bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurses' mental well-being levels and their influencing factors
Authors: Atmaca Palazoglu Cansu , Koç Zeliha 
Published: September 2023

This research was carried out as a descriptive study to determine the mental well-being levels of nurses and the factors affecting them. The research was carried out between 01/04/2023-07/04/2023 with the participation of 190 nurses working in a university hospital. The data were collected by using a 22-question information form, prepared by the researcher in line with the literature, which determines the sociodemographic and working life characteristics of the nurses, and the Warwick-Edinburgh Mental Well-Being Scale. Frequency, percentage, mean, standard deviation, median (min-max), Kruskal Wallis test, Mann Whitney U test, One-Way Analysis of Variance, and Independent Sample t-test were used for data analysis. In line with the findings obtained from this study, the mental well-being levels of nurses were determined at a moderate level. It is recommended that mental well-being-based interventions should be planned to support nurses mentally, as it will contribute to the development of their professional skills and their daily lives.
Keywords: Mental well-being; nurse; psychological well-being; well-being.
Determination of nurses' attitudes toward ethical principles in the clinical environment
Authors: Atmaca Palazoglu Cansu , Koç Zeliha 
Published: September 2023

This research was carried out as a descriptive study to determine the attitudes of nurses toward ethical principles in the clinical setting. The research was carried out between 08/04/2023 and 14/04/2023 with the participation of 203 nurses working in a university hospital. The data were collected using a 22-question introductory information form prepared by the researcher in line with the literature and the Ethical Principles Attitude Scale. The conformity of the data to normal distribution was evaluated by Shapiro-Wilk and Kolmogorov Smirnov tests. Frequency, percentage, mean, standard deviation, median (min-max), Kruskal Wallis test, and Mann-Whitney U test were used to analyze the data. In line with the findings obtained from this study, nurses' attitudes towards ethical principles were determined at a high level. It is recommended that nurses' awareness of the importance of ethical principles in the clinical environment should be increased in their professional education and postgraduation continuing education programs.
Keywords: Clinical environment; ethics; ethical principles; nurse.
Determining nursing students' moral distress levels
Authors: Tufan Satu , Koç Zeliha 
Published: September 2023

This descriptive cross-sectional study was conducted to determine the level of moral distress among nursing students. The study was conducted between April 17 and April 20, 2023, with the participation of 150 students studying in the nursing department of the Faculty of Health Sciences of a university who agreed to participate in the study. Data were collected using a questionnaire designed by the researchers based on the literature and the Moral Distress Scale for Nursing Students. The arithmetic mean, standard deviation, median, and frequency (in percent), t-test, ANOVA test, and Pearson correlation analysis were used to analyze the data. This study found that the intensity and frequency of moral stress among nursing students were not high. In line with the findings, it is recommended that ethics education be provided to nursing students, teaching them how to deal with unethical behavior they encounter in the clinical setting, and raising the awareness of nursing educators to support students' development.
Keywords: Distress; moral distress; morality student; nurses; nursing.
Factors affecting the perception of human dignity of nursing students
Authors: Tufan Satu , Koç Zeliha 
Published: September 2023

This descriptive cross-sectional study was conducted to determine the factors that influence the perception of human dignity among nursing students. The study was conducted between 14 April and 17 April 2023 with 191 students studying in the nursing department of the Faculty of Health Sciences of a university who had agreed to participate in the study. Data were collected using a questionnaire designed by the researchers on the literature and Scale of Human Dignity Perception and Understanding in Nursing. The arithmetic mean, standard deviation, median and frequency (in percent), Mann-Whitney U test, Kruskal-Walli’s test, and Spearman correlation analysis were used to analyze the data. In this study, it was found that student nurses had a high level of understanding and perception of human dignity. In line with the findings, it is recommended that student nurses' behaviors and attitudes be supported to provide care by ethical principles and values by respecting individuals' values and differences.
Keywords: Human dignity; nursing; nursing students; values.
Determining the perception of nursing diagnosis by nurses working in a state hospital
Authors: Çağa Abdullah , Kaya Gülşah , Erdoğan Tuğba Kavalalı , Sağlam Zeynep , Koc Zeliha 
Published: September 2023

The use of nursing diagnoses plays an important role in assessing nursing outcomes, improving patients' quality of life, and developing nursing practices. This study aimed to determine the perception of nursing diagnoses by nurses working in a government hospital. The study was conducted with 170 nurses working in a government hospital who were willing to participate in the study. Data were collected using a 24-question questionnaire that captured the socio-demographic and work-life characteristics of the nurses and the nursing diagnosis perception scale. This scale consists of 26 Likert-type items. A minimum of 1 and a maximum of 5 points can be scored on the scale. A low total score on the scale indicates that nurses perceive nursing diagnoses positively. Percentile calculation, Kruskal Wallis, Mann Whitney U-test, t-test, and Cronbach's alpha coefficient were used to analyze the data. In this study, results showed that nurses have a moderately positive perspective on perceiving nursing diagnoses.
Keywords: Nurse; nursing care; nursing diagnoses; perception
Penggabungan Metode Vigènere Cipher dan ElGamal Pada Pengamanan Pesan Rahasia
Authors: Ludyawati Ludyawati , Khudzaifah Muhammad , Herawati Erna 
Published: September 2023

Vigènere Cipher is a symmetric cryptographic algorithm that uses the same type of key in the encryption and decryption process. The security of the Vigènere Cipher method lies in the modulo calculation used. ElGamal is an asymmetric cryptographic algorithm that uses two different types of keys in the encryption and decryption process. The security of the ElGamal algorithm lies in the complexity of calculating large prime numbers. The Vigènere Cipher and ElGamal have their advantages and disadvantages. The researchers are interested in combining the advantages of the two methods. In this study, two locks were carried out in the encryption and decryption process. The encryption process uses a public key and the decryption process uses a public key and a secret key . The key used comes from key formation using the ElGamal algorithm. The key security formed from the ElGamal algorithm lies in the large prime , the primitive root of the prime number , and the random integer which comes from the last three digits of Student Number. The conclusion of this study is that the combination of the Vigènere Cipher and ElGamal methods can increase the security of secret messages because it produces a ciphertext with twice the size ) of the original message.
Manual de prácticas de laboratorio en microbiología veterinaria
Authors: Andrade Becerra Roy José , Pérez Rubiano Claudia , Vargas Abella Julio César 
Published: September 2023

Este manual de prácticas de laboratorio en microbiología veterinaria exhibe algunos temas de alta relevancia para la clínica veterinaria. Aborda asuntos recurrentes en el área, como la toma y envío de muestras al laboratorio, su procesamiento y la interpretación de los resultados, para dar un tratamiento oportuno y acertado a los pacientes. Se escogieron dieciséis temas comunes y significativos para nuestra casuística diaria, que son del interés de los profesionales y estudiantes de la medicina veterinaria en Colombia. El principal valor académico de este manual es su originalidad en los textos, tablas y fotos, que son propiedad de los autores, consecuencia de un proceso de recopilación o reestructuración de la experiencia y de los casos que llegan al laboratorio. El manual se estructura de una manera lógica, en un lenguaje comprensible, sencillo e ilustrado, para los futuros profesionales. La idea nació del trabajo cotidiano desarrollado en la clínica –el campo donde se mueven los profesionales– y el laboratorio, desde allí se propone integrar el conocimiento en un texto que resulte útil para sus consultas diarias. Indiscutiblemente, el aporte es significativo para resolver problemas y despejar dudas de una forma didáctica, ilustrativa y entretenida.
The effect of educational intervention informed by Roy’s adaptation model on the medication adherence of the patients with hypertension: A randomized clinical trial study
Authors: Amidi Amirmohammad , Hosseini Meimanat , Ghasemi Saeed , Khabazkhoob Mehdi 
Published: September 2023

Abstract
Background:
Hypertension is one of the most challenging public health problems around the world. Medication nonadherence to HTN has negative consequences for patients. The reliance on behavioral health models positively contributes to the proper use of interventions that aim to promote medication adherence.
Methods:
This experimental study adopts Roy’s adaptation model. Cluster random sampling was used. Tools were Roy’s Adaptive Modes Scale, Morisky Medication Adherence Scale and Demographic-clinical questionnaire. Intervention was a 4 weekly training sessions.
Results:
The findings showed that after the intervention, the mean score of medication adherence in the intervention group has significantly increased (P-value < 0.001).
Conclusions: Based on Roy’s adaptation model, educating the hypertensive patients can improve their medication adherence.
Trial registration:
This study was registered on the website of Iranian Registry of Clinical Trials with the following code: IRCT20220502054719N1 on 27/05/2022.
A mixed-method study of medical students’ perceptions of social accountability in medical education. Comparing the roles of equity identities, empathies, and curriculum regulation.
Authors: Whittenbury Kingsley J. , Ward Paul R. 
Published: September 2023

Abstract

The decline in students’ empathy during medical school is attributed in part to an informal curriculum that prioritises biomedical knowledge and lacks a patient perspective of illness. Transformation of medical professionalism to include socially accountable justice actions entails a theoretical shift in curriculum regulative discourse, and curricular justice to diverse medical students. A pre-pandemic, mixed-methods study compares the equity identities and justice discourses of medical students learning in divergent curricula; one regulated by a biopsychosocial model (BPS), the other by social accountability (SA). The study sought to identify teaching and learning needs for values transformation that legitimates integration of social change practices in medical professionalism. Participants expressed emotional empathy for the most disadvantaged groups in Australian society, but in both curricula the cognitive empathy owed to patients vulnerable to social systems inequities, and contextual reasoning of social science solutions, were generally weak. Outsiders with intersectional equity identities have greater insights to social inequities, but less intentions for primary care practice than peers with nil or one equity identity. Following clinical training in high health needs populations participants express solidarity with disadvantaged patients, but cognitive empathy is mostly instrumental; equity practices are mis-recognised as proximal and behaviour-related. Closure of this ‘know-do gap’ centres on transformative pedagogy; to induce a sociological imagination of health care justice, legitimate patients’ perspectives and broaden the social context of health causation. Professional development of emotional and cognitive empathy for patients’ social health improvement, and graduates’ prosocial aspirations, may benefit from learning the health communication science of biosemiotics, a biological approach to systems theory. The tools of Legitimation Code Theory, a discursive knowledge management system, may boost the empathic courage of medical educators to transform physician empathy, gaze, and professional capability toward socially accountable practices.
Influencing healthcare seeking behaviours of consumers through a telephone health advice and triage service: a multi-method evaluation
Authors: Delaforce Alana , Good Norm , Niven Philippa , Plate Curtis , Jayasena Rajiv , Parkinson Joy 
Published: September 2023

Abstract
Background: Globally, healthcare systems are under strain due to increased demand from inappropriate care seeking behaviours of consumers. Solutions are needed to redirect consumers to appropriate avenues for accessing health care, including, where appropriate, self-management. In response to this need, the Healthdirect Australia 24/7 National Coronavirus Helpline was established as a telephone health advice and triage service. This study aims to evaluate the call centre performance, consumer satisfaction and influence of the service on appropriate care seeking behaviours of consumers.
Methods: A multi method evaluation using an online survey and telephony metrics. The survey was distributed to e COVID positive callers from Queensland and South Australia who rang the 24/7 National Coronavirus Helpline and were triaged as being low or medium risk of hospitalisation. Of 2,784 invitations sent, 329 responses were received. Survey data were analysed using descriptive statistical analysis. Counts and percentages are used for categorical survey data. Telephony metrics included 94,494 calls made to the 24/7 National Coronavirus Helpline between May-November 2022. Simple summary statistics were undertaken on all telephony data, with categorical data presented either as totals or percentages of individual levels within categories.
Results: The call centre provided an efficient service, with most calls answered within 0.8 minute (48 seconds), and a very low rate of call abandonment (4%). The average call length was 7.22 minutes (7 minutes, 13 seconds). Consumer satisfaction was high with 71% of survey respondents rating their satisfaction as high or very high. Health seeking behaviours were positively influenced with an increase of 35% of consumers self-managing their care, a reduction of 12% in unnecessary emergency department visits, and a reduction of 5% in unnecessary emergency services calls after contacting the helpline.
Conclusions: The 24/7 National Coronavirus helpline provides an efficient service that was highly valued by survey respondents. It is likely that it is positively influencing appropriate healthcare seeking behaviours of consumers by promoting self-management or engagement with a GP according to the risk of hospitalisation, reducing unnecessary visits to the Emergency Department. Further research is needed to ascertain the effect of this model of care.
HuD (ELAVL4) gain-of-function impairs neuromuscular junctions and induces apoptosis in familial and sporadic amyotrophic lateral sclerosis models
Authors: Rosa Alessandro , Silvestri Beatrice , Mochi Michela , Mawrie Darilang , de Turris Valeria , Colantoni Alessio , Borhy Beatrice , Garone Maria Giovanna , Zammerilla Christopher , Pandey Udai 
Published: September 2023

Abstract

Early defects at the neuromuscular junction (NMJ) are among the first hallmarks of the progressive neurodegenerative disease amyotrophic lateral sclerosis (ALS). According to the “dying back” hypothesis, disruption of the NMJ not only precedes, but is also a trigger for the subsequent degeneration of the motoneuron. However, the pathogenic mechanisms linking genetic and environmental factors to NMJ defects remain elusive. Here we show that increased expression of the neural RNA binding protein HuD (ELAVL4) at the presynaptic level is sufficient to cause NMJ defects and trigger apoptosis in co-cultures of motoneurons and skeletal muscle derived from human induced pluripotent stem cells (iPSCs). These phenotypes are strikingly similar to those caused by the severe FUS P525L variant. Moreover, HuD knock-down in motoneurons reverts the adverse effects of the FUSP525L mutation in iPSC-derived cocultures. These findings were validated in vivo by taking advantage of a Drosophila model, where neuronal-restricted overexpression of the HuD-related gene, elav, exacerbates the effects of FUS expression and produces per se a motor phenotype. Notably, in this fly model, neuronal-restricted elav knockdown significantly rescues motor dysfunction caused by FUS. Finally, we show that HuD levels are increased upon oxidative stress in human motoneurons, and in sporadic ALS patients with a signature related to oxidative stress. On these bases, we propose HuD as a key protein involved in causing early pathogenic alterations and offers a potential new therapeutic target for early intervention aimed at the NMJ in ALS.
Effects and Mechanisms of the Subtypes of Apolipoprotein E to the Immune State and Prognosis of hepatocellular carcinoma patients
Authors: Gao Bowen , Zhou Peiyun , Wang Li , Wang Zhutao , Yi Yong , Zhou Jian , Fan Jia , Qiu Shuangjian , Xu Yang 
Published: September 2023

Abstract
Purpose
To investigate whether progression, immune status and prognosis of hepatocellular carcinoma (HCC) are related to the subtype and expression of apolipoprotein E (apoE).
Methods.
Immunofluorescence staining of CD11b+/LOX1+and CD14+/HLA-DR- combinations was performed on the tissue microarrays of tumor samples from 360 HCC patients to assess the abundance of infiltrating polymorphonuclear granulocyte-like myeloid-derived suppressor cells (PMN-MDSCs) and monocyte-like MDSCs (M-MDSCs). Immunohistochemistry was used to evaluate the expression of apoE2, apoE3, apoE4, arginase (ARG) and inducible nitric oxide synthase (iNOS). Univariate, multivariate COX regression, and the Kaplan-Meier methods were used to evaluate the survival. Peripheral blood samples were collected and divided into three groups according to blood apoE level in the second cohort. Flow cytometry method detected immune cells abundance.
Results
COX regression analysis showed H-score of apoE2 in tumour tissue below 16.01 (HR=6.140, p=0.00005) and H-score of apoE4 above 4.05 (HR=7.001, p=0.009) were significantly associated with shorter overall survival (OS). The density of infiltrated PMN-MDSCs (>2.87 cells/mm2 (HR=3.762, p=0.000009)) and proportion of M-MDSCs of total cells (<89.32% (HR=0.454, p=0.006)) in tumour tissue were independent risk factors for shorter recurrence-free survival (RFS). The low apoE group had a higher abundance of MDSCs in the peripheral blood compared to the normal and high blood apoE levels. The number of CD14+HLA-DR-/low M-MDSCs (p=0.0399) were higher than in the apoE high level group. Higher level of CTLA-4+ T lymphocytes were detected in the low apoE group than in the normal group.
Conclusion
The abundance of MDSCs, CTLA-4+ T lymphocytes in the peripheral blood from HCC patient was negatively correlated with the level of apoE. ApoE4 suggests poor prognosis, but apoE2 may be a potential protective factor for HCC patient’s OS.
Spatial Network and Influencing Factors of Green Water Use Efficiency in the YREB: Considering carbon emissions and pollution indicators
Authors: Zhang Rui , Zhang Lingling , Wang Zongzhi 
Published: September 2023

Abstract
Improving green water use efficiency is based on the synergy of reducing pollutants and carbon emissions, and effectively identifying its spatial development structure is a prerequisite for realizing the green transformation of water management. This paper adopted the slacks-based measure-“energy-environment-economy” (SBM-3E) model with carbon emission and pollution indicators as unanticipated outputs to measure the green water use efficiency of the 11 provinces (cities) in the Yangtze River Economic Belt from 2000 to 2018, then analyzed the efficiency network structure evolution by using the social network analysis method, finally examined the drivers of efficiency networks. The results show that: (1)The value of green water utilization efficiency decreases from 0.78 to 0.51, and its spatial distribution is downstream＞middlestream＞upstream, with the values of 0.41, 0. 61 and 0.86, respectively; (2) The overall spatial network efficiency is gradually interconnected, with the density increasing from 0.32 to 0.6; it has undergone a structural evolution from "flat" to "inverted tower". The core-edge structure of the main body status within the basin has been strengthened. (3) The efficiency network is significantly influenced by water resources endowment, industrial structure and foreign investment level. The conclusions are expected to provide useful insights for designing the basin's water protection policy and greening the region's development.
Benefits of CO2 fertilization on global grassland nitrogen cycles
Authors: Gu Baojing , Zheng Miao , Cui Jinglan , Wang Xiaoxi , Zhang Xiuming , Reis Stefan , Lam Shu Kee , Wang Sitong , Xu Jianming 
Published: September 2023

Abstract
Grasslands provide wildlife habitats, essential ecosystem services and food to humanity. Elevated atmospheric CO2 concentrations (eCO2) are a major climate change driver and have substantial effects on grasslands. Nonetheless, the grassland nitrogen cycle response to eCO2 largely remains unknown. Here we show that eCO2 alone could increase the net primary productivity by 10% (95% confidence interval, 8% to 12%) but decrease leaf nitrogen content by 8% (95% confidence interval, 5% to 10%), leading to a projected 4 million tonnes per year (Tg yr−1) increase in nitrogen uptake by global grasslands under the eCO2 SSP2-4.5 scenario by 2050. Total nitrogen input to global grasslands is expected to decrease by 24 Tg yr−1, while biological nitrogen fixation would increase by 9 Tg yr−1. The increase in nitrogen use efficiency by 29% (95% confidence interval, 18% to 40%) would lead to declines in nitrogen fertilizer use (-16 Tg yr−1) and nitrogen surplus (-28 Tg yr−1). These changes in the grassland nitrogen budget due to eCO2 would generate benefits to a value of 189 billion US dollars by avoiding human and ecosystem health damage costs. The positive effects should be considered in the development of effective management strategies for climate change adaptation and to foster sustainable development.