bluuebunny/crossref_metadata_2025_split huggingface dataset:
Moral sensitivity, moral courage, and ethical behaviour among clinical nurses
Authors: Chen Qihui , Chen Qin , Ma Chenxiao , Zhang Yanan , Gou Mengyu , Yang Weiyu 
Published: August 2024

Background: Ethical behaviour in nursing practice is integral to establishing a harmonious nurse-patient relationship and improving the quality of care. A multitude of factors shapes such behaviour. Therefore, it is crucial to understand the interplay between these factors. Research objectives: This study aimed to explore the mechanisms underlying the influence of moral sensitivity on nurses’ ethical behaviour and clarify the mediating role of moral courage. Research design: This cross-sectional quantitative study was conducted between July and August 2023. Participants and Research Context: The sample comprised 465 clinical nurses from three tertiary hospitals in Zhengzhou City, Henan Province, China. Data were collected using the Chinese version of the Moral Sensitivity Questionnaire-Revised Version, Nurses’ Moral Courage Scale, and Ethical Behaviour Scale for Nurses. Data analysis was performed with SPSS 26.0 and AMOS 24.0, using descriptive statistics, Pearson correlation analysis, structural equation modelling, and bootstrapping methods. Ethical considerations: This study was approved by the Ethical Review Committee of Life Sciences of Zhengzhou University, China. Results: The participants were predominantly female (95.1%), with a mean age of 31.9 years. Moral courage and moral sensitivity were positively correlated with ethical behaviour. Moral sensitivity was positively associated with moral courage. Moral courage partially mediates the relationship between moral sensitivity and ethical behaviour. The indirect effect of nurses’ moral sensitivity on ethical behaviour was quantified through moral courage (indirect effect = 0.290). Conclusion: Moral courage intermediates nurses’ moral sensitivity and ethical behaviour. This conclusion provides nursing administrators with the insight that improving clinical nurses’ moral sensitivity and courage can contribute to ensuring appropriate ethical behaviour.
Borderline personality disorder and parenting capacity: Understanding child protection population characteristics
Authors: Finan Samantha , Bartsch Dianna R , Kong Tessa , Beall Jacqui 
Published: August 2024

Objective This paper describes an audit of borderline symptoms, risk factors for maltreatment and types of abuse among parents who completed a parenting capacity assessment at a South Australian health-based child protection service. Method A retrospective case note audit within a 28-month period was conducted and included parents ( n = 107) who had completed a Mclean’s screening instrument for borderline personality disorder and/or had a psychiatric review with a formal diagnosis. Parents who had a borderline personality disorder diagnosis or endorsed five or more symptoms were categorised into the ‘high’ borderline symptom group. Rates of parental risk factors for maltreatment and type of abuse were compared between parents with low or high borderline symptoms. Results Forty percent of parents endorsed at least five borderline symptoms on the screening tool. On average, parents high in borderline symptoms had a greater number of parental risk factors. Conclusions These findings highlight the importance of screening for personality pathology among parents presenting to child protection services. Foundational training for staff and making evidence-based interventions available should be considered in such settings.
TeleCleft: Development and Evaluation of a Mobile Application for Monitoring Cleft Patients
Authors: Carvalho Livian Isabel de Medeiros , Araújo Eduarda Gomes Onofre de , de Souza Breno Estevam Silva , Martins Hélder Domiciano Dantas , Tanikawa Daniela Yukie Sakai , Valença Ana Maria Gondim , Mélo Cláudia Batista , de Lucena Edson Hilan Gomes , Lacerda Rosa Helena Wanderley , Bonan Paulo Rogério Ferreti 
Published: August 2024

Objective Development and evaluation of a mobile application for remote monitoring and guidance of pediatric patients diagnosed with cleft lip and/or palate (CL ± P) and their caregivers. Design This is a pilot cross-sectional, applied, and quantitative study. Setting The study was conducted in two tertiary care treatment centers in Brazil. Participants The participants included 20 caregivers and infants undergoing treatment with nasoalveolar molding (NAM) for CL ± P. Interventions The intervention involved using the TeleCleft mobile application for remote monitoring and guidance of caregivers and infants during NAM treatment. Main Outcome Measure(s) The main outcome measures included usability and satisfaction of users with the TeleCleft application. Results The results showed high usability and satisfaction ratings among users of the TeleCleft application. Most participants found remote monitoring to be effective and expressed positive opinions about its convenience and usefulness. Conclusion TeleCleft could be a viable tool for remote monitoring and guidance, reducing the need for patients and caregivers to travel to treatment centers, which could potentially alleviate the burden of care faced by families during the journey of CL ± P treatment.
Comparison of topical 5% NaCl versus 10% Mannitol for the treatment of corneal edema after phacoemulsification
Authors: Sabur Huri , Kabatas Emrah Utku 
Published: August 2024

Objective This study aimed to compare the efficacy of topical 5% Sodium Chloride (NaCl) and 10% Mannitol agents in managing corneal edema following uncomplicated cataract surgery. Methods Patients with postoperative corneal edema were enrolled, and they were divided into three groups for comparison. Anterior chamber depth (ACD), axial length (AL), intraocular lens (IOL) power, cumulative dissipated energy (CDE), best-corrected visual acuity (BCVA), central corneal thickness (CCT), and endothelial cell count (ECC) were assessed among the groups. Results Fifty-eight eyes of 58 patients were included. The study comprised the NaCl group (using topical 5% NaCl, n = 21), Mannitol group (using topical 10% Mannitol, n = 17), and a control group without osmotic agent use (n = 20). Age, gender, ACD, AL, IOL power, and CDE were similar across groups. Postoperative day-1 CCT values showed no significant difference between groups. Additionally, at postoperative 1 week, CCT values were [663.4 ± 100.2] microns in the NaCl group, [640.4 ± 68.9] microns in the Mannitol group, and [760.3 ± 76.7] microns in the Control group. Although CCT and BCVA values were better in the Mannitol group at postoperative 1 week, no statistically significant difference was found between the groups at 1 week and 1 month postoperatively. Furthermore, corneal edema positively correlated with CDE and negatively correlated with AL. Conclusion Topical 5% NaCl and 10% Mannitol agents are effective and reliable agents that showed faster recovery of corneal edema during the early postoperative period after uncomplicated cataract surgery. The choice between these agents may depend on factors such as patient tolerability, cost, and availability.
Reproduction of Awassi and Hamdani Sheep Is Associated With a Novel Missense SNP (p.24Ile>Thr) of the GnIH Gene
Authors: Al-Jabar Waleed A Abd , Al-Thuwaini Tahreer M 
Published: August 2024

Objectives: Litter size is a crucial economic factor in the sheep industry. Several factors and genes influence litter size, making the identification of genes or loci involved a genetic challenge. Gonadotropin-inhibitory hormone ( GnIH) is one of several genes that influence sheep’s reproductive traits. Thus, this study aimed to investigate whether variations in the GnIH gene affect the reproductive performance of Awassi and Hamdani ewes. Methods: DNA was extracted from 99 single-progeny ewes and 101 twin ewes. The polymerase chain reaction (PCR) produced amplicons of 262 bp, 275 bp, and 284 bp from exons 1, 2, and 3 of the GnIH gene. Single-strand conformational polymorphism (SSCP) technique was used for genotyping experiments. Sequencing and in silico analysis were performed on each set of SSCP-resolved bands. Results: Two genotypes of 262 bp amplicons were found: TT and TC. Sequence analysis revealed a novel missense mutation in the TC genotype at position c.122T>C. Five in silico tools were used to assess the impact of this mutation on GnIH protein structure, function, and stability, all of them demonstrated a deleterious effect. An analysis of statistical data revealed a strong correlation between the c.122T>C single-nucleotide polymorphism (SNP) and reproductive performance. Ewes with the SNP 122T>C exhibited a significant increase in litter size, twinning rates, lambing rates, and days to lambing when compared with ewes with the TT genotype. A lower number of lambs were born to ewes with the TT genotype than those with the TC genotype. Conclusion: These results concluded that the c.122T>C SNP variant positively influences the reproductive performance of Awassi and Hamdani sheep. Sheep that carry the c.122T>C SNP show higher litter size and increased productivity.
Associations of Smoking Behaviors and Body Mass Index Among American Participants of a Clinical Tobacco Cessation Program: A Pilot Study
Authors: Min Jihyun Jane , Kaplan Bekir , Ellison-Barnes Alejandra , Galiatsatos Panagis 
Published: August 2024

Background Tobacco usage and obesity remain critical public health issues in the United States. This study examined the relationship between smoking behaviors, specifically—cigarettes per day (CPD) and motivations to smoke—and body mass index (BMI). We hypothesized that motivations related to food or stress, as well as a higher CPD, will be positively associated with BMI. Methodology We analyzed the electronic medical records of 204 patients from the Johns Hopkins' Tobacco Treatment and Cancer Screening Clinic (TTCSC) between January and April 2022. Demographic information, smoking behavior, CPD, and motivations to smoke were recorded. Multiple linear regression analysis was performed. Results We found no statistical significance between motivations to smoke, CPD, and BMI. However, the age at a patient’s first visit to the TTCSC was negatively associated with BMI ( B = −0.152, P < 0.001). Conclusions Smoking behaviors were not significantly related to BMI in our sample. It is advisable for clinicians working in tobacco cessation clinics to consider the BMI of individuals who present for cessation services, especially for younger individuals who smoke. They may be more likely to have an elevated BMI at presentation.
Unemployment insurance for platform workers: Challenges and approaches from a comparative perspective
Authors: Barrio Alberto 
Published: August 2024

This contribution presents an overview of the challenges involved in ensuring that persons performing platform work (as either employees, self-employed, or in a third category) are able to effectively access unemployment insurance protection. It also addresses the specific approaches taken by European countries to tackle these challenges, relying especially on the contributions to this special issue on unemployment protection for the self-employed and platform workers. After presenting a brief definition of platform work, the contribution provides an overview of the main challenges linked to unemployment protection insurance posed by the features of platform work; we use primarily the Council Recommendation on access to social protection for workers and the self-employed as an evaluative framework. These challenges relate to both formal exclusion (due to classification as self-employed or marginal work) and effective exclusion (due to difficulties meeting minimum work requirements and lack of transparency on algorithmic management and platform work). The contribution then analyses some of the main approaches taken by European countries to address such challenges. Actions targeting platform work comprise (a) employment status reclassification; (b) establishment of a presumption of an employment relationship; (c) the setting of requirements to inform on the use of algorithmic management; (d) facilitation of transparency on platform work information; and (e) exemption from formal social security coverage of some forms of (marginal) platform work. General approaches with consequences for the unemployment insurance protection of platform workers include the application of the same criteria for access to unemployment benefits across employment statuses, as well as greater leniency on these criteria for certain forms of non-standard work. The contribution ends with a conclusion, which highlights the main gaps in unemployment insurance protection for platform work, and discusses avenues for action regarding platform work.
Relationship quality perceived by family caregivers of people with dementia in the context of a psychoeducational intervention: A qualitative exploration
Authors: Kipfer Stephanie , Mabire Cedric , Vézina Jean , Koppitz Andrea , Pihet Sandrine 
Published: August 2024

Background Caring for a person with dementia can be a challenging experience, often associated with chronic stress and a heavy burden on family caregivers. Dementia also impacts the relationship between the caregiver and the person with dementia. The quality of this relationship is, in turn, an important factor influencing the well-being of both dyad members. The psychoeducational intervention “Learning to feel better . . . and help better” has shown positive results regarding family caregivers’ subjective burden, psychological distress, and self-efficacy. However, relationship quality has not been addressed in the context of this intervention. Methods A longitudinal constructivist grounded theory approach was used to explore relationship quality as perceived by caregivers, possible changes and intervention components facilitating or preventing such changes. Three qualitative, semi-structured interviews (before, during and after the intervention) were performed with 13 family caregivers from three different intervention groups. The resulting 39 interviews were analysed regarding individual caregiver trajectories, per time point for all caregivers and regarding specific caregiver subgroups. Findings A model focusing on sustaining relationship quality in dementia was developed. It shows strategies that family caregivers develop and apply to facilitate positive interactions and feelings of connectedness with their family members with dementia. It also indicates that mastering such strategies requires reflective skills based on specific knowledge of dementia and coping strategies, which can be enhanced through active skills training, in which caregivers are guided to work on their individual stressful situations. Factors hampering change included difficulties in accepting dementia-related changes. Conclusion Findings suggest that psychoeducation, with active skills training based on caregivers’ current daily life situations, providing systematic procedures to handle daily challenges and specific knowledge about the impact of the disease, could support them in developing and applying supportive strategies to sustain or improve their relationship to their family member with dementia.
The hybrid approach of genetic algorithm and particle swarm optimization on reduced weld line defect in plastic injection molding
Authors: Oktem Hasan , Uygur Ilyas , Sarı Ece Simooglu , Shinde Dinesh 
Published: August 2024

Weld lines are a serious defect observed in plastic injection molded parts, impacting both their cosmetic appearance and mechanical properties. Controlling the conditions of plastic injection is crucial to mitigate these weld lines. This study introduces a novel approach to identify polypropylene injection molding (PIM) conditions aimed at reducing weld lines in polypropylene parts. The PIM conditions considered in this study include melt temperature, injection pressure, packing pressure, packing time, and cooling time. An orthogonal array Taguchi L27 design was employed for the experimental setup, producing 27 polypropylene parts with varying combinations of process conditions. The width of weld lines generated on the parts’ surfaces was measured using an optimum microscope for all trials. Parametric analysis was conducted using response surface plots and contour plots to estimate the process conditions yielding minimum weld lines. Analysis of variance and regression analysis were employed to interpret the experimental data, with the resulting regression equation used to predict weld lines for a set of PIM process conditions. Finally, two efficient optimization algorithms, genetic algorithm (GA), and particle swarm optimization (PSO), were implemented using MATLAB programming to estimate the optimum process conditions for minimizing weld lines. The GA and PSO predicted weld line widths of 6.12302 μm and 6.123 μm, respectively, representing an 18.51% improvement in results. These findings demonstrate that the novel approach presented in this study can be effectively and reliably applied to address plastic product defects in the industry.
Impact of 1.5 T Magnetic Field on Treatment Plan Quality in MR-Guided Radiotherapy: Typical Phantom Test Cases
Authors: Yan Lingling , Xu Yingjie , Dai Jianrong 
Published: August 2024

Purpose This study aims to investigate the influence of the magnetic field on treatment plan quality using typical phantom test cases, which encompass a circle target test case, AAPM TG119 test cases (prostate, head-and-neck, C-shape, multi-target test cases), and a lung test case. Materials and Methods For the typical phantom test cases, two plans were formulated. The first plan underwent optimization in the presence of a 1.5 Tesla magnetic field (1.5 T plan). The second plan was re-optimized without a magnetic field (0 T plan), utilizing the same optimization conditions as the first plan. The two plans were compared based on various parameters, including con­formity index (CI), homogeneity index (HI), fit index (FI) and dose coverage of the planning target volume (PTV), dose delivered to organs at risk (OARs) and normal tissue (NT), monitor unit (MU). A plan-quality metric (PQM) scoring procedure was employed. For the 1.5 T plans, dose verifications were performed using an MR-compatible ArcCHECK phantom. Results A smaller dose influence of the magnetic field was found for the circle target, prostate, head-and-neck, and C-shape test cases, compared with the multi-target and lung test cases. In the multi-target test case, the significant dose influence was on the inferior PTV, followed by the superior PTV. There was a relatively large dose influence on the PTV and OARs for lung test case. No statistically significant differences in PQM and MUs were observed. For the 1.5 T plans, gamma passing rates were all higher than 95% with criteria of 2 mm/3% and 2 mm/2%. Conclusion The presence of a 1.5 T magnetic field had a relatively large impact on dose parameters in the multi-target and lung test cases compared with other test cases. However, there were no significant influences on the plan-quality metric, MU and dose accuracy for all test cases.
A Randomized, Multi-Center, Open Label Study to Compare the Safety and Efficacy between Afatinib Monotherapy and Combination Therapy with HAD-B1 for the Locally Advanced or Metastatic NSCLC Patients with EGFR Mutations
Authors: Kwag Eunbin , Kim Soo-Dam , Shin Seong-Hoon , Oak Chulho , Park So-Jung , Choi Jun-Yong , Hoon Yoon Seong , Kang In-Cheol , Jeong Mi-Kyung , Woo Lee Hyun , Bang Sun-Hwi , Son Ji Woong , Lee Sanghun , Kim Seung Joon , Yoo Hwa-Seung 
Published: August 2024

Background:Lung cancer, especially non-small cell lung cancer (NSCLC), poses a significant health challenge globally due to its high mortality. Afatinib, a second-generation epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), has shown superior efficacy over traditional chemotherapy in NSCLC treatment. However, issues like secondary resistance and adverse effects call for alternative therapies. HAD-B1, comprising 4 herbal medicines, has shown promise in lung cancer treatment in both preclinical and clinical settings. This study assesses the combination of HAD-B1 and Afatinib in advanced NSCLC patients to potentially improve outcomes by addressing the limitations of current EGFR-TKI therapies.Method:A randomized, open-label trial evaluated the efficacy and safety of HAD-B1 with Afatinib in 90 EGFR-mutation-positive NSCLC patients. Participants were divided into treatment and control groups, receiving Afatinib with or without HAD-B1. The study focused on the initial dose maintenance rate and disease control rate (DCR) of Afatinib, alongside secondary outcomes like survival rates and quality of life, under continuous safety monitoring.Results:Among the 90 participants, no significant difference was found in initial dose maintenance (60.98% in the treatment group vs 52.50% in the control, P = .4414) or DCR (80.49% vs 90.00%, P = .2283). Secondary outcomes like PFS, TTP, and OS showed no notable differences. However, physical functioning significantly improved in the treatment group ( P = .0475, PPS group). The control group experienced higher rates of adverse events of special interest and adverse drug reactions ( P = .01), suggesting HAD-B1 with Afatinib might enhance physical function without increasing adverse effects.Conclusion:Combining HAD-B1 with Afatinib potentially improves quality of life and reduces adverse events in advanced NSCLC patients. Further research is necessary to confirm the long-term benefits of this combination therapy, aiming to advance NSCLC treatment outcomes.Trial registration:Clinical Research Information Service (CRIS) of the Republic of Korea, https://cris.nih.go.kr/ (ID: KCT0005414).
rTMS for Poststroke Pusher Syndrome: A Randomized, Patient-Blinded Controlled Clinical Trial
Authors: Meng Lijiao , Ge Yanlei , Tsang Raymond C.C. , Zhang Wenyue , Liu Xingyu , Li Siyi , Zhao Jingyu , Zhang Xiaoyue , Wei Qingchuan 
Published: August 2024

Background Patients with poststroke pusher syndrome (PS) require longer duration of rehabilitation and more supplemental care after discharge. Effective treatment of PS remains a challenge. The role of repetitive transcranial magnetic stimulation (rTMS) for PS has not been examined. Objective Assess the efficacy of rTMS for patients with poststroke PS in reducing pushing behavior, enhancing motor recovery and improving mobility. Methods A randomized, patient- and assessor-blinded sham-controlled trial with intention-to-treat analysis was conducted. Thirty-four eligible patients with poststroke PS were randomly allocated to receive either rTMS or sham rTMS for 2 weeks. Pushing behavior on the Burke lateropulsion scale and scale for contraversive pushing, motor function on Fugl-Meyer assessment scale-motor domain (FMA-m) and mobility on modified Rivermead mobility index were measured at baseline, 1 and 2 weeks after intervention. Repeated-measures analysis of covariance was used for data analysis. Results There was no significant interaction between intervention and time on Burke lateropulsion scale ( F = 2.747, P = .076), scale for contraversive pushing ( F = 1.583, P = .214), or change of modified Rivermead mobility index ( F = 1.183, P = .297). However, a significant interaction between intervention and time was observed for FMA-m ( F = 5.464, P = .019). Post hoc comparisons of FMA-m show better improvement in rTMS group with mean differences of 12.7 (95% CI −7.3 to 32.7) and 15.7 (95% CI −4.6 to 36.0) at post-treatment week 1 and week 2 respectively. Conclusions rTMS did not demonstrate significant efficacy in improving pushing behavior and mobility in patients with PS. However, rTMS might have potential effect in enhancing motor function for patients with PS. Registration: The study was registered in the Chinese Clinical Trial Registry (registration No. ChiCTR2200058015 at http://www.chictr.org.cn/searchprojen.aspx ) on March 26, 2022.