bluuebunny/crossref_metadata_2025_split huggingface dataset:
Application of cold argon plasma on germination, root length, and decontamination of soybean cultivars
Authors: Sayahi Khadijeh , Sari Amir Hossein , Hamidi Aidin , Nowruzi Bahareh , Hassani Farshid 
Published: January 2024

AbstractApplying cold discharge plasma can potentially alter plants' germination characteristics by triggering their physiological activities. As a main crop in many countries, soybean was examined in the present study using cultivars such as Arian, Katoul, Saba, Sari, and Williams in a cold argon plasma. This study has been motivated by the importance of plant production worldwide, considering climate change and the increasing needs of human populations for food. This study was performed to inspect the effect of cold plasma treatment on seed germination and the impact of argon plasma on microbial decontamination was investigated on soybeans. Also, the employed cultivars have not been studied until now the radicals generated from argon were detected by optical emission spectrometry (OES), and a collisional radiative model was used to describe electron density. The germination properties, including final germination percentage (FGP), mean germination time (MGT), root length, and electrical conductivity of biomolecules released from the seeds, were investigated after the plasma treatments for 30, 60, 180, 300, and 420 s. The decontamination effect of the plasma on Aspergillus flavus (A.flavus) and Fusarium solani (F.solani) was also examined. The plasma for 60 s induced a maximum FGP change of 23.12 ± 0.34% and a lowest MGT value of 1.40 ± 0.007 days. Moreover, the ultimate root length was 56.12 ± 2.89%, in the seeds treated for 60 s. The plasma exposure, however, failed to yield a significant enhancement in electrical conductivity, even when the discharge duration was extended to 180 s or longer. Therefore, the plasma duration of 180 s was selected for the blotter technique. Both fungi showed successful sterilization; their infectivity inhibition was 67 ± 4 and 65 ± 3.1%, respectively. In general, the cold plasma used for soybeans in the present study preserved their healthy qualities and reduced the degree of fungal contamination.
Effect of COVID-19 on infections associated with medical devices in critical care
Authors: Hernández Fredy Leonardo Carreño , Virguez Juanita Valencia , Vesga Juan Felipe González , Castellanos María Lucía , Beltrán Gabriela Ruiz , Toquica Laura Daniela Lorza , Gomez Carol Natalia Sánchez , Ríos Maria Valentina Stozitzky , Bolívar Yenny Rocío Cárdenas , Sanchez Jorge Iván Alvarado 
Published: January 2024

Abstract
Objectives
This study explores the hypothesis that COVID-19 patients are at a heightened risk of healthcare-associated infections (HAIs) associated with medical device usage compared to non-COVID-19 patients. Our primary objective was to investigate the correlation between COVID-19 infection in ICU patients and subsequent HAIs following invasive medical device insertion. Additionally, we aim to assess the impact of SARS-CoV-2 infection on onset times concerning specific microorganisms and the type of medical device, providing valuable insights into this intricate relationship in intensive care settings.

Methodology
A retrospective cohort study was conducted using ICU patient records at our hospital from 2020 to 2022. This investigation entailed evaluating the timing of HAIs while distinguishing between patients with and without SARS-CoV-2 infection. We identified and analyzed the type of isolation and infection attributed to the medical device while controlling for ICU duration and ventilator days using Cox regression.

Results
Our study included 127 patients without SARS-CoV-2 infection and 140 patients with SARS-CoV-2 infection. The findings indicated a higher incidence of HAI caused by various microorganisms associated with any medical device in patients with SARS-CoV-2 (HR = 6.86; 95% CI-95%: 3.26–14.43; p < 0.01). After adjusting for ICU duration and ventilator days, a heightened frequency of HAIs persisted in SARS-CoV-2-infected individuals. However, a detailed examination of HAIs revealed that only ventilation-associated pneumonia (VAP) displayed a significant association (HR = 6.69; 95% CI: 2.59–17.31; p < 0.01). A statistically significant correlation between SARS-CoV-2 infection and the isolation of S. aureus was also observed (p = 0.034). The prevalence of S. aureus infection was notably higher in patients with SARS-CoV-2 (RR = 8.080; 95% CI: 1.052–62.068; p < 0.01).

Conclusions
The frequency of pathogen isolates in invasive medical devices exhibited an association with SARS-CoV-2 infection. Critically ill patients with SARS-CoV-2 are more prone to developing early-onset VAP than those without SARS-CoV-2 infection.
An analysis of differences in Carbapenem-resistant Enterobacterales in different regions: a multicenter cross-sectional study
Authors: Guo Bo , Li Peili , Qin Bingyu , Wang Shanmei , Zhang Wenxiao , Shi Yuan , Yang Jianxu , Niu Jingjing , Chen Shifeng , Chen Xiao , Cui Lin , Fu Qizhi , Guo Lin , Hou Zhe , Li Hua , Li Xiaohui , Liu Ruifang , Liu Xiaojun , Mao Zhengrong , Niu Xingguo , Qin Chao , Song Xianrong , Sun Rongqing , Sun Tongwen , Wang Daoxie , Wang Yong , Xu Lanjuan , Xu Xin , Yang Yuejie , Zhang Baoquan , Zhou Dongmin , Li Zhaozhen , Chen Yinyin , Jin Yue , Du Juan , Shao Huanzhang 
Published: January 2024

Abstract
Objective
This study aimed to explore the characteristics of carbapenem-resistant Enterobacterales (CRE) patients in the intensive care unit (ICU) in different regions of Henan Province to provide evidence for the targeted prevention and treatment of CRE.

Methods
This was a cross-sectional study. CRE screening was conducted in the ICUs of 78 hospitals in Henan Province, China, on March 10, 2021. The patients were divided into provincial capital hospitals and nonprovincial capital hospitals for comparative analysis.

Results
This study involved 1009 patients in total, of whom 241 were CRE-positive patients, 92 were in the provincial capital hospital and 149 were in the nonprovincial capital hospital. Provincial capital hospitals had a higher rate of CRE positivity, and there was a significant difference in the rate of CRE positivity between the two groups. The body temperature; immunosuppressed state; transfer from the ICU to other hospitals; and use of enemas, arterial catheters, carbapenems, or tigecycline at the provincial capital hospital were greater than those at the nonprovincial capital hospital (P < 0.05). However, there was no significant difference in the distribution of carbapenemase strains or enzymes between the two groups.

Conclusions
The detection rate of CRE was significantly greater in provincial capital hospitals than in nonprovincial capital hospitals. The source of the patients, invasive procedures, and use of advanced antibiotics may account for the differences. Carbapenem-resistant Klebsiella pneumoniae (CR-KPN) was the most prevalent strain. Klebsiella pneumoniae carbapenemase (KPC) was the predominant carbapenemase enzyme. The distributions of carbapenemase strains and enzymes were similar in different regions.
Diagnostic value of applying preoperative breast ultrasound and clinicopathologic features to predict axillary lymph node burden in early invasive breast cancer: a study of 1247 patients
Authors: Shao Hua , Sun Yixin , Na Ziyue , Jing Hui , Li Bo , Wang Qiucheng , Zhang Cui , Cheng Wen 
Published: January 2024

Abstract
Background
Since the Z0011 trial, the assessment of axillary lymph node status has been redirected from the previous assessment of the occurrence of lymph node metastasis alone to the assessment of the degree of lymph node loading. Our aim was to apply preoperative breast ultrasound and clinicopathological features to predict the diagnostic value of axillary lymph node load in early invasive breast cancer.

Methods
The 1247 lesions were divided into a high lymph node burden group and a limited lymph node burden group according to axillary lymph node status. Univariate and multifactorial analyses were used to predict the differences in clinicopathological characteristics and breast ultrasound characteristics between the two groups with high and limited lymph node burden. Pathological findings were used as the gold standard.

Results
Univariate analysis showed significant differences in ki-67, maximum diameter (MD), lesion distance from the nipple, lesion distance from the skin, MS, and some characteristic ultrasound features (P < 0.05). In multifactorial analysis, the ultrasound features of breast tumors that were associated with a high lymph node burden at the axilla included MD (odds ratio [OR], 1.043; P < 0.001), shape (OR, 2.422; P = 0.0018), hyperechoic halo (OR, 2.546; P < 0.001), shadowing in posterior features (OR, 2.155; P = 0.007), and suspicious lymph nodes on axillary ultrasound (OR, 1.418; P = 0.031). The five risk factors were used to build the predictive model, and it achieved an area under the receiver operating characteristic (ROC) curve (AUC) of 0.702.

Conclusion
Breast ultrasound features and clinicopathological features are better predictors of high lymph node burden in early invasive breast cancer, and this prediction helps to develop more effective treatment plans.
Curricular and pedagogical approaches for physical activity prescription training: a mixed-methods study of the “Exercise is Medicine” workshops in Colombia
Authors: Páez Diana C. , Flórez Johanna , Gómez María Teresa , García Daniel , Arango-Paternina Carlos M. , Duperly John 
Published: January 2024

Abstract
Background
The physical activity (PA) prescription workshop for physicians, through the global health initiative “Exercise is Medicine” (EIM), has trained more than 4000 health care professionals (HCPs) in Latin America. It has shown to be effective in increasing PA prescription knowledge and awareness among HCPs. The purpose of this paper is to evaluate the curricular and pedagogical approach used by EIM Colombia at the PA prescription workshops implemented between 2014 and 2015.

Methods
A mixed methods study, with a sequential explanatory design was implemented among a convenience sample of HCPs attending twenty-six PA prescription workshops. HCPs health status, PA personal habits, and medical practices were collected using a questionnaire at baseline among 795 participants (pre-test measurement), and subsequently quantitatively analyzed. A workshop satisfaction survey was administered after the completion of the workshop among 602 HCPs. The curricular and pedagogical approach of the workshop, the designers’ and students’ contextual factors, and perceptions about the workshop were measured using qualitative methods (analysis of the procedures manual, two workshop observations, three semi-structured interviews, and one focus group including 8 HCPs).

Results
The workshop is student-centered and guided by an expert with an academic and clinical background. Learning was achieved with theoretical and practical components using authentic performance and collaborative learning. An active teaching and learning approach was used with strategies such as interactive lectures, hands-on elements, and role-playing (patient-counselor). The workshop emphasized an individual approach when prescribing PA integrating in clinical practice not only health benefits but also patient´s beliefs, motivations, needs, and barriers.

Conclusions
Evidence-based practices and authentic performance were the most salient pedagogical elements used by EIM Colombia at the PA prescription workshop. A knowledge assessment that includes the practical aspect is suggested for future workshops. The curricular and pedagogical approach of the PA prescription workshop implemented in Colombia is well received by the medical community and a useful continuing medical education intervention with a potential contribution to current, and future health promotion needs.
Exploring workplace-based learning in distributed healthcare settings: a qualitative study
Authors: Verhees Myrthe J. M. , Landstra Anneke M. , Engbers Rik , Koksma Jur J. , Laan Roland F. J. M. 
Published: January 2024

Abstract
Background
Distributed healthcare settings such as district hospitals, primary care, and public health facilities are becoming the real-life settings for workplace-based learning required to educate the future healthcare workforce. Therefore, a major focus should be on designing and developing workplace-based learning in these learning environments. Healthcare professionals and educational policymakers play a significant role in these settings as role models in workplace-based learning, and as leaders in integrating learning into their work environments. It is relevant to explore their beliefs, attitudes, and behaviors towards workplace-based learning in their own settings, in order to provide context-relevant recommendations that can assist in shaping workplace-based learning environments.

Methods
We used individual interviews to understand professionals’ experiences with workplace-based learning in distributed healthcare settings. We - three clinicians, an educationalist, and a philosopher - thematically analyzed transcripts of 13 interviews with healthcare professionals and educational policymakers from different healthcare settings who were involved in the clinical phase of undergraduate medical education.

Results
Clustering and categorizing of the data led to the construction of five overarching themes: Identification with and attitude towards medical education, Sense of ownership, Perceived time and space, Mutual preconceptions and relations, and Curriculum for a changing profession.

Conclusions
These themes accentuate aspects relevant to the development of workplace-based learning in distributed healthcare settings on the individual, team, or organizational level. We highlight the significance of individual professionals in the development of workplace-based learning and emphasize the need for recognition and support for those occupying the ‘broker’ role at the intersection of education and practice. For future research and educational practice, we recommend prioritizing initiatives that build on good-practices in workplace-based learning and involve dedicated individuals in distributed healthcare settings.
Effectiveness of blended pedagogy for radiographic interpretation skills in operative dentistry - a comparison of test scores and student experiences at an undergraduate dental school in Pakistan
Authors: Iqbal Marium , Dias Jacqueline Maria , Sultan Amber , Raza Hussain Ahmed , Zaman Laeeq-uz 
Published: January 2024

Abstract
Background
Utilizing Blended pedagogy (BP) in radiographic skills may prove to be an effective teaching strategy. However, studies on the use of BP in dentistry are quite limited in Pakistan, where teaching has mostly been via traditional Didactic Lectures (DL); and radiographic interpretation skills of undergraduate dental students are suboptimal. Therefore, this study aims to assess whether utilizing BP to teach radiographic interpretation skills is an effective teaching methodology in Pakistan.

Methods
This mixed-method study was conducted on final year dental students at Jinnah Medical and Dental College (JMDC). Two groups of students were utilized for this study, one taught by traditional DL and the other taught by BP for the same module. BP was conducted over six weeks. A post-module test was conducted in both groups. Additionally, the BP group completed a modified Community of Inquiry (CoI) survey tool and volunteered to discuss their experiences through a focused group discussion (FGD). Descriptive statistics were computed and independent sample t-test was used to analyse the difference between the scores of the two groups. Thematic analysis was performed for the qualitative data.

Results
The mean post-test scores were found to be significantly higher in the BP group (61.0 ± 10.2) compared to the DL group (44.4 ± 12.3) (p = < 0.001, CI = 95%, Cronbach Alpha > 0.8). The mean scores for the modified CoI instrument were 4.0 ± 0.29 for the whole instrument; 4.25 ± 0.22 for Teaching Presence, 3.71 ± 0.23 for Social Presence and 3.97 ± 0.16 Cognitive Presence, with all three having a Cronbach’s alpha > 0.75. Thematic analysis revealed that BP students mutually agreed that BP method was beneficial with the appreciation of strong support from the facilitator. However, challenges like interrupted power supply and increased effort requirement from students were pointed out.

Conclusion
Students taught radiographic interpretation skills with BP in comparison to DL had higher test scores and expressed a positive experience demonstrated via a modified CoI survey and FGD. Considering the encouraging results found, dental schools should incorporate BP in their teaching methodology and follow-up studies are needed to further support the use of BP as an effective teaching methodology in Dentistry.
Quality in care requires kindness and flexibility – a hermeneutic-phenomenological study of patients’ experiences from pathways including transitions across healthcare settings
Authors: Walløe Sisse , Beck Malene , Lauridsen Henrik Hein , Morsø Lars , Simonÿ Charlotte 
Published: January 2024

Abstract
Background
The number of people living with chronic conditions is increasing worldwide, and with that, the need for multiple long-term complex care across care settings. Undergoing transitions across healthcare settings is both challenging and perilous for patients. Nevertheless, knowledge of what facilitates quality during transitions in healthcare settings from the lifeworld perspective of patients is still lacking. Therefore, we aimed to explore the lived experience in healthcare quality for Danish adult patients during healthcare pathways including transitions across settings.

Methods
Within a hermeneutic-phenomenological approach, interviews were conducted with three women and five men with various diagnoses and care paths between 30 and 75 years of age. Data underwent a three phased thematic analysis leading to three themes.

Results
Patients with various illnesses’ experiences of quality of care is described in the themes being powerless in the face of illness; burdensome access and navigation; and being in need of mercy and striving for kindness. This highlights that patients’ experiences of quality in healthcare pathways across settings interweaves with an overall understanding of being powerless at the initial encounter. Access and navigation are burdensome, and system inflexibility adds to the burden and enhances powerlessness. However, caring care provided through the kindness of healthcare professionals supports patients in regaining control of their condition.

Conclusions
This hermeneutical-phenomenological study sheds light on the lived experiences of people who are at various stages in their care paths with transitions across healthcare settings. Although our findings are based on the lived experiences of 8 people in a Danish context, in light of the discussion with nursing theory and other research, the results can be reflected in two main aspects: I) kind and merciful professional relationships and II) system flexibility including access and navigation, were essential for their experiences of care quality during healthcare transitions. This is important knowledge when striving to provide patients with a clear voice regarding quality in care pathways stretching across settings.
A patient activation intervention in primary care for patients with chronic pain on long term opioid therapy: results from a randomized control trial
Authors: Does Monique B. , Adams Sara R. , Kline-Simon Andrea H. , Marino Catherine , Charvat-Aguilar Nancy , Weisner Constance M. , Rubinstein Andrea L. , Ghadiali Murtuza , Cowan Penney , Young-Wolff Kelly C. , Campbell Cynthia I. 
Published: January 2024

Abstract
Background
Given significant risks associated with long-term prescription opioid use, there is a need for non-pharmacological interventions for treating chronic pain. Activating patients to manage chronic pain has the potential to improve health outcomes. The ACTIVATE study was designed to evaluate the effectiveness of a 4-session patient activation intervention in primary care for patients on long-term opioid therapy.

Methods
The two-arm, pragmatic, randomized trial was conducted in two primary care clinics in an integrated health system from June 2015—August 2018. Consenting participants were randomized to the intervention (n = 189) or usual care (n = 187). Participants completed online and interviewer-administered surveys at baseline, 6- and 12- months follow-up. Prescription opioid use was extracted from the EHR. The primary outcome was patient activation assessed by the Patient Activation Measure (PAM). Secondary outcomes included mood, function, overall health, non-pharmacologic pain management strategies, and patient portal use. We conducted a repeated measure analysis and reported between-group differences at 12 months.

Results
At 12 months, the intervention and usual care arms had similar PAM scores. However, compared to usual care at 12 months, the intervention arm demonstrated: less moderate/severe depression (odds ratio [OR] = 0.40, 95%CI 0.18–0.87); higher overall health (OR = 3.14, 95%CI 1.64–6.01); greater use of the patient portal’s health/wellness resources (OR = 2.50, 95%CI 1.42–4.40) and lab/immunization history (OR = 2.70, 95%CI 1.29–5.65); and greater use of meditation (OR = 2.72; 95%CI 1.61–4.58) and exercise/physical therapy (OR = 2.24, 95%CI 1.29–3.88). At 12 months, the intervention arm had a higher physical health measure (mean difference 1.63; 95%CI: 0.27–2.98).

Conclusion
This trial evaluated the effectiveness of a primary care intervention in improving patient activation and patient-reported outcomes among adults with chronic pain on long-term opioid therapy. Despite a lack of improvement in patient activation, a brief intervention in primary care can improve outcomes such as depression, overall health, non-pharmacologic pain management, and engagement with the health system.

Trial Registration
The study was registered on 10/27/14 on ClinicalTrials.gov (NCT02290223).