bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Nomogram to Predict the Overall Survival of Patients With Resected T1-2N0-1M0 Non-Small Cell Lung Cancer and to Identify the Optimal Candidates for Adjuvant Chemotherapy in Stage IB or IIA Non-Small Cell Lung Cancer Patients
Authors: Wang Wei , Zhou Juying 
Published: September 2023

Background The benefit of adjuvant chemotherapy for IB/IIA non-small cell lung cancer (NSCLC) patients remains uncertain. This study aimed to develop a prognostic model to predict overall survival in resected NSCLC patients with T1-2N0-1M0 stage and identify optimal candidates for postoperative chemotherapy among those with stage IB or IIA disease. Methods We conducted a retrospective study using the SEER 18 database (2000–2018, November 2020 submission) of patients who underwent radical surgery for T1-2N0-1M0 NSCLC. The patients not receiving adjuvant chemotherapy were randomly divided into training and validation cohorts. A prognostic nomogram was established and evaluated using calibration and receiver operating characteristic curves. Based on the nomogram, stage IB and IIA patients were categorized into two prognostic groups, each further divided into cohorts based on adjuvant chemotherapy status. Kaplan-Meier analysis and log-rank tests were used to compare overall survival between these groups. Results A total of 14 789 patients were enrolled and randomly assigned to the training cohort (n = 10 352) and validation cohort (n = 4437). Ten independent prognostic factors were identified and integrated into the prognostic model. The area under the receiver operating characteristic curve was .706, .699, and .705 in the training cohort, and .700, .698, and .695 in the validation cohort at 1, 3, and 5 years, respectively. Among stage IB and IIA patients, only those in the high-risk group showed a significant benefit from adjuvant chemotherapy, with a 16.4% absolute increase in 5-year overall survival. Conclusions The nomogram developed in the study may help physicians choose the most appropriate management strategy for each patient.
Thematic Analysis of Mental Health Nurses’ Views of Contributing Factors Fueling Workplace Violence in Psychiatric Hospitals: Insights From Unsung Soldiers
Authors: Abu Khait Abdallah , Mrayyan Majd T. , Algunmeeyn Abdullah 
Published: September 2023

BACKGROUND: Workplace violence against mental health nurses is an international phenomenon that sparks concerns for nurses’ safety and mental health. This phenomenon has recently arisen as a crucial concern in the Middle East as it has become pervasive and has negative implications, causing nurses to accumulate psychological and emotional distress. However, no research has yet investigated the contributing factors of this phenomenon in Jordanian psychiatric hospitals from the nurses’ perspectives. AIMS: This study aimed to explore the factors contributing to workplace violence in Jordanian psychiatric hospitals from the perspective of mental health nurses. METHOD: An exploratory, qualitative design was utilized. Using audio-recorded, semi-structured, face-to-face interviews, a purposive sample of 24 mental health nurses were interviewed to collect data. Thematic analysis was used to analyze the data. RESULTS: Four overarching themes were identified: Peak Time of Violence, Unavoidable Part of the Job, Poor Organization and Lack of Policy, and Bite the Bullet. CONCLUSION: From nurses’ perspectives, an in-depth understanding of factors contributing to workplace violence provides a foundation for developing preventive interventions, improving work environment safety, and promoting nurses’ mental health. Prevention strategies and further studies are warranted to limit this phenomenon.
Effect of postoperative radiotherapy on survival in patients with completely resected and pathologically confirmed stage N2 non-small-cell lung cancer: a systematic review and meta-analysis
Authors: Wang Lin , Chen Wenyu , Xu Xiaofei , Chen Wenbo , Bao Derong , Zhang Ye , Xu Yufen 
Published: September 2023

Background: The role of postoperative radiotherapy (PORT) for patients with completely resected stage N2 non-small-cell lung cancer (NSCLC) has been controversial. This study aimed to investigate the efficacy of PORT and prognosis in these patients. Objectives: An updated meta-analysis was conducted in this study to investigate the efficacy of PORT and prognosis in patients with completely resected and pathologically confirmed stage N2 NSCLC. Design: This study is a systematic review and meta-analysis. Data source and methods: Databases were searched up to 2 March 2022. All trials on patients with completely resected and pathologically confirmed stage N2 NSCLC undergoing PORT were screened, and data indicators in the PORT and non-PORT groups were extracted, respectively. The effect of PORT on overall survival (OS), disease-free survival (DFS), local recurrence-free survival (LRFS), and distant metastasis-free survival (DMFS) was estimated. Subgroup and sensitivity analyses were performed. Results: In all, 20 studies involving 6340 patients were finally included. The PORT significantly increased OS [hazard ratio (HR) = 0.77, 95% CI: 0.71–0.84, p < 0.001), LRFS (HR = 0.63, 95% CI: 0.52–0.76, p < 0.001), and DFS (HR = 0.72, 95% CI: 0.63–0.82, p < 0.001) while it showed no significant difference in improving DMFS (HR = 0.86, 95% CI: 0.71–1.05, p = 0.14). Conclusion: Our results suggest that in the postoperative treatment of patients with completely resected and pathologically confirmed stage N2 NSCLC, the addition of PORT provides better local recurrence control and survival benefit, but no benefit for distant metastases. The PORT may be incorporated into the postoperative treatment options for some patients with high-risk factors. However, it needs to be validated by more prospective studies in the future. Trail registration: CRD42022314095.
Synthesis and characterization of granite dust microparticles reinforced bio-benzoxazine composites
Authors: Chandramohan Ayyavu , Parthiban Rangasamy , Sathishkumar Kannaiyan , Dinakaran Kannaiyan , Muthukaruppan Alagar 
Published: September 2023

In the current work, an effort has been made to create polymer composite materials using polybenzoxazine (PBz), which is synthesis from sustainable natural ingredients like furfurylamine (Fu), cardanol (Ca) and reinforced with granite dust made from industrial waste. Varied analytical approaches were used to examine the thermal, morphological, chemical structure, flame retardant and electrical properties of Ca-Fu-PBZ composites reinforced with granite dust at varied weight percentages (5, 10, 15 and 20 wt%). According to the weight percentage concentration of granite dust, the differential scanning calorimetry (DSC) data suggest that the value of Tg increased from 105 to 139°C. A pure Ca-Fu-PBZ benzoxazine matrix was found to have a dielectric constant of 3.97 at 1 MHz. Whereas 5, 10 and 20 wt percentages of reinforced Ca-Fu-PBZ composites with granite dust had dielectric constants of 3.54, 3.05, 2.51 and 2.02 at 1 MHz, respectively. For granite dust reinforced Ca-Fu-PBZ polybenzoxazine composites, the value of the limiting oxygen index (LOI) determined for the char yield obtained thermogravimetric analysis (TGA) shows greater values than those of the neat Ca-Fu-PBZ matrices. Using water contact angle, the hydrophobic behavior of polybenzoxazine composites reinforced with granite dust was investigated, and it was concluded that the hydrophobic behavior increased with the weight % of granite dust. Data from several investigations show that the thermally stable electrical insulation applications can employ the granite dust reinforced sustainable cardanol-furfurylamine based polybenzoxazine composites as potting compounds, sealants and composites.
Prevalence and associated factors of hyperuricemia among Chinese patients with diabetes: a cross-sectional study
Authors: Sun Shiyi , Chen Lihong , Chen Dawei , Li Yan , Liu Guanjian , Ma Lin , Li Jun , Cao Fangwei , Ran Xingwu 
Published: September 2023

Background: As a part of metabolic syndrome, hyperuricemia has a higher incidence in patients with diabetes than in the general population owing to various underlying factors. Objectives: The objective of the present study was to investigate the prevalence of hyperuricemia among patients with diabetes and identify associated factors. Design: A cross-sectional study. Methods: Herein, we included patients with diabetes managed at nine healthcare centers in Chenghua District, Chengdu, from February 2021 to November 2021. Clinical data, lifestyle habits, and laboratory data were collected to determine the prevalence and factors associated with hyperuricemia. Results: In total, we included 1577 patients with diabetes (males, 50.35%; females, 49.65%). The median serum uric acid level was 337.9 μmol/L, and the prevalence of hyperuricemia in patients with diabetes was 21.24%. The prevalence of hyperuricemia in male patients was significantly higher than in females (29.35% in males versus 13.03% in females, p < 0.001). Male patients with obesity ( p = 0.006) or triglyceride (TG) ⩾ 1.7 mmol/L ( p < 0.001) had a high risk of developing hyperuricemia, and hyperuricemia was negatively associated with estimated glomerular filtration rate (eGFR) ⩾ 60 mL/min/1.73 m2 ( p < 0.001), glycosylated hemoglobin (HbA1c) ⩾ 7% ( p < 0.001), fenofibrate ( p = 0.010), and sodium-glucose cotransporter 2 (SGLT-2) inhibitors ( p = 0.035). Considering females, overweight ( p = 0.004), alanine transaminase (ALT) > 40 U/L ( p < 0.001), and TG ⩾ 1.7 mmol/L ( p = 0.015) showed a significant positive correlation with hyperuricemia, while eGFR ⩾ 60 mL/min/1.73 m2 ( p < 0.001) was negatively associated with the risk of hyperuricemia. Conclusion: Hyperuricemia is highly prevalent in patients with diabetes, especially in males. In addition to traditionally associated factors, fenofibrate and SGLT-2 inhibitors were also associated with the risk of hyperuricemia. Registration: The study protocol was registered in the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ), and the registration number was ChiCTR 2100042742.
Peer Support Programs to Reduce Organizational Stress and Trauma for Public Safety Workers: A Scoping Review
Authors: Fallon Pamela , Jaegers Lisa A. , Zhang Yuan , Dugan Alicia G. , Cherniack Martin , El Ghaziri Mazen 
Published: September 2023

Background: Public safety workers (PSWs), including correctional officers (COs), law enforcement, firefighters, emergency medical service, and military personnel, are at risk of organizational stress and burnout. Exposure to traumatic events, job hazards, injuries, fatalities, and work-related stressors such as work overload, irregular shift assignments, and lack of administrative support can negatively impact PSWs’ mental health. Peer support programs (PSPs) have been cited as an intervention to address the mental health of PSWs. Purpose: The purpose of this review is to explore the use, including facilitators and barriers, of PSPs to reduce organizational stress and trauma for PSWs. Implications for COs will be discussed. Method: A scoping review was conducted using the Arksey and O’Malley methodology. A search was conducted for articles published between 1996 and 2021 using six databases. Selected articles described, implemented, or evaluated peer support as an intervention to reduce PSW organizational stress and trauma. Findings: Thirteen articles met eligibility criteria. Organizational support, including policies, practices, and peer leadership training, contributed to the sustainability of PSPs. Confidentiality, trust, and shared lived experience were also essential to PSP. Stigma was identified as the primary barrier to participation. Public safety workers found PSP helpful in normalizing experiences, increasing hope, and decreasing stigma. Peer support programs also serve to bridge the gap in mental health services use. Conclusions: Peer support programs are a potential mental health intervention to reduce organizational stress and trauma for COs. Awareness of the facilitators and barriers to PSPs is the first step in developing such programs.
Undergraduate Occupational Health Nursing Education in Chile, Colombia, Brazil, and Mexico
Authors: Valencia-Contrera Miguel , Rivera-Rojas Flerida , Castro-Bastidas José D. , Robazzi Maria Lucia do Carmo Cruz , Quintana-Zavala María , Valenzuela-Suazo Sandra 
Published: September 2023

Background: Occupational health nursing plays a fundamental role in addressing the health of the working population; however, training in this area differs around the world in terms of levels, duration, content, and requirements, and the current situation in Latin American countries is unknown. The objective of this study was to analyze undergraduate nursing education in occupational health from an international perspective considering Chile, Colombia, Brazil, and Mexico. Methods: We conducted a multicenter, descriptive study, based on bibliographic methodology, whose sample was documentary, consulting government databases in Chile, Colombia, Brazil, and Mexico. Findings: Heterogeneity was identified within the training in the countries analyzed, with a small number of courses in the course structures; in most cases, the courses were taught in the last years of training and predominantly as elective courses. Conclusions: The authors recommend that training centers develop programs associated with occupational nursing, which is considered an imperative to strengthen public health in developing countries and an ethical and equitable response to the working population.
A Qualitative Study of Men’s Experiences Using Navigate: A Localized Prostate Cancer Treatment Decision Aid
Authors: Todio Elizabeth , Schofield Penelope , Sharp Jessica 
Published: September 2023

Background. Men diagnosed with localized prostate cancer (LPC) often face a dilemma in choosing between available treatment options that have similar survival rates but for which the perceived advantages and disadvantages of each treatment differ. The Navigate decision aid was created to assist Australian men with LPC in making informed decisions about treatment that align with their personal values and preferences. Navigate presents current, unbiased information, including an interactive values clarification exercise. Objective. This study was a qualitative investigation of men’s treatment decision making for LPC, and their experiences using the Navigate Web site, to identify areas for improvement and inform implementation. Methods. Semi-structured interviews were conducted with 20 men diagnosed with LPC who completed the intervention arm of the Navigate randomized controlled trial. Interview transcripts were thematically analyzed. Results: Five main themes emerged: 1) diagnosis experiences varied, although men were strongly influenced by their clinician to make an early initial treatment decision; 2) men sought resources and support they trusted; 3) men valued Navigate’s multiformatted content and design; 4) men suggested more content was needed on a) the diagnosis journey and b) new treatment updates; and 5) men identified design flaws in the values clarification exercise on Navigate but appreciated the tool being available. Conclusions. Specialist authority influenced men to make an early treatment decision. However, Navigate was helpful in supporting men’s ongoing treatment decision making, particularly men on active surveillance who may face further treatment decisions if their cancer progresses. To gain trust and improve engagement from Navigate users, credentials and sources of information need to be prominent. Trustworthiness, timing of access, and the clinician’s role in empowering men to use available decision aids are crucial elements to be considered when implementing Navigate in clinical settings. Highlights The Navigate decision aid Web site was created to help Australian men diagnosed with localized prostate cancer (LPC) make an informed decision about their treatment. Navigate was helpful in supporting men’s ongoing treatment decision making for LPC. Men’s treatment decision making for LPC was greatly influenced by perceived authority and trust in their clinician. Trustworthiness, timing of access, and the clinician’s role in empowering men to use available decision aids are crucial.
Malaysian Medical Students’ Attitudes and Readiness Toward AI (Artificial Intelligence): A Cross-Sectional Study
Authors: Tung Alvin Yong Zong , Dong Ley Wen 
Published: September 2023

OBJECTIVES The Malaysian health ministry has started introducing artificial intelligence (AI) technology to aid local healthcare delivery. This study aims to survey Malaysian medical students’ attitudes toward AI and evaluate their readiness to work with medical AI technology. METHODS An online questionnaire on Google Forms was distributed to all 31 medical schools in Malaysia. The questionnaire consists of 3 sections: the first part surveyed the participants’ demographics, the second assessed the participants’ attitudes toward AI, and the final part utilizes the Medical Artificial Intelligence Readiness Scale for Medical Students (MAIRS-MS) scale to evaluate their AI readiness. RESULTS Three hundred and one students from 17 universities in Malaysia responded to the questionnaire. 87.36% of students agreed that AI will play an essential role in healthcare; 32.55% of students were less likely to consider a career in radiology due to the advancement of AI. The majority of students (71%) felt that teaching in AI will benefit their careers, while 69.44% agreed that all students should receive teaching in AI. Around 44.5% of students felt that they will possess the knowledge required to work with AI upon graduation. On the MAIRS-MS scale, students had a mean score of 21 of 40 for the cognitive factor, 25 of 40 for the ability factor, 10 of 15 for the vision factor, and 11 of 15 for the ethics factor. Overall, Malaysian students had a mean total score of 67±14.8 out of 110. CONCLUSION Malaysian medical students have demonstrated awareness of AI and a willingness to learn more about it. More work needs to be done to improve students’ AI readiness, particularly their knowledge and application of AI technology. Malaysian universities should start to work on incorporating AI teaching into their curricula.
Study of Combined Effect of Bacteriophage vB3530 and Chlorhexidine on the Inactivation of Pseudomonas aeruginosa
Authors: Liu Yan , Zhao Yining , Qian Changrui , Huang Zeyu , Feng Luozhu , Chen Lijiang , Yao Zhuocheng , Xu Chunquan , Ye Jianzhong , Zhou Tieli 
Published: September 2023

Abstract
Background
Chlorhexidine (CHG) is a disinfectant commonly used in hospitals. However, it has been reported that the excessive use of CHG can cause resistance in bacteria to this agent and even to other clinical antibiotics. Therefore, new methods are needed to alleviate the development of CHG tolerance and reduce its dosage. This study aimed to explore the synergistic effects of CHG in combination with bacteriophage against CHG-tolerant Pseudomonas aeruginosa (P. aeruginosa) and provide ideas for optimizing disinfection strategies in clinical environments as well as for the efficient use of disinfectants.

Methods
The CHG-tolerant P. aeruginosa strains were isolated from the First Affiliated Hospital of Wenzhou Medical University in China. The bacteriophage vB3530 was isolated from the sewage inlet of the hospital, and its genome was sequenced. Time-killing curve was used to determine the antibacterial effects of vB3530 and chlorohexidine gluconate (CHG). The phage sensitivity to 16 CHG-tolerant P. aeruginosa strains and PAO1 strain was detected using plaque assay. The emergence rate of resistant bacterial strains was detected to determine the development of phage-resistant and CHG-tolerant strains. Finally, the disinfection effects of the disinfectant and phage combination on the surface of the medical devices were preliminarily evaluated.

Results
The results showed that (1) CHG combined with bacteriophage vB3530 significantly inhibited the growth of CHG-resistant P. aeruginosa and reduced the bacterial colony forming units (CFUs) after 24 h. (2) The combination of CHG and bacteriophage inhibited the emergence of phage-resistant and CHG-tolerant strains. (3) The combination of CHG and bacteriophage significantly reduced the bacterial load on the surface of medical devices.

Conclusions
In this study, the combination of bacteriophage vB3530 and CHG presented a combined inactivation effect to CHG-tolerant P. aeruginosa and reduced the emergence of strains resistant to CHG and phage. This study demonstrated the potential of bacteriophage as adjuvants to traditional disinfectants. The use of bacteriophage in combination with commercial disinfectants might be a promising method for controlling the spread of bacteria in hospitals.
LYZ2-SH3b as a novel and efficient enzybiotic against methicillin-resistant Staphylococcus aureus
Authors: Asadi Marzieh , Taheri-Anganeh Mortaza , Ranjbar Maryam , Khatami Seyyed Hossein , Maleksabet Amir , Mostafavi-Pour Zohreh , Ghasemi Younes , Keshavarzi Abdolkhalegh , Savardashtaki Amir 
Published: September 2023

Abstract
Background
Enzybiotics are promising alternatives to conventional antibiotics for drug-resistant infections. Exolysins, as a class of enzybiotics, show antibacterial effects against methicillin-resistant Staphylococcus aureus (MRSA). This study evaluated a novel exolysin containing an SH3b domain for its antibacterial activity against MRSA.

Methods
This study designed a chimeric exolysin by fusing the Cell-binding domain (SH3b) from Lysostaphin with the lytic domain (LYZ2) from the gp61 enzyme. Subsequently, LYZ2-SH3b was cloned and expressed in Escherichia coli (E. coli). Finally, the antibacterial effects of LYZ2-SH3b compared with LYZ2 and vancomycin against reference and clinical isolates of MRSA were measured using the disc diffusion method, the minimal inhibitory concentration (MIC), and the minimal bactericidal concentration (MBC) assays.

Results
Analysis of bioinformatics showed that LYZ2-SH3b was stable, soluble, and non-allergenic. Protein purification was performed with a 0.8 mg/ml yield for LYZ2-SH3b. The plate lysis assay results indicated that, at the same concentrations, LYZ2-SH3b has a more inhibitory effect than LYZ2. The MICs of LYZ2 were 4 µg/mL (ATCC 43,300) and 8 µg/mL (clinical isolate ST239), whereas, for LYZ2-SH3b, they were 2 µg/mL (ATCC 43,300) and 4 µg/mL (clinical isolate ST239). This suggests a higher efficiency of LYZ2-SH3b compared to LYZ2. Furthermore, the MBCs of LYZ2 were 4 µg/mL (ATCC 43,300) and 8 µg/mL (clinical isolate ST239), whereas, for LYZ2-SH3b, they were 2 µg/mL (ATCC 43,300) and 4 µg/mL (clinical isolate ST239), thus confirming the superior lytic activity of LYZ2-SH3b over LYZ2.

Conclusions
The study suggests that phage endolysins, such as LYZ2-SH3b, may represent a promising new approach to treating MRSA infections, particularly in cases where antibiotic resistance is a concern. But further studies are needed.