bluuebunny/crossref_metadata_2025_split huggingface dataset:
Internal Self-Determination in Ethiopia
Authors: Afesha Nigussie 
Published: October 2024

Abstract
This paper discusses cluster statehood and its implications on minority ethnic groups. Using the three statehood exercises (South-Western Ethiopian Peoples, Southern Ethiopia and Central Ethiopian regional state) as a case study, this paper highlights the main issues and challenges minority ethnic groups face in the process of statehood exercise. These include the application of the simple majority vote rule in a statehood referendum, the implication of cluster statehood on minority ethnic groups’ rights, the challenge of clustering ethnic minorities without their wishes and restructuring minorities’ ethnic administrative boundaries without a referendum. It concludes that the simple majority followed in statehood referendum makes the role of minority ethnic groups rubber-stamp rather than reflect their real interests. Creating the Central Ethiopian State without a referendum is a flagrant disregard of the constitutional procedure and hinders the full political authority of minority nnp s to decide on their affairs.
A Comparative Investigation of Monsoon Active and Break Events over the Western North Pacific
Authors: Xu Ke , Lu Riyu 
Published: October 2024

Abstract
This study identifies 86 active events and 66 break events of the western North Pacific summer monsoon (WNPSM) from 1979 to 2020. These active and break events exhibit sharp contrast in large-scale convection and circulation fields. During the active period, deep convection almost covers the entire WNP domain (0°–25°N, 120°–170°E), accompanied by the strengthening of a local monsoon trough and monsoon westerlies extending from the Arabian Sea to the WNP. In contrast, during the break period, along with weakened monsoon westerlies, the subtropical high replaces the monsoon trough to dominate the WNP domain, leading to the disappearance of deep convection. Results about the convection evolution at multiple time scales indicate that active/break events are primarily contributed to by the wet/dry phases of intraseasonal oscillations (ISOs). The phase transitions of ISOs are nearly symmetric between active and break events. However, these two types of events present notable asymmetric features in convection anomalies relative to climatology, which can be attributable to the modulation of the seasonal mean component. Specifically, both active and break events correspond to anomalously strong seasonal mean convection, which amplifies (weakens) the convection enhancement (suppression) during the active (break) period and results in normal (enhanced) convection during adjacent periods. The preferred occurrence of active and break events in strong summer monsoons is because related mean backgrounds, including increased low-level positive vorticity, specific humidity, and easterly vertical shear, facilitate the intensification of ISOs. These mean backgrounds are likely induced by SST cooling in the north Indian Ocean and warming in the equatorial central Pacific during the simultaneous summer.

Significance Statement
The subseasonal variation in monsoon rainfall typically manifests as fluctuations between active events with abundant rainfall and break events with deficit rainfall, which can induce converse extremes such as floods and droughts, significantly affecting water management, agriculture planning, and economic activities. This study aims to reveal the characteristics, formation, and occurrence regularity of active and break events during the western North Pacific summer monsoon (WNPSM). We note that the occurrence of these active and break events is determined not only by intraseasonal oscillations but also by seasonal mean backgrounds, which result in certain asymmetrical features between the two types of events. These results will enhance our understanding of the monsoon’s intraseasonal variability and the physical association between multiple time scales over the WNP domain (0°–25°N, 120°–170°E).
Trust in scientific institutions and experts during the first 2 years of the COVID-19 pandemic in Finland
Authors: Jallinoja Piia T. , Vento Eetu V. , Väliverronen Esa T. 
Published: October 2024

Aims: To explore variations in trust in science and scientific institutions in Finland during the COVID-19 pandemic, and the factors influencing trust in experts of a key institution in the management of the pandemic, the Finnish Institute for Health and Welfare (THL). These results are contrasted with trust in the Ministry of Social Affairs and Health. Methods: Five surveys were conducted between April 2020 and March 2022 ( n=5448). The changes were tested with the chi-square test. Predictors of trust in THL and the ministry was examined with binary logistic regression. Results: Trust in science and key scientific institutions remained consistently high throughout this period. In the early pandemic, trust in the ministry declined. The most significant explanatory factors for trust in THL and the ministry were being a supporter of some other party than the right-wing Finns Party and belonging to the age groups over 50 years. Conclusions: Our findings indicate that the pandemic, marked by unpredictability, did not weaken trust in science and THL, whereas trust in the ministry responsible for managing the pandemic and university experts weakened. In increasingly politically polarised societies, the impact of political sentiments on health-related perceptions and choices should be analysed more in future public health studies.
Role of baseline soluble tumor necrosis factor receptor 2 as a biomarker in primary podocytopathy: Implications for renal impairment and disease progression
Authors: Nagaram Srinivas , Charles Priscilla , Nisha Yadav , Stephen Norton , Hanumanthappa Nandeesha , Parameswaran Sreejith , Chinnakali Palanivel , Nachiappa Ganesh Rajesh 
Published: October 2024

Abstract
Background
Podocytopathies, including minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), and collapsing glomerulopathy (CG), are kidney diseases that damage glomerular podocytes, leading to heavy proteinuria and nephrotic syndrome (NS). Inflammation plays a critical role in the progression of chronic kidney disease (CKD), with recent studies linking inflammatory biomarkers to declining kidney function. Tumor necrosis factor-alpha (TNF-α), an essential inflammatory cytokine, interacts with its circulating receptors, TNFR1 and TNFR2. The TNF-α pathway has been implicated in the pathogenesis of FSGS and MCD. Increased circulating TNFR2 levels have been associated with worsening renal function in podocytopathies, suggesting that the TNF-α inflammatory pathway significantly contributes to disease progression.

Methods
We conducted a study involving 53 patients with biopsy-proven MCD or FSGS and 53 healthy, age- and gender-matched controls. All patients were followed for 18 months. We analyzed serum and urine TNFR2 levels and gene expression at baseline and after three months. To assess the ability of TNFR2 to predict persistent decline in estimated glomerular filtration rate (eGFR < 30 mL/min/1.73m2), remission, and relapse, we employed Cox regression analysis. Additionally, we evaluated its prognostic utility for predicting progression to stage 4 CKD using ROC curve analysis.

Results
Serum and urine TNFR2 levels were significantly elevated in patients compared to controls. Serum TNFR2 was a significant predictor in univariate Cox regression analysis for persistent eGFR decline (HR 1.017, 95% CI: 1.003 to 1.032, p = 0.018), remission (HR 0.995, 95% CI: 0.992 to 0.999, p = 0.006), and relapse (HR 1.005, 95% CI: 1.001 to 1.010, p = 0.029). The ROC curve analysis demonstrated that serum TNFR2 levels had a strong prognostic ability for predicting progression to stage 4 CKD, with an AUC of 0.848 (95% CI: 0.737—0.960), sensitivity of 81%, and specificity of 71%.

Conclusion
This study underscores the critical role of circulating TNFR2 in kidney injury among patients with primary podocytopathy. Elevated TNFR2 levels are significant predictors of persistent eGFR decline and disease relapse, highlighting their potential as biomarkers for disease progression and prognosis.
Self-stigma in alcohol dependence scale: development and validity of the short form
Authors: Rieckhof Sophia , Leonhard Anya , Schindler Stephanie , Lüders Juliane , Tschentscher Nicole , Speerforck Sven , Corrigan Patrick W. , Schomerus Georg 
Published: October 2024

Abstract
Background
Self-stigma is associated with low self-esteem, high shame and reduced drinking-refusal self-efficacy in people with alcohol use disorder (AUD). The Self-Stigma in Alcohol-Dependence Scale-Short Form (SSAD-SF) was designed to enable a brief, but valid assessment of AUD self-stigma.

Methods
We reduced the 64-item SSAD, originally derived from 16 stereotypes towards people with AUD, by removing the most offensive items based on perspectives of people with lived experience. The newly created scale was then assessed and validated in a cross-sectional study involving 156 people reporting alcohol issues in various treatment settings.

Results
The 20-item SSAD-SF includes five stereotypes, with good internal consistency for each subscale and the overall scale. It reflects the four-stage progressive model of self-stigmatization with decreasing scores over the stages awareness of stereotypes, agreement with stereotypes, self-application of stereotypes, and harmful consequences for self-esteem, and highest correlations between adjacent stages. The subscales apply and harm were associated with internalized stigma, shame, reduced self-esteem, and lower drinking-refusal self-efficacy, as supported by multivariate regression models.

Discussion
The SSAD-SF is a valid instrument for measuring the process of self-stigmatization in people with AUD. Self-stigma is a consistent predictor of reduced self-esteem, higher shame and lower drinking-refusal self-efficacy in people with AUD. We discuss merits of the progressive model for understanding and addressing self-stigma in AUD.
Influence of inpatient withdrawal treatment on drug safety in alcohol use disorder — a quasi-experimental pre-post study
Authors: Schröder Sebastian , Schulze Westhoff Martin , Bleich Stefan , Bode Henry , Jendretzky Konstantin Fritz , Krichevsky Benjamin , Glahn Alexander , Heck Johannes 
Published: October 2024

Abstract
Objective
Most patients with alcohol use disorder (AUD) regularly take medication. Alcohol interacts negatively with many commonly prescribed medications. Little is known about whether the risk of potential alcohol-medication and drug-drug interactions increases or decreases in patients with AUD during inpatient withdrawal treatment. The aim of our study was to determine the prevalence and characteristics of potential alcohol-medication and drug-drug interactions in patients with AUD before and after withdrawal treatment in an addiction unit.

Design
Prospective monocentric quasi-experimental pre-post study.

Methods
Medication records before and after withdrawal treatment were analyzed and screened for potential alcohol-medication (pAMI) and drug-drug interactions (pDDI) using the drugs.com classification and the AiDKlinik® electronic interaction program, respectively.

Results
We enrolled 153 patients with AUD who were treated in an addiction unit of a university hospital in Germany. Of these, 67.3% experienced at least one pAMI before and 91.5% after withdrawal treatment. In total, there were 278 pAMIs classified as “mild,” “moderate,” or “severe” before and 370 pAMIs after withdrawal treatment. Additionally, there were 76 pDDIs classified as “moderate,” “severe,” or “contraindicated combinations” both before and after withdrawal treatment.

Conclusion
The risk of exposure to pAMIs and pDDIs increases during inpatient withdrawal treatment in patients with AUD. Improvements in the quality of prescribing should particularly focus on the use of antihypertensives and opioids.
Learning how to explore spiritual aspects in encounters with patients with chronic pain: a pre-test post-test trial on the effectiveness of a web-based learning intervention
Authors: Schmitz Felix Michael , Buzzi Ann-Lea , Brem Beate Gabriele , Schnabel Kai Philipp , Berger-Estilita Joana , Roten Fredy-Michel , Peng-Keller Simon , Guttormsen Sissel 
Published: October 2024

Abstract
Background
Integrating spiritual aspects into treatment plans can release essential resources for coping with chronic pain. However, some spiritual aspects may also induce distress and hinder the coping process. There is a lack of evidence regarding how to perform the clinical tasks of exploring spiritual aspects and of instruments assessing related competencies. Therefore, we developed a web-based learning module to provide education on the subject alongside corresponding assessment instruments. The module presents the InSpiRe (Integration of Spirituality and/or Religion in patient encounters) protocol. The instruments encompass cognitive, affective, and behavioral dimensions.

Methods
This paper aims to determine (i) the learning effects associated with completing the web-based spiritual-care learning module and (ii) the reliability and validity of the instruments employed. To address these aims, we conducted a pre-test/post-test trial with N = 32 randomly selected fourth-year medical students. During the pre-test, we assessed the students’ knowledge, attitudes, and self-efficacy regarding exploring spiritual aspects. For this purpose, we developed a short-answer knowledge test, an attitude questionnaire, and a self-efficacy scale. Additionally, the students explored spiritual aspects with a simulated patient portraying a person with chronic pain. Three trained raters evaluated the students’ performances using a self-developed scale. In the intervention phase, the students completed the 45-minute learning module on a personal computer. The module presented InSpiRe-related content as text and step-by-step video demonstrations, including hints that denote critical actions. The subsequent post-test was identical to the pre-test.

Results
The internal consistency was suitable for all respective instruments, and there was an indication of solid validity of the performance test. After completing the spiritual care learning module, the students showed statistically significant increases in knowledge scores and significant positive shifts in their attitudes and levels of self-efficacy regarding exploring spiritual aspects. They also attained significantly higher performance scores in the same regard.

Conclusions
Completing the spiritual-care module is associated with meaningful learning effects on cognitive, affective, and behavioral dimensions related to exploring spiritual aspects, as demonstrated in the post-test conducted shortly after the intervention. Due to good reliability and validity scores, the self-developed instruments can be applied appropriately.
Self-assessed levels of preparedness, engagement willingness and teaching preferences on antibiotic use of medical and pharmacy students in Romanian universities: a cross-sectional study
Authors: Ghiga Ioana , Pitchforth Emma , Popescu Gabriel Adrian , Fulop Ibolya , Lundborg Cecilia Stålsby , Machowska Anna 
Published: October 2024

Abstract
Background
To effectively support health professionals in optimizing antibiotic prescribing and dispensing, policymakers need to understand how these professionals are trained, feel prepared and want to be educated. The study aimed to assess the current situation and explore potential improvements in antibiotic use among future health professionals in Romania by: (i) evaluating their self-assessed preparedness on antibiotic-related topics, (ii) understanding their perceptions of their role in antibiotic stewardship, and (iii) gathering their recommendations for optimizing antibiotic use.

Methods
A survey of students’ self-assessment of technical preparedness, engagement willingness, expectations, teaching preferences, training received and evolution of situation in Romania. Overall, 41 and 38 questions were asked to medical and pharmacy students respectively. Scores were calculated for preparedness, engagement willingness and teaching preferences to enable various comparisons. Exploratory factor analysis was used to explore the questionnaire construct.

Results
A total of 479 participants completed the survey- 233 medical students from 7 universities and 246 pharmacy students from 4 universities. Median overall preparedness score indicated that most students felt prepared in at least 14 questions (out of 22 for medical students, and 19 for pharmacy students). Engagement scores for medical and pharmacy students were similar (2 and 3 out of 4). Overall, more than half reported that ‘yes, very likely’ they received adequate training to ensure the appropriate use of antibiotics in their professional areas (n = 254, 53.5%). Medical and pharmacy students with low preparedness scores expressed a need for more education. Most of both medical and pharmacy students considered the antibiotic situation in Romania ‘will get worse’ (n = 159, 33.5%).

Conclusions
The study’s findings have important implications for the education and training of future Romanian health professionals and highlight the need for further research on optimal and standardized tools to allow for periodic monitoring and evaluation of progress into preparedness, engagement willingness and teaching preferences on antibiotic use.
The impact of nurse managers’ boundary spacing leadership on the relationship between nurses’ work embeddedness and innovative work behaviors
Authors: Sorour Marwa Samir , Abdelaliem Sally Mohammed Farghaly , Khattab Sabrein Ali Khalifa 
Published: October 2024

Abstract
Aim
This study was designed to examine the nurse managers’ boundary-spacing leadership’s impact on the relationship between nurses’ work embeddedness and innovative work behaviors.

Background
In today's evolving healthcare environment, innovation is essential for enhancing patient care, optimizing resources, and supporting healthcare professionals. Nurses are pivotal in driving bedside innovation, but cultivating a culture of innovation within nursing teams involves more than just promoting creative ideas.

Methods
This is a descriptive correlational study that was conducted at one governmental hospital in Tanta, Egypt. Using Nurse Managers Boundary-Spacing Scale for assessing boundary-spacing leadership, The Global Job Embeddedness Scale for measuring work embeddedness, and Innovative Work Behavior Scale for assessing innovative work behavior, 250 nurses were surveyed. Data analysis was run using descriptive and inferential analysis. Correlation and regression analysis were used to examine the study hypotheses.

Results
There is a statistically significant positive relationship between boundary-spacing leadership and work embeddedness (r = 0.615, p < 0.001). Boundary-spacing leadership accounted for 56% of the variance in work embeddedness and 36% of the variance in nurses' innovative work performance. These results highlight the pivotal role of boundary-spacing leadership in both enhancing nurses' work embeddedness and boosting their innovative behaviors. The substantial variance explained by boundary-spacing leadership underscores its critical influence on fostering a supportive and innovative work environment within the nursing field.

Conclusion
Boundary spacing leadership style involves connecting internal and external resources, fostering information exchange, and advocating for the nursing team. While work embeddedness positively correlated with innovative work performance, its impact was less significant than boundary-spacing leadership. This suggests that feeling attached to the organization fosters innovation, but leadership style has a stronger influence. Furthermore, the study found a positive and significant correlation between innovative work performance and both work embeddedness and nurse managers' boundary spacing leadership.

Practical Implications
The findings emphasize that boundary-spacing leadership is crucial for enhancing both nurses' work embeddedness and innovative behaviors. Healthcare organizations should focus on developing these leadership skills to create a supportive work environment, foster innovation, and improve staff retention
Nesfatin-1 expression and blood plasma concentration in female dogs suffering from cystic endometrial hyperplasia and pyometra and its possible interaction with phoenixin-14
Authors: Rybska Marta , Skrzypski Marek , Billert Maria , Wojciechowicz Tatiana , Łukomska Anna , Pawlak Piotr , Nowak Tomasz , Pusiak Karolina , Wąsowska Barbara 
Published: October 2024

Abstract
Background
Nesfatin-1 is a neuropeptide that regulates the hypothalamic-pituitary-gonadal axis and may play a role in uterus function. It is co-expressed with other peptides, such as phoenixin, which can influence sex hormone secretion. Our previous research has confirmed that phoenixin-14 is involved in the development of cystic endometrial hyperplasia (CEH) and pyometra in dogs. Therefore, based on the similarities and interactions between these neuropeptides, we hypothesized that nesfatin-1 might also regulate the reproductive system in dogs. This study aimed to determine the expression of nesfatin-1 and its interaction with phoenixin-14 in dogs with CEH or pyometra compared to healthy females, and concerning animals’ body condition score (BCS 4–5/9 vs. BCS > 5/9).

Results
The analysis of nesfatin-1 in the uterus of bitches consisted of qPCR, western blot and immunofluorescence assays, and ELISAs. The results showed significantly higher nesfatin-1 encoding gene, nucleobindin-2 mRNA (Nucb2) and nesfatin-1 protein expression in overweight females and those suffering from CEH or pyometra compared to healthy animals. The immunoreactivity of nesfatin-1 was elevated in the uteri of bitches with higher BCS > 5/9. Moreover, nesfatin-1 blood concentrations increased in all examined overweight bitches. In the case of phoenixin signals, we found opposite results, regardless of the female body condition score.

Conclusion
The etiology of CEH and pyometra are not fully known, although we have expanded the level of knowledge with respect to the possible interaction of nesfatin-1 and phoenixin in female dogs’ uteri. They interact oppositely. With increasing female body weight, the expression of nesfatin-1 in the uterus and its peripheral blood concentration increased. However, for female dogs affected by CEH and pyometra, a decreased level of phoenixin-14, irrespective of their body condition score is characteristic. This knowledge could be crucial in the development of biomarkers for these conditions, which may lead to earlier recognition.