bluuebunny/crossref_metadata_2025_split huggingface dataset:
Midwives’ perceptions regarding clinical support by nursing managers in a Tshwane hospital
Authors: Jantjies Nomdikazi Dinah , Zenani Nombulelo , Serapelwane Maserapelo 
Published: March 2024

Abstract

Background
Despite the benefits of support on the quality of maternal care, there is a general lack of support, which proved to have a less desired effect on the level of quality care within maternal units. To ensure the midwives operate to a high standard to ensure quality and patient safety in maternal care, support from the nursing managers creates a positive psychological environment to cope and manage themselves in the complex nature of the maternity unit. The study aimed to explore and describe midwives' perceptions regarding clinical support by nursing managers in a Tshwane hospital. The study described recommendations regarding the kind of clinical support required by midwives from the nursing managers in rendering maternal care.
Methods
The study used Qualitative, explorative, descriptive, and contextual research design to achieve the aim and objectives. The study used purposive sampling to select participants with insight and experience on the phenomenon. Before conducting the research, the researcher sought ethical permission from the NuMIQ research focus area and the North-West University Health Research Ethics Committee. Unstructured, in-depth individual interviews were conducted to collect data. Data was analysed using thematic analysis.
Results
Four themes emerged from the findings of this study, namely challenges related to lack of resources, emotional distress, lack of support, and recommended measures for support.
Conclusion
Quality and patient safety in maternity care is dependent on comprehensive clinical support for the midwives. Therefore, clinical support from the nursing managers enables the midwives to mitigate the challenges experienced in maternity units. Moreover, clinical support from nursing managers limits emotional distress and physical burnout that contributes to poor mental health and lack of job satisfaction in midwives. Those factors predispose the attrition rate of midwives and lead to the occurrence of adverse events in maternal care, which affects the well-being of patients in the maternity units. Therefore, there is a need for midwives to receive clinical support from nursing managers.
Effect of sea ice loss on Earth's energy budget depends on its spatial pattern
Authors: Zhou Chen , Wang Qingming , Tan Ivy , Zhang Lujun , Zelinka Mark , Wang Minghuai , Bloch-Johnson Jonah 
Published: March 2024

Abstract
The global mean sea ice concentration (SIC) is decreasing under global warming, but the effect of SIC reduction on Earth’s energy budget remains uncertain. Here we show that SIC-induced radiation anomalies at the top of the atmosphere are sensitive to the location of SIC reduction in each season, and therefore the impact of SIC reductions on Earth’s energy balance depends on their spatial pattern. SIC-induced radiation anomalies warm the Earth system under CO2-induced long-term global warming, but the SIC-induced radiation anomalies during specific historical periods could counterintuitively even cool the Earth system if the SIC reduction occurs with certain spatial patterns. Idealized experiments indicate that SIC-induced surface warming is greater in the Arctic regions, resulting in a more negative Planck feedback. Global low cloud fraction responses to Arctic and Antarctic SIC reduction are also distinct, leading to more negative SIC-cloud feedback in some Arctic regions. As a result, SIC reduction in some Arctic regions induces negative Planck and cloud feedbacks that overwhelm the positive sea ice albedo feedback, resulting in a net cooling radiative effect on the planet, while the radiative effect of SIC reduction over most Antarctic regions warms the earth.
Fast fabrication of “all-in-one” injectable hydrogels as antibiotic alternatives for enhanced bacterial inhibition and accelerating wound healing
Authors: Xin Juan , Yang Zhangyou , Zhang Shurong , Sun Lili , Wang Xin , Tang Yang , Xiao Yan , Huang Honglin , Li Wei 
Published: March 2024

Abstract

Skin wound infection has become a notable medical threat. Herein, the polysaccharide-based injectable hydrogels with multifunctionality were developed by a simple and fast gelation process not only to inactivate bacteria but also to accelerate bacteria-infected wound healing. Sodium nitroprusside (SNP) loaded PCN-224 metal-organic frameworks nanoparticles were introduced into the polymer matrix formed by the dynamic and reversible coordinate bonds between Ag+ with carboxyl and amino or hydroxyl groups on carboxymethyl chitosan (CMCS), multiple hydrogen bonds and electrostatic interactions in the polymer to fabricate SNP@PCN@Gel hydrogels. SNP@PCN@Gel displayed interconnected porous structure, excellent self-healing capacity, low cytotoxicity, good blood compatibility, and robust antibacterial activity. SNP@PCN@Gel could produce reactive oxygen species (ROS), showed rapid generation of NO along with Fe2+ and long-term sustained release of Ag+, thereby effectively killing bacteria by synergistic photothermal (hyperthermia), photodynamic (ROS), chemodynamic (Fenton reaction), gas (NO) and ion (Ag+ and -NH3+ in CMCS) therapy. Remarkably, the hydrogels significantly promoted granulation tissue formation, reepithelization, collagen deposition and angiogenesis as well as wound contraction in bacteria-infected wound healing. Taken together, the strategy represented a general method to engineer the unprecedented photoactivatable “all-in-one” hydrogels with enhanced antibacterial activity and paved a new way for development of antibiotic alternatives and wound dressing.
Comparison of bundled rib implants and titanium mesh implants in thoracic spinal tuberculosis surgery
Authors: Jin Yanghui , Wang Yifan , Shi Shiyuan , Hu Shengping , Zhang Lijuan , Zhong Ying , Feng Junkai 
Published: March 2024

Abstract
Objective: This study aimed to compare bundled multifracture rib implants and titanium mesh implants for thoracic spinal tuberculosis using the transverse costal approach.
Methods: Patients with thoracic spinal tuberculosis were divided into two groups. Both groups underwent surgery via the transverse costal approach. After removal of the necrotic tissue from the tuberculosis lesion, group A received titanium mesh bone grafts and group B received bundled rib bone grafts. Bone grafting time, blood loss during surgery, Cobb angle correction after surgery, loss of Cobb angle after the last follow-up, and bone graft fusion time were compared between the two groups.
Results: Thirty-eight patients (n = 19 per group) were included in this study. The follow-up duration was 24–42 months. The mean operative time was significantly longer in group A than in group B (154.63 ± 15.48 min vs. 130.95 ± 25.51 min, t = 3.460, P = 0.001). Implant fusion time, intraoperative bleeding volume, and preoperative Cobb angle were not significantly different between the two groups (7.11 ± 0.46 months vs. 7.16 ± 0.60 months, P > 0.05; 556.68 ± 116.76 ml vs. 518.63 ± 108.48 ml, P > 0.05; 36.47° ± 7.57° and 37.63° ± 6.45°, P > 0.05, respectively). After treatment, spinal nerve function recovered at least partially in both groups. The Oswestry dysfunction indices were not significantly different between the two groups (P > 0.05).
Conclusion: Compared with the titanium mesh implant, the bundled rib implant is more convenient, has easy bone block implantation procedure, and requires shorter time for bone grafting. No differences in intraoperative blood loss, postoperative bone graft fusion time, and spinal nerve function recovery were detected. Furthermore, stabilization function is achieved earlier with the bundled rip implant after thoracic spinal tuberculosis lesion removal, supporting the use of this implant.
PCSK9 inhibitors ameliorate arterial stiffness in ACS patients: evidences from mendelian randomization, cohort studies and basic experiments
Authors: Xu Linghao , Wang Liang , Wang Yuanqi , Wang Yiqiong , Jiang Yuanzhen , Du Peizhao , Cheng Jing , Zhang Chunsheng , Wang Ruijie , Jiao Tiantian , Lin Xueqi , Xing Lijian , Tapu Md Sakibur Rahman , Li Jiming 
Published: March 2024

Abstract
Background
Current evidences suggest that Proprotein Convertase Subtilisin/kexin Type 9 inhibitors (PCSK9i) exhibit a protective influence on acute coronary syndrome (ACS). Nevertheless, further investigation is required to comprehend the impact and mechanisms of these pharmaceutical agents on inflammatory factors and arterial stiffness (AS) in patients with ACS. Consequently, the objective of this study is to ascertain the influence of PCSK9i on arterial stiffness in ACS patients and elucidate the underlying mechanisms behind their actions.
Methods
This study employed Mendelian randomization (MR) analysis to examine the association between genetic prediction of PCSK9 inhibition and arterial stiffness. A total of 71 patients with ACS were randomly allocated into either a PCSK9i group or a control group. Blood lipid levels, inflammatory markers and pulse wave velocity (PWV) data were collected before treatment and at 1 and 6 months after treatment for analysis. Additionally, cell experiments were conducted to investigate the impact of PCSK9i on osteogenesis of vascular smooth muscle cells (VSMCs), utilizing western blot (WB), enzyme-linked immunosorbent assay (ELISA), and calcification index measurements.
Results
The results of the MR analysis suggest that genetic prediction of PCSK9 inhibition has potential to reduce the pulse wave reflection index (PWV). Following treatment of statins combined with PCSK9 inhibitors for 1 and 6 months, the PCSK9i group exhibited significantly lower levels of total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), C-reactive protein (CRP), interleukin-6 (IL-6), fibrinogen (FIB) and procalcitonin (PCT) compared to the control group (p < 0.05). Additionally, PWV in the PCSK9i group demonstrated significant reduction after 6 months of treatment and was found to be associated with the circulating CRP level. In cell experiments, PCSK9i pretreatment ameliorated osteogenesis of VSMCs through reducing the deposition of calcium ions, alkaline phosphatase (ALP) activity, and expression of runt-related transcription factor 2(RUNX2).
Conclusion
PCSK9i have potential to enhance arterial stiffness at various aspects, including the genetic, clinical, and cellular domains. Specifically, at the clinical level, this impact may be attributed to alterations in circulating CRP levels. At the cellular level, it is associated with the signaling pathway linked to RUNX2.
miR-361 prevents the formation of hypertrophic scars by inhibiting TGF-β1
Authors: Han Ziyang , Lin Feng , Wu Weiping , Bai Zeming , Zuo Na , Wang Hongyi , Zhou Dapeng 
Published: March 2024

Abstract
Excessive wound repair following dermal injuries, such as burns or trauma, may lead to pathological scar formation. Transforming growth factor-β1 (TGF-β1) is a potent growth factor involved in wound healing. It is considered to be a key regulator of hypertrophic scars (HS) and various fibrotic diseases. MicroRNAs (miRNAs/miRs) widely participate in the pathophysiological processes of various diseases by playing a role in post-transcriptional gene regulation. At present, at least to the best of our knowledge, there are no study assessing the role of miR-361 in HS. The present study thus investigated the role of this miRNA in HS and found that miR-361 expression was downregulated in HS. miR-361 suppressed the proliferation of HS fibroblasts by inhibiting TGF-β1 expression. Moreover, miR-361 inhibited the formation of scars on rabbit ears by inhibiting the expression of TGF-β1. Thus, miR-361 may play a protective role in HS by suppressing TGF-β1.
Petrogenesis and tectonic implications of the Xiachehe granite porphyries in the Wutai-Hengshan area (North China Craton): Constraints from geochemistry, zircon U-Pb geochronology and Hf isotopes
Authors: Ye Feng , Dong Guochen , Ren Jianxun , Lemdjou Yanick Brice , Ketchaya Yanick Blaise , Li Songfeng , Bai Yubo 
Published: March 2024

Abstract

The Wutai-Hengshan area located in the Trans-North China Orogen (TNCO) is a classic example of the geological evolution in the North China Craton (NCC) and carries varied Mesozoic magmatism associated with lithospheric destruction. In this paper, we provide zircon U-Pb geochronology, whole-rock chemistry, and zircon Lu-Hf isotopic data of the Xiachehe granite porphyries to discuss their petrogenesis and tectonic implications. According to the results of laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS), Xiachehe granite porphyries yield zircon U-Pb ages of 135.1 ± 0.8 Ma, representing age in the Early Cretaceous. The Xiachehe granite porphyries are high-K calc-alkaline and peraluminous. These rocks have REE and trace element patterns, characterized by enrichment in large-ion lithophile elements (LILE) and light rare-earth elements (LREE), and depletion in high-field-strength elements (HFSE), heavy rare-earth elements (HREE), with negative Eu anomalies. Therefore, They are classified as I-type granites with adakitic features. The Xiachehe granite porphyries have homogeneous zircon Hf isotopic compositions. Their zircons have negative εHf(t) values (-20.7 to -19.3) and two-stage Hf model ages of 2417–2501 Ma, indicating that the studied rocks were derived from partial melting of Neoarchean-Paleoproterozoic crustal materials with mantle-derived inputs. Therefore, it is suggested that the Xiachehe granite porphyries formed in a back-arc extensional setting likely associated with the ancient Pacific Plate subduction and retreat beneath the Eurasian continent. The TNCO was influenced by the subduction and retreat of the ancient Pacific Plate in the Early Cretaceous.
Safety and efficacy of hepatic arterial infusion chemotherapy (HAIC) combined with PD1 inhibitors for the treatment of primary liver cancer with microvascular invasion
Authors: Zhang FengTao 
Published: March 2024

Abstract

To investigate the safety and efficacy of hepatic arterial infusion chemotherapy (HAIC) combined with anti-PD1 monoclonal antibody (anti-PD1 mAb) in advanced primary liver cancer with microvascular invasion. Patients were retrospectively classified into two cohorts, namely the HAIC-PD1 group and the HAIC group, based on their treatment regimen. Clinical data were collected from January 2018 to December 2021 for a cohort of 61 patients with advanced primary liver cancer who underwent combination therapy of HAIC-mFOLFOX6 and anti-PD1 monoclonal antibody (HAIC-PD1 group), alongside a separate cohort of 95 patients who received HAIC-mFOLFOX6(HAIC group) alone. The above-mentioned 156 patients were matched by propensity score to obtain the overall cohort and the matched cohort. The differences in overall survival(OS) and progression-free survival(PFS) were compared between the groups and the tumor treatment response was evaluated according to the modified Response Evaluation Criteria in Solid Tumors (mRECIST). Furthermore, a comparison of objective response rate (ORR) and disease control rate (DCR) was conducted between the overall cohort and the matched cohort. Univariate and multivariate analyses were employed to identify independent risk factors affecting OS and PFS. In both the overall cohort and the matched cohort, the HAIC-PD1 group demonstrated superior OS and PFS outcomes compared to the simple HAIC group (P<0.0001). However, no significant differences were observed in ORR or DCR between the HAIC-PD1 group and the HAIC group. Multivariate analysis revealed that ALBI grade and treatment group served as predictive factors for OS, while extrahepatic metastasis along with the treatment group acted as independent risk factors for PFS. Notably, combining HAIC with anti-PD1 monoclonal antibody therapy exhibited more pronounced survival benefits than HAIC alone in patients with advanced HCC featuring vascular invasion; moreover, both approaches displayed similar efficacy in controlling tumor progression.
The Relationship Between autoimmune disorders and intracranial aneurysms in East Asian and European populations: A bidirectional and multivariable two-sample mendelian randomization study
Authors: Tang Chao , Ruan Rongcheng , Pan Bingxiao , Xu MingHong , Huang Jing , Xiong Zhaoying , Zhang Zhenxing 
Published: March 2024

Abstract
Background In the setting of autoimmune disorders(ADs), the formation of intracranial aneurysms (IA) is poorly understood, and the underlying systemic inflammatory characteristics of ADs may affect IA through shared inflammatory pathways. Our research sought to determine the likelihood that ADs contributed to IA and to calculate the magnitude of causal effects.
Methods We included 6 common ADs to explore their causal relationship with IA. We performed a bidirectional two-sample univariable Mendelian randomization (UVMR) analysis. The inverse variance weighted (IVW) and Bayesian weighted Mendelian randomization (BWMR) method were used as the primary analysis and a series of sensitivity analyses were performed to assess the robustness of our results. Data for ADs are from open GWAS, and data for IA are from the ISGC Cerebrovascular Disease Knowledge Portal (11084 cases and 311458 controls). These analyses were conducted in both East Asian and European populations. We grouped 6 ADs by connective tissue disease, inflammatory bowel disease, and thyroid disease, and futher performed a multivariate MR (MVMR1) analysis to explore the independent causal relationship between each AD and IA, and MVMR 2 analysis to account for potential confounders such as smoking, alcohol consumption, and systolic blood pressure.
Results In UVMR, we found that Systemic lupus erythematosus (SLE) was associated with a high risk of IA in East Asian populations (IVW OR, 1.06; 95%CI, 1.02-1.11; p = 0.0065, UVMR), and this result is supported by BWMR (OR, 1.06; 95%CI, 1.02-1.11; p = 0.0067, BWMR), MVMR1(OR, 1.06; 95%CI, 1.01-1.10; p = 0.015, MVMR1), MVMR2(OR, 1.05; 95%CI, 1.00-1.11; p = 0.049, MVMR2), and sensitivity analyses. Reverse MR analysis did not show a causal relationship between IA and ADs.
Conclusion This MR study provides evidence to support SLE as a risk factor for IA in East Asian populations, and the management of intracranial aneurysms in patients with SLE should be strengthened to avoid stroke events.
The association between infrastructure damage in the aftermath of Cyclone Idai and malaria risk in Sofala Province, Mozambique: an ecological study
Authors: Glowac Calder , Ferrão João L. , Searle Kelly M. 
Published: March 2024

Abstract

Background
In April of 2019 Mozambique was hit by Cyclone Idai leaving substantial damage to infrastructure and nearly two million people in need of humanitarian assistance. Malaria risk has been associated with living in a rural setting, vicinity to water, and household structure, all factors which are impacted by severe storms. This study quantified the association between damage to infrastructure (health care facilities and schools) following Cyclone Idai and malaria outcomes: malaria incidence, severe malaria, and administration of intermittent preventative treatment (IPTp) in Sofala Province, Mozambique.
Methods
To quantify infrastructure damage, historical satellite imagery was assessed visually using Google Earth Pro®. Damage to 66 school and 105 health centers was assessed for severity and duration. Location data was imported to QGIS and joined with district level data on malaria outcomes and environmental covariates. Multivariable Poisson regression models were used to quantify the associations between facility damage and malaria incidence and severe malaria. Generalized linear models were used to determine the association between facility damage and changes in malaria incidence and administration of IPTp from 2018–2019.
Results
An increase in facility damage was associated with an increase in malaria incidence and severe malaria. An increase in proportion of facilities damaged by 10% was associated with a 7.3% (95% CI: 6.8–7.8%) increase in malaria incidence. Risk of severe malaria was 2.16 (95% CI: 1.42–3.32) times higher in districts with any damage compared to those with no damage. However, proportional facility damage was associated with decreased malaria incidence and increased access to IPTp from 2018–2019, but these were not statistically significant.
Conclusion
An increase in proportion of facilities damaged following Cyclone Idai was associated with increased risk of malaria and severe malaria at the district level. This may be a function of decreased access to healthcare and an increased exposure to risk factors for malaria. A non-statistically significant decrease in malaria incidence was also found at the district level from 2018 to 2019, indicating that malaria may have been underreported in 2019, likely again a function of decreased access to healthcare.
Exploring the Controversy: Dysplasia in Oral Lichen Planus - A Comparative Study Based on WHO Criteria and the Binary System
Authors: Marques Letícia Côgo , Lopes Danielle Nobre , Gonçalves Lúcio Souza , Cunha Karin Soares , Junior Arley Silva , Conde Danielle Castex 
Published: March 2024

Abstract

Background
To assess the presence and degree of epithelial dysplasia of epithelial dysplasia according to the World Health Organization (WHO) criteria and the binary system in oral lichen planus (OLP) and oral lichenoid lesions (OLL), and to compare the influence of individual architectural and cytological criteria on the assessment of the degree of epithelial dysplasia in these lesions.
Methods
Sixty-five biopsies from lesions diagnosed as OLP and OLL underwent evaluation by two oral pathologists to diagnose oral epithelial dysplasia. This assessment utilized both WHO criteria and the binary system, with consideration given to individual architectural and cytological criteria in the diagnostic process.
Results
All biopsies showed epithelial dysplasia, with the majority classified as mild epithelial dysplasia according to WHO criteria (73.8%) and low risk by the binary system (61.5%). There was a statistically significant association in the classification of epithelial dysplasia between WHO criteria and the binary system. No statistically significant differences were found in the association of the presence and degree of epithelial dysplasia with the diagnosis of OLP and LLO. Statistical analysis indicated that an increase in the number of mitotic figures was associated with the severity of epithelial dysplasia (moderate/severe) according to the WHO system. Drop-shaped projections of epithelial ridges, an increased number of mitotic figures, superficial mitoses, premature keratinization in single cells, abnormal variation in cell shape, and atypical mitotic figures were associated with the high risk by the binary system.
Conclusion
The presence of epithelial dysplasia is common in both oral lichen planus and oral lichenoid lesions, and the degree of epithelial dysplasia does not statistically differ between these lesions. The absence of epithelial dysplasia should not be considered a diagnostic criterion for classifying OLP. The binary system may provide a more precise assessment of epithelial dysplasia in OLP and LLO lesions.