bluuebunny/crossref_metadata_2025_split huggingface dataset:
Self-efficacy, grit, and rural career aspirations among early career nurses: A repeated cross-sectional study
Authors: Terry Daniel , Peck Blake , Baker Ed , Schmitz David 
Published: September 2023

Abstract
Background: The present global nursing workforce shortage represents an impediment to the delivery of safe, evidence-based healthcare. Despite all collective efforts a consistent stream of nurses leaving the profession remains, particularly within the first five years of practice, further exacerbated in rural communities.
Methods: As part of a longitudinal investigation examining early career nurse career trajectories, changes in self-efficacy, grit, and career aspirations were compared, using a repeated cross-sectional design, among second- and fourth-year nurses after graduation. Participants included, 117 (response rate 52.2%) who completed an online questionnaire 18-24 months after graduating, and 32 participants (response rate of 21.0%) who agree to repeat the questionnaire 36-48 months after graduating. The questionnaire included demographic and employment items, and measures examining general and occupational self-efficacy, grit, and rural career aspirations.
Results: No differences between general and occupational self-efficacy or grit were identified between send and fourth year nurses. In addition, the importance placed on undertaking rural career also remains unchanged. However, a higher proportion of fourth year nurses were more likely to be in management or were considering leaving the profession, as anticipated.
Conclusions: This examination of early career nurses who are now in their second and fourth-year post-graduation highlights self-efficacy, grit, and rural career aspirations remains stable between two- and four-years following graduation, while nursing in their fourth year were more likely to consider leaving the profession. Nursing retention is a ‘Wicked Problem’ that is unavoidably a complex amalgam of macro, meso and micro factors that we are yet to fully appreciate.
Whole Genome Resequencing Reveals the Evolutionary History and Geographic Isolation of the eastern Asian Hickory (Carya)
Authors: Zhang Da , Yang Rui-Feng , Chen Jia-Hui , Pan Lang-Bo , Duan Wei , Zhang Qi-Xiang , Xia Guo-Hua , Huang Youjun 
Published: September 2023

Abstract
Background
The biogeographic characteristics of disjunctive distribution play a crucial role in plant geography and understanding mechanisms related to endangerment. Genome sequencing offers an opportunity to explore genetic relationships, population dispersal, and the floristic evolution of disjunctively distributed flora. In this study, we conducted comprehensive whole-genome deep resequencing of EA Carya to elucidate their evolutionary history and the factors contributing to disjunctive distribution.
Results
After conducting high-depth sequencing of five EA Carya species and filtering the data, we obtained a dataset comprising 3,869,439 high-quality SNPs. The phylogenetic analysis of the entire Carya revealed two monophyletic clades, separating EA Carya from NA Carya. Population genetic analysis indicated that C. kweichowensis, an endangered species, exhibited the lowest nucleotide diversity and the earliest divergence among the studied EA Carya species. Through selection elimination analysis, we identified a set of adaptive genes in C.hunanensis characterized by the highest nucleotide diversity and the widest distribution compared to other EA Caryaspecies. These genes were primarily associated with mitochondrial function and alkaloid biosynthesis. Additionally, species distribution modeling predicted the suitable habitat for the five EA Carya species, revealing the potential distribution of the endangered C. kweichowensis. Importantly, our analysis indicated minimal spatial overlap in distribution regions among EA Carya species during different time periods.
Conclusions
The results of population historical dynamics combined with climate and geological changes support the hypothesis that EA Carya migrated from NA to Europe during the Paleogene or Eocene and continued their migration to Asia, subsequently moving eastward until reaching EA. The uneven regional distribution of EA Carya is believed to be a consequence of Quaternary climate fluctuations, mountain barriers hindering species dispersal, and the limited cold tolerance of these trees. EA Carya highlight the significant role of climate and geological changes in their regional distribution and migration routes in Asia. Furthermore, the discovery of potential habitats offers a promising avenue for the conservation of C. kweichowensis.
Th17/Treg balance is restored during the suppression of experimental autoimmune encephalomyelitis treated by Astragalus polysaccharides via the microbiota-gut-brain axis
Authors: Ma Jinyun , Lu Qijin , Zhao Yan , Liu Xiaojun , Ding Guiqing , Wang Yuanhua , Wang Xiaohan , Chen Yuxin , Zhang Tong , Cheng Xiaodong 
Published: September 2023

Abstract
The Th17/Treg imbalance is an important cause of immune cell infiltration into the central nervous system (CNS) and subsequent neuroinflammation, demyelination, and neurodegeneration in multiple sclerosis (MS). Increasing attention has been given to the role of the microbiota-gut-brain axis in MS pathogenesis. The gut microbiota affects the Th17/Treg balance in the gut as well as in distal areas, such as the CNS, which further contributes to the onset and progression of MS. Our previous studies have shown that Astragalus polysaccharide (APS) has a role in alleviating the clinical symptoms and demyelination of experimental autoimmune encephalomyelitis (EAE) mice, a classic MS model. However, the mechanism of action is not fully understood. In this study, we found that APS suppressed inflammation and regulated the Th17/Treg balance in the CNS and peripheral blood of EAE mice. It was further shown that APS inhibited gut inflammation and reduced Th17 function. The experiment with an antibiotic cocktail interfering with the gut microbiota proved that APS alleviated EAE by regulating the gut microbiota. Through 16S rRNA sequencing, we showed that APS regulated gut microbiota diversity and composition in EAE mice. Then, we found that APS regulated metabolite composition in feces and plasma, thus altering gut and blood metabolic functions. The neuroactive ligand‒receptor interaction pathway was enriched in both fecal and plasma metabolites. Metabolites related to this pathway, including sphingosine 1 phosphate (S1P), prostaglandin E2 (PGE2), ADP, and ATP, were downregulated by APS. The levels of bile acid metabolites such as taurochenodeoxycholate-7-sulfate and N-palmitoyl aspartic acid were upregulated by APS. In summary, our study demonstrated that APS exerts a suppressive effect on EAE by regulating gut microbiota composition, affecting metabolite composition, and improving the Th17/Treg balance in the peripheral blood and CNS.
Laparoscopic versus open distal gastrectomy for advanced gastric cancer in elderly patients：a propensity‑score matched analysis
Authors: Yao Qing , Sun Qian-Nan , Wang Dao-Rong 
Published: September 2023

Abstract
Background
Scarce research has reported the efficacy and safety of laparoscopic distal gastrectomy in elderly patients. This retrospective study aimed to compare the outcomes of laparoscopic and open distal gastrectomy for advanced gastric cancer in elderly patients.
Methods
A total of 303 elderly patients who underwent distal gastrectomy for advanced gastric cancer from June 2017 to June 2021 were enrolled. Variables used to calculate propensity score matching included sex, age, body mass index, American Society of Anesthesiologists, history of diabetes, and history of hypertension. The statistical significance of continuous variables was tested using an independent sample t test. Chi-square or Fisher exact tests were used for categorical variables. Kaplan–Meier curve and log-rank test were used to the evaluation of 3-year overall survival and recurrence-free survival.
Results
After performing 1:1 propensity score matching, 248 patients were included for analysis (laparoscopic = 124, open = 124). Compared with the open group, the laparoscopic group showed significant advantages in estimated blood loss (P < 0.001), pain scale on the first postoperative day (P = 0.002), time to first flatus (P = 0.004), time to first liquid diet (P = 0.005), hospital stays (P < 0.001), and total complications (P = 0.011), but devoted much more operation (P < 0.001). No statistical difference was observed between the two groups in 3-year recurrence-free survival (P = 0.315) or overall survival (P = 0.159).
Conclusions
Our analysis demonstrated that laparoscopic surgery had the advantages of less intraoperative blood loss, fewer postoperative complications, and faster postoperative recovery in elderly patients who underwent distal gastrectomy for advanced gastric
Parturition Effects on Sociality and Dynamic Interactions of Female White-tailed Deer
Authors: Haus Jacob , Dion Justin , Webb Stephen , Rogerson Joseph , Bowman Jacob 
Published: September 2023

Abstract
Background
Female white-tailed deer (Odocoileus virginianus) typically form matriarchal social groups throughout much of the year; however, little research has examined the effect of parturition on sociality. We used measures of dynamic interaction, a function of travel direction and displacement, to examine social interactions between adult females before and after parturition. We monitored parturient, free-ranging individuals on a 126-ha property using vaginal implant transmitters linked to GPS collars during a 2-month period surrounding peak parturition (1 May–30 June 2016). We calculated local dynamic interaction (di; cohesiveness of movement for each time step) and global dynamic interaction (DI; cohesiveness of movement throughout the study period) metrics for all female pairs with overlapping 95% kernel density home range estimates (n = 29 interaction pairings).
Results
Global DI was correlated positively with home range overlap (%). Mean local di values indicated moderate social cohesion within the population prior to parturition. Following parturition, mean local di values declined below zero suggesting avoidance among female pairs with overlapping ranges. Mean local di began to increase approximately 15 days postpartum but did not return to prepartum levels during our study period (~ 25 days postpartum).
Conclusions
The changes in female social dynamics following parturition are likely a trade-off among several factors such as neonate mobility, predator avoidance, and nutritional demands. However, the trends we observed are to be expected given the life history of female deer around parturition in which sociality declines around parturition and then returns gradually to pre-parturition levels.
Pleural effusion with high adenosine deaminase is not always tuberculous pleurisy
Authors: Choe Junsu , Shin Sun Hye , Jeon Kyeongman , Huh Hee Jae , Park Hyung-Doo , Jeong Byeong-Ho 
Published: September 2023

Abstract
Background: Adenosine deaminase (ADA) is a useful biomarker for the diagnosis of tuberculous pleurisy (TBP). However, pleural effusions with high ADA can also be caused by other diseases, particularly hematologic malignant pleural effusion (hMPE).
This study aimed to investigate the factors that could differentiate TBP and hMPE in patients with pleural effusion ADA ≥ 40 IU/L.
Methods: This was a retrospective observational study of patients with pleural effusion ADA ≥ 40 IU/L, conducted at a Korean tertiary referral hospital with an intermediate tuberculosis burden between January 2010 and December 2017. Multivariable logistic regression analyses were performed to investigate the predictors associated with TBP and hMPE, respectively.
Results: Among 1134 patients with ADA ≥ 40 IU/L, 375 (33.1%) and 85 (7.5%) were diagnosed with TBP and hMPE, respectively. TBP and hMPE accounted for 59% (257/433) and 6% (27/433) in patients with ADA between 40 and 70 IU/L, respectively. However, in patients with ADA ≥ 150 IU/L, they accounted for 7% (9/123) and 19% (23/123), respectively. When ADA between 40 and 70 IU/L was the reference category, ADA between 70 and 150 IU/L was independently associated with TBP (adjusted odds ratio [aOR], 3.11; 95% confidence interval [CI], 1.95–4.95; P <0.001). ADA ≥ 150 IU/L was negatively associated with TBP (aOR, 0.35; 95% CI, 0.14–0.90; P = 0.029) and positively associated with hMPE (aOR, 13.21; 95% CI, 5.67–30.79; P<0.001). In addition, TBP was independently associated with lymphocytes ≥ 35% and a lactate dehydrogenase (LD)/ADA ratio < 18 in pleural effusion. hMPE was independently associated with pleural polymorphonuclear neutrophils < 50%, thrombocytopenia, and higher serum LD.
Conclusion: In patients with high levels of pleural effusion ADA, hMPE should be considered. Several markers in pleural effusion and serum may help to more effectively differentiate TBP from hMPE.
A Mortality Prediction System for Neonatal Jaundice Using Machine Learning Techniques
Authors: Bhadouria Aashi Singh 
Published: September 2023

Abstract
Birth complications, especially jaundice, are a leading cause of child death and morbidity across the world. The severity of these diseases may decrease if researchers learn more about their origins and develop effective treatments. Certain advancements have been made, but they are insufficient. Newborns often have jaundice as their primary medical issue. Jaundice may be brought on by a variety of factors. An elevated bilirubin level is a hallmark of jaundice. The incidence of hyperbilirubinemia in newborns is highest during the first postnatal week. The inability to detect problems early enough to get prompt treatment, as well as the similarity of symptoms that may lead to misdiagnosis, are both potential causes of failure. The situation is far worse for Ethiopia and other countries already in distress. A lack of paediatricians and neonatologists might be a reason for alarm. Due to a lack of appropriate diagnostic tools, experts in newborn health are often forced to rely their judgements only on interviews. It's probable the interviewer didn't know much about contagious diseases in infants. This suggests there is room for a faulty or insufficient diagnosis. For machine learning to make accurate forecasts, sufficient amounts of relevant past data must be made available. Jaundice has a high mortality rate, however this may be reduced with prompt identification and classification. The diagnostic accuracy of illnesses may be enhanced by using machine learning techniques. In this essay, I do a deep dive into medical data mining and pull out all the stops to provide you the information you need. It is necessary to investigate, analyse, extract, choose, and categorise the characteristics. Finally, it offers some therapeutic ideas. It helps the doctor diagnose jaundice faster so that effective therapy may be started sooner. The procedure is simplified and made more natural with the use of computer vision and machine learning methods. The refined method of classification improves accuracy. Using a classification stacking method, we found that the top causes of mortality in newborns include serious infections, birth asphyxia, necrotizing enterocolitis, and respiratory distress syndrome. Most infant fatalities may be traced back to these three factors. Dates included in the data set are 2018 through 2021. Support Vector Machine (SVM) performed best when pitted against the newly developed stacking model, XGBoost (XGB), Random Forest (RF), and other machine learning models. The proposed stacking model performed better than its competitors in terms of accuracy (97.04 percent). This is important because we hope it will help hospitals, particularly those with less resources, detect infant diseases sooner.
Therapeutic Targeting Tongue Squamous Cell Carcinoma via ICAM1 Antibody-Drug Conjugates in Preclinical Models
Authors: Guo Peng , Ma Letao , Lu Ye , Dai Yujie , Yang Teng , Yang Yuxuan , Shimura Takaya , Sha Chulin , Li Xinfang , Fang Jianmin , Zheng Weihui 
Published: September 2023

Abstract
To date, the treatment options for metastatic and recurrent tongue squamous cell carcinoma (TSCC) remain limited due to the lack of effective drug targets and therapeutics. Here we report the identification of ICAM1 as a TSCC target candidate for the development of antibody-drug conjugates (ADC), an emerging class of targeted therapeutics. We first performed an unbiased and quantitative screening of a panel of 69 TSCC cell surface antigens that identified ICAM1 as the most abundant hit. The overexpression level of ICAM1 was validated in 26 TSCC clinical specimens and four cell lines along with genomic information of 153 TSCC patients from the TCGA database. Subsequently, two ICAM1-targeted ADCs were designed and synthesized using two cytotoxic payloads of different mechanisms of action: monomethyl auristatin E (MMAE), a microtubule inhibitor, and deruxtecan (DXd), a type I DNA topoisomerase inhibitor, respectively. The therapeutic efficacy of these ICAM1 ADCs was determined in vitro and in vivo. Both ADCs selectively and potently ablate TSCC tumors in the established SAS cell line and patient-derived xenograft models. Our experimental results strongly support ICAM1 as a promising ADC target candidate for TSCC therapy.
Dihydrofolate Reductase (DHFR) Inhibition Promotes Ferroptotic Cell Death Through Nrf2 Suppression to Enhance Radiosensitivity In Pancreatic Ductal Adenocarcinoma (PDAC) Cells
Authors: Xue Jiao , Ma Jiayan , Duan Jingjing , Wu Zhongliang , Xia Wei , Tao Jialong , Zhu Wei , Zhu Yaqun , Peng Qiliang , YU Chenxiao , Gu Ying 
Published: September 2023

Abstract
Pancreatic cancer is one of the most aggressive and fatal malignancies of the digestive system. Radiotherapy plays an important role for local control of locally advanced, unresectable pancreatic cancer (LAPC). Given that the application of radiotherapy is restricted by radiation resistance of pancreatic cancer, radiosensitizers hold promise to overcome pancreatic ductal adenocarcinoma (PDAC) radioresistance and improve patient outcomes. Our research demonstrated that high dihydrofolate reductase (DHFR) expression correlates with poorer survival in pancreatic cancer, associated with transcriptional reprograms regulating proliferation and DNA repair. Methotrexate, an inhibitor of DHFR, sensitizes PDAC cell lines to ionizing radiation, reducing clonogenicity and proliferation, and synergistically triggering robust ferroptotic cell death via Nrf2 pathway inhibition. Our findings unveil a novel therapeutic perspective leveraging synergistic oxidative damage and deregulated metabolism to confront radioresistance in PDAC.
Evaluation of clinical characteristics and risk factors associated with Chlamydia psittaci infection based on metagenomic next-generation sequencing
Authors: yuan lei , 陈 嫱 , zhu yu , 赖 兰敏 , Zhao Rui , Liu Yang 
Published: September 2023

Abstract
Introduction
This study aimed to evaluate the clinical characteristics, imaging examination, laboratory examination and treatment options of Chlamydia psittaci associated pneumonia, as well as the risk factors affecting the progress of Chlamydia psittaci pneumonia, in order to improve the effect of therapeutics.
Methods
We retrospectively analyzed the clinical data of patients with chlamydia psittaci associated pneumonia in the First Affiliated Hospital of Nanchang University from January 2021 to December 2021. The patient's past medical history, clinical manifestations, laboratory examinations, chest CT findings, treatment status, and prognosis data were collected.
Results
All cases of Chlamydia psittaci in our research have been confirmed by mNGS. Among 46 cases of Chlamydia psittaci pneumonia, Poultry exposure was reported in 35 cases. In severe cases of Chlamydia psittaci pneumonia, Neutrophils, Procalcitonin(PCT), Lactate Dehydrogenase(LDH), Hydroxybutyrate Dehydrogenase(HBDH), Creatine Kinase Isoenzymes-B(CK-MB) and D-Dimer levels were remarkably higher than that of non-severe cases, except for lymphocytes(all P < 0.05). Chest CT scans showed Bilateral, multiple lobar lungs, pleural effusions involvement in those suffering from severe Chlamydia psittaci pneumonia(P < 0.05). Multivariate analysis revealed that higher lymphocyte(OR 0.836, 95% CI 0.714–0.962, P = 0.041) was the only protective factor for survival. Despite the difference in alpha diversity between the severe and mild groups of Chlamydia psittaci pneumonia, the slight difference was not significant. There were notable differences between the two pathogens, including Streptococcus australis and Streptococcus pneumoniae(P < 0.05).
Conclusion
Metagenomic next-generation sequencing (mNGS) is an effective detection method for the early diagnosis and selection of appropriate antibiotics for Chlamydia psittaci pneumonia.
Correlation between the Size of Cervical Ossification of the Posterior Longitudinal Ligament and Bone Mineral Density
Authors: Kwak Kyu Wan , Park Yoon Ghil , Park Jinyoung 
Published: September 2023

Abstract
Objective
Bone mineral density (BMD) has been shown to increase in patients with ossification of the posterior longitudinal ligament (OPLL). However, the correlation between the OPLL size and BMD has not been studied yet. This study aimed to investigate the correlation between the size of the OPLL and BMD.
Methods
This cross-sectional study enrolled 84 patients who underwent cervical OPLL surgery and preoperative examinations with both computed tomography (CT) and dual-energy X-ray absorptiometry (DXA) between January 2015 and March 2021. The maximal OPLL occupying the cervical spine lesion (levels C2–7) was identified from axial images of the preoperative cervical spine CT scans, and the anterior-posterior diameter, area of the cervical spinal canal, and OPLL were measured at this location. BMD was measured in the lumbar spinal levels L1–4, femoral neck, trochanteric area, intertrochanteric area, and total femur area using DXA.
Results
The average OPLL-occupying diameter ratio of the cervical spine positively correlated with the average Z-score of the lumbar spine (r = 0.22, P < 0.05). The average OPLL-occupying area ratio of the cervical spine was positively correlated with the average T-score and Z-score of the lumbar spine (r = 0.22, P < 0.05 and r = 0.24, P < 0.05, respectively).
Conclusion
The axial size of the cervical OPLL is positively correlated with the BMD of the lumbar spine. Since the underlying mechanism of OPLL development remains unknown, these findings may improve the understanding of its pathogenesis.
Relationship between anxiety and problematic smartphone use in first-year junior high school students: moderated mediation effects of physical activity and school adjustment
Authors: Cao Mei , Yang Haibo , Chen Duanduan 
Published: September 2023

Abstract
Background and aims
Despite previous research identifying anxiety as a risk factor for problematic smartphone use among students, the mediating and moderating mechanisms underlying the relationship between the two aforementioned variables are poorly understood. This study aims to explore the relationship between anxiety and problematic smartphone use among first-year junior high school students, together with the mediating effects of school adjustment and the moderating effects of physical activity on the mentioned relationship.
Method
This study was conducted using a Web-based self-report questionnaire survey with data collected from 445 first-year junior high school students in Jinan City, Shandong Province. Mediation and moderation analyses were performed using the PROCESS macro in SPSS.
Results
The results showed that anxiety predicted problematic smartphone use not only directly but also indirectly via school adjustment. School adjustment played a partial mediating role in the relationship between anxiety and problematic smartphone use. Physical activity also played a moderating role in the relationship between anxiety and school adjustment.
Conclusion
School adjustment and physical activity may be important variables in the relationship between anxiety and problematic smartphone use.