bluuebunny/crossref_metadata_2025_split huggingface dataset:
Fostering Competence and Performance Development in the Nursing Profession in Ghana
Authors: Quartey Samuel Howard 
Published: February 2025

ABSTRACTThis study explored the competence and performance development experiences of nurses working in public hospitals in Ghana. The study employed an exploratory qualitative research design. Participants were 25 public sector nurses who were purposively selected from two major hospitals in Ghana. Data were gathered using semi‐structured interviews. The data were analyzed using an inductive thematic analytic framework. The findings indicated that nurses develop their competence by training continuously, joining fora, furthering education, and doing research. In addition, the findings revealed that nurses also develop their performance through scientific problem‐solving, professionalism, ethics and protocols, nursing interventions, and patient–staff relationships. The findings further showed that favourable staff–manager relationships, staff motivation and satisfaction, and hospital equipment described the nature of a supportive hospital work environment. This study opens an attractive research window on the competence and performance development of public sector nurses in Ghana.
Impact of lymph node dissection during surgery on the efficacy of pembrolizumab in patients with metastatic urothelial carcinoma
Authors: Kanno Toru , Ito Katsuhiro , Kita Yuki , Mochizuki Takanori , Sano Tomoyasu , Yokomizo Akira , Abe Takashige , Tsuchihashi Kazunari , Tatarano Shuichi , Inokuchi Junichi , Takahashi Atsushi , Matsui Yoshiyuki , Nishiyama Hiroyuki , Kitamura Hiroshi , Saito Ryoichi , Kobayashi Takashi ,   the Japan Urological Oncology Group
Published: February 2025

ObjectivesThe impact of lymph node dissection (LND) on the efficacy of pembrolizumab in patients with urothelial carcinoma (UC) who develop metastasis after surgery remains unclear. This study aimed to investigate the efficacy of pembrolizumab in patients with metastatic UC who underwent primary tumor resection with LND.Patients and methodsThis retrospective study included patients who initially underwent radical surgery with or without LND for non‐metastatic UC and later received pembrolizumab for recurrent lesions. Data were collected from a retrospective nationwide Japanese cohort study in patients with metastatic UC treated with pembrolizumab. The primary endpoints were overall response rate (ORR) and overall survival (OS). Multivariate analysis was performed to identify predictors of OS.ResultsA total of 393 patients (273 [69.5%] underwent LND, and 120 (30.5%) did not) were included in this study. The ORRs for patients with and without LND were 30.8% and 27.3%, respectively (p = 0.460). No significant difference in OS was observed between the two groups (p = 0.471). Multivariate Cox regression analysis revealed that a neutrophil‐to‐lymphocyte ratio ≥3.0, Eastern Cooperative Oncology Group performance status ≥2, hemoglobin <11, and liver metastasis were associated with worse OS. However, LND was not associated with OS.ConclusionsLND during primary tumor resection did not affect the efficacy of pembrolizumab in patients with metastatic UC.
First‐principles’ study of surface adsorption behaviors of oxygen on Nb2C MXenes and their modification by PANI
Authors: Wang Ming Lei , Zhou Yunkai , Yin Ziyue , Zhang Yanhui , Wang Li‐Min , Zhang Xinyu , Liu Ri‐Ping 
Published: February 2025

AbstractLarge‐scale application of MXene are mainly limited by their easy oxidation behavior, which destroys their structure stabilities and thereby deteriorates their electrochemical properties as well. In order to understand the mechanism of chemical stability of Nb2C–X2 (X = O or OH) against oxygen attack and the modification effects of three types of polyaniline (PANI) [pernigraniline polyaniline (oxid‐PANI), leucoemeraldine polyaniline (red‐PANI), emeraldine polyaniline (rmid‐PANI)], the oxygen adsorption behaviors on surface slabs of Nb2C–X2, PANI and PANI‐modified Nb2C–X2 are systematically investigated and compared by applying density functional theory (DFT) calculations in this work. Among the 42 adsorption systems studied, the nanocomposite of oxid‐PANI/Nb2CO2 stands out due to the oxidation resistance and the structure stability owing to the effects of PANI modification. This is demonstrated by the decreased adsorption activity on the end of Nb2CO2 compared with the original Nb2CO2. Furthermore, the Bader charge analysis and the electron density difference maps illustrate that around 0.11 e transfers from the PANI‐end to the MXene‐end, which explains the physics behind the improvement of oxidation resistance in the MXene matrix. Therefore, our studies here indicate that the improvement of the oxidation resistance and the structure stability of Nb2C‐type MXenes can be effectively qualified by the PANI‐modification, which gives theoretical guidelines for the preparation and the applications of MXene materials.
Effects of heat treatment on mechanical and thermophysical properties of KD‐SA SiCf/SiC composites
Authors: Zhang Jin , Wang Yanfei , Chen Xiangjian , Gou Yanzi , Li Duan , Liu Rongjun 
Published: February 2025

AbstractThe mechanical and thermophysical properties of KD‐SA SiCf/SiC composites manufactured by the hybrid chemical vapor infiltration (CVI)–precursor impregnation and pyrolysis (PIP) technique were systematically studied at 1400, 1600, and 1800°C, respectively, under argon atmosphere for 1 h. The results show that Si element in SiC fiber escapes and diffuses to pyrolytic carbon (PyC) interphase after 1400°C heat treatment, forming a Si‐rich line in PyC interphase. With a further increase of heat treatment temperature, the Si sublimation in the Si‐rich line leads to the cracking of the PyC interphase as well as the increase of the order degree of the PyC interphase, resulting in a significant decrease in the interfacial shear strength of the composite. Due to the decomposition of PIP SiC matrix and Si sublimation of SiC fiber, the flexural strength of the composite decreases after heat treatment at 1400°C. When the heat treatment temperature increases to 1600 and 1800°C, the flexural strength of the composite is slightly increased compared with 1400°C. Moreover, the thermal conductivity of the composites has been improved significantly by raising temperatures due to an increase of the crystallinity of the PIP SiC matrix.
Association Between Body Image, Fear of Childbirth and Maternal‐Fetal Attachment: The Relative Mediation Analysis
Authors: Zhao Fei , Zhang Xinhan , Yue Chenying , Zhang Zixuan , Yuan Miao , Chen Xinxia 
Published: February 2025

ABSTRACTAimsTo explore the association between body image, fear of childbirth and maternal‐fetal attachment and the mediating effects of fear of childbirth among different body image profiles.DesignA cross‐sectional study.MethodsPregnant women were recruited from obstetric outpatient clinics between February 2022 and October 2023. Face‐to‐face data were collected using validated questionnaires. First, the mediating role of fear of birth was examined between body image and maternal‐fetal attachment by calculating the total scores. Then, latent analysis was performed to identify body image profiles, and the relative mediation effects were examined for fear of childbirth in the association between body image profiles and maternal‐fetal attachment.ResultsThis study included 676 pregnant women, most of whom were in their third trimester. Using the total score, fear of childbirth was found to partially mediate the relationship between body image and maternal‐fetal attachment. Latent profile analysis revealed three body image profiles in pregnant women: positive, moderate and negative. Using positive body image as the reference, pregnant women with moderate body image experienced a higher fear of childbirth, resulting in lower maternal‐fetal attachment. Notably, the relative mediating effect of fear of childbirth was more pronounced in women with more negative body image profiles.ConclusionBody image affected maternal‐fetal attachment directly and indirectly through fear of childbirth, with stronger mediating effects among women with more negative body image profiles.ImplicationsThe findings provide evidence on the underlying pathways between body image and maternal‐fetal attachment and suggest body image and fear of childbirth as potential intervention targets to improve maternal‐fetal attachment. Pregnant women with more negative body image may benefit more from such interventions.ImpactLittle is known about the pathway between body image and maternal‐fetal attachment in pregnant women. Body image affects maternal‐fetal attachment directly and indirectly through fear of childbirth. The mediating effects of fear of childbirth were more pronounced among women with more negative body image profiles. These findings highlight fear of childbirth in the association between body image and maternal‐fetal attachment and identify women with a more negative body image as high‐risk populations, which provides insights for developing personalised interventions to improve perinatal psychological health.Reporting MethodThe study has followed the STROBE checklist for reporting method.Patient or Public ContributionNo patient or public contribution.
Peripheral Intravenous Catheter Care at Australian Emergency Departments: A Cross‐Sectional Observational Study
Authors: Xu Hui (Grace) , Doubrovsky Anna , Rickard Claire M. , Rockliff Lauryn , Tang Christopher , Ullman Amanda J. 
Published: February 2025

ABSTRACTBackgroundPeripheral intravenous catheters (PIVCs) serve as crucial devices for essential care administration in emergency departments (ED). In Australia, to standardise clinical practice, the national PIVC Clinical Care Standard was introduced in 2021, however adherence to the Standard has not been adequately explored. Therefore, this study aims to investigate ED clinicians' adherence to the Standard via prospective audit.MethodThis cross‐sectional observational study of PIVCs was conducted in three Australian EDs between 2022 and 2023. Data were collected in alignment with the quality indicators in the PIVC Clinical Care Standard. Research nurses collected the data from bedside observation and chart audit, with data analysed descriptively.FindingsOut of 1568 episodes of PIVC care recorded, there were notable shortcomings. ED nurses and doctors provided minimal patient partnership during insertion episodes: PIVC self‐care education (n = 4, 1.4%), discussion of potential risks/benefits (n = 8, 2.9%), and reporting of concerns (n = 16, 5.8%). Insertions primarily occurred at the antecubital fossa (n = 225, 81.2%), with a common issue being inadequate time for antiseptic solution to air dry (n = 156, 56.3%). Ongoing needs assessment was unable to be assessed due to documentation limitations, which were generally incomplete. Idle catheters (inserted but not used) were prevalent (n = 115, 41.8%), and only a quarter of inpatient ward admissions (n = 75, 27.3%) had clear indications for PIVC use.ConclusionThese findings highlight the suboptimal ED PIVC practices that require attention and improvement. Innovative interventions and technology are necessary to address some of these suboptimal practices due to their complexity and persistent challenges, despite previous efforts by clinicians and researchers.Implications for the Profession and Patient CareThe findings underscore the need for well‐resourced efforts to ensure adherence to evidence‐based practices in dynamic clinical settings.Reporting MethodThe study is reported following the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement.Patient or Public ContributionNone.
Exploring the Axis of Gut Microbiota‐Inflammatory Cytokine‐Atrial Fibrillation in the Pathogenesis of Atrial Fibrillation
Authors: Chen Jun , Wang Yucheng , Wang Kangnan , Mei Ziwei , Wang Lihong 
Published: February 2025

ABSTRACTA relationship may exist between the gut microbiota, inflammatory factors and atrial fibrillation (AF); however, the precise biological mechanisms linking these components remain uncertain.In this study, 211 single‐nucleotide polymorphisms associated with the gut microbiota were collected from the MiBioGen consortium. Summary data for AF were sourced from large‐scale genome‐wide association studies. Two‐step Mendelian randomization (MR) was applied to estimate the possible mediating effect of inflammatory cytokines on the causality between the gut microbiota and AF. MR confirmed the effects of class Lentisphaeria, family Bifidobacteriaceae, family XIII, genus Anaerostipes, genus Howardella, genus Intestinibacter, genus Lachnospiraceae (NK4A136 group), genus Odoribacter, genus Ruminococcus gnavus, order Bifidobacteriales, order Victivallales and phylum Lentisphaerae on AF prevention. Moreover, MR revealed the role of Fms‐related tyrosine kinase 3 ligand, interleukin‐6, interleukin‐7, leukaemia inhibitory factor receptor, sulfotransferase 1A1 and tumour necrosis factor ligand superfamily member 12 in protecting against AF. Fibroblast growth factor 5, interleukin‐2 receptor subunit β, and tumour necrosis factor had a causal effect, increasing AF risk. The mediation exploration indicated that the indirect effect of genus Rikenellaceae (RC9 gut group)(id.11191) on AF mediated by interleukin‐6 was OR 1.011 (95% confidence interval 1.002–1.024; mediation proportion=23.913%). This study supplies genetic insights into the potential causal association between the gut microbiota and AF. These causal associations and mediating effects are useful for managing AF through manipulation of the gut microbiota.
Determining the Relationship Between Perceived Social Support and Immunosuppressive Medication Adherence After Kidney Transplantation: A Descriptive Correlational Study
Authors: Karazeybek Ebru 
Published: February 2025

ABSTRACTBackgroundWhat is known about how the level of social support, which is among the factors affecting medication adherence, affects medication adherence is limited.ObjectivesThis study investigated the relationship between perceived social support and immunosuppressive medication adherence among kidney recipients.DesignThis study was conducted using a descriptive correlational research method.ParticipantsThe study conducted research with 168 kidney transplant recipients who agreed to participate between April and June 2021. Participants completed the Immunosuppressive Medication Adherence Scale (IMAS) and the Multidimensional Scale of Perceived Social Support (MSPSS).Measurements and ResultsParticipants had a mean IMAS and MSPSS score of 50.24 ± 3.71 and 57.21 ± 13.96, respectively. Participants' MSPSS total (r = 0.209, p = 0.006) and ‘family’ (r = 0.248, p = 0.001) and ‘friends’ (r = 0.226, p = 0.003) subscale scores were weakly and positively correlated with their IMAS total score.ConclusionUnderstanding the effect of perceived social support on immunosuppressive medication adherence is important for designing future interventions to increase immunosuppressive medication adherence.
The West Catching Up With the East: High‐Magnification NBI Is Accurate for the Diagnosis of Gastric Neoplasia in a Western Population
Authors: Young Edward , Wan Nicholas , Philpott Hamish , Singh Rajvinder 
Published: February 2025

ABSTRACTBackground and AimAccurate endoscopic prediction of histology is key to recognition of early gastric neoplasia and selection of appropriate resection techniques. Narrow‐band imaging with magnification (M‐NBI) has proven to be highly accurate for gastric lesions in eastern countries; however, we sought to examine whether it can be effectively utilized in the west where evidence is scarce.MethodsThis is an analysis of a prospective database of gastric lesions at a single Australian center from 2009 to 2023. All lesions were assessed endoscopically using M‐NBI and a determination made whether the lesion was neoplastic or non‐neoplastic, as well as prediction of histological subtype. This was then correlated with final histology.ResultsA total of 232 lesions in 183 patients were included: 135 non‐neoplastic and 97 neoplastic lesions. Thirty‐five were adenomas, 29 early gastric cancers, and 6 advanced adenocarcinomas. For differentiating neoplastic versus non‐neoplastic lesions, M‐NBI had a sensitivity of 97.9% (CI 92.6%–99.7%) and specificity of 97.1% (CI 92.7%–99.2%). M‐NBI was also highly accurate (97.0%, CI 93.9%–98.8%) for identifying lesions suitable for endoscopic resection. The observed agreement between the M‐NBI predicted histology and the final pathology was 91.8% with a derived kappa statistic of 0.87, indicating excellent agreement. Comparatively, prior biopsies had an observed agreement of 40.4% with final histology, with a derived kappa statistic of 0.27.ConclusionsM‐NBI can be used with a high degree of accuracy in a western population. M‐NBI can effectively differentiate neoplastic from non‐neoplastic gastric lesions and delineate histological subtypes with superior accuracy to previous biopsies.
Evaluation of a Trauma‐Informed Nutrition Curriculum for Women With Children Living in Transitional Housing
Authors: Milton Austin , Frech Natalie , Shadid Anna , Hollman Nicholas , Bell Sarah Beth , Wetherill Marianna S. 
Published: February 2025

ABSTRACTObjectiveThis study describes the implementation of a 6‐week nutrition and culinary education curriculum at a transitional housing facility for single mothers in Tulsa, Oklahoma, United States.MethodsUsing a novel, trauma‐informed approach to nutrition education, we delivered the Around the Table: Nourishing Families curriculum across three, small group cohorts (n = 15) over a period of 2 years. Lessons emphasized small group dialogue and group‐directed learning on the topics of toxic stress, food as nourishment and family resilience combined with hands‐on recipe preparation by the group. We evaluated process measures of participation and attrition and outcome measures of self‐reported food skills, dietary intake, emotional well‐being, and other indicators of nutrition self‐care using a pre–post design.ResultsFood skills significantly improved post‐curriculum (p = 0.026) with additional improvement in several areas of dietary intake, mindful eating, nutrition self‐care and greater use of healthy foods at family mealtimes.ConclusionsHands‐on, participatory nutrition and cooking education that emphasizes mind–body connections to food can be a feasible strategy for teaching introductory food skills and may also support socioemotional healing in this population.
Dietary Energy and Nutrient Intake Among Pregnant Women in Sri Lanka: Findings From the Sri Lanka Mother and Newborn Growth Cohort Study
Authors: Pathirathna Malshani Lakshika , Haruna Megumi , Sasaki Satoshi , Yonezawa Kaori , Usui Yuriko , Hagiwara Yasuhiro 
Published: February 2025

ABSTRACTBackgroundMaternal nutrition during pregnancy is crucial to ensure positive outcomes for both the mother and newborn. Despite its importance, maternal nutritional status remains poor, particularly in low‐ and middle‐income countries, where social, cultural and economic factors play a pivotal role. This study assessed the adequacy of energy and dietary nutrient intake among Sri Lankan pregnant women compared to their dietary reference intakes.MethodsThis study was part of the Sri Lanka Mother and Newborn Growth study, a nationwide prospective cohort of 2000 pregnant women. We prospectively investigated maternal dietary intake using a validated food frequency questionnaire during the first, second and third trimesters.ResultsWe observed an imbalanced macronutrient distribution, with carbohydrates contributing over 67% of total median energy intake, while protein and fat contributed approximately 11% and 17%, respectively. Ethnic and socio‐economic disparities in energy and macronutrient intake were notable. The Sinhalese ethnic group showed the highest median percentage of energy consumption derived from carbohydrates at 68.0% (IQR: 64.6%‒71.1%), significantly exceeding the intake of Tamil and Moor groups. Estate residents reported the lowest proportion of energy from protein (10.6%, IQR: 10.1%‒11.3%), which was significantly lower than the intakes of urban and rural residents. Additionally, women in the lowest income group had a lower total energy intake (1871 kcal/day, IQR: 1464–2392) than those in higher income groups, highlighting socio‐economic influences on maternal nutrition. Micronutrient deficiencies were pervasive, particularly for vitamin B2 (88.6%–91.0%), folate (99.3%–99.8%), vitamin B12 (97.8%–99.5%), calcium (80.8%–91.4%) and iron (91.1%–96.5%). Sodium intake exceeded recommended levels for over 75% of women across all trimesters.ConclusionImbalances in macronutrient intake and widespread micronutrient deficiencies among Sri Lankan pregnant women underscore the urgent need for interventions targeting maternal nutrition. Addressing socio‐economic disparities is critical to improving maternal and neonatal health outcomes.
Exploring Midwives’ Experiences Within Canada's First Alongside Midwifery Unit: Impacts and Implications for Midwifery Practice
Authors: Murray‐Davis Beth , Grenier Lindsay N. , Malott Anne M. , Mattison Cristina A. , Cameron Carol , Hutton Eileen K. , Darling Elizabeth K. 
Published: February 2025

IntroductionAlthough midwifery‐led units in hospitals are associated with positive outcomes, little is known about the experiences of the midwives who work within this model. Despite the increase in midwifery‐led units globally, the first unit of this kind opened its doors in Canada in 2018. The Alongside Midwifery Unit (AMU) is staffed by a hospitalist midwife (a novel role in this country) and community midwives, working in a caseload model, who attend their clients’ labor and birth on the unit. The AMU is a low‐risk birthing unit located adjacent to the obstetric unit, offering midwifery‐led care, in a homelike setting. Our aim was to explore and describe the experiences of midwives working in this model of care on the AMU.MethodsQualitative semistructured interviews and one focus group with community and hospitalist midwives working at the AMU were conducted and analyzed using a grounded theory approach.ResultsWe identified that midwives were able to maintain the midwifery philosophy of care, strengthen relationships, amplify hospital integration, and grow midwifery leadership in this model.DiscussionImplementation of an AMU supports best practice, intra‐ and interprofessional relationships, and integration of midwives. Our findings demonstrate a positive impact of this model along with the absence of detrimental impact on midwifery values and philosophy. An improved understanding of the impact of the AMU on midwives and their practice is useful for refining the model of care and informing implementation in other settings. This research contributes to the growing evidence demonstrating the benefits of midwifery‐led units.