of conventional radiographs, and the necessity of inter-disciplinary communication.

Results
National guidelines are available regarding referral for X-rays in chiropractic practice. Standardized protocols ensure image acquisition of the highest quality in the chiropractors’ radiological department. Conventional X-ray examination is not indicated on clinical suspicion of osteoporosis alone, as bone mineral density testing is the diagnostic test. Radiological assessment of all available X-rays of patients above the age of 50 years should include evaluation of the bone quality, and hip and vertebral fracture assessment. The Singh index, Genant Semi-Quantitative tool (GSQ), and Algorithm-Based Qualitative method (ABQ) should be used consistently during interpretation. Referral for additional imaging and evaluation should be prompt and systematic when needed.

Conclusions
This article presents an overview of evidence-based radiological procedures for the purpose of promoting early diagnosis of osteoporosis. We present recommendations to the clinicians where we propose an opportunistic evaluation of X-rays, done for any reason, which include systematic evaluation of bone quality, presence of hip and vertebral fractures, and vertebral deformation of all patients above the age of 50 years. Detailed referral to healthcare professionals for further diagnostic evaluation is performed when needed. Consistent, high-quality radiological procedures in chiropractic practices could feasibly contribute to the timely diagnosis of osteoporosis, ultimately minimizing the impact of osteoporosis-related complications on patients’ health.