bluuebunny/crossref_metadata_2025_split huggingface dataset:
Locally advanced breast cancer: breast-conserving surgery and other factors linked to overall survival after neoadjuvant treatment
Authors: Nobrega Gabriela Bezerra , Mota Bruna Salani , de Freitas Gabriela Boufelli , Maesaka Jonathan Yugo , Mota Rosa Maria Salani , Goncalves Rodrigo , Trinconi Angela Francisca , Ricci Marcos Desidério , Piato José Roberto , Soares-Jr José Maria , Baracat Edmund Chada , Filassi José Roberto 
Published: November 2023

BackgroundRecent data suggest that breast-conserving surgery (BCS) may positively impact overall survival (OS) in early breast cancer. However, the role of BCS in locally advanced breast cancer (LABC) following neoadjuvant therapy (NAT) remains uncertain.MethodsWe conducted a retrospective cohort study involving 530 LABC patients who underwent surgery after NAT between 2010 and 2015. Outcomes examined included OS, distant recurrence rates (DRR), and loco-regional recurrence rates (LRRs).ResultsAmong the 927 breast cancer patients who received NAT, 530 were eligible for our study. Of these, 24.6% underwent BCS, while 75.4% underwent mastectomy (MS). The median follow-up duration was 79 months. BCS patients exhibited a higher pathological complete response (PCR) rate compared to those who underwent MS (22.3% vs. 10%, p &lt; 0.001). The 6-year OS rates for BCS and MS were 81.5% and 62%, respectively (p &lt; 0.000). In multivariate OS analysis, MS was associated with worse outcomes (OR 1.678; 95% CI 1.069–2.635; p = 0.024), as was body mass index (BMI) (OR 1.031; 95% CI 1.006–1.058; p = 0.017), and stage IIIB or IIIC (OR 2.450; 95% CI 1.561–3.846; p &lt; 0.000). Conversely, PCR (OR 0.42; 95% CI 0.220–0.801; p = 0.008) was associated with improved survival. DRR was significantly lower in BCS (15.4%) compared to MS (36.8%) (OR 0.298; 95% CI 0.177–0.504). LRRs were comparable between BCS (9.2%) and MS (9.5%) (OR 0.693; 95% CI 0.347–1.383).ConclusionOur findings suggest that BCS is oncologically safe, even for patients with large lesions, and is associated with superior OS rates compared to MS. Additionally, lower BMI, lower pretreatment stage, and achieving PCR were associated with improved survival outcomes.
Artificial intelligence in language instruction: impact on English learning achievement, L2 motivation, and self-regulated learning
Authors: Wei Ling 
Published: November 2023

IntroductionThis mixed methods study examines the effects of AI-mediated language instruction on English learning achievement, L2 motivation, and self-regulated learning among English as a Foreign Language (EFL) learners. It addresses the increasing interest in AI-driven educational technologies and their potential to revolutionize language instruction.MethodsTwo intact classes, consisting of a total of 60 university students, participated in this study. The experimental group received AI-mediated instruction, while the control group received traditional language instruction. Pre-tests and post-tests were administered to evaluate English learning achievement across various domains, including grammar, vocabulary, reading comprehension, and writing skills. Additionally, self-report questionnaires were employed to assess L2 motivation and self-regulated learning.ResultsQuantitative analysis revealed that the experimental group achieved significantly higher English learning outcomes in all assessed areas compared to the control group. Furthermore, they exhibited greater L2 motivation and more extensive utilization of self-regulated learning strategies. These results suggest that AI-mediated instruction positively impacts English learning achievement, L2 motivation, and self-regulated learning.DiscussionQualitative analysis of semi-structured interviews with 14 students from the experimental group shed light on the transformative effects of the AI platform. It was found to enhance engagement and offer personalized learning experiences, ultimately boosting motivation and fostering self-regulated learning. These findings emphasize the potential of AI-mediated language instruction to improve language learning outcomes, motivate learners, and promote autonomy.ConclusionThis study contributes to evidence-based language pedagogy, offering valuable insights to educators and researchers interested in incorporating AI-powered platforms into language classrooms. The results support the notion that AI-mediated language instruction holds promise in revolutionizing language learning, and it highlights the positive impact of AI-driven educational technologies in the realm of language education.
Meeting preschool screen time recommendations: which parental strategies matter?
Authors: Fitzpatrick Caroline , Cristini Emma , Bernard Jonathan Y. , Garon-Carrier Gabrielle 
Published: November 2023

BackgroundHigh levels of screen use by preschoolers may contribute to adverse health and developmental outcomes. Little is known about which parental strategies may be protective against intensive screen use by children. Our aim is to estimate whether parent strategies for mediating child screen time including restrictive and instructive mediation and social coviewing, predict preschooler adherence to the screen time recommendation of ≤1 h/day during the COVID-19 pandemic. We also examine if parent restrictive mediation interacts with child temperament characteristics.MethodsOur sample is composed of 315 Canadian parents of preschoolers surveyed during the COVID-19 pandemic. Parents provided measures of child adherence to screen time guidelines at ages 3.5 (baseline) and 4.5 years. Parents also reported how often they used restrictive and instructional mediation, and social coviewing to manage their child’s screen use. Control variables include child sex and temperament (effortful control, negative affectivity, extraversion), educational attainment, and parenting stress at age 3.5.ResultsA logistic regression revealed that parental restrictiveness was associated with a 4 time increase in the odds of adherence to screen time guidelines, OR = 4.07 (95% CI [1.70–13.03]). Parental social coviewing decreased the chances of adherence by 80% (OR = 0.20, 95% CI [0.09–0.48]). Furthermore, children not meeting recommendation at 3.5 were 98% less likely to respect the recommendation 1 year later (OR = 0.02, 95% CI [0.01–0.07]). Results were adjusted for child sex, temperament, baseline screen time, and parent education and stress The interaction between the restriction mediation and child temperament on later screen time was not significant.ConclusionOur results indicate that some parental strategies may be more effective than others for managing preschooler screen time. Parent use of restrictive mediation was most likely to forecast child adherence to later screen time recommendations. The present results may contribute to the development of targeted family-based interventions designed to promote healthy development from a young age.
Climate change and mental health of Indigenous peoples living in their territory: a concept mapping study
Authors: Grande Antonio Jose , Dias Ieda M. A. V. , Jardim Paulo T. C. , Vieira Machado Alessandra Aparecida , Soratto Jacks , da Rosa Maria Inês , Roever Leonardo , Bisognin Ceretta Luciane , Zourntos Xanthi , Harding Seeromanie 
Published: November 2023

BackgroundThe alarming increase in annual deforestation rates has had devastating consequences in climate change, and it is affecting Indigenous people, who depend entirely on the land for survival and has also weakened the rainforest's crucial role in stabilizing the global climate. Recognizing and respecting Indigenous people's needs and social, economic, and historical conditions influence health and healthcare. This study aimed to conduct online concept mapping workshops with university students to identify perceived important and feasible actions for improving the mental health of Indigenous people living in their territory in association with climate change.MethodsConcept mapping, a participatory mixed methodology, was conducted virtually with 20 Indigenous students at two universities in Brazil. A focus prompt was developed from consultations with Indigenous stakeholders and read—“To improve the mental health of Indigenous peoples in their territory during climate change crises, it is necessary to….”ResultsUniversity students organized 42 unique statements in 6 clusters that cover a wide range of topics: family support, 0.68 (SD 0.19); respect and understanding, 0.37 (SD 0.08); improvement actions, 0.52 (SD 0.07); public policies in favor of Indigenous people's mental health, 0.24 (0.09); health actions, 0.15 (SD 0.08); Indigenous training in health and its importance in improving mental health 0.32 (SD 0.07).ConclusionThese clusters range from community initiatives, public policies, health actions, and strengthening professional services in Indigenous communities. These all provide numerous concrete ideas for developing interventions designed to address mental health challenges associated with climate change.
Influenza vaccination rates among healthcare workers: a systematic review and meta-analysis investigating influencing factors
Authors: Fan Jingchun , Xu Shijie , Liu Yijun , Ma Xiaoting , Cao Juan , Fan Chunling , Bao Shisan 
Published: November 2023

IntroductionHealthcare workers risk of exposure to the influenza virus in their work, is a high-risk group for flu infections. Thus WHO recommends prioritizing flu vaccination for them–an approach adopted by &gt;40 countries and/or regions worldwide.MethodsCross-sectional studies on influenza vaccination rates among healthcare workers were collected from PubMed, EMBASE, CNKI, and CBM databases from inception to February 26, 2023. Influenza vaccination rates and relevant data for multiple logistic regression analysis, such as odds ratios (OR) and 95% confidence intervals (CI), were extracted.ResultsA total of 92 studies comprising 125 vaccination data points from 26 countries were included in the analysis. The meta-analysis revealed that the overall vaccination rate among healthcare workers was 41.7%. Further analysis indicated that the vaccination rate was 46.9% or 35.6% in low income or high income countries. Vaccination rates in the Americas, the Middle East, Oceania, Europe, Asia, and Africa were 67.1, 51.3, 48.7, 42.5, 28.5, and 6.5%, respectively. Influencing factors were age, length of service, education, department, occupation, awareness of the risk of influenza, and/or vaccines.ConclusionThe global influenza vaccination rate among healthcare workers is low, and comprehensive measures are needed to promote influenza vaccination among this population.Systematic review registrationwww.inplysy.com, identifier: 202350051.
Enhancing Compressive Strength in Cementitious Composites through Effective Use of Wasted Oyster Shells and Admixtures
Authors: Cha Inyeong , Kim Jinwoong , Lee Heeyoung 
Published: November 2023

Wasted oyster shells generate environmental pollution and odor, thereby causing inconvenience to people. In addition, low-quality aggregates are generated owing to the lack of sand. To address these problems, cementitious composites that replaced sand with oyster shell powder were fabricated in this study, and a total 120 specimens were fabricated (specimen size: 50×50×50 mm3). The oyster shell substitution rate for sand, admixture type, and presence or absence of admixture were set as the experimental parameters. Herein, 0, 30, 70, and 100% of sand was replaced with oyster shell powder to examine the compressive strength of the cementitious composites according to the oyster shell powder content. The experiment results confirmed the decrease in the compressive strength of the cementitious composite with an increase in the oyster shell powder content. In the case of the cementitious composites mixed with oyster shell powder, silica fume, blast furnace slag, and an air-entraining water-reducing agent, the compressive strength increased by up to 30% with an increase in the oyster shell powder content. The results of cementitious composites containing oyster shell powder and admixture fabricated in this study indicate the potential of oyster shells as a new construction material that can replace sand.
Understanding GPs’ referral decisions for younger patients with symptoms of cancer: a qualitative interview study
Authors: di Martino Erica , Honey Stephanie , Bradley Stephen H , Ali Omer M , Neal Richard D , Scott Suzanne E 
Published: November 2023

BackgroundCancer incidence increases with age, so some clinical guidelines include patient age as one of the criteria used to decide whether a patient should be referred through the urgent suspected cancer (USC) pathway. Little is known about how strictly GPs adhere to these age criteria and what factors might influence their referral decisions for younger patients.AimTo understand GPs’ clinical decision making for younger patients with concerning symptoms who do not meet the age criteria for USC referral.Design and settingQualitative study using in-depth, semi-structured interviews with GPs working in surgeries across England.MethodParticipants (n= 23) were asked to recall consultations with younger patients with cancer symptoms, describe factors influencing their clinical decisions, and discuss their overall attitude to age thresholds in cancer referral guidelines. A thematic analysis guided by the Framework approach was used to identify recurring themes.ResultsGPs’ decision making regarding younger patients was influenced by several factors, including personal experiences, patients’ views and behaviour, level of clinical concern, and ability to bypass system constraints. GPs weighted potential benefits and harms of a referral outside guidelines both on the patient and the health system. If clinical concern was high, GPs used their knowledge of local systems to ensure patients were investigated promptly even when not meeting the age criteria.ConclusionWhile most GPs interpret age criteria flexibly and follow their own judgement and experience when making clinical decisions regarding younger patients, system constraints may be a barrier to timely investigation.
Local Inflammation But Not Kidney Cell Infection Associated with High APOL1 Expression in COVID-Associated Nephropathy
Authors: Nguyen Jane K. , Wu Zhenzhen , Agudelo Jose , Herlitz Leal C. , Miller Aaron W. , Bruggeman Leslie A. 
Published: November 2023

Key Points

In coronavirus disease-19 biopsies, detection of severe acute respiratory syndrome coronavirus 2 was rare with no evidence of viral replication, whereas autopsy tissue failed quality control.In patients with FSGS, apolipoprotein L1 expression differed by degree of immune cell infiltrates, with some podocytes exhibiting up to 18-fold higher expression.In COVAN, the predicted high induction of apolipoprotein L1 expression occurs in a pattern consistent with the stochastic nature of FSGS pathology.
Seismic-based paleoenvironmental analysis of the Paleocene carbonate shelf in Ajdabiya Trough, north-central of Libya
Authors: Asheibi Abdeladim M. 
Published: November 2023

Abstract
The results of the seismic and well logs interpretation, together with previous literature, were used to construct a generalized model of the development of the Paleocene reefs, and a depositional model for the Paleocene carbonate shelf in Ajdabiya Trough that focuses on the initiation, growth, and demise of the reefs in this basin. The Intisar reefs began as algal-foraminiferal banks. Growth of the reefs was halted by a short-lived transgression that drowned reefs and led to shale deposition of Kheir shales. The inversion of 3-D seismic data to acoustic impedance has allowed for a better determination of the main facies in Intisar reefs. These facies reflect different depositional conditions and different ages. They are: 1) algal-foraminiferal packstone/grainstone; 2) bioclastic grainstone/packstone; 3) coralline floatstone/bindstone; 4) reefal boundstone and; 5) bio-lithoclastic talus.
The Upper Sabil consists of a prograding carbonate shelf with ramp platform morphology, and its differentiated deposits indicate four main depositional facies tracts: 1) inner shelf margin; 2) barrier reefs; 3) pinnacle reefs and; 4) outer shelf margin. The proposed model for the growth of the Paleocene reefs in the Ajdabiya Trough represents consecutive stages of development: 1) the Lower Sabil Carbonate was deposited during the very early Upper Paleocene time; 2) the influx of the Sheterat Shale during the major marine transgression; 3) the sea-level began a very slow fall due to variable subsidence of the underlying strata (a deposition of micrite over the Sheterat Shale, the lower part of the Upper Sabil Carbonate); 4) the rise in sea level is evident from an increase in foraminifera and algae constituents over the high areas of the lower part of the Upper Sabil Carbonate; 5) the isolated Intisar reefs were born under the proper local circumstances. The rate of subsidence was very slow, and the coral reef had significant upward growth and; 6) a major transgression happened at the end of the Paleocene, and the consequent deepening of the water in the area drowned and killed the Intisar reefs and capped it with Kheir Shale.
Sequence stratigraphy and underlying tectonism of the Northern Richardson Mountains and adjacent Mackenzie Delta related to the formation of the Arctic Ocean
Authors: Millar Ryan A. , Daniels Benjamin , Catuneanu Octavian , Matthews William A. , Hadlari Thomas 
Published: November 2023

Abstract
Jurassic-Cretaceous rifting within Arctic North America that eventually resulted in the formation of the Amerasia Basin greatly affected deposition within nearshore terrestrial basins in surrounding areas, such as the Brooks-Mackenzie Basin and the Sverdrup Basin. In this paper, four measured stratigraphic sections and detrital U-Pb zircon data (N = 14; n = 3339) from outcrops within the Northern Richardson Mountains are integrated with well-log and core data from the adjacent Mackenzie Delta to establish a model-independent sequence stratigraphic framework for the Brooks-Mackenzie Basin. This framework is used to elucidate the underlying tectonic forces responsible for the observed stratigraphy, relating patterns of deposition to various phases of rift development. The proposed interpretation classifies the sub-Jurassic unconformity as a first-order sequence boundary, demarcating a change in tectonic setting from pre-rift to rift, meaning it is also classified as the rift onset unconformity for the Amerasia Basin. The overlying Bug Creek Group is largely progradational, representing a first-order lowstand systems tract corresponding to early syn-rift strata. Detrital zircon data from the Bug Creek Group lacks syn-depositional detrital zircon and resembles the underlying Permian, suggesting a recycled source of sediment. A change in the detrital zircon signature is observed within the uppermost Aklavik Formation, representing a new source. This also coincides with a rapid transition from shoreface sandstones of the Aklavik Formation to the lower offshore deposits of the Husky Formation caused by normal faulting in the Husky Lakes Fault Zone which is associated with a dramatic basin expansion. Maximum transgression occurs above the Arenaceous Member of the Husky Formation, likely near the Jurassic-Cretaceous boundary, representing a first-order maximum flooding surface and rift-climax. Above the maximum flooding surface, the overall progradational signature represents a first-order highstand systems tract and early post-rift deposits. The sub-Hauterivian basal Kamik unconformity is observed at the base of the subsequent falling stage systems tract. This first-order sequence boundary is approximately time equivalent to the breakup unconformity for the Arctic Ocean, with the overlying Kamik Formation resembling the Isachsen Formation in the Sverdrup Basin.
The Integration of Social Media in Integrated Marketing Communication: A Systematic Review and Theorical Framework
Authors: Harizi Ariola , Trebicka Brunela 
Published: November 2023

This study examines the impact and significance of integrating social media into integrated marketing communication (IMC) strategies. By analyzing the literature and synthesizing existing research, this study aims to evaluate the role of social media in enhancing communication effectiveness, consumer engagement, and brand promotion. The research objective is to assess the level of coherence and consensus among scholars regarding marketing communication strategies and explore emerging trends in social media integration within IMC. This study employs a systematic review methodology to collect and analyze relevant articles from prominent literature databases. Findings underscore the importance of IMC as a holistic approach to marketing communication and demonstrate how social media platforms facilitate two-way interaction between companies and consumers. Additionally, the analysis delves into the influence of social media on consumer perception and engagement, examines the connection between social media integration and the marketing mix, and identifies emerging trends for future research (Bry?a et al., 2022). Overall, this study provides valuable insights into the significance of social media integration within IMC strategies and offers implications for marketers to effectively leverage these platforms for improved communication outcomes.

Received: 23 May 2023 / Accepted: 12 October 2023 / Published: 5 November 2023
The Synergy Between Financial Education, Economic Well-Being, and Financial Stress: An Analysis of Interconnections and Reciprocal Effects
Authors: Moreira-Choez Jenniffer Sobeida , Arteaga Kerly Cecilia Cruz , Benavides-Lara Raúl Marcelo , Gutierrez Martha Tatiana Velasquez , Herrera Maricela Kathiusca Giler , Lamus de Rodríguez Tibisay Milene 
Published: November 2023

Background: Economic well-being and financial stress have been identified as crucial factors determining quality of life. This study aims to analyze financial education, economic well-being, financial stress, and their interrelations. With this, we seek to provide a more nuanced insight into the financial reality and its implications on individuals' quality of life, which has contributed to the enrichment of the field of study in question. Methods: The research is framed within an applied inquiry paradigm, with a quantitative approach. The survey technique was used, followed by subsequent statistical analysis. The sample consisted of 100 faculty members from the Technical University of Manabí. Results: Among the results, it was highlighted that financial education was positively associated with age, education, and marital status. This indicates that as people age, they acquire more financial knowledge and skills, resulting in better financial education. Conclusions: Among the most relevant conclusions, it supports the idea that financial education and economic well-being are interrelated and can be influenced by individual and socioeconomic factors. It is essential to address financial education and promote healthy financial practices from an early age, to provide opportunities for continuous learning throughout life.

Received: 21 September 2023 / Accepted: 15 October 2023 / Published: 5 November 2023