bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dexmedetomidine as an anesthetic adjunct is associated with reduced complications and CICU length of stay after heart valve surgery
Authors: Fan Zhi-Wei , Tang Yu-Xian , Pan Tuo , Zhang Hai-Tao , Zhang He , Yan Da-Liang , Wang Dong-Jin , Li Kai 
Published: April 2023

Abstract
Background: We sought to explore the relationship between dexmedetomidine as an anesthetic adjuvant in cardiac surgery and postoperative complications and length of stay (LOS) in the cardiac intensive care unit (CICU).
Methods: We conducted a retrospective study of patients aged 18 years and older who underwent heart valve surgery between October 2020 and June 2022. The study endpoints were a combination of adverse outcomes, which included major postoperative complications (cardiac arrest, atrial fibrillation, myocardial injury/infarction, heart failure) and prolonged CICU LOS (defined as LOS≥90th percentile). Multivariate logistic regression analysis was performed for variables that were significant in the univariate analysis.
Results: A total of 856 patients entered our study. Of these, 283（33.06%） patients experienced at least one adverse outcome and the remaining 573 were included in the prognostic control group. Multivariate logistic regression analysis revealed that age > 60years (odds ratio [OR], 1.73; 95% confidence interval [CI], 1.27–2.37; p=0.01), cardiopulmonary bypass( CPB)> 190min (OR, 1.58; 95% CI, 1.01-2.48; p = 0.04) and postoperative mechanical ventilation time > 10 h (OR, 2.03; 95% CI, 1.49-2.77; p < 0.01) were independent risk factors for major complications and prolonged CICU length of stay in patients undergoing heart valve surgery. Intraoperative use of dexmedetomidine as an anesthetic adjuvant was a protective factor for such patients (odds ratio, 0.53; 95% confidence interval, 0.37-0.78; p = 0.01).
Conclusions: Age, duration of cardiopulmonary bypass, and duration of mechanical ventilation are associated with major complications and increased CICU stay after heart valve surgery. Intraoperative use of dexmedetomidine may improve such clinical outcomes.
Online Education Isn’t the Best Choice: Evidence-Based Medical Education in the Post-epidemic Era—A Cross-Sectional Study
Authors: Liu Jiarui , Liang Jun , Lang Jie , Zhang Lijia , Tang Mingwen , Chen Xinyu , Xie Yan , Zhang Jianling , Su Liyu , Wang Xin , Zhang Yi 
Published: April 2023

Abstract
Background The COVID-19 pandemic led many educational institutions to shift to online courses, making blended education a significant trend in teaching. We examined the effectiveness of blended learning in an evidence-based medicine course.Methods We compared the examination scores of a blended learning group, an online only group, and a traditional offline group and conducted a questionnaire survey on students’ preferences for different learning modes and the reasons for their preferences. A total of 2100 undergraduate students in clinical medicine were included in this cross-sectional study. Examination results were collected, and questionnaires were administered to the study participants. We compared the mean theoretical scores and exam pass rates of the three teaching groups using ANOVA and c2test for multiple comparisons.Results The blended group’s theoretical scores and pass rate were significantly higher than those of the offline and online groups. Furthermore, 71.6% preferred the blended teaching mode. Most students believed that blended teaching was the most effective mode—offline education: 7.86%; online education: 26.14%; blended education: 66%. Subsequently, in a questionnaire administered to a blended group of students, their foremost reason for liking online instruction was ‘flexible in time and space’ (99%), followed by ‘can be viewed repeatedly, facilitating a better understanding of knowledge points’ (98%). Their foremost reason for liking offline teaching was ‘helps to create a good learning atmosphere’ (97%), followed by ‘teachers can control students’ learning status in real time’ (89%).Conclusions This study explored the effectiveness of learning in evidence-based medicine courses by comparing the learning outcomes and personal perceptions of three different teaching modes. This is the first cross-sectional study in which three different teaching models are compared and discussed in an evidence-based medicine course. We also elaborate on the specific instructional protocols for each model. This study shows that using a blended education approach in evidence-based medicine courses can improve students’ learning motivation, autonomy, and satisfaction. It also enhances instructional efficiency, thereby improving students’ understanding of the course content.
Mist CVD-based growth of crystalline alpha chromium oxide (α-Cr2O3) on c-plane sapphire substrate with chromium acetylacetonate as a precursor
Authors: Sadullah Md , Hussain Syed Mohd , Ghosh Kunal 
Published: April 2023

Abstract
α-Cr2O3 is used as a buffer layer for the growth of α-Ga2O3 on sapphire for power devices. Presently, the growth of crystalline corundum-structured metal oxides, except for αCr2O3 are performed with metal acetylacetonates. In this paper, we report, for the first time, the development of a crystalline α-Cr2O3 on c-plane sapphire with chromium acetylacetonate as precursor over a wide temperature range varying from 400 oC to 550 oC. The temperature range not only ensures the compatibility of the process with α-Ga2O3 technology but also satisfies the requirement that the window is large enough to adequately optimize the quality of crystalline α-Cr2O3 thin film. XRD, SEM, AFM and XPS was performed to analyse the quality of the crystalline α-Cr2O3 layer. The best quality α-Cr2O3 is obtained at 500°C with the molarity of chromium acetylacetonate being 0.05, with a deposition rate of 35.37 nm/min and a crystallite size of 31.21 nm.
Comparison of efficacy and safety between PD-1 inhibitors and PD- L1 inhibitors plus platinum-etoposide as first-line treatment for extensive-stage small-cell lung cancer: a multicenter, real-world analysis
Authors: Wang Yanrong , Li Lingling , Hu Jia , Zhao Yan , Yan Huan , Gao Ming , Yang Xuejiao , Zhang Xia , Ma Junxun , Dai Guanghai 
Published: April 2023

Abstract
Background Immunotherapy in combination with platinum-etoposide (EP) chemotherapy has been approved as a first-line treatment for extensive-stage small cell lung cancer (ES-SCLC). However, real-world (RW) data regarding the use of immune checkpoint inhibitors (ICIs) in ES-SCLC are lacking. We aimed to assess the differences between programmed death protein 1 (PD-1) inhibitors and programmed death ligand 1 (PD-L1) inhibitors plus EP chemotherapy as first-line treatment for ES SCLC.
Methods We conducted a real-world, multicenter, retrospective cohort, controlled study to compare the prognosis, efficacy, and safety of PD-1 and PD-L1 inhibitors along with chemotherapy for patients with ES-SCLC. Each patient received up to six cycles of etoposide, carboplatin, or cisplatin combined with ICIs drugs, including PD-1 and PD-L1 inhibitors. The primary endpoints were investigator-assessed progression-free survival (PFS) and overall survival (OS). The secondary endpoints were investigator-assessed objective response rate (ORR), disease control rate (DCR), and duration of response (DOR)according to the Response Evaluation Criteria in Solid Tumors (RECIST, version 1.1).
Results Between January 2017 and December 2021, 194 patients with ES-SCLC from three clinical centers in a PLA general hospital were included in our study, including 93 patients in the PD-1 group and 101 patients in the PD-L1 group. At the time of data cutoff, progression-free survival in the PD-1 group (median PFS, 6.8months; 95%CI, 5.3-8.1) was similar to the PD-L1 group (median PFS, 6.4months; 95%CI, 5.5-7.5); the stratified hazard ratio for PFS was 1.12 (95%CI, 0.83-1.53; P=0.452). The median OS was similar in the PD-1 and PD-L1 group (15.8m vs 17.7m, P = 0.566); the hazard ratio was 0.90 (95% CI, 0.62-1.30, P=0.566). The two groups had comparable investigator-assessed confirmed objective response rates (ORR) (76.3% vs 76.2%) and median duration of response (DOR) (6.2m vs 6.1m). Adverse effects (AEs) related discontinuation occurred in 4(4.3%) patients in the PD-1 group and 2(2.0%) patients in the PD-L1 group. Deaths due to AEs of any cause occurred in 2(2.2%) patients in the PD-1 inhibitor group and 1(1.0%) patient in the PD-L1 inhibitor group, separately.
Conclusions Our research revealed that no significant differences in efficacy or prognosis were observed between PD-1 inhibitor + EP chemotherapy and PD-L1 inhibitor + EP chemotherapy. The two groups seemed to have comparable safety profiles, but the number of discontinuation or death events is too few to draw a firm conclusion.
Transient power equalization control strategy of virtual synchronous generator in isolated island microgrid with heterogeneous power supply
Authors: Gao Changwei , Sun Yongchang , Zheng Weiqiang , Wang Wei 
Published: April 2023

Abstract
In the parallel supply system of synchronous generator and virtual synchronous generator, the physical structure and control structure of the two kinds of power supply are quite different, and it is difficult to distribute the transient power of the two kinds of power supply evenly when the load changes abruptly. Especially in the case of sudden load increase, virtual synchronous generator bears too much load in the transient process because of its fast adjustment speed, and even causes short-term overload, which makes the capacity of virtual synchronous generator can not be fully utilized. In view of this problem, firstly, the mechanism of transient power uneven distribution of two heterogeneous power sources is explained from the differences of frequency modulation, voltage regulation and output impedance. Secondly, virtual speed regulation, virtual excitation and dynamic virtual impedance are added to the traditional virtual synchronous generator control to simulate the speed regulation characteristics and electromagnetic transient characteristics of the synchronous generator, so as to realize the transient and steady-state power equalization between heterogeneous power supplies when the virtual synchronous generator and the synchronous generator run in parallel. Thirdly, in order to ensure the fast dynamic response characteristics of the virtual synchronous generator in independent operation mode, the traditional virtual synchronous generator control algorithm is still maintained in independent operation mode, and the mode switching control link based on state tracking is designed to realize smooth switching between the two working modes. Finally, the hardware in loop experiment results based on RT-LAB show that the proposed control method can realize the transient and steady-state power equalization when the virtual synchronous generator and the synchronous generator operate in parallel, it can keep the fast voltage regulation and frequency modulation ability when the virtual synchronous generator operates independently, and can realize smooth switching between independent and parallel operation modes.
Integrated Geotechnical and Mineralogical Evaluation of the Subgrade of some failed Pavements along Enugu-Onitsha Expressway Southeastern Nigeria
Authors: Ukor Kelechi Paulinus , igwe ogbonnaya , Onwuka Obialo Solomon , Nzereogu Stella Kosi , Nnaji Eze Kelechi , Echezona Pearl Elochukwu 
Published: April 2023

Abstract
This research is focused on the constant pavement failure in parts of the Enugu-Onitsha expressway. The failed portions are constructed on the natural subgrade known to be the Shale of Enugu and Mamu Formations. Five (5) samples each were obtained from the Formations and were subjected to geotechnical test, mineralogical analysis, scanning electron microscopy (SEM) and, statistical analysis. The outcome of the geotechnical test revealed that the liquid limits (LL) are of high plasticity with values ranging from 57.69–62.61% and 53.57–56.24%, plasticity index (PI) values ranging from 20.32–24.37% and 13.37–15.32%, Slake durability index (SDI) values ranging from 0.55–31.8% and 63.4–71.6%, for Enugu and Mamu Shales respectively. From the Unconfined compressive strength (UCS) test, the cohesion (C) values ranged from 37.36–43.89KPa and 24.22- 27.07KPa, soaked California bearing ratio (CBR) values ranged from 1.03–1.22% and 0.90–1.60% for Enugu and Mamu Shales respectively. The test results are below the requirements laid down by the Federal Ministry of Works and Housing (FMWH) for pavement construction. X-Ray Diffraction (XRD) analysis revealed major minerals to be quartz and kaolinite. Moreover, kaolinite disperses and migrates when moist hence geotechnical failure. Images from SEM revealed the presence of micropores and fractures which can be used as a reference to the geotechnical test results. Statistical analysis of key geotechnical parameters such as SDI, PI, C, and CBR revealed a strong correlation. The evaluated results pointed out that the underlined natural subgrade is poor for pavement construction, and thus requires stabilization.
A novel prognostic risk model construction and immune landscape analysis of gastric cancer based on disulfidptosis-related lncRNAs
Authors: tian yuan , Wang Guanlong , Li Rui , Xu Kai , Li Hongxia , He lei 
Published: April 2023

Abstract
Background: Disulfidptosis is a novel form of cell death that induces disulfide stress leading to cell death. Therefore, this may be a new direction for future cancer therapy. More and more studies have shown that long non-coding RNAs (lncRNAs) can regulate gastric cancer-related biological processes. At present, there is no research on disulfidptosis-related lncRNAs (DRLs) in GC.
Methods: The Cancer Genome Atlas (TCGA) was used to retrieve information about RNA sequencing data, clinical data, and genetic mutation data of GC patients. RNA sequencing data, clinical data, and genomic mutation data of GC patients were downloaded from the Cancer Genome Atlas. First, TCGA data are randomly assigned to the training set and the validation set. Then, a predictive risk model was built in the training set using univariate and multivariate Cox regression models, as well as the least absolute shrinkage and selection operator (LASSO). The predictive value of the model was verified by receiver operating characteristic (ROC) curves and the concordance index (C-index) in the validation set and the entire set. The univariate and multivariate Cox regression analysis, nomogram, and correlation analysis of clinicopathological characteristics were used to confirm the clinical utility of the prognostic risk model. Finally, we further used tumor mutation burden (TMB) and tumor immune dysfunction and exclusion (TIDE) scores to evaluate the effectiveness of immunotherapy and analyze the sensitivity of related drugs.
Results: Six prognostically-related DRLs (TNFRSF10A-AS1, LINC02829, LINC00460, AL139147.1, IGFL2-AS1, and AC104123.1) were used to construct the model. The overall survival (OS) of the high-risk group and the low-risk group was statistically significant, according to the Kaplan-Meier survival graph. The ROC and C-index show that the model has the good predictive ability. Risk score was revealed to be an independent prognostic factor by univariate and multivariate Cox regression analysis. The prognostic risk model was negatively correlated with TMB. According to the results of TIDE, immunotherapy has a better therapeutic effect on the high-risk group. In addition, the prognostic risk model of GC was significantly correlated with drug sensitivity.
Conclusions: In summary, this study identified six DRLs as predictors of GC prognosis, which may be a potential biomarker for predicting drug sensitivity and immunotherapy efficacy of GC in the future.
SNX14 inhibits autophagy via the PI3K/AKT/mTOR signaling cascade in breast cancer cells
Authors: Lv Sha , Jiang Hongyan , Yu Lingyan , Zhang Yafei , Sun Liangliang , Xu Junjun 
Published: April 2023

Abstract

Background
Sorting nexin 14 (SNX14) is a member of the sorting junction protein family. Its specific roles in cancer development remain unclear. Therefore, in this study, we aimed to determine the effects and underlying mechanisms of SNX14on autophagy of breast cancer cells to aid in the therapeutic treatment of breast cancer.
Methods
In this study, we performed in vitro experiments to determine the effect of SNX14 on breast cancer cell growth. Moreover, we used an MCF7 breast cancer tumor-bearing mouse model to confirm the effect of SNX14 on tumor cell growth in vivo. We also performed western blotting and quantitative polymerase chain reaction to identify the mechanism by which SNX14 affects breast cancer MCF7 cells.
Results
We found that SNX14 regulated the onset and progression of breast cancer by promoting the proliferation and inhibiting the autophagy of MCF7 breast cancer cells. In vivo experiments further confirmed that SNX14 knockdown inhibited the tumorigenicity and inhibited the growth of tumor cells in tumor tissues of nude mice. In addition, western blotting analysis revealed that SNX14 modulate the autophagy of MCF7 breast cancer cells via the phosphoinositide 3-kinase/protein kinase B/mechanistic target of rapamycin kinase signaling pathway.
Conclusion
Our findings indicate that SNX14 is an essential tumor-promoting factor in the development of breast cancer.
An online cross-sectional survey investigating community pharmacists’ information needs for evidence-based self-medication counselling
Authors: Alexa Jennifer Maria , Bertsche Thilo 
Published: April 2023

Abstract
Background
Community pharmacists play an important role in healthcare. They are the only professional point of contact for all self-medication-related matters. Little research has been done regarding the information needs of pharmacists for evidence-based self-medication counselling.
Aim
To explore pharmacists’ information needs in 5 predefined areas of information needs: individual needs, quality needs, utilization needs, implication needs, and access needs.
Setting
Community pharmacies in Germany.
Method
After ethical approval, we conducted a mixed-methods study in form of an exploratory, semi-quantitative, cross-sectional online survey. Members of 3 different chambers of pharmacists were invited to participate anonymously in the survey and without any incentives after giving informed consent.
Main outcome measure
Quantitative outcome: Frequency of relevance / importance of items within predefined information needs areas, except for access needs. Qualitative outcome: Open-text responses concerning all information needs.
Results
Data from a total of 823 participants, who completed the survey, were analyzed. General and specific information such as dosage (74.2 % [611/823]) and when to refer to a physician (64.6 % [532/823]) as well as an over-the-counter-product’s effectiveness according to medical guidelines (71.4 % [588/823]) were rated as very important. Participants reported to prefer digital information sources (50.5 % [416/823] strongly agreed), especially in the form of an easily accessible database (61.6 % [507/823] strongly agreed) that contains regularly updated, manufacturer independent, critically appraised, concise information.
Conclusion
Community pharmacists expressed distinct information needs for evidence-based self-medication counselling. Further information on essential evidence-based pharmacy knowledge may be necessary to support the correct implementation.
Increased scale and accessibility of sediment transport research in rivers through practical, open-source turbidity and depth sensors
Authors: Langhorst Theodore , Pavelsky Tamlin , Eidam Emily , Cooper Lillian , Davis Julianne , Spellman Katie , Clement Sarah , Arp Christopher , Bondurant Allen , Friedmann Elisa , Gleason Colin 
Published: April 2023

Abstract
Open-source designs for turbidity and depth sensors are becoming increasingly capable and available, but the knowledge required to construct them limits their use compared to expensive, commercial sensors. Here, we present an open-source optical backscatter and water pressure sensor that can be ordered almost fully assembled, requires no coding to deploy, and costs approximately $50 USD. We share three examples of these sensors’ ability to facilitate new research. First, we observed complex changes in spatial and temporal patterns of suspended sediment transport in the Arctic Sagavanirktok River using a network of sensors. Second, we measured turbidity during the freeze-up period in the Tanana River, a period of high risk to sensors. Last, we built and deployed sensors with middle-school students to monitor turbidity under full ice cover on the Tanana River. The success of open-source sensors in these examples shows a marked increase in scale and accessibility of river science.
Development of service standards and manpower calculation criteria for hospital clinical pharmacies in South Korea: a survey-based study
Authors: Lee Mirinae , Kim Seung-Eun , Jung Ji-Hye , Park Yoon-Hee , Han Hyewon 
Published: April 2023

Abstract
Background After the revision of the Korean Pharmaceutical Affairs Act, the certification of specialized pharmacists is scheduled to be legally recognized in 2023. Considering that the specialized pharmacist certification was developed based on the working model of hospital clinical pharmacists, standards for clinical pharmacists in hospital and appropriate manpower calculation are needed.
AimTo develop practical standards for clinical pharmacists and to present the standards for calculating the level of manpower based on the actual workload survey.
Method In order to develop clinical pharmacy services standards, literature review was performed. To classify essential tasks, a modified Delphi study was performed in a tertiary hospital. Based on this, manpower calculation was performed through a multi-center survey for pharmacists in hospitals with more than 1,000 beds. The survey respondents were working in one out of four fields: pediatrics, organ transplantation, oncology, and critical care.
Results Clinical pharmacy services were classified into 4 types: medication therapy management, medication education, medication use evaluation, and multidisciplinary team activities. Essential tasks accounted for 93% of the total tasks for clinical pharmacy services. The required full-time equivalent (FTE) through workload calculation was 2.5±1.9 on average for each field, while the FTE allocated to actual practice was 2.1±1.6.
Conclusion An agreement was reached on the essential work of clinical pharmacy services. However, the FTE of clinical pharmacists in actual practice was insufficient compared to the required amount. In order to establish and expand clinical pharmacy services in hospital, it is necessary to ensure manpower for essential tasks.