bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of cytotoxicity and anticancer activity of kombucha and doxorubicin combination therapy on colorectal cancer cell line HCT-116
Authors: Rasouli Latifeh , Aryaeian Naheed , Gorjian Mehran , Nourbakhsh Mitra , Amiri Fatemehsadat 
Published: April 2024

BACKGROUND:
Colorectal cancer is the third leading to death type of cancer in the world. The therapeutic guideline varied between different methods. As the main therapeutic guideline is chemotherapy, recent studies had shown utilization of natural products in combination with conventional medication, elevate the efficiency of chemotherapeutic methods. Kombucha is a traditional beverage obtained from the fermentation of green tea as a rich source of flavonoid medicinal plant. This study aimed to evaluate the natural potential of combination therapy of this natural product with doxorubicin as a chemotherapeutic agent.

MATERIALS AND METHODS:
The study was performed as in vitro evaluation of biological activity of kombucha on HCT-116 cell line (human colon cancer cell line). The cytotoxic effect of different kombucha beverages (fermented green tea) in comparison with green tea extract was evaluated by dimethylthiazolyl tetrazolium bromide (MTT) assay. In the next step, anticancer activity of doxorubicin as a general guideline chemotherapeutic agent in combination with kombucha was evaluated by cell cycle analysis and apoptosis assay flow cytometry. Apoptotic genes expression pattern was determined using real-time polymerase chain reaction. The experiments were designed in three independent replications and statistically analyzed using SPSS software.

RESULTS:
The results show that kombucha compared with the green tea extract caused more (1.2 fold) early apoptosis induction and G0/G1 phase arrest. Moreover, kombucha increased the expression levels of p21, p53, and B-cell leukemia/lymphoma 2 (Bcl-2)-associated X protein genes (2, 2.5, and 1.5 fold, respectively) while it decreased Bcl-2 gene expression level (5–8 fold) compared with doxorubicin alone. Combination of kombucha with doxorubicin shows 2-fold increased G0/G1 phase compared with the doxorubicin treatment.

CONCLUSION:
This result indicated that kombucha caused boosted anticancer activity of doxorubicin agent. These findings suggest that kombucha may be has an assistor and useful role in colorectal cancer treatment align with chemotherapy.
Development and psychometric evaluation of the perceived care tension questionnaire for caregivers of hemodialysis patients
Authors: Rabiei Leili , Kheiri Soleiman , Masoudi Reza 
Published: April 2024

BACKGROUND:
The complex, multifaceted care environment and the threatening situation of caring for hemodialysis patients cause tension in their family caregivers. Due to the severe tension, family caregivers are likely to ignore their basic needs and only pay attention to the patient's needs and related issues. This study was conducted with the aim of designing and evaluating the Perceived Care tension Questionnaire for Caregivers of Hemodialysis Patients (PCTQHFC).

MATERIALS AND METHODS:
The present study was a sequential exploratory mixed methods study of scale development variant conducted in two phases: qualitative and quantitative. This study was conducted in 2019 in Shahrekord. The qualitative phase included item development and scale development. In the quantitative phase (Item Analysis), the validation characteristics of the tool were examined using face, content and construct validity, and its reliability by internal consistency and stability. Findings were performed using software SPSS 18.

RESULTS:
Principal components analysis with orthogonal rotation to generate factors, showed that five factors, namely emotional exhaustion, inadequate social support, care burden, confusion and ambiguity and lack of adaptability skills had an eigenvalue of higher than 1, so that they explained, respectively, 75.98%, 61.36%, 72.49%, 76.33%, and 70.31% of the total variance. The internal consistency was obtained 0.811 and the inter-class correlation coefficient for the whole instrument 0.832.

CONCLUSION:
PCTQHFC is a culturally appropriate measure with strong psychometric properties. The instrument designed in this study measures the care tension of hemodialysis patients. Therefore, researchers, health-care providers, and community health policymakers can plan and implement interventions to reduce the tension of caregivers of hemodialysis patients by analyzing and identifying the tensions of caregivers.
Diabetic foot infections
Authors: Sannathimmappa Mohan Bilikallahalli , Nambiar Vinod , Aravindakshan Rajeev , Al Khabori Mohammad Saleem Jawad , Al-Flaiti Asma Hamed Sulaiman , Al-Azri Kadhiya Nasser Mohamed , Al-Reesi Ali Khamis Saif , Al Kiyumi Alya Rashid Mohammad 
Published: April 2024

BACKGROUND:
In diabetic foot infections (DFIs), the diversity of microbial profile and ever-changing antibiotic-resistance patterns emphasize accurate characterization of microbial profile and antibiotic susceptibility pattern. The aim of the study was to investigate the pathogens associated with DFI and their antibiotic susceptibility patterns.

MATERIALS AND METHODS:
A cross-sectional retrospective study was conducted at a tertiary-care hospital, Oman. The socio-demographic and microbiological profile and antibiotic susceptibility patterns of pathogens isolated from patients with DFIs from January 2013 to December 2018 were reviewed. Quantitative and qualitative variables were expressed as mean ± standard deviation and percentages, respectively. A Chi-square test was used for testing the association between multidrug-resistant (MDR) organisms and variables.

RESULTS:
In total, 233 isolates recovered from 133 clinical specimens with an average of 1.8 organisms per specimen were included in the study. Fifty-six and forty-four percent of specimens showed monomicrobial and polymicrobial growth of two or more organisms, respectively. The frequency of isolation was predominant among males (65%). Aerobic Gram-negative rods were predominantly (75%) isolated compared to Gram-positive organisms (25%). Staphylococcus aureus and Pseudomonas aeruginosa were the most frequently isolated Gram-positive and Gram-negative bacteria, respectively. Thirty-eight percent of them were MDR strains. Gram-negative organisms showed fairly good susceptibility ranging from 75% to 100% to carbapenems, aminoglycosides, and piperacillin-tazobactam. While doxycycline and trimethoprim-sulfamethoxazole showed good susceptibility toward Gram-positive organisms.

CONCLUSION:
DFIs are often polymicrobial with a predominance of Gram-negative pathogens. This study recommends the use of carbapenems and doxycycline for empirical therapy of Gram-negative and Gram-positive bacterial DFIs, respectively.
Coronavirus disease-2019 risk management using strengths, weaknesses, opportunities, threats analysis approach in the health system
Authors: Bazyar Jafar , Alimoradi Siednour , Seydi Mohammadreza , Pourvakhshoori Negar , Sadeghifar Jamil 
Published: April 2024

BACKGROUND:
Utilizing the successful experiences of countries and local regions can be useful in the management and control of coronavirus disease-2019 (COVID-19), so the research team aims to determine and extract the strengths, weaknesses, opportunities, and threats of the health system in the risk management of COVID-19 using strengths, weaknesses, opportunities, threats (SWOT) analytical approach.

MATERIALS AND METHODS:
This study was performed by a qualitative multimethod approach. In addition to reviewing the minutes of meetings and approvals of the Provincial Anti-Corona Headquarters, focused group meetings and in-depth semi-structured individual interviews were conducted. The results were extracted based on the SWOT analytical approach in the form of strengths, weaknesses, opportunities, and threats of the health system and then based on the SWOT matrix, the necessary strategies were identified.

RESULTS:
In the necessary strategies, based on SWOT matrix in SO strategies: SO1, formation of regional health assessment teams; SO2, promotion of preparedness, resilience, and effective response; SO3, activation of research and training centers; SO4, integrated management, supervision, and coordination; in WO strategies: WO1, analysis and COVID-19 risk monitoring; WO2, communication and risk information management; WO3, people-based management; and WO4, activation of local economic institutions and manufacturing centers; in ST: ST1, comprehensive care system strategies; and ST2, enhancing social trust with a transparency approach; and finally in WT strategies; WT1, stress management; and WT2, specific financial system design for disaster management were identified.

CONCLUSION:
Now, for the prevention and control of this disease, the need of empathy and participation of all human societies is felt more than anything else. These experience and analysis are based on the SWOT approach for the health system to be able to provide solutions and practical points that can be used by stakeholders.
Development and validation of English version of COVID-19 Depression Scale for health-care workers
Authors: Divvi Anusha , Kengadaran Shivashankar , Katuri Lakshmi Subhashini , Jampani Ravindranath , Prabakar Jayashri , Muthukrishnan Kavitha , Kengadaran Sivabalakumaran 
Published: April 2024

BACKGROUND:
Health-care workers (HCWs) are highly vulnerable to depression during an epidemic outbreak. Protecting the mental well-being of HCWs is a priority while battling with COVID-19. However, documentation on COVID-19-related depression among HCWs is scarce due to the limited availability of measuring scales. Hence, this study was purposed to develop a scale to measure depression relating to COVID-19 and evaluate its psychometric properties among HCWs.

MATERIALS AND METHODS:
A validation study was carried out among 320 HCWs including physicians of various medical specialties, dental specialists, and nurses in the year 2020. Exploratory factor analysis using Promax rotation with Kaiser normalization for the determination of factor structure was employed in data analysis using SPSS version 16 software.

RESULTS:
COVID-19 Depression Scale for HCWs (CDS-HW) demonstrated a two-component structure identified as “work-related anxiety” and “psychological distress.” The mean CDS-HW score of the study participants was observed to be 23.67 ± 2.82, and the scale demonstrated good internal consistency reliability (Cronbach's alpha: 0.741).

CONCLUSION:
CDS-HW is a rapidly administrable, valid, and reliable tool that can be used to measure COVID-19-related depression among HCWs.
Epidemiology and factors associated with COVID-19 outbreak-related deaths in patients admitted to medical centers of Mazandaran University of Medical Sciences
Authors: Khankeh Hamidreza , Farrokhi Mehrdad , Ghadicolaei Hassan Talebi , Mazhin Sadegh Ahmadi , Roudini Juliet , Mohsenzadeh Yazdan , Hadinejad Zoya 
Published: April 2024

BACKGROUND:
The first case of COVID-19 was reported in Iran on February 19, 2020, in Qom. Since Mazandaran is one of the high-risk provinces with many patients and deaths, this study was conducted to investigate the epidemiological characteristics of COVID-19-related deaths in Mazandaran.

MATERIALS AND METHODS:
In this descriptive study, demographic information and clinical findings in patients who died following COVID-19 in the medical centers of Mazandaran University of Medical Sciences from February 8, 2020, to October 10, 2020, were extracted. Data were analyzed by using SPSS 21. Logistic regression was used to compare the data. P < 0.05 was considered as the significance level.

RESULTS:
Out of a total of 34,039 patients admitted during the 8 months, 2907 patients died. Of these, 1529 (52%) were male, and the rest were female. In terms of age, 10 cases in the age group of fewer than 15 years, 229 cases in the age group of 15–44 years, 864 patients in the age group of 45–64 years, and 1793 people in the age group of 65 years and over died. 2206 people (more than 75%) by personal visit referred to medical centers. The mortality rate was more than 8 cases per 100 hospitalized patients. Men were 16% more likely to die from COVID-19 than women.

DISCUSSION AND CONCLUSION:
Older adults over 65 have the highest incidence and death rate due to this disease. The incidence rate was higher in women, and the death rate was higher in men, which differs from the national pattern.
Investigating the relationship of computerized examination anxiety with other variables at the university level
Authors: Rasheed Abeer 
Published: April 2024

BACKGROUND:
In the daily lives of people, the level of anxiety plays a significant role. This applies to students, who experience anxiety when taking examinations referred to as examination anxiety. Majority of the current educational institutions have shifted from a traditional evaluation system to one that is computerized. The present study aim is to identify the computerized examination anxiety (CEA) among college students in the Faculty of Health and to compare the differences among them based on study system and gender.

MATERIALS AND METHODS:
The research is a descriptive quantitative design. The research population consists of 138 health college students. CEA scale was used to identify the level of examination anxiety among students. Data were then exposed to analysis, namely the descriptive statistics, independent sample t-test, and Chi-square tests, to obtain the answers to the research questions at the level of <0.05.

RESULTS:
Based on the findings, the CEA experienced by the health students was of moderate level. The findings also showed insignificant differences between students’ levels of anxiety based on gender and study system at <0.05 value.

CONCLUSION:
The study contributed to literature by adding a study related to CEA during COVID-19. The study enumerated implications and recommendations based on the findings.
Potential vaccine hesitancy regarding COVID-19 vaccines in Kashmiri population
Authors: Ain Syed Najmul , Ahmad Rabia , Qulsum Reyana , Gilani Mohamad Azhar 
Published: April 2024

BACKGROUND:
India is all set to begin vaccination against COVID-19. A good number of people are falling prey to anti-vaccination campaigns, and therefore, some amount of vaccine hesitancy must have developed. The primary objective of the study was to find the level of potential COVID-19 vaccine hesitancy in Kashmiri population.

MATERIALS AND METHODS:
This was a cross-sectional study conducted in the valley of Kashmir. A predesigned questionnaire was shared online. The participation of respondents was voluntary. Exclusions were made on account of residence outside Kashmir valley, duplicate forms, and wrong information. The data were entered into Microsoft Excel 2010 and analyzed using SPSS version 23.

RESULTS:
A total of 487 respondents were included. About 67% of the participants were in the age group of ≤30 years, 55% female, 54% rural, and 16% had ever been COVID-19 positive. About 14% of the participants were completely hesitant about receiving the COVID-19 vaccine, whereas 40% were unsure if they will accept the vaccination. The main reason for the total nonacceptance of the vaccine was the doubts about the safety of COVID-19 vaccines (67%). Urban people were more likely to be hesitant to the vaccine than rural people (odds ratio [OR] 1.845, confidence interval CI 1.022 to 3.333). Those who were ever COVID-19 positive were 3.3 times more likely to say “no” to COVID-19 vaccination than those who were never positive.

CONCLUSION:
Strategic steps must be taken to minimize the vaccine hesitancy associated with COVID-19 vaccination. Authorities should direct efforts toward vaccine education, creating awareness among people about the importance of COVID-19 vaccination.
The effect of sexual health education program on sexual function and attitude in women at reproductive age in Iran
Authors: Rezaei Nazanin , Taheri Safoura , Tavalaee Zahra , Rezaie Sedighe , Azadi Arman 
Published: April 2024

BACKGROUND:Female sexual dysfunction is a common and often distressing public health problem. This study aimed to determine the effect of the sexual health program on female sexual function and attitude in reproductive age in the west of Iran.MATERIALS AND METHODS:This was a field trial study. A total of 103 women attending health centers were assigned into two groups; an experiment and a control group. Data collection tool involved sociodemographic characteristics questionnaire, sexual female attitude questionnaire, and the Female Sexual Function Index (FSFI), which was completed by participants before and after the implementation of a sexual health education program. Data were analyzed using SPSS software version 22.RESULTS:The results revealed that after the intervention, female sexual function in the experiment group based on the FSFI tool was significantly improved (P< 0.01) in the domains of desire, arousal, orgasm, satisfaction, pain, and the total score compared with the control group. Besides, there was no significant difference between posttest mean score of sexual attitude in the experiment group and control group (P> 0.05). However, a significant difference was found in the mean score of sexual attitudes in the experimental group before and after the intervention (P= 0.004).CONCLUSION:The findings showed that sexual health program was effective in improving women's sexual function and attitude in the experiment group. It is recommended that the effect of other training methods remain to be addressed on women's sexual function and attitude.
Assessment of determinants predicting success on the Saudi Nursing Licensure Examination by employing artificial neural network
Authors: Butcon Vincent Edward , Pasay-An Eddieson , Indonto Maria Charito Laarni , Villacorte Liza , Cajigal Jupiter 
Published: April 2024

BACKGROUND:
This study aims to use the artificial neural network as a novel approach to explore factors that determine and predict successful performance of nursing interns in Saudi Arabia on the Saudi Nursing Licensure Examination (SNLE).

MATERIALS AND METHODS:
The study employed a cross-sectional, analytic approach. A total of 62 nursing interns were recruited by convenience sampling from the University of Hail to participate. Data collection was conducted from September to December 2019. Descriptive statistics were used to describe the demographic characteristics of the nursing interns and their responses regarding examination determinants. Neural network analysis was used to identify factors that are highly predictive of the success of the nursing interns on the SNLE.

RESULTS:
Overall, the nursing interns were undecided (3.94 ± 0.14) about the influential factors determining their success. Their study hours (100%) and grade point average (GPA) (96.9%) were identified as strong determinants reflective of the tenacity and vigor of the nursing interns, based on the predictive power of the model. Meanwhile, age (45.7%), marital status (21.3%), gender (15.2%), and the type of academic program (5.9%) were considered the least important of the sociodemographic variables.

CONCLUSION:
Exam preparation activities such as preparation programs, review classes, and exam simulations must be promoted and enhanced to increase the passing tendencies of the nursing interns in the SNLE. The GPA and increased study hours make the most significant contributions to success on the SNLE as compared to other variables such as age, gender, marital status, and the academic program. This study serves as a springboard for nursing educators and administrators in laying tailored strategies to strengthen the nurse interns’ GPA and time management.
Improving psychological security and empowerment
Authors: Yazdimoghaddam Hamideh , Manzari Zahra Sadat , Heydari Abbas , Mohammadi Eesa 
Published: April 2024

BACKGROUND:
Caring for brain dead patients is the heaviest of duties for nurses, and despite tremendous stress, there are no theories/models to support nurses in this situation. This study designed a supportive model for nurses to provide care for potential organ donors.

MATERIALS AND METHODS:
This qualitative study was conducted in two stages. In the first stage, semi-structured interviews with 31 nurses and other stakeholders, observation and field notes continued until data saturation, (on 2018), were analyzed using continuous and comparative analysis through Corbin–Strauss method. In the second stage, theory synthesis of Walker and Avant's strategies for theory construction (2011) was used to design a supportive model/theory. The theory synthesis includes three stages: (i) selection of focal concept (the concept of “moral obligation to provide holistic care until the last minute” was selected); (ii) review of studies to identify the factors related to focal concept relevant studies (42 articles were reviewed, statements and concepts related to focal concept were then extracted and classified, and their relations were specified); and (iii) organization of concepts and statements within a relevant general and effective manifestation of the phenomenon under study which led to developing of a model.

RESULTS:
In this supportive model/theory, “improving psychological security and empowerment” was conceptualized within the conceptual framework. This supportive model entails three main components, including (i) informational and educational support, (ii) systematically support, and (iii) management support.

CONCLUSIONS:
According to the results, nurses with moral obligation to provide holistic care were faced with several challenges. Therefore, it is recommended that the healthcare system take supportive proceedings for nurses in various fields of the care for brain dead patients to resolve educational, moral, and legal challenges. This supportive model is essential for maintaining the nurses’ health, increasing the quality of nursing care and the health of potential transplant organs.
Prevalence of anxiety, stress, and depression among health care and nonhealth-care professionals in India
Authors: Singh Kishore Kumar , Jyotirmay  , Kumar Avanindra , Goel Aashana , Gulati Saakshi , Nayak Bikash Bishwadarshee 
Published: April 2024

BACKGROUND:
The psychological impact of anxiety, stress, and depression among health care and nonhealth-care professionals in India contribute significantly to the global burden of mental illness in the world. Impaired mental health and stress influence the efficiency and productivity of work. Long-term professional stress among individuals can lead to chronic illness, increased blood pressure, and many systemic disorders. The aim of this study was to assess the prevalence of anxiety, stress, and depression among the health care and nonhealth-care professionals in India.

MATERIALS AND METHODS:
This prospective survey-based study included 200 study participants (80 nonhealth care and 120 health-care workers) who were asked to submit their feedback and opinion on a questionnaire survey. Depression, stress, and anxiety were scored as per patient health questionnaire-4 and UCLA scale. The reliability of questionnaires was assessed using the Cronbach's alpha (r = 0.90). The statistical analysis was done using the Chi-square test.

RESULTS:
Higher prevalence ratio of anxiety, depression, and stress was observed among nonhealth care compared to health-care professionals.

CONCLUSION:
Psychological disturbances were found to be higher among nonmedical when compared to health-care workers or professionals. Thus, psychological counseling is required to manage the stress levels in both health care and nonhealth-care professionals.