bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of self-directed learning on clinical competence: The mediating role of clinical learning environment among internship nursing students
Authors: Vasli Parvaneh , Asadiparvar-Masouleh Hanieh 
Published: January 2023

Abstract
Introduction: It is crucial to recognize the factors affecting the clinical competence of internship nursing students. This study aimed to determine the effects of self-directed learning on the clinical competence of internship nursing students with the mediating role of the clinical learning environment.
Methods: This cross-sectional research was performed on 300 internship nursing students selected by convenience sampling. Data were collected in one stage using three tools of Self-Directed Learning Readiness Scale for Nursing Education, Education Environment Measure, and Clinical Competence Questionnaire. Data analysis was performed in SPSS version 21 and Smart-PLS version 3 using Partial least squares-SEM with considering a p-value of 0.05.
Results: The results showed that 20.5% of the variance in clinical competence could be explained by self-directed and clinical learning environments. Self-directed learning had a positive and significant effect on clinical competence (path coefficient=0.14, 95% CI: 0.02, 0.26; p=0.027), and on clinical learning environment as well (path coefficient=0.41, 95% CI: 0.31, 0.52; p<0.001). A relationship was reported between clinical learning environment and clinical competence (path coefficient=0.38, 95% CI: 0.25, 0.50; p<0.001). The indirect effect of self-directed learning on clinical competence was positive and significant (path coefficient=0.11, 95% CI: 0.07, 0.17; p<0.001). Self-directed learning has a significant total effect on clinical competence (path coefficient=0.30, 95% CI: 0.19, 0.40; p<0.001).
Conclusions: It is recommended that nursing education managers and instructors consider some plans to enhance self-directed learning among nursing students and improve the clinical learning environment.
Methyl jasmonate and β-cyclodextrin shake hands to boost withaferin A production from the hairy root culture of Withania somnifera
Authors: Karami Mahbobeh , Naghavi Mohammad Reza , Nasiri Jaber , Farzin Narjes 
Published: January 2023

Abstract
For the first time, an effort was made to study potential effects of leaf and stem explants of three genotypes of Withania somnifera (L.) Dunal (i.e., G1, G2, and G3) for hairy root induction via applying four strains of Agrobacterium rhizogenes (i.e., LBA 9402, A4, and ATTC 15834) and A. tumefaciens (i.e., C58C1). Furthermore, to improve withaferin A production, the superior treatment was subjected to elicitation with β-cyclodextrin (β-CD) and methyl jasmonate (MeJA) (alone or in combination) after 48 h exposure time. Among 24 treatments resulted from multiplying three main factors, the superiority of “G3/ATCC/LEAF” treatment was verified in terms of “induction rate” and “number of induced roots” alongside “growth curve”, and utilized subsequently for elicitation assay. The highest amounts of withaferin A were quantified for both hairy root sample groups of “0.5 mM β-CD + 100 µM MeJA” (9.57 mg/g DW) and “5.0 mM β-CD + 100 µM MeJA” (17.45 mg/g DW), with the fold change values of 6.84-fold and 12.46-fold compared to control, respectively. Similarly, either individual or simultaneous applications of both elicitors, apart from some fluctuations, could overall boost transcript magnitudes of the four selected genes of HMGR, SQS, SMT-1, and SDS/CYP710A involved in withanolides biosynthetic pathway as compared with control. The results, altogether, demonstrated the superiority of leaf explant and Agropine-type strain of ATCC 15834 for hairy root induction, followed by synergistic effect of exogenous application of both MeJA and β-CD on the in vitro production of withaferin A, and possibly other types of withanolides in the hairy root culture of W. somnifera.
His-Purkinje System Pacing versus Biventricular Pacing in clinical efficacy: A Systematic Review and Meta-Analysis
Authors: Wang Ya , Liu Fangchao , Liu Mengyao , Wang Zefeng , Lu Xiangfeng , Huang Jianfeng , Gu Dongfeng 
Published: January 2023

Abstract
Background
His-Purkinje system pacing (HPSP), including His-bundle pacing (HBP) and Left bundle branch pacing area (LBBaP), imitates the natural conduction of the heart as an alternative to biventricular pacing (BVP) in cardiac resynchronization therapy (CRT). However, current evidence on the feasibility and efficacy of HPSP were from studies with limited sample size, and the aim of this study was to provide a comprehensive assessment through a systematically review and meta-analysis.
Methods
PubMed, EMBASE, Cochrane Library and Web of Science database were searched from inception to October 27, 2022 to compare the clinical outcomes associated with HPSP and BVP in patients for CRT. Clinical outcomes of interest including QRS duration (QRSd), left ventricular (LV) function and New York Heart Association (NYHA) functional classification, pacing threshold, echocardiographic and clinical response and hospitalization rate of HF were also extracted and summarized for meta-analysis.
Results
A total of 12 studies (nine observational studies and three randomized studies) involving 644 patients were included. The patients were matched on age and sex and were followed for 6–24 months. Compared with BVP, CRT patients treated by HPSP had shorter QRSd [mean difference (MD): -28.03 ms, 95% confidence interval (CI): -35.54 to -20.53, P༜0.001, I2 = 85%], greater LV functional improvement with increased left ventricular ejection fraction (LVEF) (MD: 5.81, 95% CI: 4.24 to 7.38, P༜0.001, I2 = 0%) and decreased left ventricular end-diastolic dimension (LVEDD) (MD: -4.05, 95% CI: -5.89 to -2.20, P༜0.001, I2 = 0%), more improved NYHA functional classification (MD: -0.45, 95% CI: -0.67 to -0.23, P༜0.001, I2 = 70%). In addition, HPSP were more likely to have higher echocardiographic [odds ratio (OR): 2.76, 95% CI: 1.74 to 4.39, P < 0.001, I2 = 0%], clinical (OR: 2.10, 95% CI: 1.16 to 3.80, P = 0.01, I2 = 0%) and super clinical (OR: 3.17, 95% CI: 2.09 to 4.79, P < 0.001, I2 = 0%) responses than BVP, while there was no difference in the hospitalization rate of HF (OR: 0.34, 95% CI: 0.10 to 1.17, P = 0.09, I2 = 0%) between them. When considering threshold change, HBP was less stable than LBBaP (MD: -0.16 V, 95% CI: -0.25 to -0.06, P = 0.0009, I2 = 35%), but had no difference with BVP (MD: 0.11 V, 95% CI: -0.09 to 0.31, P = 0.28, I2 = 0%).
Conclusion
Our findings suggested that HPSP was associated with more remarkable improvement of cardiac function in patients with indication for CRT and a potential alternative to BVP to achieve a physiological pacing through native his-purkinje system.
Prevalence of Antibiotic Residues, Antibiotic Resistance Bacteria and Antibiotic Resistance Genes in Hospital Wastewater: Silent threat to Human Health
Authors: Liyanage Gayani Yasodara , Weerasekara Manjula , Manage Pathmalal Marakkale 
Published: January 2023

Abstract
Hospital wastewater tends to be a hotspot for the environmental spread of antibiotic resistance, as recent studies have shown that antibiotic residues, resistant bacteria, and resistant genes occur in aquatic environments. The present study reports antibiotic residues, bacteria that are resistant to antibiotics, and genes associated with antibiotic resistance in hospital wastewater in Sri Lanka. The highest concentration of AMX (0.001-0.024 µg/ml) and AMP (0.001-0.023 µg/ml) among the selected antibiotics were detected in hospital wastewater effluent. The antibiotic-resistant pathogenic bacteria, E. coli (31 %), Staphylococcus sp. (23%), Acinetobactersp. (19%), Streptococcus sp. (10%), Pseudomonas aerugenosa (8%), Klebsiella pneumonia (6%), Moraxella sp. (3%), Aeromonas hydrophila (1%) and Streptomycessp. (1%) were found as indigenous bacteria which indicate increase the risk of ARGs which directly effect on public health. The study's findings made apparent the significance of developing a specific treatment plant at the site to remove antibiotics before discharging hospital wastewater to the natural environment. Therefore, it is necessary to develop and apply innovative treatment technologies as a national policy to protect people from silent killers who will no longer be susceptible to antibiotics in the future, which has been identified as a challenge in the health sector.
Towards Image - Based Personalization of Glioblastoma Therapy A Clinical and Biological Validation Study of a Novel, Deep Learning - Driven Tumor Growth Model
Authors: Metz Marie-Christin , Ezhov Ivan , Zimmer Lucas , Peeken Jan C. , Buchner Josef A. , Lipkova Jana , Kofler Florian , Waldmannstetter Diana , Delbridge Claire , Diehl Christian , Bernhardt Denise , Schmidt-Graf Friederike , Gempt Jens , Combs Stephanie E. , Zimmer Claus , Menze Bjoern , Wiestler Benedikt 
Published: January 2023

Abstract
Background
The diffuse growth pattern of glioblastoma is one of the main challenges for improving patient survival. Computational tumor growth modeling has emerged as a promising tool to guide personalized therapy. Here, we performed clinical and biological validation of a novel, deep learning - based growth model, aiming to close the gap between the experimental state and clinical implementation.
Methods
124 patients from The Cancer Genome Archive network and 397 patients from the UCSF Glioma MRI Dataset were assessed for correlations between clinical data, genetic pathway activation maps (generated with PARADIGM; TCGA only), and infiltration (Dw) as well as proliferation (r) parameters stemming from a Fisher-Kolmogorov growth model adjusted to the patients’ preoperative images using deep learning. Cox multivariable regression and Spearman correlation were performed to test for statistical significance. To further evaluate clinical potential, we performed the same growth modeling on preoperative MRI data from 30 patients of our institution and compared model-derived tumor volume and recurrence coverage with standard radiotherapy plans.
Results
The parameter ratio Dw/r (p < 0.05 in TCGA) as well as the simulated tumor volume (p < 0.05 in TCGA and UCSF) were significantly inversely correlated with overall survival. Interestingly, we observed a significant correlation between 11 signaling pathways that are associated with proliferation, and the estimated proliferation parameter r. Depending on the cutoff value for tumor cell density, we observed a significant improvement of recurrence coverage without significantly increased radiation volume utilizing model-derived target volumes instead of standard radiation plans.
Conclusion
Identifying a significant correlation between computed growth parameters, and clinical and biological data, we highlight the potential of tumor growth modeling for individualized therapy of glioblastoma. This might improve accuracy of personalized radiation planning in the near future.
Diagnostic Value of D-Dimer Concentration for Pregnancy-related Venous Thromboembolism: A Retrospective Study
Authors: Zhang Chao , Liang Ruxian , Long Yan 
Published: January 2023

Abstract
Background
Venous thromboembolism includes deep vein thrombosis and pulmonary embolism. Pulmonary embolism is the leading cause of maternal death and results in adverse pregnancy outcomes. Plasma D-dimer detection has high diagnostic value in nonpregnant people. We retrospectively analyzed factors affecting the plasma D-dimer concentration to establish a pregnancy-specific reference interval of plasma D-dimer. Our goal was to explore the diagnostic value of D-dimer for pregnancy-related venous thromboembolism.
Methods
The general condition, complications, and pregnancy outcomes of 2,012 women hospitalized for delivery from 1 January 2020 to 31 December 2020 in Beijing Friendship Hospital Affiliated to Capital Medical University were collected. The D-dimer concentration was collected in the first, second, and third trimesters and within 48 hours after delivery. The trend of the D-dimer concentration and influencing factors were statistically analyzed. Pregnancy-specific D-dimer reference intervals were established.
Results
The plasma D-dimer concentration gradually increased as pregnancy progressed. The median (2.5th–97.5th percentiles) in the first, second, and third trimesters and within 48 hours postpartum were 0.60 (0.30–1.50), 1.15 (0.31–5.38), 1.70 (0.80–4.89), and 4.65 (1.12–40.78) µg/mL, respectively. In the first trimester, multiparity and in vitro fertilization and embryo transfer (IVF-ET) were associated with significantly higher D-dimer concentrations. In the third trimester, twin pregnancy and IVF-ET were associated with significantly higher D-dimer concentrations. Cesarean section was an independent risk factor within 48 hours postpartum. After removal of interfering factors, reference intervals of the D-dimer levels in the first trimesters were established, 95%CI (unilateral) ~ 1.00µg/mL. The optimal cutoff value for VTE in the third trimester predicted by the ROC curve was 3.40 µg/mL.
Conclusions
The plasma D-dimer level gradually increased as pregnancy progressed. Risk factors for abnormally high D-dimer levels included multiparity and IVF-ET in the first trimester, twin pregnancy and IVF-ET in the third trimester, and cesarean section in puerperium. Upper limit value of the D-dimer levels in the first and third trimesters were suggested with 1.00 µg/mL and 3.40 µg/mL.
Epigenome-wide association study of diabetic chronic kidney disease progression in the Korean population: the KNOW-CKD study
Authors: Park Sue K. , Sung Hye Youn , Lee Sangjun , Han Miyeun , An Woo Ju , Ryu Hyunjin , Kang Eunjeong , Park Yong Seek , Lee Seung Eun , Ahn Curie , Oh Kook-Hwan , Ahn Jung-Hyuck 
Published: January 2023

Abstract

Since the etiology of diabetic chronic kidney disease (CKD) is multifactorial, studies on DNA methylation for kidney function deterioration have rarely been performed despite the need for an epigenetic approach. Therefore, this study aimed to identify epigenetic markers associated with CKD progression based on the decline in the estimated glomerular filtration rate in diabetic CKD patients in Korea. An epigenome-wide association study (EWAS) was performed using whole blood samples from 180 CKD patients recruited from the KNOW-CKD cohort. Pyrosequencing was also performed on 133 CKD participants as an external replication analysis. Functional analyses, including the analysis of disease-gene networks, reactome pathways, and protein-protein interaction networks, were conducted to identify the biological mechanisms of CpG sites. A phenome-wide association study was performed to determine the associations between CpG sites and other phenotypes. Two epigenetic markers, cg10297223 on AGTR1 (EWAS: ∆M-value = 0.365, false discovery rate (FDR) = 3.18E-03, pyrosequencing: Beta (SE) = 0.788 (0.397), P-value = 4.90E-02) and cg02990553 on KRT28 (EWAS: ∆M-value = 0.350, FDR = 2.84E-04, pyrosequencing: Beta (SE) = 0.459 (0.912), P-value = 6.10E-01), were found to be associated with diabetic CKD progression. Based on the functional analyses, other phenotypes (blood pressure and cardiac arrhythmia for AGTR1) and biological pathways (keratinization and cornified envelope for KRT28) related to CKD were also identified. cg10297223 on AGTR1 and cg02990553 on KRT28 are associated with diabetic CKD progression in the Korean population. Additional studies on the association between whole blood- and kidney tissue-specific DNA methylation are needed.
Micropropagation studies in Bergenia ligulata: A potential plant remedy to kidney stones
Authors: DEEBA FARAH , Singh Pooja , Warsi Zafar Iqbal , Kumari Mamta , Rahman Laiq Ur 
Published: January 2023

Abstract
Rhizomes of Bergenia are frequently used as antiurolithiatic agents in hilly regions of India, leading to this plant becoming threatened. Furthermore, Bergenia also serves as a diuretic, antitussive, and antipyretic, and is used as a treatment for diarrhoea, vomiting, fever, cough, pulmonary infections, menorrhagia, excessive uterine haemorrhage, and stomach ulcers. Using leaf/petiole explants from Bergenia ligulata, one-step regeneration was demonstrated. MS media supplemented with 0.2 and 0.4 mg L-1 BAP with 0.1 mg L-1 NAA resulted in the highest number of shoots on either explant (leaf/petiole). However, multiple shoots were produced on MS media fortified with 2 mg L-1 BAP and 0.5 mg L-1 Kn. An efficient and rapid regeneration protocol for this plant is presented in this study.
Flood inundation assessment in the data-scarce region using hydrodynamic models and google earth engine -A case of Ghed region, Ozat River basin, Gujarat, India
Authors: Trambadia Nevil K , Patel Dhruvesh P , Patel Vinodkumar M , Gundalia Manoj J 
Published: January 2023

Abstract
Flooding is an inevitable phenomenon of nature; however, its effect can be reduced via flood assessment. Therefore, flood inundation mapping is vital for flood assessment and mitigation planning in developing countries. But, flood assessment needs massive data sets to perform the flood simulation. Hence, the availability of precious observed data for flood assessment plays a significant role in research methodology to overcome the limitation and barriers for efficient modeling. The present study aims to evaluate the inundated area of Ghed region using 2-dimensional (2D) hydrodynamic analysis. The new HEC-RAS v6 uses an open-source digital elevation model (DEM) for hydraulic analysis to develop flood inundation, velocity, depth, arrival time, and percentage time inundation maps. The results are validated with 2017 and 2021 satellite images, hence the machine-learning algorithm generated in the Google Earth Engine (GEE) cloud platform to visualize the flooded area. In GEE, a flood mapping algorithm (FMA) generates data from sentinel 1-C band synthetic-aperture radar (SAR) sensors and compares it to the 2D model's output. The observed data sets are used to validate the hydrodynamic models for calibration of Manning roughness value in the case of a 1D model and water depth study for a 2D model. In this context, regression analysis was employed to validate water surface elevation, and four key locations were compared for maximum water depth. It has been determined that more than 170 km2 of land has been flooded yearly. The satellite image examination identifies frequently flooded areas via derivation of post-flood scenarios in GEE. The findings of this research aid decision-makers in developing an early warning system and establishing new hydraulic structures.
Ascaris lumbricoides in a young nose-A rare finding
Authors: Iqbal Sahar , Sahrish Fariha , Masood Sara , Irum Saima , Niazi Mehwish , Noor Nazia 
Published: January 2023

Abstract
Background: Ascaris lumbricoides (A. lumbricoides) is one of the most common nematodes (roundworms) affecting humans more frequently. It generally infests the gastrointestinal tract. However, unusual sites may rarely be affected. Sinusitis is a quite common clinical complaint seen in ENT departments. However, A. lumbricoides as a cause of sinusitis is fairly uncommon. The rarity of the disease, vague clinical complaints, and nonspecific radiological findings may end in delayed diagnosis, leading to severe complications. Clinicians should keep in mind this rare diagnosis, especially in underdeveloped countries.
Case presentation: A 3-year-old girl with a low socioeconomic background presented in the Department of ENT, Ch. Mohammad Akram Teaching & Research Hospital, Lahore, with a 15-day history of unilateral nasal blockage, and foul-smelling nasal discharge (blood stained on and off) from the right nostril. On examination, there was vague swelling on the right lateral wall of the nose that was firm to hard. The right maxillary sinus area and infra-orbital region were also vaguely enlarged. A radiographic examination of the head and neck revealed haziness in the right maxillary sinus; however, the rest of the paranasal sinuses were unremarkable. The right nasal cavity was filled with pale yellow/necrotic secretions. A thick pus-like collection was noted coming out from the maxillary ostium. Surgeons suspected some foreign bodies; however, no viable or dead cord-like structures were found during surgical manipulation.
Discussion: Ascariasis is a worldwide common helminthic infection that is especially endemic in tropical/subtropical regions because of the suboptimal sanitary conditions. People are also unaware of their hygiene and how to dispose of their excreta, which is a major issue in the rural populations of developing countries. The major route of transmitting infection is ingesting embryonated eggs in the form of contaminated food/water or using raw vegetables/fruits without proper washing.
2q31 microdeletion syndrome with the velocardiofacial phenotype and review of the literature: a case report
Authors: Candelo Estephania , Giraldo-Ocampo Sebastian , Nevado Julian , Lapunzina Pablo , Pachajoa Harry 
Published: January 2023

Abstract

Background

2q31 deletion creates a characteristic phenotype including mild-to-severe developmental delay, short stature, facial dysmorphism, and variable defects on the extremities. The dysmorphic characteristics include microcephaly, downslanting palpebral fissures, a long and flat philtrum, micrognathia, and dysplastic and low-set ears. To date, 38 patients have been diagnosed using comparative genomic hybridization. Therefore, more patients with detailed clinical data are necessary to delineate the spectrum of clinical manifestation associated with a deletion in 2q31 cytoband.

Case presentation

We present an 8-year-old female patient with clinical characteristics of the velocardiofacial syndrome, including facial dysmorphism, congenital heart disease with persistent truncus arteriosus, interauricular communication (ostium secundum), and seizure syndrome. An array comparative genomic hybridization showed the discontinuous deletion comprising the 2q31.1-2q31.3 cytobands, establishing a diagnosis of 2q31 microdeletion syndrome. The patient has been treated with supportive swallowing and speech therapy. A literature review of the previous cases is also presented here.

Conclusion

here we report the first patient with a complex, discontinuous deletion in the 2q31-2q32 regions, which contributes to the phenotypical and mutational characterization of patients carrying deletions in these cytobands. Furthermore, this case highlights the importance of high-resolution techniques and coverage in diagnosing patients with complex phenotypes.
Indoor SLAM based on line observation probability using a hand-drawn map
Authors: Keigo Akiba , Suzuki Ryuki , JI Yonghoon , Pathak Sarthak , Umeda Kazunori 
Published: January 2023

Abstract
In this paper, we propose a novel method to build indoor map information by utilizing a hand-drawn map as prior information is given. So far, previous studies using the hand-drawn map have been limited to robot pose estimation and navigation. In our approach, finding the correspondence between the shape of the real environment and the shape of the hand-drawn map is performed to build accurate map information. In addition, even if the estimation of the robot pose on the hand-drawn map fails, our method can continue to build the map by re-estimating the robot’s pose on the hand-drawn map based on the previous corresponding information. In the simulations, we verified the accuracy of the built map using three hand-drawn maps.