bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and validation of educational competencies Required for anesthesia technologists: A developmental study
Authors: Maroufi Shahnam Sedigh , Bagheri Neda , Majd Parisa Moradi , Saei Azam , Abolghasemi Jamileh 
Published: February 2025

BACKGROUND:
Competency-based approach is the dominant approach in curriculum planning. Despite the use of the competency approach in other fields related to the healthcare system in various countries and also in some fields in Iran, the undergraduate curriculum of Anesthesia Technology in Iran is predominantly presented traditionally (goal-oriented). Since obtaining competency for Anesthesia Technologists is important, this study aimed to determine the required educational competencies for them.

MATERIALS AND METHODS:
This quantitative developmental study was conducted in 2022–2023 in three general stages: determining competencies through literature reviews, conducting a group session with experts in the field of anesthesia and developing an initial questionnaire, and then examining the validity and reliability of the initial questionnaire by experts and finalizing the competencies. The validity of the questionnaire was assessed using CVR and CVI, and the reliability was calculated through Intra-class Correlation Coefficient (ICC) and Cronbach’s alpha.

RESULTS:
61 competencies were classified into five domains: “ethics and professionalism,” “collaboration and communication,” “evidence-based practice and professional learning,” “safety and risk management,” and “technical competencies.” The questionnaire had sufficient face and content validity, and its reliability was calculated using an ICC of 0.997 and Cronbach’s alpha of 0.992.

DISCUSSION:
Developing a competency-based curriculum is feasible by developing a competency framework, and this study is the first step towards creating a competency-based curriculum by developing a reliable and valid competency framework.
Effectiveness of a group intervention based on cognitive–behavioral approach on the levels of ambiguity tolerance, distress tolerance, and academic achievement motivation in students
Authors: Nashtban Negar Sharafi , Aghajani Reza , Salehi Somaieh 
Published: February 2025

BACKGROUND:
Students who are about to take their final-year college entrance examinations experience considerable worries and psychological stress. Enhancing ambiguity tolerance, distress tolerance, and academic achievement motivation during this period can greatly contribute to their psychological well-being and academic success. The aim of this research was to determine the effectiveness of a group intervention based on a cognitive–behavioral approach on the levels of ambiguity tolerance, distress tolerance, and academic achievement motivation among students in this educational phase.

MATERIALS AND METHODS:
This study is a quasi-experimental research design with a pre-test, post-test design, and a 1-month follow-up with a control group. The population includes all students in District 16 of Tehran. Using convenience sampling, 20 male students from the high in District 16 were selected as the experimental group, and 20 of them were selected as the control group (using G*Power). The research instruments included the Second-Type Ambiguity Tolerance Questionnaire, Distress Tolerance Questionnaire, and Academic Achievement Motivation Questionnaire. Cognitive–behavioral therapy (CBT) sessions were conducted in a group format, following an 8-weekly session plan, with each session lasting 2 hours for the experimental group. Data were analyzed using repeated-measures analysis of variance (ANOVA).

RESULTS:
The results of the repeated-measures ANOVA showed that CBT had a significant effect on increasing ambiguity tolerance, distress tolerance, and academic achievement motivation (P < 0.05), and this effect remained stable during the follow-up stage.

CONCLUSION:
The results indicated that a group intervention based on the cognitive–behavioral approach increased ambiguity tolerance, distress tolerance, and academic achievement motivation in male students in their final year of high school (on the verge of college entrance examination). Therefore, these interventions are recommended for college-bound students to enhance their psychological well-being and academic success.
Effect of early clinical exposure on communication, history-taking, and nursing diagnosis skills: A brief report
Authors: Sarabi Nasrin , Yazdi Fateme , Hamidipour Nasim 
Published: February 2025

BACKGROUND:
Clinical education is a key component of the nursing curriculum. Therefore, it is necessary to use new methods to learn basic clinical skills better. This study examines the effect of an early exposure educational program on first-year nursing students’ communication, history-taking, and nursing diagnostic skills.

MATERIALS AND METHODS:
Using a census method, this brief report included all first-year students of the Dezful University of Medical Sciences in two academic semesters in 2023. An early exposure program was implemented for one group of students. In the second semester, both groups’ communication skills, history-taking, and nursing diagnoses were measured in the clinical environment using a checklist. Pearson’s and Spearman’s correlation coefficients were used in this study. Data were analyzed using the IBM SPSS version 16 (IBM Corp., Armonk, NY, USA) with a 95% determination level.

RESULTS:
Communication skills (35.6 ± 4.87, 23.73 ± 2.28), patient history-taking (14.03 ± 1.158, 8.47 ± 1.59), and nursing diagnosis (8.03 ± 1.31, 3.26 ± 1.86) were significantly higher in the intervention group than in the control group. In the intervention group, there was a significant and positive correlation between communication and nursing diagnosis (r = 0.366), communication and history-taking (r = 0.433), and history-taking with nursing diagnosis (r = 0.523).

CONCLUSIONS:
Based on the positive results of this study, nursing managers should provide the possibility of implementing methods, such as early exposure, by creating a suitable platform.
Comparison of the effect of guided visualization technique and cryotherapy on pain intensity during needle insertion into arterial–venous vessels of hemodialysis undergoing patients: A cross-over clinical trial
Authors: Ghazanfari Zahra , Teshnizi Saeed H. , Yousefi Pooneh , Faghih Aref 
Published: February 2025

BACKGROUND:
End-stage renal disease patients experience pain during needle insertion each time they undergo vascular access. This pain is the most severe aspect of hemodialysis-related stress. Based on this, this study was conducted with the aim of the effect of guided visualization technique and cryotherapy on the intensity of pain when the needle enters the arterialvenous vessels in patients undergoing hemodialysis.

MATERIALS AND METHODS:
This cross-over clinical trial was conducted on 60 patients undergoing hemodialysis from September to December 2023. Patients were randomly assigned to three independent groups (n = 20 people per group). This study was conducted in three stages, during which each group received guided visualization, cryotherapy, and routine care (control) separately. Pain intensity was measured individually using the numerical rating scale at the end of each interventions. Data analysis was performed using data statistics (Stata) version 14 and Statistical Package for the Social Science version 26.

RESULTS:
The results showed that guided visualization significantly outperformed cryotherapy across all three groups and stages. Additionally, both guided visualization and cryotherapy significantly outperformed the control group in reducing pain following needle insertion in patients undergoing hemodialysis.

CONCLUSION:
Guided visualization can be used as a safe and secure method to reduce pain when the needle enters the arteriovenous fistula in patients undergoing hemodialysis.

TRIAL REGISTRATION NUMBER:
IRCT202308080590. (21/08/2023).
Time management and readiness for self-directed learning among medical undergraduates of a tertiary healthcare institution- A cross-sectional study from Eastern India
Authors: Naik Bijaya Nanda , Rao Rajath , Verma Manisha , Nirala Santosh Kumar , Pandey Sanjay , Singh Chandramani , Ranjan Alok , Manjhi Pramod Kumar 
Published: February 2025

BACKGROUND:
“Emphasizing time on task” has been included in the seven principles of undergraduate medical education. Improper time management (TM) leads to frustration, dissatisfaction, anxiety, and depression of not achieving the desired academic performance. This study was planned to examine the relationship between TM, self-directed learning readiness, and academic performance among the medical students of a tertiary healthcare institution.

MATERIALS AND METHODS:
This cross-sectional study was conducted among 295 medical undergraduate students for six months using a standard tool Fisher’s self-directed learning readiness (SDLR) questionnaire for SDL readiness and Britton and Tesser’s TM questionnaire for TM-skills. An SDLR score of ≤150 and a TMQ score of ≤58 were taken as low readiness for SDL and poor TM skill. Descriptive analysis was performed, and a multivariable binary logistic regression analysis was performed to discover the correlation of good TM skills.

RESULTS:
A total of 175[59.3%, 95% CI: 53.6–64.9] had low readiness for SDL, and 216[73.2%, 95% CI: 67.9–77.9] had poor TM skills. Academic scores showed a weak positive correlation (r = 0.2, P = <0.001) with TM scores. Females [adjusted odds ratio (AOR) = 2.9,95% CI: 1.6–5.6], students belonging to rural domicile [AOR = 2.3, 95% CI: 1.1–3.8], and high readiness for SDL [AOR = 4.8, 95% CI: 2.6–8.8] were independent correlates of good TM skills.

CONCLUSION:
Every six and seven out of ten medical undergraduates were found to have low readiness for SDL and poor TM skills, respectively. Emphasizing SDL as a part of professional education and the importance of TM in professional courses such as Medicine and Bachelor of Surgery is important.
Self-care and health-related quality of life in Mexican older adults with type 2 diabetes
Authors: Cortés-Hernández María E. , Cano-Estrada Edith A. , Castañeda-Márquez Ana C. , Hurtado-Salgado Erika M. , Aya-Roa Kevin J. , Hernández-Mariano José Á. 
Published: February 2025

BACKGROUND:
Type 2 diabetes (T2D) is one of the most prevalent chronic diseases in the world and represents one of the main risk factors for cardiovascular diseases. The evidence suggests that inadequate self-care behavior among patients with chronic diseases might negatively affect their health-related quality of life (HRQoL); however, the evidence in older adults with diabetes is inconclusive, and the information is scarce in the Mexican context. Therefore, this study aimed to determine self-care behavior and HRQoL in Mexican older adults with T2D and evaluate the association between both variables.

MATERIALS AND METHODS:
An analytical cross-sectional design was used. Participants (n = 300) were recruited at six senior centers in Hidalgo, Mexico. The Self-Care Capacity and Perception Test for Older Adults and the brief version of the World Health Organization Quality of Life Scale (WHOQOL-BREF) were used to assess self-care behavior and HRQoL, respectively. The associations between the variables of interest were evaluated by logistic regression models adjusted for confounders.

RESULTS:
Older adults with inadequate self-care behavior were more likely to have poor HRQoL in all domains of the WHOQOL-BREF: physical health [adjusted odds ratio (aOR) = 4.10; 95% CI = 1.59, 10.57], psychological health (aOR = 6.98; 95% CI = 2.41, 20.19), social relationships (aOR = 7.02; 95% CI = 2.64, 18.67), and environmental health (aOR = 4.25; 95%CI = 1.43, 11.50). Partially adequate self-care behavior also showed a significant association with poor HRQoL.

CONCLUSION:
Self-care behavior was independently associated with HRQoL in Mexican older adults with T2D. Thus, it is important to plan awareness-raising interventions to improve self-care behaviors in older adults with chronic conditions.
Evaluation of psychometric properties of Persian version of Body Compassion Scale: Validation with clinical and nonclinical samples
Authors: Khanjani Sajad , Foroughi Ali-Akbar , Parvizifard Ali Akbar , Soleymani Moghadam Mahboobeh , Rajabi Moslem , Mojtahedzadeh Parya , Altman Jennifer 
Published: February 2025

Background:
Body compassion combines the concepts of body image and compassion for oneself. This concept includes the three components of defusion, common humanity, and acceptance. Due to the importance of this concept, this study was conducted to investigate the psychometric properties of the Persian version of the Body Compassion Scale (BCS) in clinical and nonclinical samples.

Materials and Methods:
This research is of correlational type in the field of psychometrics. The statistical population of the clinical sample included patients referred to cosmetic surgery clinics in Tehran in 2019–2020. Accordingly, 379 people were selected using the convenience sampling. They completed the BCS, Body Image Shame Scale, The Levels of Self-Criticism, Appearance Anxiety Inventory, and Body Image Acceptance and Action Questionnaire. The statistical population in the nonclinical sample includes people present in public places (such as public parks and cinemas) and universities in Kermanshah in 2020–2019. Ultimately, 367 people were selected using the convenience sampling method. Participants completed the BCS, External Shame Scale, Self-Compassion Scale, and Body Imaging Psychological Inflexibility Scale. Data were analyzed using LISREL 8.80 and SPSS 24 software.

Results:
The results showed that the three-factor structure of the BCS in both clinical and nonclinical samples has a good fit. Reliability was appropriate by calculating Cronbach’s alpha and the test-retest of scale in clinical and nonclinical samples. Convergent and divergent validity of the scale was also good in both clinical and nonclinical samples.

Conclusion:
The results showed that the Persian version of the BCS has good psychometric properties in both clinical and nonclinical samples. Therefore, this scale can be a valuable instrument in clinical and research work in the Iranian society.
Trends, Pattern and Correlates of Perinatal Mortality in India (2005–2021)
Authors: Yadav Jeetendra , Aggarwal Sumit , Gupta Urvashi , Sharma Saurabh 
Published: February 2025

Abstract

Background:
Perinatal mortality (PM) is linked to maternal and neonatal healthcare and the socioeconomic and bio-demographic attributes of the mother and family.

Aim:
This study assesses the trends and risk factors of PM in India from 2005 to 2021.

Materials and Methods:
Analysing the data from three rounds of National Family Health Surveys (NFHS), the study examined socio-demographic and biological predictors of Perinatal for children who died within 7 days of birth after 28 weeks of gestation.

Results:
India’s Perinatal rate (PNMR) declined by 33.3%, from 48 per 1000 live births in NFHS-3–32 per 1000 in NFHS-5. States such as Goa, Andhra Pradesh and Rajasthan showed reductions exceeding 50%, while Uttarakhand, Sikkim and Meghalaya experienced increase in PMR. The key risk factors for PM included advancing maternal age (>28 years, odds ratio [OR] = 2.27), higher birth order (≥3, OR = 1.45) and short birth intervals (<2 years). Protective factors included higher maternal and paternal education, wealthier socioeconomic status and birth intervals of 2–3 years.

Conclusion:
India has witnessed a gradual decline in PNMR over the two decades; however, disparities persist across socio-economic groups and states, with slower declines in empowered action group and north-eastern states. Strengthening maternal and neonatal healthcare, improving the quality of antenatal and intrapartum care and focused efforts to enhance access to quality healthcare services, particularly among vulnerable populations, are essential to achieve the Sustainable Development Goal targets of single-digit PMR by the year 2030.
Dl-3-n-butylphthalide ameliorates diabetic foot ulcer by inhibiting apoptosis and promoting angiogenesis
Authors: Wei Wu-Han , Bai Yuan-Ling , Zhu Dong , Zhang Jing-Yu , Yin Qi-Chuan , Li Qiang , Shen Cai-Qi , Jin Pei-Sheng 
Published: February 2025

BACKGROUND
Diabetic foot ulcers (DFU) are estimated to affect about 18.6 million people worldwide annually. The pathogenesis of DFU is complex, and the available drugs are not effective. Dl-3-n-butylphthalide (NBP) is a synthetic mixture of racemates used in China for the treatment of ischemic stroke. It was initially isolated from the seeds of Apium graveolens Linn, with studies showing its potential role in treating diabetes and its complications.
AIM
To predict and validate the mechanism by which NBP treats DFU.
METHODS
Network pharmacological analysis was performed to identify pharmacological targets and signaling pathways mediating the treatment effect of NBP on DFU. In vivo and in vitro experiments were conducted to validate the therapeutic effects and mechanisms of NBP on DFU.
RESULTS
Network pharmacology analysis identified 26 pharmacological targets of NBP and predicted that NBP could treat DFU partially by modulating apoptosis and vascular signaling pathways. Results from animal experiments showed that NBP significantly improved DFU by increasing neovascularization and fibroblast proliferation. In vitro tests demonstrated that NBP treatment promoted the migration and proliferation of human umbilical vein endothelial cells and human dermal fibroblasts, while inhibiting the apoptosis of human umbilical vein endothelial cells, human dermal fibroblasts, and human keratinocytes cells.
CONCLUSION
This study found that NBP could treat DFU by decreasing the rate of apoptosis and increasing angiogenesis via the advanced glycation end products-receptor of advanced glycation end products signaling pathway and binding to the heme oxygenase 1, caspase 3, B cell leukemia/lymphoma 2, brain derived neurotrophic factor, and nuclear factor erythroid 2 L2 genes.
Analysis of risk factors and predictive value of a nomogram model for sepsis in patients with diabetic foot
Authors: Han Wen-Wen , Fang Jian-Jiang 
Published: February 2025

BACKGROUND
Sepsis is a severe complication in hospitalized patients with diabetic foot (DF), often associated with high morbidity and mortality. Despite its clinical significance, limited tools exist for early risk prediction.
AIM
To identify key risk factors and evaluate the predictive value of a nomogram model for sepsis in this population.
METHODS
This retrospective study included 216 patients with DF admitted from January 2022 to June 2024. Patients were classified into sepsis (n = 31) and non-sepsis (n = 185) groups. Baseline characteristics, clinical parameters, and laboratory data were analyzed. Independent risk factors were identified through multivariable logistic regression, and a nomogram model was developed and validated. The model's performance was assessed by its discrimination (AUC), calibration (Hosmer-Lemeshow test, calibration plots), and clinical utility [decision curve analysis (DCA)].
RESULTS
The multivariable analysis identified six independent predictors of sepsis: Diabetes duration, DF Texas grade, white blood cell count, glycated hemoglobin, C-reactive protein, and albumin. A nomogram integrating these factors achieved excellent diagnostic performance, with an AUC of 0.908 (95%CI: 0.865-0.956) and robust internal validation (AUC: 0.906). Calibration results showed strong agreement between predicted and observed probabilities (Hosmer-Lemeshow P = 0.926). DCA demonstrated superior net benefit compared to extreme intervention scenarios, highlighting its clinical utility.
CONCLUSION
The nomogram prediction model, based on six key risk factors, demonstrates strong predictive value, calibration, and clinical utility for sepsis in patients with DF. This tool offers a practical approach for early risk stratification, enabling timely interventions and improved clinical management in this high-risk population.
The Degree of Practicing Cultural Competence among Students of Faculties of Education in Jordanian Universities and its Relationship to Active Citizenship
Authors: Al-Mashaqbeh Areej Ahmed , Elimat Saleh Nasser 
Published: February 2025

The study aimed to identify the degree of practicing cultural competence among students of faculties of education in Jordanian universities and its relationship to active citizenship from their point of view. The descriptive survey methodology was used, and the questionnaire was a tool for data collection and analysis after ensuring its validity and reliability. It was applied to a simple random sample of (343) male and female students. The results showed that the degree of practicing cultural competence among students of faculties of education in Jordanian universities was medium, and also showed that the degree of practicing active citizenship among students was medium, and there was a high direct positive correlation statistically significant between the degree of practicing cultural competence among students of faculties of education in Jordanian universities, and active citizenship.
The Professional Competencies of the Technological Instructional Designer
Authors: Alshaer Muna Abdel-Rahim , Al-Ajlouni Khalid Ibrahim 
Published: February 2025

The study aimed to identify the professional competencies of the technological instructional designer (novice; expert; team leader, project manager) based on professional organizations and existing research literature and from the academic experts and employers in Jordan point of view. The qualitative methodology "content analysis" was used in this study to conduct a systematic review that includes (7) professional organizations and (10) selective related studies to prepare the technological instructional designer competencies framework (TID CF) which has been validated by (14) Experts (9 of them are academic experts and 5 are employers in educational technology and instructional design field). The outcome of this study was a proposed technological instructional designer competency framework (TID CF) consisting of (5) domains; Professional foundations; planning and analysis; design and development; evaluation and implementation; management, including (25) competencies supported by (132) performance statements. The study recommended the use of the proposed technological instructional designer competencies framework to guide the academic programs to align with the expectations of the needs in the field and to plan professional development opportunities.
Double Ethical Standards among Yarmouk University Students
Authors: Alnajjar Farah Hilal , Al-Ibrahim Adnan B. , Abu Dalbouh Musa Abdel Karim 
Published: February 2025

The current study aimed to explore the double ethical standards among Yarmouk University Students. The study used the descriptive survey methodology. The sample of the study consisted of (1099) Faculty member the second academic semester of 2019/2020. In order to achieve the objectives of the study, the researchers designed questionnaire of (20) items It was distributed into three fields: Status, the desire for control, the desire for prestige.The results showed that the double ethical standards came to a medium degree, The results also showed that there were statistically significant differences in the means of the study sample’s estimates of double ethical standards due to the variables of gender in favor of males, and the number of years of experience in favor of less than 10 years, and the type of college in favor of human faculties in prevarication, desire in prestige and scientific faculties in the desire to control, the academic rank in favor of the assistant professor in elusiveness, and the desire to control, for the rank of professor in the desire for status.