bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recurrence Risk Perception, Fear of Progression, and Health Behaviors Among Patients With Ischemic Stroke
Authors: Wang Xiangmin , Dong Xiaohang , Tan Xiyi , Lin Qinger , Zhou Hongzhen 
Published: August 2024

Background: The relationship between recurrence risk perception, fear of progression, and health behaviors in patients with ischemic stroke is unclear. Objective: To explore the effect of accuracy and level of recurrence risk perception on health behaviors and the mediating role of fear of progression. Methods: We conducted a 2-wave survey. Patients with ischemic stroke (N = 261) were recruited from 2 hospitals in Guangzhou, China. Before discharge, demographic information, objective recurrence risk, perceived recurrence risk, fear of progression, and health behaviors were investigated. After 1 month, the patient’s health behaviors were followed up. Results: The median (quartiles 1-3) scores for recurrence risk perception and fear of progression were 43.0 (39.0-46.0) and 22.0 (18.0-28.0), respectively. Only 22.2% of the patients correctly perceived the risk of recurrence, 23.0% underestimated the risk, and 30.7% overestimated the risk. Patients who overestimated the risk of recurrence (β = 0.421, P = .002) or had a higher perceived level of recurrence risk (β = 0.446, P < .001) had a higher fear of progression, which contributed to better health behaviors at 1 month (β = 0.197, P = .001). Fear of progression played a partial and full mediating role, respectively. Patients who underestimated the recurrence risk had worse health behaviors than those who accurately perceived it (β = −0.296, P = .033). Conclusion: Both accuracy and level of recurrence risk perception were independent predictors of future health behaviors, and fear of progression was mediating. Health care professionals should develop individualized risk education programs to help stroke patients properly understand and cope with the risk of recurrence.
Influence of laser texturing on the properties of fusion joints between aluminum alloys and carbon fiber reinforced thermoplastic composites
Authors: Wang Fuji , Yu Yongkang , Fu Rao , Si Likun , Wang Qi , Luo Chaoyang , Wang Ziming 
Published: August 2024

Laser texturing is an effective method to enhance the fusion joining of aluminum alloy (Al) to carbon fiber reinforced thermoplastics composite (CFRTP). The enhancement effect is related to the morphology and spacing of the microstructures on Al surface. However, because of the correlation between the morphology and the spacing of the microstructures, excessive dense microstructures change the morphology, leading to a reduction in the enhancement effect, while sparse microstructures are also difficult to significantly enhance the joint. To this end, this paper proposes an improved laser texturing process to enhance fusion joints, through the investigation of the recast layer formation process during laser texturing on the Al surface, which comprehensively reveals the synergistic effects of microstructural morphology and spacing on joint properties. The results indicated that the increase of the number of laser processes and the microstructure spacing increased the height of the recast layer, with the difference that the microstructure spacing had less effect after increasing to a certain value. With the increase of microstructure spacing, the morphology of the microstructure on the Al surface transformed from the serrated microstructure to the double-scale microstructure, and finally to the independent microstructure, affected by the recast layer on sides of the microstructure. Once the dual-scale microstructures were formed on the Al surface, the shear strength of the Al/CFRTP fusion joint was the highest with a value of 25.05 MPa. The findings could provide a basis for laser texturing pretreatment for fusion joining.
Histopathological Response to Neoadjuvant Chemotherapy in Patients With Enneking Stage II Conventional Osteosarcoma of Extremities: A Retrospective-Single Institution Study in Vietnam
Authors: Do Kien Hung , Nguyen Tai Van , Hoang Trang Thu , Do Thanh Cam , Phan Phuong Dac , Nguyen Chu Van , Le Van Quang 
Published: August 2024

Background The standard treatment for localized osteosarcoma is neoadjuvant chemotherapy before surgery, followed by adjuvant chemotherapy. Our aim was to report the rate of histopathological response to neoadjuvant chemotherapy for the treatment of extremity osteosarcoma in Vietnam. Methods We performed a retrospective study of stage II conventional osteosarcoma patients under 40 years-old who received MAP regimen as neoadjuvant chemotherapy at the Vietnam National Cancer Hospital between June 2019 and June 2022. Histopathological response was evaluated using the Huvos grading system, in which a good histopathological response was defined as a necrotic rate of 90% or more. Results Thirty-five eligible patients were included in the study. Male patients accounted for 65.7%, with a median age of 16 years (range, 8-38 years). Of the 35 cases, 31 were reported as stage IIB (88.6%). The femur and tibia were the most common sites in our study, accounting for 51.4% and 34.3%, respectively. The most common pathologic subtype was osteoblastic osteosarcoma (68.6%), followed by chondroblastic subtype (20%). After two cycles of MAP-regimen neoadjuvant chemotherapy, 28 of 35 patients (80%) underwent limb-sparing surgery. A good histopathological response was observed in 18 of 35 patients (51.4%). There were significant correlations between the duration of symptoms ( P = 0.016), LDH ( P = 0.001) serum levels at initial presentation, and ALP ( P = 0.043) serum levels at initial presentation with histopathological response. Conclusion This retrospective study suggests a possible association between symptom duration, pre-treatment LDH levels, and pre-treatment ALP levels with histopathological response rates. Additional clinical investigations with long-term follow-up are needed to investigate survival outcomes in the Asian population.
Predictors for Development of Chronic Rhinosinusitis in Transplant Recipients
Authors: Candelo Estephania , Bohorquez-Caballero Anyull D. , Avila-Castano Karol , Mercado Lydia A. , Donaldson Angela 
Published: August 2024

Objectives Studies suggest that transplant patients are at a higher risk of developing chronic rhinosinusitis (CRS). However, there is a dearth of studies describing the factors that may be linked to the development of CRS in this population. Our objective is to identify the risk factors associated with the development of CRS in transplant recipients. Study design Retrospective cohort. Setting Tertiary care center. Methods This cohort included 3347 transplant recipients seen between 2017 and 2022. Of these, 2128 patients met the inclusion criteria and were grouped according to whether they were diagnosed with CRS during the post-transplant period. The analysis included both univariate and multivariate analysis to ascertain the odds ratio (OR) and predictive factors. Results Of the 2128 patients, 649/2128 (30.4%) had CRS. CRS patients had an increased prevalence of previous endoscopic sinus surgery, allergic rhinitis, and recurrent acute rhinosinusitis in the pre-transplant period compared to the non-CRS group. According to the multivariate analysis, patients with primary immunodeficiency and additional transplant were 1.9 and 3.1 times more likely to develop CRS during the posttransplant period (95% CI: 1.3–2.6, p < .0001), (95% CI: 1.3 −7.3, p = .01), respectively. Sirolimus use was also associated with the development of CRS (OR = 1.4, 95% CI: 1.1–1.9, p = .01). Conclusion This study is the largest cohort aimed at determining the predictive factors associated with the development of CRS. Patients with pretransplant rhinologic conditions, hematologic deficiencies, and the utilization of specific immunosuppressants were found to have a higher likelihood of developing CRS following transplantation.
Evaluation of the automated dispensing cabinets users’ level of satisfaction and the influencing factors in Al-Ahsa hospitals
Authors: Alomair Manar K. , Alabduladheem Lama S. , Almajed Marwah A. , Alobaid Amjad A. , Mohamed Maged E. , Alsultan Abdulaziz O. , Younis Nancy S. 
Published: August 2024

Automated dispensing cabinets (ADCs) are decentralized, computer-controlled systems used to store, distribute, and track medications at the point of care in the wards. Objective The objective of the current study is to evaluate how healthcare practitioners are satisfied with ADCs and scrutinize some influencing factors that could affect this satisfaction. Material A cross-sectional survey study was designed and distributed online to healthcare providers in Al-hasa hospitals. Results A total of 166 participants. Regarding the frequency and pattern of ADC use, around 79.5% used ADC and 85.4% were informed about using ADC on a daily basis. As for the level of satisfaction with ADC, an exact 81.9% gave a high rate for overall satisfaction, 81.3% were highly satisfied with the system's accuracy, and 74.7% were highly satisfied with the time it takes to complete the task. Regarding usability of the system, 69.8% thought it was easy whereas 36.8% agreed that the time required for reloading medication is longer than before ADC. Furthermore, 79.5% agreed that ADC allowed them to accomplish their job safely, and 67.4% agreed that it improved their productivity. Regarding challenges, 74.7% agreed that all drawer types assure safe access and removal of medications, and 18.7% agreed that there is a significant potential for loss of data. Conclusion This study investigated healthcare staff's perceptions and satisfaction with ADCs in Al-hasa hospitals. The healthcare participants were mostly highly satisfied with the use of the ADCs which translated into better patient care and improved patient safety as well as higher productivity.
Investigation of nurses’ general attitudes toward artificial intelligence and their perceptions of ChatGPT usage and influencing factors
Authors: Tuncer Gülsüm Zekiye , Tuncer Metin 
Published: August 2024

Purpose This study aimed to investigate professional nurses’ general attitudes toward artificial intelligence, their knowledge and perceptions of ChatGPT usage, and the influencing factors. Methods The population of the research consists of nurses who follow a social media platform account in Turkey. The sample of the study consisted of 288 nurses who participated in the study between December 2023 and March 2024. Data were collected through an account on a social media platform via Google Forms using the Information Identification Questionnaire for ChatGPT and Artificial Intelligence Programs and the General Attitudes to Artificial Intelligence Scale (GAAIS). Results The mean scores obtained from the overall GAAIS and its Positive Attitudes subscale from the participants in this study were 67.54 ± 13.14 and 41.89 ± 11.24, respectively. Of the participants, 48.3% knew about ChatGPT and artificial intelligence programs. Of the participants, 27.8% used ChatGPT and artificial intelligence programs. Their scores for the Positive Attitude subscale were higher than were the scores of those who did not use such programs. Of the participants, 84.4% thought that nurses should be made aware of ChatGPT and artificial intelligence programs, 67% thought that the use of these programs would contribute to nurses’ professional development, 42.4% thought that the use of these programs would not reduce nurses’ workload, and 58.3% thought that the use of these programs would positively affect patient care. Conclusion In this study, it can be said that nurses in Turkey have positive attitudes toward integrating ChatGPT and AI programs to improve patient outcomes and add them to nursing practices. Implications for nursing practice The present study in which nurses’ attitudes toward the implementation of ChatGPT and artificial intelligence programs were investigated is expected to provide information for healthcare institutions, policy makers and artificial intelligence developers on the integration of ChatGPT and artificial intelligence into nursing practice. It is necessary to create environments that use AI technologies that reduce the nursing workload of nurses in the clinical area and positively affect the quality of patient care.
The impact of surge capacity enhancement training for nursing managers on hospital disaster preparedness and response: an action research study
Authors: Shafiei Alireza , Arsalani Narges , Beyrami Jam Mehdi , Khankeh Hamid Reza 
Published: August 2024

Abstract
Introduction
Hospitals as the main providers of healthcare services play an essential role in the management of disasters and emergencies. Nurses are one of the important and influential elements in increasing the surge capacity of hospitals. Accordingly, the present study aimed to assess the effect of surge capacity enhancement training for nursing managers on hospital disaster preparedness and response.

Methods
All nursing managers employed at Motahari Hospital in Tehran took part in this interventional pre- and post-test action research study. Ultimately, a total of 20 nursing managers were chosen through a census method and underwent training in hospital capacity fluctuations. The Iranian version of the “Hospital Emergency Response Checklist” was used to measure hospital disaster preparedness and response before and after the intervention.

Results
The overall hospital disaster preparedness and response score was 184 (medium level) before the intervention and 216 (high level) after the intervention. The intervention was effective in improving the dimensions of hospital disaster preparedness, including “command and control”, “triage”, “human resources”, “communication”, “surge capacity”, “logistics and supply”, “safety and security”, and “recovery”, but had not much impact on the “continuity of essential services” component.

Conclusion
The research demonstrated that enhancing the disaster preparedness of hospitals can be achieved by training nursing managers using an action research approach. Encouraging their active participation in identifying deficiencies, problems, and weaknesses related to surge capacity, and promoting the adoption and implementation of suitable strategies, can enhance overall hospital disaster preparedness.
Paramedics’ experiences and observations: work-related emotions and well-being resources during the initial months of the COVID-19 pandemic—a qualitative study
Authors: Myrskykari Henna , Nordquist Hilla 
Published: August 2024

Abstract
Background
As first responders, paramedics are an extremely important part of the care chain. COVID-19 significantly impacted their working circumstances. We examined, according to the experiences and observations of paramedics, (1) what kinds of emotions the Emergency Medical Service (EMS) personnel experienced in their new working circumstances, and (2) what work-related factors became resources for the well-being of EMS personnel during the initial months of the COVID-19 pandemic.

Methods
This qualitative study utilized reflective essay material written by experienced, advanced-level Finnish paramedics (n = 30). The essays used in this study were written during the fall of 2020 and reflected the period when Finland had declared a state of emergency (on 17.3.2020) and the Emergency Powers Act was implemented. The data was analyzed using an inductive thematic analysis.

Results
The emotions experienced by the EMS personnel in their new working circumstances formed three themes: (1) New concerns arose that were constantly present; (2) Surviving without proper guidance; and (3) Rapidly approaching breaking point. Three themes were formed from work-related factors that were identified as resources for the well-being of the EMS personnel. These were: (1) A high level of organizational efficiency was achieved; (2) Adaptable EMS operations; and (3) Encouraging atmosphere.

Conclusions
Crisis management practices should be more attentive to personnel needs, ensuring that managerial and psychological support is readily available in crisis situations. Preparedness that ensures effective organizational adaptation also supports personnel well-being during sudden changes in working circumstances.
Comparing clinical and genomic features based on the tumor location in patients with resected pancreatic cancer
Authors: Yun Won-Gun , Kim Daeun , Lee Mirang , Han Youngmin , Chae Yoon Soo , Jung Hye-Sol , Cho Young Jae , Kwon Wooil , Park Joon Seong , Park Daechan , Jang Jin-Young 
Published: August 2024

Abstract
Background
Pancreatic cancer is anatomically divided into pancreatic head and body/tail cancers, and some studies have reported differences in prognosis. However, whether this discrepancy is induced from the difference of tumor biology is hotly debated. Therefore, we aimed to evaluate the differences in clinical outcomes and tumor biology depending on the tumor location.

Methods
In this retrospective cohort study, we identified 800 patients with pancreatic ductal adenocarcinoma who had undergone upfront curative-intent surgery. Cox regression analysis was performed to explore the prognostic impact of the tumor location. Among them, 153 patients with sufficient tumor tissue and blood samples who provided informed consent for next-generation sequencing were selected as the cohort for genomic analysis.

Results
Out of the 800 patients, 500 (62.5%) had pancreatic head cancer, and 300 (37.5%) had body/tail cancer. Tumor location in the body/tail of the pancreas was not identified as a significant predictor of survival outcomes compared to that in the head in multivariate analysis (hazard ratio, 0.94; 95% confidence interval, 0.77–1.14; P = 0.511). Additionally, in the genomic analyses of 153 patients, there were no significant differences in mutational landscapes, distribution of subtypes based on transcriptomic profiling, and estimated infiltration levels of various immune cells between pancreatic head and body/tail cancers.

Conclusions
We could not find differences in prognosis and tumor biology depending on tumor location in pancreatic ductal adenocarcinoma. Discrepancies in prognosis may represent a combination of lead time, selection bias, and clinical differences, including the surgical burden between tumor sites.
The prognostic value of programmed death-ligand 1 (PD-L1) expression in resected colorectal cancer without neoadjuvant therapy - differences between antibody clones and cell types
Authors: Nobin Hampus , Garvin Stina , Hagman Helga , Nodin Björn , Jirström Karin , Brunnström Hans 
Published: August 2024

Abstract
Background
Programmed death-ligand 1 (PD-L1) expression on tumor cells is associated with poor prognosis in several malignancies, while partly contradictory and inconclusive results have been presented for colorectal cancer (CRC). This study aimed to evaluate PD-L1 as a prognostic biomarker in CRC by comparing three different antibody clones.

Methods
Patients surgically treated for CRC between January 1st, 2007, and December 31st, 2015, in Kalmar County, Sweden, were retrospectively included. Tissue microarrays from 862 primary tumors without neoadjuvant treatment were assessed for immunohistochemical expression of PD-L1 in tumor cells (TC) and immune cells (IC) using clones 73-10, SP263, and 22C3. Cox regression proportional hazard models were used to estimate hazard ratios for overall survival (OS) and disease-free interval (DFI) in univariable and multivariable analyses, with 1% and 5% set as cut-offs for positive expression in TC and IC respectively.

Results
PD-L1 expression in TC was found in 89 (10%) cases for clone 73-10, 76 (9%) for clone SP263, and 38 (4%) for clone 22C3, while the numbers for IC were 317 (37%) cases for clone 73-10, 264 (31%) for clone SP263, and 89 (10%) for clone 22C3. PD-L1 expression in IC was associated with prolonged OS and DFI in univariable analysis for all three clones. The link to prolonged DFI remained in multivariable analysis for 73-10 and SP263, but only for 73-10 regarding OS. PD-L1 expression in TC was not prognostic of OS in any analysis, while it was associated with prolonged DFI for SP263, and a trend was seen for 73-10. The link to prolonged DFI remained for SP263 and was strengthened for 73-10 in multivariable analysis.

Conclusions
The prognostic value of PD-L1 expression in both IC and TC differs between antibody clones, with 73-10 and SP263 being more reliable for prognostic information than 22C3 in resected CRC.
Outcomes of retropupillary iris claw lens implantation in patients with intraocular lens dislocation and low (less than 1000 cells/mm2) corneal endothelial cell density
Authors: Lee Seung Min , Kim Tae Young , Kang Hyun Goo , Lee Junwon , Kim Min 
Published: August 2024

AbstractBackgroundPosterior chamber intraocular lens (IOL) dislocation is a common complication of cataract surgery. Dislocated IOLs often require surgical intervention due to the potentially severe risks of leaving this condition untreated. If a patient with extremely low corneal endothelial cell density (ECD) presents with IOL dislocation, the surgeon faces a crucial dilemma of choosing the most optimal surgical treatment option. We sought to investigate the efficacy and safety of retropupillary iris claw intraocular lens (R-IOL) implantation in patients with IOL dislocation and extremely low (< 1000 cells/mm2) ECD.MethodsWe retrospectively reviewed the medical records of nine patients (all men) whose pre-operative ECD was < 1000 cells/mm2and who underwent R-IOL implantation due to intraocular subluxation or total dislocation into the vitreous cavity between 2014 and 2020. We evaluated corneal endothelial function and visual outcomes after surgery.ResultsNine patients were included in this study. The mean age at diagnosis was 64.89 ± 7.15 years (range 57–76 years), and the follow-up duration was 37.93 ± 23.72 months (range 18.07–89.07 months). No patients developed bullous keratopathy during follow-up. Compared to the initial ECD, corneal thickness (CT), coefficient variation of cell area (CV) and percentage of hexagonal cells (HEX), there was no statistically significant decrease in the ECD, CV, and HEX at last follow-up (P = 0.944, 0.778, 0.445, 0.443). There was significant improvement in the mean uncorrected distance visual acuity (UDVA) at the last follow-up (average 0.13 logMAR, 20/27 Snellen) compared to the pre-operative mean UDVA (average 1.09 logMAR, 20/250 Snellen) (P < 0.01).ConclusionsR-IOL implantation did not result in a statistically significant decline in corneal endothelial function in patients with preoperatively low ECD, and it significantly improved the mean UDVA postoperatively. R-IOL implantation appears to be a safe and effective treatment modality for intraocular lens dislocation in patients with low ECD (< 1000 cells/mm²); however, long-term follow-up studies are warranted to corroborate these findings.