bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of bacterial co-isolation on treatment initiation and long-term prognosis of patients with nontuberculous mycobacterial pulmonary disease: analysis of a prospective cohort study
Authors: Kim Joong-Yub , Kim Sung A , Hyung Kwonhyung , Yim Jae-Joon , Kwak Nakwon 
Published: October 2024

Abstract
Background
Nontuberculous mycobacterial pulmonary disease (NTM-PD), a chronic respiratory condition, presents a growing challenge globally. Uncertainties exist regarding the impact of concurrent bacterial co-isolation on treatment initiation and long-term prognosis.

Methods
This study analysed data from participants enrolled in an ongoing prospective observational cohort study on NTM-PD (NCT01616745) between 1 July 2011, and 31 December 2022, who provided sputum samples for bacterial culture at enrolment. Identification of potential pathogenic microorganisms (PPMs) was defined as a positive bacterial culture. Clinical characteristics were compared between NTM-PD patients with Pseudomonas, non-pseudomonal PPMs, and those without PPM co-isolation. Cox proportional hazard regression models were employed to assess the association of bacterial co-isolation with rates of NTM-PD treatment initiation and all-cause mortality.

Results
Overall, 453 patients (median age, 62 years; 30% male) were included in the analysis. PPMs were co-isolated in 77 patients (17%), including 13 with Pseudomonas species. Co-isolation of Pseudomonas was associated with a significantly higher erythrocyte sedimentation rate (P = 0.02) and St. George’s Respiratory Questionnaire score (P = 0.01). Non-pseudomonal PPM co-isolation was significantly associated with a higher likelihood of NTM-PD treatment initiation (adjusted hazards ratio [aHR], 1.56, 95% confidence interval [CI], 1.03–2.36, P = 0.036), whereas co-isolation of Pseudomonas was independently correlated with increased all-cause mortality (aHR, 3.25, 95% CI, 1.08–9.84, P = 0.037).

Conclusions
Our findings emphasize the importance of microbial surveillance, as bacterial co-isolation affects treatment initiation and prognosis in patients with NTM-PD.
Decoding oxygen prescriptions: electronic health record documentation versus patient-reported use
Authors: Tang Wilson , Smith J. , Dakkak J. , Balasubramanian A. , Seth B. , Leotta C. , Mathai S. C. , McCormack M. C. , Acharya S. , Calypso A. , Danoff S. K. 
Published: October 2024

Abstract
Background
Long term oxygen therapy (LTOT) is prescribed for hypoxemia in pulmonary disease. Like other medical therapies, LTOT requires a prescription documenting the dosage (flow rate) and directions (at rest, with activity) which goes to a supplier. Communication with patients regarding oxygen prescription (flow rate, frequency, directions), monitoring (pulse oximetry) and dosage adjustment (oxygen titration) differs in comparison with medication prescriptions. We examined the communication of oxygen management plans in the electronic health record (EHR), and their consistency with patient-reported LTOT use.

Study design and methods
A cross-sectional study was conducted in 71 adults with chronic lung disease on LTOT. Physician communication regarding oxygen management was obtained from the EHR. Participants were interviewed on their LTOT management plan. The information from each source was compared.

Results
The study population was, on average, 64 years, two-thirds women, and most used oxygen for over 3 years. Only 45% of both at-rest and with-activity oxygen prescriptions were documented in the Electronic Health Record (EHR). Less than 20% of prescriptions were relayed to the patient in the after-visit summary. Of those with EHR-documented oxygen prescriptions, 44% of patients adhered to prescribed oxygen flow rates. Nearly all patients used a pulse oximeter (96%).

Interpretation
We identified significant gaps in communication of oxygen management plans from provider to patient. Even when the oxygen prescription was clearly documented, there were differences in patient-reported oxygen management. Critical gaps in oxygen therapy result from the lack of consistent documentation of oxygen prescriptions in the EHR and patient-facing documents. Addressing these issues systematically may improve home oxygen management.
The hidden link: dysmenorrhea, emotion regulation, and attitudes toward marriage in female nursing students
Authors: Amin Shaimaa Mohamed , El-Sayed Mona Metwally , El-Monshed Ahmed Hashem , Khedr Mahmoud Abdelwahab , Atta Mohamed Hussein Ramadan 
Published: October 2024

Abstract
Background
Menstrual pain, or dysmenorrhea, can cause physical discomfort and mood swings, potentially impacting the attitudes of female nursing students toward marriage. Effective emotion regulation strategies are essential for managing stress and shaping their perspectives on marriage. This study sought to investigate the relationship between dysmenorrhea, emotional regulation skills, and attitudes toward marriage among female nursing students.

Methods
A cross-sectional survey was conducted using a stratified sample of 504 female nursing students from four academic years. The study used a combination of the Working Ability, Location, Intensity, Days of Pain, Dysmenorrhea (WaLIDD) Questionnaire, the Marital Attitude Scale, and the Emotion Regulation Questionnaire to assess various factors among the participants. The Pearson correlation coefficient was utilized to examine the relationships among the three primary variables. Additionally, linear regression analysis was employed to forecast attitudes toward marriage based on factors such as dysmenorrhea, residence, family type, regularity of the menstrual cycle, and age at menarche.

Results
The findings of the study are significant, revealing a negative correlation between dysmenorrhea and marital attitudes (r = -0.105, p = 0.019). Dysmenorrhea exhibited minimal and non-significant correlations with emotion regulation strategies, including cognitive reappraisal (r = -0.006, p = 0.898) and expressive suppression (r = 0.013, p = 0.774). In contrast, marital attitudes significantly influenced emotion regulation (β = -0.169, p < 0.001). Moderation analyses indicated significant effects of various factors on marital attitudes, including residence (β = -0.5136, p = 0.0478), family type (β = 5.9923, p = 0.0060), regularity of the menstrual cycle (β = 6.1262, p = 0.0014), and age at menarche (β = 1.5521, p = 0.0491).

Conclusion
A significant negative correlation between dysmenorrhea and certain attitudes, specifically optimistic and realistic marital attitudes, was found. This indicates that higher levels of dysmenorrhea are associated with less favorable perspectives in these domains. Additionally, the study demonstrates that negative marital attitudes were linked to poorer emotional regulation. This suggests that individuals with more pessimistic views about marriage may face challenges in effectively managing their emotions. These results underscore the intricate connections between physical health, attitudes, and emotional well-being. They highlight the need to address dysmenorrhea within nursing education and practice, considering its broader psychological impact.
Navigating transitions: a qualitative study of nursing teams’ experiences of educational and cultural transitions in Germany
Authors: Schumann Marwa , Peppler Lisa , Beck Patricia , Schenk Liane 
Published: October 2024

Abstract
Background
The global migration of health professionals in general and nurses in particular, has led to nursing shortages and socioeconomic impacts on health systems in both source and destination countries. Adding to the complexity of the situation is the fact that the nursing profession itself is evolving from a vocational to an academic one. Although nursing migration and academization have been studied from either an institutional or an individual perspective, there is a gap in the literature regarding how nursing teams experience these transitions. This study aims to explore how nursing teams navigate through the transitions of academization and internationalization of the current dynamic nursing landscape in Germany.

Methods
Based on social constructivism epistemology this qualitative study involved face-to-face focus group discussions conducted at several hospital sites in Germany from September 2021 to May 2023. The focus group discussions were audio-recorded, transcribed, and analysed using content analysis; the four dimensions of transition theory according to Schlossberg’s Four S (4 S) framework (self, situation, support, and strategy) were used as a priori items to construct the coding framework.

Results
Nine focus group discussions were conducted with a total of 40 nurses from different educational and migrant backgrounds. The analysis showed that the transition experiences of the nursing teams were heterogeneous, with educational and national backgrounds playing an important role in how realistic their expectations of their professional roles and identities were. The dynamic situation characterized by a shortage of qualified nursing staff, increases the pressure on nursing teams and underscores the importance of employer-provided and peer support. Onboarding and communication are key strategies used depending on the duration of the employee turnover.

Conclusion
This study provides insights into the challenges and coping strategies of nursing teams in the current dynamic scene of migration, academicization and professional socialisation in Germany. Extending the Schlossberg 4 S framework from the individual to the team perspective provides a comprehensive view of the transitional experiences of nursing teams. Within each domain of the framework, the experiences of nursing teams are remarkably diverse. Educational background (vocational or academic) and origin (German or foreign trained) play an important role in shaping the transitional experiences of nursing teams.
Effective prevention of early resignation of newly graduated nurses: a transactional analysis
Authors: Ogawa Masanori , Ae Ryusuke , Sasahara Teppei , Omi Keiko 
Published: October 2024

Abstract
Background
New employees often exhibit stress reactions to changes in their environment and some of these may result in resignations. Employees in medical institutions are no exceptions. Considering the shortage of nurses in Japan, countermeasures are needed against the resignation of newly graduated nurses. Many studies have indicated that multifaced factors affect the resignation of newly graduated nurses. Even though individual characteristics are important factors in this regard, training and support for newly graduated nurses do not focus on the nurses’ characteristics. The purpose of this study is to examine the characteristics influencing the early resignation of newly graduated nurses and suggest ways to support them and prevent their early resignation based on their characteristics.

Methods
With the approval of the Ethics Committee, various characteristics of 353 newly graduated nurses (personality, interpersonal relationships, trait anxiety, nurse orientation, desire to be a nurse, and self-proclaimed academic ability) were assessed using a transactional analysis, the State-Trait Anxiety Inventory, and self-reporting numerical rating scales. The characteristics of those who resigned within 1 year (case group) and those who did not (control group) were compared using chi-square test and logistic regression analysis.

Results
Our sample of 353 participants included 32 nurses from the case group and 304 nurses from the control group. Most participants showed similar personality traits. However, the control group had a significantly lower percentage with negative self, strong trait anxiety, negative self and strong trait anxiety, and low orientation compared to the case group. Our logistic regression analysis showed that strong trait anxiety and low nurse orientation are significantly related with the early resignation of nurses.

Conclusions
The early resignation of newly graduated nurses may be prevented by understanding their characteristics at the time of gaining employment and implementing early intervention programs, such as education programs to reduce anxiety, and helping those with strong trait anxiety and low nurse orientation to find meaning in work.
Patients’ knowledge of the indications for their medications – a scoping review
Authors: Bülow Cille , Clausen Stine Søndersted , Thøgersen Patrick Lundholm , Dalin Dagmar Abelone , Hansen Johanne Mølby , Johansson Karl Sebastian , Lundh Andreas , Christensen Mikkel Bring 
Published: October 2024

Abstract
Background
Inadequate medication knowledge may contribute to inappropriate medication use and treatment harms. We aimed to map and synthesise the existing evidence on patients’ knowledge of the indications for their medications.

Method
We searched MEDLINE, Embase, CINAHL, PsychInfo and the Cochrane Library for studies that assessed patients’ knowledge of the indications for their medications from inception to June 16, 2022. A pair of reviewers independently screened and extracted data on study characteristics, aims, and methods used to assess and report patients’ knowledge of the indications for their medications.

Results
We included 99 studies conducted in 33 countries, published between 1979 and 2021, with 42,377 participants in total (median 126 participants [Interquartile range: 63–338]). Studies were observational (n = 77), experimental (n = 18), or qualitative interviews (n = 4). The exact question used to assess knowledge of the indications was reported in 27 studies and was phrased in 25 different ways. Knowledge of the indications was reported as a proportion of either 1) all participants (n = 65) or 2) the total number of medications used by all patients (n = 13). Sixteen studies used both reporting methods, while five only reported a proportion without specifying the denominator. Fourteen studies in various populations reported the number of participants with correct knowledge of all their medications, ranging from 19% (long-term psychiatric in-patients) to 87% (general practice patients).

Conclusion
We did not identify any established scientific standard for assessing patients’ knowledge of the indications for their medications. The wide range of study methodologies and reporting styles observed call for a methodological consensus in this research field. Estimates of correct knowledge varied widely between studies, but whether this was due to differences in study populations or study methodology could not be determined. Furthermore, we did not identify any study investigating whether participants’ knowledge of the indications for their medications was associated with the quality, e.g. appropriateness, of their treatment.
Measuring internalized health-related stigma across health conditions: development and validation of the I-HEARTS Scale
Authors: Pearl Rebecca L. , Li Yulin , Groshon Laurie C. , Hernandez Marian , Saunders Danielle , Sheynblyum Miriam , Driscoll Kimberly A. , Gelfand Joel M. , Manavalan Preeti , Montanez-Wiscovich Marjorie , Pereira Deidre B. , Puhl Rebecca M. , Wadden Thomas A. , Waxenberg Lori B. , Westen Sarah C. , Lou Xiang-Yang 
Published: October 2024

Abstract
Background
Health-related stigma and its internalization among individuals with chronic health conditions contribute to impaired mental and physical health and quality of life. Research on health-related stigma has been siloed, with disease-specific measures that may not capture the experiences of individuals with multiple health conditions and that prevent comparisons across health conditions. The current study aimed to develop and test a transdiagnostic measure of internalized health-related stigma for use among adults with different physical health conditions.

Methods
An existing measure of internalized mental health stigma was adapted to assess stigma due to chronic physical health conditions following COSMIN procedures, with input from advisory boards of community members living with a range of stigmatized health conditions (obesity, type 1 and type 2 diabetes, skin diseases, HIV, chronic pain, and cancers) and of health professionals who specialized in these conditions. The new Internalized Health-Related Stigma (I-HEARTS) Scale was tested in an online sample of 300 adults with these health conditions, recruited from ResearchMatch. Additional psychosocial measures of mental health and quality of life were administered, and participants provided information about their health conditions and demographic characteristics. Exploratory factor analysis and tests of reliability and validity were conducted to determine the psychometric properties of the I-HEARTS Scale, and k-means clustering and receiver of characteristic curve analysis were used to determine a clinically meaningful cutoff score indicating high levels of internalized stigma.

Results
Factor analysis results yielded a 25-item scale with a 3-factor solution, with subscales of Perceived and Anticipated Stigma, Stereotype Application and Self-Devaluation, and Stigma Resistance. Psychometric properties for internal consistency, inter-item and item-total correlations, and test-retest reliability were strong. Certain demographics (e.g., younger age) and characteristics related to health conditions (e.g., greater symptom severity) were associated with higher levels of internalized stigma. I-HEARTS Scale scores correlated moderately to strongly with related but distinct psychosocial measures, and a cutoff score of 3.40 or higher on the 1–7 rating scale was determined to indicate clinically meaningful levels of internalized stigma.

Conclusions
The I-HEARTS Scale is a reliable and valid measure for the assessment of internalized health-related stigma among adults with varied stigmatized chronic health conditions.

Study pre-registration
https://osf.io/84c5d/?view_only=87238512f6d6475c87f8f64280a8a15f.
Male reproductive system of the deep-sea acorn worm Quatuoralisia malakhovi (Hemichordata, Enteropneusta, Torquaratoridae) from the Bering Sea
Authors: Lukinykh Anastasiya Ivanovna , Ezhova Olga Vladimirovna , Yushin Vladimir Vladimirovich , Galkin Sergey Vladimirovich , Malakhov Vladimir Vasilievich 
Published: October 2024

Abstract
Background
The deep-sea acorn worm Quatuoralisia malakhovi belongs to the phylum Hemichordata, class Enteropneusta, family Torquaratoridae, which was described in 2005. Owing to their epibenthic lifestyle and deep-sea habitat features, torquaratorids differ anatomically from shallow-water acorn worms; however, their morphology and fine structure are poorly studied. We have the opportunity to make three complete detailed series of histological sections of Q. malakhovi and to study the microscopic anatomy, histology and fine structure of the reproductive system of this acorn worm using scanning and transmission electron microscopy.

Results
The sexes of Q. malakhovi are separate and indistinguishable externally. The lobed testes occupy the dorsal side of the genital wings and distinctly bulge into the peribranchial cavity by their mature lobes. The central part of the testis is always submerged into the genital wing and opens via a single gonad pore. The monociliary muscle cells stretch along the external wall of the testis and surround the gonad pore, probably taking part in the contraction of the testis lobes for spawning. The germinative epithelium of the testis contains spermatogenic cells at different stages of development and interstitial cells. Yolk cells are not found. Interstitial cells embrace the spermatogonia and spermatogenic columns, providing horizontal compartmentalization of the germinative epithelium, and contain numerous phagosomes with remnants of degenerating spermatogenic cells. The testis wall contains haemal lacunae, which are usually located on the side opposite the gonad pore. We describe the fine structure of spermatogonia, spermatocytes clustered in spermatogenic columns, spermatids, and spermatozoa. Spermatozoa are of the ectaquasperm type and consist of an acorn-shaped head and a flagellum 18–25 µm long. The sperm head includes a beak-shaped acrosomal part, a spherical nucleus and a midpiece containing a ring of 5 or rarely 6 mitochondria.

Conclusions
The male reproductive system and sperm structure of Q. malakhovi, a representative of the family Torquaratoridae, have a number of differences from shallow-water acorn worms; however, the spermatogenesis and sperm structure of Q. malakhovi generally follow the pattern of the other three enteropneust families, and the phylogenetic significance of these deviations should be the subject of further research.
Creation of a replicable anatomic model of terrible triad of the elbow
Authors: Baltassat Antoine , Baldairon Florent , Berthe Samuel , Bellier Alexandre , Bahlouli Nadia , Clavert Philippe 
Published: October 2024

Abstract
Background
Terrible triad of the elbow (TTE) is a complex dislocation associating radial head (RH) and coronoid process (CP) fractures. There is at present no reproducible anatomic model for TTE, and pathophysiology is unclear. The main aim of the present study was to create and validate an anatomic model of TTE. Secondary objectives were to assess breaking forces and relative forearm rotation with respect to the humerus before dislocation.

Methods
An experimental comparative study was conducted on 5 fresh human specimens aged 87.4 ± 8.6 years, testing 10 upper limbs. After dissection conserving the medial and lateral ligaments, interosseous membrane and joint capsule, elbows were reproducibly positioned in maximal pronation and 15° flexion, for axial compression on a rapid (100 mm/min) or slow (10 mm/min) protocol, applied by randomization between the two elbows of a given cadaver, measuring breaking forces and relative forearm rotation with respect to the humerus before dislocation.

Results
The rapid protocol reproduced 4 posterolateral and 1 divergent anteroposterior TTE, and the slow protocol 5 posterolateral TTE. Mean breaking forces were 3,126 ± 1,066 N for the lateral collateral ligament (LCL), 3,026 ± 1,308 N for the RH and 2,613 ± 1,120 N for the CP. Comparing mean breaking forces for all injured structures in a given elbow on the rapid protocol found a p-value of 0.033. Comparison of difference in breaking forces in the three structures (LCL, RH and CP) between the slow and rapid protocols found a mean difference of -4%. Mean relative forearm rotation with respect to the humerus before dislocation was 1.6 ± 1.2° in external rotation.

Conclusions
We create and validate an anatomic model of TTE by exerting axial compression on an elbow in 15° flexion and maximal pronation at speeds of 100 and 10 mm/min.