bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ethical dilemmas in prioritizing patients for scarce radiotherapy resources
Authors: DeBoer Rebecca J. , Ho Anita , Mutoniwase Espérance , Nguyen Cam , Umutesi Grace , Bigirimana Jean Bosco , Nsabimana Nicaise , Van Loon Katherine , Shulman Lawrence N. , Triedman Scott A. , Cubaka Vincent K. , Shyirambere Cyprien 
Published: January 2024

Background
Radiotherapy is an essential component of cancer treatment, yet many countries do not have adequate capacity to serve all patients who would benefit from it. Allocation systems are needed to guide patient prioritization for radiotherapy in resource-limited contexts. These systems should be informed by allocation principles deemed relevant to stakeholders. This study explores the ethical dilemmas and views of decision-makers engaged in real-world prioritization of scarce radiotherapy resources at a cancer center in Rwanda in order to identify relevant principles.

Methods
Semi-structured interviews were conducted with a purposive sample of 22 oncology clinicians, program leaders, and clinical advisors. Interviews explored the factors considered by decision-makers when prioritizing patients for radiotherapy. The framework method of thematic analysis was used to characterize these factors. Bioethical analysis was then applied to determine their underlying normative principles.

Results
Participants considered both clinical and non-clinical factors relevant to patient prioritization for radiotherapy. They widely agreed that disease curability should be the primary overarching driver of prioritization, with the goal of saving the most lives. However, they described tension between curability and competing factors including age, palliative benefit, and waiting time. They were divided about the role that non-clinical factors such as social value should play, and agreed that poverty should not be a barrier.

Conclusions
Multiple competing principles create tension with the agreed upon overarching goal of maximizing lives saved, including another utilitarian approach of maximizing life-years saved as well as non-utilitarian principles, such as egalitarianism, prioritarianism, and deontology. Clinical guidelines for patient prioritization for radiotherapy can combine multiple principles into a single allocation system to a significant extent. However, conflicting views about the role that social factors should play, and the dynamic nature of resource availability, highlight the need for ongoing work to evaluate and refine priority setting systems based on stakeholder views.
Influence of work-related stress on patient safety culture among nurses in a tertiary hospital: a cross-sectional study
Authors: Sani Mohammed Mohammed , Jafaru Yahaya , Ashipala Daniel Opotamutale , Sahabi Abubakar Kalgo 
Published: January 2024

Abstract
Background
One of the global issues facing the nursing profession is work-related stress because it interferes with care quality and organisational competency. These kinds of stressful situations can cause damage to the mental ability of the affected individual resulting in low job productivity. In a Nigerian healthcare setting, patient safety is under-researched.

Aim
This study aimed to assess the influence of work-related stress on patient safety culture among nurses in a tertiary hospital.

Materials and methods
The study adopted a descriptive cross-sectional survey. The Population of the study was nurses who are currently serving as employees at Federal Medical Center Birnin-Kebbi. Proportional and systematic sampling methods were used in the selection of the sample of the study. The tools used for this study were adapted Hospital Survey on Patient Safety (HSOPS) and Nurses’ Occupational Stressor Scale. Ethical approval was obtained from the research ethical committee of the hospital.

Results
The moderate stress experience was having the highest percentage (45.0%). The highest percentage of the nurses (69.9%) practised a moderate safety culture. There were weak or very weak significant negative correlations (P < 0.01) between patient safety culture practices and occupational stress across all the subscales of the nurses’ occupational stressors scale except in the occupational hazards subscale in which there was extremely weak and non-significant negative correlation. Work–family conflict was a significant predictor of patient safety culture, t (208) = -2.341, P < 0.05. Difficulty in taking leave was a significant predictor of patient safety culture, t (208) = -2.190, P < 0.05.

Conclusion
There was a significant negative correlation between stress and safety practice which implies that as stress increased safety practice decreased. These study findings can be used to develop ongoing strategies and targeted interventions in addressing work-related stress.
Occurrence and molecular characterization of Escherichia coli strains isolated from black grouse (Lyrurus tetrix) from the Karkonosze National Park in Poland
Authors: Kwaśna Natalia , Majewska Maja , Karwańska Magdalena , Siedlecka Magdalena , Pałucki Artur , Piasecki Tomasz 
Published: January 2024

AbstractThe purpose of this study was to characterize Escherichia coli (E. coli) strains isolated from wild black grouse (Lyrurus tetrix), carried out due to the crossing of hiking trails with wild bird habitats from the Karkonosze National Park. Twenty-seven E. coli isolates were obtained from fecal samples collected during the winter months of 2017 and 2018. The strains were assigned to their relevant phylo-groups and the prevalence of virulence genes characteristic of APEC strains (irp2, astA, iss, iucD, papC, tsh, vat, cva/cvi, stx2f) was checked using PCR analysis. In addition, the phenotypic and genotypic resistance to antibiotics was determined. The entire study provided a better understanding of the potential bacteriological threat to wild birds of the Karkonosze National Park. The results showed that 55.6% of the strains belonged to phylo-group B1 (15/27), 33.3% to group B2 (9/27) and 11.1% to group D (3/27). Among the virulence genes tested, irp2 was detected in 25.9% of isolates (7/27), vat in 22.2% (6/27) and iucD in 3.7% (1/27). The tested E. coli strains showed susceptibility to most antimicrobials, only 14 (51.9%) of them were intermediate resistant or resistant to sulfamethoxazole. The presence of none of the tested genes responsible for resistance to selected antibiotics was identified. Our research indicates a low level of transfer of antimicrobial substances to the natural environment and confirms the effectiveness of the Karkonosze National Park’s activities to protect and restore black grouse habitats.
MiR-124-3p negatively impacts embryo implantation via suppressing uterine receptivity formation and embryo development
Authors: Yao Kezhen , Kang Quanmin , Chen Kai , Shi Biwei , Jin Xiaofen 
Published: January 2024

AbstractDuring embryo implantation, blastocyst interacts with the receptivity endometrium and the endometrial epithelium secretes nurturing fluid to support embryonic development. Interferon-λ (IFN-λ) is a novel, non-redundant regulator that participates in the fetal–maternal interaction; however, the precise molecular mechanism underlying its impact on uterine receptivity remains elusive. Here, microarray profiling revealed that 149 specific miRNAs were differentially expressed in the human endometrial cells following IFN-λ treatment. In particular, miR-124-3p expression was significantly reduced after IFN-λ treatment (p < 0.05). An in vivo mouse pregnancy model showed that miR-124-3p overexpression notably decreased embryo implantation rate and led to an aberrant epithelial phenotype. Furthermore, miR-124-3p negatively impacted the migration and proliferation of endometrial cells, and hindered embryonic developmental competence in terms of blastocyst formation and global DNA re-methylation. Downstream analysis showed that LIF, MUC1 and BCL2 are potential target genes for miR-124-3p, which was confirmed using western blotting and immunofluorescence assays. In conclusion, IFN-λ-driven downregulation of miR-124-3p during embryo implantation modulates uterine receptivity. The dual functional role of miR-124-3p suggests a cross-talk model wherein, maternal endometrial miRNA acts as a transcriptomic modifier of the peri-implantation endometrium and embryo development.
New insights on collagen structural organization and spatial distribution around dental implants: a comparison between machined and laser-treated surfaces
Authors: Belloni Alessia , Argentieri Giulio , Orilisi Giulia , Notarstefano Valentina , Giorgini Elisabetta , D’Addazio Gianmaria , Orsini Giovanna , Caputi Sergio , Sinjari Bruna 
Published: January 2024

Abstract
Background
One of the main factors for the osseointegration of dental implants is the development of an adequate soft tissue barrier, mainly composed by collagen, which protects the implant from bacterial development. The structural features of the peri-implant collagen are influenced by the implant components and, in particular, by the type of the surface. In the clinical practice, healing abutments are characterized by smooth surfaces, named machined. Recently, a new laser technique, Synthegra, has been developed to obtain a topography-controlled surface with micrometric regular pores that seems reducing the risk of peri-implantitis. Based on this background, this study aims investigating the structural organization and spatial distribution of collagen surrounding healing abutments characterized by laser-treated and machined surfaces.

Methods
Gingiva portions surrounding custom-made healing abutments (HA), characterized by alternated laser-treated and machined surfaces, were collected and analyzed by combining Fourier Transform InfraRed Imaging (FTIRI) spectroscopy, a non-invasive and high-resolution bidimensional analytical technique, with histological and multivariate analyses.

Results
Masson’s trichrome staining, specific for collagen, highlighted a massive presence of collagen in all the analyzed samples, evidencing a surface-related spatial distribution. The nature of collagen, investigated by the FTIRI spectroscopy, appeared more abundant close to the laser-treated surface, with a perpendicular disposition of the bundles respect to the HA; conversely, a parallel distribution was observed around the machined surface. A different secondary structure was also found, with a higher amount of triple helices and a lower quantity of random coils in collagen close to the laser treated surfaces.

Conclusions
FTIRI spectroscopy demonstrates that the use of a laser treated transmucosal surface can improve the morphological organization of the peri-implant collagen, which presents a distribution more similar to that of natural teeth.
Trial registration: This trial is registered with ClinicalTrials.gov Identifier: (Registration Number: NCT05754970). Registered 06/03/2023, retrospectively registered, https://clinicaltrials.gov/show/NCT05754970.
Adverse clinical outcomes and immunosuppressive microenvironment of RHO-GTPase activation pattern in hepatocellular carcinoma
Authors: Yang Qi , Zhuo Zewei , Qiu Xinqi , Luo Ruibang , Guo Kehang , Wu Huihuan , Jiang Rui , Li Jingwei , Lian Qizhou , Chen Pengfei , Sha Weihong , Chen Hao 
Published: January 2024

Abstract
Background
Emerging evidence suggests that Rho GTPases play a crucial role in tumorigenesis and metastasis, but their involvement in the tumor microenvironment (TME) and prognosis of hepatocellular carcinoma (HCC) is not well understood.

Methods
We aim to develop a tumor prognosis prediction system called the Rho GTPases-related gene score (RGPRG score) using Rho GTPase signaling genes and further bioinformatic analyses.

Results
Our work found that HCC patients with a high RGPRG score had significantly worse survival and increased immunosuppressive cell fractions compared to those with a low RGPRG score. Single-cell cohort analysis revealed an immune-active TME in patients with a low RGPRG score, with strengthened communication from T/NK cells to other cells through MIF signaling networks. Targeting these alterations in TME, the patients with high RGPRG score have worse immunotherapeutic outcomes and decreased survival time in the immunotherapy cohort. Moreover, the RGPRG score was found to be correlated with survival in 27 other cancers. In vitro experiments confirmed that knockdown of the key Rho GTPase-signaling biomarker SFN significantly inhibited HCC cell proliferation, invasion, and migration.

Conclusions
This study provides new insight into the TME features and clinical use of Rho GTPase gene pattern at the bulk-seq and single-cell level, which may contribute to guiding personalized treatment and improving clinical outcome in HCC.
Stress hyperglycemia increases short-term mortality in acute ischemic stroke patients after mechanical thrombectomy
Authors: Yang Bing , Chen Xuefang , Li Fangze , Zhang Junrun , Dong Dawei , Ou Huiyue , Lu Longyan , He Niu , Xu Xiaohong , Xin Xiufeng , Lu Jingchong , Guan Min , Qiao Hongyu , Xu Anding , Zhu Huili 
Published: January 2024

Abstract
Background and purpose
Glucose-to-glycated hemoglobin ratio (GAR) is considered a more reliable marker of stress hyperglycemia by correcting for basal blood glucose levels. This study aimed to investigate the extent to which GAR is associated with 3 month and 1 year all-cause mortalities in patients with acute ischemic stroke (AIS) undergoing mechanical thrombectomy (MT).

Methods
We retrospectively followed 553 AIS patients who underwent MT. The degree of stress hyperglycemia was quantified as the GAR, defined as fasting plasma glucose (mmol/L)/hemoglobin A1c (HbA1c) (%) on the second day after admission. According to the GAR quartiles, the patients were further categorized into four groups (group 1-group 4). We assessed the association between GAR and all-cause mortalities, clinical outcomes during hospitalization and function outcomes at 3 months. The associations between stress hyperglycemia and all-cause mortalities were analyzed using a Cox proportional-hazards model, while other outcomes were analyzed using multiple logistic regression analysis.

Results
The follow-up lasted a median of 18 months (range 0–66 months). The 3 month mortality rate was 9.58% (n = 53) and the 1 year mortality rate was 18.62% (n = 103). The Kaplan–Meier analysis revealed a significant inverse relationship between GAR and mortality (P < 0.001). In the Cox proportional-hazards model at 3 months, compared with group1, group 4 of GAR was associated with a significant increase in the risk of 3 month mortality (hazard ratio [HR] = 4.11, 95% confidence interval [CI] 1.41–12.0, P = 0.01) after adjusting for potential covariates. On multivariate logistic regression analysis, GAR was strongly associated with an increased risk of 3 month poor function outcome.

Conclusions
Stress hyperglycemia, quantified by a higher GAR, is associated with all-cause mortality and poor functional outcomes in patients with AIS who undergo MT. Furthermore, GAR may contribute to improving the predictive efficiency of all-cause mortality in patients with AIS after MT, especially short-term all-cause mortality.
RETRACTED ARTICLE: Improved RFID mutual authentication protocol against exhaustive attack in the context of big data
Authors: Li Kongze 
Published: January 2024

AbstractThe development of big data has epromoted the development of Internet technology, but it has brought more network security and privacy problems. Therefore, how to solve network security problems is the main research direction of current network technology development. In order to deal with the harm of network attacks to personal privacy security, this paper studies and proposes an RFID mutual authentication protocol against exhaustive attacks based on improved Hash function, and proposes a security proof based on BAN logic rules. At the same time, to enhance the computing resources of the improved protocol, this paper proposes an improved authentication query protocol for multi-source RFID tags. In the performance analysis, when the distance between the reader and the tag reaches 10 m, the improved protocol can still be higher than 90%. The application test shows that the improved protocol proposed in the study is capable of resisting exhaustive attacks, its execution time is short, and it is less affected by the number of tags. The above results show that in the context of big data, the improved RFID mutual authentication protocol proposed by the research against network exhaustive attacks has a more significant defense effect, can effectively protect user privacy, and has a greater reference value in network security research.
Key-in-session identity negotiations in a first line treatment for adult anorexia nervosa
Authors: Heywood Lauren , Conti Janet , Touyz Stephen , Madden Sloan , Hay Phillipa 
Published: January 2024

Abstract
Background
Exploration of client identity negotiations during treatment for Anorexia Nervosa (AN) is a relatively new area of research. Research suggests that difficulties with identity negotiations may present as a barrier to treatment. This study sought to explore individuals’ identity negotiations during therapy sessions using Compulsive Exercise Activity Therapy (LEAP) combined with Cognitive Behaviour Therapy for Anorexia Nervosa (CBT-AN). Analysis focused on moments in therapy where individuals’ identities were dominated or defined by AN and where alternative identities could be generated.

Method
40 in-session transcripts from sessions at early, mid and end points of the CBT-AN (with LEAP) treatment were qualitatively analysed for nine of the 78 participants in the original randomised control trial. Through a constructivist framework, thematic analysis was used to identify surface and latent meanings and discursive material participants used to negotiate their identities in the context of therapy sessions.

Results
Analysis of in-therapy transcripts generated two themes pertaining to identity negotiations: (1) troubled identities and (2) rebuilding identities and lives outside of AN. Early therapy sessions explored fragmented and AN dominated identities, including how AN was troubling to participants’ sense of self, contributed to conflicted identities, positioned them outside of normality, and was associated with isolated and othering identities. Within therapy sessions, participants engaged in a recursive process of shifting relationships with AN and themselves and building identities and lives outside of the AN identity. This included generating hopes for recovery and the future more frequently in mid- to late- therapy sessions.

Conclusion
Identity negotiations evident in the therapeutic conversations aligned with the key components of the CBT-AN intervention, including addressing (1) the characterisation of oneself as ‘an anorexic’ and (2) the diversification of roles and activities to broaden and enhance self-concepts. Future developments of therapeutic interventions for AN would benefit from greater consideration of ways to assist individuals to more comprehensively address problematic identities, including uncovering identities hidden by the AN identity and generating preferred identities.
Trial Registration: Ethics approval was obtained at the time of the initial study and for this embedded research by the HREC at the Western Sydney University (HR777332).
Effects of laser cleaning on the condition of different silk model samples using varying wavelengths and pulse durations
Authors: Brockmann Nora , Sicken Anne , Krüger Jörg 
Published: January 2024

Abstract
The cleaning of aged silk fibers poses a common challenge in the conservation of textiles, since traditional cleaning techniques often yield unsatisfactory results or even harm objects. In this regard, cleaning objects with laser radiation is a promising addition to the range of available methods. Due to it being contactless, even brittle and touch-sensitive objects with disfiguring or harmful soiling could potentially be cleaned and therefore made accessible for research and presentation. Examples of treatment have sometimes shown spectacular results. Still there is some skepticism concerning the safety of this treatment for textile materials, which has been strengthened through previous 532 nm wavelength nanosecond laser cleaning studies on silk fibers. Taking these published results into account, the range of examined laser parameters has been extended in this study, from 532 nm nanosecond laser to 1064 nm nanosecond and even 800 nm femtosecond laser, reevaluating the effect of this treatment on the fibers. The physicochemical processes taking place on the silk fibers when cleaning with lasers are complex and still not fully understood. The aim of this project was therefore to bring more clarification about potential effects of those processes on the condition of silk samples treated with a set of different parameters for wavelength, pulse duration, energy density and number of pulses per spot. It also looks at the influence of the presence of soiling on the results. The analysis of potential effects was then carried out using statistical methods and advanced analytics. Scanning electron microscopy, Fourier-transform infrared spectroscopy and colorimetry technology provided the required insights to better assess the effects. Results show that laser cleaning of silk fibers, like most other conventional cleaning techniques, is not completely without risk, but knowing what the possible effects are helps making decisions on whether the benefits of the technique used justify these risks.
Assessment of interleukin 6 (IL-6) as a marker of inflammation among adult patients with pulmonary tuberculosis in Zaria, Nigeria
Authors: Sa’ad Mairiga , Abba Abdullah A. , Musa Bolanle Olufunke Priscilla , Ahmad Abdurrahman El-fulaty , Mohammed Musa 
Published: January 2024

AbstractTuberculosis (TB) remains a significant cause of morbidity and mortality worldwide. Complications of the disease are associated with the host’s inflammatory response. The study aimed to determine the plasma level of interleukin-6 as a biomarker of inflammation among adult patients with pulmonary tuberculosis in Zaria.Method This was a cross-sectional study. Blood samples were taken from 30 treatment-naïve (TN), 30 treatment-experienced (TE), and 30 healthy controls (HC).Results The means and standard deviations of interleukin-6 plasma levels for tuberculosis treatment naive, treatment experience and apparently healthy control are 64.4 ± 19.4, 57.9 ± 21.4, and 49.9 ± 7.7 pg/L, respectively. This study found upregulated plasma levels of interleukin-6 among treatment naive compared to treatment experience but the statistically not significant and significantly upregulated level of interleukin 6 among treatment naïve compared to apparently healthy control (p = 0.006). There was a downregulated level of interleukin-6 among HC compared to TN and TE but statistically not significant.Conclusion The role of interleukin-6 as a surrogate biomarker for the management of patients with pulmonary tuberculosis is promising but requires further study.