bluuebunny/crossref_metadata_2025_split huggingface dataset:
The role of bidirectional associations of depression, anxiety and emotional exhaustion on turnover intention among nurses: a multicenter cross-sectional study in China
Authors: Qin Ning , Yao Ziqiang , Guo Meiying 
Published: May 2023

Abstract
Background: A high turnover rate in nursing has become a global concern. Mental health issues may increase the turnover intention of nurses and lead to turnover behaviors. However, very little is known about the role of bidirectional associations between emotional exhaustion and depression/anxiety on turnover intention. This study aimed to examine the associations among depression, anxiety, emotional exhaustion and turnover intention, and to test the role of bidirectional associations of depression, anxiety and emotional exhaustion on turnover intention among nurses.
Methods: An online multicenter cross-sectional study was conducted in Hunan Province, China, from December 2021 to February 2022. The questionnaire captured data on the Turnover Intention Scale, the Emotional Exhaustion Scale, the Patient Health Questionnaire-2 and the Generalized Anxiety Disorder Scale-2, as well as sociodemographic information. Data analysis was performed by univariate analysis, Pearson correlation analysis, multiple linear regression analysis, and structural equation modeling.
Results: The average turnover intention score among Chinese nurses was 14.34±3.75. The prevalence of depression and anxiety was 25.9% and 22.3%, respectively. Depression (r = 0.378, P<0.001), anxiety (r = 0.391, P<0.001), and emotional exhaustion (r = 0.532, P<0.001) were positively associated with turnover intention. Emotional exhaustion partially mediated on the associations between depression/anxiety and turnover intention, with both mediating effects accounting for 60.7%. The mediating ratios of depression/anxiety on the associations between emotional exhaustion and turnover intentions were 17.6% and 16.5%, respectively.
Conclusions: Depression, anxiety and emotional exhaustion showed significant positive effects on turnover intention among nurses. Emotional exhaustion played a partial mediation role between depression/anxiety and turnover intention, while depression/anxiety played no significant mediations between emotional exhaustion and turnover intention.
A Novel Immune-Related LncRNA Pair Model to Predict the Prognosis of Triple-Negative Breast Cancer
Authors: Li Jing-ying , Fan Ping , Peng Hui , Wang Shi-yan , Chen En-Qiang 
Published: May 2023

Abstract
Background
Breast cancer (BC) is the most prevalent cancer type and is the principal cause of cancer-related death in women. Anti-PD-1/PD-L1 immunotherapy has shown promising activity in metastatic TNBC, but the potential factors affecting its efficacy have not been elucidated. Immune-related long noncoding RNAs (irlncRNAs) have been reported to be involved in immune escape to influence the carcinogenic process through the PD-1/PD-L1 signaling pathway. Therefore, exploring the potential regulatory mechanism of irlncRNAs in PD-1/PD-L1 immunotherapy in TNBC is of great importance.
Methods
In the current study, we retrieved transcriptome profiling data from The Cancer Genome Atlas (TCGA) and identified differentially expressed irlncRNA (DEirlncRNA) pairs. Least absolute shrinkage and selection operator (LASSO) regression analysis was performed to construct a risk assessment model.
Results
Receiver operating characteristic (ROC) curve analysis indicated that the risk model may serve as a potential prediction factor in TNBC patients. Clinical stage and risk score proved to be independent prognostic predictors by univariate and multivariate Cox regression analyses. Subsequently, we investigated the correlation between the risk model and tumor-infiltrating immune cells and immune checkpoints. Finally, we identified USP30-AS1 through the StarBase and MEM databases, predicted the potential target genes of USP30-AS1, and then discovered that these target genes were closely associated with immune responses.
Conclusion
Although the current study did not investigate the specific mechanism by in vivo and in vitro experiments, we constructed a risk assessment model by immune-related lncRNA pairs regardless of expression levels, which has the potential to predict the efficacy of anti-PD-1/PD-L1 immunotherapy and provide a novel strategy for TNBC treatment.
Service quality evaluation of county-level public hospitals in Chongqing under smart healthcare
Authors: Qiu Yuantang , Xiao Chun , Li Jing 
Published: May 2023

Abstract

Background:Based on the perspective of patient experience, this study investigates patients' perceptions and expectations of the quality of smart healthcare services, to provide a reference for the development of smart healthcare in hospitals at the same level.
Methods: From October to November 2021, county 10 public hospitals were selected using cluster sampling. Based on the SERVQUAL scale, patient expectations and perception scores were surveyed across 24 items in four dimensions: ability, application, platform, and effectiveness. The gap between perception and expectation was calculated, and the influencing factors were analyzed. Finally, the IPA model was used to analyze and evaluate the results.
Results: A total of 915 patients were included in the outpatient and inpatient departments. The average perception score of patients was 3.86, and the average expectation score was 4.44, with a gap of -0.58. Paired sample t-tests showed that there were significant differences between patients' perceptions and expectations across the 24 items (P < 0.05). IPA quadrant analysis showed that 5 items fell into quadrant IV. The results of a generalized linear model indicated that patients with college degree (β=-0.146,95%CI:-0.259~-0.033), patients with income between 2001~3500RMB (β=0.280,95%CI:0.144~0.416), and patients with income between 3501~5000RMB (β=0.250,95%CI:0.130~0.370). Patients whose insurance type is urban and rural residents' medical insurance (β=-0.234,95%CI:-0.37~0.098) will affect the evaluation of service quality.
Conclusions: The services provided by smart healthcare have not met patients' expectations, and the personalized medical needs of different patients should be valued. Further improvement is needed in the control of medical expenses, system design and operation, and the balance of technology and human care.
Anoikis-Related LncRNA Signature Predicts Prognosis and Is Associated With Immune Infiltration in Hepatocellular Carcinoma
Authors: Zhu Jiahong , Zhao Wenjing , Zhao Suming , Yang Junkai , Liu Cheng , Wang Yilang , Zhao Hui 
Published: May 2023

Abstract
Anoikis is a term used to describe the programmed cell death that takes place when cells become disconnected from the extracellular matrix[1]. Numerous long non-coding RNAs (lncRNAs) have been found to be linked to anoikis resistance in various tumors, including glioma[2], breast cancer[3], and bladder cancer[4]. There is a lack of studies examining the relationship between ARLs and HCC prognosis. Further research is needed to explore this potential link and understand the role of ARLs in HCC progression.
Patients and methods:
In this study, we acquired 36 genes associated with anoikis through the GO and GSEA databases, and identified 22 differentially expressed lncrnas that were correlated with these genes based on data from The Cancer Genome Atlas (TCGA). Using Cox regression analyses, we created an anoikis-related lncRNA signature (ARlncSig) in a training cohort, which we then validated in both a testing cohort and a combined cohort composed of data from both cohorts. Then, we collected 8 pairs of liver cancer tissues and adjacent tissues from Affiliated Tumor Hospital of Nantong University.
Results:
Five ARLs were developed as a risk stratification system to categorize patients into low- and high-risk groups. The high-risk group exhibited a notably lower overall survival (OS) rate in comparison to the low-risk group. The model's predictive performance is supported by the receiver operating characteristic curve, calibration of nomogram, clinical correlation analysis, and clinical decision curve. Furthermore, differential analysis of immune function, immune checkpoint, response to chemotherapy, and immune cell subpopulations indicated significant discrepancies between the high and low-risk groups. IC50 analysis determined that commonly prescribed drugs were more effective for patients in the high-risk group. Lastly, quantitative real-time PCR validated the expression levels of the five lncRNAs in specific drug-resistant cell lines. In conclusion, our ARlncSig model possesses critical predictive value in the prognosis of HCC patients, and it may provide clinical guidance for personalized immunotherapy.
TB-TBP: A Task-Based Adaptive Routing Algorithm for Network-On-Chip in Heterogenous CPU-GPU Architectures
Authors: Fang Juan , Wei Zhichao , Liu Yaqi , Hou Yumin 
Published: May 2023

Abstract
With the rapid development of heterogeneous Network-on-Chip (NoC), a vast amount of shared resources are integrated into NoC. Intense resource competition exists between CPUs and GPUs, leading to congestion and a decrease in overall network performance. Reasonable node placement can minimize network confficts at the topology level. This paper ffrst discusses the placement of shared last-level cache (LLC) and memory controller (MC), then selects a more rational placement method and optimizes the path. To solve the hot spots problem for center placement method, a task-based routing algorithm is designed to plan the path. Simulation results demonstrate that, compared to the traditional routing algorithm, the overall network latency is reduced by 9%, and the CPU performance is improved by 13.6%. Furthermore, a dynamic task-based routing algorithm is proposed. Compared to the static task routing algorithm, the overall network latency is reduced by 2.08%, and the CPU performance is improved by 4.09%.
Aiming to a Smart Agriculture through the Electrochemical Impedance of a Chitosan-Molybdate Membrane as a Function of Available Phosphate Species
Authors: Beltrán-Ortega M. A. , Oropeza-Guzmán M. T. , Calva-Yáñez J. C. 
Published: May 2023

Abstract

The identification and quantification of nutrients in the soil is of great importance in agriculture because plants depend on their presence in the soil or their supply as fertilizer to grow properly. However, there is currently no well-defined method for quantifying macronutrients in the field. Therefore, chitosan membranes that have been developed are biocompatible and biodegradable and are applied to stainless steel and carbon inks whose function is to adsorb phosphorus (P) species present in cultivated soils. Studies on Z-potential were carried out on chitosan solutions, varying the pH to measure the surface charge. It was found that as the pH of the solution increased, from 2 to 10, the surface charge decreased until a negative surface charge (from 59.9mV to -5mV). The chitosan/chitosan molybdate membranes were also examined by atomic force microscope (AFM) to observe their roughness and morphology. The chitosan membrane has a smoother appearance than the chitosan-molybdate membrane, confirmed by roughness at the micrometric scale. Electrochemical characterization included electrochemical impedance spectroscopy (EIS) measurements in solutions containing hydrogen phosphide ions HPO4= to determine the changes in resistance of the chitosan/chitosan-molybdate membranes. As the ion concentration in the solution increased, the charge transfer resistance (Rtc) decreased. However, when ammonium molybdate was added to the chitosan membrane, it acted as a promoter for the uptake of HPO4= by the membrane. Thus, based on their characterization, chitosan biosensors have shown that they are capable of attracting anionic species, which contributes to the minimization of preference zones on the surface of a sensing electrode.
Analyzing Forest Management Practice in Different Felling Series: A Case Study from Community Forest of Rupandehi District, Nepal
Authors: Acharya Bishwabandhu , Khanal Yajnamurti , Ojha Susil 
Published: May 2023

Abstract
Scientific Forest management (SciFM) in community forestry emphasizes establishing and growing regeneration by adopting different silvicultural systems. To assess the effectiveness of forest management practices, we examined the regeneration condition and its pattern in the forest with a scientific forest management plan. Data relating to regeneration status and its growth pattern were collected from two community forests using stratified random sampling. The results depicted good regeneration conditions (Seedling > 5000, Sapling > 2000) in all the felling series of both the forest. The number of seedlings and saplings was found highest in the sixth-year felling series (22,000 per ha) in Kanchan CF while it was highest in the fifth-year felling series (35,700 per ha) in the case of Rajapani CF. The forest of both the CF was dominated by Sal (Shorea robusta) followed by Asna (Terminalia alata) and Karma (Adina cordifolia). The number of seedlings per hectare was found higher in the strata with the latest regeneration felling while the number of poles per hectare is found higher in the strata with the oldest regeneration felling in a condition where there was less human pressure. The overall growth pattern of regeneration based on average diameter and an average height of Kanchan CF showed an upward sloping curve with the increase in years after the regeneration felling while that of Rajapani CF showed a slightly irregular curve representing irregular growth of regeneration based on average height. There were altogether 14 and 13 species in Kanchan CF and Rajapani CF respectively where both CF showed a similar degree of species richness and evenness. This research contributes to assessing forest sustainability based on regeneration growth with appropriate management strategies. It recommends the implementation of SciFM with proper monitoring and continuous management practices to enhance the forest's health and growth.
"Orthopedic injuries in Yemen civil war: a retrospective study of incidence, management, and outcomes".
Authors: Hutaif Mohammad 
Published: May 2023

Abstract
Background:
The Yemen civil war has caused a humanitarian crisis and a high incidence of orthopedic injuries. However, little information exists on how the war has affected their management in Yemen.
Objective:
To analyze the incidence, management, and outcomes of complex orthopedic injuries in Yemen civil war.
Methods: We conducted a retrospective study of orthopedic injuries treated in three major teaching hospitals in Yemen from January 2015 to May 2021. We collected data using a checklist that included injury type, cause, demographics, treatment method, treatment time, and outcomes. We analyzed the data using SPSS software with descriptive statistics and logistic regression models.
Results:
We reviewed the medical records of 3050 patients who received treatment for orthopedic injuries, mostly males (67%) with an average age of 32 years. Explosions were the primary cause of injury (70%), followed by gunshots (15%). Fractures were the most frequent type of injury (88%), followed by dislocations (10%) and ligament and tendon injuries (2%). Among the fractures, the femur (35%), tibia (30%), and humerus (18%) were the most frequently affected bones. The average hospital stay was 30 days, and the death rate was 7%. Soft-tissue/neurovascular injuries occurred in up to 94% of cases. Most orthopedic injuries required surgery (85%), with external fixation being the most frequently used surgical procedure (60%), followed by open reduction and internal fixation (ORIF) (30%) and amputation
(10%). Surgical complications were high, potentially requiring further surgery. Furthermore, 20% of patients who underwent ORIF needed more surgery due to infections, implant failure, or malunion. Open fractures accounted for 91% of all fractures observed in the study.
Conclusions:
The Yemen civil war has significantly affected the incidence and management of complex orthopedic injuries. The high incidence of these injuries has resulted in a significant burden on the healthcare system in Yemen. The findings from this study emphasize the urgent need for resources and medical care to manage these injuries effectively.
Random Frogs: Using future climate and land-use scenarios to predict amphibian distribution change in the Upper Missouri River Basin
Authors: Campbell Kaitlyn S. , Baltensperger Andrew P. , Kerby Jacob L. 
Published: May 2023

Abstract
Context
Climate change and anthropogenic stressors have contributed to rapid declines in biodiversity worldwide, particularly for amphibians. Amphibians play important ecological roles, yet little is known about how distribution hotspots may change or the factors influencing distribution patterns in the North American Great Plains.
Objectives
Ecological niche models improve understanding of biotic and abiotic factors associated with species' distributions and can highlight potential threats to species conservation. Here, we identify important predictors of amphibian distributions and predict how land use and climate change may alter distributions in the Upper Missouri River Basin.
Methods
We used publicly available occurrence data, 16 environmental and climatic predictors, and the machine-learning algorithm, Random Forests, to create spatially-explicit distribution models for eight amphibian species. Models were scored to current conditions (2005) and two future climate-change/land-use scenarios to predict changes in amphibian distributions for 2060.
Results
Models were highly accurate and revealed more pronounced distributional changes under the intensive RCP8.5/CONUS A2 scenario compared to the moderate RCP6.0/CONUS B2 scenario. Both scenarios predicted gains for most southeastern species (i.e., Blanchard’s cricket frogs, Plains leopard frogs, Woodhouse’s toads, and Great Plains toads) and declines for all western montane species. Overall, distribution changes were most influenced by climatic and geographic predictors, (e.g., summer temperature, precipitation, and elevation), and geography, versus anthropogenic land-use variables.
Conclusions
Changes in occurrence area varied by species and geography, however, high-elevation western species were more negatively impacted. Our distribution models provide a framework for future conservation efforts aiding the persistence of amphibian species across a warming, agriculturally dominated landscape.
Nexus between ethnobotany and urban life: native plants customarily used as medicine and food in Karachi, Pakistan (country’s largest metropolis)
Authors: Perveen Anjum , Ijaz Shabir , Iqbal Javed , Ashraf Saima , Kousar Shazia 
Published: May 2023

Abstract
Traditional medicine uses and knowledge is more famous and well documented in rural/remote areas in Pakistan and worldwide than the urban areas. The present effort was made to document the ethnomedicinal practices among the communities of Karachi city and provides the basis for the development of natural drug discovery. We are aware of no other quantitative ethnobotanical investigation on the use of medicinal plants in the study area prior to this study. For ethnobotanical data collection, 177 local informants and traditional healers were interviewed, using semi-structured interviews.Various quantitative indices such as relative frequency of citation (RFC), fidelity level(FL), use value(UV), and the Jaccard Index (JI) were applied to the documented data. The traditional medical uses of 97 plants species belonging to 47 families were reported. Solanaceae (seven taxa) followed by Boraginaceae and Fabaceae (six taxa each), Cucurbitaceae (five taxa); Amaranthaceae, Convolvulaceae, Malvaceae, Verbenaceae and Zygophyllaceae (four taxa each) were the leading families contributed with the highest number of taxa. The highest plant-used part was leaf, with 45 reports (28.84%), followed by fruit (15.38%). It was observed that the majority of species were used to treat stomach problems, respiratory issues, general wellness, skin conditions, liver-related conditions, and fever respectively. The ethnomedical findings reported in this study offer concrete proof of the Karachi city residents' use of therapeutic plants. The research also showed that the region's medicinal plants constitute a significant source of herbal medicines used to treat ailments. This survey can serve as a starting point for future scientific research to create new plant-based pharmaceuticals for the market.
Head-to-head comparison of two loop-mediated isothermal amplification (LAMP) kits for diagnosis of malaria in a non-endemic setting
Authors: Ivarsson Anna-Clara , Fransén Elin , Broumou Ioanna , Färnert Anna , Persson Kristina , Söbirk Sara Karlsson 
Published: May 2023

Abstract
Introduction: Light microscopy and rapid diagnostic tests (RDT) have long been the recommended diagnostic methods for malaria. However, in recent years, LAMP techniques have been shown to offer superior diagnostic performance, in particular concerning low-grade parasitaemia, by delivering higher sensitivity and specificity with low laboratory capacity requirements in little more than an hour. In this study we assessed the diagnostic performance of two Loop-mediated Isothermal Amplification (LAMP) kits head-to-head, compared to highly sensitive quantitative real time PCR (qPCR), in a non-endemic setting.
Methods: In this retrospective validation study two LAMP kits; Alethia® illumigene Malaria kit and HumaTurb Loopamp™ Malaria Pan Detection (PDT) kit, were evaluated head-to-head for detection of Plasmodium-DNA in 133 biobanked blood samples from suspected malaria cases at the Clinical Microbiology Laboratory of Region Skåne, Sweden to determine their diagnostic performance compared to qPCR.
Results: Of the 133 samples tested, qPCR detected Plasmodium DNA in 41 samples (the true positives), and the two LAMP methods detected 41 and 37 of those, respectively. The results from the HumaTurb Loopamp™ Malaria PDT kit were in complete congruence with the qPCR, with a sensitivity of 100% (95% CI 91.40 - 100%) and specificity of 100% (95% CI 96.07 – 100%); and the PPV and NPV were both 100%. The Alethia® illumigene Malaria kit had a sensitivity of 90.24% (95% CI 76.87 – 97.28) and a specificity of 95.65% (95% CI 89.24 – 98.80) as compared to qPCR. The PPV was 90.31% (95% CI 78.06-96.07) and the NPV was 95.62% (95%CI 89.58-98.23) with the malaria positivity rate of 30.8 % in the study material. This performance would give a PPV of 69.75% (95% CI 46.80 – 85.81) and NPV 98.88% (97.20 – 99.56) in a situation where samples tested had a 10% positivity rate, which more accurately resembles the situation in Skåne.
Conclusions: This head-to-head comparison showed superior performance of the HumaTurb Loopamp™ Malaria PDT kit compared to the Alethia® illumigene Malaria kit for detection of malaria.