bluuebunny/crossref_metadata_2025_split huggingface dataset:
Supporting service integration through early childhood education: challenges and opportunities in regional contexts
Authors: Neilsen-Hewett Cathrine , de Rosnay Marc , Singleton Janine , Stouse-Lee Kim 
Published: September 2023

IntroductionChildren and families residing in regional Australia experience higher rates of vulnerabilities coupled with inadequate access to the early childhood health and early intervention services which pose increased risk to their health, development and wellbeing. The current study was designed to respond to the inherent complexity of supporting effective integrated service provision in regional communities, with a view to develop a model of effective service integration that leverages the capacity and opportunity of universal early childhood education (ECE) provision.MethodThe study adopted a qualitative multiple case study design to explore the perceptions of ECE professionals across six regional ECE services and two early intervention professionals operating from a regional early childhood intervention (ECI) organization. Data included an initial audit of the service system landscape coupled with facilitated discussions (focus groups and interviews) to identify facilitators and challenges to service integration and current patterns of service usage and engagement.ResultsFindings highlighted the foundational importance of relationships for establishing trust, engagement and service sustainability, as well as the need for embedding structural supports, including the professionalization of educators, the utilization of a key worker model, and staff retention. Systemic constraints, including limitations and inconsistencies in community infrastructure, program atrophy, and the complexity of referral systems, were seen to undermine effective service integration.DiscussionFindings speak to the potentiality of the ECE context as a hub for effective service integration within a functional practice framework for ECE. We conclude by offering a suggested model to ensure service connections, and enhance professional capacity and sustainability.
Assessing the role of central lymph node ratio in predicting recurrence in N1a low-to-intermediate risk papillary thyroid carcinoma
Authors: Ma Teng , Cui Jian , Shi Peng , Liang Mei , Song Wenxiao , Zhang Xueyan , Wang Lulu , Shi Yafei 
Published: September 2023

IntroductionLymph node metastasis in patients with papillary thyroid carcinoma (PTC) is associated with postoperative recurrence. Recently, most studies have focused on the evaluation of recurrence in patients with late-stage PTC, with limited data on those with early-stage PTC. We aimed to assess the relationship between lymph node ratio (LNR) and recurrence in low-to-intermediate-risk patients and validate its diagnostic efficiency in both structural (STR) and biochemical recurrence (BIR).MethodsClinical data of patients with PTC diagnosed at the Affiliated Hospital of Jining Medical University were retrospectively collected. The optimal LNR cut-off values for disease-free survival (DFS) were determined using X-tile software. Predictors were validated using univariate and multivariate Cox regression analyses.ResultsLNR had a higher diagnostic effectiveness than metastatic lymph nodes in patients with low-to-intermediate recurrence risk N1a PTC. The optimal LNR cutoff values for STR and BIR were 0.75 and 0.80, respectively. Multivariate Cox regression analysis showed that LNR≥0.75 and LNR≥0.80 were independent factors for STR and BIR, respectively. The 5-year DFS was 90.5% in the high LNR (≥0.75) and 96.8% in low LNR (&lt;0.75) groups for STR. Regarding BIR, the 5-year DFS was 75.7% in the high LNR (≥0.80) and 86.9% in low LNR (&lt;0.80) groups. The high and low LNR survival curves exhibited significant differences on the log-rank test.ConclusionLNR was associated with recurrence in patients with low-to-intermediate recurrence risk N1a PTC. We recommend those with LNR≥0.75 require a comprehensive evaluation of lateral neck lymphadenopathy and consideration for lateral neck dissection and RAI treatment.
Better oral hygiene is associated with a reduced risk of osteoporotic fracture: a nationwide cohort study
Authors: Park Jung-Hyun , Park Moo-Seok , Kim Hyung-Jun , Lee Heajung , Kim Jin-Woo , Song Tae-Jin 
Published: September 2023

BackgroundThe aim of this study was to examine the longitudinal association between oral health parameters and osteoporotic fracture.MethodsThe study included participants who received oral health screening by dentists from the National Health Screening cohort database of Korea between 2003 and 2006. The primary outcome was osteoporotic fracture occurrence, which was defined using specific international classification of diseases-10 codes; vertebral fracture (S22.0, S22.1, S32.0, S32.7, T08, M48.4, M48.5, and M49.5), hip fracture (S72.0 and S72.1), distal radius fracture (S52.5 and S52.6), and humerus fracture (S42.2 and S42.3). The presence of periodontitis and various oral health examination findings, such as missing teeth, caries, frequency of tooth brushing, and dental scaling, were analyzed using a Cox proportional hazard model to assess their association with osteoporotic fracture occurrence.ResultsThe analysis included a total of 194,192 participants, among whom 16,683 (8.59%) developed osteoporotic fracture during a median follow-up of 10.3 years. Poor oral health status, including periodontitis (adjusted hazard ratio [aHR]: 1.09, 95% confidence interval [CI]: 1.01–1.18, p = 0.039), a higher number of missing teeth (≥15; aHR: 1.59, 95% CI: 1.45–1.75, p &lt; 0.001), and dental caries (≥6; aHR: 1.17, 95% CI: 1.02–1.35, p = 0.030), was associated with an increased risk of osteoporotic fracture. On the other hand, better oral hygiene behaviors such as brushing teeth frequently (≥3 times per day; aHR: 0.82, 95% CI: 0.78–0.86, p &lt; 0.001) and having dental scaling within 1 year (aHR: 0.87, 95% CI: 0.84–0.90, p &lt; 0.001) were negatively associated with the occurrence of osteoporotic fracture.ConclusionThe study found that poor oral health, such as periodontitis, missing teeth, and dental caries, was associated with an increased risk of osteoporotic fracture. Conversely, good oral hygiene behaviors like frequent teeth brushing and dental scaling within 1 year were associated with a reduced risk. Further research is needed to confirm this association.
In-situ stress prediction in ultra-deep carbonate reservoirs of Fuman Oilfield, Tarim Basin of China
Authors: Yin Guoqing , Wu Kongyou , Ju Wei , Qin Yun , Qian Ziwei , Xu Ke , Lu Zhongyuan , Wang Peng , Liang Xiaobai , Liang Yan 
Published: September 2023

The Fuman Oilfield in Tarim Basin has great potential for ultra-deep carbonate oil and gas resources, and is an important area for future storage and production increase. The present-day in-situ stress field is critical during the exploration and development. However, no systemic investigations have been carried out in this oilfield. Therefore, in this study, the present-day in-situ stress field in the Ordovician carbonate reservoir is predicted and analyzed based on well log calculation and geomechanical numerical modeling. The results indicate that, 1) NE-SW-trending is the dominant horizontal maximum principal stress (SHmax) orientation. The vertical principal stress is the maximum principal stress, showing the Ordovician reservoir is under a normal faulting stress regime. 2) The distribution of in-situ stresses in the Ordovician carbonate reservoir is heterogeneous, which is mainly controlled burial depth and fault/fracture development. High stress magnitudes in the Yingshan Formation are mainly in the southeastern part of Fudong area, Fuman Oilfield. The present-day horizontal differential stress mainly ranges from 27 MPa to 30 MPa in the Yingshan carbonate reservoir. iii) Natural fractures are generally stale under the present-day in-situ stress state. Fractures that parallel to the SHmax orientation with high fracture dip angle are easier to be reactivated. The results are expected to provide geomechanical references for further oil and gas development in the Fuman Oilfield of Tarim Basin.
Biogeographic patterns and environmental drivers of species richness in the globally distributed Millettioid/Phaseoloid clade (Fabaceae, subfamily Papilionoideae)
Authors: Oyebanji Oyetola O. , Onditi Kenneth O. , Azevedo Josué A. R. , Rahaingoson Fabien R. , Nneji Lotanna M. , Adeleye Matthew. A. , Stull Gregory W. , Zhang Rong , Yi Ting-Shuang 
Published: September 2023

IntroductionThe Millettioid/Phaseoloid (MP) clade of Fabaceae is globally distributed, economically important, and highly diverse, making it an attractive system for studying biogeographic and macroecological patterns at a global scale. We conducted the first global macroecological study to map and explore the environmental drivers of the MP clade's species richness patterns.MethodsWe compiled 116,212 species occurrences (161 genera) for the MP clade and 20 environmental variables (19 bioclimatic variables and elevation). Geospatial analyses were performed to estimate species richness patterns and biogeographic heterogeneity. The effects of environmental variables on the species richness of the MP clade were measured through multiple regression models.ResultsOur study identified the megathermal regions as hotspots of species richness for the MP clade. While species distributions and richness largely fit the latitudinal diversity gradient pattern, there was a significant negative relationship between the species richness of the MP clade along the latitude and longitude. The Afrotropic biogeographic realm had the highest alpha diversity (~36%); in terms of biome types, tropical and subtropical moist broadleaf forests had the highest alpha diversity (25%), while the beta diversity revealed a high dispersal rate and habitat tracking. Furthermore, the species richness was positively influenced by multiple climatic factors, with the mean diurnal range of temperatures and precipitation in the warmest quarter having strongest influence.DiscussionOverall, the staggering species richness patterns could be explained by multiple diversity gradient hypotheses. Particularly, colder climates play a crucial role in shaping the species richness pattern by limiting the ecological opportunities for MP clade species in the higher latitudes of the Northern Hemisphere. This suggests that the species richness patterns of the MP clade can be described as "when dispersal meets adaptation." Our study provides a new basis for identifying priority regions for conservation of legumes.
Osimertinib inhibits brain metastases and improves long-term survival in a patient with advanced squamous cell lung cancer: a case report and literatures review
Authors: Zhang Zhiqin , Lin Jiamao , Yang Linke , Li Yang 
Published: September 2023

BackgroundSquamous cell carcinoma (SCC) is one of the most common subtypes of non-small cell lung cancer, but its treatment options remain limited. Epidermal growth factor receptor (EGFR)–tyrosine kinase inhibitors (TKIs) have limited efficacy in the treatment of lung SCC. Here, we report an SCC patient who developed EGFR-T790M mutation and showed gefitinib resistance achieved an extremely long survival by taking Osimertinib alternatively.Case summaryA patient, 66-year-old non-smoking and drinking male with advanced SCC who was deemed inoperable at the time of diagnosis. The first genetic testing showed deletion mutation of exon 19 of EGFR. The patient was then treated with gefitinib with no significant efficacy. EGFR-T790M mutation was found in the second genetic test. The treatment regimen was changed to radiotherapy with Osimertinib, and the patient’s primary lesion and the brain metastases were well controlled.ConclusionThis typical case highlights the important role of Osimertinib in patients with SCC carrying EGFR mutations.
Oral squamous cell carcinoma – do we always need elective neck dissection? evaluation of clinicopathological factors of greatest prognostic significance: a cross-sectional observational study
Authors: Michcik Adam , Polcyn Adam , Sikora Maciej , Wach Tomasz , Garbacewicz Łukasz , Drogoszewska Barbara 
Published: September 2023

The aim of the study was to find clinical and pathological factors with the greatest prognostic significance in patients with OSCC. The analysis included 125 patients grouped according to the tumor primary site (TPS): the floor of the mouth (FOM), tongue (TC) and retromolar triangle (RMT). Grading (G), tumor size (pT), nodal metastases (NM), local recurrence (LR), nodal recurrence (NR), perineural invasion (PNI), lymphovascular invasion (LVI), extranodal extension (pENE), and nodal yield (NY) were evaluated in each group.ResultsWith regard to TPS, FOM appeared to be the most metastatic. However, the recurrence rate was similar to TC tumors, which were characterized by higher G than those in other locations. When analyzing G, the highest percentage of LR (40.5%) and NM (34.5%) was observed among patients with G2. As G increased, so did the number of pENE G1 – 7.4%; G2 – 31%; G3 – 35.7%; LVI: G1 – 25.9%; G2 – 50%; G3 – 57.1%; PNI: G1 – 29.6%; G2 – 47.6%; G3 – 92.9%; NR G1 – 14.8%; G2 – 32.1%; G3 – 21.4%. Grading did not affect the type of growth and did not directly affect the occurrence of NR. pT and DOI increased the frequency of NM but we did not observe any effect of pT and DOI on LR, PNI, and LVI. NY in the study group did not increase the risk of NR.ConclusionTumor primary sites within the FOM, TC, and pT classification are the factors that increase the risk of NM and LR. However, apart from the primary site predisposing to the occurrence of NM, the histological structure of the tumor turned out to be the most important feature affecting the patient’s prognosis. The number of cases of pENE+, LVI+, PNI+, NM+, and NR+ increased with the increase in G. Although the pT, DOI increased the frequency of NM, we did not observe the effect of the pT and DOI on LR, PNI and LVI. Thus, even in the case of a small tumor of the FOM and TC with at least G2, elective neck dissection should be performed each time.
Caregiver’s quality of life in advanced cancer: validation of the construct in a real-life setting of early palliative care
Authors: Borelli Eleonora , Bigi Sarah , Potenza Leonardo , Gilioli Fabio , Efficace Fabio , Porro Carlo Adolfo , Luppi Mario , Bandieri Elena 
Published: September 2023

IntroductionEarly palliative care (EPC) improves the quality of life (QoL) of advanced cancer patients and their caregivers. The increasingly widespread use of this care model requires the development of measures supporting its interventions. Although the construct of patient’s QoL has been extensively investigated and several QoL measures have been further validated, there is a paucity of data concerning the QoL of the caregiver. In 2018, McDonald and colleagues addressed this issue by interviewing 23 primary caregivers of advanced cancer patients who participated in an EPC randomized clinical trial to understand their perspective on the QoL construct. The Authors identified six major dimensions associated with the construct of caregiver’s QoL. The present retrospective study aimed to validate these dimensions on a larger sample and in a real-life EPC setting.MethodsPreviously collected reports from 137 primary caregivers of advanced cancer patients on EPC answering questions about their experience with this care model were qualitatively analyzed through a deductive, thematic approach to identify and confirm the six dimensions constituting the construct of interest based on McDonald’s and colleagues’ results.ResultsThe six dimensions (“living in the patient’s world”, “burden of illness and caregiving”, “assuming the caregiver role”, “renegotiating relationships”, “confronting mortality”, and “maintaining resilience”) were consistently found in the reports from primary caregivers in a real-life EPC setting, confirming to be significant themes associated to their QoL.ConclusionA definite and recurrent construct of primary caregiver’s QoL as described by McDonald and colleagues was also found in a larger sample and in a real-life EPC setting. Thus it may lay the groundwork for the development of a dedicated questionnaire.
Expectations of new technologies in nursing care among hospital patients in Germany – an interview study
Authors: Klawunn Ronny , Albrecht Urs-Vito , Dierks Marie-Luise 
Published: September 2023

IntroductionNew technologies will be increasingly available for nursing care, including robots, patient mobilisation devices, digital event detection or prevention equipment. Technologies are expected to support nurses, increase patients’ safety and reduce costs. Yet, although these technologies will significantly shape patients’ experience, we need to learn more about patients’ perspectives regarding new technology in care. This study aims to investigate attitudes, expectations, worries and anticipated implementation effects of new assistive technology in nursing care by patients.MethodsQualitative, guided, semi-open interviews were conducted. The recruitment was carried out in a trauma surgery ward of a university hospital in Germany. Eight different technologies were presented via video clips and additional information to the patients, followed by in-depth discussions. The interviews were analysed using qualitative evaluative content analysis. The Consolidated Criteria for Reporting Qualitative Research (COREQ) Checklist was used to ensure study quality.ResultsStudy participants anticipate different outcomes for the implementation of new nursing technology: (1) For patients, they consider the potential for improvement in health and well-being as well as for their hospital stay experience, but also fear possible health risks or social or emotional factors like loss of autonomy or loneliness. (2) For professional nurses, participants expect relief from physically stressful work routines; however, they might be replaced by machines and lose their employment (3) For the nursing process, safety and quality improvements for care delivery may encounter a negative quantification of human life and risks of constant surveillance.ConclusionPatients identify opportunities, challenges and shortcomings of nursing technology implementation. They describe nuanced and mixed accounts of patients’ perspectives that are structured in a ‘continuum of anticipated effects’ of implementing technology in our article. The results can inform future implementation strategies.
Attitudes and intentions toward seeking professional psychological help among Chinese healthcare workers during the COVID-19 pandemic
Authors: Huang Ruirui , Peng Xiaoyan , Yu Shuai , Tian Yumei , Gao Chuanying 
Published: September 2023

BackgroundIt has been suggested that healthcare workers (HCWs) are experiencing massive stressors that threaten their mental health during the COVID-19 pandemic, but little is known about their attitudes and intentions toward seeking professional psychological help. This study aimed to investigate the attitudes and intentions of Chinese HCWs toward seeking professional psychological help during the COVID-19 pandemic and the associated factors.MethodsA total of 1,224 Chinese HCWs working in hospitals were recruited online from 12 hospitals in Hunan province in China for a survey conducted in November 2022. The Chinese version of the attitudes toward seeking professional psychological help scale-short form (ATSPPH-SF) and the general help-seeking questionnaire (GHSQ) were separately used to assess the attitudes and intentions of the respondents toward seeking professional psychological help. Demographic and socio-psychological data were collected using a self-developed questionnaire, the perceived social support scale, the self-stigma of seeking help scale, and the patient health questionnaire-9 scale.ResultsThe 1,208 HCWs in the final analysis showed relatively negative attitudes and low intentions toward seeking professional psychological help during the COVID-19 pandemic. Results of the multiple linear regression analysis showed that female sex (p = 0.031), experience of psychological learning (p &lt; 0.001), and social support (p &lt; 0.001) had a positive predictive effect on the attitudes of these HCWs toward seeking professional psychological help, whereas self-stigma of seeking help (p &lt; 0.001) and depressive symptoms (p &lt; 0.001) exerted negative effects. Moreover, experience of psychological learning (p = 0.004) and social support (p &lt; 0.001) had a positive predictive effect on the intentions of these HCWs toward seeking professional psychological help, whereas divorced marital status (p = 0.011) and self-stigma of seeking help (p &lt; 0.001) exerted negative effects.ConclusionThe overall attitudes and intentions of HCWs toward seeking professional psychological help were not optimistic. Effective interventions targeted at influencing factors should be formulated to promote the professional psychological help-seeking attitudes and intentions of HCWs who are at risk of developing mental health problems.
Impact of desert dust storms, PM10 levels and daily temperature on mortality and emergency department visits due to stroke
Authors: Oktay M. Murat , Al Behcet , Boğan Mustafa , Kul Seval , Gümüşboğa Hasan , Bayram Hasan 
Published: September 2023

ObjectiveIt is known that the inhalation of air pollutants adversely affects human health. These air pollutants originated from natural sources such as desert storms or human activities including traffic, power generating, domestic heating, etc. This study aimed to investigate the impacts of desert dust storms, particulate matter ≤10 μm (PM10) and daily maximum temperature (MT) on mortality and emergency department (ED) visits due to stroke in the city of Gaziantep, Southeast Turkey.MethodThe data on mortality and ED visits due to stroke were retrospectively recruited from January 1, 2009, to March 31, 2014, in Gaziantep City Centre.ResultsPM10 levels did not affect ED visits or mortality due to stroke; however, MT increased both ED visits [adjusted odds ratio (OR) = 1.002, 95% confidence interval (CI) = 1.001–1.003] and mortality (OR = 1.006, 95% CI = 0.997–1.014) due to stroke in women. The presence of desert storms increased ED visits due to stroke in the total population (OR = 1.219, 95% CI = 1.199–1.240), and all subgroups. It was observed that desert dust storms did not have an increasing effect on mortality.ConclusionOur findings suggest that MT and desert dust storms can induce morbidity and mortality due to stroke.
When There is No Guidance From the Guidelines: Renal Transplantation in Recipients With Class III Obesity
Authors: Gillespie Hannah , O’Neill Stephen , Curtis Rebecca M. K. , Callaghan Chris , Courtney Aisling E. 
Published: September 2023

Whilst renal transplantation is the optimal treatment for many patients with end-stage kidney disease, the latest international guidelines are unable to make recommendations for the management of patients with end-stage kidney stage kidney disease and Class III Obesity (BMI ≥40 kg/m2). Data on all adult patients receiving a kidney-only-transplant in the UK between 2015–2021 were analysed from a prospectively collected database and interrogated across a range of parameters. We then analysed in detail the outcomes of patients transplanted at the highest-volume unit. There were 22,845 renal transplants in the study time-period; just 44 (0.2%) were performed in recipients with a BMI ≥40 kg/m2. Most transplant centres did not transplant any patients in this category. In the centre with the highest volume, there were 21 transplants (9 living donor) performed in 20 individuals (13 male, median age 46 years). One-year patient and death-censored graft survival was 95% and 85%. Successful transplantation is possible in patients with BMI ≥40 kg/m2 but carries additional risk. Obesity should not be the sole factor considered when deciding on transplant suitability. Restricting transplantation to a small number of high-volume centres in each country should be considered to optimize outcomes.